JP2018149273A - 髄内釘移植用システム及び方法 - Google Patents
髄内釘移植用システム及び方法 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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/92—Impactors or extractors, e.g. for removing intramedullary devices
- A61B17/921—Impactors or extractors, e.g. for removing intramedullary devices for intramedullary devices
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- 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
- A61B17/1717—Guides or aligning means for drills, mills, pins or wires for applying intramedullary nails or pins
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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
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1613—Component parts
- A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
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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
- A61B17/16—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
- A61B17/1721—Guides or aligning means for drills, mills, pins or wires for applying pins along or parallel to the axis of the femoral neck
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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
- A61B17/16—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
- A61B17/1725—Guides or aligning means for drills, mills, pins or wires for applying transverse screws or pins through intramedullary nails or pins
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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
- A61B17/72—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
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- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- 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
- A61B17/7258—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone
- A61B17/7275—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone with expanding cylindrical parts
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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
- A61B17/7283—Intramedullary pins, nails or other devices with special cross-section of the nail
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- 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
- A61B17/74—Devices for the head or neck or trochanter of the femur
- A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
- A61B17/744—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to an intramedullary nail
-
- 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
-
- 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
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1664—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the hip
- A61B17/1668—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the hip for the upper femur
-
- 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
- A61B17/1742—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hip
-
- 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
- A61B17/8875—Screwdrivers, spanners or wrenches
-
- 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
- A61B17/90—Guides therefor
Abstract
Description
本願は、2016年9月22日に出願された、米国特許第15/272,850の一部継続出願であり、その内容は、その全体が全ての目的のために参照により本明細書に組み込まれる。
Claims (20)
- 骨を安定化するように構成された髄内システムであって、
髄内釘であって、
第1の軸に沿った細長い本体であって、近位部分及び遠位部分を有する、本体と、
前記近位部分内に形成された第1の開孔であって、第1の角度で前記第1の軸を横断する第2の軸を画定している、第1の開孔と、
前記近位部分内に形成された第2の開孔であって、第2の角度で前記第1の軸を横断する第3の軸を画定しており、前記第3の軸が、前記第1の軸で前記第2の軸と交差しており、前記第1の角度及び前記第2の角度が、余角である、第2の開孔と、を有する、髄内釘と、
第1の端部から第2の端部まで延在する無頭締付具であって、前記第1の開孔または前記第2の開孔を通して位置付けられるように構成されたシャフトを有し、前記無頭締付具の前記第1の端部が、前記骨に対して、または前記骨内に位置付けられるように構成されている、無頭締付具と、を備える、髄内システム。 - 前記第1の開孔が、第1の程度で矢状面からAP面内で径方向にオフセットされており、前記第2の開孔が、前記第1の程度よりも大きい第2の程度で矢状面からAP面内で径方向にオフセットされている、請求項1に記載のシステム。
- 前記第2の程度が、前記第1の程度の2倍である、請求項2に記載のシステム。
- 前記近位部分内に形成された第3の開孔であって、第3の角度で前記第1の軸を横断する第4の軸を画定している、第3の開孔と、
前記近位部分内に形成された第4の開孔であって、第4の角度で前記第1の軸を横断する第5の軸を画定しており、前記第5の軸が、前記第1の軸で前記第4の軸と交差しており、前記第3の角度及び前記第4の角度が、余角である、第4の開孔と、をさらに含む、請求項1に記載のシステム。 - 前記第3の開孔が、第1の程度で矢状面からAP面内で径方向にオフセットされており、前記第4の開孔が、前記第1の程度よりも大きい第2の程度で矢状面からAP面内で径方向にオフセットされている、請求項4に記載のシステム。
- 係止ねじを受容するように構成された少なくとも1つの近位開口をさらに含む、請求項4に記載のシステム。
- 前記第1の開孔及び前記第3の開孔または前記第2の開孔及び前記第4の開孔を通過するように構成された第1及び第2の固定装置と、
前記近位開口を通過し、かつ前記第1及び第2の固定装置の後方に通過して、固定角度構成体を画定するように構成された第3の固定装置と、をさらに備える、請求項6に記載のシステム。 - 斜角で前記第1の軸を横断する第6の軸を画定している少なくとも1つの遠位開孔をさらに含む、請求項1に記載のシステム。
- 髄内釘を骨内に挿入するためのシステムであって、
髄内釘であって、近位端部、遠位端部、前記近位端部と前記遠位端部との間に延在している少なくとも1つの側面、及び前記髄内釘を通る開孔を有する、髄内釘と、
挿入工具であって、
ハンドル部分であって、第1の接続アセンブリを画定している、ハンドル部分と、
前記ハンドル部分から延在している連結部分であって、前記髄内釘の前記近位端部に取り外し可能に連結するように構成されている、連結部分と、
少なくとも1つの支持ブロックを有する本体及び第2の接続アセンブリを有する照準ガイドであって、前記第1の接続アセンブリ及び前記第2の接続アセンブリが、前記ハンドル部分及び前記照準ガイドを解放可能に相互接続するように構成されており、前記少なくとも1つのガイドブロックが、ガイドシース孔であって、そこを通るガイドシースを受容するように構成されている、ガイドシース孔を画定しており、前記ガイドシース孔が、前記髄内釘が前記連結部分に連結されたときに、前記ガイドシース孔が前記髄内釘内の前記開孔と実質的に整列するように位置付けられている、照準ガイドと、を備える挿入工具と、を備える、システム。 - 前記第1の接続アセンブリまたは前記第2の接続アセンブリの一方が、少なくとも1つの接続ポストを含み、前記接続アセンブリの他方が、ポスト受容孔と、前記ポスト受容孔内に延在し、かつ前記接続ポストに解放可能に係合するように構成された接続ボタンとを含む、請求項9に記載のシステム。
- 前記接続ポストが、円周方向スロットを含み、前記接続ボタンが、前記円周方向スロットに選択可能に係合するように構成された係合部分を含む、請求項10に記載のシステム。
- 前記第1の接続アセンブリまたは前記第2の接続アセンブリの一方が、少なくとも2つの接続ポストを含み、前記接続アセンブリの他方が、少なくとも2つのポスト受容孔を含み、接続ボタンが、前記ポスト受容孔のうちの1つ内に延在しており、内部に受容された前記接続ポストに解放可能に係合するように構成されている、請求項9に記載のシステム。
- 前記ガイドシース孔に沿って位置付けられ、かつ前記ガイドシース上の第2の保持部材と係合して、前記ガイドシース孔に対する前記ガイドシースの移動を制限するように構成された第1の保持部材と、
前記支持ブロック上に配設された保持解放機構と、をさらに備える、請求項9に記載のシステム。 - カニューレアセンブリであって、
可撓性カニューレであって、そこを通して延在している貫通経路を有する、可撓性カニューレと、
前記可撓性カニューレと接続された剛性ハンドルと、を含む、カニューレアセンブリをさらに備え、
前記髄内釘が、挿入中に前記可撓性カニューレ貫通経路を通過する、請求項9に記載のシステム。 - 前記剛性ハンドルが、単独で、または可撓性カニューレと併せて、一対の脛骨ピンガイドを画定しており、前記剛性ハンドルが、少なくとも2つの大腿骨ピンガイドをさらに画定している、請求項14に記載のシステム。
- 前記カニューレアセンブリが、
前記可撓性カニューレ貫通経路を通して延在するように構成されたドリルスリーブ及びトロカールをさらに備える、請求項14に記載のシステム。 - 髄内釘及び挿入工具を相互接続するための接続アセンブリであって、前記髄内釘が、近位端部と遠位端部との間に延在しており、かつ前記近位端部内に画定された円周方向スロットを有し、前記挿入工具が、内部に画定された孔を有する照準アームを含み、前記接続アセンブリが、
近位端部から遠位端部まで延在している中空本体を有する整列先端部であって、前記近位端部が、前記照準アームの前記孔内にしっかりと接続されるように構成されている、整列先端部と、
コレット近位端部からコレット遠位端部まで延在している中空本体を有する拡張コレットであって、前記コレット遠位端部が、径方向外方に延在しているカラー及び内側螺合部を有し、前記コレット本体が、前記本体の前記遠位端部が径方向内方に圧縮することを可能にする前記本体の前記遠位端部から延在している軸方向スロットを画定しており、それにより前記カラーが前記整列先端部の貫通経路を通して、前記髄内釘の前記円周方向スロット内へと通過することを可能にする、拡張コレットと、
螺合シャフトを有する接続ボルトであって、前記照準アーム内の前記孔を通して、前記拡張コレットの前記内側螺合部と螺合係合して、前記カラーがその外径に対して外方に押圧されるように延在している、接続ボルトと、を備える、接続アセンブリ。 - 前記先端中空本体の前記近位端部が、圧入により前記照準アームの前記孔内に受容されるように構成されている、請求項17に記載の接続アセンブリ。
- 前記先端中空本体の前記遠位端部が、前記髄内釘の前記近位端部内の開口内に受容されるように構成された凹状部分を有する、請求項17に記載の接続アセンブリ。
- 前記接続ボルトが、前記整列先端部中空本体の前記近位端部と接触し、かつ前記髄内釘にわたって圧縮を生じさせる、ヘッド部を含む、請求項17に記載の接続アセンブリ。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US15/272,850 US10299847B2 (en) | 2016-09-22 | 2016-09-22 | Systems and methods for intramedullary nail implantation |
US15/423,773 US10251691B2 (en) | 2016-09-22 | 2017-02-03 | Systems and methods for intramedullary nail implantation |
US15/423,773 | 2017-02-03 |
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JP2018149273A true JP2018149273A (ja) | 2018-09-27 |
JP7058511B2 JP7058511B2 (ja) | 2022-04-22 |
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JP2017181396A Pending JP2018069044A (ja) | 2016-09-22 | 2017-09-21 | 髄内釘移植のためのシステム及び方法 |
JP2018016251A Active JP7058511B2 (ja) | 2016-09-22 | 2018-02-01 | 髄内釘移植用システム及び方法 |
JP2018161010A Active JP6929256B2 (ja) | 2016-09-22 | 2018-08-30 | 髄内釘埋め込みのためのシステムおよび方法 |
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US (11) | US10299847B2 (ja) |
EP (2) | EP3298972A3 (ja) |
JP (3) | JP2018069044A (ja) |
Cited By (8)
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JP2020062398A (ja) * | 2018-10-08 | 2020-04-23 | グローバス メディカル インコーポレイティッド | 髄内釘埋め込みのためのシステムおよび方法 |
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KR20220006790A (ko) * | 2020-07-09 | 2022-01-18 | 주식회사 제일메디칼코퍼레이션 | 수술용 조준기구 |
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US20180078299A1 (en) | 2018-03-22 |
EP3357438A2 (en) | 2018-08-08 |
US20190247103A1 (en) | 2019-08-15 |
EP3357438A3 (en) | 2018-10-24 |
US10463416B2 (en) | 2019-11-05 |
US11179184B2 (en) | 2021-11-23 |
US11090098B2 (en) | 2021-08-17 |
JP2018069044A (ja) | 2018-05-10 |
US10307197B2 (en) | 2019-06-04 |
US20180078294A1 (en) | 2018-03-22 |
JP7058511B2 (ja) | 2022-04-22 |
US10299847B2 (en) | 2019-05-28 |
US20180078290A1 (en) | 2018-03-22 |
JP6929256B2 (ja) | 2021-09-01 |
US11213337B2 (en) | 2022-01-04 |
US20200015875A1 (en) | 2020-01-16 |
US20220047313A1 (en) | 2022-02-17 |
US20210346077A1 (en) | 2021-11-11 |
US20220079647A1 (en) | 2022-03-17 |
US10251691B2 (en) | 2019-04-09 |
EP3298972A3 (en) | 2018-07-04 |
EP3298972A2 (en) | 2018-03-28 |
US20180078291A1 (en) | 2018-03-22 |
EP3357438B1 (en) | 2021-07-07 |
US20190175240A1 (en) | 2019-06-13 |
JP2019093110A (ja) | 2019-06-20 |
US20180078292A1 (en) | 2018-03-22 |
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