ES2545456T3 - Sistema de placa ósea con ángulo variable altamente versátil - Google Patents
Sistema de placa ósea con ángulo variable altamente versátil Download PDFInfo
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- ES2545456T3 ES2545456T3 ES12006617.0T ES12006617T ES2545456T3 ES 2545456 T3 ES2545456 T3 ES 2545456T3 ES 12006617 T ES12006617 T ES 12006617T ES 2545456 T3 ES2545456 T3 ES 2545456T3
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- 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
- A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
- A61B17/8057—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded the interlocking form comprising a thread
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1728—Guides or aligning means for drills, mills, pins or wires for holes for bone plates or plate screws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1782—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hand or wrist
-
- 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
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- B—PERFORMING OPERATIONS; TRANSPORTING
- B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
- B23G—THREAD CUTTING; WORKING OF SCREWS, BOLT HEADS, OR NUTS, IN CONJUNCTION THEREWITH
- B23G1/00—Thread cutting; Automatic machines specially designed therefor
- B23G1/02—Thread cutting; Automatic machines specially designed therefor on an external or internal cylindrical or conical surface, e.g. on recesses
-
- 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
-
- 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
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/062—Measuring instruments not otherwise provided for penetration depth
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/06—Measuring instruments not otherwise provided for
- A61B2090/067—Measuring instruments not otherwise provided for for measuring angles
Abstract
Sistema de placa ósea que comprende: una superficie superior (1137), una superficie inferior de acoplamiento con el hueso (1139), y un orificio (1140) que se extiende a través de esta desde la superficie superior (1137) hasta la superficie inferior (1139), teniendo dicho orificio (1140) una superficie interior (1135) definiendo un eje central (1119) y que está configurado y dimensionado para recibir en su interior un tornillo con bloqueo de ángulo variable; e incluyendo dicha superficie interior (1135) de citado orificio (1140) una porción superior (1144), una porción intermedia (1146), y una porción inferior (1148), extendiéndose la porción superior (1144) desde la superficie superior (1137) hasta la porción intermedia (1146), extendiéndose la porción intermedia (1146) entre la porción superior (1144) y la porción inferior (1148), y extendiéndose la porción inferior (1148) desde la porción intermedia (1146) hasta la superficie inferior (1139), y sirviendo un saliente (1145) en la intersección de la porción superior (1144) y la porción intermedia (1146) como tope para la cabeza de tornillo de un tornillo óseo sin bloqueo; y la porción intermedia (1146) tiene una pluralidad de columnas discretas (1142) de dientes o de segmentos roscados dispuestos alrededor de la circunferencia del orificio (1140) en la superficie interior (1135) del orificio (1140), y extendiéndose cada columna (1142) en una dirección desde la superficie superior (1137) a la superficie inferior (1139); y estando configuradas y dimensionadas las columnas (1142) para acoplarse a una rosca en la cabeza del tornillo con bloqueo de ángulo variable, y pudiendo recibir el orificio (1140) al tornillo con bloqueo de ángulo variable bajo un ángulo seleccionable en cualquier dirección con respecto al eje central del orificio (1140) dentro de un rango de ángulos que forman un cono; caracterizado porque - la porción inferior (1148) es cónica o curvada hacia dentro desde la superficie inferior (1139) a la porción intermedia (1146); y - la porción inferior (1148) está en forma de esfera cortada.
Description
E12006617
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la cabeza de tornillo 14102 no engrana en las columnas de segmentos roscados 1542, pero en su lugar contacta con el saliente 1545 del orificio 1440 cuando está totalmente asentado en el mismo. [0051] Las figuras 14A, 14B, 16A y 16 B 16B muestran un tornillo óseo con bloqueo convencional 14200, insertado a través de un segundo orificio de placa ósea 1440. El tornillo óseo con bloqueo 14200, tiene una cabeza de tornillo
5 14202 con una rosca 14203 en una superficie exterior, por lo tanto, tanto la cabeza del tornillo y la rosca son de tamaño adecuado y dimensionadas de tal manera que la rosca 14203 puede engranar de forma roscada y emparejarse con las columnas de segmentos roscados1542. Para engranar y emparejarse correctamente con las columnas de segmentos roscados1542, el tornillo óseo con bloqueo 14200 debe ser insertado a través del orificio 1440 coaxialmente al eje central 1419 del orificio. El tornillo 14200 también tiene un vástago roscado 14204 para engranar el hueso. El vástago 14204 también es de tamaño adecuado y dimensionado para su inserción a través del orificio 1440. [0052] Las figuras 14A, 14B, 17A, y 17B muestran el tornillo óseo con bloqueo de ángulo variable 1460, insertado a través de un tercer orificio de una placa ósea 1440. El tornillo óseo con bloqueo de ángulo variable 1460, construido de acuerdo con la invención, tiene un vástago roscado 1404 y una cabeza parcialmente esférica 1402 con una rosca
15 1403 sobre una superficie exterior de la misma. La rosca de la cabeza de tornillo 1403 tiene un perfil que sigue ventajosamente el radio (es decir, no lineal) de curvatura en forma de arco de la porción de forma esférica de la cabeza 1402. El tornillo 1460, se muestra insertado en el tercer orificio 1440 no coaxialmente con el eje central 1719 con la rosca 1403 engranando de forma segura las columnas de segmentos roscados1542. [0053] Las figuras 18A a 21C ilustran diversas características de una realización de un orificio de placa ósea no conforme a la invención. Aparte de la formación de columnas alrededor de la superficie interior del orificio, por lo menos algunas de estas características no son necesarias de usar en realizaciones alternativas de un orificio de placa ósea según la invención. También debe tenerse en cuenta que el orden en el que se describen y se muestran estas características no implica el fin o los pasos de un proceso particular para la fabricación de un orificio de placa ósea de la invención. Como es evidente para los expertos en la técnica, hay más de una forma en la que los orificios
25 de la invención pueden ser fabricados. [0054] Un orificio de placa ósea de la invención típicamente comienza con un orificio circular inicial 1865, como se muestra en las figuras 18A a 18C. El orificio inicial 1865 tiene un eje central 1819 y se extiende completamente a través de una placa ósea 1800 desde la superficie superior 1837 a la superficie inferior 1839. En una realización, el diámetro del orificio de inicio es de aproximadamente 2,2 mm. [0055] Las figuras 19A a 19C muestran un perfil de la superficie interior de un orificio de la placa ósea sin otras características. El perfil del orificio 1965 de la placa ósea 1900 incluye una parte superior estrechada hacia dentro 1944, una porción central protuberante, estrechándose hacia el interior 1946, y una porción inferior torneada esféricamente 1948. En una realización, cada una de las porciones central e inferior del orificio se extiende a lo largo del eje central 1919 en alrededor de 1mm, y siendo el radio del torneado esférico de unos 1,75 mm.
35 [0056] Otra característica es una muesca de“llave en X”2065 opcional, que se muestra en las figuras 20A a 20C. La muesca de“llave en X”es preferentemente presada, cortada o estampada por completo a través de la placa ósea alrededor del mismo eje central 1819 como orificio inicial 1865. En una realización, cada pata de la "X" tiene una anchura de aproximadamente 1,5 mm y termina en un forma de arco que tiene un radio de aproximadamente 0,75 m. En esta misma realización, el espacio entre los extremos de las patas co-lineales es de unos 4,25 mm. Las muescas de llave en X forman un diseño de hoja de trébol destinado a alojar una guía de taladrado que tiene un diseño de punta de broca de guía complementaria, como se describe adicionalmente a continuación con respecto a las figuras 25A a 27D. [0057] Otra característica es una muesca de destalonado 2165 preferentemente de 12 grados, como se muestra en las figuras 21A a 21C (sin otras características de orificio). La muesca de destalonado 2165 incluye ocho secciones
45 cortadas simétricamente 2166, dos secciones por cuadrante, en el que cada sección se inclina hacia dentro en aproximadamente de 12 grados desde la superficie superior 2137 de la placa ósea. La muesca de destalonado está realizada a través de toda la placa ósea. En una realización, cada eje de la muesca de destalonado 2119 es de aproximadamente 1,1mm desde el eje central 1819 del orificio de la placa ósea. [0058] Las figuras 22 A a 22C muestran un perfil de orificio con porción superior 1944, una porción central 1946, y una porción inferior 1948, la muesca de llave en X 2065, la muesca de destalonado 2165, y cuatro columnas formadas en el mismo 2242 que aún no han tenido dientes o segmentos roscados cortados en ellas. Las columnas 2242 se forman mediante la eliminación de secciones axiales desde la superficie interior de la porción central del orificio. [0059] Un proceso de corte de rosca forma en las columnas 2242 los segmentos roscados. Obsérvese que si la
55 porción central 1946 no hubiera tenido las columnas formadas en la misma, el proceso de corte de la rosca habría recortado una rosca helicoidal 2367 en y completamente alrededor de la superficie interior de la porción central 2346 del orificio 2365 como se muestra en las figuras 23A a 23C. El perfil de la rosca (es decir, los picos, valles, flancos, y los ángulos formados por los flancos adyacentes) de los segmentos roscados es preferiblemente el mismo que el perfil descrito anteriormente para las columnas de segmentos roscados que se muestran en las figuras 11 y 12. [0060] Como se ha descrito previamente, en lugar de formar segmentos roscados en las columnas 2242, en los mismos pueden estar formados alternativamente dientes. Los dientes se forman cortando ranuras en la columna que son perpendiculares, o al menos sustancialmente perpendiculares, al eje central del orificio. Téngase en cuenta que si la porción central 1946 no hubiera tenido las columnas formadas en la misma, el proceso de corte de ranura habría formado una serie concéntrica, paralela de surcos y picos alternos.
65 [0061] Las figuras 24A a 24D muestran una forma de realización completa de un orificio de placa ósea de acuerdo con la invención. El orificio 2440 incluye columnas de segmentos roscados2442, muesca de llave en X 2065, y la
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E12006617
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32P03=0,99 33P03=0,80 34P03=0,60 32P04=1,00 33P04=0,79 34P04=0,58 32P05=0,99 33P05=0,75 34P05=0,55 32P06=0,95 33P06=0,68 34P06=0,49 32P07=0,90 33P07=0,60 34P07=0,41 32P08=0,82 32P09=0,72
[0072] Otras realizaciones de tornillos óseos de bloqueo de ángulo variable de la invención pueden tener otros pasos de rosca variables. [0073] Téngase en cuenta que en cada caso, la distancia angular entre picos de rosca adyacentes (o valles de rosca adyacentes), medidos a lo largo del radio de curvatura es constante, como se ilustra en la figura 35. Es decir, cada
5 distancia angular 35AD entre picos de rosca adyacentes 3510, medidos a lo largo del radio de curvatura 3525 es el mismo - en contraposición con el paso de rosca 35P01-35P005 que, como se ilustra en las figuras 32 a 34, varían según se mida a lo largo o paralelo al eje central 3519. [0074] Mediante la combinación de tornillos con bloqueo de ángulo variable, tornillos con bloqueo, y tornillos sin bloqueo en la misma placa ósea utilizando el mismo tipo de orificio de placa ósea, la invención proporciona una
10 nueva fijación mixta. Con tornillos sin bloqueo, la reducción de la fractura se mantiene por la fricción entre la placa ósea y el hueso. Esta fricción se genera apretando los tornillos sin bloqueo en el hueso. Sin embargo, el microdesplazamiento entre los tornillos sin bloqueo y el hueso lleva a la resorción ósea y, en consecuencia a la pérdida de la reducción. Además, la inserción de los tornillos sin bloqueo requiere hueso para soportar los esfuerzos de ajuste del tornillo, que crea mucha solicitación del hueso que rodea los tornillos sin bloqueo. Por lo general, la alta
15 solicitación puede hacer que las roscas de los tornillos sin bloqueo se pasen (es decir, la rosca del hueso fallan a cizalla) y/o el deslizamiento en el hueso (dado que el hueso es un material visco-elástico). Cualquiera de estos fenómenos también se traduce en pérdida de la reducción. [0075] Añadiendo, al menos, un tornillo con bloqueo o con bloqueo de ángulo variable, se minimiza o elimina la pérdida de reducción. Específicamente, asegurando los tornillos con bloqueo a la placa ósea y no al hueso, se
20 reduce el efecto del comportamiento visco-elástico del hueso, las roscas no se pasan, y se impide el microdesplazamiento. La unión entre los tornillos con bloqueo y la placa ósea es una conexión de alta resistencia de construcción de ángulo fijo en la que para fallar el tornillo con bloqueo tiene que cortarse lateralmente a través del hueso. [0076] La utilización de tornillos de ángulo variable proporciona una ventaja aún mayor que los tornillos con bloqueo,
25 debido a que los tornillos de ángulo variable se pueden fijar bajo un ángulo más deseable que los tornillos con bloqueo. [0077] Además, como el manejo de ciertas fracturas pen(sic)-articulares típicamente implica la inserción de tornillos bajo varios ángulos con respecto a la placa ósea, y en vista de la importancia de mantener las relaciones angulares iniciales entre los tornillos individuales y la placa ósea, el sistema de placa ósea altamente versátil de la invención
30 está particularmente bien adaptado para estas aplicaciones clínicas. [0078] Nótese que las características descritas e ilustradas en el presente documento se pueden usar singularmente
o en combinación con otras características y realizaciones de sistemas de placa ósea. [0079] La invención por lo tanto se ha descrito anteriormente en conexión con las realizaciones preferidas. La invención no está, sin embargo, limitada a estas realizaciones, que son sólo ejemplos de la invención. Los expertos
35 en la técnica apreciarán que pueden hacerse varias modificaciones dentro del alcance de la invención, y la invención solo está limitada por las reivindicaciones que siguen.
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Claims (1)
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Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US95550607P | 2007-08-13 | 2007-08-13 | |
US955506P | 2007-08-13 | ||
US11/971,358 US8574268B2 (en) | 2004-01-26 | 2008-01-09 | Highly-versatile variable-angle bone plate system |
US971358 | 2008-01-09 |
Publications (1)
Publication Number | Publication Date |
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ES2545456T3 true ES2545456T3 (es) | 2015-09-11 |
Family
ID=39870474
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
ES08797698.1T Active ES2545778T3 (es) | 2007-08-13 | 2008-08-12 | Sistema de placa ósea de ángulo variable altamente versátil |
ES12006606.3T Active ES2524901T3 (es) | 2007-08-13 | 2008-08-12 | Sistema de placa ósea altamente versátil con ángulo variable |
ES12006617.0T Active ES2545456T3 (es) | 2007-08-13 | 2008-08-12 | Sistema de placa ósea con ángulo variable altamente versátil |
Family Applications Before (2)
Application Number | Title | Priority Date | Filing Date |
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ES08797698.1T Active ES2545778T3 (es) | 2007-08-13 | 2008-08-12 | Sistema de placa ósea de ángulo variable altamente versátil |
ES12006606.3T Active ES2524901T3 (es) | 2007-08-13 | 2008-08-12 | Sistema de placa ósea altamente versátil con ángulo variable |
Country Status (14)
Country | Link |
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US (3) | US8574268B2 (es) |
EP (4) | EP2559394B1 (es) |
JP (2) | JP5608080B2 (es) |
KR (1) | KR101569173B1 (es) |
CN (2) | CN101778604B (es) |
BR (1) | BRPI0815225A2 (es) |
CA (2) | CA2696138C (es) |
CO (1) | CO6260041A2 (es) |
ES (3) | ES2545778T3 (es) |
HR (2) | HRP20150801T1 (es) |
HU (2) | HUE027127T2 (es) |
PL (3) | PL2559392T3 (es) |
SI (2) | SI2559394T1 (es) |
WO (1) | WO2009023666A2 (es) |
Families Citing this family (231)
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EP1578286A4 (en) | 2002-12-13 | 2009-01-14 | Pelikan Technologies Inc | METHOD AND DEVICE FOR MEASURING ANALYTES |
US7951176B2 (en) | 2003-05-30 | 2011-05-31 | Synthes Usa, Llc | Bone plate |
US11259851B2 (en) | 2003-08-26 | 2022-03-01 | DePuy Synthes Products, Inc. | Bone plate |
CA2536960C (en) | 2003-08-26 | 2011-12-06 | Synthes Gmbh | Bone plate |
US8105367B2 (en) | 2003-09-29 | 2012-01-31 | Smith & Nephew, Inc. | Bone plate and bone plate assemblies including polyaxial fasteners |
US8182485B1 (en) * | 2003-11-21 | 2012-05-22 | Toby Orthopaedics, Llc | Fracture fixation system |
US8574268B2 (en) | 2004-01-26 | 2013-11-05 | DePuy Synthes Product, LLC | Highly-versatile variable-angle bone plate system |
US7637928B2 (en) * | 2004-01-26 | 2009-12-29 | Synthes Usa, Llc | Variable angle locked bone fixation system |
US11291484B2 (en) | 2004-01-26 | 2022-04-05 | DePuy Synthes Products, Inc. | Highly-versatile variable-angle bone plate system |
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DE202006019220U1 (de) * | 2006-12-19 | 2007-05-24 | Zrinski Ag | Orthopädisches Schraubenverschlusssystem |
US9668759B2 (en) * | 2007-07-11 | 2017-06-06 | Orthohelix Surgical Designs, Inc. | Surgical drill guide having keyway for axial alignment of a fastener for use for an orthopedic plate |
CN101808589B (zh) | 2007-10-12 | 2014-06-25 | 斯恩蒂斯有限公司 | 重建设备 |
WO2009058969A1 (en) * | 2007-10-30 | 2009-05-07 | Synthes (U.S.A.) | Variable angle locked bone plate |
CN102626338B (zh) | 2008-01-14 | 2014-11-26 | 康文图斯整形外科公司 | 用于骨折修补的装置和方法 |
US8728126B2 (en) * | 2008-03-10 | 2014-05-20 | Dennis L. Steffen | Bone fixation system and method |
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CA2719699C (en) | 2008-03-26 | 2018-05-15 | Synthes Usa, Llc | Universal anchor for attaching objects to bone tissue |
AU2008354730A1 (en) | 2008-04-17 | 2009-10-22 | Toby Orthopaedics, Inc. | Soft tissue attachment system and clip |
US8257407B2 (en) * | 2008-04-23 | 2012-09-04 | Aryan Henry E | Bone plate system and method |
US8882838B2 (en) * | 2008-06-05 | 2014-11-11 | DePuy Synthes Products, LLC | Articulating disc implant |
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2008
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