JP2006506197A - 調節可能な骨プレート - Google Patents
調節可能な骨プレート Download PDFInfo
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Abstract
Description
本明細書で説明したような骨プレートは、骨への取付けによって、少なくとも1つの骨を安定化させるように構成された、比較的薄型の(または板様の)固定デバイスを備える。固定デバイスは、固定デバイスが、骨不連続部の反対側に配置された骨部分の相対的な位置を固定するように、骨不連続部(骨折部、切片、骨ジョイントなど)に架かるように構成されてもよい。固定デバイスは一般に、骨の外部表面と接触して配置されるように構成されており、したがって、骨の少なくともほぼ外部に配置される。骨プレートは、恒久的に定位置に残されてもよく、または付随された骨が部分的にまたは完全に治癒した後に取り外されてもよい。
骨プレートのアンカーおよび/または支持部分が、プレート部材と称される、骨プレートの別個の構成要素によって画定されてもよい。各プレート部材は、骨プレートの異なるアンカーおよび/または支持部分を画定してもよい。本明細書に記載されている枢動自在な骨プレートは、2つ以上のプレート部材を備えてもよい。いくつかの実施形態では、骨プレートは、少なくとも3つのプレート部材を備えてもよく、プレート部材の隣接する各対は、機械的ジョイントによって接続されている。
本明細書に記載されている骨プレートは、1つまたは複数のジョイントを備えてもよい。各ジョイントは、プレート部材が互いに対して運動することを許すプレート部材間のいかなる接続部であってもよい。ジョイントは、骨プレートのプレート部材が、プレート部材の角度配置および/または間隔が調節されるように互いに対して回転自在に(曲げおよび/捩り)および/または並進方向に運動することを許すように配置されてもよい。各ジョイントは、(1)プレート部材が独立して運動することができる調節可能な形状、および(2)プレート部材の角度配置および/または間隔が固定される固定形状を有してもよい。
骨プレートは、基準マークを備えてもよい。基準マークは、枢動自在なジョイント、直線状に滑動自在なジョイント、および/またはスロットに隣接して配置されてもよい。基準マークは、骨プレートのある部分の別の部分に対する角度配置および/または直線配置を示してもよい。別法として、基準マークは、スロット内の骨ねじの位置を示してもよい。基準マークは、骨プレート上のいかなる目に見える指標であってもよい。これらの指標は、最初の製造中、例えば、指標を形成するように構成された金型を使用してプレートを鋳造することによって(例えばそれぞれ溝または隆起をプレート内に形成するための金型内の隆起または溝)、プレート上またはプレート内に形成されてもよい。別法として、またはそれに加えて、指標は、製造後に、例えば、プレートの既存の構成要素内に指標をエッチングするまたは切削することによって、および/またはプレートの追加の構成要素として追加することによってプレートに追加されてもよい。いくつかの場合、指標は、設置前または設置中にプレートと同格に配置されたガイドまたはテンプレート上に別法としてまたは追加として設けられ、設置終了前に取り除かれてもよい。例示的な基準マークは、特に、点、破線、記号、文字、数字、文字、単語、形状および/または色を含んでもよい。
以下の例は、枢動自在な骨プレートを備える本発明の選択された態様および実施形態、および骨を固定するために枢動自在な骨プレートの例示的な使用を説明している。これらの例は、例示のために設けられており、本発明の全範囲を限定または規定するようには意図されていない。
枢動自在な骨プレートで固定するための例示的な骨折部
この例は、本教示の枢動自在な骨プレートで固定されることができる例示的な骨折部を説明している(図2参照)。
3つの軸の周りの枢動運動のためのジョイントを備える骨プレート
この例は、その中で骨プレートの部分が互いに対して曲がりかつ捩れることができる、折れた遠位のとう骨上で使用するための骨プレートを説明している(図3〜図6参照)。
枢動および並進運動用のジョイントを備える骨プレート
この例は、骨プレートが、曲げる、捩る、および互いに対して並進方向に滑動することができる、折れた遠位のとう骨上で使用するための骨プレートを説明している(図7、図8参照)。
離隔された枢動自在なジョイントを備える骨プレート
この例は、直交する軸の周りに枢動運動するように構成された複数の離隔されたジョイントを備える骨プレートを説明している(図9参照)。
滑動および枢動のための一体型ジョイントを備える骨プレート
この例は、滑動および枢動のための一体型ジョイントがその中にある、折れたとう骨を固定するための骨プレートを説明している(図10参照)。
結合された並進および枢動運動を有する骨プレート
この例は、骨プレートが並進および枢動運動を結合する、折れたとう骨を固定するための骨プレートを説明している(図11〜図14参照)。
基準マークを備える骨プレート
この例は、プレートの角度および/または並進方向の調節を測定するように構成された基準マークを備える骨プレートを説明している(図15および図16参照)。
枢動自在な骨プレート
この例は、骨プレートの部分が互いに対して曲がる、および捩れることができる、折れた遠位のとう骨上で使用するための別の枢動自在な骨プレートを説明している(図17〜図19参照)。この骨プレートのいくつかの態様は、実施例2において上で説明され骨その中でより詳細に説明されたプレートと共有される。
選択された実施形態
この節は、一連の番号付き段落として示された、本発明の選択された実施形態を説明する。
1. (a)各部分が、前記部分を骨に取り付ける固定具とともに使用するための取付構造を有する複数の骨取付部分と、(b)前記骨取付部分を接合し、前記骨取付部分の1つを前記部分の別のものに対して枢動調節するための少なくとも1つの軸を事前に規定する分岐領域とを備え、前記分岐領域が、調節の後、枢動運動を少なくとも実質上制限するように構成されている、骨を固定するための骨プレート。
2. 前記取付構造の少なくとも1つが、固定具を受けるための開口である段落1の骨プレート。
3. 前記固定具が骨ねじである段落2の骨プレート。
4. 前記取付構造の少なくとも1つが、固定具を受けるためのフックである段落1の骨プレート。
5. 前記固定具がワイヤである段落4の骨プレート。
6. 各部分が複数の取付構造を有する段落1の骨プレート。
7. 各骨取付部分が別個の構成要素である段落1の骨プレート。
8. 前記骨取付部分が、T字形状をほぼ画定する段落1の骨プレート。
9. 少なくとも1つの骨取付部分が、前記プレートを調節するための工具と係合するように構成された工具係合部位を有する段落1の骨プレート。
10. 工具係合部位が、骨取付部分の1つの枢動させるためのハンドルなどの工具をねじで受けるように構成されているねじ山付き開口である段落9の骨プレート。
11. 前記分岐領域が、前記骨取付部分が前記骨に取り付けられるとき、前記骨から離隔されるように構成された横方向隆起を備える段落1の骨プレート。
12. 前記軸が、前記プレートが曲げられ、捩られることができるように、複数の軸である段落1の骨プレート。
13. 前記分岐領域が部分的なボールジョイントを備える段落1の骨プレート。
14. 前記分岐領域が、横方向軸の周囲に曲げるための枢動運動を制限する段落1の骨プレート。
15. 前記骨取付部分もまた、互いに対して滑動可能である段落1の骨プレート。
16. 前記複数の骨取付部分が少なくとも3個である段落1の骨プレート。
17. 前記分岐領域が、前記骨取付部分の枢動配置を固定するために随意に実装可能なロッキング構造を備える段落1の骨プレート。
18. 前記ロッキング構造が、前記分岐領域で前記骨取付部分の少なくとも2つと接触するねじ山付きの固定具を備える段落17の骨プレート。
19. 前記骨取付部分が滑動可能であり、前記ロッキング構造が、前記部分の滑動および枢動運動を防止するために実装可能である段落17の骨プレート。
20. 前記骨プレートが、遠位のとう骨または指骨とともに使用するように構成されている段落1の骨プレート。
21. 段落1〜20の骨プレートを使用する方法。
21 骨折部
22 骨プレート
24 第1のプレート部材
26 第2のプレート部材
30 骨ねじ
32,34 部分
38 ジョイント
40,42 ステップ
44 戻り止め
46 ハンドル
60 上右肢
62 コリース骨折部
66 前腕
68 手
70 遠位の骨折部
72 近位の骨セグメント
74 掌側部
80,170,270,320,390,450 骨プレート
82,172,216,272,322,392 近位のプレート部材
84,218,274,324,394 遠位のプレート部材
86,175,212,214,326,328,396,456 ジョイント
88,102,190 骨ねじ
90〜94,104,130,132,192,234,292,294,414,416,458〜464,470,476 開口
98 基準マーク
106,108 曲げ運動
110 捩り運動
112,246,402 ロックねじ
114 ハンドル
122,124,502,504 半球表面
126,182,506 リテーナ
128,508 キャビティ
129,180,244,350 戻り止め機構
140,142 内部表面
144,146 外部表面
148 皿孔
150,514 孔
174,220,340 橋部材
176 隆起またはガイド
178 くぼみまたは軌道
184 固定具
186,236,296 ねじ山付き孔
188 保持表面
194 通路
222,240,280,397 枢動運動
224,332,398 法線方向軸
226,228,284,286 接触表面
232,288,290,352 コネクタ
242 横方向軸
278 軸方向運動
282 軸
29 ねじ山付きスロット
302 皿孔表面
342,344 表面
346 経路
354 ねじ山付きナット
356,410 スロット
358 壁
360 シェルフ
398 枢軸
404 角度指標機構
406 角度基準マーク
408 目印
412 指標機構
418 基準マーク
426 標準設定マーク
452 近位のアンカー部分
454 遠位のアンカー部分
466 中心軸
486 横方向輪郭形状
488 掌側遠位縁部
490 遠位横方向周縁
492 遠位中間周縁
532,534 骨領域
538 茎状突起
540 茎状不連続部
Claims (59)
- 第1および第2のプレート部材を少なくとも1つの骨の部分に固定する固定具を受けるように構成された1つまたは複数の開口をそれぞれが画定する第1および第2のプレート部材と、
前記第1および第2のプレート部材を接続し、前記第1および第2のプレート部材の間の角度配置を画定するジョイントであって、前記ジョイントが、(1)その中で前記角度配置が、前記第1のプレート部材の2つ以上の平行でない軸の周りの枢動運動によって調節可能である枢動自在な形状と、(2)その中で前記角度配置が固定される固定形状とを有するジョイントとを備える骨固定用骨プレート。 - 前記少なくとも1つの骨の部分が、少なくとも2つの骨の部分であり、前記第1および第2のプレート部材が、前記少なくとも2つの骨の部分に固定されるように構成されている請求項1に記載の骨プレート。
- 前記第1および第2のプレート部材の少なくとも1つによって画定される前記1つまたは複数の開口の少なくとも1つが、ねじ山付きである請求項1に記載の骨プレート。
- 前記第1および第2のプレート部材が、とう骨の遠位の部分に固定されるように構成されている請求項1に記載の骨プレート。
- 前記第1および第2のプレート部材は、前記骨プレートがほぼT字型であるように調節されることができる請求項1に記載の骨プレート。
- 各プレート部材のための前記1つまたは複数の開口の少なくとも一部が、直線状に配列されている請求項1に記載の骨プレート。
- 前記第1のプレート部材が、ほぼT字型である請求項1に記載の骨プレート。
- 前記第1および第2のプレート部材が、少なくとも実質上相補的であるそれぞれ凹状および凸状の表面を備え、前記凹状および凸状の表面が、ジョイントの枢動自在な形状内で互いに滑動するように構成されている請求項1に記載の骨プレート。
- 前記ジョイントが、固定形状を形成するために、前記第1および第2のプレート部材を共に圧縮するように構成された戻り止め機構を備える請求項1に記載の骨プレート。
- 前記ジョイントが、異なる軸の周りの前記第1のプレート部材の前記第2のプレート部材に対する枢動運動を許す少なくとも2つの別個のジョイントを備える請求項1に記載の骨プレート。
- 前記ジョイントが、第1のジョイントであり、前記第1のプレート部材が前記第2のプレート部材に対して並進運動することを許すように構成された第2のジョイントをさらに備える請求項1に記載の骨プレート。
- 前記第1および第2のプレート部材の少なくとも一方の上に配置され、前記第1および第2のプレート部材の互いに対する角度配置を標示するように構成された複数の基準マークをさらに備える請求項1に記載の骨プレート。
- 第1および第2のプレート部材を1つの骨の異なる部分に固定するための固定具を受けるように構成された1つまたは複数の開口をそれぞれが画定し、前記1つの骨の表面領域上に嵌合するように構成されている第1および第2のプレート部材と、
前記第1および第2のプレート部材を接続し、前記第1および第2のプレート部材の間の角度配置を画定するジョイントであって、前記ジョイントが、その中で前記角度配置が調節可能である調節可能な形状と、その中で前記角度配置が固定される固定形状とを有するジョイントと、を備える骨間固定用の骨プレート。 - 前記ジョイントが、少なくとも2つの平行でない軸の周りの前記第1のプレート部材の前記第2のプレート部材に対する枢動運動を許すように構成されている請求項13に記載の骨プレート。
- 前記第1および第2のプレート部材が、とう骨の遠位部分の掌側表面上に嵌合するように構成されている請求項13に記載の骨プレート。
- 前記ジョイントが、ねじ山付き固定具を備え、前記ジョイントが、前記ねじ山付き固定具の回転によって固定形状で配置されるように構成されている請求項13に記載の骨プレート。
- 前記第1および第2のプレート部材の少なくとも一方の上に配置され、前記第1および第2のプレート部材の互いに対する角度配置を標示するように構成された複数の基準マークをさらに備える請求項13に記載の骨プレート。
- 少なくとも1つの骨に固定されるように構成された第1および第2の部分と、
前記第1および第2の部分を接続し、前記第1および第2の部分の間の角度配置を画定するジョイントであって、前記ジョイントが、(1)その中で前記角度配置が、3つの直交する軸の周りの前記第1の部分の前記第2の部分に対する枢動運動によって調節可能である枢動自在な形状と、(2)その中で前記角度配置が固定される固定形状とを有するジョイントと、を備える骨固定用の骨プレート。 - 前記少なくとも1つの骨が、少なくとも2つの骨であり、前記第1および第2の部分が、前記少なくとも2つの部分に固定されるように構成されている請求項18に記載の骨プレート。
- 前記第1および第2の部分が、とう骨の遠位の部分に固定されるように構成されている請求項18に記載の骨プレート。
- 前記第1および第2の部分は、前記骨プレートがほぼT字型であるように調節されることができる請求項18に記載の骨プレート。
- 前記第1および第2の部分が、少なくとも実質上相補的であるそれぞれ凹状および凸状の表面を備え、前記凹状および凸状の表面が、ジョイントの調節可能な形状内で互いに滑動するように構成されている請求項18に記載の骨プレート。
- 前記ジョイントが、固定形状を形成するために、前記第1および第2の部分を共に圧縮するように構成された戻り止め機構を備える請求項18に記載の骨プレート。
- 前記第1および第2の部分の少なくとも一方の上に配置され、前記第1および第2の部分の互いに対する角度配置を標示するように構成された複数の基準マークをさらに備える請求項18に記載の骨プレート。
- 第1および第2のプレート部材を1つの骨の異なる部分に固定するステップと、
前記1つの骨の異なる部分を互いに対して運動するように固定するステップの後、前記第1および第2のプレート部材を互いに対して枢動させるステップと、
前記1つの骨の異なる部分が固定されるように、前記第1および第2のプレート部材の互いに対する枢動運動を制限するステップと、を含む骨固定方法。 - 前記固定するステップが、前記第1および第2のプレート部材の開口を通って前記1つの骨の中に骨ねじを配置するステップを含む請求項25に記載の方法。
- 前記枢動させるステップが、(1)前記第1のプレート部材と接続されたハンドルを動かすステップと、(2)前記移動させるステップの後、前記ハンドル部材を取り外すステップとを含む請求項25に記載の方法。
- 前記枢動させるステップが、前記第1および第2のプレート部材を少なくとも2つの軸の周りに互いに対して枢動させるステップを含む請求項25に記載の方法。
- 前記制限するステップが、前記第1および第2のプレート部材を、これらのプレート部材が互いに係合するように共に圧縮するステップを含む請求項25に記載の方法。
- 前記圧縮するステップが、ねじ山付きの固定具を回転させるステップを含む請求項29に記載の方法。
- 前記1つの骨が不連続部を有し、前記固定するステップが、前記第1のプレート部材を前記不連続部の一方の側の1つの骨に固定するステップと、前記第2のプレート部材を前記不連続部の他方の側に固定するステップとを含む請求項25に記載の方法。
- 枢動するステップ中、および制限するステップの前またはそれと同時に、前記プレート部材の少なくとも1つの上に配置され、複数の事前に規定された調節を標示するように構成された複数の基準マークを観察するステップをさらに含む請求項25に記載の方法。
- 互いに枢動自在に接続された第1および第2のプレート部材を有する骨プレートを選択するステップと、
前記第1および第2のプレート部材を骨に固定するステップと、
少なくとも2つの平行でない軸の周りの前記第1および第2のプレート部材の相対的な枢動運動によって前記第1のプレート部材の前記第2のプレート部材に対する角度配置を調節するステップと、
前記角度位置を固定するために前記第1および第2のプレート部材の枢動運動を制限するステップと、を含む骨を固定する方法。 - 前記調節するステップが、固定するステップの後で行われる請求項33に記載の方法。
- 前記制限するステップが、前記第1および第2のプレート部材を、これらのプレート部材が互いに係合するように共に圧縮するステップを含む請求項33に記載の方法。
- 前記固定するステップが、前記骨プレートをとう骨の遠位部分に固定する請求項33に記載の方法。
- 前記骨が不連続部を有し、前記固定するステップが、前記第1のプレート部材を前記不連続部の一方の側の1つの骨に固定するステップと、前記第2のプレート部材を前記不連続部の他方の側に固定するステップとを含む請求項33に記載の方法。
- 前記角度配置を調節するステップが、前記プレート部材の少なくとも1つの上に配置され、複数の事前に規定された調節を標示するように構成された複数の基準マークを観察するステップを含む、請求項33に記載の方法。
- 第1および第2の部材を1つの骨の異なる部分に固定するための手段と、
前記第1および第2の部材に固定された前記1つの骨の前記異なる部分が、互いに対して運動するように、前記第1の部材を前記第2の部材に対して枢動させるための手段と、
前記1つの骨の異なる部分が固定されるように、前記第1および第2の部材の互いに対する枢動運動を制限するための手段と、を備える骨固定用骨プレート。 - 骨プレートが骨に対して相対的な配置を有するように、骨プレートを少なくとも1つの骨、またはその部分に固定するステップと、
前記相対的な配置に対する調節を選択するステップと、
骨プレートの移動および基準マークの観察によって調節を加え、前記基準マークが、前記骨プレート上に配置され、複数の所定の調節を標示するように構成されているステップと、を含む骨固定方法。 - 少なくとも1つの骨の異なる部分に取り付けるように構成され、第1および第2のプレート部材の相対的な配置が調節可能であるようにジョイントによって接続された第1および第2のプレート部材と、
前記第1および第2のプレート部材の少なくとも1つの上に配置され、前記相対的な配置を標示するように構成された複数の基準マークと、を備える骨固定用骨プレート。 - 前記ジョイントが、前記第1および第2のプレート部材の互いに対する枢動運動を許すように構成されている請求項41に記載の骨プレート。
- 前記基準マークが、角度配置を表示するように構成された数字を含む請求項42に記載の骨プレート。
- 前記ジョイントが、前記第1および第2のプレート部材の互いに対する滑動運動を許すように構成されている請求項41に記載の骨プレート。
- 前記基準マークが、並進方向配置を記述するように構成された数字を含む請求項44に記載の骨プレート。
- 前記骨プレートが、とう骨の遠位部分で使用するように構成されている請求項41に記載の骨プレート。
- 前記基準マークの少なくとも一部が、前記ジョイントに隣接する円弧状の列で配置されている請求項41に記載の骨プレート。
- 前記基準マークが、線分または点の少なくとも1つを含み、前記線分または点の少なくとも1つが規則的に離隔されている請求項41に記載の骨プレート。
- 前記基準マークが、前記第1のプレート部材上の目印および前記第2のプレート部材上の規則的に離隔された1組のマークを備え、前記規則的に離隔された1組のマークが、前記相対的な配置を測定するために目印と比較されるように構成されている請求項41に記載の骨プレート。
- 標準的な設定に対応する前記規則的に離隔された1組のマークが、代替および/または追加の指標によって残りの規則的に離隔されたマークに対して表示される請求項49に記載の骨プレート。
- 請求項40に記載の少なくとも1つの骨プレートと、
前記骨プレートの前記第1および第2の部材の少なくとも1つの上に配置された前記複数の基準マークの少なくとも2つに対応する複数の基準マークを有する測定デバイスと、を備える骨固定用キット。 - 前記測定デバイスがx線テンプレートを備える請求項51に記載のキット。
- 骨プレートのプレート部材を少なくとも1つの骨の異なる部分に固定し、前記異なる部分が相対的な配置を有するステップと、
前記相対的な配置に対する調節を選択するステップと、
前記プレート部材の相対的な運動および基準マークの観察によって調節を加え、前記基準マークが、前記プレート部材の少なくとも1つの上に配置され、複数の事前に規定された調節を標示するように構成されているステップと、を含む骨固定方法。 - 前記固定するステップが、前記選択するステップの前に行われる請求項53に記載の方法。
- 切断領域を形成するために少なくとも1つの骨の切断するステップをさらに含み、前記固定するステップが、前記プレート部材を前記切断領域の反対側に固定することを含む請求項53に記載の方法。
- 前記切断するステップが、少なくとも1つの骨のセグメントを摘出する請求項55に記載の方法。
- 前記調節を選択するステップが、前記異なる部分の1つまたは複数の角度配置を測定するステップを含む請求項53に記載の方法。
- 前記所定の調節が1組の所定の数値に対応しており、前記選択するステップが、調節のための数値を選択するステップを含み、前記加えるステップが、前記基準マークが前記数値が到達されたことを標示するまで、前記プレート部材を移動させるステップを含む請求項53に記載の方法。
- プレート部材を固定するまたは調節を加えるステップの前に、前記相対的な配置の調節を予め設定するステップをさらに含む請求項53に記載の方法。
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- 2003-11-19 US US10/716,719 patent/US7090676B2/en not_active Expired - Lifetime
- 2003-11-19 WO PCT/US2003/037231 patent/WO2004045389A2/en active Application Filing
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- 2003-11-19 JP JP2004554004A patent/JP4028552B2/ja not_active Expired - Lifetime
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2006
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2007
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2010
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2012
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Also Published As
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EP1567071A4 (en) | 2010-04-28 |
US9308033B2 (en) | 2016-04-12 |
US9414871B2 (en) | 2016-08-16 |
US7704251B2 (en) | 2010-04-27 |
US20040102776A1 (en) | 2004-05-27 |
GB2412590A (en) | 2005-10-05 |
JP4028552B2 (ja) | 2007-12-26 |
US10456180B2 (en) | 2019-10-29 |
GB2412590B (en) | 2006-05-17 |
US20070276405A1 (en) | 2007-11-29 |
US20150216574A1 (en) | 2015-08-06 |
US20170035477A1 (en) | 2017-02-09 |
US20040102778A1 (en) | 2004-05-27 |
JP2007275651A (ja) | 2007-10-25 |
EP1567071A2 (en) | 2005-08-31 |
US8425574B2 (en) | 2013-04-23 |
KR101081269B1 (ko) | 2011-11-08 |
WO2004045389A2 (en) | 2004-06-03 |
GB0512488D0 (en) | 2005-07-27 |
EP1567071B1 (en) | 2012-05-30 |
US7090676B2 (en) | 2006-08-15 |
WO2004045389A3 (en) | 2004-08-19 |
AU2003295749A1 (en) | 2004-06-15 |
AU2003295749B2 (en) | 2007-12-06 |
US20110022049A1 (en) | 2011-01-27 |
US7326212B2 (en) | 2008-02-05 |
KR20050075440A (ko) | 2005-07-20 |
US20130090656A1 (en) | 2013-04-11 |
US20110137351A1 (en) | 2011-06-09 |
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