WO1988003781A1 - Dispositif d'osteosynthese - Google Patents

Dispositif d'osteosynthese Download PDF

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Publication number
WO1988003781A1
WO1988003781A1 PCT/CH1987/000158 CH8700158W WO8803781A1 WO 1988003781 A1 WO1988003781 A1 WO 1988003781A1 CH 8700158 W CH8700158 W CH 8700158W WO 8803781 A1 WO8803781 A1 WO 8803781A1
Authority
WO
WIPO (PCT)
Prior art keywords
bone
screw
head
screw holes
osteosynthesis plate
Prior art date
Application number
PCT/CH1987/000158
Other languages
German (de)
English (en)
Inventor
Joram Raveh
Franz Sutter
Original Assignee
Synthes Ag
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from CH470786A external-priority patent/CH669105A5/de
Priority claimed from CH35387A external-priority patent/CH672245A5/de
Application filed by Synthes Ag filed Critical Synthes Ag
Publication of WO1988003781A1 publication Critical patent/WO1988003781A1/fr

Links

Classifications

    • 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
    • A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
    • A61B17/8038—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers the additional component being inserted in the screw head
    • 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
    • A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
    • A61B17/8047—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers wherein the additional element surrounds the screw head in the plate hole
    • 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
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8605—Heads, i.e. proximal ends projecting from bone
    • 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
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • A61B17/7059—Cortical plates
    • 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
    • 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
    • A61B17/8071—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 for the jaw
    • 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
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8695—Washers
    • 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
    • A61F2/30—Joints
    • A61F2/30767—Special external or bone-contacting surface, e.g. coating for improving bone ingrowth

Definitions

  • the invention relates to an osteosynthetic device, in particular an internal fixator, consisting of an osteosynthesis plate with at least two screw holes and bone screws that can be inserted therein.
  • Fixation devices for osteosynthesis have been known for a long time. Most systems, however, do not allow a rigid, functionally stable fixation between the head of the bone screw and the osteosynthesis plate, which often results in bone resorption at the contact surface between the osteosynthesis plate and bone, with subsequent instability and loosening. With other rigid systems, the relative position of the plate and screws cannot be varied.
  • the invention seeks to remedy this.
  • the invention has for its object to combine the advantages of an external fixator with those of the internal plate osteosynthesis and to achieve long-term functionally stable anchoring of the implant, wherein the axial position of the bone screws relative to the osteosynthesis plate can be variable over a wide range.
  • the invention achieves the stated object with a device which has the features of claim 1.
  • the advantages achieved by the invention are essentially to be seen in the fact that, thanks to the device according to the invention, firstly, the stability of the implant increases with the length of time and the load, and secondly, the stability of the osteosynthesis no longer by pressing the plate against the bone, but by rigid fixation of the screw to the plate can be achieved. Additional advantages result from the rotatability of the screw head, which reduces the requirements for the directional accuracy of the holes for the bone screws. An additional advantage results if the bone contact surfaces of the device according to the invention are provided with a bio-inert, porous layer, because then a direct, interface-free bond is formed on the contact surface between the bone and the implant surface.
  • Fig. 1 shows a longitudinal section through an inventive
  • Fig. 2 shows a cross section along the line II-II in Figure 1;
  • FIG. 3 shows a side view of the osteosynthesis plate of the device according to the invention
  • Figure 4 illustrates a top view of the osteosynthesis plate
  • FIG. 5 shows a section parallel to FIG. 2, but at the level of a bone screw
  • FIG. 6 shows the screw head from FIG. 5, with the preferred, continuously decreasing cross section, on an enlarged scale
  • FIG. 7 shows a top view of the screw head from FIG. 6;
  • FIG. 8 shows a cross section through the bio-inert porous surface of the osteosynthesis plate or the hollow bone screw intended for bone contact
  • Figure 9 represents the equilibrium diagram for the binary mixture
  • Figure 10 represents the equilibrium diagram for the binary mixture
  • FIG. 11 shows a perspective view of two devices connected to an osteosynthetic device according to the invention
  • FIG. 12 shows a longitudinal section through the osteosynthesis plate according to FIG. 11;
  • FIG. 13 illustrates a perspective view of the slotted hollow cylinder serving as an insert
  • FIG. 14 shows a cross section analogous to FIG. 5 with a
  • Fig. 16 shows a cross section through an inventive
  • Fig. 17 shows a cross section through an inventive
  • Expansion screw with smooth outer cone shows a partial cross section through a device according to the invention with an additional, non-expandable bone screw
  • FIG. 19 shows the device according to the invention according to FIG. 18, the head of the additional, non-spreadable
  • Bone screw is shown in cross section
  • FIG. 20 shows a partial cross section through a device according to the invention with a slotted ball screw head
  • FIG. 21 shows further details of the expansion screw according to FIG. 20 in cross section
  • Fig. 26 shows a cross section through an inventive
  • FIG. 28 shows a partial cross section through a device according to the invention with a conical plate hole and a spherical-layer-shaped screw head;
  • FIG. 29 shows the device according to the invention according to FIG. 28 with a screw axis inclined with respect to the vertical.
  • FIG. 1 shows various aspects of an internal fixator according to the invention.
  • the bone screws 3, as shown in the second screw hole from the left, are inserted into the screw holes 2 of the osteosynthesis plate 1 with their shaft 9 in screwed in the bone 4.
  • the screw head 7 is provided with longitudinal slots 10 and a bore 25, so that the insert 11, which is designed as an expansion screw with an external thread 14, can be screwed into the bore 25 provided with an internal thread 13 while the screw head 7 is widened.
  • the screwing in is expediently carried out by means of an instrument which engages in the longitudinal slots 12 of the insert 11.
  • the convex lateral surface 18 of the screw head 7 is wedged with the concave drilling wall 8 of the screw hole 2, which results in an extremely rigid connection between the osteosynthesis plate 1 and screw 3.
  • the osteosynthesis plate 1 has essentially no planar surface areas.
  • the profile 17 lying between the screw holes 2 is tapered on all sides and thus allows a simpler deformation of the osteosynthesis plate on the occasion of its adaptation to the bone surface 4.
  • the bending moment is preferably the between the screw holes 2 lying profile 17 smaller or the same size as that of the profile running through the screw holes 2.
  • the concave configuration of the drilling wall 8 can either be realized, as shown in FIGS. 1, 5 and 15, by appropriate shaping of the screw holes 2 or, as shown in FIGS. 13 and 14, by inserting a correspondingly designed hollow cylinder 19 into the cylindrical bore 20 of the osteosynthesis plate 1, the axial insertion of the hollow cylinder 19 being limited and secured by an edge 21 which is oversized in relation to the diameter of the bore 20.
  • the hollow cylinder 19 can either be made of metal, for example titanium, or can also consist of a deformable material, for example a plastic such as polyethylene (HMPE), under the action of the head 7 of the bone screw 3 screwed and spread into the screw hole 2.
  • HMPE polyethylene
  • the outer surface 22 of the hollow cylinder 19, as shown in FIG. 13, has one or more slots 23 in the lower zone adjacent to the bone contact surface 4 and is slightly undersized in diameter compared to the cylindrical bore 20 of the osteosynthesis plate 1.
  • the slots 23 can also be made in the upper zone adjacent to the edge 21.
  • the two parts 4a, 4b are through an osteosynthesis plate 1 connected to each other, which can be screwed with a solid core shaft 9 having bone screws 3 through the screw holes 2 to the bone 4, the pure titanium osteosynthesis plate 1 being bent manually with the usual surgical instruments and adapted to the bone relief 4.
  • the osteosynthesis plate 1 has essentially no planar surface parts and the profile 17 lying between the screw holes 2 is tapered on all sides.
  • the holes in the bone 4 for the bone screws 3 are made in accordance with the usual surgical technique, expediently using a drilling jig.
  • the screw hole 2 has a cross-sectional constriction 5 in the direction of the bone contact surface 4, which is designed as a stop 6 for the bone screw 3 and allows exact axial positioning and securing.
  • the screwing in of the bone screws 3 can take place by means of an instrument which engages in the longitudinal slots 10 and bore 25 of the screw head 7.
  • the conical threaded expansion bolts 11 are screwed in, which have longitudinal slots 12 on the outer, larger end, which serve to receive the screwing instrument (screwdriver).
  • the preferably conical internal thread 13 of the screw head 7 corresponds to the external thread 14 of the insert 11.
  • the osteosynthesis plate 1 can be removed again, the inserts 11 being unscrewed first and then the bone screws 3.
  • an implant in particular a joint endoprosthesis, for example a temporomandibular joint prosthesis, the bone screws 3 and the osteosynthesis plate 1, to which the implant is then connected, remain permanently in the body of the implant
  • the bone screws 3 can be designed as hollow screws in order to promote the ingrowth of bone tissue.
  • Those surfaces of the bone screws 3 which are intended for contact with the bone 4 have a bio-inert, porous layer 16.
  • This porous layer can either consist, as shown in FIG. 8, of titanium or its alloys, which is applied using a plasma spray or similar process, or else be produced by sandblasting, for example with aluminum oxide particles. Electrolytic surface processes or coating with ceramic (apatite) are also suitable means of making the surface bone-friendly.
  • Achieving a porous titanium layer with an adhesive strength of at least 9.5 kp / mm 2 , preferably of at least 12.0 kp / mm 2, has proven to be important for the desired success proven on the preferably metallic substrate.
  • adhesive strengths of at least 20 kp / mm 2 , preferably at least 40 kp / mm 2 can be achieved.
  • a suitable method for achieving such adhesive strengths is the plasma flame method, but other chemical methods are also suitable.
  • the coating of the internal fixator according to the invention with the bio-inert, porous layer can be done, for example, by spraying on titanium powder with a grain size distribution of approximately 0.05-0.1 mm in a gas mixture of nitrogen and hydrogen flowing out under high pressure in an electric arc at a temperature of 15 ' 000 to 20,000 ° C take place.
  • the titanium hydride particles supplied in an inert gas carrier for example argon, reach a speed of about 600 m / s within the 15 to 20 cm long acceleration distance at which they hit the metal surface to be coated and there a 0.01 depending on the duration of the process - Form 0.50 mm, preferably 0.03 - 0.06 mm thick, bio-inert, porous layer.
  • the coating is expediently carried out in such a way that the resulting pores have a diameter of approximately 30-200 ⁇ m, preferably approximately 40-70 ⁇ m.
  • the chemical composition of the coating is also important for the bio-inert properties.
  • Porous surface layers have proven to be advantageous which, in addition to the base material (titanium, Ti-6Al-4V etc.), have a carbon content of less than 0.5% (preferably less than 0.3%) and a nitrogen content of less than 4% ( preferably less than 3%) and have an oxygen content between 8-10% (all figures are in% by weight).
  • the titanium in the titanium plasma layer is expediently at least in the form of the hexagonally coordinated ⁇ -Ti and the cubically coordinated 6-TiO and 5-TiN, preferably in a proportion of 76-87% by weight of the hexagonally coordinated ⁇ -Ti.
  • the corresponding phases are from the two equilibrium diagrams shown in FIGS. 9 and 10 for the binary alloys O-Ti (FIG. 9; source: THSchofield and AEBacon, J. Inst. Metals, 1955/6. 84.47) and N- Ti (Fig. 10; source: AE Pally et al. Trans.Amer -Soc.Met., 1954, 46, 312).
  • the preferred material titanium alloys, zirconium, Siobium, tantalum or platinum.
  • the osteosynthesis plate 1 can be removed again, the inserts 11 being unscrewed first and then the bone screws 3.
  • the internal fixator according to the invention is used to fix an implant, in particular a joint endoprosthesis, for example a temporomandibular joint prosthesis, the bone screws 3 and that remain Osteosynthesis plate 1 to which the implant then connects continuously in the patient's body.
  • Bio-inert, preferably reinforced plastic materials can also be used as the osteosynthesis plate 1 for the internal fixator according to the invention, for example in the form of deformable, polymerizable composite structures as described in Swiss patent application No. 03 428 / 86-1.
  • the internal fixator according to the invention is particularly suitable in maxillofacial surgery and for the fixation of endogenous prostheses and vertebral plates.
  • osteosynthesis plates with the usual dimensions have proven to be unsuitable.
  • Osteosynthesis plates 1 which have the following dimensions, have proven to be particularly advantageous for these purposes:
  • the screw head 7 of the bone screws 3 to be used is also very small, the two threads 13, 14 are designed to be continuous at least in the upper part facing away from the bone contact surface 4, so that when the insert 11 is screwed in, it expands the head 7 takes place.
  • a shape of the screw head 7 according to FIG. 6 has proven to be particularly expedient.
  • the lateral surface 18 of the head 7 is increasingly convex only in the lower zone adjacent to the bone contact surface 4, while the upper part practically ends in a cylindrical shape.
  • an appropriately designed drilling wall 8 of the very dovetail hole 2 there is an optimal, rigid and functionally stable connection between the osteosynthesis plate 1 and the bone screw 3.
  • FIG. 16 Another variant of the screw head 7 is shown in FIG. 16.
  • the cylindrical screw head 7 fits into the corresponding cylindrical part of the drilling wall 8 of the screw hole 2.
  • the power transmission takes place between the screw head 7 and the axial stop 6 designed as a taper in the bore 2 of the osteosynthesis plate 1.
  • FIGS. 22-24 Further variants of this print run are shown in FIGS. 22-24.
  • the advantage of these variants is the maximum lateral and axial load capacity.
  • the insert 11 is designed as a conical expansion screw with an external thread 14 which fits the internal thread 13 of the screw head 7 provided with longitudinal slots 10.
  • the variant of the screw head 7 shown in FIG. 17 largely corresponds to the embodiment according to FIG. 16 with the exception of the insert 11, which is designed here as a cone with a smooth outer surface 27, which by means of the cylindrical screw attachment 28 with the likewise smooth outer shell 26 of the conical bore 25 in Screw head 7 can be jammed.
  • FIGS. 20 and 21 The variant of a slotted ball screw head 7 shown in FIGS. 20 and 21 has a further significant advantage, which consists in that, in addition to the rigid and releasable connection between the bone screw 3 and the osteosynthesis plate 1, the screw axis 30 is inclined by the angle ⁇ up to 30 ° to the screw hole axis 24 is possible.
  • the spherical bonnet head 7 provided with longitudinal slots 10 can be expanded and rigidly fixed by means of the insert 11 designed as an expanding screw.
  • FIGS. 22 to 25 show variants of the screw hole bores 2 according to the invention with various embodiments of the annular tapered part 6. In FIG.
  • FIG. 22 shows a variant of the embodiment according to FIG. 22, which consists in the step-shaped taper 6 being inclined downwards.
  • FIG. 24 shows a screw hole 2 which is analogous to FIG. 5, but which widens again in the lower part facing the bone.
  • FIG. 25 shows a spherically formed borehole wall 8 which is particularly suitable for ball screw heads 7 according to FIGS. 26 and 27.
  • FIGS. 25 and 27 correspond essentially to the embodiment shown in FIG. 21, but with a screw hole 2 according to FIG. 24 or 25 and an insert 11 designed as a conical screw bolt.
  • the slots 10 of the screw ball head 7 are slotted crosswise and milled so deep that there is sufficient mechanical strength, but the screw ball head 7 can be easily pressed into one of the various screw holes 2 according to FIGS. 22 to 25.
  • an axial deviation of the screw axis of up to 30 ° is possible.
  • a further advantage is the possibility of an inevitable forward and backward movement of the screw-plate connection.
  • FIGS. 25 and 27 correspond essentially to the embodiment shown in FIG. 21, but with a screw hole 2 according to FIG. 24 or 25 and an insert 11 designed as a conical screw bolt.
  • the slots 10 of the screw ball head 7 are slotted crosswise and milled so deep that there is sufficient mechanical strength, but the screw ball head 7 can be easily pressed into one of the various screw holes 2 according to FIGS. 22 to 25.
  • FIG. 27 and 28 shows an osteosynthetic plate 1 with a borehole wall 8 of the hole 2 designed as a cone, the cone angle ⁇ being between 2-6 °, preferably between 3 and 5 ° and being, for example, 4 °.
  • the screw 3 provided for this hole 2 has a head 7 which is essentially designed as a spherical layer with slots 10 and into which an expansion screw 7 can be screwed. Due to the inner shape of the borehole wall 8 and the outer shape of the screw head 7, a deviation of the screw axis 30 by the angle .alpha. Compared to the hole axis 24 is possible with a consistently good mounting, which considerably extends the application range of the device according to the invention.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)

Abstract

Dans ce fixateur interne pour l'ostéosynthèse, les vis (3) peuvent être fixées de façon rigide et stable à une plaque de titane pur (1). Les parois d'alésage (8) des trous de vis (2) présentent dans au moins une zone voisine de la surface de contact (4) avec l'os une diminution (5) de la section, qui sert de butée (6) à la tête (7) de la vis (3). Cette tête (7) pourvue d'une fente longitudinale (10) et d'un alésage (25) peut être amenée en contact intime avec la plaque d'ostéosynthèse (1) en vissant un écarteur (11) dans la tête (7). La surface sphérique de la tête (7) et de l'alésage (8) permet un certain ajustement axial des vis (3) de façon que les exigences quant à la précision de l'alésage soient moins élevées. Les surfaces du fixateur interne, qui entrent en contact avec l'os (4), sont pourvues, de préférence, d'une couche poreuse (16) pour favoriser la croissance de l'os. Application de ce fixateur interne, outre pour l'ostéosynthèse proprement dite, pour la fixation d'implants, notamment d'endoprothèses articulatoires, par exemple de la mâchoire, de la hanche ou des vertèbres.
PCT/CH1987/000158 1986-11-25 1987-11-25 Dispositif d'osteosynthese WO1988003781A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
CH470786A CH669105A5 (de) 1986-11-25 1986-11-25 Interne fixationsvorrichtung fuer die osteosynthese.
CH4707/86-0 1986-11-25
CH353/87-0 1987-02-02
CH35387A CH672245A5 (en) 1987-02-02 1987-02-02 Inner osteosynthesis fastener with bone screws

Publications (1)

Publication Number Publication Date
WO1988003781A1 true WO1988003781A1 (fr) 1988-06-02

Family

ID=25684311

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CH1987/000158 WO1988003781A1 (fr) 1986-11-25 1987-11-25 Dispositif d'osteosynthese

Country Status (3)

Country Link
EP (1) EP0293411A1 (fr)
JP (1) JPH02500490A (fr)
WO (1) WO1988003781A1 (fr)

Cited By (124)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0419564A1 (fr) † 1988-06-13 1991-04-03 MICHELSON, Gary Karlin Implant spinal filete
US5062851A (en) * 1989-04-25 1991-11-05 Medevelop Ab Anchoring element for supporting a joint mechanism of a finger or other reconstructed joint
EP0530585A2 (fr) * 1991-09-03 1993-03-10 Synthes AG, Chur Vis et plaques résorbables autobloquantes pour l'immobilisation interne de fractures osseuses et la fixation d'un tendon à un os
WO1993022983A1 (fr) * 1992-05-15 1993-11-25 Citieffe S.R.L. Clou pour dispositifs de fixation externe
WO1994000066A1 (fr) 1992-06-25 1994-01-06 Synthes Ag Chur Dispositif de contention osteosynthetique
WO1994004086A1 (fr) * 1992-08-25 1994-03-03 Alexandre Worcel Dispositif d'osteosynthese
US5360450A (en) * 1992-03-09 1994-11-01 Howmedica International Div.Ne Pfizer Italiana S.P.A. Prosthesis for the correction of flatfoot
ES2067421A1 (es) * 1992-09-07 1995-03-16 Alacreu Jose Vicente Barbera Mejoras en el objeto de la patente principal n-p9201814/9 por sistema de fusion vertebral cervical.
WO1995035067A2 (fr) * 1994-06-17 1995-12-28 Sven Olerud Vis osteologique d'osteosynthese
WO1996008206A1 (fr) * 1994-09-15 1996-03-21 Smith & Nephew Richards Inc. Dispositif d'osteosynthese
GB2294399A (en) * 1994-10-28 1996-05-01 Jbs Sa Hollow bone-screw and sealing member for stabilising vertebrae
US5534027A (en) * 1993-06-21 1996-07-09 Zimmer, Inc. Method for providing a barrier to the advancement of wear debris in an orthopaedic implant assembly
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EP0293411A1 (fr) 1988-12-07

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