WO2023055336A1

WO2023055336A1 - Orthopaedic expandable blade screw anchor system

Info

Publication number: WO2023055336A1
Application number: PCT/TR2022/051070
Authority: WO
Inventors: Yunus Emre BEKTAS; Hakan CICI; Nihat Demirhan DEMIRKIRAN
Original assignee: Kutahya Saglik Bilimleri Universitesi
Priority date: 2021-09-30
Filing date: 2022-09-30
Publication date: 2023-04-06
Also published as: TR2021015278A2

Abstract

The invention relates to an orthopaedic expandable blade screw anchor system (100), which can be produced in full compliance with the sizes of all screws and anchors, which makes the fixation of the screw stronger without causing additional damage to the bone or joint, without traumatising the skin, accelerates the healing of the bone and tendon, allows early joint movements to be started due to secure fixation in all cases requiring the use of screws in orthopaedic surgeries and in cases requiring bone integration with tendon-ligament in sports surgery.

Description

ORTHOPAEDIC EXPANDABLE BLADE SCREW ANCHOR SYSTEM

Technical Field

The present invention relates to an orthopaedic expandable blade screw-anchor system used in the surgical treatment of all fractures in the human body, in the integration of tissues to each other and in bone integration.

Background Art

Every year, around one hundred million people worldwide suffer from orthopaedic fractures and sports injuries, and more than half of them are operated on by orthopaedic surgeons, considering the sample size of the studies. Considering the fact that life expectancy is increasing, especially in developed and developing countries, it can be said that the increase in the number of orthopaedical injuries and surgery is inevitable. In this sense, faster and safer surgical fracture fixation of fractures is of critical importance in terms of reducing the incidence of mortality, reducing the duration of hospitalisation and the risk of infection, reducing the loss of the social labour force by accelerating early return to work and making positive contributions to health and economy.

Nowadays, it is stated in many scientific articles that the rate of application of surgical treatment in orthopaedic fractures and sports injuries has increased compared to conservative treatment (plaster, rest, etc.). While plaster and bracing are used in conservative treatment, screws, anchors, plates, nails, and wires with different properties are used in surgical treatment. Surgical treatment aims to restore the articular surface, stable fixation of the fracture segment to the main bone, preservative of fracture fragment nutrition and physiological movements of the joints. However, the available surgical treatment options may have some complications and disadvantages. The main disadvantages of screw-anchor fixation are that the strength and continuity of the compression on the fracture line are relatively weak in surgical fixation with cannulated and/or non-cannulated full-threaded and/or half-threaded screws, the temporary weakening of the bone as a result of lysis during the macrophage-active period of bone healing after fixation with screws, and the screw may loosen and cause the screw to come back.

Although plate fixation methods provide more strength rotationally and axially than screw-only fractures, they have disadvantages such as increased bleeding due to more skin incisions, increased risk of infection, and prolonged healing time. In addition, skin problems, vascular, nerve or tendon irritation and damage may develop.

Methods in which wires and cables such as tension bands are used and sometimes combined with screws may raise questions about the compatibility of the metallic alloy used with MRI (magnetic resonance imaging), and in cases where MRI is required, metallic implants (such as steel alloy cables and wires) may need to be removed by reoperation planning. In addition, there may be deficiencies, such as insufficient compression in the fracture line and low rotational stability, which prevent healing.

It is known that there are two crucial factors in bone healing: osteoconduction and autoinduction. In line with this information, contact and compression of the fracture ends in bone fractures, and healthy blood circulation in the fractured area is also essential in terms of the effect of biological healing factors.

In the United States, a patent application document numbered US10874445, one of the applications in the state of the art, a screw fixing apparatus is mentioned. The apparatus is especially designed to function like an anchor to fix the screws tightly, since the screws used in the surgical treatment of the cervical thoracic and lumbar spine and sacrum bones in the human body have the potential to damage the spinal cord and surrounding nerve tissues and there are risks such as loosening from the bone. However, in this system, the problem of integrability into the bones of different parts of the body and the expandability of the anchor in the bone may be limited in terms of both the limitation in anatomical usage and biomechanical adequacy.

In the United States, a patent application document numbered US2006235410, one of the applications in state of the art, expandable surgical stabilisers, is mentioned. Here, a biocompatible screw stabiliser (anchor) designed for bone, cartilage or bone-cartilage fixation has been developed, which is placed in the cortical bone (the area where the screw first contacts) and functions by opening the wings at the end when a screw or pin is sent through it. The aim is to increase the adhesion surface on the bone when the screw is sent, and then to prevent loosening and ensure that the screw and anchor are easily removed in cases where removal is required. Before applying the screw to the bone or cartilage, the drilling process is performed with a drill, and the anchor is placed in this carved area. The diameter of the entrance part of the anchor is smaller than the head part, which is attached to the bone last. It has a gap so that the screw can pass through it, and there are threads inside. As the screw is advanced into the anchor, the conical region at the end expands and becomes a rectangular shape, resulting in expansion within the bone. However, here the anchor cannot go beyond the fractured area and only strengthens the initial bone contact area where the screw is applied. In addition, the thinner tip of the anchor does not catch the strength in the head, even if there is expansion after screw application, and its biomechanical adequacy remains limited. Therefore, its resistance to tensile forces can be predicted as weak. Likewise, the compression strength at the fracture line will only be as much as the screw is applied. It cannot create an additional torsional counterforce.

In the United States, a patent application document numbered US2006149258 from the applications in the known state of the art, a surgical instrument and method for fixing ligaments is mentioned. It may have disadvantages, such as the fact that it can only be used in ligament repair, the expansion area is located at the end, so it only has the force to compress the ligament between the bone and the anchor, and it does not contain additional protrusions that provide additional resistance to axial loads.

Summary of the Invention

The invention aims to create a surgical implant system that accelerates fracture healing by providing complete anatomical fixation applied together with screwanchors used in different types of bone-cartilage fractures and sports surgery, does not create an additional traumatised area in the area where it will be applied, can perform controlled and continuous compression, reduces the need for revision (secondary) surgery after screw and anchor applications that loosen due to insufficient biomechanical strength, but when it is desired to be removed from the body, it can be removed thanks to the groove and screwdriver input.

A further aim of the invention is to minimise soft tissue damage during implant application, thanks to the hexagonal, star, etc. head screwdriver placed inside the guide wire and the anchor and the threads that are compatible with the tip of the anchor at the tip of the screwdriver, and is to ensure that the drilled bone is advanced by turning it to the left without creating additional traumatising area over the guide wire with the threaded rod connecting the screwdriver and the anchor and a cyclic stabiliser valve apparatus connecting the screwdriver and the threaded rod at the very end of the screwdriver, and to affect the healing of soft tissue and bone positively. In this way, the key to bone healing is to shorten the fracture healing time by increasing osteoinduction.

Another aim of the invention is to accelerate the healing time by increasing osteoconduction in bone healing by providing controlled and bidirectional compression to the fracture line by applying the wire and screwing process as described in the screw anchor system.

Another aim of the invention is to reduce the dependency on the fluoroscopy device, which enables imaging using radiation, by using the apparatus guiding the screw anchor system. This is planned to make a significant contribution to minimising the damage of radiation to both the surgical team and the patient.

Another aim of the invention is to contribute to the stability of the fracture line by creating resistance against the forces coming from sagittal, coronal and horizontal planes and rotational movements to the fracture line thanks to the configuration of the screw anchor system in the bone and allow early joint movements to be started.

Another aim of the invention is that the initiation of early joint movements and controlled contact and loading exercises to the floor can prevent the occurrence of costly processes that interrupt the daily life of patients, such as joint movement limitation, osteopenia, persistent pain, osteoarthrosis, which can be seen as postoperative complications in fracture healing.

Detailed Disclosure of the Invention

The “Orthopaedic Expandable Blade Screw-Anchor System” realised to achieve the aim of the present invention is shown in the attached figures and in the following figures:

Figure 1 - is the schematic representation of the screw anchor system, which is the subject of the invention, on the example of the femoral neck fracture model.

Figure 2 - is the representation of the anchor structure disclosed within the scope of the invention from four different directions.

Figure 3 - is the perspective (a-1, a-2) representation of the anchor structure disclosed in the scope of the invention from two different angles, and the section (b) along its longitudinal axis.

Figure 4 - is the perspective illustration of the screwdriver and anchor fixing bar, which are the auxiliary apparatus of the screw anchor system, which is the subject of the invention.

Figure 5 - is a perspective illustration of the cannulated drill bit.

The parts in the figures are numbered, and the descriptions are as in the following 100. Orthopaedic expandable blade screw-anchor system

1. Standard cannulated screw

1.1. Cannulated screw washer

2. Anchor

2.1. Anchor shaft

2.1.1. Anchor shaft proximal section

2.1.2. Anchor shaft centre section

2.1.3. Anchor shaft distal section

2.2. Proximal head of the anchor

2.2.1. Cylindrical wing

2.2.2. Blade tooth

2.2.3. Openable slit

2.2.4. Groove

2.3. Distal head of the anchor

2.3.1. Screw thread

2.3.2. Blade-like projections

2.3.3. In-anchor screwdriver slot

2.3.4. In-anchor fixing groove slot

2.3.5. Hole in the anchor

2.3.6. Thread slots

3. Cannulated screwdriver for anchor

4. Anchor fixing rod

FU. The upper end of femoral

FH. Femoral head

FN. Femoral neck

KH. Fracture Line

K-wire. Kirschner wire

MU. Cannulated drill bit

LA. Longitudinal axis The orthopaedic expandable blade screw anchor system (100), which is the subject of the invention, can be applied in all cases requiring the use of screws in orthopaedic surgeries and in cases requiring tendon-ligament and bone integration in sports surgery and can be produced in full compliance with the sizes of all screws and anchors wherein it comprises

- to connect the bone parts separated from each other by the fracture line (KH), a standard cannulated screw (1) positioned in a canal drilled in such a way that it starts from one bone fragment and extends along a longitudinal axis (LA) towards the other and terminates in the bone tissue after crossing the fracture line (CF),

- in order to provide retention between this standard cannulated screw (1) and the bone tissue, a 20 cylindrical anchor (2) placed in the open canal in the bone tissue before the standard cannulated screw (1) and closed at one end, which allows the standard cannulated screw (1), which enters through the open end, to adhere both to itself and to the bone tissue,

- a Kirschner wire (K-wire), which is used to guide the standard cannulated screw (1) and anchor (2) so that the standard cannulated screw (1) and anchor (2) can be guided smoothly through the canal in the bone tissue, and which is inserted after the canal is opened and removed after the standard cannulated screw (1) and anchor (2) are attached, characterised in that

- said anchor (2) o comprises when one end of said anchor (2) of closed cylindrical form is positioned in the canal extending into the bone, a distal head of said anchor (2.2) directed towards the bone 30 tissue and having a closed end of the cylindrical form (2.3), the proximal head of nn anchor (2.2), which is close to the entrance of the canal and is the open end of the cylindrical form, and an anchor shaft (2.1) extending between these two ends, is a lateral surface of the cylindrical anchor (2) and comprises an anchor shaft (2.1.1) which is divided into 3 sections, namely the proximal section (2.1.1) of the anchor shaft close to the proximal head (2.2) 5 of the anchor, the distal section (2.1.3) of the anchor shaft close to the distal head (2.3) of the anchor, and the middle section (2.1.2) of the anchor shaft between these two sections, has (preferably at least 2) the cylindrical wings (2.2.1), which, when viewed from the front, appear as parts forming a ring, and the slots (2.2.3), which can be opened between the cylindrical wings (2.2.1) forming the ring, extending from the proximal part of the anchor shaft (2.1.1) to the central part of the anchor shaft (2.1.2), the proximal head of the anchor (2.2) with grooves (2.2.4) at the end of these openable slots (2.2.3), at the junction of the cylindrical wings

(2.2.1) and the proximal head of the anchor (2.2) with wave-shaped bladed teeth (2.2.2) on the outer wall of each cylindrical wing

(2.2.1), also extending along the proximal section of the anchor shaft

(2.1.1) comprises, on the outer wall thereof, screw grooves (2.3.1) located along the distal part of the anchor shaft (2.1.3), bladed projections (2. 3.2), an in-anchor screwdriver slot (2.3.3) positioned in the distal part (2.1.3) of the anchor shaft where the screw grooves (2.3.1) are located, an in-anchor screwdriver slot (2.3.3) positioned in the distal part (2.1.3) of the anchor shaft so as to extend between the in-anchor screwdriver slot (2.3.3) and the closed end of the anchor (2). 1.3) and having a smaller diameter compared to the in-anchor screwdriver slot (2.3.3), an in-anchor fixing groove slot (2.3.4), an in-anchor hole (2.3.5) in the anchor (2) which runs parallel to the longitudinal axis (LA) and determines the direction of reciprocating movement in accordance with the Kirschner wire (K-wire) passing through it, and an anchor (2. 3.5) and the distal head (2.3) of the anchor (2.3.3) with thread slots (2.3.6) extending along the periphery of the anchor hole (2.3.5) and having a cyclic pattern of thread slots (2.3.6) in accordance with the structure of the threads on the outer periphery of the standard cannulated screw (1),

- has a closed cylindrical form at one end and contains an in-anchor cannulated screwdriver (3) with a screwdriver cannula in its centre along the longitudinal axis (LA), which is threaded into the in-anchor hole (2.3.5) and inserted into the in-anchor screwdriver slot (2.3.3) to facilitate the smooth advancement of the anchor (2) through the bone,

- means that the screwdriver with a cannulated screwdriver for anchor (3) is a screwdriver with a threaded hole at both ends, one end with a nut, the other end close to the screwdriver with a cannulated screwdriver for anchor (2.3.3), the other end of which has a threaded hole and is thus fixed to the anchor (2), which is also fixed to the cannulated screwdriver for the anchor (3) by tightening the nut on the side of the cannulated screwdriver for the anchor (3).

In an embodiment of the invention, a cannulated drill bit (MU) compatible with a Kirschner wire (K-wire) is used to open a channel in the bone tissue for working in the metaphyseal (spongy inner bone) bone. The cannulated drill bit (MU) is a temporary apparatus that opens a channel for the insertion of the invention into the bone. It is removed after grooving, and an anchor (2) is applied to the resulting cavity. Similarly, Kirschner wire (K-wire) acts as a guide for the drill, standard cannulated screw (1) and cannulated screwdriver (3) inside the anchor and is pulled out of the anchor (2) after the final product is applied.

The subject matter of the invention, the orthopaedic expandable blade screw-anchor system (100), is illustrated in Figure 1 to be explained by way of an exemplary application on a fracture model, in that it fixes the fracture line (KH) formed in the femoral neck (FN) between the upper end of the femur (FU) and the femoral head (FH) and is explained herein accordingly. The inventive orthopaedic expandable blade screw-anchor system (100) can be applied in all orthopaedic interventions and is illustrated in the context of the disclosure of the application text as an exemplary application for a fracture line (KH) occurring in the femoral neck (FN). The illustration herein describes only one exemplary embodiment and is not limited to this embodiment.

The two ends of the anchor shaft (2.1), the proximal head of the anchor (2.2) and the distal head of the anchor (2.3) have different characteristics. In this structure, which consists of two ends of the cylindrical form (the distal head of the anchor (2.3) and the proximal head of the anchor (2.2)) and the body between them (the anchor shaft (2.1)), the distal head of the anchor (2.3) has a larger diameter than the proximal head of the anchor (2. 2), and in the longitudinal axis (LA) the proximal section of the anchor shaft (2.1.1) near the proximal head of the anchor (2.2) is shorter than the distal section of the anchor shaft (2.1.3) near the distal head of the anchor (2.1.3). However, the largest diameter in its initial formative state belongs to the centre section of the anchor shaft (2.1.2). The anchor shaft (2.1) tapers at different inclinations to the distal head of the anchor (2.3) and the proximal head of the anchor (2.2), parallel to the longitudinal axis (LA). The thickness and length of the anchor shaft (2.1) can be of different sizes according to the diameter of the standard cannulated screw (1) to be used in the application area. In this way, the anchor (2) can show the desired tensile resistance and compressive effect by demonstrating full compatibility with the standard cannulated screw (1).

Inside the anchor (2), there is a hole in the anchor (2.3.5) for the Kirschner wire (K- wire), which runs parallel to the longitudinal axis (LA) and narrows at the distal end of the anchor (2.3), providing the appropriate movement for the guide wire. To allow the Kirschner wire (K-wire) to guide the joining of all parts, all parts positioned along the longitudinal axis (LA) have an opening through which the Kirschner wire (K-wire) can pass.

The proximal head of the anchor (2.2) is provided with cylindrical wings (2.2.1), preferably consisting of four segments, which, when viewed from above, appear as four quarter rings spaced apart, forming a circle, and which extend along the proximal section (2.1.1) of the anchor shaft. Each cylindrical wing (2.2.1) has waveshaped bladed teeth (2.2.2) on its outer wall, also extending along the anchor shaft proximal section (2.1.1). The wave-shaped bladed teeth (2.2.2) become smaller as they move from the anchor shaft proximal section (2.1.1) towards the anchor shaft centre section (2.1.2), which has the largest diameter. In addition, with the rotation of the anchor (2), the attachment of the bladed teeth (2.2.2), which cut into the cancellous bone tissue, to the tissue is increased due to the bone filling between them. For this purpose, the waveform of the bladed teeth (2.2.2) is preferably inclined in the tightening direction (clockwise) of the standard cannulated screw (1). On the outer wall of the distal part of the anchor shaft (2.1.3), there are nonstandard screw grooves (2.3.1) to facilitate the advancement of the anchor (2) through the bone by rotating in a counterclockwise direction, and at the distal head of the anchor (2.3), there are blade like projections (2.3.2) intended to provide resistance during rotation. The non-standard threads (2.3.1) are screw threads that will advance when rotated anti -clockwise as opposed to normal.

Between the cylindrical wings (2.2.1), which resemble a circle when viewed from above, there are slots (2.2.3) extending from the proximal part of the anchor shaft (2.1.1) to the central part of the anchor shaft (2.1.2) and grooves (2.2.4) at the end of these slots (2.2.3), where the cylindrical wings (2.2.1) meet. These openable slots (2.2.3) and grooves (2.2.4) allow the standard cannulated screw (1) to be inserted into the anchor (2), opening this cylindrical structure and changing the circle formation, thus expanding the anchor.

The anchor shaft (2.1) comprises an anchor hole (2.3.5), also roughly cylindrical in shape, in the form of an inner volume of cylindrical form and having an inner wall of smaller diameter at the proximal head of the anchor (2.2) and increasing in diameter towards the centre of the anchor shaft (2.1.2). From the proximal head of the anchor (2.2) to the in-anchor screwdriver slot (2.3.3), there are thread slots (2.3.6) in a cyclic pattern running along the inner wall of the in-anchor hole (2.3.5) along the anchor shaft (2.1) and in line with the structure of the screw threads on the outer wall of the standard cannulated screw (1). The standard cannulated screw

(1), which travels through the hole (2.3.5) in the anchor (2.3.5) through the thread slots (2.3.6), is firmly attached to the anchor (2) employing these thread slots (2.3.6) and travels towards the opposite end of the anchor (2). In the meantime, the cylindrical wings (2.2.1) open to allow the anchor (2) to expand and the waveshaped bladed teeth (2.2.2) provide a tight grip on the bone, preventing the anchor

(2) from rotating and fixing it to the bone. The opening capability of the cylindrical wings (2.2.1) may vary depending on the outer diameter of the standard cannulated screw (1) that runs in the anchor (2) and the thickness of the wings. Furthermore, each cylindrical wing (2.2.1) preferably has three wave-formed bladed teeth (2.2.2), but this number maybe 1 or more depending on the number of cylindrical wings (2.2.1) and the size of the bladed teeth (2.2.2). In addition, the bladed teeth (2.2.2) may be positioned parallel or perpendicular to the longitudinal axis (LA) or right- rotated or left-rotated.

When the anchor (2) is cross-sectioned along its longitudinal axis (LA), as shown in Figure 3-b, there is an intra-anchor screwdriver slot (2.3.3) positioned in the central part of the anchor shaft (2.1.2) - and to some extent in the distal part of the anchor shaft (2.1.3) - where the tip of the intra-anchor cannulated screwdriver (3) is located, which allows the anchor (2) to move easily through the bone. There is an in-anchor screwdriver slot (2.3.3) that enables the screwdriver to (3) an in-anchor cannula to fit easily into the anchor (2). When the anchor is inserted into the bone, the standard cannulated screw (1) and the fixing apparatus are removed after the end of the procedure. The screwdriver slot (2.3.3) in the said anchor may vary in hexagonal star or other screwdriver formation. Although it can be in different forms, in terms of ease of use and comprehensibility within the scope of the invention, the formation that can be designed according to hexagon, star, alien and other screwdriver heads is preferred and is shown in this way in the figures. Immediately below the anchor screwdriver slot (2.3.3), there is an anchor fixing groove slot (2.3.4) positioned in the distal part of the anchor shaft (2.1.3), extending to the distal head (2.3) of the smaller diameter anchor. After the screwdriver (3) with a cannulated screwdriver for anchor (2) is advanced along the longitudinal axis (LA) of the anchor (2) and inserted into the screwdriver slot (2.3.3), the screwdriver with a cannulated screwdriver for anchor (3) is passed through the screwdriver cannula in the screwdriver with a cannulated screwdriver for anchor (3) to fix the screwdriver with a cannulated screwdriver for anchor (2), which is advanced and inserted into the screwdriver slot (2.3. 3), which is threaded at both ends and has a nut at one end and a threaded hole at the other end, and which is fixed to the anchor (2) by tightening the nut on the cannulated screwdriver for anchor (3) side after it is fixed to the anchor (2), an anchor fixing rod (4) provides the connection between the cannulated screwdriver for anchor (3) and the anchor

(2). As can be seen in Figure 5, there is a groove along the long axis of the anchor cannulated screwdriver (3), and this part is called anchor cannulated screwdriver

(3) because of this groove.

Firstly, a Kirschner wire (K-wire) is sent from the outermost part of the femoral upper part (FU) in a direction parallel to the femoral neck (FN), targeting the centre of the femoral head (FH). The cannulated drill bit (MU) compatible with the Kirschner wire (K-wire) is advanced in the bone. In this way, a suitable area is opened for the standard cannulated screw (1) and anchor (2) to work in the metaphyseal bone (spongy inner bone). The anchor cannulated screwdriver (3) must be integrated into the orthopaedic expandable blade screw-anchor system (100) of the invention before final application, whereby the anchor cannulated screwdriver (3) is advanced into the inside of the anchor shaft (2.1) parallel to the longitudinal axis (LA) and inserted into the anchor screwdriver slot (2.3.3). The anchor fixing rod (4), with a nut on one end and a threaded hole on the other end, which is an apparatus compatible with the screwdriver cannula in the centre of the screwdriver with an in-anchor cannula (3), is pushed through the aforementioned channel (screwdriver cannula) to the distal part of the anchor shaft (2.1.3). When the anchor fixing rod (4) reaches the in-anchor fixing groove slot (2.3.4), it is fixed to the anchor (2) by turning it in a screw-turning manner. The described anchor fixing rod (4) is provided with a nut on the outer part of the anchor fixing rod (4), which is on the side of the screwdriver (3) with an in-anchor cannula, and the nut is tightened by turning the nut by means of the grooves at the upper end of the anchor fixing rod (4). In this way, the anchor fixing bar (4) and the handle of the screwdriver (3) with a cannulated screwdriver in the anchor are fixed together. In this way, the screwanchor system (100) with an orthopaedic expandable blade is fixed to the screwdriver (3).

Using the Kirschner wire (K-wire) as a guide, the inventive orthopaedic expandable blade screw-anchor system (100) is guided along its longitudinal axis (LA) through the Kirschner wire (K-wire) by means of a gap extending in the bone. This advancing movement is achieved by the screw threads (2.3.1) in the distal head (2.3) of the anchor (2.3) in a smooth and controlled manner by the rotational movement of the screwdriver (3) with the cannulated cannula inside the anchor. The anchor (2) is advanced until the femoral head (FH) reaches the end point, and when the rotation is finished, the anchor (2) is pushed slightly in the direction of the longitudinal axis (LA) so that the blade like projections (2.3.2) at the end of the grooves are driven into the metaphyseal bone, which is the primary fixation of the anchor (2). Then, with the Kirschner wire (K-wire) used as a guide remaining in place, the anchor fixing rod (4) and the screwdriver (3) with a cannulated in-anchor screwdriver (3) are removed from the anchor (2) in the reverse order of the procedures described above.

The length of the standard cannulated screw (1) is calculated as the length of the previously measured and drilled groove, and then the length of the screw threads (2.3.1) at the distal head of the anchor (2.3) is subtracted from the first measurement to determine the final measurement length. For example, the intra-osseous canal drilled through the femoral neck (FN) is 100 mm. The length of the anchor (2) sent and fixed to the lowest part of the canal is 32 mm. The distal head of the anchor (2.3) is 8 mm. The length of the standard cannulated screw (1) to be advanced in the bone canal will be 100-8=92 mm. The 24 mm section at the end of the standard cannulated screw (1) will be positioned in the anchor (2). With the Kirschner wire (K-wire) still used as a guide and the anchor (2) now fixed in the femoral head (FH), the standard cannulated screw (1) and the cannulated screw washer (1.1) of the specified length are driven into the bone on the guiding Kirschner wire (K-wire) with the cannulated screwdriver (3) in the anchor. The cannulated screw washer (1.1) remains outside the bone at the upper end of the femur (FU), while the standard cannulated screw (1) continues through the cancellous bone and crosses the fracture line (KH). The standard cannulated screw (1) meets the anchor (2) on the same longitudinal axis (LA) as the standard cannulated screw (1) on the same Kirschner wire (K-wire), the primary fixation of which has been completed as described above and continues along the longitudinal axis (LA) in the anchor shaft (2.1) as the standard cannulated screw (1) continues to rotate. Simultaneously with the rotation of the standard cannulated screw (1), starting from the proximal end (2.2) of the anchor, the cylindrical wings (2.2.1), consisting of four parts, open and expand. To prevent the anchor (2) from rotating in the bone during expansion, the wave-formed bladed teeth (2.2.2) increase the adhesion to the bone and realise the secondary fixation of the anchor (2). Furthermore, the expansion of the proximal head (2.2) of the anchor (2.2) together with the edges of the openable slots (2.2.3), which mediate the expansion of the cylindrical wings (2.2.1), increases the resistance of the standard cannulated screw (1) against tensile forces and additionally multiplies the compression strength to a certain extent. The centre section (2.1.2) of the anchor shaft of the standard cannulated screw (1) rotates to the end point by means of the thread slots (2.3.6) terminating on the inside, and the anchor (2) and the standard cannulated screw (1) are locked together.

The inventive orthopaedic expandable bladed screw-anchor system (100), through compressing the fracture line (KH) with a tight fixation, narrows the fracture line (KH), accelerates healing and prevents subsequent deformations of the fracture line (KH). Finally, the Kirschner wire (K-wire) used as a guide is removed and the other routine steps of the operation are started. The invention relates to an orthopaedic expandable blade screw-anchor system (100), stainless steel, carbon fibre, titanium, titanium or cobalt-chromium alloys (preferably Ti-6A-4V due to biological compatibility), synthetic biodegradable materials (preferably, polyglycolic acid, poly lactic acid, polymers and copolymers, polyhydroxybutyrate, polydioxon, magnesium) soluble synthetic materials (preferably, polyethylene oxide block copolymers, polyvinyl alcohols, cellulose), natural soluble materials (preferably fibrin, collagen, gelatin, dextran), insoluble materials (preferably polyethylene, polypropylene or other synthetic polymers compatible with the human body), substances that increase bone adhesion (preferably tantalum sputtering or citronium) and at least one material selected from a group consisting of combinations thereof.

The invention relates to an orthopaedic expandable blade screw-bar system (100),

• accelerates bone healing by providing fracture fixation of fixing materials such as screws and anchors used in the surgical treatment of all fractures occurring in the human body and in the surgical treatment of tendon and ligament (ligament) damages such as sports surgery and in integration of these tissues to each other and to the bone, without damaging the fracture line (KH) and the joint, without traumatising the skin and without damaging the vessels, nerves and ligaments in and around the bone,

• acts as a kind of anchor to the existing screw-anchor systems, increases the biomechanical strength of the fixation, prevents the development of complications such as joint stiffness, osteoarthrosis or osteopenia by providing early joint movements due to secure fixation,

• can reduce problems such as loosening or bone non-union due to tight fixation, can be produced in diameter and length suitable for all screwanchor systems and features used in orthopaedic surgery today, and can function and work in the same direction with fixation materials such as screw-anchor with the help of guide wires, • increases in diameter by expanding with the opening of four cylindrical wings (2.2.1) after the standard cannulated screw (1) is directed into the inner cavity of the standard cannulated screw (1) compatible with the grooves of the standard cannulated screw (1) and contributes to rotational stability by increasing the adhesion on the metaphyseal bone thanks to the wave-designed blade teeth (2.2.2.2) contributes to rotational stability by increasing the adhesion on the metaphyseal bone and at the same time, it can counteract the initial distracting (separating) forces together with the wing opening thanks to the in-anchor stabilising groove slot (2.3.4) with left-rotating grooves at the very end of the anchor (2).

Consequently, with the inventive orthopaedic expandable blade screw-bar system (100),

• a structure that can be used in fragmented bone fractures and cartilage fractures accompanied by joint collapse has been created,

• a structure that can be applied in sports surgery applications such as anterior cruciate ligament - posterior cruciate ligament repair or rotator cuff muscle repair has been created,

• a structure that can be applied in a wide range of applications has been created with the feature of providing adhesion to increase bone fusion with ligament (ligament),

• a structure that can be dimensioned in accordance with all screw-anchor shapes and diameters that have found use in orthopaedic surgery has been created,

• a structure with bone and soft tissue harmony is provided,

• thanks to the hole in the anchor (2.3.5) in the centre of the anchor (2) and the Kirschner wire (K-wire) with the guiding feature, a structure that can be guided exactly to the area to be applied and can easily work in the same direction as the standard cannulated screw (1) to be sent is provided, • a structure that can be applied in the determined direction without the use of additional scopi (surgical imaging device that emits X-rays) has been created,

• a structure capable of bilateral compression of the fracture line (KH) was created with a standard cannulated screw (1) accompanied by a Kirschner wire (K-wire),

• thanks to the thread slots (2.3.6) in the anchor (2), it is ensured that a structure is formed that maintains the compression force at the fracture line (KH),

• a structure that resists the loop force by means of the wave-like bladed teeth (2.2.2) on the outer wall and thus is firmly fixed to the bone and, at the same time, can resist tensile forces by opening the cylindrical wings (2.2.1) from the first contact with the standard cannulated screwdriver (1) to the last movement in which the loop is completed,

• it is ensured that a structure that is safe in terms of accelerating bone healing and starting early movements is provided.

Within the scope of the invention, in different types of fractures, as a result of the operation of the standard cannulated screw (1) in harmony with the anchor (2), which allows the anchor (2) to be sent to the bone by means of guide apparatus (Kirschner wire (K-wire)) and screwdrivers (screwdriver (3) with the cannula in the anchor) designed in accordance with the bone morphology, an orthopaedic expandable blade screw-pier system (100) has been developed that can provide controlled and continuous compression to the fracture line (KH), can be applied in a way that does not cause soft tissue damage and vascular, nerve and tendon irritation, and is thought to reduce the need for fluoroscopy to be used during surgery.

Claims

CLAIMS The subject of the invention, as claimed, can be applied in all cases requiring the use of screws in orthopaedic surgeries and cases requiring tendonligament and bone integration in sports surgery and can be produced in full compliance with the sizes of all screws and anchors wherein it comprises

- a Kirschner wire (K-wire) used to guide the standard cannulated screw (1) and the anchor (2) for smooth progression of the standard cannulated screw (1) and the anchor (2) through the canal in the bone tissue, which is inserted after opening the canal and removed after attachment of the standard cannulated screw (1) and the anchor (2),

- especially an orthopaedic expandable blade screw anchor system characterised by (100) comprising o when one end of said anchor (2) of closed cylindrical form is positioned in the canal extending into the bone, a distal head of said anchor (2.2) directed towards the bone 30 tissue and having a closed end of the cylindrical form (2.3), the proximal head of an anchor (2.2), which is close to the entrance of the canal and is the open end of the cylindrical form, and an anchor shaft (2.1) extending between these two ends, a lateral surface of the cylindrical anchor (2) and comprises an anchor shaft (2.1.1) which is divided into 3 sections, namely the proximal section (2.1.1) of the anchor shaft close to the proximal head (2.2) 5 of the anchor, the distal section (2.1.3) of the anchor shaft close to the distal head (2.3) of the anchor, and the middle section (2.1.2) of the anchor shaft between these two sections, the cylindrical wings (2.2.1), which, when viewed from the front, appear as parts forming a ring, and the slots (2.2.3), which can be opened between the cylindrical wings (2.2.1) forming the ring, extending from the proximal part of the anchor shaft (2.1.1) to the central part of the anchor shaft (2.1.2), the proximal head of the anchor (2.2) with grooves (2.2.4) at the end of these openable slots (2.2.3), at the junction of the cylindrical wings (2.2.1) and the proximal head of the anchor (2.2) with wave-shaped bladed teeth (2.2.2) on the outer wall of each cylindrical wing (2.2.1), also extending along the proximal section of the anchor shaft (2.1.1) on the outer wall thereof, screw grooves (2.3.1) located along the distal part of the anchor shaft (2.1.3), bladed projections (2. 3.2), an in-anchor screwdriver slot (2.3.3) positioned in the distal part (2.1.3) of the anchor shaft where the screw grooves (2.3.1) are located, an in-anchor screwdriver slot (2.3.3) positioned in the distal part (2.1.3) of the anchor shaft so as to extend between the in-anchor screwdriver slot (2.3.3) and the closed end of the anchor (2). 1.3) and having a smaller diameter compared to the in-anchor screwdriver slot (2.3.3), an in-anchor fixing groove slot (2.3.4), an in-anchor hole (2.3.5) in the anchor (2) which runs parallel to the longitudinal axis (LA) and determines the direction of reciprocating movement in accordance with the Kirschner wire (K-wire) passing through it, and a anchor (2. 3.5) and the distal head (2.3) of the anchor (2.3.3) with thread slots (2.3.6) extending along the periphery of the anchor hole (2.3.5) and having a cyclic pattern of thread slots (2.3.6) in accordance with the structure of the threads on the outer periphery of the standard cannulated screw (1), o screw grooves (2.3.1) located on the outer wall along the distal part of the anchor shaft (2.1.3), bladed projections (2. 3.2) extending outwards to coincide with the closed end of the anchor (2), which are intended to provide resistance during rotational movement and are inserted into the cancellous bone. 3.

2), an in-anchor screwdriver slot (2.3.3) positioned in the distal part (2.1.3) of the anchor shaft where the screw grooves (2.3.1) are located, an in-anchor screwdriver slot (2.3.3) positioned in the distal part (2.1. 3) and having a smaller diameter than the anchor screwdriver slot (2.3.3), an anchor fixing groove slot (2.

3.

4), an anchor hole (2.3.5) in the anchor (2) which runs parallel to the longitudinal axis (LA) and determines the direction of reciprocating movement in accordance with the Kirschner wire (K-wire) passing through it, and an anchor hole (2. 3.5) and an anchor (2) comprising a distal head (2.3) of the anchor (2.3) with thread slots (2.3.6) extending along the periphery of the anchor hole (2.3.

5) and having a cyclic pattern of thread slots (2.3.

6) in accordance with the pattern of threads on the outer wall of a standard cannulated screw (1),

- a closed cylindrical form at one end and contains an in-anchor cannulated screwdriver (3) with a screwdriver cannula in its centre along the longitudinal axis (LA), which is threaded into the in-anchor hole (2.3.5) and inserted into the in-anchor screwdriver slot (2.3.3) to facilitate the smooth advancement of the anchor (2) through the bone,

- the screwdriver with a cannulated screwdriver for anchor (3) is a screwdriver with a threaded hole at both ends, one end with a nut, the other end close to the screwdriver with a cannulated screwdriver for anchor (2.3.3.3), the other end of which has a threaded hole and is thus fixed to the anchor (2), which is also fixed to the cannulated screwdriver for the anchor (3) by tightening the nut on the side of the cannulated screwdriver for the anchor (3). The orthopaedic expandable blade screw anchor system in Claim 1 (100) is characterised in that the cannulated drill bit (MU) is compatible with the Kirschner wire (K-wire) and provides a channel in the bone tissue for working in the metaphyseal bone (cancellous inner bone). The orthopaedic expandable blade screw anchor system (100) in Claim 1 is characterised by a proximal head (2.2) of the anchor comprising at least 2 cylindrical blades (2.2.1). The orthopaedic expandable blade screw anchor system (100) in Claim 1 is characterised in that the anchor shaft (2.1) has a diameter that tapers from the proximal head of the anchor (2.2) towards the distal head of the anchor (2.3). The orthopaedic expandable blade screw anchor system (100) in Claim 1, characterised by blade teeth (2.2.2) positioned on the cylindrical blades (2.2.1) parallel or perpendicular or right-rotated or left-rotated to the longitudinal axis (LA). The orthopaedic expandable blade screw anchor system (100) in Claim 1 is characterised in that it is manufactured from at least one material selected from a group consisting of stainless steel, carbon fibre, titanium, titanium or cobalt-chromium alloys, synthetic biodegradable materials, soluble synthetic materials, naturally soluble materials, insoluble materials, substances that increase bone adhesion and combinations thereof.

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7. The orthopaedic expandable blade screw anchor system in Claim 6 is characterised in that it is manufactured from titanium alloy Ti-6A-4V due to its biological compatibility (100).

8. The orthopaedic expandable blade screw anchor system in Claim 6 is characterised in that it is manufactured from a synthetic biodegradable material selected from the group consisting of polyglycolic acid, polylactic acid, polymers and copolymers, polyhydroxybutyrate, polydioxon, magnesium and combinations thereof (100).

9. The orthopaedic expandable blade screw anchor system (100) in Claim 6 is characterised in that it is manufactured from a soluble synthetic material selected from a group comprising polyethylene oxide block copolymers, polyvinyl alcohols, cellulose, and combinations thereof.

10. The orthopaedic expandable blade screw anchor system in Claim 6 is characterised in that it is manufactured from a naturally soluble material selected from the group consisting of fibrin, collagen, gelatin, dextran and combinations thereof (100).

11. The orthopaedic expandable blade screw anchor system (100) in Claim 6 is characterised in that it is manufactured from insoluble material selected from a group comprising polyethylene, polypropylene or other synthetic polymers compatible with the human body and combinations thereof.

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