WO1994001048A1 - Double-threaded bone screw for use in medicine in through-bone osteosynthesis in the fields of accident surgery, traumatology and orthopaedics - Google Patents

Double-threaded bone screw for use in medicine in through-bone osteosynthesis in the fields of accident surgery, traumatology and orthopaedics Download PDF

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Publication number
WO1994001048A1
WO1994001048A1 PCT/EP1992/001561 EP9201561W WO9401048A1 WO 1994001048 A1 WO1994001048 A1 WO 1994001048A1 EP 9201561 W EP9201561 W EP 9201561W WO 9401048 A1 WO9401048 A1 WO 9401048A1
Authority
WO
WIPO (PCT)
Prior art keywords
bone
screw
thread
bone screw
fastening
Prior art date
Application number
PCT/EP1992/001561
Other languages
German (de)
French (fr)
Inventor
Georg Ihli
Johannes Derzap
Original Assignee
Georg Ihli
Johannes Derzap
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
Application filed by Georg Ihli, Johannes Derzap filed Critical Georg Ihli
Priority to PCT/EP1992/001561 priority Critical patent/WO1994001048A1/en
Priority to AU23120/92A priority patent/AU2312092A/en
Publication of WO1994001048A1 publication Critical patent/WO1994001048A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/8605Heads, i.e. proximal ends projecting from bone
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/60Surgical 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 for external osteosynthesis, e.g. distractors, contractors

Definitions

  • the double-threaded bone screw is used to attach the bone fragments to the corresponding elements of various external fixator systems (unilateral / bilateral, ramen, ring, etc.) and the additional possibility of reducing bone fragments.
  • mounting elements also does not ensure sufficient stability, because this type of fastening slowly loosens at the smooth end of the bone screw in the course of the healing process.
  • the consequences and disadvantages of this type of the following are: Absorption and osteolysis of parts of the bone surrounding the screw and the resulting pain and inflammation from soft parts to the bone (osteomyelitis), this could also lead to incorrect joint binding under these circumstances.
  • the invention seeks to remedy this.
  • the invention as characterized in the claims, considerably simplifies the task of attaching the bone screw to corresponding holding elements of the external fixator, such as:
  • the invention is illustrated using an example in the application of the double-threaded bone screw, for example in the case of a fracture of the lower leg in the diaphyseal area.
  • a skin incision is made about 1 cm on the ventromedial side of the upper third of the lower leg, Fig. 2.
  • the trocar is advanced with the tissue protection sleeve to the bone, FIG. 4.
  • the bone is drilled out with a drill Fig. 5.
  • the second double-threaded bone screw is inserted about 3 cm distally, FIG. 7, as well as other double-threaded bone screw pairs below the fracture line.
  • the double-threaded bone screws are fastened to the jaws of the external surgeon and additionally screwed with nuts. The final position is shown in FIG. 8.

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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)

Abstract

This special bone screw comprises threads at both ends of the screw. At one end of the screw which is intended to be inserted into the corresponding part of the bone, there is a coarse bone thread for spongy or cortical tissues (Fig. 1c). At the other end of the bone screw, designed for securing to supporting components of the external system fixer, is cut an ISO metric thread (a). This threaded end of the bone screw provides great stability in securing the bone screws by means of locknuts in securing the bone screws. By converting the rotating movement of the nuts into a linear movement of the bone screw, additonal facilities for repositioning the bone fragments is attained (Fig. 10).

Description

DOPPELGEWINDEENDIGE KNOCHENSCHRAUBE FÜR DIE ANWENDUNG IN DER MEDIZIN BEI DER TRANSOSSALE OSTEOSYNTHESE IN DEN TEILBEREICHEN UNFALLCHIRUR¬ GIE, TRAUMATOLOGIE UND ORTHOPÄDIE.DOUBLE-THREADED BONE SCREW FOR USE IN MEDICINE IN TRANSOSSAL OSTEOSYNTHESIS IN THE SUB-AREAS OF ACCIDENT SURGERY, TRAUMATOLOGY AND ORTHOPEDICS.
Die Doppelgewindeendige Knochenschraube dient für die Befestigung der Knochenfragmente an entsprechenden Elementen von verschiedenen Fixateur Externen Systemen (uni-/ bilateralen, Ramen, Ring usw.) sowie dadurch entstehende zusätzliche Repositionsmöglichkeit von Knochenfragmenten.The double-threaded bone screw is used to attach the bone fragments to the corresponding elements of various external fixator systems (unilateral / bilateral, ramen, ring, etc.) and the additional possibility of reducing bone fragments.
Es sind schon verschiedene Arten von Knochenschrauben bekannt, die ein spezielles Knochengewinde (Spongiosa oder Corticalis) aber nur auf einem Ende der Schrauben besitzen, welche in das Knochenfragment direkt eingeführt werden.Various types of bone screws are already known which have a special bone thread (cancellous bone or corticalis) but only on one end of the screws, which are inserted directly into the bone fragment.
Mit dem anderem glattem Ende werden Knochenschrauben an verschiedene Halterungselemente wie z.B.:With the other smooth end, bone screws are attached to various mounting elements such as:
Klemmbacken (Orthofix, Heidelberg External Fixation System usw.) Gelenken (AO, Hoffmann, Wagner, Martin Dynofix usw.) Kugelgriff (Ortho Fixateur Externe) usw. - von Fixateur Externe befestigt.Jaws (Orthofix, Heidelberg External Fixation System etc.) Joints (AO, Hoffmann, Wagner, Martin Dynofix etc.) Ball handle (Ortho Fixateur Externe) etc. - attached by Fixateur Externe.
Da diese Halterungselemente noch an tragbare Teile wie Ringe und Stangen des Fixateur Externe befestigt werden müssen, sind sie mei¬ stens kompliziert und monströs aufgebaut und oft gewährleisten sie dadurch nicht die optimale Positionen.Since these mounting elements still have to be attached to portable parts such as rings and rods of the external fixator, they are mostly complicated and monstrous and often do not guarantee the optimal positions.
Die Konstruktion von Halterungselementen gewährleistet auch nicht die ausreichende Stabilität, weil sich diese Befestigungsart am glattem Ende der Knochenschraube im laufe des Heilungsprozesses lang¬ sam löst. Die dadurch verursachten Mikrobewegungen der Knochenschrau¬ be verursachen nicht genügende Stabilität der Fixateur Externe. Durch diesen Vorgang entstehende Konsequenzen und Nachteile folgender Art: Resorption und Osteolyse von Knochenteilen die die Schraube umgeben und die dadurch entstehende Schmerzen und Entzündungen von Weich¬ teilen bis hin zum Knochen (Osteomyelitis), dies könnte unter diesen Umständen auch zur falschen Gelenkbindung führen.The construction of mounting elements also does not ensure sufficient stability, because this type of fastening slowly loosens at the smooth end of the bone screw in the course of the healing process. The micro-movements of the bone screw caused thereby cause insufficient stability of the external fixator. The consequences and disadvantages of this type of the following are: Absorption and osteolysis of parts of the bone surrounding the screw and the resulting pain and inflammation from soft parts to the bone (osteomyelitis), this could also lead to incorrect joint binding under these circumstances.
Hier will die Erfindung Abhilfe schaffen. Die Erfindung, wie sie in den Ansprüchen gekennzeichnet ist,vereinfacht wesentlich die Aufga¬ be der Befestigung der Knochenschraube an entsprechenden Halterungs¬ elementen des Fixateur Externe wie z.B.:The invention seeks to remedy this. The invention, as characterized in the claims, considerably simplifies the task of attaching the bone screw to corresponding holding elements of the external fixator, such as:
Kiembacken, Gelenke, Kugelgriffe usw. von uni- / bilateralen, Rahmen- Systemen sowie Abstandstücken, hohe Muttern mit zusätzlicher Seiten- gewindebohrung, Bushing (Muffe) ebenfalls mit einer Seitengewindeboh- rung, lange Lochplatten mit einem metrischem Gewindeende, um 90 ° - gedrehte Lochplatte usw. vom Ringfixateur durch zusätzliche Sicherung der Befestigungsstabilität mit gegenseitig kontrierten Muttern.Keel jaws, joints, ball handles etc. of unilateral / bilateral, frame systems and spacers, tall nuts with additional side tapped hole, bushing (socket) also with a side tapped hole, long perforated plates with a metric thread end, turned by 90 ° Perforated plate etc. from the ring fixator by additionally securing the fastening stability with mutually controlled nuts.
Durch die Umwandlung der drehenden Momente der Muttern in geradlini¬ ger Bewegung der Knochenschraube kann man zusätzlich streng dosier- und kontrolierbare sowie feinere Repositionen der Knochenfragmente erreichen.By converting the rotating moments of the nuts into a straight line movement of the bone screw, one can additionally achieve strictly metered and controlled as well as finer repositions of the bone fragments.
Im folgenden wird die Erfindung anhand eines Beispiels bei der Anwen- düng der Doppelgewindeendigen Knochenschraube zum Beispiel bei einem Unterschenkelknochenbruch im diaphisären Bereich dargestellt.In the following, the invention is illustrated using an example in the application of the double-threaded bone screw, for example in the case of a fracture of the lower leg in the diaphyseal area.
Nach der typischen Operationsvorbereitung - Anästhesie des Patienten und der sterilen Abdeckung des Operationsbereichs, wird eine Hautin- zision ca 1 cm an der ventromedialen Seite des oberen Drittels des Unterschenkels gemacht Fig. 2.After the typical preparation for the operation - anesthesia of the patient and the sterile covering of the operating area, a skin incision is made about 1 cm on the ventromedial side of the upper third of the lower leg, Fig. 2.
Dann werden die Weichteile durch eine Schere bis zum Knochen aufge¬ spreizt Fig. 3.Then the soft parts are spread out to the bone by scissors FIG. 3.
Als nächstes wird das Vorschieben des Trocars mit der Gewebeschutz¬ hülse bis zum Knochen vorgenommen Fig. 4. Nach der Entfernung des Trocars wird der Knochen mit einem Bohrer auf- gebohrt Fig. 5.Next, the trocar is advanced with the tissue protection sleeve to the bone, FIG. 4. After removing the trocar, the bone is drilled out with a drill Fig. 5.
Das Eindrehen der Doppelgewindeendigen Knochenschraube in den Knochen zeigt die Fig. 6.The screwing of the double-threaded bone screw into the bone is shown in FIG. 6.
Analogisch wird die zweite Doppelgewindeendige Knochenschraube ca. 3 cm distal eingesetzt Fig. 7, sowie andere Doppelgewindeendige Knochen¬ schraubenpaare unterhalb der Bruchlinie. Als letzter Schritt werden die Doppelgewindeendigen Knochenschrauben an die Klemmbacken des Fi¬ xateur Externe befestigt und zusätzlich mit Muttern verschraubt. Die endgültige Position zeigt die Fig. 8. Analogously, the second double-threaded bone screw is inserted about 3 cm distally, FIG. 7, as well as other double-threaded bone screw pairs below the fracture line. As a last step, the double-threaded bone screws are fastened to the jaws of the external surgeon and additionally screwed with nuts. The final position is shown in FIG. 8.

Claims

Patentansprüche Claims
1. Knochenschraube mit zwei Gewindearten die sich auf den Schrauben¬ enden befinden und zur Verwendung bei der transossale Östeosyn- these und in den Teilbereichen der Medizin wie Unfallchirurgie, Traumatologie und der Orthopädie verwendet werden ( Fig. 1).1. Bone screw with two types of thread which are located on the screw ends and are used for use in transosseous osteosynthesis and in the sub-areas of medicine such as trauma surgery, traumatology and orthopedics (FIG. 1).
Das auf einem Ende der Schraube befindende grobe Knochengewinde vom Typ Spongiosa oder Corticalis ( c ), daß zur Einführung in die entsprechende zubehandelnde Knochenteile dient. Am anderem Ende der Knochenschraube befindet sich ein metrisches ISO - Ge¬ winde ( a ) zur Befestigung der Fixateur Externe.The coarse bone thread of the type spongiosa or corticalis (c), which is used for insertion into the corresponding bone parts to be treated, is located on one end of the screw. At the other end of the bone screw there is a metric ISO thread (a) for fastening the external fixator.
Das zuerst beschriebene Schraubenende mit dem groben Knochenge¬ winde wird nach der Vorbohrung in den zu operierenden Knochen eingeführt bzw. eingedreht.The screw end with the coarse bone thread described first is inserted or screwed into the bone to be operated on after predrilling.
Das zweite Schraubenende mit dem metrischem Gewinde wird durch Halterungselemente wie Fig. 9. zeigt: Klemmbacken ( f ) Abstandsstücken ( g,h ), hohe Muttern ( i ), Bushing ( Muffe ) ( k ), lange Platten usw. befestigt.The second screw end with the metric thread is fastened by holding elements as shown in FIG. 9: clamping jaws (f) spacers (g, h), tall nuts (i), bushing (sleeve) (k), long plates, etc.
Durch die Anwendung vom metrischem Gewinde wird die Verbindung und Befestigung der Knochenschrauben wesentlich vereinfacht, weil dadurch Mikrobewegungen der Knochenschraube ganz ausge- schlössen werden, und dabei wird eine Stabilität im höchstenThe use of the metric thread considerably simplifies the connection and fastening of the bone screws, because micro movements of the bone screw are completely excluded, and stability is at its highest
Mase der gesamten Konstruktion des Fixateur Externe gewährlei¬ stet. Durch Umwandlung der drehenden Momente der Muttern in ge¬ radliniger Bewegung der Knochenschraube, entsteht eine zusätz¬ liche Repositionsmöglichkeit der Knochenfragmente ( Fig. 10 ).Mase of the entire construction of the external fixator guaranteed. By converting the rotating moments of the nuts into a straight line movement of the bone screw, there is an additional possibility of repositioning the bone fragments (FIG. 10).
2. Doppelgewindeendige Knochenschraube nach Patentanspruch 1 da¬ durch gekenzeichnet ist, daß auf einem Ende ein grobes Knochen¬ gewinde ( c, Fig 1 ) angeschnitten wird und zur Befestigung in den Knochen dient. Auf dem anderem Ende der Knochenschraube wel¬ che zur Befestigung an Fixateur Externe vorgesehen ist, wird ein metrisches ISO - Gewinde ( a, Fig 1 ) angeschnitten, was die Be¬ festigung von Knochenschrauben mit Muttern und Halterungselementen wesentlich vereinfacht und verbessert, es führt dadurch zusätlich zu einer höheren Stabilität der gesamten Konstruktion der Fixateur Externe. Es bietet zusätzlich noch eine Repositionsmöglichkeit für die Knochenfragmente. 2. Double-threaded bone screw according to claim 1 is characterized by the fact that a coarse bone thread (c, FIG. 1) is cut on one end and is used for fastening in the bone. On the other end of the bone screw, which is intended for attachment to external fixators, is a metric ISO thread (a, Fig. 1) is cut, which considerably simplifies and improves the fastening of bone screws with nuts and mounting elements; it additionally leads to a higher stability of the overall construction of the external fixator. It also offers a reduction option for the bone fragments.
PCT/EP1992/001561 1992-07-10 1992-07-10 Double-threaded bone screw for use in medicine in through-bone osteosynthesis in the fields of accident surgery, traumatology and orthopaedics WO1994001048A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
PCT/EP1992/001561 WO1994001048A1 (en) 1992-07-10 1992-07-10 Double-threaded bone screw for use in medicine in through-bone osteosynthesis in the fields of accident surgery, traumatology and orthopaedics
AU23120/92A AU2312092A (en) 1992-07-10 1992-07-10 Double-threaded bone screw for use in medicine in through-bone osteosynthesis in the fields of accident surgery, traumatology and orthopaedics

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EP1992/001561 WO1994001048A1 (en) 1992-07-10 1992-07-10 Double-threaded bone screw for use in medicine in through-bone osteosynthesis in the fields of accident surgery, traumatology and orthopaedics

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WO1994001048A1 true WO1994001048A1 (en) 1994-01-20

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8075604B2 (en) 2006-02-16 2011-12-13 Warsaw Orthopedic, Inc. Multi-thread bone screw and method
US8128671B2 (en) 2007-04-04 2012-03-06 Warsaw Orthopedic, Inc. Variable flank bone screw
CN115040224A (en) * 2022-06-13 2022-09-13 北京市春立正达医疗器械股份有限公司 High-stability bone screw for orthopedic trauma

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1789060A (en) * 1928-09-29 1931-01-13 King Scheerer Corp Bone-fracture clamp
US4456005A (en) * 1982-09-30 1984-06-26 Lichty Terry K External compression bone fixation device
DE8632645U1 (en) * 1986-12-05 1988-03-31 Bauer, Johann, Dr.Med. Compression screw
DE8815977U1 (en) * 1988-02-05 1989-02-16 Orthoplant Endoprothetik GmbH i.L., 28259 Bremen Rod-shaped fastening element
EP0450075A1 (en) * 1989-10-23 1991-10-09 Nauchno-Issledovatelsky Institut Radiofiziki Imeni Akademika A.A.Raspletina Apparatus for osteosynthesis

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1789060A (en) * 1928-09-29 1931-01-13 King Scheerer Corp Bone-fracture clamp
US4456005A (en) * 1982-09-30 1984-06-26 Lichty Terry K External compression bone fixation device
DE8632645U1 (en) * 1986-12-05 1988-03-31 Bauer, Johann, Dr.Med. Compression screw
DE8815977U1 (en) * 1988-02-05 1989-02-16 Orthoplant Endoprothetik GmbH i.L., 28259 Bremen Rod-shaped fastening element
EP0450075A1 (en) * 1989-10-23 1991-10-09 Nauchno-Issledovatelsky Institut Radiofiziki Imeni Akademika A.A.Raspletina Apparatus for osteosynthesis

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8075604B2 (en) 2006-02-16 2011-12-13 Warsaw Orthopedic, Inc. Multi-thread bone screw and method
US9247976B2 (en) 2006-02-16 2016-02-02 Warsaw Orthopedic, Inc Multi-thread bone screw and method
US8128671B2 (en) 2007-04-04 2012-03-06 Warsaw Orthopedic, Inc. Variable flank bone screw
CN115040224A (en) * 2022-06-13 2022-09-13 北京市春立正达医疗器械股份有限公司 High-stability bone screw for orthopedic trauma

Also Published As

Publication number Publication date
AU2312092A (en) 1994-01-31

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