JP5314074B2 - 骨固定装置 - Google Patents
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- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
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- A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
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Description
図1は、折れた肋骨22を固定する例示的骨プレート20を示す。骨プレート20は、骨に受容され、少なくとも部分的に骨の周囲に巻き付く1つまたは複数のクリップ部分24、26を含んでよい。例えば、この図では、クリップ部分は、肋骨の上位側(上方)から受容され、肋骨の上面28とほぼそれに対向する表面30、32(例えば特に前および後、外および内および/または中央および外側の表面)を並置させている。したがって各クリップ部分は、ブリッジ領域38から延在し、それによって接続された1対の概ね対向するアーム34、36を含むことができる(図2参照)。プレート20は、さらに、骨に沿って概ね軸方向に延在し、骨の骨折部42にスパンするスパン部分40も含んでよい(図1参照)。スパン部分は、クリップ部分を接続するよう、クリップ部分の間に延在することができる。
骨プレートはそれぞれ、1つまたは複数のクリップ部分を含んでよい。クリップ部分とは、本明細書では、クリップ部分が骨の概ね対向する表面に隣接して配置されるように、骨に受容されるように構成されたプレートの任意の領域である。したがって、クリップ部分は、概ね周方向で骨の周囲の少なくとも一部(または全体)に延在し、少なくとも部分的に(または全体的に)骨の周囲に巻き付くことができる。クリップ部分は、約1/4から3/4など、骨の周囲の任意の適切な部分に沿って延在してよい。
骨プレートはそれぞれ、1つまたは複数のスパン部分を含んでよい。本明細書では、スパン部分とは、プレートの2つ以上のクリップ部分の間に延在するように構成された骨プレートの任意の領域である。したがって、スパン部分は、骨に沿ってほぼ軸方向に延在し、概ね骨の(骨折部のような)不連続部にスパンすることができる。
骨プレートは、任意の適切な機能を果たす孔を有してよい。例えば、孔は、プレート構成要素を相互および/または折れた骨に取り付けるために締結具を収容するように構成されることができる。択一的または付加的に、プレートの局所的剛性を変化させ、かつ/または癒合を促進するために、骨折部への血流を促進したりする構成である孔を設けることができる。
骨プレートは、任意の適切な数のプレート構成要素を有してよい。例えば、骨プレートは一体であるか、相互および骨に締結具で取り付けるように構成された2つ以上の部片を有することができる。幾つかの実施形態では、骨プレートの第1および第2構成要素は、第3、第4、またはさらに大きい数の同様の構成要素で補足することができ、各構成要素は独自に一体成形されるか、相互の構成要素から別個に形成される。プレートの様々な構成要素は、任意の用途によって適宜、または所望に応じて、単独で使用するか、任意の適切な組合せで使用することができる。様々な構成要素は、同じかまたは異なる形状およびサイズを有するように構成してもよい。
骨プレートは、任意の適切な材料で形成することができる。一般的に、骨プレートは、少なくともプレートがスパンする骨の区間と同じ剛性および強度(通常は何の不連続部もない骨と同じ剛性および強度)とすべきであるが、骨に多大な歪みを生ぜしめないように十分な可撓性、屈曲性および/または弾力性とすべきである。骨プレートの形成に適切な材料は、金属、ポリマ、プラスチック、セラミック、複合材などを含むことができる。このような材料は生物適合性でよい。例示的生物適合性材料は、特に金属/合金(例えばチタンまたはチタン合金、コバルト、クロムおよび/またはモリブデンの合金、ステンレス鋼など)および/または生物再吸収性材料(ポリガラクティック酸(polygalactic acid;PGA)、ポリ乳酸(PLA)、ポリカプロラクトン、ポリジオキサノン、その共重合体など)を含む。
本明細書に記載された骨プレートは、様々な付属品とともに使用するか、キットで供給する、あるいはその両方でよい。これらの付属品は、特に単独またはキットから、準備、設置および/または骨プレートの取り外し(関連する締結具を含む)中などに使用することができる。例示的付属品は、骨キャリパ、型、穴形成器具、ドライバなどを含むことができる。固定すべき骨のサイズを測定するために骨キャリパを使用することができる。サイズの測定は、特に適切な骨プレート/骨構成要素、骨プレート/骨構成要素を屈曲させるために適切な型および/または骨プレート/プレート構成要素を骨に取り付けるために適切な(長さなどによる)締結具などの選択を容易にすることができる。型は、例えば外科医がプレートを設置することによって手術前および/または手術中に骨プレートを成形できるようにする。さらに、型は、折れた肋骨のような特定の折れた骨(または骨の区画)に少なくともほぼ一致するように、骨プレートを成形できるようにする。調節可能なドリル止めがあるドリルのような穴形成器具を使用して、例えば骨の測定サイズに基づいて、所望の深さまで骨に穴を開けることができる。ねじ回しなどのドライバを使用して、締結具を設置かつ/または外すことができる。付属品およびキットのさらなる態様について、以下で説明する。
骨プレートは、固定すべき骨の1つまたは複数の寸法を測定するために、任意選択で骨キャリパのような任意の適切な測定器具とともに使用することができる。例えば、図7は、肋骨112の太さを測定するために使用中の例示的な骨キャリパ110を示す。キャリパ110は、弓形の端部分114を含み、これは肋骨の予め選択した(例えば上の)表面に一致するように構成され、骨の別の(例えば後方の)表面に部分的に巻き付くように構成してもよい。さらに一般的には、キャリパの端部分114(および他の部分)は、肋骨以外の様々な骨の太さを測定するために、同様の機器を使用できるように、任意の所望の骨のサイズおよび/または形状に一致するような構成でよい。キャリパ110は、締付け部材116も含んでよく、これは可動測定スケール118に取り付けることができる。キャリパの端部分114を測定中の骨に隣接して配置したら、部材116が骨に接触するまで、スケール118を移動させる。これで120で示すように、スケールから骨のおおよその太さを読み取ることができる。
骨プレートは、任意選択で任意の適切な型および/または穴形成ツールとともに使用することができる。型は、プレートを平面構成から曲げるか、曲げ構成からプレートの形状を調節する、またはその両方を実行するように構成することができる。一般的に締結具の配置を容易にするために、骨および/または骨プレートに穴を形成するために穴形成ツールを使用することができる。
上述した骨プレート、締結具、付属品などは、単独および/またはキットで、相互にかつ/またはさらに他の付属品との組合せで提供することができる。キットは、特に様々な骨および/または骨の領域に適合するように構築された骨プレートのセットを含むことができる。例えば、キットは、様々なサイズおよび形状の肋骨および/または鎖骨に適合し、さらに肋骨および/または鎖骨の様々な領域に適合するように構成されたプレートを含むことができる。また、キットは、骨の1つまたは複数の寸法を測定し、かつ/または骨プレート(またはその一部)を手術中に曲げて、設置するための機器を含んでよい。例えば、機器は、骨キャリパ、調節可能な曲げ型および/または深さ止めを含むドリルビットを含むことができる。キットは、ケースまたはオーガナイザ、指示書、様々な長さおよび/または直径の骨ねじなどの装着用ハードウェア、装着用ハードウェアを設置かつ/または除去するねじ回しなどのドライバおよび/または骨プレートに関連する他の付属品も含んでよい。
本教示の骨プレートは、任意の適切な方法で骨に設置することができる。本セクションでは、骨プレートで骨を固定するのに適切な例示的方法のステップについて説明する。以上および本教示の他の箇所で説明するステップは、任意の適切な順序、任意の適切な組合せ、および任意の適切な回数で実行することができる。
以下の実施例は、例示的な骨プレート、およびプレート構成要素から骨プレートを組み立てる例示的な構成など、本教示の選択された態様および実施形態について説明する。これらの実施例およびその様々な形状および態様は、例示のために含まれ、本教示の全範囲を画定または制限するものではない。
複数の孔スパン部分がある骨プレート
この実施例は、複数の孔があるスパン部分を有する例示的な骨プレートについて説明する。孔は、クリップ構成要素を、スパン部分に沿った2つ以上の位置でスパン部分に組み付け、それに取り付けることができるように配置構成されることができる。
プレート構成要素の列がある骨プレート
この実施例は、プレート構成要素の列として組み立てることができる骨プレートについて説明する。
[一体構造の骨プレート]
この実施例は、一体構造を有する例示的な骨プレートについて説明する。
[選択された実施形態]
このセクションでは、見出しをつけた一連のパラグラフとして提示した本教示の選択された実施形態について説明する。
22 骨
24 クリップ部分
26 クリップ部分
28 上面
30 表面
32 表面
34 アーム
36 アーム
38 ブリッジ領域
40 スパン部分
42 骨折部
44 骨ねじ
46 孔
48 骨部片
50 骨部片
52 プレート構成要素
54 骨構成要素
56 重なった構成
58 外面
60 内面
62 遠位端領域
64 孔対
66 孔対
68 孔対
70 孔対
72 骨ねじ
74 隆起部
76 隆起部
78 ねじ区画
80 ねじ山
82 ロック孔
84 隆起部
86 領域
88 領域
90 内面
92 外面
94 壁
96 壁
110 骨キャリパ
112 肋骨
114 端部分
116 締付け部材
118 スケール
130 曲げ型
132 骨プレート
134、136 圧縮部材
140 ドリル
142 ドリルビット
144 骨
146 孔
148 軸
150 穿孔チップ
152 深さ止め
154 アレンボルト
156 スケール
160 ねじ
162 ロック用孔
164 表面
166 遠位端
180 型アセンブリ
182 プレート部材
184 クリップ部分
186 金床
188 受け器
190 キャビティ
210 骨プレート
212 スパン構成要素
214 スパン部分
216 第1クリップ部分
218 クリップ構成要素
220 クリップ構成要素
222 スパン孔
224 クリップ孔
226 クリップ孔
240 骨プレート
242 スパン構成要素
244 スパン構成要素
246 孔
260 骨プレート
262 スパン部分
264 クリップ部分
266 クリップ部分
Claims (9)
- 骨を固定するための骨固定装置であって、
それぞれが一組のアームを有している第1のクリップ部分及び第2のクリップ部分であって、前記一組のアームが、クリップ部分が前記一組のアームの間において前記骨を受容するように構成されており、前記クリップ部分のうち少なくとも1つのクリップ部分が、近位孔及び遠位孔を含んでいる、前記第1のクリップ部分及び前記第2のクリップ部分と、
前記第1のクリップ部分及び前記第2のクリップ部分それぞれの前記一組のアームのうち一方のアームのみの大部分又は全体を通じて、前記第1のクリップ部分及び前記第2のクリップ部分に接続されているスパン部分であって、前記骨の不連続部をスパンするために、前記クリップ部分同士の間において前記骨に沿って延在するように構成されている前記スパン部分と、
ネジ部を含んでいる締結具であって、前記ネジ部を介して前記遠位孔を係合及び固定するために、前記近位孔から前記遠位孔に至るまで延在している前記締結具と、
を備えている前記骨固定装置において、
前記遠位孔が、長穴であり、
前記遠位孔の周囲には、前記遠位孔に沿って延在している直線状部分であって、前記締結具を前記クリップ部分にロックするために前記締結具の前記ネジ部に係合するように構成されている前記直線状部分を含んでいる、隆起部が形成されていることを特徴とする骨固定装置。 - 前記クリップ部分それぞれが、前記骨の略対向する両表面に隣接して配置されるように構成されており、
前記スパン部分が、前記略対向する両表面のうち一方の表面のみに沿って延在するように構成されていることを特徴とする請求項1に記載の骨固定装置。 - 前記スパン部分及び前記第2のクリップ部分が、前記第1のクリップ部分と一体になっていることを特徴とする請求項1又は2に記載の骨固定装置。
- 骨を固定するための骨固定装置であって、
クリップ部分それぞれが前記骨の略対向する両表面に隣接して配置されるように前記骨を受容するように構成されている略U字状の少なくとも2つの前記クリップ部分であって、少なくとも1つの前記クリップ部分が、近位孔及び遠位孔を含んでいる、前記クリップ部分と、
少なくとも2つの前記クリップ部分を接続すると共に、前記クリップ部分が前記骨を受容する場合に前記骨の不連続部をスパンするように構成されている非U字状のスパン部分と、
ネジ部を含んでいる締結具であって、前記ネジ部を介して前記遠位孔を係合及びロックするために、前記近位孔から前記遠位孔に至るまで延在している前記締結具と、
を備えていることを特徴とする骨固定装置。 - 前記遠位孔が、雌ネジ部を含んでいることを特徴とする請求項4に記載の骨固定装置。
- 前記遠位孔が、長穴であり、
前記遠位孔の周囲には、前記遠位孔に沿って延在している直線状部分であって、前記締結具を前記クリップ部分にロックするために前記締結具の前記ネジ部に係合するように構成されている前記直線状部分を含んでいる、隆起部が形成されていることを特徴とする請求項4に記載の骨固定装置。 - 骨を固定するための骨固定装置であって、
それぞれが一組のアームを有している第1のクリップ部分及び第2のクリップ部分であって、前記一組のアームが、クリップ部分が前記一組のアームの間において前記骨を受容するように構成されており、前記クリップ部分のうち少なくとも1つのクリップ部分が、近位孔及び遠位孔を含んでいる、前記第1のクリップ部分及び前記第2のクリップ部分と、
前記第1のクリップ部分及び前記第2のクリップ部分それぞれの前記一組のアームのうち一方のアームのみの大部分又は全体を通じて、前記第1のクリップ部分及び前記第2のクリップ部分に接続されているスパン部分であって、前記骨の不連続部をスパンするために、前記クリップ部分同士の間において前記骨に沿って延在するように構成されている前記スパン部分と、
ネジ部を含んでいる締結具であって、前記ネジ部を介して前記遠位孔を係合及び固定するために、前記近位孔から前記遠位孔に至るまで延在している前記締結具と、
を備えている前記骨固定装置において、
前記遠位孔が、雌ネジ部を含んでいることを特徴とする骨固定装置。 - 前記クリップ部分それぞれが、前記骨の略対向する両表面に隣接して配置されるように構成されており、
前記スパン部分が、前記略対向する両表面のうち一方の表面のみに沿って延在するように構成されていることを特徴とする請求項7に記載の骨固定装置。 - 前記スパン部分及び前記第2のクリップ部分が、前記第1のクリップ部分と一体になっていることを特徴とする請求項7又は8に記載の骨固定装置。
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2004
- 2004-08-27 US US10/927,824 patent/US7635365B2/en active Active
- 2004-08-30 GB GB0606114A patent/GB2423935B/en active Active
- 2004-08-30 JP JP2006524950A patent/JP4808621B2/ja active Active
- 2004-08-30 WO PCT/US2004/028253 patent/WO2005020800A2/en active Application Filing
- 2004-08-30 EP EP04782685A patent/EP1667590B1/en not_active Not-in-force
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Cited By (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US9808297B2 (en) | 2008-10-10 | 2017-11-07 | Acute Innovations Llc | Bone fixation system with opposed mounting portions |
US11083504B2 (en) | 2008-10-10 | 2021-08-10 | Acumed Llc | Bone fixation system with opposed mounting portions |
US11911083B2 (en) | 2008-10-10 | 2024-02-27 | Acumed Llc | Bone fixation system with opposed mounting portions |
US9775657B2 (en) | 2011-09-30 | 2017-10-03 | Acute Innovations Llc | Bone fixation system with opposed mounting portions |
Also Published As
Publication number | Publication date |
---|---|
US20140128923A1 (en) | 2014-05-08 |
GB2423935A (en) | 2006-09-13 |
EP1667590B1 (en) | 2012-11-28 |
EP1667590A2 (en) | 2006-06-14 |
US7635365B2 (en) | 2009-12-22 |
EP1667590A4 (en) | 2008-11-26 |
US8632573B2 (en) | 2014-01-21 |
WO2005020800A3 (en) | 2006-03-23 |
JP2007503885A (ja) | 2007-03-01 |
WO2005020800A2 (en) | 2005-03-10 |
GB2423935B (en) | 2007-10-31 |
US20100331844A1 (en) | 2010-12-30 |
US7695501B2 (en) | 2010-04-13 |
US20050085819A1 (en) | 2005-04-21 |
JP2011156386A (ja) | 2011-08-18 |
US20070123883A1 (en) | 2007-05-31 |
JP4808621B2 (ja) | 2011-11-02 |
GB0606114D0 (en) | 2006-05-03 |
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