EP3629958A1 - Liaison par vis pour soutenir et stabiliser une fracture de l'os iliaque ou pour stabiliser et rigidifier l'articulation sacro-iliaque - Google Patents

Liaison par vis pour soutenir et stabiliser une fracture de l'os iliaque ou pour stabiliser et rigidifier l'articulation sacro-iliaque

Info

Publication number
EP3629958A1
EP3629958A1 EP18736783.4A EP18736783A EP3629958A1 EP 3629958 A1 EP3629958 A1 EP 3629958A1 EP 18736783 A EP18736783 A EP 18736783A EP 3629958 A1 EP3629958 A1 EP 3629958A1
Authority
EP
European Patent Office
Prior art keywords
screw
ilium
disc
threaded
stabilizing
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.)
Withdrawn
Application number
EP18736783.4A
Other languages
German (de)
English (en)
Inventor
Nazar Sadiq
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Sadiq Nazar
Original Assignee
Individual
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Priority claimed from DE202017002906.5U external-priority patent/DE202017002906U1/de
Priority claimed from DE102017005222.0A external-priority patent/DE102017005222B4/de
Application filed by Individual filed Critical Individual
Publication of EP3629958A1 publication Critical patent/EP3629958A1/fr
Withdrawn legal-status Critical Current

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
    • A61B17/683—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut
    • 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
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7055—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant connected to sacrum, pelvis or skull
    • 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
    • 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
    • A61B17/8665—Nuts
    • 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
    • A61B17/8695—Washers
    • 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
    • A61B17/686—Plugs, i.e. elements forming interface between bone hole and implant or fastener, e.g. screw
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
    • A61B17/8066—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones for pelvic reconstruction
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/808—Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
    • 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
    • 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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8872—Instruments for putting said fixation devices against or away from the bone

Definitions

  • Pelvic ring fracture or for stabilization and stiffening of the iliac / iliac joint The invention relates to screwed joints for supporting and stabilizing a posterior pelvic fracture or for stabilizing and stiffening the iliac / iliac joint, either with a threaded rod in conjunction with
  • the publication DE 10 2013 005 391 A1 discloses a system for supporting a degenerative sacral iliac joint, which has a tensioning element which is held by means of a holding device between the left and right pelvic bones.
  • the holding device has a support extending through a bore in the respective pelvic bone and a respective end piece.
  • the document US 6,635,059 B2 includes a screw system for fixation of the sacrum and / or inter-iliac joint and / or for use in other skeletal areas.
  • the document US 2015/0320450 A1 discloses a sacral fixation system, wherein in particular a stabilization of the pelvic ring or the sacro-iliac joint is to be achieved.
  • the system includes one
  • Threaded rod in conjunction with threaded nuts, with a washer between the nut and the bone.
  • the ilium facing side of the disc is formed in at least two planes obliquely to each other. Furthermore, the disc has an opening for the passage of a portion of the threaded rod. When using such discs also compresses the compression force of the screw on a small bone surface of the ilium.
  • the indicated in claim 1 is based on the object to provide a simple and secure to place screw as an implant for supporting a posterior pelvic fracture or to stabilize the iliac joint.
  • the screw connections are characterized by a secure support and stabilization of a posterior pelvic fracture or by a secure
  • Screw connection as an implant is either a threaded rod in
  • Screw head a disc, wherein the pointing to the iliac bone side of the disc is formed in at least two planes obliquely to each other and the bevels are arranged at an angle to each other.
  • the disc has an opening for passage of a portion of the threaded rod or screw, the aperture being widened toward the ilium bone.
  • the screw connection is a surgical implant for the stabilization of the posterior pelvic ring in fractures of the sacrum and in existing pathology in the area of the sacral iliac joint (sacroiliac joint).
  • the implant can remain permanently or at least for a defined period of time. With the screw connection sufficient or maximum stability in the area of the fracture is achieved in order to prevent the formation of a false joint (pseudarthrosis) and to achieve a rapid load-stable supply of the fracture. Safe support of the posterior pelvic fracture or the safe
  • Stabilization of the inter-iliac joint is ensured in particular by the anatomically shaped disc with the special opening.
  • the disc is based on the geometry and angles of the iliac bone
  • the ibex-facing side of the disc is formed at least in two planes at an angle to each other, wherein the bevels are further arranged at an angle to each other.
  • the surface inclination and the angle of the side are adapted to the anatomy of the ilium.
  • the levels can be carried out to tabular and / or spherical regular or irregular.
  • the bevels can also be flat and / or spherical. This can be a
  • the widened towards the ilium opening of the disc allows an exact placement of the threaded rod or the screw.
  • the threaded rod is a rod, at least the end portions of which has a thread for engaging the nuts as threaded nuts.
  • This can advantageously be a titanium rod.
  • This is simply placed trans-sacral in combination with the anatomically shaped discs.
  • the threaded rod is located in an introduced hole. Due to the Material properties and the geometry of the threaded rod in conjunction with the discs is achieved a good but no rigid compression in the area of the outer cortical bone of the ilium. Complications in the form of a fracture in the area of the sciatic incisal and a fracture of the outer cortical bone of the ilium are largely avoidable. This is further achieved by the anatomically shaped sides of the discs, so that a distribution of the compression forces on a large bone surface of the
  • the screw is advantageously the stabilization of the traumatic fracture of the sacrum of all types according to Denis I, II and III for mono- and bilateral fractures, especially for Os sacrum fractures with reduced bone quality and pathological fractures, such as osteoporosis and osteopenia, and pathological fracture due to primary tumors or bone metastasis.
  • a treatment of the pseudarthrosis after failed conservative or surgical treatment of Os sacrum fractures by reaching the sufficient stability of the bone in the fracture area.
  • a treatment is the
  • the slope is according to the embodiment of claim 3 in cross section a straight line or a bow.
  • the inner wall of the opening is a cone according to the embodiment of claim 4.
  • the pointing to the ilium side of the disc has, according to the embodiment of claim 5 at least one elongated recess to support the attachment of the disc to the periosteum.
  • the oblong depression leads to a better adhesion of the discs to the periosteum (periosteum).
  • the screw has according to the embodiment of claim 6, a conical screw head, which allows the alignment and placement of the screw through the opening of the disc in the sacrum in normal anatomy and dysmorphism of the sacrum. This is achieved by the conical screw head, which allows different inclinations of the screw. This allows the screw to be placed in the os sacrum in normal anatomy and dysmorphism of the os sacrum.
  • the screw has, according to the embodiment of claim 7, the conical screw head, a cylindrical shaft and a thread. Damage to the inner wall of the opening of the disc are prevented by the cylindrical shaft.
  • the screw according to the embodiment of claim 8 has a continuous channel with at least one outlet opening in the region of the thread.
  • the channel in the screw can be used for placement of the screw over a target wire in os sacrum and / or for the application of
  • Bone cement can be used in augmentation of the screw.
  • the side facing away from the ilium side of the disc has after the
  • At least two of the positioning on the hip bone holes serving for releasably engaging increases of a
  • Placement sleeve This is for optimal placement of the anatomically shaped disc on the outer cortical bone of the ilium especially in a minimally invasive technique.
  • the elevations are according to the embodiment of claim 10 axial extensions of the placement sleeve.
  • the slopes of the disc are adapted according to the embodiment of claim 1 1 to the iliac bone in the area of ala ossis ilii.
  • Placement sleeve are arranged according to the embodiment of claim 12 so that the alignment arm points to the ventral edge of the acetabulum of the hip joint. This ensures accurate placement and alignment of the discs on the right and left sides of the os ilium. Thus, an otherwise required intraoperative X-ray control of the position of the discs is minimized or avoided. Optimal placement of the anatomically shaped disc to the os ilium is achieved when the alignment arm is aligned with the venting edge of the acetabulum of the hip joint. In this case, the fits
  • the surface of the disk pointing in the direction of the ilium is attached to the anatomy of the ilium in the area of the ala ossis ilii.
  • FIG. 1 shows a screw connection for supporting a posterior pelvic fracture
  • FIG. 2 shows a side view of the pelvis with a disc on the ilium
  • FIG. 3 shows a disk of a screw connection for supporting a rear one
  • Fig. 5 discs of a screw connection for supporting a rear
  • Fig. 6 is a disc with two positioning on the hip bone serving
  • a screw connection for supporting a posterior pelvic fracture consists essentially of a threaded rod 1 in conjunction with threaded nuts and anatomically shaped discs. 2
  • Fig. 1 shows a screw connection for supporting a rear
  • Fig. 2 shows a side view of the basin with a disc 2 am
  • FIG. 3 shows a disc 2 of a screw connection for supporting a posterior pelvic fracture or for stabilizing the iliac joint in a basic representation.
  • the side facing the ilium 3 of the disc 2 is formed in at least two planes obliquely to each other, wherein the bevels are arranged at an angle to each other.
  • the slope is in cross section a straight line and / or a bow.
  • the disc 2 also has an opening 4 for the passage of a
  • the opening 4 is widened in the direction of the ilium, in particular conical.
  • the ibex opposite side 5 of the disc 2 and the opening. 4 passing through threaded rod 1 include a right angle or approximately a right angle.
  • FIG. 4 shows a basic plan view of a pane 2.
  • the ilium facing side 3 of the disc 2 has two elongated depressions to support the attachment of the disc 2 to the
  • the recesses are grooves 6, wherein a groove 6a in cross-section a V-shape and the other groove 6b may have an L-shape in cross section.
  • FIG. 5 shows discs 2 of a screw connection for supporting a posterior pelvic fracture in a schematic representation.
  • the iliac-facing sides 3 and openings 4 of the discs 2 are designed to be arranged on the left ilium and the right ilium mirrored to each other. These can be marked with an R for right and an L for left.
  • FIG. 6 shows a disc 2 with two holes 7 for positioning on the ilium, for the detachable engagement of elevations of one
  • the side facing away from the hip bone side 5 of the disc 2 has at least two of the positioning on the hip bone serving holes 7 for releasably engaging elevations 9 of a placement sleeve eighth
  • Fig. 7 shows a disc 2 with the placement sleeve 8 in a schematic representation.
  • the elevations 9 are axial extensions of the placement sleeve 8.
  • the slopes of the disc 2 are adapted to the iliac bone in the area of the ala ossis ilii.
  • the disc 2 and an alignment arm 10 of the connected to the disc 2 Placement sleeve 8 are arranged so that the alignment arm 10 faces the ventral edge of the acetabulum of the hip joint.
  • a screw joint for stabilizing the iliac joint may consist of a disc 2 and a screw 1 in conjunction with the sacrum.
  • FIG. 8 shows a screw 1 1 for stabilizing the sacral fracture and / or stiffening of the inter-iliac joint in a basic representation.
  • the screw 1 has a conical screw head 12, which allows the alignment and placement of the screw 1 1 through the opening 4 of the disc 2 in the sacrum in normal anatomy and dysmorphism of the sacrum. Furthermore, the screw 1 1 has a cylindrical shaft 13 and a thread 14. 9 shows a screw 1 1 for stabilizing the sacral fracture and / or stiffening of the iliac crest joint in a schematic sectional view.
  • the screw 1 1 has a continuous channel 15 with at least one outlet opening 16 in the region of the thread 14th

Abstract

La présente invention concerne des liaisons par vis pour soutenir et stabiliser une fracture de l'os iliaque ou pour stabiliser et rigidifier l'articulation sacro-iliaque, soit à l'aide d'une tige filetée reliée à des écrous filetés, soit à l'aide d'une vis reliée au sacrum. Les liaisons par vis se caractérisent par un soutien et une stabilisation sûrs d'une fracture de l'os iliaque ou par une stabilisation et une rigidification sûres de l'articulation sacro-iliaque. La liaison par vis sous forme d'implant est donc soit une tige filetée reliée à des écrous filetés pour soutenir la fracture de l'os iliaque, soit une vis reliée au sacrum. À cet effet, un disque est placé entre le sacrum et l'écrou fileté ou la tête de vis, la face de la vis tournée vers le sacrum étant conçue sur au moins deux plans en biais l'un par rapport à l'autre et les surfaces inclinées étant agencées de manière à former un angle l'une par rapport à l'autre. Le disque présente un orifice pour laisser passer une partie de la tige filetée ou de la vis, ledit orifice étant élargi en direction du sacrum.
EP18736783.4A 2017-05-31 2018-05-29 Liaison par vis pour soutenir et stabiliser une fracture de l'os iliaque ou pour stabiliser et rigidifier l'articulation sacro-iliaque Withdrawn EP3629958A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
DE202017002906.5U DE202017002906U1 (de) 2017-05-31 2017-05-31 Schraubverbindung zum Stützen und Stabilisieren einer hinteren Beckenringfraktur oder zur Stabilisierung und Versteifung des Kreuz-Darmbein-Gelenks
DE102017005222.0A DE102017005222B4 (de) 2017-05-31 2017-05-31 Schraubverbindung zum Stützen und Stabilisieren einer hinteren Beckenringfraktur oder zur Stabilisierung und Versteifung des Kreuz-Darmbein-Gelenks
PCT/DE2018/000167 WO2018219376A1 (fr) 2017-05-31 2018-05-29 Liaison par vis pour soutenir et stabiliser une fracture de l'os iliaque ou pour stabiliser et rigidifier l'articulation sacro-iliaque

Publications (1)

Publication Number Publication Date
EP3629958A1 true EP3629958A1 (fr) 2020-04-08

Family

ID=62814758

Family Applications (1)

Application Number Title Priority Date Filing Date
EP18736783.4A Withdrawn EP3629958A1 (fr) 2017-05-31 2018-05-29 Liaison par vis pour soutenir et stabiliser une fracture de l'os iliaque ou pour stabiliser et rigidifier l'articulation sacro-iliaque

Country Status (4)

Country Link
US (1) US20200146721A1 (fr)
EP (1) EP3629958A1 (fr)
CN (1) CN110678133A (fr)
WO (1) WO2018219376A1 (fr)

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WO2019067584A1 (fr) 2017-09-26 2019-04-04 Si-Bone Inc. Systèmes et procédés de décortication de l'articulation sacro-iliaque
JP2022520101A (ja) 2019-02-14 2022-03-28 エスアイ－ボーン・インコーポレイテッド 脊椎の固定及び、又は融合のためのインプラント
DE102020128211A1 (de) * 2020-10-27 2022-04-28 Dieter Marquardt Medizintechnik Gmbh Medizinisches Verschraubungssystem für Versorgungen im Bereich des Beckens
JP2023553120A (ja) 2020-12-09 2023-12-20 エスアイ－ボーン・インコーポレイテッド 仙腸関節安定化インプラントおよびインプラント方法
US11918475B2 (en) 2021-03-31 2024-03-05 DePuy Synthes Products, Inc. Modular acetabular surgical implant assembly
US11553948B2 (en) 2021-05-20 2023-01-17 University Of Utah Research Foundation Bone fixation devices, systems, and methods
JP7140934B1 (ja) * 2022-04-05 2022-09-21 公明 古賀 腸骨連結部材

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Also Published As

Publication number Publication date
CN110678133A (zh) 2020-01-10
US20200146721A1 (en) 2020-05-14
WO2018219376A1 (fr) 2018-12-06

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