CN1306913C - 骨固定元件 - Google Patents

骨固定元件 Download PDF

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Publication number
CN1306913C
CN1306913C CNB028292162A CN02829216A CN1306913C CN 1306913 C CN1306913 C CN 1306913C CN B028292162 A CNB028292162 A CN B028292162A CN 02829216 A CN02829216 A CN 02829216A CN 1306913 C CN1306913 C CN 1306913C
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CN
China
Prior art keywords
hollow cylinder
fixation element
bone fixation
perforation
bone
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Fee Related
Application number
CNB028292162A
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English (en)
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CN1630491A (zh
Inventor
约尔格·戈尔德哈恩
约恩·泽贝克
埃里希·施奈德
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AO Technology AG
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Synthes AG Chur
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Publication of CN1630491A publication Critical patent/CN1630491A/zh
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    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
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    • A61B17/86—Pins or screws or threaded wires; nuts therefor
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Abstract

骨固定元件(1)由一个空心圆柱体(2)组成，它包括许多个在其圆周表面(4)上的穿孔(3)、一个适于插入骨头中的敞开的前端(5)、一个后端(6)和一个圆柱体纵轴线(7)。所述空心圆柱体(2)的刚性在其纵轴线(7)上从后端(6)向着前端(5)降低。由于其结构，该骨固定元件(1)满足适配刚性的要求，并由此可以保证长期地锚定在骨头中、尤其是骨质疏松的骨头中并同时满足生物学方面的边界条件。

Description

骨固定元件
技术领域
本发明涉及一种骨固定元件。
背景技术
目前的植入术对于周围组织、尤其是骨头对外部植入体的反应考虑较少。因此首先是局部的微循环或灌注(Perfusion)受到伤害以及改变局部的生物构造。
尤其是对于由钛或钢制成的相对刚性的植入体的影响在目前的植入术中考虑不足。为了防止疲劳折断，要将植入体设计得尽可能地刚硬。因为植入的植入体在骨折治疗期间和在其保留在体内的整个期间至少部分地承担骨头的负荷，因此使骨结构在相关区域相对较薄弱(Wolff sches法则)。这种骨结构变化可能导致植入体松动。
尤其是在骨质疏松手术中用于骨折治疗的空心圆柱体(例如按照DE-C 19628473和DE-U 297 10 979)可能导致这些现象。在此，这类植入体正好是骨整形术中感兴趣的，因为人们期望这种植入体具有更低的植入体失灵频率。骨头要保留在空心圆柱体内部并穿过孔长出新的骨头。这两种在理论上需要都要求植入体更好地锚定在骨质疏松的骨头中。
发明内容
本发明要实现这种补救。本发明的目的是，实现一种骨固定元件，它避免上述缺陷。
微循环或灌注的损伤源于植入体着生期间供应血管的断流。一些实验已经证实，在空心圆柱体内部和外部的供血康复能够在非常短的时间里实现。为了在空心圆柱体内部供血，圆柱体外壳上的穿孔以及导致组织液体灌注的循环压缩是重要的。灌注的程度又取决于植入体的刚性。通过骨头负荷在康复过程中的循环压缩同样导致相邻骨段的再生。一个植入体的骨头结合也决定性地取决于其机械特性、尤其是其刚性。
本发明的目的是，实现一种骨固定元件，它由于其结构而满足按照适配刚性所提出的要求，并因此长期保证在骨头中、尤其是在骨质疏松骨头中的锚定并同时妥善处理生物学方面的边界条件。它固定尚留的骨组织并促使新骨头的长入和长出。
上述目的通过本发明的骨固定元件得以实现。
按照本发明的空心圆柱体形式的骨固定元件，包括许多个在其圆周表面上的穿孔、一个适于插入到骨头中的敞开的前端、一个后端和一个圆柱体纵轴线，其特征在于，所述空心圆柱体的刚性在其纵轴线上从后端向着前端降低。
通过本发明所实现的优点主要是，由于按照本发明的骨固定件使空心圆柱体的刚性可以尽可能地接近在空心圆柱体周围的骨头的刚性，尤其是接近在椎骨中存在的皮层(E-模量约10’000至20’000MPa)与松质(Spongiosa)(E-模量约100至5’000MPa)之间的差别。此外，在负荷作用下骨固定件的偏移以及压缩在椎骨内部比在边缘区域更加强烈地失效。
这种在植入体纵轴线上的刚度变化可以通过两个措施实现：
1.减少在皮层与松质之间的过渡区的壁厚；和
2.通过在空心圆柱体敞开端方向上增加的孔隙梯度。
对于薄壁的平均半径为Rm的圆形轮廓，作为刚性的测量尺度，轴向和极性的面转动惯量(lx和lp)与壁厚t和孔隙率p(孔面积/总面积)的关系近似如下：
lp≈2·π·Rm 3·t·p
lx≈π·Rm 3·t·p
对于尽可能紧密的相同尺寸圆孔的布置最大可达到的孔隙率约为90％。但是为了保证壁在结构上的完整性，孔隙率不应超过85％。
通过参数的有限元分析可以得出，一个圆形横截面的刚性与壁厚呈指数关系。在t/Rm＝{0.4…0.08}时，W横截面～t2.7343，即壁厚减小50％导致面转动惯量减半，而圆横截面的强度降低到约15％。
在骨固定元件的一个特殊的实施例中，其刚性从后端向着前端连续地降低。空心圆柱体的刚性最好在空心圆柱体的前三分之一比空心圆柱体的后三分之一大至少20％。
在一个特殊的实施例中，所述骨固定元件的后端配有一些结构，它们适合于形状或力锁合地容纳一个作用力载体、最好是一个骨板。
在一个特殊的实施例中，作为所述穿孔面积的总和S与总表面积M之间的比例S/M，孔隙率从后向前增加。所述孔隙率在空心圆柱体的前三分之一最好比空心圆柱体的后三分之一大至少20％。
在另一实施例中，空心圆柱体的壁厚从后端向前端最好连续地减薄。空心圆柱体的壁厚最好在空心圆柱体的前三分之一比空心圆柱体的后三分之一薄至少20％。
在一个特殊的实施例中，在空心圆柱体圆周表面上的所述穿孔的最小直径为至少0.5mm。
在空心圆柱体的圆周表面上最好局部地设置有外螺纹。
所述穿孔的形状可以是圆的或椭圆的或者也可以是角形的，最好是三角或四角的。
在一个特殊的实施例中，每十分之一圆柱体高度的穿孔数向前端的方向增加，但是各穿孔的面积保持不变。在另一实施例中，每十分之一圆柱体高度的穿孔数向前端的方向保持不变，但是各穿孔的面积向着前端的方向增加。
附图说明
下面借助于多个实施例的局部示意图细描述本发明和本发明的扩展结构。附图中：
图1为空心圆柱体的局部展开图，在空心圆柱体壁的多个横截面上通过加大孔径而实现增加的孔隙率；
图2为一种用于改变带椭圆形穿孔的空心圆柱体壁的孔隙率的变型方案；
图3为一种用于改变带正方形穿孔的空心圆柱体壁的孔隙率的变型方案；
图4为一种用于改变带三角形穿孔的空心圆柱体壁的孔隙率的变型方案；
图5为一个局部剖切的骨固定元件的立体图。
具体实施方式
下面对优选实施例的描述用于结合附图更好地理解本发明。
在图5中示出的骨固定元件1主要由一个空心圆柱体2组成，它包括在其圆周表面4上的大量的穿孔3、一个适于导入骨头的敞开的前端5、一个后端6和一个圆柱体纵轴线7。
在图1中所示的空心圆柱体壁展开图示出，穿孔如何从后向前连续地加大，由此使空心圆柱体的刚性在其纵轴线上从后端向着前端相应地降低。
在后端6上，所述圆周表面6配有外螺纹8。一个圆锥形头部9构成所述骨固定元件的后端段，它可以插进一个在图中未示出的骨板中。
在图2至4中示出用于改变具有不同孔形的孔隙率的变型方案。代替圆形孔使用椭圆性、正方形或三角形的穿孔，其中这些孔也从后向前有规律地加大。这种孔形的目的是，使骨固定元件的刚性从后向前降低。这一点也可以这样来实现，即使用相同大小的孔，但是这些孔从后向前更频繁或更紧密地出现。

Claims (14)

1.一种空心圆柱体(2)形式的骨固定元件(1)，包括许多个在其圆周表面(4)上的穿孔(3)、一个适于插入到骨头中的敞开的前端(5)、一个后端(6)和一个圆柱体纵轴线(7)，其特征在于，所述空心圆柱体(2)的刚性在其纵轴线(7)上从后端(6)向着前端(5)降低。
2.如权利要求1所述的骨固定元件(1)，其特征在于，所述刚性连续地降低。
3.如权利要求1或2所述的骨固定元件(1)，其特征在于，所述空心圆柱体(2)的刚性在空心圆柱体(2)的前三分之一比在空心圆柱体(2)的后三分之一大至少20％。
4.如权利要求1或2所述的骨固定元件(1)，其特征在于，所述后端(6)配有一些结构，这些结构适用于形状或力锁合地容纳一个作用力载体。
5.如权利要求1所述的骨固定元件(1)，其特征在于，孔隙率，作为所述穿孔面积的总和S与整个圆周表面(4)面积M之间的比例S/M，从后端(6)向着前端(5)增大。
6.如权利要求5所述的骨固定元件(1)，其特征在于，所述孔隙率在空心圆柱体(2)的前三分之一比在空心圆柱体(2)后三分之一大至少20％。
7.如权利要求1所述的骨固定元件(1)，其特征在于，所述空心圆柱体(2)的壁厚从后端(6)向着前端(5)减小。
8.如权利要求7所述的骨固定元件(1)，其特征在于，所述空心圆柱体(2)的壁厚在空心圆柱体(2)的前三分之一比在空心圆柱体(2)后三分之一薄至少20％。
9.如权利要求1或2所述的骨固定元件(1)，其特征在于，在空心圆柱体(2)的圆周表面(4)上的所述穿孔(3)的最小直径为至少0.5mm。
10.如权利要求1或2所述的骨固定元件(1)，其特征在于，在空心圆柱体(2)的圆周表面(4)上至少局部地设有外螺纹(8)。
11.如权利要求1或2所述的骨固定元件(1)，其特征在于，所述穿孔(3)的形状是圆形或椭圆形的。
12.如权利要求1或2所述的骨固定元件(1)，其特征在于，所述穿孔的形状是角形的。
13.如权利要求1或2所述的骨固定元件(1)，其特征在于，每十分之一圆柱体高度上的穿孔(3)的数量向着前端(5)的方向增加，但是各穿孔(3)的面积保持不变。
14.如权利要求1或2所述的骨固定元件(1)，其特征在于，每十分之一圆柱体高度上的穿孔(3)的数量向着前端(5)的方向保持不变，但是各穿孔(3)的面积向着前端(5)的方向增加。
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