TW519484B - Bone plate - Google Patents

Bone plate Download PDF

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Publication number
TW519484B
TW519484B TW089123554A TW89123554A TW519484B TW 519484 B TW519484 B TW 519484B TW 089123554 A TW089123554 A TW 089123554A TW 89123554 A TW89123554 A TW 89123554A TW 519484 B TW519484 B TW 519484B
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Taiwan
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bone plate
scope
bone
patent application
item
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TW089123554A
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English (en)
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Robert Frigg
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Synthes Ag
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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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8004—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones
    • A61B17/8014—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones the extension or compression force being caused by interaction of the plate hole and the screws
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
    • 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
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/28—Bones
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
    • A61B17/8057—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded the interlocking form comprising a thread

Description

519484 A7 ___B7____ 五、發明說明（/ ) 本發明關於申請專利範圍第一項引文的一種骨板與申 請專利範圍第20項引文之一種具有此種骨板的固定裝置。 基本上人們知道有二大類之用骨板造成之骨合成物 (Osteosynthese) 〇 第一種係關於「剛性骨合成術（物）」，剛性骨合成物 係在關節骨折簡單之骨幹骨折時作供養（照顧處理 )(Versorgaung英：catering)(當不能打骨釘時），以及在骨 切除（Osteotomy)時使用。除了可作解剖學上的復位 (Reposition)外，骨本身也支持骨合成物的穩定性，這點使 末端較早受負荷且較不會疼痛。在那些骨行血（血流通 )(Durchblutung)受到創傷處(Trauma)影響而大大減少的場合 ，也可觀察到穩定之骨折供養的優點。在接合不全(nonunion) 的供養時或在已有之感染的場合 ，骨折部須穩定地 供養，俾能使骨痊癒，並使感染部不會由於供養不穩定而 另外在骨折縫隙中受刺激(reizen)。 第二種係關於「可撓性(軟性)骨合成物」。可撓性(生 物)骨合成物最大優點見於管狀骨的骨幹區域中之片段骨折 (Trtimmerfraktur)的供養的場合見到。在這種骨折時，目的 是把骨的長度保持以及將骨末端（關節）互相保持在正確位 置。在此’骨折區域不直接固定或推拿(manipulieren)，這 點不會另外影響到此區域的行血。骨板的作用與鎖合標記 釘(骨髓內釘)相似，後者只錨固到幹骺端(Metaphysis)中。 如果我們注意骨板合成物的兩末端，則可發現它們互 相離開多遠。由於並非經常所有的骨折部可正好歸入上述 _ _3_ 本紙張尺度適用中國國家標準（CNS)A4規格（210 X 297公釐） (請先閱讀背面之注意事項再填寫本頁) -------訂---------· 519484 A7 _____B7________ 五、發明說明（i ) 二種骨合成術類型中，因此外科醫生往往須和實際情形妥 協，因爲他沒有現成的植入物(Implantat)使他能將該二種 方法倂用而不作一些妥協（牽就）。如果一種關節骨折能用 拉力螺絲(Zugschraube)利用骨板作壓縮，且整個關節部經 由一個內固定器利用角度穩定（固定不變）的螺絲連接到骨 幹(Diaphyse)，則這二種方法的組合就很有意義。另—種應 用情形，舉例而言，係在骨質疏鬆(porotisch)的骨的情形 ，其中一骨板可利用軸向穩定及角度穩定的螺絲錨固在幹 骨后端的斷片，其中，在骨幹的區域可穩定地裝骨板 (Verplattimg)，並藉一骨板拉力螺絲穿過骨折部之助而達 成。由於這種供養，可達成一種初級的骨折部安定化。 這種情況使得人們須對二種骨合成術各開發骨植入物 並上市。這兩組植入物分別對其目的方法作最佳的設計。 因此這兩種系統的缺點在於它們缺少組合(合倂）的可能性 〇 在美專利US 5,709,686 Talos等人的專利中發表了一 種此類的組合板，其中有一圓筒形螺紋設在長孔的中央部 中。這種習知的骨板缺點如下： 1 )螺紋在板的長孔兩端之間的中間兩側的位置，因而螺 紋的區域限制在60°〜179° ; 2 )螺紋在板的長孔[夾緊孔（Spannloch)]中的兩端之間的 中間兩側的位置，有一種危險，即長孔側邊的腹板會 被擴張開， 3 )由於螺紋呈圓筒形，必須使用一種特殊設計的螺絲、胃 ___4_- --- 本紙張尺度適用中國國家標準（CNS)A4規格（210 X 297公釐） (請先閱讀背面之注意事項再填寫本頁)
519484 A7 _________B7____ 五、發明說明（3 ) ，它在旋入時能支持在骨板表面。 對此本發明提出對策。本發明的目的在提供一種骨板 ’它可將上述二種骨合成術合倂，但不會因此在該二種純 粹骨供養方法受到限制。依此，本發明須能當作壓縮板及 所謂的內固定器(Fixateur interne)用而不必妥協。 本發明係利用一種具有申請專利範圍第1項的特點的 骨板達成上述目的。 在本發明範疇中，所用之長孔的直徑由板縱軸方向測 量係比垂直於板縱軸測量的孔直徑更大。因此這種長孔可 設計成卵形、橢圓形或長方形或包含這些形狀的組合；只 是爵鳳形的孔要從這種定義中排除掉。 在一較佳實施例中，此組合孔的圓形孔具有一種構造 部，此構造部宜呈一種內螺紋或周圍層板(Lamelle)或唇突 (Lippe)的形狀。這種三度空間構造可設在單一平面(它與骨 板上側平行)或設在數個與該上側平行的平面中。 此圓形孔的直徑d宜小於該組合孔之長孔的短軸b。 典型的情形，d比b小了 5〜25%。 使用該骨板當做內固定器，則會使板骨絲看板-螺絲界 面的機械應力大大提高，因爲骨板並非壓到骨上’因此該 骨折部係利用骨板與骨間的摩擦力而固定。在一種較佳實 施例中，這種機械式多重負荷係用以下方式計算：螺紋在 長孔中延伸過至少180。的範圍，因此螺絲頭螺紋至少繞 行了這種角度範圍。在薄骨板的場合，這種情形特別重要 〇 5 ___ 本紙張尺度適用中國國家標準（CNS)A4規格（210 X 297公釐） (請先閱讀背面之注意事項再填寫本頁)
— — — — — — I 訂111 I II I I » 519484 A7 ____Β7__ 五、發明說明（f ) 一種較佳的進一步特色在於，該三度空間的構造部(例 如呈一種內螺紋的形狀)在組合孔中向骨板下側變細窄（且 宜呈錐形變細窄）。其優點爲：螺絲的固定作業利用板孔的 錐形螺紋與所用之螺絲頭之對應的錐形螺紋達成。如果要 使用自攻孔螺絲，則這種固定方式特別重要。由於該螺絲 之頭區域中有錐形螺紋，因此螺絲放入骨中的過程可以不 受骨板影響地達成。只有在螺絲頭的螺紋錐形部侵入骨板 之長孔的內螺紋中，螺絲才鎖固住。儘管在骨板孔錐形部 及在骨中螺紋的前端不同，但該錐形螺絲頭螺紋可在骨板 的螺紋錐形部中對準中心。 當錐形螺紋部旋緊時，在骨板孔中產生徑向力量。爲 了將此力量充分吸收，該錐形之骨板孔須有足夠之穩定性 0 這種在一較佳實施例中向骨板下側呈錐形變窄細的內 螺紋宜具有5〜20°的錐形角，典型値爲1〇。。 在本發明另一較佳設計中，內螺紋--沿骨板縱軸方 向看--係設在長孔兩端之一上。這種位置可使它在結構 上有較大的螺紋區域，例如延伸過它所形成之幾何體的 190° 〜280。，且宜 200° 〜250。。 如果長孔設計錐形，則內螺紋之延伸度量在骨板的下 側及上側分別作測量，則會產生不同大小的値。在上側作 測量時，螺紋的區域宜延伸過180°〜230。範圍；在下伺J 測量時則爲200°〜270°範圍。 在另一較佳實施例，該末端之錐形螺紋設在長孔(夾緊 6 本紙張尺度適用中國國家標準（CNS)A4規格（21^X 297公釐)— " --- (請先閱讀背面之注意事項再填寫本頁) *I5J· .線 519484 A7 ^---2Z--- 五、發明說明（jr ) 孔)較近骨板中央的一端。如此有一優點，即骨板夾緊孔的 夾緊功能不受影響。 在又一較佳實施例中，該組合孔之朝向上側上部中有 一凹形（宜爲球形）變寬部，以容納一枚具一球形頭的骨螺 絲。一種一般之骨螺絲的球形頭在此凹形之球形變寬部有 最佳的容納座。如果骨螺絲係呈偏心放入(這點對於要作骨 折部壓縮乃是必需者)則主要採這種容納方式。 在再一較佳實施例中，下側設計成凹形，由於板下側 設計成凹形，故它能較佳地配合脛骨、腓骨、肱骨及前臂 骨的圓形骨橫截面。由於在骨板下側之孔做成凹形，故一 般的骨螺絲可協協插入骨板孔中。這點主要對於小的骨碎 片(它須被旋緊到骨板上)很重要。 在另一較佳實施例中，內螺紋從下側到上側延伸過骨 板的整個高度範圍，以達成儘量高的穩定性。 在又一較佳實施例中，該組合孔在其乾向下側的部分 中在其未構造化的扇形部中變寬，因此骨螺絲可作外樞轉 〇 再一實施例中，除了本發明的骨板外，另外包含至少 一骨螺絲；它可有一種構造部，與該三度空間的構造部相 當，設在螺絲頭上，例如呈。一外螺紋方式，該外螺紋宜設 計成自切材方式及/或自攻孔方式。當使用骨板做壓縮板， 則該板孔的夾緊孔幾何性質不會受該末端的錐形螺紋孔的 不利影響。螺紋孔設計成錐形的優點爲螺絲可不受板的影 響而放入骨中，·其中，該螺絲在旋緊時，才經由一個對應 ί紙^5^用中國國家標準（CNS)A4規格（210 x 297公釐） — (請先閱讀背面之注意事項再填寫本頁) . 線 519484 A7 _____B7____ 五、發明說明（έ ) 地設計成錐形且有螺紋的螺絲頭與骨板連接。這點主要係 在使用自攻孔’自切材式的螺絲時很有利。 本發明及本發明之進一步特色在以下利用數個實施例 的部分示意圖更詳細地說明。 圖式中： 第一圖係由一圓形孔及一長孔構成之組合孔的示意圖 第二圖係一個本發明之骨板的上視圖，它具有一個具 二度空間構造部的組合孔， 第三圖爲經第二圖之組合孔的圓孔的一縱剖面圖， 第四圖係本發明骨板的一立體圖，它具有一枚骨螺終 Μ，放入在具有一體成紋之螺紋的組合孔中。 第二圖中所示之本發明骨板有一上側（1)，一下側(2)， 及二個孔(4)，該下側(2)用於與骨接觸，該孔(4)將上側（1) 與下側連接，且沿骨板縱軸(3)而設，用於容納該骨螺絲。 箭頭(7)表示朝向骨板一端的方向，而箭頭表示朝向骨板 中央的方向。 較近骨板中央的孔(4)的直徑沿板縱軸(3)方向量係比此 孔垂直於骨板縱軸(3)方向量的直徑。 如第一圖之示意圖所示，孔(4)由一圓孔（14)(直徑d， 對稱中心Sk)及一長孔(24)(對稱中心SyJ構成，該二孔互相 垂疊。 長孔(24)有一長軸a，沿板縱軸(3)方向延伸，並有一 與長軸(6)成垂直延伸的短軸b，其中對稱中心Sk與之 _________8______ 本紙張尺度適用中國國家標準（CNS)A4規格（210 X 297公爱） (請先閱讀背面之注意事項再填寫本頁) 一· -•% 519484 A7 _____Β7____ 五、發明說明（Γ| ) 間的距離小於d/2+a/2的總和。此二對稱中心（1)位在板縱 軸(3)上或至少在其附近。 長孔(24)的朝向上側（1)的上部中有一凹形（且宜爲球形 )的變寬部(6)以容納一枚具有一球形頭的骨螺絲。 如第三圖所示，該三度空間構造部（5)係呈一種較近板 端之孔(4)的內螺紋（5)形式，從上側（1)直到下側(2)延伸過 骨板的整個高度範圍。 在第二及第三圖中所示之本發明較佳實施例中，內螺 紋設在長孔(24)較近板中央的那一端。內螺紋延伸過一個 256°的範圍一一在下側(2)量，如圓弧（9)所示一一以及一 223°的範圍一一在上側（1)量，如圓弧（10)所示。 各依內螺紋（1)直徑而定，產生如下之較佳參數·· 螺紋直徑 2.4 mm 3.5 mm 5.0 mm 雙向螺紋 JA JA JA 螺紋的螺距 0.6 0.8 1.0 螺紋之深度(=外直徑與內直 0.175 0.2295 0.2810 徑的差的一半） 角度範圍(在上側 200° 200° 190° 角度範圍(在下側） 260° 240° 250° 第四圖中顯示一個第二圖的骨板，該骨板有一骨螺絲 (11)，該骨螺絲（11)具有一外螺紋（12) ’與骨板之內螺紋對 應且設在螺絲頭（13)上。 該骨螺絲（11)宜設計成自攻孔及/或自切材式° _9 ___—_ 本紙張尺度適用中國國家標準（CNS)A4規格（210 X 297公釐） (請先閱讀背面之注意事項再填寫本頁) • I I I---^訂·--I I I I--*15^
AL

Claims (1)

  1. A8B8C8D8 丨骨螺絲（1)，其特 」(4) ’由以下合成： 具直徑d及對稱 519484 六、申請專利範圍 1. 一種骨板，具有一上側（1)，一個用於與骨接觸的下 側(2)及數個孔(4)，該孔將該上側（1)與J側(2)連接且沿板 縱軸(3)設置，以容I (A) 至少有一組合： (a) —圓孔（14)， (b) —長孔（24)，具對稱中心（SU，該長孔有一長軸a ，沿骨板縱軸方向延伸’並有一條垂直於該長軸延伸的短 軸b，其中， (B) 該對稱中心Sk與之間的距離比d/2+a/2的總和小 ，且該二對稱中心設在骨板縱軸(3)的區域中，且 (〇該圓孔（14)設有一種三度空間式的構造部(5)。 2. 如申請專利範圍第1項之骨板，其中： 該圓孔（14)設有一種三度空間的構造部（5)，且宜呈疾 一種內螺紋或一種周圍之層板或唇突的形式。 3. 如申請專利範圍第2項之骨板，其中： 該三度空間的構造部(5)設在一個與上側（1)平行的平面 中。 4. 如申請專利範圍第2項之骨板，其中： 該三度空間的構造部(5)設在數個與上側（1)平行的平面 中。 5. 如申請專利範圍第1或第2項之骨板，其中： 該圓孔（14)的直徑d比長孔(24)的短軸b小，且宜小上 5 〜25%。 6. 如申請專利範圍第1或第2項之骨板’其中： 本紙張尺度適用中國國家標準（CNS)A4規格(210 X 297公釐) (請先閲讀背面之注意事項再填寫本頁)
    519484 A8 B8 C8 D8 、申請專利範圍 ........... (請先閲讀背面之注意事項再塡寫本頁) 該三度空間的構造部（5)延伸過該圓形孔（14)的至少 180°範圍。 7·如申請專利範圍第6項之骨板，其中： 該三度空間的構造部(5)延伸過該圓形孔（14)的190° 〜280°範圍，且宜爲200°〜250°範圍。 8·如申請專利範圍第6項之骨板，其中： 該三度空間的構造部(5)在上側（1)量係延伸過180°〜 230°範圍，而在下側量係爲200°〜270°範圍。 9·如申請專利範圍第1或第2項之骨板，其中： 該組合孔（14)+(24)從上側（1)往下側變細窄。 1〇·如申請專利範圍第1或第2項之骨板，其中： 該三度空間構造部(5)- -沿骨板縱軸(3)方向看一-係 設在該組合孔（14)(24)的較近板中央(8)的那一端。 Π·如申請專利範圍第1或第2項之骨板，其中： 該長孔(24)之朝向上側（1)的上部中有一凹下（且宜爲球 开多)的變寬部(6)以容納一枚具一球形頭（13)的骨螺絲。 12. 如申請專利範圍第1或第2項之骨板，其中： 言亥下側（1)設計成凹形或平面狀。 13. 如申請專利範圍第1或第2項之骨板，其中： 該三度空間構造部(5)從上側（1)到下側（2)延伸過骨板 的整個高度範圍。 14·如申請專利範圍第1或第2項之骨板，其中： 該組合孔（14)+(24)在其未構造化的區段中在其朝下側 的下部中變寬。 本、氏張尺度相中國國家標準(CNS)A4規格(210 X 297公釐） A8B8C8D8 519484 六、申請專利範圍 15. 如申請專利範圍第1或第2項之骨板，其中： (請先閲讀背面之注意事項再塡寫本頁) 該對稱中心3]^與之間的距離A係遵守以下條件： 0.5(d/2+a/2)<A<1.0(d/2+a/2)。 16. 如申請專利範圍第1或第2項之骨板，其中： 該孔(4)至少有一孔的軸對一個與上側（1)平行的平面夾 成一個70〜110°的角度。 17. 如申請專利範圍第1或第2項之骨板，其中： 該骨板由數個部段構成，且宜造成該板之L形或T形 之形狀，且該個別部段的板縱軸(3)互相夾成一鈍角或銳角 〇 18. 如申請專利範圍第17項之骨板，其中： 該骨板至少有二個部段設在不同平面中。 19. 如申請專利範圍第17項之骨板，其中： 在該骨板之最長部段中，該三度空間構造部(5)--沿 此最長部段的骨板縱軸（3)方向看--係設在該組合孔 (14)+(24)之較接近該骨板之隨後的較短部段的那一端。 20. 一^種固定裝置，具有一*申請專利範圍弟1項的骨板 ，其中，該固定裝置另外至少包含一枚骨螺絲（11)° 21·如申請專利範圍第20項之固定裝置’其中： 該骨螺絲（11)具有一種三度空間的構造部（12)，宜呈一 外螺紋形式，與該三度空間構造部(5)對應，且設在螺絲頭 (13)上。 22·如申請專利範圍第20或21項之固疋裝置’其中· 該骨螺絲（11)設計成自切材及/或自攻孔方式。 本紙張尺度適用中國國家標準（CNS)A4規格(210 X 297公釐)
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US20080132955A1 (en) 2008-06-05
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US7354441B2 (en) 2008-04-08
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ATE310457T1 (de) 2005-12-15
CA2398372A1 (en) 2001-08-02
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US20040236332A1 (en) 2004-11-25
US20020183752A1 (en) 2002-12-05
CA2398372C (en) 2007-01-09
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CN100415182C (zh) 2008-09-03
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