KR100848950B1 - 뼈 고정 장치 - Google Patents
뼈 고정 장치 Download PDFInfo
- Publication number
- KR100848950B1 KR100848950B1 KR1020047020368A KR20047020368A KR100848950B1 KR 100848950 B1 KR100848950 B1 KR 100848950B1 KR 1020047020368 A KR1020047020368 A KR 1020047020368A KR 20047020368 A KR20047020368 A KR 20047020368A KR 100848950 B1 KR100848950 B1 KR 100848950B1
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- KR
- South Korea
- Prior art keywords
- hollow cylinder
- bone fixation
- fixation device
- perforations
- bone
- Prior art date
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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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
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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
- A61B17/84—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
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- A—HUMAN NECESSITIES
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- 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
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- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0018—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in elasticity, stiffness or compressibility
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0023—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in porosity
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0026—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in surface structures
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0036—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in thickness
Abstract
뼈 고정 장치(1)는, 그 외피(4)에 n 개의 천공부(3)를 갖는 중공 실린더(2)와, 뼈 내부로 안내하기에 적합하게 개방된 전방 단부(5)와, 후방 단부(6)와, 실린더 종축(7)으로 구성된다. 중공 실린더(2)의 강도는 그 종축(7)에 거쳐 후방 단부(6)로부터 전방 단부(5) 쪽으로 감소된다. 뼈 고정 장치(1)는 그 구조 덕분으로 적응 강도에 따른 요구를 충족시킴으로써 뼈에 대한, 특히 골다공증 뼈에 대한 고착이 장기적으로 보장되며, 동시에 생물학적 제한 조건에도 적합하다.
뼈 고정 장치, 천공부, 중공 실린더, 전방 단부, 후방 단부, 종축.
Description
본 발명은 청구범위 제1항의 전제부에 따른 뼈 고정 장치에 관한 것이다.
종래의 이식물들에서는 이식물을 둘러싸는 조직, 특히 뼈의 이물질에 대한 반응이 충분히 고려되지 않았다. 이러한 경우에 특히 국부적인 미소순환(microcirculation) 또는 관류(perfusion)가 손상되고, 국부적인 생물 역학이 변경된다.
특히, 티타늄 또는 강으로 된 비교적 강성인 이식물의 영향은 지금까지의 이식물에서는 충분히 고려되지 않았다. 피로 파괴(fatigue fracture)를 방지하기 위하여, 이식물은 가능한 한 강성으로 견고하게 설계된다. 사용된 이식물은 골절 치료 중에 그리고 이식물이 신체 내에 존재하는 전체 시간 동안에 적어도 부분적으로 뼈의 부하 전달을 대신하기 때문에, 해당 부위에는 상대적으로 뼈 구조의 성김 현상이 발생한다(볼프 법칙; Wolff's law). 이러한 뼈 변형은 이식물의 헐거워짐을 야기한다.
(예를 들어 독일 특허 제DE-C 19628473호 및 독일 특허 제DE-U 297 10 979호에 따른) 특히 골다공증 뼈의 골절 치료를 위해 제공되는 중공 실린더는 상기 현상을 야기할 수 있다. 여기서, 상기 이식물에 의해 이식 실패가 적어질 수 있기 때 문에, 이식물의 상기 범주는 골다공증 문제에 있어서 흥미롭다. 뼈는 중공 실린더 중 하나의 내부에 보유되야 하고 뼈는 천공(perforation)을 통해 생장해야 한다. 상기 두 경우 모두 이론적으로 이식물이 골다공증 뼈 내에서 개선된 고착을 제공해야 한다.
본 발명은 이러한 문제점을 해결할 것이다. 본 발명의 목적은 상기 단점들을 방지하는 뼈 고정 수단을 제공하는 것이다.
미소순환 및 관류 손상은 이식물의 삽입 중에 혈액 공급 혈관의 파손에 그 원인이 있다. 중공 실린더 내부 또는 외부에서 혈액 공급의 회복은 매우 짧은 시간 동안 가능하다는 것이 자체 진단에서 증명되었다. 중공 실린더 내의 혈액 공급을 위해 실린더 외피의 천공, 및 임파액 관류를 형성하는 주기적인 압력이 중요하다. 관류의 크기는 이식물의 강도에 따른다. 회복 단계에서 뼈의 하중을 통한 주기적인 압력은 인접한 뼈 부분의 재생을 유도한다. 즉, 이식물의 골질 동화는 이식물의 기계적 특성, 결정적으로 특히 그 강도에 따른다.
본 발명의 목적은, 그 구조 덕분으로 적응 강도에 따른 요구를 충족시킴으로써 뼈에 대한, 특히 골다공증 뼈에 대한 고착이 장기적으로 보장되며, 동시에 생물학적 제한 조건에도 적합한 뼈 고정 수단을 제공하는 것이다. 이는 보유되는 골질 구조의 획득을 보장하고 새로운 뼈의 고착 및 성장을 촉진한다.
본 발명의 이러한 목적은 청구항 제1항의 특징을 갖는 뼈 고정 수단에 의해 해결된다.
본 발명에 의해 달성되는 장점은, 실질적으로, 본 발명에 따른 뼈 고정 수단을 통해, 중공 실린더의 강도가 중공 실린더를 둘러싸는 뼈의 강도에 접근할 수 있고, 특히 척추 내에 존재하는, 피질(약 10'000 내지 20'000MPa의 E-모듈)과 뼈 해면 조직(약 100 내지 5'000MPa의 E-모듈) 사이의 차이에 접근할 수 있는 강도를 제공하는 것이다. 또한, 뼈 고정 수단에 부하가 걸릴 경우, 뼈 고정 수단의 오프셋 및 압력이 척추 주변보다 척추 내에서 더 강하게 행해져야 한다.
이식물의 종축에 대한 이러한 강도 변화는 이하 두가지 조치로 해결될 수 있다.
1. 피질과 골 해면 조직 사이의 전이 영역 내의 벽 두께 감소, 및
2. 중공 실린더의 개방 단부 방향으로 증가되는 다공 구배를 통해 달성된다.
강도 측정값으로서의 축방향 및 양극의 단면 2차 모멘트(Ix 및 Ip)는 평균 반경(Rm)을 갖는 박막벽 원형 프로파일에서 이하와 같이 벽 두께(t)와 다공(P, 다공면/전체 표면)을 따른다.
동일한 크기의 원형 다공을 최대 가능 밀도로 배치할 경우 최대 가능한 다공은 약 90%이다. 그러나, 이는 벽의 구조적 동화를 보장하기 위해 85%를 초과하지 않아야 한다.
매개 변수적으로 한정된 인자 분석을 통해 원형 단면의 강도가 지수적으로 벽 두께에 따른다는 것이 결정될 수 있다.
W단면 ~ t2.7343은 t/Rm = {0.4...0.08}에 적용된다.
즉, 벽 두께의 50% 감소는 단면 2차 모멘트를 절반으로 되게 하고 원형 단면의 강도를 약 15% 감소시킨다.
특별 실시예에서, 뼈 고정 장치의 강도는 후방 단부로부터 전방 단부 쪽으로 연속적으로 감소된다. 바람직하게는 중공 실린더의 강도에서, 중공 실린더의 전방 1/3 내의 강도가 중공 실린더의 후방 1/3 내의 강도보다 더 크다.
특별 실시예에서, 뼈 고정 장치의 후방 단부에는 힘 지지부, 바람직하게는 골판(bone plate)에 형태 맞춤 또는 억지 끼워 맞춤되기에 적합한 수단이 마련된다.
특별 실시예에서, -전체 외피면(M)에 대한 n 개의 천공면의 합(S) 사이의 비율(S/M)에 있어서- 다공은 후방 단부로부터 전방 단부 쪽으로 증가한다. 다공은 중공 실린더의 전방 1/3 내에서 중공 실린더의 후방 1/3 내에서 보다 적어도 20% 더 크다.
다른 실시예에서, 중공 실린더의 벽 두께는 후방 단부로부터 전방 단부 쪽으로 바람직하게는 연속적으로 감소한다. 바람직하게는, 중공 실린더의 벽 두께는 중공 실린더의 전방 1/3 내의 두께가 중공 실린더의 후방 1/3 내의 두께 보다 적어도 20% 더 작다.
특별 실시예에서, 중공 실린더의 외피면 내의 n 개의 천공부는 적어도 0.5mm 의 최소 직경을 가진다.
바람직하게는, 외측 나사산은 적어도 부분적으로 중공 실린더의 외피면 상에 마련된다.
천공부의 형태는 원형, 타원형, 각형 바람직하게는 삼각형 또는 사각형일 수 있다.
특별 실시예에서, 실린더 길이의 1/10 마다 천공부의 수는 전방 단부 쪽으로 증가하나, 개별 천공부의 면은 일정하게 유지된다. 다른 실시예에서, 실린더 길이의 1/10 마다 천공부의 수는 전방 단부 쪽으로 일정하게 유지되나, 개별 천공부의 면은 전방 단부 쪽으로 증가된다.
이하, 본 발명 및 본 발명의 구성이 여러 실시예의 부분 개략도를 참조로 상세히 설명된다.
도1은 중공 실린더 벽을 관통하는 복수의 단면을 갖는 천공부의 확대에 의해 증가되는 다공을 갖는 중공 실린더 벽의 부분도이다.
도2는 타원형 천공부를 갖는 중공 실린더 벽의 다공 변경을 위한 변형예이다.
도3은 정사각형 천공부를 갖는 중공 실린더 벽의 다공 변경을 위한 변형예이다.
도4는 삼각형 천공부를 갖는 중공 실린더 벽의 다공 변경을 위한 변형예이다.
도5는 부분적으로 절결된 뼈 고정 장치의 사시도이다.
이하 본 발명의 양호한 이해를 위해, 바람직한 실시예는 도면을 참조로 설명된다.
도5에 도시된 뼈 고정 장치(1)는, 실제로 그 외피면(4)에 복수의 천공부(3)를 갖는 중공 실린더(2)와, 뼈 내부로 안내하기에 적합하게 개방된 전방 단부(5)와, 후방 단부(6)와, 실린더 종축(7)으로 구성된다. 도1에 도시된 중공 실린더 벽의 절결 부분은 천공부(3)가 후방으로부터 전방으로 연속적으로 확대되어, 중공 실린더의 강도가 그 종축에 거쳐 후방 단부로부터 전방 단부쪽으로 상응하게 감소되는 것을 나타낸다. 외피면(4)은 후방 단부(6)에 외측 나사산(8)을 갖는다. 뼈 고정 장치의 후방 종단부는 도면에 도시되지 않은 골판 내로 삽입 가능한 원추형 헤드(9)를 형성한다.
도2 내지 도4에는 다공의 변형을 위해 변경된 구멍 기하학을 갖는 변형예가 도시된다. 원형 천공부 대신 타원형, 사각형 또는 삼각형의 천공부가 사용되며, 이들도 마찬가자로 후방으로부터 전방으로 규칙적으로 확대된다. 이러한 구멍 기하학의 목적은 뼈 고정 장치의 강도가 후방으로부터 전방으로 감소되도록 하는 것이다. 이는, 후방으로부터 전방으로 더 조밀하거나 또는 더 밀착되는 일정한 크기의 구멍들이 사용됨으로써 달성될 수 있다.
Claims (14)
- 중공 실린더의 외피(4)에 복수 개의 천공부(3)와, 개방된 전방 단부(5)와, 후방 단부(6)와, 실린더 종축(7)을 갖는 중공 실린더(2) 형태의 뼈 고정 장치(1)에 있어서,중공 실린더(2)의 강도는 그 종축(7)에 거쳐 후방 단부(6)로부터 전방 단부(5) 쪽으로 감소되는 것을 특징으로 하는 뼈 고정 장치(1).
- 제1항에 있어서, 상기 강도는 연속적으로 감소하는 것을 특징으로 하는 뼈 고정 장치(1).
- 제1항에 있어서, 중공 실린더(2)의 강도에서, 중공 실린더(2)의 전방 1/3 내의 강도가 중공 실린더(2)의 후방 1/3 내의 강도보다 20% 이상 더 큰 것을 특징으로 하는 뼈 고정 장치(1).
- 제1항에 있어서, 후방 단부(6)에는 힘 지지부가 마련되는 것을 특징으로 하는 뼈 고정 장치(1).
- 제1항 내지 제4항 중 어느 한 항에 있어서, 전체 외피면(4)(M)에 대한 복수 개의 천공면의 합(S) 사이의 비율(S/M)에 있어서 다공률은 후방 단부(6)로부터 전방 단부(5) 쪽으로 증가하는 것을 특징으로 하는 뼈 고정 장치(1).
- 제5항에 있어서, 다공률은 중공 실린더(2)의 전방 1/3 내에서 중공 실린더(2)의 후방 1/3 내 보다 20% 이상 더 큰 것을 특징으로 하는 뼈 고정 장치(1).
- 제1항에 있어서, 중공 실린더(2)의 벽 두께는 후방 단부(6)로부터 전방 단부(5) 쪽으로 감소하는 것을 특징으로 하는 뼈 고정 장치(1).
- 제7항에 있어서, 중공 실린더(2)의 벽 두께에서, 중공 실린더(2)의 전방 1/3 내의 두께가 중공 실린더(2)의 후방 1/3 내의 두께 보다 20% 이상 더 작은 것을 특징으로 하는 뼈 고정 장치(1).
- 제1항에 있어서, 중공 실린더(2)의 외피면(4) 내의 복수 개의 천공부(3)는 0.5mm의 최소 직경을 갖는 것을 특징으로 하는 뼈 고정 장치(1).
- 제1항에 있어서, 외측 나사산(8)은 부분적으로 또는 전체적으로 중공 실린더(2)의 외피면(4) 상에 마련되는 것을 특징으로 하는 뼈 고정 장치(1).
- 제1항에 있어서, 천공부(3)의 형태는 원형 또는 타원형인 것을 특징으로 하는 뼈 고정 장치(1).
- 제1항에 있어서, 천공부(3)의 형태는 각형인 것을 특징으로 하는 뼈 고정 장치(1).
- 제1항에 있어서, 천공부(3)의 수는 실린더 길이의 1/10 마다 전방 단부(5) 쪽으로 증가하나, 개별 천공부(3)의 면은 일정하게 유지되는 것을 특징으로 하는 뼈 고정 장치(1).
- 제1항에 있어서, 천공부(3)의 수는 실린더 길이의 1/10 마다 전방 단부(5) 쪽으로 일정하게 유지되나, 개별 천공부(3)의 면은 전방 단부(5) 쪽으로 증가되는 것을 특징으로 하는 뼈 고정 장치(1).
Applications Claiming Priority (1)
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PCT/CH2002/000347 WO2004002344A1 (de) | 2002-06-26 | 2002-06-26 | Knochenfixationselement |
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KR20050023306A KR20050023306A (ko) | 2005-03-09 |
KR100848950B1 true KR100848950B1 (ko) | 2008-07-29 |
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US (1) | US20050165482A1 (ko) |
EP (1) | EP1515657B1 (ko) |
JP (1) | JP4357419B2 (ko) |
KR (1) | KR100848950B1 (ko) |
CN (1) | CN1306913C (ko) |
AT (1) | ATE389359T1 (ko) |
AU (1) | AU2002312707B2 (ko) |
BR (1) | BR0215789B1 (ko) |
CA (1) | CA2491123C (ko) |
DE (1) | DE50211934D1 (ko) |
ES (1) | ES2301647T3 (ko) |
MX (1) | MXPA04012962A (ko) |
NZ (1) | NZ537230A (ko) |
WO (1) | WO2004002344A1 (ko) |
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- 2002-06-26 AU AU2002312707A patent/AU2002312707B2/en not_active Ceased
- 2002-06-26 WO PCT/CH2002/000347 patent/WO2004002344A1/de active IP Right Grant
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- 2002-06-26 BR BRPI0215789-6A patent/BR0215789B1/pt not_active IP Right Cessation
- 2002-06-26 CN CNB028292162A patent/CN1306913C/zh not_active Expired - Fee Related
- 2002-06-26 KR KR1020047020368A patent/KR100848950B1/ko not_active IP Right Cessation
- 2002-06-26 JP JP2004516393A patent/JP4357419B2/ja not_active Expired - Fee Related
- 2002-06-26 MX MXPA04012962A patent/MXPA04012962A/es not_active Application Discontinuation
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- 2002-06-26 NZ NZ537230A patent/NZ537230A/en not_active IP Right Cessation
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Also Published As
Publication number | Publication date |
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JP2005537042A (ja) | 2005-12-08 |
WO2004002344A1 (de) | 2004-01-08 |
ES2301647T3 (es) | 2008-07-01 |
MXPA04012962A (es) | 2005-05-16 |
CA2491123C (en) | 2010-06-01 |
CN1630491A (zh) | 2005-06-22 |
JP4357419B2 (ja) | 2009-11-04 |
BR0215789B1 (pt) | 2012-08-21 |
EP1515657B1 (de) | 2008-03-19 |
ATE389359T1 (de) | 2008-04-15 |
EP1515657A1 (de) | 2005-03-23 |
BR0215789A (pt) | 2005-03-01 |
AU2002312707A1 (en) | 2004-01-19 |
CN1306913C (zh) | 2007-03-28 |
KR20050023306A (ko) | 2005-03-09 |
US20050165482A1 (en) | 2005-07-28 |
AU2002312707B2 (en) | 2005-12-01 |
DE50211934D1 (de) | 2008-04-30 |
CA2491123A1 (en) | 2004-01-08 |
NZ537230A (en) | 2005-11-25 |
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