CN1368866A - 手术导引体 - Google Patents
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Abstract
本发明涉及一种手术用导引体(1),它用于接收要固定在骨内的纵向固定元件(10),如线、钉、栓或螺钉。本发明的导引体包括顶表面(3)、底表面(4)、和至少三个连接所述导引体的顶表面(3)和底表面(4)的开口(2),所述这些开口的中心不在一条直线上。至少两个开口(2)的中心轴(5)互相成倾斜的关系。导引体(1)使固定元件(10)可以在各种交叉角插入。导引体(1)主要防止延伸到骨松质或髓内部位的固定元件(10)在近端或在远端方向移位。
Description
国际专利申请PCT/CH00/00129“手术导引体”的英文翻译代表SynthesAG Chur。
本发明涉及一种导引体,它用于接收纵向如权利要求1特征部分之前所要求的固定元件和涉及一种固定器具,该固定器具包括如权利要求15和24特征部分之前所要求的这样的导引体。
导引体可具有骨缝合术中内固定器的功能,并可用于肱骨近端部分或在位于接近关节的长骨的其它部位。
从BENOIST的US 5,476,467已知一种用于导引基施纳线的扇形波纹导引器具。这种结构的缺点在于固定元件(基施纳线)仅可以通过互相平行的导杆。此外,不可能使用缝合线连接骨折的碎片或部分,而这样的连接不能通过基施纳线达到。由于它的波纹结构,导引器具并不直接放置在骨上,这样必须过量地使用更长的线。
本发明目的在于提供对此器具的改进措施。因此本发明的目的是产生一种导引体,该导引体用于接收要固定在骨内的纵向固定元件,这样可以在各种交叉角插入固定元件。导引体主要防止延伸到髓内部位或松质的线在近端或在远端方向移位。
根据本发明,此目的通过显示权利要求1特征的导引体和通过显示权利要求15和24特征的两种固定器具而达到。
通过本发明达到的优点在于可以使用侵入性最小的外科技术和将要插入的植入材料减到最小。由于可以在三维空间排列固定元件,在骨质疏松症骨或骨受疾病侵袭的情况下,根据本发明的导引体特别适于骨缝合术。骨缝合器具的稳定性主要通过栓或线和它们在骨内的交叉放置而达到。由于导引体和骨直接接触,可以将要插入的不和骨接触的丝线部分减少到最小。这样可以使患者更早地将重力放置在骨折的位置,更早地使用受伤的肢体和,理想地是更有利于加速治愈过程。
根据本发明的优选改进,导引体的一个开口含有内螺纹,使得也可以插入具有外螺纹的固定元件。
导引体开口的直径合适地为2-6mm。
根据本发明的优选改进,导引体含有许多排列在导引体边缘部位的附加孔,这样,如果需要,可以通过缝合线将骨折的部分固定到板上。术语“边缘部位”理解为宽度不超过10mm的区域。这此附加孔应当合适地不含有任何锐边以防止损害固定在其中的缝合线。
合适地,这样的附加孔的数目是4-6,孔直径为1.5-2.5mm。
根据本发明进一步的优选改进,导引体由多个网格组成,网格优选由金属线制成,网格互相堆叠和通过框架保持在它们的相对位置,网格的重叠网孔形成开口。基施纳线可以自由选择地在一定的角度和在一定的位置穿过网格孔,并通过互相堆叠的线网格保持在它们的相对位置。
优选,基施纳线含有用于和线网格配合的螺纹以防止线移位。本发明这种改进体现的优点在于基施线的位置和角度并不预先确定,而是根据要治疗的骨折的具体情况自由地选择。
优选,2-8个(典型是4-6个)这样的网格正好互相堆叠以达到植入物的最小总高度。网格的网孔尺寸优选为1.5-2.0mm并一般应当小于用作固定元件的基施纳线的直径。单个网格应当以这样的方式堆叠使得从没有两个网格会具有彼此相同的位置(结构)。因此在单个网格层之间的扭转角会由使用的网格数确定(如6个网格有60°)。形成单个网格的丝线优选具有0.2-0.6mm的厚度。
用作固定元件的基施纳线优选含有外螺纹。导引体的至少一部分开口应当含有与基施纳线外螺纹相对应的内螺纹。优选,固定元件含有无头后端部分并在它的整个长度上具有均匀的直径。在它的前端部分,该部分相当于总长度的10-50%之间,固定元件优选含有非螺纹部分。固定元件的直径为2-6mm和网格的网孔尺寸应当小于固定元件的直径。
根据本发明的优选改进,包括导引体的固定器具另外包括至少一个具有同心孔的中空、圆柱形连接件,该连接件可以按这样的方式插入导引体的开口中,使得连接件与其成摩擦或固定配合。固定元件可以通过压力配合、强制配合或磨擦保持在中空、圆柱形连接件中。
以下,参见几个实施方案的部分图示更详细地说明本发明和本发明的改进。
附图中:
图1是基施纳线插入其中的导引体的透视图。
图2是在基施纳线插入区域的图1导引体的剖视图。
图3是取自它的一个开口区域的导引体的剖视图,开口包括可插入该开口中的螺纹连接件和可插入该连接件中的固定元件。
图4是取自它的一个开口区域的导引体的剖视图,该开口包括可插入该开口中的非螺纹连接件和可插入该连接件中的固定元件。
图5是由多层线网格组成的导引体的透视图;和
图6是由多层线网格和用于接收固定螺钉的口缘组成的导引体的透视图。
图1所示的导引体由厚度为2-5mm的平板或弯曲板组成,该板由适于作为植入物的金属材料制成或由塑料材料(包括可生物降解塑料材料)制成。板含有多个形式为孔,直径为2-6mm的开口2,开口连接导引体1的顶表面3和底表面4。开口2的排列方式使得至少三个开口的中心不位于一条直线上。开口2用于接收手术固定元件10,如直径为2-6mm的线、钉、栓或螺钉。在图1中,这些元件是具有外螺纹11和尖锐前端12的基施纳线。至少两个这些开口2的中心轴5成互相倾斜的关系,使得固定元件10可以在三维空间排列。相对于板形导引体1的平面,开口2的中心轴5优选形成50-90°的角度。在导引体1的边缘部件7上,含有六个直径为2mm的附加孔8,这些附加孔用于缝合线的固定,如下所述。
导引体1的底表面4优选适应于它要应用的骨表面的形状,以与骨形成足够大的接触表面。
如图2所示,形状为孔的开口2可含有和固定元件10的外螺纹11相对应的内螺纹6。优选,固定元件10含有无头后端部分并因此在它的整个长度上具有均匀的直径,这样通常可以使用成形的基施纳线。此外,在它的前端部分12,它可以相应于固定元件(10)总长度的10-50%之间,该固定元件10含有非螺纹部分。螺纹仅在固定元件10固定于板形导引体1中时是必须的,而不用于它在骨中的固定。
图3显示固定器具的优选实施方案,其包括导引体1,其中包括具有同心孔21的中空、圆柱形(或中空、圆锥形)连接件20,该连接件可以按这样的方式插入开口2中,使得连接件与其成摩擦或固定配合。连接件20可以按简单的方式插入开口2中,其中它可以由磨擦力保持位置,条件是它和开口严密配合。然而,它也可以装配外螺纹22,该外螺纹和开口2的内螺纹6相匹配。
在此情况下,固定元件10,不是直接通过开口2,而是可以通过中空、圆柱形连接件20的同心孔21。在连接件20中含有内螺纹23,该内螺纹和固定元件10的外螺纹11相对应。固定元件10也可以是非螺纹的,并可以仅通过由连接件20施加的径向夹紧而固定在导引体1中。
在另一个实施方案中,如图4所示,连接件20是圆锥形弹簧夹头或虎钳夹头的形式,它可以按能够达到磨擦配合这样的方式插入导引体1的相应圆锥形开口2中,故不需要螺纹。
导引体1可以通过最小的切口引入到患者体内,该切口例如可在肱骨近端部位形成,该导引体可以通过固定元件10固定到肱骨上。不排除另外使用骨粘固粉作为加固手段。由于板具有足够多的开口2以及位于导引体1边缘部位7的附加孔8,后者特别用于将缝合线固定在其上,这些元件可用于将带子固定到肱骨骨碎片上。固定元件10的三维排列防止它们变得松驰,这样极大地改进了固定器具的总体稳定性。
在导引体1另外的实施方案中,如图5所示(在此为导引板的形式),固定元件10通过多层编织网31保持位置和稳定在它们的各自角向位置,该多层编织网由框架32保持在一起。固定元件10被驱动直接穿过多层网格31。这可以在由单个开口2确定的整个直径的任何位置进行。排列在框架32上的侧部孔34可用于通过缝合线固定导引体1。
图5导引体的变体见图6,它另外包括排列在框架32上的唇形伸长孔33,该伸长孔也可以是法向的(normal),圆柱形孔的形式。它用于接收螺钉(图中未示出),在固定元件10穿过导引体1并插入骨中之前,通过它可使导引体1固定到骨上。
在根据图5和6的实施方案中,要使用的固定元件10(典型地是基施纳线)具有外螺纹以防止它们移位。
Claims (26)
1.一种导引体(1),它用于接收要固定在骨内的纵向固定元件(10),如线、钉、栓或螺钉,导引体(1)以板的形状成形,具有顶表面(3)、用于和骨接触的底表面(4)、和许多连接导引体(1)顶表面(3)和底表面(4)的开口(2),其特征在于开口(2)在导引体(1)中的排列方式使得至少两个手术固定元件(10)可以通过开口(2)插入并以互相成倾斜的位置固定在骨内。
2.权利要求1的导引体(1),其特征在于开口(2)为孔的形式。
3.权利要求1或2的导引体(1),其特征在于它含有至少三个连接导引体顶表面(3)和底表面(4)的开口(2),并且开口(2)的中心不位于一条直线上。
4.权利要求1-3中任意一项的导引体(1),其特征在于至少两个开口(2)具有互相成倾斜关系的中心轴(5)。
5.权利要求1-4中任意一项的导引体(1),其特征在于至少一个开口(2)含有内螺纹(6)。
6.权利要求1-5中任意一项的导引体(1),其特征在于开口(2)的直径为2-6mm。
7.权利要求1-6中任意一项的导引体(1),其特征在于在导引体(1)边缘部位(7)的区域,包括许多附加孔(8),该孔的直径优选小于开口(2)的直径。
8.权利要求7的导引体(1),其特征在于附加孔(8)的数目在4-6之间。
9.权利要求7或8的导引体(1),其特征在于附加孔(8)的直径为1.5-2.5mm。
10.权利要求1-9中任意一项的导引体(1),其特征在于它由多个彼此堆叠的网格(31)组成,网格通过框架(32)保持在它们的相对位置并且网格的重叠网孔形成开口(2)。
11.权利要求10的导引体(1),其特征在于重叠网格(31)的数目n在2<n<8,优选4<n<6的范围内。
12.权利要求10或11的导引体(1),其特征在于网格(31)的网孔尺寸为1.5-2.0mm之间。
13.权利要求10-12中任意一项的导引体(1),其特征在于各个网格(31)为彼此扭转的排列方式。
14.权利要求10-13中任意一项的导引体(1),其特征在于形成单个网格(31)的线厚度为0.2-0.6mm之间。
15.一种包括权利要求1-14中任意一项的导引体(1)的骨外科用固定器具,其特征在于它包括至少一个固定元件(10)。
16.权利要求15的固定器具,其特征在于固定元件(10)含有外螺纹(11)。
17.权利要求16的固定器具,其特征在于开口(2)的至少一部分含有内螺纹(6),该内螺纹与所述外螺纹(11)相对应。
18.权利要求15-17中任意一项的固定器具,其特征在于固定元件(10)含有无头后端部分。
19.权利要求15-18中任意一项的固定器具,其特征在于固定元件(10)在它的整个长度上具有均匀的直径。
20.权利要求15-19中任意一项的固定器具,其特征在于在它的前端部分(12),固定元件(10)含有非螺纹部分。
21.权利要求20的固定器具,其特征在于该前端部分(12)相应于固定元件(10)总长度的10-50%之间。
22.权利要求15-21中任意一项的固定器具,其特征在于固定元件(10)直径为2-6mm之间。
23.权利要求15-22中任意一项的固定器具,其特征在于网格(31)的网孔尺寸小于固定元件(10)的直径。
24.一种包括权利要求1-14中任意一项的导引体(1)的骨外科用固定器具,其特征在于它包括至少一个具有同心孔(21)的中空、圆柱形连接件(20),该连接件(20)可以按这样的方式插入导引体(1)的开口(2)中,使得连接件与其成摩擦或固定配合。
25.权利要求24和15-23中任意一项的固定器具。
26.权利要求24或25的固定器具,其特征在于固定元件(10)可以通过压力配合、强制配合或磨擦保持在中空、圆柱形连接件(20)中。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE29913994.8 | 1999-08-11 | ||
DE29913994U DE29913994U1 (de) | 1999-08-11 | 1999-08-11 | Chirurgische Führungsplatte |
Publications (2)
Publication Number | Publication Date |
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CN1368866A true CN1368866A (zh) | 2002-09-11 |
CN1268293C CN1268293C (zh) | 2006-08-09 |
Family
ID=8077341
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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CNB008114579A Expired - Fee Related CN1268293C (zh) | 1999-08-11 | 2000-03-07 | 手术导引体 |
Country Status (11)
Country | Link |
---|---|
US (1) | US8753379B1 (zh) |
EP (1) | EP1202675B1 (zh) |
JP (1) | JP4750989B2 (zh) |
CN (1) | CN1268293C (zh) |
AT (1) | ATE292419T1 (zh) |
AU (1) | AU759419B2 (zh) |
CA (1) | CA2405235A1 (zh) |
DE (2) | DE29913994U1 (zh) |
ES (1) | ES2238269T3 (zh) |
PT (1) | PT1202675E (zh) |
WO (1) | WO2001012081A1 (zh) |
Cited By (1)
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CN110650694A (zh) * | 2017-05-23 | 2020-01-03 | 拜欧米特制造有限责任公司 | 偏置导向器 |
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1999
- 1999-08-11 DE DE29913994U patent/DE29913994U1/de not_active Expired - Lifetime
-
2000
- 2000-03-07 CA CA002405235A patent/CA2405235A1/en not_active Abandoned
- 2000-03-07 AT AT00906129T patent/ATE292419T1/de active
- 2000-03-07 PT PT00906129T patent/PT1202675E/pt unknown
- 2000-03-07 JP JP2001516429A patent/JP4750989B2/ja not_active Expired - Fee Related
- 2000-03-07 DE DE50010000T patent/DE50010000D1/de not_active Expired - Lifetime
- 2000-03-07 WO PCT/CH2000/000129 patent/WO2001012081A1/de active IP Right Grant
- 2000-03-07 ES ES00906129T patent/ES2238269T3/es not_active Expired - Lifetime
- 2000-03-07 AU AU27914/00A patent/AU759419B2/en not_active Ceased
- 2000-03-07 US US10/240,526 patent/US8753379B1/en active Active
- 2000-03-07 CN CNB008114579A patent/CN1268293C/zh not_active Expired - Fee Related
- 2000-03-07 EP EP00906129A patent/EP1202675B1/de not_active Expired - Lifetime
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN110650694A (zh) * | 2017-05-23 | 2020-01-03 | 拜欧米特制造有限责任公司 | 偏置导向器 |
Also Published As
Publication number | Publication date |
---|---|
ATE292419T1 (de) | 2005-04-15 |
CA2405235A1 (en) | 2001-02-22 |
AU2791400A (en) | 2001-03-13 |
CN1268293C (zh) | 2006-08-09 |
EP1202675A1 (de) | 2002-05-08 |
DE29913994U1 (de) | 2000-12-21 |
JP4750989B2 (ja) | 2011-08-17 |
US8753379B1 (en) | 2014-06-17 |
ES2238269T3 (es) | 2005-09-01 |
JP2003506189A (ja) | 2003-02-18 |
DE50010000D1 (de) | 2005-05-12 |
EP1202675B1 (de) | 2005-04-06 |
AU759419B2 (en) | 2003-04-17 |
WO2001012081A1 (de) | 2001-02-22 |
PT1202675E (pt) | 2005-08-31 |
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