KR20040053174A - Orthopedic stabilization device and method - Google Patents

Abstract

Orthopedic stabilizing structures include a threaded fastener capable of articulation containing a variety of skeletal shapes, rods and cups that hold the threaded fasteners and the rods held together in a fixed position relative to the skeletal structure.

Description

Orthopedic stabilization device and method {ORTHOPEDIC STABILIZATION DEVICE AND METHOD}

Currently, orthopedic procedures involving the stabilization of skeletal structures may not first provide the ability to orient the stabilizing structure against a number of common angulations, and secondly to provide a reliable thread that joins the patient's bones. It has a common drawback.

The present invention relates generally to devices used in orthopedic surgery to stabilize and align skeletal structures. In particular, the present invention includes a fastener rotatable about an axis in a support cup, a cup formed therein to receive a rod and means for rotationally oriented in a fixed position and securing the rod. Moreover, the present invention includes fasteners that use radial or axial forces to lock them in place without the use of rotatable fasteners or rods.

1 is a front view of a fastener.

2 is a side view of the fastener.

3 is a cross-sectional view of the fastener shape.

Figure 3a is a view of Figure 3 with a taper.

4 shows a fastener and stabilizing structure.

5 is another view of FIG.

6 illustrates a corner of the FIG. 4 structure.

7 is a detailed view of the bolt used in the structure.

8 is a detailed view of the bolt receiving area.

9 is a side view of the cup.

FIG. 10 is an adjacent side view (90 degrees) of FIG. 9 showing radial slots; FIG.

11 is a front view of FIGS. 9 and 10.

12 is a bottom view of FIGS. 9 to 11;

Fig. 13 is a cross sectional view of Fig. 9 along lines 13-13.

14 is a cross-sectional view similar to FIG.

FIG. 15 is a view in which fasteners and rods are added to FIG.

FIG. 16 is a view showing a fixed bolt in FIG.

17 is a diagram illustrating an apparatus employed as an example.

18 shows another screw pattern.

19A and 19B show the bolt of the initial view modified to include the stem.

Figure 20 is a perspective view of the clamp used with the stem of Figure 19;

Figure 21 shows a clamp mounted on the stem.

Figure 22 shows two clamps on the stem from one side.

Figure 23 shows two clamps on the stem from the other side.

24 is an exploded view of FIGS. 18 to 23. FIG.

FIG. 25 is a view showing the edged portions of FIGS. 22 and 23. FIG.

FIG. 26 is a view showing a fastener different from that shown in FIG.

27 is a perspective view of FIG.

FIG. 28 is a side cross-sectional view of a cup for use with FIGS. 26 and 27. FIG.

Figure 29 is a side sectional view of another embodiment of Figure 28;

30 shows the fastener of FIG. 26 deployed in the cup of FIG. 28 with a stationary rod.

FIG. 31 is a second view of FIG. 30;

32 is a side view of FIG.

33 is an exploded view of FIG. 30 with threaded bolts.

Fig. 34 is a view showing Fig. 33 from one side.

FIG. 35 shows a cornered portion of FIG. 34; FIG.

36 shows one fastener with a drive head.

36A is a top view of another fastener drive.

36B is a top view of the third fastener drive.

37 is a view of an elongated fastener with a non-threaded intermediate shaft portion.

FIG. 38 is an example of an exploded view of the fastener of FIG.

FIG. 39 is a view of another embodiment different from FIG. 36. FIG.

40 is a view of an embodiment different from that of FIG.

FIG. 41 is a view showing an example of the fasteners of FIG. 39 and FIG.

42A and 42B are side views of another embodiment of a fastener having a hollow top.

FIG. 43A is a side view of the rod holder mating with the fastener of FIG. 42; FIG.

FIG. 43B is an end view of the rod holder that mates with the fastener of FIG. 42. FIG.

FIG. 44 is a view of the fastener of FIG. 42 mating with the holder of FIG.

45A and 45B are side views of another embodiment of a fastener having a hollow top.

FIG. 46A is a side view of the rod holder mating with the fastener of FIG. 45; FIG.

46B is an end view of the rod holder that mates with the fastener of FIG.

FIG. 47 shows the fastener of FIG. 45 mating with the holder of FIG. 46;

Figure 48 illustrates an embodiment of a fastener having an extended hexagonal top that is mated with a corresponding holder.

Figure 49A is a cross sectional view of the assembly of Figure 48 attached to a threaded rod having fine adjustment stabilization means.

Figure 49B is a side view of an embodiment of another fastener attached to a threaded rod having fine adjustment stabilization means.

50 is another embodiment of a threaded fastener.

FIG. 51 shows the rod holder mating with the fastener of FIG.

FIG. 52 illustrates the fastener of FIG. 50 mated with the FIG. 51 holder.

53A and 53B are exploded views of FIGS. 50 to 52 with rods.

The present invention further includes an improved screw pattern that processes a variety of skeletal parts in a manner related to allowing the jointing of the device at multiple corners and provides both axial compression and radial inward traction along the length of the fastener. It provides the ability to anchor to skeletal structures that provide great stabilization.

The industrial application of the present invention will be explained through the description of the following object of the present invention.

Accordingly, a primary object of the present invention is to provide an orthopedic stabilizing structure.

Another object of the present invention is to provide an improved thread accordingly.

Another object of the present invention is to accommodate a plurality of corner portions when processing a skeletal structure.

In view of the first advantage, an object of the present invention is to provide a transverse slot for receiving a threaded shaft having one end with a rotating means, a dimensioned area allowing rotation of the threaded shaft about one end. To provide an orthopedic device comprising a provided cup, a rod through the slot and a means for securing the threaded shaft and the rod in a fixed position relative to the cup.

In view of the second advantage, an object of the present invention is to provide a framework structure comprising deploying a fastener with a support cup, orienting the cup so that the rod is in contact with the fastener, and securing the rod and the fastener together. To provide a way to support.

In view of the third advantage, it is an object of the present invention to provide an orthopedic device comprising a combination of fasteners having a top and a threaded body provided with birds, said birds having a top surface and a bottom surface, The upper face is formed thereon to receive the rod, and the lower face includes a seating area to be received in the cup so that the fasteners can be divided into the cup in the cup.

In view of the fourth advantage, an object of the present invention is to provide an orthopedic fastener comprising a shaft having a first screw pattern at one end and a second screw pattern at the other end, the screw pattern being interleaved. It has a means for pulling the radially inwardly inclined bone.

In view of the fifth advantage, it is an object of the present invention to provide a method of deploying an orthopedic fastener, including inserting the fastener to induce a radially inward directed force and an axial compressive force relative to the fastener.

In view of the sixth advantage, an object of the present invention is to provide an orthopedic device comprising a combination of a support rod, a plurality of fastener supports attached to the support rod, and a plurality of fasteners coupled with the plurality of fastener supports. The fastener comprises a means for mating with the fastener support in a fixed direction and a threaded body, and subsequent movement of the fastener is prevented by the interaction of the fastener support with the means for mating with the fastener support.

In view of the seventh advantage, it is an object of the present invention to provide an orthopedic device comprising a combination of means for securing and mating fasteners and a clamp having means for securing and receiving a support member, said fasteners It has a corresponding means and a threaded body fixed by and engaged with the clamp, the fastener comprising means for mating with the clamp in an infinite number of directions.

In view of the eighth advantage, it is an object of the present invention to provide an orthopedic device comprising a clamp in combination comprising a means for receiving and securing a first support member and a means for receiving a second support member. The second support member includes a support cup with a fastener therein and means for allowing rotational movement of the fastener in the support cup.

In view of the ninth advantage, an object of the present invention is to provide a clamp having means for receiving a support member and a means for mating with a fastener, a fastener for fastening the fastener to the clamp by compression of the split shaft and for fixing the support member to the clamp; An orthopedic device comprising a combination of securing means in combination, wherein the means for mating with the fastener comprises a split shaft, the fastener has corresponding means for mating with the threaded body and the clamp, the fastener being Means for mating the clamp in a myriad of directions.

This object of the present invention becomes apparent when the following detailed description is considered in connection with the accompanying drawings.

Like reference numerals in the various drawings indicate like reference numerals, wherein the reference numeral 100 represents an orthopedic stabilizer according to the present invention.

The apparatus 100 allows moving the threaded fastener 10 around the arrow C even though the long axis of the threaded shaft as shown in FIG. 4 is shown as currently aligned, as shown in FIG. It may be rotated and bent from the vertical long axis of the cup 130. The rotary means 120 embodied as a disk has a cylindrical outer surface 122 and flat upper and lower surfaces 124, 126. Thus, rotation about arrow C causes rotation about geometric center 128. The disk 120 is integrally fixed to the fastener 10. The rotating means 120 is restrained in a cup 130 having a central bore 132 and an upper portion with a screw 111. In addition, the transverse slot 134 is cut along the diameter of the fastener 10 and the integral disk 120, as well as the cup allowing sliding insertion within the rod 136 transverse to the long axis of the cup 130. do. 9 to 16 will be described. The rod may have any of a variety of cross-sectional profiles (eg, square, round, elliptical, etc.). The cup 130 is dimensioned such that the rotation means 120 tangentially align along one cylindrical face 122 with the rod 136. The threaded bore 132 receives the threaded bolt 110 to press the rod 136 against the rotating means 120 to secure in their relationship once the proper rotation has occurred.

In essence, fastener 10 includes a threaded shaft 32 having a first screw pattern 12 at one end and a second screw pattern 14 at the other end. As shown in Figures 1 and 2, the first end threaded pattern 12 terminates at point 16, the screw having a diameter to form a screw pattern in which the spiral increases as it extends from point 16. This increases.

The second screw pattern 14 has a large diameter, but has a similar screw contour as will be described in detail. Preferably, as can be seen with reference to Figures 1 and 2, the shaft 32 is of various lengths, tapering from the end 18 to the point 16 and narrowed.

Another nuance of the first and second screw patterns has a coarse screw than the second screw pattern 14 which is a fine screw. Point 16 is the starting point for insertion into the bone during an orthopedic procedure. To facilitate, the pilot hole can be drilled into a bone, but since the taper then tapers the nature of the first screw 12, the part is screwed on itself. It should be noted that the crest 70 for both the first and second screw patterns is sharpened. This typically allows for cutting into a bone that has a firmer exterior than the interior. By providing a coarse screw pattern for the first screw 12, this screw is inserted into the bone faster than the second screw pattern 14. As a result, when the bone begins to engage by the second screw pattern, the axial compressive force of the bone occurs along the direction of the two arrows A. In addition, because of the screw geometry, the screw is subjected to an inwardly directed force in the radial direction along the direction of the double arrow (B). In the prior art, the conventional fasteners extend inward in the radial direction, while the present invention provides inward or traction force B and compression force A in the radial direction.

The screw 60 of the fastener 10 for the screws 12, 14 is one continuous helical winding screw that spirals in the direction of the middle of the shaft 32 starting at the end and away from the end. This can be seen from FIG.

The screw 60 includes a root 80 defining a small diameter 64 of the screw 60 and a sharp crest 70 defining a large diameter 62 of the screw. As can be seen in FIG. 3, the screw 60 has an upper surface 66 extending from the bottom edge 84 of the root 80 to the sharp crest 70. The screw 60 also includes a lower surface 68 extending from the upper edge 82 of the root 80 to the sharp crest 70. When the upper surface 66 and the lower surface 68 extend from the root 80 to the crest 70, the surfaces 66 and 68 are inclined toward the middle of the fasteners.

In cross section, surfaces 66 and 68 extend linearly from root 80 to sharp crest 70. However, when the contour is rotated helically around the threaded shaft 32 along the screw 60, the upper surface 66 and the lower surface 68 assume a curved surface shape. This shape is similar to that formed by the linear cross section of the surface of the cone with the tip of the cone directed downward and rotating and rising upward along the central axis. Thus, the top surface 66 and the bottom surface 68 have curved surfaces of similar dimensions as in cones, but are linear in cross section.

The upper surface 66 extends from the root 80 to the sharp crest 70 at an upper surface angle α that emanates from a reference plane perpendicular to the central long axis 2 of the fastener. The upper surface angle α is preferably 20 ° but can be anything between 0 ° and 90 °. The bottom face 68 is dressed with a sharp crest 70 at the root 80 at a bottom face angle β with respect to the reference plane. The bottom face angle β is preferably 40 °, but may vary between 0 ° and 90 °.

The upper surface angle α is preferably smaller than the lower surface angle β. In this way, the screw 60 has a large thickness, has a large strength adjacent to the smaller diameter 64 at the larger diameter 62, and thus can withstand the loads received in the bone.

The surface, in particular the cornered portion of the upper surface 66, is subjected to an inward force in the radial direction. When combining the upper and lower screw patterns, the axial compressive force can be seen. This can be seen in the flat wall 54 of FIG. This is the replacement point 16 and requires a deeper pilot hole.

The second threaded portion 14 has the geometry of FIG. 3 except that the screw 60a is reversed and is a more sophisticated screw (larger thread per inch in the axial direction) than the first threaded portion 12 as described above. . In other words, FIG. 3 is turned upside down against the screw 14.

Figure 3a shows a cross section of a screw with a taper as described above. For the screw pattern 14, FIG. 3A is upside down and has a reverse taper as shown.

The bottom 129 of the cup 130 (see FIG. 4) is a gap extending in an included arc, preferably close to 90 °, to allow the fastener 10 to allow wide rotation with respect to arrow C. FIG. (22) is provided. Rotation over this gap 22 is prevented by the gap wall 22 and the cup wall structure 24 which persists the slot 134 extending downwardly in diameter on both surfaces of the cylindrical cup 100. The free end 138 of the cup 100 applies (second) pressure to the disc 120 and (3) unitizes and retains the free end 138 to hold the rod 136 in place (first). Pressing is necessary to support the bolt 110 (FIG. 16).

The screw 60 of the screwed bolt 110 (see FIGS. 7 and 16) is a substantially one continuous thread-wound screw starting at the bottom 54 and spiraling up to the top 52. While this single screw design is preferred, other devices may also be used that include a complex series of screws that thread together from the bottom 54 to the top 52.

The screw 60 includes a crest 170 forming the major diameter 62 of the screw and a root 80 forming the minor diameter 64 of the screw. As described in detail in FIG. 7, the screw 60 has a top surface 66 extending from the bottom edge 84 of the root 80 to the top edge 72 of the crest 170. The screw 60 also includes a bottom surface 68 extending from the top edge 82 of the root 80 to the bottom edge 74 of the crest 170. When surfaces 66 and 68 extend from root 80 to crest 170, upper surface 66 and lower surface 68 are angled upwards. Crest 170 and root 80 represent a constant distance from central axis 2 between top edge 82 and bottom edge 84. In comparison with FIG. 3, the crest 170 is blunt while the crest 170 is sharp. Further, bolt 110 and screw 111 may have a sharp contour, such as crest 70 (replaces crest 170) and vice versa.

In cross section, surfaces 66 and 68 extend linearly from root 80 to crest 170. However, when this appearance is rotated helically relative to the bolt 110 screwed with the screw, the upper surface 66 and the lower surface 68 take a curved surface profile. This contour is similar to that formed by the linear cross section of the surface of the cone, with the tip of the cone being oriented downward and rotating the cone to translate upward along its axis of rotation. Accordingly, the upper surface 66 and the lower surface 68 have a three-dimensional curved surface similar to that of the cone, but have a linear characteristic in cross section.

The upper surface 66 extends from the root 80 to the crest 170 at an upper surface angle α extending from the reference plane 4 perpendicular to the central axis 2. The upper surface angle α is preferably 20 °, but can be any angle between 0 ° and 90 °. Lower surface 68 extends from root 80 to crest 170 at lower surface angle β with respect to reference plane 4. The lower surface angle β is preferably 40 °, but may vary between 0 ° and 90 °.

The upper surface angle α is preferably smaller than the lower surface angle β such that the thickness of the screw 60 in the crest 170 is smaller than the thickness of the screw 60 between adjacent roots 80. In this way, the screw is provided with a greater thickness, thus greater strength adjacent to the minor diameter 64 than at the major diameter 62 so as to support more of the load experienced inside the threaded bore 132. do.

Referring to FIG. 8, a detailed view of the threaded bore 132 on the free end 138 bore is shown. The bore is in shape and preferably substantially compensates for the screw shaft of the bolt 110. The bore includes a screw T. The thread shape of the bolt 110 and screw T pulls along the arrow D the free end 136 of the cup 130.

17 shows a fractured bone and the device 100 applied. The fastener 10 with the disc 120 and the cup 130 is positioned such that the fastener 10 is located inside the bone but the disc is rotatable inside the gap 22 as described above. Recall that the screws 12 and 14 are axially compressed and pulled radially inwards from within the bone. Next, the rod 138 is located inside the slot 134 of the cup 130.

The rod is shown as having a bend 165 to indicate the versatility of the system. Next, the bolt 110 is coupled to the screw 111 at the free end 138 of the cup 130. Bolt 110 supports rod 136, and rod 136, disk 120 and fastener 10 become rigid. In addition, the free ends 138 are pulled firmly together.

FIG. 18 is similar to FIG. 4 showing an embodiment in which the first and second screw patterns have a conventional geometry but the second screw pattern has a larger thread pitch density while forming a more sophisticated screw than the first screw pattern. Drawing.

19A and 19B are views similar to FIG. 16 except that bolt 110 includes an elongated stem 112 that protrudes from the top of bolt 110 and protrudes from cup 130. Stem 112 may include a necked down area 113 adjacent to bolt 110. The stem is preferably cylindrical if the neck down zone 113 can be surface exposed to rotate the stem 112 with a tool.

20 is a perspective view of stem clamp 210 attached to stem 112. The clamp 210 includes a cylindrical bore 212 sized to receive the stem 112, includes a slit 214 on the outer wall, and radially with a groove 216 extending into the clamp body. Aligned. The slits and grooves collectively cooperate with the bores 218 passing through the clamp 210 perpendicular to the grooves 216. When the slit 214 and the groove 216 are pulled together along the arrow D, the stem 112 is locked in place. The clamp 210 is substantially boxed and includes a top surface 222 that is planar except for two outer raised edge walls 224 oriented parallel to the stem bore 212. In combination with the top surface 222, the edge wall 224 defines a receiving slot on the bottom surface that is dimensioned to receive a protrusion 226 similar to the rectangular protrusion 226 shown in FIG. 20. Accordingly, the protrusion 226 includes a protruding wall extending to the body of the clamp 210 such that the spacing between the edge walls 224 is equal to the spacing of the protrusions between the protruding walls 228. It should be noted that the protrusion 226 is offset from the top surface 222 (and its recess formed by the edge wall 224) by 90 °. This allows a plurality of clamp blocks 210 to be stacked as shown in FIGS. 22 and 23 in a stable manner. Bolts 230 passing through the plurality of bores 218 hold the clamp in place via the nut 232. The corner portion 203 of the clamp 210 may be chamfered.

FIG. 24 shows whether this other embodiment uses a stem as an extension to receive the rod 136 mentioned in FIG. Instead of interposing the rod 136 between the disk 120 and the bolt 110, the rod is received through one bore 218 of one clamp 210 that is mated as shown in FIG. 23, The second bore receives the stem 112. This embodiment favors the external placement of the rod 136 outside of the patient's body. To use the apparatus of FIG. 24, fastener 10 (with disc 120 and cup 130) is screwed along the bore. Next, the stem 112 having the bolt 110 integral with it is screwed into the cup 130. The stem 112 allows the cup to be angled to follow the bone appearance (see FIG. 25), but is not yet tightened. Next, the clamps 210 are positioned on the stem 112 in pairs with the rods 136. Next, the stem 112 is tightened against the disk 120 to secure the cup 130 by pressing the bolt 110 against the cylindrical outer surface 122 of the disk 120. Next, it should be noted that the geometry of the disk 120 and its placement in the slot 134 prevents the fasteners from loosening inside the bone with the screw shapes 12, 14 described above. Next, the rod 136, clamp 210 and stem 210 are secured in place by bolts 230 and nuts 232. At this time, the fracture (or other orthopedic abnormality) is stabilized. When a face may be formed in the neck down portion 113, the end 114 of the stem 112 may have a drive head instead of or in addition to the face on the stem 112.

26, 27 and 32 show front, perspective and side views, respectively, of another fastener 310 as compared to FIG. Similar parts to the previous embodiments are not described in detail. Most notably, the rotating means 120 of FIG. 1 is replaced with a saddle 320. The saddle 320 has a rounded top surface 336 dimensioned to receive the rod 136 (see FIGS. 30 and 33) with the tangential substrate about the approximately circumference of the rod 136. Accordingly, the radius of curvature of the top surface 336 of the saddle coincides with the radius of curvature of the rod 136. Compared with the configuration of FIG. 4, the saddle 320 has the advantage of greater surface contact with the rod 136. This has a larger contact area, making the work required to hold the rod 136 and fastener 310 in a fixed position easier. Also, since the main portion of the disc 120 is effectively replaced by the low profile saddle 320, which is the outer arc of the circle of the disc in FIG. 6, the overall height of the device is made smaller and shorter as in the example in FIG. While the overall length of the fastener is reduced. As a result, the cup 130 'may be shorter correspondingly. Figures 27 and 32 show the outer shoulder 338 of the birds with curvature corresponding to their sheet 340 (see Figure 33) in the cup 130 '. As before, the gap 22 allows relative rotation between the fastener 310 and the rod 136 relative to arrow C. FIG.

Threaded fasteners 10 may be provided in various embodiments. The rotating means 120 of the threaded fastener 10 shown in FIGS. 1 and 2 has a drive head 18 with the remote end 18 proximate the second screw pattern 14 shown in the figure as a hexagon. But may be replaced as hex wrench recess 21 (FIG. 36B), likewise recessed elliptical drive head 20 (FIG. 36A), or any other shape for reliably driving the fasteners. have. Thus, the threaded fastener 10 of Figs. 36 and 37 does not have a rotating means. This threaded fastener 10 may be inserted directly into the bone instead of or in conjunction with another threaded fastener 10 (FIG. 38).

39-41 show a variant in which the tapered shaft 32 uses the specified screw 12 of the embodiment of FIG. 1 but a conventional screw 114 on the second threaded portion. The drive head 18 may be the drive head of FIGS. 36, 36A, and 36B or otherwise.

The conventional screw 114 is mated with a threaded bore 116 on the member 118, which may be contoured along the anatomical structure of the bone to be supported. Thus, member 118 may have a compound contour as illustrated by edge 119. As shown, the screw 12 is embedded in the bone of the patient. In an embodiment, the screw 12 cooperates with the screw 114 to provide axial compression A, and the screw 12 also provides a radial inward force B described in the previous figures.

Alternatively, the rotating means 120 embodied as solid disks in FIGS. 1 and 2 may be replaced with hollow disks as shown in FIGS. 42A and 42B, 45A and 45B. The hollow portion may have an angular profile, such as an octagonal profile 402A, and another profile, such as a circular profile 404A surrounded by a tooth 406A, or any other profile that permits the fastening of the threaded fastener 10. May have Fasteners 10 of FIGS. 42A and 42B, 45A and 45B slide on rod holders having complementary profiles 402B and 404B for hollow portions 402A and 404A. 45A and 45B additionally engage the teeth 406B located on the end 420 of the rod holder. The rod 442 is held adjacent to the fastener 10 in the slot 424 on the rod holder. The threaded portion 426 of the slot 424 is mated with an external threaded shaft 428 that secures the assembly.

The fastener 10 of FIG. 48 has an extended hexagonal bar portion 408A that mates with a hexagonal through passage 408B in a corresponding complementary formed rod holder. The rod holder includes a slot 424 for the threaded rod 430 and a screw 426 that engages the shaft 428. The assembly shown in FIG. 48 may be arranged such that one of the vertices 410 of the hexagonal bar 408A engages the threaded rod 430 and permits positioning along the threaded bar 430.

49A and 49B, adjustment and stabilization means 432A, 432B are shown in pairs, one adjacent to each side of the fastener 10 and holder assembly. Any fastener and holder assembly shown in FIGS. 4, 21-23, 33, 44, 47, and 48 may be used with the threaded bar 430 and the adjustment and stabilization means 432A, 432B. have.

50 is an embodiment of a threaded fastener 10 having a multi-faceted profile 452 and having a valley 450 terminating at a screw 466. Corresponding socket (FIG. 51) has a cavity 456 including a rod 462, and the cavity 456 extends from the rod end 458 to the socket end 460. Thus, the socket end is not solid and forms the split shaft 464. The socket end 460 is connected to the rod end 456 by a clamping portion 454 having a profile that matches the profile of the multi-faceted profile 452 of the threaded fastener 10. The socket rests in the valley 450 of the fastener (FIG. 52). The threaded bolt 110 is mated with the screw 466 at the top of the fastener 10. Pressure from the bolt 110 on the split shaft 464 and the clamping portion 454 secures the rod end 458 to the rod 462 in addition to the fastening of the fastener 10 to the clamping portion 454. 53A and 53B show the embodiment of FIGS. 50-52 deployed on rod 462. FIG. 53B shows an edge for a rod 462 that is possible using a combination of the clamping portion 454 and the multi-faceted profile 452 of the fastener 10.

Moreover, while the invention has been described as such, it is to be understood that many structural modifications and variations may be practiced without departing from the spirit and scope of the invention as described below and by the claims below. It is obvious.

According to the present invention an orthopedic stabilizing structure is provided.

Claims (29)

A screw shaft having one end having rotation means about a single axis transverse to the long axis of the threaded shaft and means for preventing all other rotations; Lower rotation means and all other rotations having an upper end with internal threads and receiving an area dimensioned to allow rotation of the threaded shaft about the one end and about a single axis transverse to the long axis of the threaded shaft; In combination comprising a cup having a means of preventing The cup has a transverse slot, A rod passing through the slot and mating in a close tangential direction to contact the rotating means; Orthopedic device having bolt means screwed to an internal thread of the cup to secure the rod and the threaded shaft to a fixed position relative to the cup. The orthopedic device of claim 1, wherein the threaded shaft has first and second threaded patterns thereon. To support the skeletal structure, Deploying the plurality of fasteners in the plurality of support cups, Screwing the fastener into the bone to be treated such that the bone receives both axial compression and radial inward force against the fastener; Deploying a support rod in the support cup; Orienting a cup relative to the rod such that the rod abuts against the fastener; Securing the rod and fastener together by inducing radial inward forces on the cup. The orthopedic device of claim 2, wherein the first and second screw patterns of the threaded shaft have different thread pitches such that the second screw pattern has finer threads than the first screw pattern. 5. The orthopedic device of claim 4, wherein the screw pattern has crests axially biased from their respective roots and induces radial inward force. 6. The orthopedic device of claim 5, wherein the first and second thread crests induce a compressive force in the axial direction facing each other. A combination fastener having a threaded body and an upper portion with saddles, The birds have an upper surface and a continuous lower surface, The upper surface is contoured to receive a cylindrical rod thereon; The upper surface tangentially aligns approximately 1/2 of the circumference of the rod, The bottom surface includes a seating area for receiving in a cup, whereby the shoulder of the fastener can mate tangentially with the cup and articulated, the cup having a seat complementary to the shoulder, the cup being An orthopedic device having an upwardly projecting inwardly threaded free end with an inclined screw and a bolt having an inclined screw disposed within the cup screw to provide radial inward force to eliminate the need for a collar. In combination comprising a bone engaging shaft having a first screw pattern at one end and a second screw pattern at the other end, Wherein said one screw pattern has a means for radially inwardly pulling a bone that is bone bonded and embedded therein. Method for deploying orthopedic fasteners into bone, Inserting the fastener into the bone to induce an axial compressive force and a radial inward force relative to the fastener. With support rods, A plurality of fastener supports attached to the support rods, A combination of a plurality of fasteners coupled with the plurality of fastener supports, The fastener comprises a threaded body and means for mating with the fastener support in a fixed orientation, and subsequent movement of the fastener is prevented by the interaction of the fastener support with the means for mating with the fastener support. . A combination comprising a clamp having means for receiving and securing a support member and means for mating with and securing the fastener, The fastener has a threaded body and complementary means mated with the clamp and secured by the clamp, the fastener having means for mating with the clamp in a limited number of directions. A combination comprising a clamp having means for receiving and embedding a first support member and means for receiving a second support member, And said second support member comprises a support cup containing a fastener and means for allowing rotational movement of said fastener within said support cup. A clamp and fastening means in combination comprising means for receiving a support member and means for mating with a fastener, Said means for mating with said fastener comprises a split shaft, said split shaft being an extension of said means for receiving a support member, said fastener having a threaded body and complementary means for mating with said clamp, said fastener Means for mating with the clamp in a limited number of directions, And said securing means engages said fastener to secure said support member in said clamp and secure said fastener to said clamp by compression of said split shaft. The screw pattern of claim 8, wherein the screw pattern has a sharp crest having a major diameter and a root defining a minor diameter, the screw extending from the top edge of the root and an upper surface extending from the bottom edge of the root to the sharp crest. A fastener having a bottom surface extending into a sharp crest, said surface being inclined to the middle of said fastener. 15. The fastener of claim 14 wherein the top surface forms a slope at an angle less than the bottom surface. Screws constrained in a cup having axial and radial bone engaging compressive screws and having free ends terminating in the disk and having recesses complementary to the disk to allow relative rotation of the cup and shaft about the geometric center of the disk With the shaft, A rod accommodated in the cup in tangential direction with the disk; Orthopedic stabilization device in combination comprising means for holding the rod, cup, and disc in a fixed relationship. In combination comprising a cup having a recess for receiving a threaded shaft, The cup recess and the shaft comprise means for allowing shaft rotation in only one plane, the cup having an internal screw on a portion of the recess that does not face the threaded shaft, And the inner screw has a screw pattern complementary to the bolt such that a bolt is screwed into the inner screw and a radial inward force is applied to the inner screw when the bolt reaches a limit of travel. 18. The orthopedic stabilization device of claim 17 wherein the bolt comprises a stem protruding away from the cup, the stem operatively coupled to the clamp by means of adjusting the position of the clamp along the stem. 18. The orthopedic stabilization device of claim 17 wherein the threaded shaft has two screw patterns similar to the bolt and the internal thread, the two screw patterns facing each other and one having a finer pitch than the other. 19. The orthopedic stabilization device of claim 18 wherein the threaded shaft has two screw patterns similar to the bolt and the internal thread, the two screw patterns facing each other and one having a finer pitch than the other. In combination comprising a cup having a recess for receiving a threaded shaft having saddles positioned within the cup, The cup recess and the shaft comprise seating means allowing shaft rotation in only one plane, the cup having an internal screw on a portion of the recess that does not face the threaded shaft, And the inner screw has a screw pattern complementary to the bolt such that a radial outward force is applied to the inner screw when a bolt is screwed to the inner screw and the bolt reaches a limit of travel distance. 22. The orthopedic stabilization device of claim 21 comprising an adjustable rod disposed within the cup seated in the saddle. 22. The orthopedic stabilization device of claim 21 wherein the threaded shaft has two screw patterns similar to the bolt and the internal thread, the two screw patterns facing each other and one having a finer pitch than the other. 23. The orthopedic stabilization device of claim 22 wherein the threaded shaft has two screw patterns similar to the bolt and the internal thread, the two threaded patterns facing each other and one having a finer pitch than the other. Constrained in a cup having both axial and radial bone engaging compressible screws, having a free end terminating in the saddle and having a recess complementary to the saddle to allow relative rotation of the cup and shaft around the geometric center of the birds With screw shaft, A rod accommodated in the cup in a tangential direction with the saddle; Orthopedic stabilization device in combination comprising means for holding the rod, cup and saddle in a fixed relationship. A screw shaft having one end portion provided with rotation means about a single axis traversing the long axis of the threaded shaft and means for preventing any other rotation; Lower rotation means and all other rotations for receiving an area having a size that allows rotation of the threaded shaft about an upper end with an internal thread and around the one end and around a single axis transverse to the threaded shaft and the long axis; A cup having a transverse slot with means for interfering therewith, An adjacent rod passing through the slot and mating in close tangential direction with the rotating means; And an orthopedic stabilization device in combination comprising bolt means screwed to an internal thread of the cup to secure the rod and the threaded shaft relative to the cup in a fixed position. In combination comprising a cup having a recess for receiving a bone engaging screw shaft having a bone engaging screw for inducing radial inward force; The cup recess and shaft comprise means for allowing shaft rotation in only one plane, the cup having an internal screw on a portion of the recess that does not face a threaded shaft, Orthopedic stabilization device having a screw pattern complementary to the bolt such that a radial inward force is applied to the inner screw when the bolt is screwed to the inner thread and the bolt reaches a limit of travel distance. 28. The orthopedic stabilization device of claim 27 wherein the threaded shaft has two screw patterns similar to the bolt and the internal thread, the two screw patterns facing each other and one having a finer pitch than the other. Recesses complementary to the disk to allow relative rotation of the cup and shaft around a single axis of rotation defined by the geometric center of the disk with an axial and radial bone engaging compressive screw and a free end terminating in the disk. A screw shaft constrained inside the cup having, And a rod housed in the cup tangentially and tangential to the disc, and a means for holding the rod, cup, and disc in a fixed relationship.