JP2009545404A - 骨固定システムおよび使用方法 - Google Patents
骨固定システムおよび使用方法 Download PDFInfo
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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
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
- A61B17/7241—Intramedullary pins, nails or other devices with special means of locking the nail to the bone the nail having separate elements through which screws pass
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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
- A61B17/72—Intramedullary pins, nails or other devices
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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
- A61B17/683—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
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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
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the 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
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
- A61B17/725—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with locking pins or screws of special form
-
- 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
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/809—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with bone-penetrating elements, e.g. blades or prongs
-
- 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
- A61B2017/681—Alignment, compression, or distraction mechanisms
Abstract
【選択図】図1
Description
前記骨髄内ロッド30は骨螺子33によって適所に固定される。一旦適所に固定されると前記骨髄内ロッド30は前記断片24を整列しかつ安定化するのに役に立つ。
また、領域52は前記骨12の前記骨髄内管18に位置しながら前記骨係合位置にまで移動してもよい。そのような方法を用いることで、前記骨係合表面53は前記骨髄内管18を取り巻く前記皮質の骨物質上の表面と係合する。
Claims (45)
- 貫通する孔を有し骨髄内管内で受け止められるように配置された部材と、
第1の部分、第2の部分、および前記第1の部分と前記第2の部分との間に延び、前記孔を通って延びる大きさに形成した第3の部分を有する可撓性のある細長要素と、
第1の領域と、
第2の領域とを有し、
前記第1の領域は、第1の骨係合表面を有し、かつ該第1の領域を前記細長要素の前記第1の部分と作用して結合するための第1の結合構造を有し、
前記第2の領域は、第2の骨係合表面を有し、かつ該第2の領域を前記細長要素の前記第2の部分と作用して結合するための第2の結合構造を有する器具。 - 前記第1の骨係合表面は凹面である請求項1に記載の器具。
- 前記第1の骨係合表面は外部の骨表面に略一致するように形成された請求項2に記載の器具。
- 前記第1の骨係合表面は腓骨の外部の骨表面に略一致するように形成された請求項2に記載の器具。
- 前記第2の骨係合表面は実質上平坦である請求項4に記載の器具。
- 前記第2の骨係合表面は脛骨の外部表面と係合する請求項4に記載の器具。
- 前記部材は細長くかつ前記孔は前記部材の縦方向を実質上横切る方向に延びる請求項1に記載の器具。
- 前記細長要素は実質上円柱状である請求項1に記載の器具。
- 前記第1、第2、および第3の領域は実質上等しい直径を有する請求項8に記載の器具。
- 前記第1の領域は、そこを貫通する他の孔を有する請求項1に記載の器具。
- 前記第1の領域は、骨に延びるように配置された突起を有する請求項10に記載の器具。
- 前記他の孔は前記突起を貫通する請求項11に記載の器具。
- 前記細長要素の前記第1の部分は前記他の孔を通って延びるような大きさに形成された請求項12に記載の器具。
- 前記第1の結合構造は、前記細長要素の前記第1の部分に圧着されて配置されたフェルールを有する請求項13に記載の器具。
- 前記第2の結合構造は、前記細長要素の前記第2の部分に圧着されて配置された他のフェルールを有する請求項14に記載の器具。
- 前記細長要素の前記第3の部分は前記部材内の前記孔を通って延び、
前記細長要素の前記第1の部分は前記第1の領域における前記他の孔を通って延び、
前記第1および第2の領域は前記第1および第2の骨係合表面が略相互に向き合い、かつ前記突起が前記第1の領域から前記第2の領域に向かって延び、
前記第1の結合構造の前記フェルールは、前記第1の領域での前記第2の領域から遠い側で前記細長要素の前記第1の部分に圧着され、
前記第2の結合構造の前記フェルールは、前記第2の領域での前記第1の領域から遠い側で前記細長要素の前記第2の部分に圧着された請求項15に記載の器具。 - 前記突起は、前記第1の領域の中央部分に対して偏心した位置に位置する請求項11に記載の器具。
- 前記突起は、前記第1の領域の中央部分に位置した請求項11に記載の器具。
- 前記突起は、前記部材の前記孔に少なくとも部分的に延びるように設けられた請求項11に記載の器具。
- 前記第1の領域は制限された曲げ動作を行なうことができる請求項1に記載の器具。
- 湾曲した骨係合表面を有する固定領域と、外部の骨表面に略一致するように形成した骨係合表面の一部分と、外部の骨表面と接触する前記骨係合表面を支持するように設けた構造とを有し、該構造は骨部分を通して延びるように設けた可撓性の細長要素を有しかつ、前記細長要素および前記固定領域とが作用して結合する部分を含有する器具。
- 前記骨係合表面は腓骨の外部の骨表面と略一致するように形成された請求項21に記載の器具。
- 前記構造は、他の外部の骨表面と係合するように配置された他の領域を有し、かつ、前記細長要素および前記他の領域とが作用して結合するように配置された請求項21に記載の器具。
- 前記他の領域は脛骨の外部骨表面と係合するように配置された請求項23に記載の器具。
- 前記固定領域はそこを貫通する孔を有する請求項23に記載の器具。
- 前記固定領域は骨内に延びるように設けられた突起を有する請求項25に記載の器具。
- 前記孔は前記突起を通って延びる請求項26に記載の器具。
- 前記細長要素は前記孔を貫通するように配置された請求項27に記載の器具。
- 前記細長要素は前記骨および前記孔を通して延び、
前記固定領域および他の領域は、前記骨係合表面が、略前記他の領域に面し、かつ、前記突起が前記固定領域から前記他の領域に延びるような方向に向いており、
前記部分は前記細長要素および前記固定領域と、前記他の領域から遠い前記固定領域の側において結合し、
前記他の部分は前記細長要素および他の領域と、前記固定領域から遠い前記他の領域の側において結合する請求項28に記載の器具。 - 外部の骨表面と結合するように配置された間隔を置いた第1および第2の表面部分を有する第1の領域と、
前記第1の領域に固定された第2の領域とを有し、
前記第1の表面部分は第1の方向に第1の力を及ぼすように配置され、前記第2の表面部分は第2の方向に第2の力を及ぼすように配置されて、前記第1および第2の方向は相互にある角度を形成し、
前記第2の領域は骨に延びるように配置されかつそこを貫通する孔を有する器具。 - 前記第2の領域は実質上円柱状である請求項30に記載の器具。
- 前記第1の領域は制限された曲げ運動を行なうことができる請求項30に記載の器具。
- 前記第1の領域は硬い物質で形成された請求項30に記載の器具。
- 前記第1の領域はさらに、骨を結合するように配置された間隔をおいた第1および第2の返しを有して、前記第1および第2の返しは外部の骨表面に関して適所で前記第1の領域を固定するのに役立つ請求項30に記載の器具。
- 前記孔は前記第1の領域を通して延びる請求項30に記載の器具。
- 前記第2の領域は前記第1の領域の中央部分で前記第1の領域に固定された請求項30に記載の器具。
- 前記第2の領域は、前記第1の領域の中央部分に対して偏心した前記第1の領域に固定された請求項30に記載の器具。
-
部材を骨の骨髄内管に挿入し、
領域上の骨係合表面が略前記部材に向かいかつ前記骨の骨表面部分と係合するように前記領域を位置させ、かつ、
前記部材から離れる前記領域の相対運動を阻止する構造を取り付けるとともに、
前記構造は前記骨の孔を通して延び、かつ前記部材および前記領域の間に延びかつ作用して前記部材と前記領域のいずれかと係合する細長い可撓性の要素を有する方法。 - 前記取付けは、前記骨内の前記孔と実質上一直線に配列した前記部材内の孔を通して前記可撓性の要素を挿入する工程を有するとともに、
他の領域を、その上の他の骨係合表面が他の骨表面部分と係合し、前記領域は間隔を空け、前記部材が前記領域の間に設けられ、かつ前記領域上の前記骨係合表面は略相互に向き合うように位置決めする工程を有し、かつ、
前記取付けは、前記部材内の前記孔を通して延びかつ前記領域の間に延びかつ前記領域の各々と作用し合って協働する前記可撓性の要素の一部分に張力を与える工程を有し、前記可撓性の要素は相互に離れる前記領域の相対的な移動を阻止する請求項38に記載の方法。 - 前記骨内に前記孔を作成する工程をさらに有する請求項39に記載の方法。
- 他の骨内の他の孔を作成する工程をさらに有し、前記他の孔は実質上前記骨内の前記孔と一直線に整列している請求項40に記載の方法。
- 前記骨は腓骨である請求項41に記載の方法。
- 前記他の骨は脛骨である請求項42に記載の方法。
- 前記取付け工程は、前記骨および前記部材内の前記実質上一直線に整列した孔を通って前記可撓性部材を挿入する工程を有する請求項41に記載の方法。
- 前記可撓性部材は針と結合し、前記取付け工程は、前記実質上一直線に整列した孔を通って前記針を挿入する工程を有する請求項44に記載の方法。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US11/461,502 US7963966B2 (en) | 2000-06-06 | 2006-08-01 | Bone fixation system and method of use |
US11/461,502 | 2006-08-01 | ||
PCT/US2007/074832 WO2008016910A2 (en) | 2006-08-01 | 2007-07-31 | Bone fixation system and method of use |
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JP2013245864A Division JP2014113483A (ja) | 2006-08-01 | 2013-11-28 | 骨固定システムおよび使用方法 |
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EP (3) | EP2046213B1 (ja) |
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WO (1) | WO2008016910A2 (ja) |
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JP2012503532A (ja) * | 2008-09-25 | 2012-02-09 | エリック パーセル ダグラス | 切断術用安定化装置 |
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US20110034927A1 (en) | 2011-02-10 |
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JP5426376B2 (ja) | 2014-02-26 |
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EP2046213A4 (en) | 2012-10-24 |
EP2792324A1 (en) | 2014-10-22 |
EP2792324B1 (en) | 2019-04-24 |
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