EP1139893A1 - Self-compressive osteosynthesis screw for small bone surgery - Google Patents
Self-compressive osteosynthesis screw for small bone surgeryInfo
- Publication number
- EP1139893A1 EP1139893A1 EP99964745A EP99964745A EP1139893A1 EP 1139893 A1 EP1139893 A1 EP 1139893A1 EP 99964745 A EP99964745 A EP 99964745A EP 99964745 A EP99964745 A EP 99964745A EP 1139893 A1 EP1139893 A1 EP 1139893A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- screw
- diameter
- thread
- head
- proximal head
- 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.)
- Ceased
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- 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
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8625—Shanks, i.e. parts contacting bone tissue
- A61B17/863—Shanks, i.e. parts contacting bone tissue with thread interrupted or changing its form along shank, other than constant taper
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- 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
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8605—Heads, i.e. proximal ends projecting from bone
- A61B17/861—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- 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
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/864—Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B2017/564—Methods for bone or joint treatment
- A61B2017/565—Methods for bone or joint treatment for surgical correction of axial deviation, e.g. hallux valgus or genu valgus
Definitions
- the present invention relates to an autocompressive and atraumatic osteosynthesis screw for the surgery of small bones or small bone fragments, in particular those of the foot.
- French patent 2,722,086 (94 08 445) describes a BAROUK screw, comprising a threaded proximal head, a body forming a threaded distal part and, between the head and the distal part, a smooth section of short length relative to the length of the distal part.
- the thread of the latter has a pitch greater than that of the thread of the proximal head, and a longitudinal channel is arranged from one end to the other of the body of the screw to receive a guide pin. The difference between the steps of the two threads causes compression of the two bone fragments one on the other during screwing.
- This cannulated screw has a relatively large diameter due to its longitudinal channel and therefore can only be used for fixation of fractures or for bone osteotomies of sufficient size, in particular the first metatarsal in the so-called osteotomy. "Scarf". Indeed the diameter of the threaded head of this screw at the bottom of the thread is about 3mm.
- Dr. WEIL For smaller bones such as the other four metatarsals, we must, when we want to perform an osteotomy described by Dr. WEIL, to correct an excess of length of these metatarsals, use a screw of smaller dimensions such as that described by French patent No. 2,721,819 (94 08 373).
- Such a screw is extended by a self-breaking end piece thanks to a rupture line formed between the head of the screw and the base of the end piece. The reduction in the diameter of this breakable screw is obtained by the fact that it is not pierced with a longitudinal channel for guiding a spindle.
- the object of the invention is to propose an osteosynthesis screw of the aforementioned type, for the surgery of small bones or small bone fragments, which can be used in place of the two known screws mentioned above, not only for one any of the five metatarsals, but also for osteotomies of small bones or small bone fragments as well as for the fixation of fractures in other applications than foot surgery, for example for bones of the hand.
- the autocompressive and atraumatic osteosynthesis screw includes means to allow it to fix small bones or small bone fragments of the skeleton after an osteotomy or a fracture, and in particular any one of the five metatarsals of a human foot.
- said means comprise a diameter of the thread of the distal part slightly greater than the diameter of the bottom of the thread of the proximal head, as well as the fact that the diameter of the channel is between 0.8 and 1.0mm approx.
- the diameter of the bottom of the thread of the proximal head is approximately 2.2 to 2.7mm, and the outside diameter of the thread of the distal part is between approximately 2.5 and 3.0mm approximately.
- a screw is thus produced whose dimensions are sufficiently reduced compared to the screw according to French patent 2,722,096 to allow it to be used in osteotomies or fixation of fractures of small bones such as average metatarsals without risk of causing bursting of these bones, and retaining enough strength in the screw to withstand the stresses experienced during their period of use.
- Figure 1 is a longitudinal elevational view on an enlarged scale of an embodiment of the osteosynthesis screw according to the invention.
- FIG. 2 is an end view along arrow F1 of the screw of FIG. 1.
- Figure 3 is an end view along arrow F2 of the screw of Figure
- Figure 4 is a schematic top view of the bones of a human foot, the first phalanx having a hallux valgus and the first metatarsal a metatarsus varus which can be corrected by means of screws according to the invention.
- Figure 5 is a longitudinal elevational view on an enlarged scale of the first metatarsal of Figure 4 showing the longitudinal and transverse section lines of the metatarsal bone to be treated.
- Figure 6 is a longitudinal elevational view on an enlarged scale, illustrating the use of a screw according to the invention in a Weil osteotomy of a middle metatarsal.
- the osteosynthesis screw 1 for the surgery of small bones or small bone fragments shown in FIGS. 1 to 3 comprises a proximal head 2 provided with a thread 3, as well as a body 4 forming a threaded distal part
- a smooth section 6 is made, of short length compared to that of the distal part 5.
- the thread 7 of the latter has a pitch p1 greater than the pitch p2 of the thread 3 of the proximal head 2.
- a longitudinal channel 8 is arranged axially from one end to the other of the screw 1 and opens at its two opposite ends, this channel 8 being provided to be able to receive a guide pin not shown.
- Two self-tapping notches 9 are arranged at the distal end of the part 5.
- the axial channel 8 widens to delimit a housing 11 whose wall constitutes a hexagonal imprint 12 adapted to receive a tool for corresponding screw not shown.
- the outside diameter d1 of the thread 7 of the distal part 5 is slightly greater than the diameter d2 of the bottom 10 of the thread 3 of the head 2. Therefore, taking into account the height of the threads of the thread 3, the outside diameter d3 of that - This can be of the order of for example 3.1 mm for a diameter d2 of 2.2mm and a diameter d1 of 2.6mm.
- This external diameter d3 of 3.1 mm is a maximum acceptable by the four lateral metatarsals and is also suitable for the first metatarsal which requires screws of a minimum size.
- the thread 3 has a maximum depth sufficient to ensure satisfactory bone attachment, without, on the other hand, reaching the wall of the impression 12 with a hexagon.
- the fact that the top of the distal thread 7 has a diameter d1 barely greater than the diameter d2 of the bottom of the thread 3 prevents this distal thread from damaging the entry of the hole into the bone. Otherwise, the proximal thread 3 would interfere with the distal thread of different pitch, which is obviously undesirable for obtaining satisfactory bone anchoring.
- the outside diameter d1 of the distal thread 7 is 2.6mm for a diameter d2 of 2.2mm, we obtain a radial width of 0.2mm of the thread 3 in the wall of the bone at the entrance of the hole . This low insertion value of the thread 3 avoids substantially damaging the bone. It should also be noted that the outside diameter d1 of the distal thread 7 cannot be reduced too much, otherwise it would not ensure sufficient bone bonding.
- the outside diameter d1 of the distal thread 7 must be between approximately 2.3 and 2.8mm, the diameter d2 must be between approximately 2.0mm and 2.5mm, while the outside diameter d3 of the proximal thread 3 must be between substantially 2.8mm and 3.5mm.
- the length of the screw is between 10 and 22mm. It covers all morphotypes and roughly corresponds to the different thicknesses of the metatarsals.
- the table below contains an example of the characteristics of an anterior BAROUK screw and an embodiment of the self-compressive and atraumatic screw 1 according to the invention.
- Figures 4 and 5 schematically illustrate a hallux valgus treatment which can be carried out through the use of self-compressive and atraumatic screws 1 according to the invention.
- the first metatarsal 14 is deformed in the medial direction (arrow F3 and position 14a shown in phantom), constituting the metatarsus varus.
- the surgical method for the treatment of this metatarsus varus consists, for short, in carrying out a longitudinal section of the metatarsal bone 14 along a longitudinal plane 15 and transverse planes 16 inclined at angles of 60 ° to the longitudinal plane 15.
- the surgeon moves laterally, ie towards the metatarsals 13, the lower bone fragment 14b. Then the surgeon inserts fixing screws 1 to firmly assemble and compress one over the other the two bone fragments 14b and 14c. Finally, the surgeon partially cuts the bone portion 17 which forms a medial projection relative to the bone fragment 14b.
- FIG. 6 illustrates a second example of implementation of the screw 1 according to the invention, in the context of a Weil osteotomy.
- the screw 1 is used to fix the plantar part 13b of a metatarsal 13 previously cut longitudinally into two parts 13a and
- the pitch of the screws 1 is of the order of 1 mm, substantially equal to that of the earlier, more bulky BAROUK screws. This increases the strength of the screw in the bone, which is often porotic or small.
- the screw can be made of any suitable biocompatible material, such as a titanium alloy.
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Neurology (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
Description
Claims
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR9816678A FR2787989B1 (en) | 1998-12-30 | 1998-12-30 | SELF-COMPRESSIVE OSTEOSYNTHESIS SCREW FOR SMALL BONE SURGERY |
FR9816678 | 1998-12-30 | ||
PCT/FR1999/003321 WO2000040164A1 (en) | 1998-12-30 | 1999-12-30 | Self-compressive osteosynthesis screw for small bone surgery |
Publications (1)
Publication Number | Publication Date |
---|---|
EP1139893A1 true EP1139893A1 (en) | 2001-10-10 |
Family
ID=9534716
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP99964745A Ceased EP1139893A1 (en) | 1998-12-30 | 1999-12-30 | Self-compressive osteosynthesis screw for small bone surgery |
Country Status (5)
Country | Link |
---|---|
EP (1) | EP1139893A1 (en) |
JP (1) | JP2002534151A (en) |
AU (1) | AU776105B2 (en) |
FR (1) | FR2787989B1 (en) |
WO (1) | WO2000040164A1 (en) |
Families Citing this family (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE50102314D1 (en) * | 2000-12-18 | 2004-06-24 | Herbert Bernsteiner | Locking screw for implants |
CA2390912C (en) * | 2001-07-05 | 2008-01-29 | Depuy France | Self-tapping screw for small-bone surgery |
EP1302170A3 (en) * | 2001-10-16 | 2004-04-14 | Inverlock Trading Limited | Dowel or screw for setting small bone fragments |
US7517350B2 (en) | 2002-11-20 | 2009-04-14 | Orthopediatrics Corp. | Convertible threaded compression device and method of use |
US7641677B2 (en) | 2002-11-20 | 2010-01-05 | Orthopediatrics Corp. | Compression bone fragment wire |
US9072559B2 (en) * | 2013-03-08 | 2015-07-07 | DePuy Synthes Products, Inc. | Universal length screw design and cutting instrument |
FR3021206B1 (en) * | 2014-05-22 | 2021-08-06 | Euros Sa | OSTEOSYNTHESIS SCREW INTENDED FOR THE SOLIDARIZATION OF BONE FRAGMENTS |
US11045239B2 (en) * | 2018-09-14 | 2021-06-29 | Voom Medical Devices, Inc. | Orthopedic bone screw |
Family Cites Families (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
GB1565178A (en) * | 1977-02-24 | 1980-04-16 | Interfix Ltd | Bone screw |
US5019079A (en) * | 1989-11-20 | 1991-05-28 | Zimmer, Inc. | Bone screw |
FR2721819B1 (en) | 1994-07-04 | 1996-10-04 | Amp Dev | SELF-DRILLING AND SELF-TAPPING ANKLE DEVICE WITH A SHRINKABLE END CAP, FOR LOCKING AN OSTEOSYNTHESIS PLATE OR COAPTING TWO BONE FRAGMENTS |
FR2722086A1 (en) | 1994-07-05 | 1996-01-12 | Amp Developpement | SCREW DEVICE WITH THREADED HEAD FOR ALLOWING THE COAPTATION OF TWO BONE FRAGMENTS. |
FR2722096A1 (en) | 1994-07-11 | 1996-01-12 | Oreal | SOLID SKIN CLEANSING COMPOSITION CONTAINING PARTICULATE STRUCTURING AGENT |
FR2758972B1 (en) * | 1997-02-04 | 1999-05-07 | Eos Medical | THREADED HEAD SCREW DEVICE FOR ALLOWING FIXING OF SMALL BONE FRAGMENTS |
-
1998
- 1998-12-30 FR FR9816678A patent/FR2787989B1/en not_active Expired - Fee Related
-
1999
- 1999-12-30 JP JP2000591924A patent/JP2002534151A/en not_active Withdrawn
- 1999-12-30 EP EP99964745A patent/EP1139893A1/en not_active Ceased
- 1999-12-30 WO PCT/FR1999/003321 patent/WO2000040164A1/en not_active Application Discontinuation
- 1999-12-30 AU AU30496/00A patent/AU776105B2/en not_active Ceased
Non-Patent Citations (1)
Title |
---|
See references of WO0040164A1 * |
Also Published As
Publication number | Publication date |
---|---|
AU776105B2 (en) | 2004-08-26 |
AU3049600A (en) | 2000-07-24 |
JP2002534151A (en) | 2002-10-15 |
FR2787989B1 (en) | 2001-07-13 |
FR2787989A1 (en) | 2000-07-07 |
WO2000040164A1 (en) | 2000-07-13 |
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