JP5777047B2 - bone plate system - Google Patents

bone plate system Download PDF

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JP5777047B2
JP5777047B2 JP2011031454A JP2011031454A JP5777047B2 JP 5777047 B2 JP5777047 B2 JP 5777047B2 JP 2011031454 A JP2011031454 A JP 2011031454A JP 2011031454 A JP2011031454 A JP 2011031454A JP 5777047 B2 JP5777047 B2 JP 5777047B2
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screw
bone plate
tibia
hole
front
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JP2012165976A (en
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宏一 黒田
宏一 黒田
光也 浦田
光也 浦田
水野 均
均 水野
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オリンパステルモバイオマテリアル株式会社
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Description

The present invention relates to a bone plate system.

  Conventionally, as a bone plate for fixing a part of a long bone including a fractured femur or tibia, a band plate shape having a screw hole for fastening to a male screw provided on the heads of a plurality of screws fastened to the long bone (See, for example, Patent Document 1).

Special table 2007-500069 gazette

  However, when using the bone plate of Patent Document 1 for high tibial osteotomy for knee osteoarthritis, the bone plate is fixed to the through-hole formed in the tibia in order to transplant the ligament in the anterior cruciate ligament reconstruction There is a tendency for inconvenience that the screw interferes. When such interference occurs, there is a disadvantage that the implanted ligament is damaged by the screw, or the screw is damaged by the drill when the through hole is formed.

The present invention has been made in view of the above-described circumstances, and avoids interference between a screw for fixing a bone plate and a through-hole formed in a tibia for transplanting a ligament in anterior cruciate ligament reconstruction. and its object is to provide a can be Rukotsu plate system be.

In order to achieve the above object, the present invention provides the following means.
A reference example of the present invention includes a band plate-like main body portion disposed along the tibia on a high side surface of the tibia, and an intersection portion extending in a direction intersecting the longitudinal direction of the main body portion at one end of the main body portion. A plurality of screw holes arranged in the crossing portion and the main body portion so as to penetrate in the thickness direction are provided in the crossing portion and the main body portion, and are arranged in the crossing portion or in the vicinity of the crossing portion of the screw holes. And providing a bone plate in which an anterior screw hole that is closest to the front side of the tibia when the body portion is disposed along the tibia has a larger inner diameter than other screw holes.

According to this reference example , in the high tibial osteotomy, the band plate-like main body part and the crossing part are assigned to the high side surface of the cut tibia, the screw penetrated through the screw hole is fastened to the tibia and the screw hole The bone plate can be fixed to the tibia. In this case, among the plurality of screw holes provided at or near the intersection, the anterior screw hole at a position where the main body is closest to the front side of the tibia when the main body is disposed along the tibia Therefore, even if a thick and short screw is fastened, the same fixing force and bone reinforcement as those of the thin and long screw in the other screw hole can be obtained. As a result, it is possible to prevent interference due to the screw reaching the anterior cruciate ligament reconstruction through-hole formed through the high front surface of the tibia, and prevent damage to the implanted ligament and screw. it can.

In the above reference example , the front screw hole is formed by tapping along the axis of the lower hole and one or more axes inclined in the arrangement direction of the screw holes with respect to the axis. You may have.
By doing so, the front screw hole formed by tapping along one or more axes is made to cut a part of the thread formed before tapping. Thus, female screw threads along a plurality of axes are formed. Therefore, when fixing the bone plate to the surface of the bone, the screw can be fastened along the plurality of axial directions with respect to the screw hole, and the inconvenience that the internal thread is shaved during fastening and chips are generated is prevented. can do.

  As a result, the fixing angle of the screw to the bone plate can be selected from a plurality of angles. Therefore, the screw does not interfere with the through-hole even when the screw fastened to the anterior screw hole is close to the through-hole for reconstruction of the anterior cruciate ligament formed through the high front surface of the tibia due to individual differences. It can be directed in the direction, and interference can be avoided more reliably.

In the above reference example , the female screw may be a taper female screw.
The female screw may be formed on the inner surface of the spherical screw hole.
By doing in this way, even when it makes the axis of a screw incline with respect to the axis of a screw hole, the fastening state of a male screw and a female screw can be achieved over a wide range, and high fixing force can be obtained.

The present invention is provided with a strip-like main body disposed along the tibia on a high side surface of the tibia, and an intersection extending at one end of the main body in a direction intersecting the longitudinal direction of the main body. A bone plate provided with a plurality of screw holes arranged at intervals in the crossing portion or the body portion and penetrating in the plate thickness direction; and a screw for fixing the bone plate to the tibia. Has a male screw fastened to a female screw of a screw hole provided in the bone plate at the head, and the main body portion is disposed on a high side surface of the tibial bone among the plurality of screw holes . Sometimes the front screw hole that is closest to the front side of the tibia has a larger inner diameter than the other screw holes , and the front screw that is fastened to the front screw hole is fastened to the other screw hole. that the screw from rather short, and the other of the screw is greater than the outside Providing a bone plate system with dimensions.
In the above invention, the front screw hole has a female screw formed by tapping along the axis of the lower hole and one or more axes inclined in the arrangement direction of the screw holes with respect to the axis. You may do it.
In the above invention, the female screw may be a tapered female screw.
The female screw may be formed on the inner surface of the spherical screw hole.

  According to the present invention, it is possible to avoid the interference between the screw for fixing the bone plate and the through-hole formed in the tibia for transplanting the ligament in the anterior cruciate ligament reconstruction.

It is a front view which shows the bone plate which concerns on one Embodiment of this invention. It is a bone plate system longitudinal cross-sectional view based on this embodiment which has the bone plate of FIG. It is a longitudinal cross-sectional view in the wide part of the bone plate which shows the bone plate system of FIG. It is a figure which shows the tap process of the internal thread provided in the wide part of the bone plate of FIG. 1, (a) The process direction along the axis line C1 of a pilot hole, (b) The process direction along the axis line C2 inclined in one direction (C) It is a partial longitudinal cross-sectional view which each shows the processing direction in alignment with the axis C3 inclined in the other direction. In the tapping of FIG. 4, (a) tapping along the axis C1 of the pilot hole, (b) thread cut in the tapping along the axis C2, and (c) thread tapping in the tapping direction along the axis C3. It is a partial longitudinal section showing each. It is a figure which shows the state which fastened the external thread part of the screw of the bone plate system of FIG. 3 to the screw hole, (a) Fastening direction along the axis C1, (b) Fastening direction along the axis C2, (c) Axis C3 It is a partial longitudinal cross-sectional view which respectively shows the fastening direction which follows this. FIG. 6 is a partial longitudinal sectional view showing a modification of the bone plate of FIG. 1 and the bone plate system of FIG. 2. It is a modification of the bone plate of FIG. 1, (a) When a front screw hole exists in a wide part, (b) It is a front view which respectively shows the case where a front screw hole exists in a main-body part.

A bone plate 1 and a bone plate system 2 according to an embodiment of the present invention will be described below with reference to the drawings.
As shown in FIG. 2, the bone plate system 2 according to the present embodiment includes a bone plate 1 and a plurality of screws 3 a and 3 b for fixing the bone plate 1 to the high side surface of the tibia A. .

  The bone plate 1 according to the present embodiment is an elongated band plate-like member that is fixed to the side surface of the tibia A after osteotomy in the high-tibial osteotomy of knee osteoarthritis, and ends from the diaphysis of the tibia A In order to be able to follow the curved surface shape of the side surface of the tibia A at the position of transition toward the part, it has a slightly curved shape in accordance with a typical surface shape.

This bone plate 1 is provided with a wide part (intersection part) 1b whose width dimension extends in a direction perpendicular to the longitudinal direction at one end in the longitudinal direction of the elongated main body part 1a, and is formed in a substantially T-shape as a whole. .
The bone plate 1 is provided with a plurality of screw holes 5a, 5b, 5c at intervals in the longitudinal direction. The wide portion 1b is provided with a plurality of, for example, three screw holes 5a and 5b at intervals in a direction intersecting the longitudinal direction.

  Of the screw holes 5a, 5b, 5c spaced apart in the longitudinal direction, the screw holes 5b provided in the wide portion 1b and the five screw holes 5c provided in the main body portion 1a are normal taper screws, It has an inner diameter dimension that gradually decreases from one side to the other side in the plate thickness direction, that is, toward the surface facing the tibia A. The screw holes 5 a, 5 b, 5 c have axes along the thickness direction of the bone plate 1.

  As shown in FIG. 1, these screw holes 5a, 5b, 5c adjacent in the longitudinal direction are slightly parallel to each other in the direction intersecting the longitudinal direction, so that their axes are substantially parallel or twisted. It has become. Thereby, even if the length of the screws 3a and 3b fastened to these screw holes 5a, 5b and 5c is made sufficiently long, they can be fastened without interfering with each other.

  In the bone plate 1 according to the present embodiment, among the three screw holes 5a and 5b arranged in the wide portion 1b, the screw hole arranged on the rightmost side in the drawing (hereinafter also referred to as a front screw hole). ) The inner diameter of 5a is formed larger than the inner diameter of the other screw holes 5b. The bone plate 1 shown in FIG. 1 is attached to, for example, the inner high side surface of the tibia A of the left foot, and the anterior screw hole 5a is the It is arranged on the front side. In addition, in the case of the bone plate 1 attached to the high side surface inside the tibia A of the right foot, the screw hole 5a arranged on the leftmost side only needs to be formed larger than the inner diameter dimension of the other screw hole 5b.

  Then, as shown in FIGS. 4A to 4C, the front screw hole 5a is inclined with respect to the lower hole in the direction along the axis C1 of the lower hole and with respect to the axis C1. It has a female screw 6a formed by tapping with a tap D in the direction along the other two axes C2 and C3. As a result, the female screw 6a in the front screw hole 5a is such that a new female screw 6a is formed across a part of the thread of the previously formed female screw 6a. That is, as shown in FIGS. 4B and 4C, a part of the thread in the region E indicated by hatching is cut off.

Specifically, as shown in FIG. 5 (a), after the tap process is performed along the axis C1 by the tap D, the axis C2, which is inclined as shown in FIGS. 5 (b) and 5 (c). By tapping along C3, a female screw 6a is formed by scraping the thread of the female screw 6a formed in the screw hole 5a at the portion F.
The female screw 6b of the other screw holes 5b and 5c is a taper screw having a single axis.

  In the present embodiment, the tapping axes C2 and C3 are inclined in a plane along the direction perpendicular to the longitudinal direction of the bone plate 1 including the axis C1 of the lower hole of the screw hole 5a. The inclination angles of the tapping axes C2 and C3 vary depending on the pitch of the female screw 6a formed in the front screw hole 5a, but in this embodiment, the threads facing the longitudinal direction of the bone plate 1 are one by one. The tap D is inclined and inserted so that it is shifted and just matches. Thereby, the screw 3a fastened to the front screw hole 5a can be fastened by being inclined in a direction perpendicular to the longitudinal direction of the bone plate 1, as shown in FIGS.

  As shown in FIGS. 2 and 3, the screws 3a and 3b are formed in the shape of an elongated round bar, and are fixed to a bone hole (not shown) formed in the tibia A on the outer peripheral surface thereof. In addition to the screws 4a, the outer peripheral surfaces of the screws 3a and 3b are provided with male screws 4b for fixing the plate made of taper screws fastened to the screw holes 5a, 5b and 5c of the bone plate 1.

  Moreover, in the bone plate system 2 concerning this embodiment, while the screw (front screw) 3a fastened by the front side screw hole 5a has a big external dimension compared with the other screw 3b, from other screw 3b. Has a short length.

The operation of the bone plate 1 and the bone plate system 2 according to the present embodiment configured as described above will be described below.
In order to perform high tibial osteotomy for osteoarthritis of the knee using the bone plate system 2 according to the present embodiment, in a direction inclined from the inner surface of the tibia A toward the outer side with respect to the longitudinal axis of the tibia A A notch is formed and the cut surface is opened using a predetermined tool. Then, as shown in FIG. 2, with the wedge-shaped filling material B inserted between the expanded cut surfaces A1, the bone plate 1 is applied to the inner surface of the tibia A, and the wide portion 1b is sandwiched between the cuts. One screw hole 5c close to, and the other four screw holes 5c are arranged, and a lower hole is formed in the screw hole 5c.

  At this time, for the screw holes 5b and 5c other than the front screw hole 5a, lower holes are formed along the axial direction of the screw holes 5b and 5c. On the other hand, for the front screw hole 5a of the wide portion 1b, a pilot hole is formed in a selected direction in a plane substantially parallel to the end face of the tibia A. Then, the screw holes 5a, 5b, 5c are passed through and the male screws 4a for fixing the bones of the screws 3a, 3b are fastened to the lower holes. Finally, the screws 3a, 3b are inserted into the screw holes 5a, 5b, 5c. The male screw 4b for fixing the plate provided at the head is fastened.

  Thereby, the bone plate 1 is fixed to the tibia A in a state where the bone plate 1 is disposed along the surface of the tibia A. Since the female screw 6a, 6b of each screw hole 5a, 5b, 5c and the male screw 4b for fixing the plate of the screw 3a, 3b are constituted by a taper screw, the fixing force is increased by the progress of the fastening, and the bone plate is more reliably secured. 1 can be fixed to the surface of the tibia A.

  In this case, among the three screw holes 5a and 5b formed in the wide portion 1b, the front screw hole 5a to be disposed at the position closest to the front surface side of the tibia A is connected to the other screw holes 5b. A screw 3a shorter than the screw 3b to be fastened is fastened. Therefore, as shown in FIGS. 2 and 3, even if the through-hole 7 for reconstruction of the anterior cruciate ligament formed from the front surface of the tibia A is close, the tip of the short screw 3 a hardly reaches the through-hole 7. There is an advantage that the transplanted ligament (not shown) inserted and arranged in the through-hole 7 is not damaged by the contact with the screw 3a.

  Furthermore, since the inner diameter dimension of the front screw hole 5a is larger than the inner diameter dimension of the other screw holes 5b and 5c, the front screw hole 5a is thicker than the screw 3b fastened to the other screw holes 5b and 5c. The screw 3a can be fastened. As a result, even if the screw 3a to be fastened to the front screw hole 5a is shortened, the fixing force can be prevented from being significantly reduced as compared with other thin and long screws 3b. Reinforcing with the same strength as that of the screw 3b can be achieved.

  Further, according to the bone plate 1 and the bone plate system 2 according to the present embodiment, the fastening angle of the male screw 4b of the screw 3a to the female screw 6a of the front screw hole 5a provided in the wide portion 1b is as shown in FIG. As shown in (a), in addition to the angle at which the axis of the screw 3a coincides with the axis of the front screw hole 5a, as shown in FIGS. 6 (b) and 6 (c), in the longitudinal direction of the bone plate 1 It is possible to select three fastening methods with an angle shifted in one direction by one screw thread with respect to the fastening position to the portion of the female screw 6 facing in the orthogonal direction.

  In high-tibial osteotomy for knee osteoarthritis, the degree of opening of the cut formed in the tibia A differs depending on the degree of deformation of the tibia A, and the surface shape of the tibia A varies from patient to patient. According to the bone plate 1 and the bone plate system 2 according to the present embodiment, the through-hole 7 for anterior cruciate ligament reconstruction formed through the high front surface of the tibia A is located at the attachment position of the bone plate 1 due to individual differences or the like. Even if the screw 3a is formed at a close position, the screw 3a can be fastened in a direction away from the through hole 7 by appropriately selecting the fastening direction of the screw 3a to the screw hole 5a. Therefore, according to this embodiment, even if the bone plate 1 having a single shape is applied to all patients, there is an advantage that the fixing direction of the screw 3a can be set to an appropriate direction.

  Further, according to the bone plate 1 and the bone plate system 2 according to the present embodiment, even if the fastening direction of the screw 3a to the front screw hole 5a in the wide portion 1b is inclined, tapping is performed in a plurality of different directions in advance. Therefore, it is possible to prevent the female screw 6a from being shaved by fastening, and to prevent the occurrence of inconvenience that metal powder is generated.

  Further, since the female screw portion 6a of the front screw hole 5a of the bone plate 1 and the male screw 4b for fixing the plate of the screw 3a are formed by taper screws, the degree of freedom for fastening the male screw 4b to the female screw portion 6a is high. Even if the screw 3a is inclined with respect to the axis of the front screw hole 5a, there is an advantage that both can be fastened more reliably.

  Moreover, in this embodiment, the wide part 1b was provided in the bone plate 1, and the three screw holes 5a and 5b were provided in the wide part 1b at intervals in the direction crossing the longitudinal direction of the bone plate 1. Therefore, the tension applied to the three screws 3a and 3b fastened to the screw holes 5a and 5b can receive a moment applied to the bone plate 1, and the bone plate 1 can be firmly attached even if the tibia A is twisted. It can be held in a fixed state.

In the present embodiment, the bone plate 1 is formed in a substantially T shape. However, the present invention is not limited to this, and the bone plate 1 is formed in a substantially L shape as shown in FIGS. 8A and 8B. May be.
The bone plate 1 shown in FIGS. 8 (a) and 8 (b) is a bone plate 1 for a patient with a light body weight (small skeleton) and a shorter body length than the bone plate 1 of FIG. is there. Further, as shown in FIG. 8 (b), the screw hole closest to the front side of the main body 1a, not the wide portion 1b, may be the front screw hole 5a, and the inner diameter may be formed larger than the other inner diameters. .

Further, although the three screw holes 5a and 5b are provided in the wide portion 1b, two or more arbitrary numbers of screw holes 5a and 5b may be arranged instead.
In addition, the three screw holes 5a and 5b of the wide portion 1b are arranged at intervals in a direction orthogonal to the longitudinal axis. Instead, in a direction intersecting with the longitudinal direction at an angle of 90 ° or less. You may arrange | position at intervals.

Further, in this embodiment, only the front screw hole 5a has a structure having the female screw portion 6a that can be screwed in three directions having different accuracy, but instead of this, another screw hole 5b is used. , 5c may have the same structure.
Moreover, in this embodiment, although the case where it fastened by shifting the thread of the female thread part 6a which opposes by one thread | yarn was demonstrated, it replaced with this, and it is for two threads by restraining the pitch of a screw sufficiently small. You may decide to shift and fasten.

  Further, in the present embodiment, the female screw portions 6a, 6b of the screw holes 5a, 5b provided in the wide portion 1b and the male screws 4b for fixing the plates of the screws 3a, 3b fastened thereto are configured by taper screws. Alternatively, as shown in FIG. 7, a female screw portion 6a and a male screw 4b having a thread extending toward the substantially central direction of the sphere may be employed on the inner and outer surfaces curved in a substantially spherical shape. Good. By doing in this way, even if the axis of the screw 3a is inclined with respect to the axis of the screw hole 5a, a large contact range between the female screw portion 6a and the male screw 4b for fixing the plate can be secured. There is an advantage that a sufficient fixing force can be obtained.

  In the present embodiment, the tapping axes C2 and C3 are inclined in a plane along a direction perpendicular to the longitudinal direction to allow the screw 3a to be inclined in the plane. However, the tapping axis is inclined. You may decide to comprise the screw hole 5a which enables the inclination of the screw 3a to another direction by changing a direction. Moreover, by doing in this way, selection of the fastening angle of the screw 3a not only in 2 directions but 3 directions or more is attained.

  In the bone plate system 2 according to the present embodiment, the front screw hole 5a has a larger inner diameter than the other screw holes 5b and 5c, but instead, the other screw hole 5b. , 5c may have the same inner diameter. In this case, the fixing force is reduced, but when the fixing force is sufficiently secured, a screw 3a having the same diameter as that of the other screw 3b may be fastened.

A Tibia (bone)
1 Bone plate 1a Body 1b Wide part (intersection)
2 Bone plate system 3a screw (front screw)
3b Screw 4a, 4b Male thread part (Male thread)
5a Front screw hole (screw hole)
5b, 5c Screw hole 6a Female screw

Claims (4)

  1. A strip-like main body portion disposed along the tibia on a high side surface of the tibia, and an intersecting portion extending in a direction intersecting a longitudinal direction of the main body portion at one end of the main body portion; A bone plate provided with a plurality of screw holes penetrating in the thickness direction arranged at intervals in the main body part, and
    A screw for fixing the bone plate to the tibia;
    The screw has a male screw fastened to a female screw of a screw hole provided in the bone plate at the head,
    Among the plurality of screw holes, an anterior screw hole that is closest to the front surface side of the tibia when the main body portion is disposed on the high side surface of the tibia has an inner diameter larger than that of the other screw holes. And
    It said front screw which is fastened to the front side screw holes, rather short than screw fastened to the other of the screw hole and the bone plate system having other of said screw larger outer diameter.
  2. The front screw hole, to claim 1 having the female thread which is configured by applying a tapping along one or more axes that are inclined to the arrangement direction of the screw hole with respect to the axis and said axis of the prepared hole The bone plate system described.
  3. The bone plate system according to claim 1 or 2 , wherein the female screw is a tapered female screw.
  4. The bone plate system according to claim 2 or 3 , wherein the female screw is formed on an inner surface of a spherical screw hole.
JP2011031454A 2011-02-16 2011-02-16 bone plate system Active JP5777047B2 (en)

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JP5777047B2 true JP5777047B2 (en) 2015-09-09

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JP6296466B2 (en) 2014-03-26 2018-03-20 オリンパステルモバイオマテリアル株式会社 Bone plate and bone plate system
JP6446093B2 (en) * 2017-06-07 2018-12-26 オリンパステルモバイオマテリアル株式会社 Kit with bone prosthetic material and bone plate

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JP2002542875A (en) * 1999-05-03 2002-12-17 メダルティス・アクチェンゲゼルシャフト Bone plate that can block
US20020156474A1 (en) * 2001-04-20 2002-10-24 Michael Wack Polyaxial locking plate
WO2005018472A1 (en) * 2003-08-26 2005-03-03 Synthes Gmbh Bone plate
US8574268B2 (en) * 2004-01-26 2013-11-05 DePuy Synthes Product, LLC Highly-versatile variable-angle bone plate system

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