JP3575208B2 - Bone screw - Google Patents

Bone screw Download PDF

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Publication number
JP3575208B2
JP3575208B2 JP01949297A JP1949297A JP3575208B2 JP 3575208 B2 JP3575208 B2 JP 3575208B2 JP 01949297 A JP01949297 A JP 01949297A JP 1949297 A JP1949297 A JP 1949297A JP 3575208 B2 JP3575208 B2 JP 3575208B2
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screw
bone
osteosynthesis
main body
holes
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JPH10211213A (en
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啓泰 竹内
滋郎 丹羽
圭造 森川
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Mitsubishi Materials Corp
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Mitsubishi Materials Corp
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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
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7097—Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants
    • A61B17/7098—Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants wherein the implant is permeable or has openings, e.g. fenestrated 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
    • A61B17/74—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
    • 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
    • A61B17/68—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
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue
    • A61B17/8635—Tips of screws

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Neurology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Description

【０００１】
【発明の属する技術分野】
本発明は、骨接合用螺子に係り、特に骨粗鬆症を合併した大腿骨頸部骨折に対する手術等における骨強化法の実施に用いて好適な骨接合用螺子に関する。
【０００２】
【従来の技術】
従来、骨粗鬆症を合併する大腿骨頸部骨折に対する手術では、キャニュレイテッドスクリューと称される骨接合用螺子がしばしば用いられている。
これは、外周面に一端側から螺子部が形成された棒状の螺子本体に、該螺子本体を軸線方向に貫通するガイド孔と称する中空孔が形成されてなるもので、骨頭部に挿入したガイドピンにガイド孔を挿通し、レンチあるいはスクリュードライバーによって螺子本体を時計回りに回転させ、挿入し、骨頭部と骨幹部に生じた骨折部を圧迫固定するものである。
【０００３】
ところが、重度の骨粗鬆患者の場合など、大腿骨頭の骨質が脆弱化していると、キャニュレイテッドスクリューによる機械的な固定だけでは固定強度が不十分であった。このため、何等かの補強手術法が必要とされているが、その一つとして、近年、リン酸カルシウムセメントなどのバイオアクティブな骨セメントを併用する充填補強法が注目されている。
従来の骨セメントでは、重合時の発熱、未重合モノマーの循環系に対する影響、生体親和性などの点で使用に難があったが、リン酸カルシウムセメントは、発熱性、生体毒性の問題がない上に骨親和性に優れているため、かかる問題がなく、骨梁が粗となった骨にこれを注入し、脆弱化した骨を強化するとともに引き抜き強度を高めることが可能となる。
【０００４】
【発明が解決しようとする課題】
しかし、骨セメントを併用する充填補強法を採用する場合、骨セメントとしてリン酸カルシウムセメントを用いるとしても、従来のキャニュレイテッドスクリューでは、本来その構造が骨セメントの併用を目的として作製されていないため、骨セメントを別個の手段で注入した後に、あらためてキャニュレイテッドスクリューにより固定を行う二段階の操作が必要であった。
【０００５】
本発明は、上記事情に鑑みてなされたもので、任意に骨セメントを注入することができる上、従来の骨接合螺子が有する固定強度を損なうことなく充分に螺子として機能する骨接合用螺子を提供することを目的とする。
【０００６】
【課題を解決するための手段】
しかして、本発明は、外周面に一端側から螺子部が形成された棒状の螺子本体に、該螺子本体を軸線方向に貫通する中空孔が形成されてなり、螺子部側から骨内に挿入されて骨に螺合させられる骨接合用螺子において、上記螺子本体の周壁（螺子本体の径方向に向く壁部）に、内端が上記中空孔に連通し外端が外部に開放された複数の透孔を、該透孔の数および／または開口面積が螺子本体の上記一端に近付くにつれて大になるように、螺子本体の軸線方向及び周方向に離散して形成したことを特徴とする。
【０００７】
上記において、複数の透孔は、螺子部に形成されていることが好ましく、透孔の各々は、略円形の断面を有していても、スリット状の断面を有していても、略長円形の断面を有していても、さらにはこれら種々の形状を組合わせたものでも構わない。
また、透孔は螺子部の山部と谷部に渡って形成しても構わないし、細孔の場合は螺子部の谷部にのみ形成することもできる。
【０００８】
本発明の骨接合用螺子は、従来のキャニュレイテッドスクリューと同様にして使用することもできるが、重度の骨粗鬆患者の場合など、患者の大腿骨頭の骨質が脆弱化している場合には、従来のキャニュレイテッドスクリューと同様にして大腿骨頭に固定した後に、骨セメント、特にリン酸カルシウムセメントなどのバイオアクティブな骨セメントを、ガイドピンのガイド孔とのなる中空孔に注入する。注入された骨セメントは中空孔から周壁の透孔を通じて、粗鬆化した骨の骨梁間に入り込む。これにより、骨自体が強化されるとともに引き抜き強度も高められる。
また、本発明の骨接合用螺子では、周壁に形成されている透孔に骨セメントもしくは骨組織が侵入することになるため、固定後の螺子の回転も合わせて防止することができる。この回転防止の効果は、螺子を固定する部位に予め骨セメントを注入した場合においても発揮される。
また、骨内の挿入方向である一端側により多くの骨セメントを吐出させることができるので、挿入した螺子の固定がより強固になる。
【０００９】
【発明の実施の形態】
以下、本発明に係る骨接合用螺子の好適な実施の形態を、添付図面を参照して詳細に説明する。
【００１０】
図１は、骨接合用螺子の全体を示す側面図であり、図中１は、螺子本体を示す。螺子本体１は、生体融和性、強度、剛性等を兼ね備えた材料であるチタン合金から形成されており、先端（一端）側に螺子部２を備え、基端（他端）側が非螺子部３とされ、他端には六角レンチあるいはスクリュードライバーの先端等が挿入係合される頭部４が設けられている。
ここで、螺子本体１の長さ、径、螺子部もしくは非螺子部の長さ、螺子山径等は、あらゆる患者に適応できるように種々のものが用意されることとなる。
上記螺子本体１には、該螺子本体１を軸線方向（長軸方向）に貫通する中空孔５が形成されており、該中空孔５に後記するガイドピンが挿入できるようになっている。また、螺子本体１の先端は凹状に切り欠かれて骨への挿入が容易となるようにされている。
【００１１】
上記の構成までは、基本的には従来のキャニュレイテッドスクリューと同様であるが、本発明に係る骨接合用螺子では、図２に拡大して示すように、上記螺子本体１の周壁で螺子部２の谷部２ａには、内端が上記中空孔５に連通し外端が外部に開放された複数の透孔６が、螺子本体１の軸線方向及び周方向に離散した状態で形成されている。そして、ガイドピンの挿通孔ともなる上記中空孔５に骨セメントを注入すると、この複数の透孔６を通じて、骨セメントが周壁から側方に放出させられるようになっている。
【００１２】
ここで、図１及び図２に示す例では、透孔６は、全て同一の径の略円形の断面のものとし、螺子部２の螺旋状の谷部２ａに等間隔に設けている。しかし、透孔６の形状、配置等は、この例に限るものではなく、種々の変形が可能である。
【００１３】
図３は、かかる変形例の一つを示すもので、上記螺子部２の谷部２ａに、同一の離間間隔を開けて、該谷部２ａの延びる方向に長い長円状の透孔６ａを設けている。この長円状の透孔６ａは、螺子本体１の先端に近接する位置では長径がかなり長い長円であるが、螺子本体１の基端に向かうにつれて、長円の長径が徐々に短くなっていっており、螺子部２の終端付近ではほぼ円形とされている。
このような構造では、螺子本体１の先端側になるほど透孔の開口面積が大きくなり、螺子本体１の先端寄りの周壁からより多くの骨セメントが放出されるようになる。
【００１４】
図４は他の変形例を示すもので、この例では、透孔６ｂは螺子部２の谷部２ａのみならず山部２ｂにも渡って形成されており、螺子本体１の周方向及び軸線方向に等間隔に配設されているが、螺子本体１の先端側では螺子本体１の軸線方向に延びるスリット状とされ、基端側になるにつれて短くされた形状とされている。この例でも、螺子本体１の先端側になるほど開口面積が大きくなり、螺子本体１の先端側の周壁からより多くの骨セメントが放出されるようになる。
【００１５】
このような複数の透孔の形状、大きさ、数及び配置は、上記以外にも種々の変形が可能である。特に、螺子部２に限って形成すべきものでもなく、骨中に挿入される部位ならば、螺子本体１の周壁のどこに形成してもよく、従って、非螺子部３に形成しても構わない。また、適応症例に応じて透孔の離散位置を変更して形成することもできる。
【００１６】
しかして、上記構成の骨接合用螺子を用いて骨接合手術を行う場合は、先ず、従来のキャニュレイテッドスクリューと同様にして骨接合用螺子を骨中に挿入する。すなわち、図５に示すように、アングルガイド７で骨接合用螺子を刺入する角度を決め、ガイドピン８を骨幹部外側から骨頭内に挿入する。ついで、図６に示すように、ガイドピンデプスゲージ９を用いて、ガイドピン８の骨内挿入部の長さを測定し、使用する骨接合用螺子の長さを決める。そして、図７に示すように、骨接合用螺子の中空孔５へガイドピン８を挿入することにより、骨接合用螺子の先端が骨幹部に至るまで挿入する。ついで、図８に示すように、六角レンチあるいはスクリュードライバー等により骨接合用螺子を螺入し、骨頭部と骨幹部に生じた骨折部を圧迫固定し、その後ガイドピン８を抜去する。図９は２本の骨接合用螺子の装着が完了した状態を示す。
なお、螺子本体１の頭部４が骨中に埋没する恐れのある場合は、頭部４の前にワッシャ（図示せず）を介在させる。
【００１７】
ついで、骨セメント、特にリン酸カルシウムセメントなどのバイオアクティブな骨セメントを各骨接合用螺子の基端側から中空孔５内に注入する。中空孔５内に注入された骨セメントは複数の透孔６、６ａ、６ｂを通じて粗鬆化した骨中に押し出される。このようにして、骨自体が強化されるとともに、骨接合用螺子の引き抜き強度も高められる。また、骨セメントもしくは骨組織が透孔６、６ａ、６ｂに進入するため、螺子の逆回転（もどり）も確実に防止できる。
【００１８】
上記構成の骨接合用螺子にあっては、中空孔５から周壁の透孔６、６ａ、６ｂを通じて、骨セメントを骨梁が粗となった大腿骨頸内に注入することができるので、骨セメントの注入手技を骨折固定手術と同時にしかも容易に実施することができる。
また、透孔６、６ａ、６ｂは、螺子本体１の軸線方向及び周方向に離散して形成されているので、骨中の必要な部位に骨セメントを満遍なくかつ的確に流し込むことが可能になる。
【００１９】
なお、本発明に係る骨接合用螺子の使用方法は、上記したものに限るものではなく、注入する骨セメントの種類、適用する症例、用途等についても任意である。また、単に従来のキャニュレイテッドスクリューの代替として使用することもできる。
【００２０】
【発明の効果】
本発明に係る骨接合用螺子では、患者の大腿骨頭等に固定した後に、骨セメント、特にリン酸カルシウムセメントなどのバイオアクティブな骨セメントを、中空孔と透孔を通じて骨内に注入することができるので、骨梁自体を強化できる上に引き抜き強度を高めることができる。特に、骨内の挿入方向である一端側により多くの骨セメントを吐出させることができるので、挿入した螺子の固定がより強固になる。
また、透孔を、螺子本体の軸線方向及び周方向に離散して形成しているので、骨中の必要な部位に骨セメントを満遍なくかつ的確に流し込むことができる等の効果を奏する。
【図面の簡単な説明】
【図１】本発明に係る骨接合用螺子の全体を示す一部破断側面図である。
【図２】図１の骨接合用螺子の要部の拡大図である。
【図３】図２と同様の図で、本発明の変形例を示す図である。
【図４】図２と同様の図で、本発明の他の変形例を示す図である。
【図５】本発明に係る骨接合用螺子の使用方法の一過程を示す概略図で、ガイドピンを挿入している状態を示す図である。
【図６】図５と同様の図で、ガイドピンの挿入長さを測定している状態を示す図である。
【図７】図５と同様の図で、骨接合用螺子をガイドピンに挿入している状態を示す図である。
【図８】図５と同様の図で、骨接合用螺子を螺入している状態を示す図である。
【図９】図５と同様の図で、骨接合用螺子を螺入した状態を示す図である。
【符号の説明】
１ 螺子本体
２ 螺子部
３ 非螺子部
５ 中空孔
６，６ａ，６ｂ 透孔[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to an osteosynthesis screw, and more particularly to an osteosynthesis screw suitable for use in performing a bone strengthening method in surgery or the like for a femoral neck fracture with osteoporosis.
[0002]
[Prior art]
2. Description of the Related Art Conventionally, osteosynthesis screws called cannulated screws are often used in surgery for femoral neck fractures associated with osteoporosis.
This is a rod-shaped screw body in which a screw portion is formed from one end side on the outer peripheral surface, and a hollow hole called a guide hole that penetrates the screw body in the axial direction is formed. The guide hole is inserted through the pin, and the screw body is rotated clockwise by a wrench or a screwdriver to insert the screw body, thereby compressing and fixing the fractured portion formed in the bone head and diaphysis.
[0003]
However, when the bone quality of the femoral head is weakened, such as in a case of severe osteoporosis, mechanical fixation with a cannulated screw alone has insufficient fixing strength. For this reason, some reinforcement surgery methods are required, and as one of them, a filling reinforcement method using bioactive bone cement such as calcium phosphate cement has recently been receiving attention.
Conventional bone cements have been difficult to use in terms of heat generation during polymerization, the effect of unpolymerized monomers on the circulatory system, and biocompatibility.However, calcium phosphate cement has no problems with heat buildup and biotoxicity. Since it has excellent osteophilicity, it does not have such a problem, and it can be injected into a bone having a rough trabecular bone to strengthen weakened bone and enhance pull-out strength.
[0004]
[Problems to be solved by the invention]
However, when adopting the filling reinforcement method using bone cement together, even if calcium phosphate cement is used as the bone cement, the conventional cannulated screw is not originally manufactured for the purpose of using the bone cement together with the structure. After the bone cement was injected by a separate means, a two-stage operation of fixing with a cannulated screw was necessary.
[0005]
The present invention has been made in view of the above circumstances, and is capable of injecting bone cement arbitrarily, and a screw for osteosynthesis which functions sufficiently as a screw without impairing the fixing strength of a conventional osteosynthesis screw. The purpose is to provide.
[0006]
[Means for Solving the Problems]
Thus, according to the present invention, a rod-shaped screw body having a screw portion formed on one end side on the outer peripheral surface is formed with a hollow hole passing through the screw body in the axial direction, and inserted into the bone from the screw portion side. In the osteosynthesis screw to be screwed into the bone, a plurality of inner screws are formed on the peripheral wall of the screw main body (a wall portion facing the radial direction of the screw main body), the inner end of which is communicated with the hollow hole, and the outer end is open to the outside. Are formed discretely in the axial direction and circumferential direction of the screw main body such that the number and / or opening area of the through holes increase as approaching the one end of the screw main body.
[0007]
In the above, the plurality of through-holes are preferably formed in the screw portion, and each of the through-holes may have a substantially circular cross section or a slit-like cross section, or may have a substantially long cross section. It may have a circular cross section, or may be a combination of these various shapes.
In addition, the through hole may be formed over the crest and the valley of the screw portion, and in the case of the fine hole, it may be formed only at the valley of the screw portion.
[0008]
The osteosynthesis screw of the present invention can be used in the same manner as a conventional cannulated screw, but when the bone quality of the patient's femoral head is weakened, such as in a case of severe osteoporosis. After fixing to a femoral head in the same manner as a conventional cannulated screw, bone cement, particularly bioactive bone cement such as calcium phosphate cement, is injected into a hollow hole serving as a guide hole of a guide pin. The injected bone cement penetrates between the trabeculae of the roughened bone from the hollow hole through the through hole in the peripheral wall. As a result, the bone itself is strengthened and the pull-out strength is increased.
In addition, in the screw for osteosynthesis of the present invention, since bone cement or bone tissue enters the through holes formed in the peripheral wall, rotation of the screw after fixation can also be prevented. This effect of preventing rotation is exhibited even when bone cement is injected in advance into the portion where the screw is fixed.
In addition, more bone cement can be discharged to one end side in the insertion direction in the bone, so that the inserted screw is more firmly fixed.
[0009]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, preferred embodiments of a screw for osteosynthesis according to the present invention will be described in detail with reference to the accompanying drawings.
[0010]
FIG. 1 is a side view showing the entire osteosynthesis screw, where 1 indicates a screw main body. The screw main body 1 is formed of a titanium alloy, which is a material having biocompatibility, strength, rigidity, and the like. The screw main body 1 includes a screw portion 2 at a distal end (one end) side, and a non-screw portion 3 at a base end (other end) side. The other end is provided with a head 4 into which a hexagon wrench or the tip of a screw driver is inserted and engaged.
Here, various lengths and diameters of the screw main body 1, lengths of the screw portion or non-screw portion, screw thread diameters, and the like are prepared so as to be adaptable to any patient.
The screw main body 1 is formed with a hollow hole 5 penetrating the screw main body 1 in the axial direction (long axis direction), and a guide pin described later can be inserted into the hollow hole 5. Further, the tip of the screw body 1 is cut out in a concave shape so as to facilitate insertion into a bone.
[0011]
Up to the above configuration, it is basically the same as the conventional cannulated screw. However, in the osteosynthesis screw according to the present invention, as shown in an enlarged view in FIG. A plurality of through holes 6 having an inner end communicating with the hollow hole 5 and an outer end open to the outside are formed in the valley portion 2a of the screw portion 2 in a state of being separated in the axial direction and the circumferential direction of the screw main body 1. Have been. Then, when bone cement is injected into the hollow hole 5 which also serves as a guide pin insertion hole, the bone cement is discharged laterally from the peripheral wall through the plurality of through holes 6.
[0012]
Here, in the examples shown in FIGS. 1 and 2, all the through holes 6 have a substantially circular cross section of the same diameter, and are provided at equal intervals in the spiral valley portion 2 a of the screw portion 2. However, the shape, arrangement, and the like of the through holes 6 are not limited to this example, and various modifications are possible.
[0013]
FIG. 3 shows one such modified example. In the valley portion 2a of the screw portion 2, an elliptical through hole 6a that is long in the direction in which the valley portion 2a extends is provided at the same interval. Provided. The oblong through hole 6a is an ellipse having a considerably long diameter at a position close to the distal end of the screw main body 1, but the long diameter of the ellipse gradually decreases toward the base end of the screw main body 1. In the vicinity of the end of the screw portion 2, the shape is substantially circular.
In such a structure, the opening area of the through hole increases toward the distal end of the screw main body 1, and more bone cement is released from the peripheral wall near the distal end of the screw main body 1.
[0014]
FIG. 4 shows another modification. In this example, the through holes 6b are formed not only in the valleys 2a but also in the ridges 2b of the screw portion 2, and the circumferential direction and the axial line of the screw main body 1 are formed. The screw body 1 is arranged at equal intervals in the direction, but has a slit shape extending in the axial direction of the screw body 1 on the distal end side of the screw body 1 and has a shape shortened toward the base end side. Also in this example, the opening area becomes larger toward the distal end side of the screw main body 1, and more bone cement is released from the peripheral wall on the distal end side of the screw main body 1.
[0015]
The shape, size, number, and arrangement of the plurality of through holes can be variously modified in addition to the above. In particular, it should not be formed only on the screw portion 2, but may be formed on any part of the peripheral wall of the screw main body 1 as long as it is a part to be inserted into the bone, and may be formed on the non-screw portion 3. . In addition, the holes can be formed by changing the discrete positions of the through holes according to the indication case.
[0016]
When performing an osteosynthesis operation using the osteosynthesis screw having the above configuration, first, the osteosynthesis screw is inserted into the bone in the same manner as a conventional cannulated screw. That is, as shown in FIG. 5, the angle at which the osteosynthesis screw is inserted by the angle guide 7 is determined, and the guide pin 8 is inserted into the head from outside the diaphysis. Next, as shown in FIG. 6, the length of an intraosseous insertion portion of the guide pin 8 is measured using a guide pin depth gauge 9, and the length of an osteosynthesis screw to be used is determined. Then, as shown in FIG. 7, by inserting the guide pin 8 into the hollow hole 5 of the osteosynthesis screw, the distal end of the osteosynthesis screw is inserted until it reaches the diaphysis. Next, as shown in FIG. 8, a bone screw is screwed in with a hexagon wrench or a screwdriver, and the fractures formed in the bone head and diaphysis are pressed and fixed, and then the guide pins 8 are removed. FIG. 9 shows a state in which the attachment of the two osteosynthesis screws has been completed.
In the case where the head 4 of the screw body 1 may be buried in the bone, a washer (not shown) is interposed in front of the head 4.
[0017]
Next, a bone cement, particularly a bioactive bone cement such as calcium phosphate cement, is injected into the hollow hole 5 from the base end side of each osteosynthesis screw. The bone cement injected into the hollow hole 5 is extruded into the roughened bone through the plurality of through holes 6, 6a, 6b. In this way, the bone itself is strengthened and the pull-out strength of the osteosynthesis screw is increased. In addition, since bone cement or bone tissue enters the through holes 6, 6a, 6b, reverse rotation (return) of the screw can be reliably prevented.
[0018]
In the osteosynthesis screw having the above-described configuration, bone cement can be injected into the femoral neck where the trabecular bone has been roughened from the hollow hole 5 through the through holes 6, 6a and 6b in the peripheral wall. The cement injection procedure can be performed simultaneously and easily with the fracture fixation operation.
Further, since the through holes 6, 6a, 6b are formed discretely in the axial direction and the circumferential direction of the screw main body 1, it becomes possible to flow the bone cement evenly and accurately into a necessary portion in the bone. .
[0019]
In addition, the method of using the osteosynthesis screw according to the present invention is not limited to the above, and the type of bone cement to be injected, the case to be applied, the use, and the like are arbitrary. It can also be used simply as a replacement for a conventional cannulated screw.
[0020]
【The invention's effect】
In the osteosynthesis screw according to the present invention, a bone cement, particularly a bioactive bone cement such as calcium phosphate cement, can be injected into the bone through the hollow hole and the through-hole after being fixed to the femoral head or the like of the patient. In addition, the trabecular bone itself can be strengthened and the pull-out strength can be increased. In particular, since more bone cement can be discharged to one end side in the insertion direction in the bone, the inserted screw is more firmly fixed.
Further, since the through-holes are formed discretely in the axial direction and the circumferential direction of the screw main body, there is an effect that the bone cement can be uniformly and accurately poured into a necessary portion in the bone.
[Brief description of the drawings]
FIG. 1 is a partially broken side view showing the entire osteosynthesis screw according to the present invention.
FIG. 2 is an enlarged view of a main part of the osteosynthesis screw of FIG. 1;
FIG. 3 is a view similar to FIG. 2, showing a modification of the present invention.
FIG. 4 is a view similar to FIG. 2, showing another modification of the present invention.
FIG. 5 is a schematic view showing a process of using the osteosynthesis screw according to the present invention, in which a guide pin is inserted.
FIG. 6 is a view similar to FIG. 5, showing a state in which the insertion length of the guide pin is measured.
FIG. 7 is a view similar to FIG. 5, but showing a state in which a bone screw is inserted into a guide pin.
FIG. 8 is a view similar to FIG. 5, but showing a state in which a bone screw is screwed.
FIG. 9 is a view similar to FIG. 5, but showing a state in which a bone screw is screwed.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Screw main body 2 Screw part 3 Non-screw part 5 Hollow holes 6, 6a, 6b Through holes

Claims (5)

外周面に一端側から螺子部が形成された棒状の螺子本体に、該螺子本体を軸線方向に貫通する中空孔が形成されてなり、螺子部側から骨内に挿入されて骨に螺合させられる骨接合用螺子において、上記螺子本体の周壁には、内端が上記中空孔に連通し外端が外部に開放された複数の透孔が、該透孔の数および／または開口面積が螺子本体の上記一端に近付くにつれて大になるように、螺子本体の軸線方向及び周方向に離散して形成されてなることを特徴とする骨接合用螺子。A rod-shaped screw main body having a screw part formed on one end side on the outer peripheral surface is formed with a hollow hole penetrating the screw main body in the axial direction, inserted into the bone from the screw part side and screwed into the bone. In the screw for osteosynthesis, a plurality of through holes having an inner end communicating with the hollow hole and an outer end open to the outside are formed on the peripheral wall of the screw main body, and the number and / or the opening area of the through holes are different . An osteosynthesis screw, which is formed discretely in the axial direction and the circumferential direction of the screw main body so as to become larger as approaching the one end of the main body. 上記複数の透孔が、前記螺子部に形成されていることを特徴とする請求項１に記載の骨接合用螺子。The osteosynthesis screw according to claim 1, wherein the plurality of through holes are formed in the screw portion. 透孔が略円形の断面を有することを特徴とする請求項１または２に記載の骨接合用螺子。The osteosynthesis screw according to claim 1 or 2, wherein the through-hole has a substantially circular cross section. 透孔がスリット状の断面を有することを特徴とする請求項１または２に記載の骨接合用螺子。The osteosynthesis screw according to claim 1 or 2, wherein the through-hole has a slit-shaped cross section. 透孔が略長円形の断面を有することを特徴とする請求項１または２に記載の骨接合用螺子。The osteosynthesis screw according to claim 1 or 2, wherein the through-hole has a substantially oval cross section.
JP01949297A 1997-01-31 1997-01-31 Bone screw Expired - Lifetime JP3575208B2 (en)

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