CA1259867A - Connector for fractured bones - Google Patents
Connector for fractured bonesInfo
- Publication number
- CA1259867A CA1259867A CA000513363A CA513363A CA1259867A CA 1259867 A CA1259867 A CA 1259867A CA 000513363 A CA000513363 A CA 000513363A CA 513363 A CA513363 A CA 513363A CA 1259867 A CA1259867 A CA 1259867A
- Authority
- CA
- Canada
- Prior art keywords
- sleeve
- plug sleeve
- trailing
- expansion means
- leading
- Prior art date
- Legal status (The legal status 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 status listed.)
- Expired
Links
- 210000000988 bone and bone Anatomy 0.000 title claims abstract description 46
- 239000012634 fragment Substances 0.000 claims abstract description 15
- 239000004033 plastic Substances 0.000 claims abstract description 4
- 229920003023 plastic Polymers 0.000 claims abstract description 4
- 239000002184 metal Substances 0.000 claims description 4
- 239000011248 coating agent Substances 0.000 claims description 3
- 238000000576 coating method Methods 0.000 claims description 3
- 230000007704 transition Effects 0.000 claims description 3
- 206010017076 Fracture Diseases 0.000 claims 4
- 208000010392 Bone Fractures Diseases 0.000 description 6
- 230000001054 cortical effect Effects 0.000 description 3
- 230000006378 damage Effects 0.000 description 3
- 230000000694 effects Effects 0.000 description 3
- 238000003780 insertion Methods 0.000 description 3
- 230000037431 insertion Effects 0.000 description 3
- 239000004698 Polyethylene Substances 0.000 description 2
- -1 polyethylene Polymers 0.000 description 2
- 229920000573 polyethylene Polymers 0.000 description 2
- 229910001220 stainless steel Inorganic materials 0.000 description 2
- 239000010935 stainless steel Substances 0.000 description 2
- 239000000126 substance Substances 0.000 description 2
- AYFVYJQAPQTCCC-GBXIJSLDSA-N L-threonine Chemical compound C[C@@H](O)[C@H](N)C(O)=O AYFVYJQAPQTCCC-GBXIJSLDSA-N 0.000 description 1
- 239000007769 metal material Substances 0.000 description 1
- 238000000034 method Methods 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000007493 shaping process Methods 0.000 description 1
- 238000007738 vacuum evaporation Methods 0.000 description 1
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
- A61B17/686—Plugs, i.e. elements forming interface between bone hole and implant or fastener, e.g. screw
-
- F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
- F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
- F16B—DEVICES FOR FASTENING OR SECURING CONSTRUCTIONAL ELEMENTS OR MACHINE PARTS TOGETHER, e.g. NAILS, BOLTS, CIRCLIPS, CLAMPS, CLIPS OR WEDGES; JOINTS OR JOINTING
- F16B13/00—Dowels or other devices fastened in walls or the like by inserting them in holes made therein for that purpose
- F16B13/12—Separate metal or non-separate or non-metal dowel sleeves fastened by inserting the screw, nail or the like
- F16B13/124—Separate metal or non-separate or non-metal dowel sleeves fastened by inserting the screw, nail or the like fastened by inserting a threaded element, e.g. screw or bolt
-
- F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
- F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
- F16B—DEVICES FOR FASTENING OR SECURING CONSTRUCTIONAL ELEMENTS OR MACHINE PARTS TOGETHER, e.g. NAILS, BOLTS, CIRCLIPS, CLAMPS, CLIPS OR WEDGES; JOINTS OR JOINTING
- F16B37/00—Nuts or like thread-engaging members
- F16B37/12—Nuts or like thread-engaging members with thread-engaging surfaces formed by inserted coil-springs, discs, or the like; Independent pieces of wound wire used as nuts; Threaded inserts for holes
- F16B37/122—Threaded inserts, e.g. "rampa bolts"
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S606/00—Surgery
- Y10S606/907—Composed of particular material or coated
Landscapes
- 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
ABSTRACT OF THE DISCLOSURE
A connector for osteosynthesis, especially for fastening bone fragments comprises a plug sleeve and a screw engageable in the plug sleeve, the plug sleeve being formed of a viscoplastic, tissue-compatible plastics and having a thread shape on its outer surface. The plug sleeve can be slightly expanded at its end facing the head of the screw and also expanded to a greater extent at its other end, so that simple assembly and firm clamping in the bone tissue is achieved. It is possible to monitor the position of the plug sleeve in the bone constantly during assembly on an X-ray screen in conjunction with a metallic screwdriver or a measuring scale provided on the screwdriver for screwing the sleeve into the bone.
A connector for osteosynthesis, especially for fastening bone fragments comprises a plug sleeve and a screw engageable in the plug sleeve, the plug sleeve being formed of a viscoplastic, tissue-compatible plastics and having a thread shape on its outer surface. The plug sleeve can be slightly expanded at its end facing the head of the screw and also expanded to a greater extent at its other end, so that simple assembly and firm clamping in the bone tissue is achieved. It is possible to monitor the position of the plug sleeve in the bone constantly during assembly on an X-ray screen in conjunction with a metallic screwdriver or a measuring scale provided on the screwdriver for screwing the sleeve into the bone.
Description
¦ The present invention relates to a connector or fasten-ing element for osteosynthesis, particularly for fastening bone fragments using a support plate.
- 5 Depending on the type of bone fracture, draw-in bolts are used directly or in combination with support plates for fixing bone fragments. Depending upon the location in which the1 are to be used~ cortical or spongiosal screws which have dif~er- !
ent forms of thread are used. The spon~iosal screws have a very o !l pronounced~ deep thread in order to achieve an adequate hold in ¦
Il the very soft bone tissue~ The disadvantage of these screws, j however, is that they are very difficult to unscrew, particularl~
¦l from the cortical substance, once the fracture has mended. A
further disadvantage in directly fastening bones together,using screws is that the direct connection between the screw and the bone is ihf~exible. Brief overstressing of the bone resuIts in damage to the connection, which can lead to loosening thP screws or possibly even breaking out.
Connectors of the foregoing type are known. Onë of ,, such connectors is disclosed in applicant's U.S. patent 3,678,925~.
I I .
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I
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1. .
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It is an ob~ect of the present invention to provide an impxoved connector for osteosynthesis.
Il The invention is based on the idea of providing a S ¦I fastening element or connector for osteosynthesis, which allows high pull-out values ~nd is ca~able of resilientlv ab~orbiny overstressing, and is easy to assemble and dismantle.
These and other objects of the invention are a~tained 'l by a connector for fractured bone~, comprising a plug sleeve ll adapted for inserting into a ~ractured bone bridging the fracturq ! thereof, and having a leading portion adapted to be located in I¦ one bone fragment and a trailing portion adapted to communicate il with the other bone frasment; and an expander screw insertable l and engageab~e in said plug sleeve, said plug sleev having an ~, , outer surface having a shape of a thread, said sleeve being expanda~le at said leading portion and at said trailing portion, ¦! said screw having a head which is faced by said trailing portion !
¦l in assem~ly.
For the placement of the connector in a frac~-ured bone, ll a bore,corresponding in diamete~ approximately to the core diameter of the plug sleev ,is ormed in the bone. Using a thre~d tap, a thread which approximate~y corresponds in pitch and ~' profile to the thread of the plug sleeve is cut in ~he bone.
,, Using a screwdriver or a hexagonal key which engages in a shaped !
25 1l portion of the plug sleeve, the plug sleeve can then be screwed i ¦l in the region of the fracture to such an extent that the plug ~ -3-1. .
, , 1l !
1 !
I
i !
l~
¦ sleeve comes to rest in the region on the far side of the I fracture. It can often be necessary for th~ bore for receiving i the plug sleeve to completely ~enetrat:e the cortical substance l of the remote fragment in order to obt:ain a secure fastening.
! T-7hen the screw is screwed into the plug sleeve, the plug sleeve jl is slightly opened out at the trailiny end facing the head of ¦ the screws, so that the plug sleeve is clamped at least to such an extent that it cannot turn when the screw is screwed in. In ~,i this manner the plug sleeve is reliably prevented from turning when the screw is screwed in and, as a result, altering its position or even emerging from the bone again at the end of bore opposite the head of the screw. As the screw is screwed in, the thread crests of the screw in the trailing part of the inter-.. i nal bore cut slightly into the inner wall of the plug sleeve,which is made from a tissue-compatible plastics, and thus effect the above mentioned expansion. The leading portion of the plug sleeve is also opened out or expanded. ;
The expansion means may be provided at said trailing ; portion and said leading ~ort.ion, respectively, the expansion means at said trailing portion being able to open out said traili~g , portion to a lesser degree than the expansion means a~ said i leadin~ ~ortion.
The leading portion is expanded considerably more as ~he screw is screwed in further, the thread tuxns of the plug sleeve ' m ~s area being ~ressed firmly into~-the bone tis~ue, so that the plug slee~
.
'i I
. . .
Il .
1 !1 is fixed 50 that it i5 capable of bearing high loads The head ! f the screw lies against the~fragment close to the head or Il against an additional support plate mentioned above and effects ¦~ the clamping of the adiacent fragments in the region of the frac~-¦.' ure surface.
Since the opening out or expansion that takes place at 1~ the trailing end of the plug sleeve when the screw is screwed .~ in,has the sole purpose of preventing a further rotation of the I
~ plug sleeve, only a slight opening out or expansion occurs here.
ll The plug sleeve may have an internal throuc~ bore which I¦ h~ a smaller diameter in said leading portion than that in said ¦I trailing portion.
¦l A portion of said internal bore made in said trailing ! portion may be slightly small~r in diameter than the outer diamete'r ll of the thread of said screw and the diameter of a portion of il said internal bore~made in said leading portion,is smaller than ~
a core diameter of said screw. l;
The different degrees of expansion in the two end Il regions of the plug sleeve are achieved due to the fact that I' the internal diameter in the trailing portion is noticeably , larger than the internal diameter in the leading portion.
l l l , The expansion means at said leading portion may be ,I formed by at least one first longitudinal slot extending from a ¦
,' leading end of said sleeve over a part of its length and the ,l expansion means at said trailing portion may be formed by at ,1 . I
,l -5- ' I
li l ,. . I
1~ 867 I .
I ., ', 1 1l least one second longitudinal slot extending from a trailing endj I¦ of said sleeve over a part of its len~th and being shorter than ¦I said first longitudinal slot.
¦~ The plug sleeve preerably has at each of its two ends 5 ¦I two opposlng longitudinal slot5 which allow expansion when the ¦ screw is introduced. In the trailing region the length of the slot can constitute, for example, between 1/10 and 1/5 of the :¦
length of the plug sleeve, whilst in the leading portion the ', longitudinal slots extend, for example, as far as the center of ll the plug sleeve.
After the bore has been made in the bone fra~ments and ¦
the thread for the plug sleeve has been made by means Of a threa~
tap, the plug sleeve can be screwed into the bore with a screwdr~ver.
~ A stop may be provided at a transition between the `i portion of said internal bore in said leading portion and the portion of the internal bore in said trailing portion, said internal bore having a shaped portion for receiving therein a 1' screwdriver of a corresponding shape, said shaped portion 1 extending via a defined distance up to said stop against which ., a tip of the screwdriver rests whe~ the plug sleeve is screwed i~.
~ The plug sleeve may be of such a length that the tip of the screwdriver can be pushed into the sleeve exactly as far as a leading end thereof.
. The screwdriver for screwing in the plug sleeve may have~
~, a shaft provided wi~h a length measuring scale which indicates t~e l'i ,, '.
, !
1, , t;7 distance at least to the tip of the screwdriver and to the leading end of the plug sleeve.
The shaped portion of the sleeve bore may be a hexagonal Il socket. While being inserted into the sleeve the screwdriver 1l obtains a defined position in the p:Lug sleeve, so that the length measuring scale provided on the screwdriver shaft indicates Il exactly the distan~e to the above mentioned stop or, if the ¦, scale is adapted accordingly, the distance to the leading end of Il, the plug sleeve. The insertion depth of the plug sleeve can in ¦¦ this manner be read out on the length measuring scale when the I¦ plug sleeve is screwed in. Furthermore, lt is also possible to ¦I follow the insertion of the plug sleeve by means of an X-ray apparatus, since the position of the tip of the screwdriver can ,' ~ be followed. As a result of the defined position of the tip of ~I the screwdriver inside the plug sleeve, it is possible to concludlie the correspondingly exact position of the plug sleeve.
The screwdriver shaft can, in the leading region, be matched to the entire internal shaped portion of the plug sleeve, l so that the tip of the screwdriver lies exactly at the leading l~ end of the plug sleeve when the plug sleeve is screwed in. ' In order to follow the exact position of the plug sleeve¦
on the screen of an X-ray apparatus, the plug sleeve can also be ¦
at least partially metallized. ~his can be obtained by applying ~ a ooa ~ g to a part of the outer sur~ace o~ the plug sleeve.
The plug sleeve, consisti- for example, of a polyethylene of !
1 ! ul~rahigh molecuiar weight, cannot be det~cted in an X-ray image.
The metal sheathing, formed of a stainless steel, is used in order to be able to monitor the fit.tin~ of the plug sleeve or I¦ to locate the plug sleeve, and it can be applied to the non-S ¦¦ expanding part of the plug sleeve either in the form of ~ sleeve'Il or by vacuum evaporation.
! i The thread crests and the thread troughs of the plug ¦l sleeve thread may be rounded. Rounding the thread profile protects the bone tissue against damage as the plug sleeve is 1', screwed in.
The novel features which are considered as character-istic for the invention are set forth in part:Lcular in the a~pend-ed claims. The invention itself, however, both as to its construc-1l tion and its method of operation, together with additional .
li objects and advantages thereof, will be best understood from the. following description of specific embodiments when read in 1' connection with the accompanying drawing.
I, . I
',1 1 Il , . .
Il ~.ZSg867 BRIEF DESCRIPTION_OF THE DRAWING
Fig. 1 shows an exploded vi.ew of the connector according to the in~enkion;
Fig. 2 illustrates a screwdriver for drawing in the plug sleeve of the connector shown in Fig. 1;
Fiy. 3 is the connector in the assembled condition, anchored in the bone;
Fig. 4 is a sectional view on line IV-IV of Fig. 1;
and Fig. 5 is a portion V of the conneckor of Fig. 1, on enlarge~ scale.
' :
il6C7 DESCRIPTION OF THE PRE,FERRED EMBODIMENT
:
Referring now to the drawings in detail the connector for fractured bones according to the invention - comprises an expander or draw-in screw 1 of stainless steel and a plug sleeve 2 which is formed of a tissue-compatible plastic, for example polyethylene of ultrahigh molecular weight. Sleeve 2 has an internal bore 3 the rear portion of which has the diameter which is slightly smaller than the external diameter of the thread of expander screw 1. The thread crests therefore cut slightly into the inner wall of the plug sleeve 2 when screw 1 is screwed into the sleeve. At the same time, a slight opening out or expansion is provided in the region of the trailing portion 2a of the plug sleeve.
The plug sleeve thus has in that region of the trailing portion 2a two opposing longitudinal slots 4 which allow opening out or expansion of the plug sleeve 2.
The internal bore 3 o the sleeve further has a portion 3a which is provided with a hexagonal socket 5 which serves the purpose of the placement of a hexagonal key or a screwdriver of corresponding shape. From the portion 3a, the internal bore 3 tapers to a diameter that is smaller than the core diameter o~ the screw 1. This smaller portion of bore 3 is designated at 36. In ~he region of a leading portion 2b of the plug sleeve 2, the plug sleeve has two opposing longitudinal slots 6 which extend approximately over half the length of the plug sleeve 2, so that this region is expanded when the screw 1 is screwed in. Since the longitudinal slots 6 are significantly 10~
1 ; longer tha the longitudinal slot~ 4 a~ the rear end of the plug sleeve and since the internal diameter of the sleeve in the regio~
of the longitudinal slots 6 is substantially smaller than that ¦¦ in the region of the longitudinal slots 4 there is a significantl~
¦¦ greater ex~ansion at the forward portion 2b than that in the j trailing portion 2a when the screw 1 is screwed into the plug sleeve 2. This opening out or expansion, in the region of Il the trailing portion 2a serves to secure the plug sleeve 2 ii agains~ undesired twisting when the screw 1 is screwed in, whilst ¦ the opening out in the region of the leading portion 2b effects the actual clamping of the plug sleeve 2 in khe bone, so that the plug sleeve 2 is still held securely in the bone even in the ¦ case of strong tightening of the screw 1 and the resulting high tensile forces.
¦! The outer surf~ce of the plug sleeve 2 is provided ¦1 over its entire length with a thread 7,the thread crests and thread troughs o which are rvunded. The plug sleeve 2 can have an unthreaded portion ~not shown here) to which a metal coating , is applied which enables the pluy sleeve to be detected ih an j X-ray image.
~I To fix the connector or fastening element in the bone Il first of all,a bore corresponding approximately to the core diameter of the plug sIeeve 2 is drilled. Using a khread tap, a ~ll thread,which corresponds to the thread 7 of the plug sleeve 2,is !I then~made in the bone tissue. In order to keep destruction of I¦ the bone kissue to a minim~m, the thread tap has a leading ¦¦ cutting portion and an adjoining, thread-shaping portion. Such a ¦¦ thread kap is described in German Patent Application P 35 24 946. 3.
I' .
',, --1 1--' . ' 1~7 !l I
1 ,~Using the screwdriver shown in Figure 2, the plug sleeve
- 5 Depending on the type of bone fracture, draw-in bolts are used directly or in combination with support plates for fixing bone fragments. Depending upon the location in which the1 are to be used~ cortical or spongiosal screws which have dif~er- !
ent forms of thread are used. The spon~iosal screws have a very o !l pronounced~ deep thread in order to achieve an adequate hold in ¦
Il the very soft bone tissue~ The disadvantage of these screws, j however, is that they are very difficult to unscrew, particularl~
¦l from the cortical substance, once the fracture has mended. A
further disadvantage in directly fastening bones together,using screws is that the direct connection between the screw and the bone is ihf~exible. Brief overstressing of the bone resuIts in damage to the connection, which can lead to loosening thP screws or possibly even breaking out.
Connectors of the foregoing type are known. Onë of ,, such connectors is disclosed in applicant's U.S. patent 3,678,925~.
I I .
.1i . I
~ -2-.~
I
: !
1. .
~ i 1,, . .
s~
!
It is an ob~ect of the present invention to provide an impxoved connector for osteosynthesis.
Il The invention is based on the idea of providing a S ¦I fastening element or connector for osteosynthesis, which allows high pull-out values ~nd is ca~able of resilientlv ab~orbiny overstressing, and is easy to assemble and dismantle.
These and other objects of the invention are a~tained 'l by a connector for fractured bone~, comprising a plug sleeve ll adapted for inserting into a ~ractured bone bridging the fracturq ! thereof, and having a leading portion adapted to be located in I¦ one bone fragment and a trailing portion adapted to communicate il with the other bone frasment; and an expander screw insertable l and engageab~e in said plug sleeve, said plug sleev having an ~, , outer surface having a shape of a thread, said sleeve being expanda~le at said leading portion and at said trailing portion, ¦! said screw having a head which is faced by said trailing portion !
¦l in assem~ly.
For the placement of the connector in a frac~-ured bone, ll a bore,corresponding in diamete~ approximately to the core diameter of the plug sleev ,is ormed in the bone. Using a thre~d tap, a thread which approximate~y corresponds in pitch and ~' profile to the thread of the plug sleeve is cut in ~he bone.
,, Using a screwdriver or a hexagonal key which engages in a shaped !
25 1l portion of the plug sleeve, the plug sleeve can then be screwed i ¦l in the region of the fracture to such an extent that the plug ~ -3-1. .
, , 1l !
1 !
I
i !
l~
¦ sleeve comes to rest in the region on the far side of the I fracture. It can often be necessary for th~ bore for receiving i the plug sleeve to completely ~enetrat:e the cortical substance l of the remote fragment in order to obt:ain a secure fastening.
! T-7hen the screw is screwed into the plug sleeve, the plug sleeve jl is slightly opened out at the trailiny end facing the head of ¦ the screws, so that the plug sleeve is clamped at least to such an extent that it cannot turn when the screw is screwed in. In ~,i this manner the plug sleeve is reliably prevented from turning when the screw is screwed in and, as a result, altering its position or even emerging from the bone again at the end of bore opposite the head of the screw. As the screw is screwed in, the thread crests of the screw in the trailing part of the inter-.. i nal bore cut slightly into the inner wall of the plug sleeve,which is made from a tissue-compatible plastics, and thus effect the above mentioned expansion. The leading portion of the plug sleeve is also opened out or expanded. ;
The expansion means may be provided at said trailing ; portion and said leading ~ort.ion, respectively, the expansion means at said trailing portion being able to open out said traili~g , portion to a lesser degree than the expansion means a~ said i leadin~ ~ortion.
The leading portion is expanded considerably more as ~he screw is screwed in further, the thread tuxns of the plug sleeve ' m ~s area being ~ressed firmly into~-the bone tis~ue, so that the plug slee~
.
'i I
. . .
Il .
1 !1 is fixed 50 that it i5 capable of bearing high loads The head ! f the screw lies against the~fragment close to the head or Il against an additional support plate mentioned above and effects ¦~ the clamping of the adiacent fragments in the region of the frac~-¦.' ure surface.
Since the opening out or expansion that takes place at 1~ the trailing end of the plug sleeve when the screw is screwed .~ in,has the sole purpose of preventing a further rotation of the I
~ plug sleeve, only a slight opening out or expansion occurs here.
ll The plug sleeve may have an internal throuc~ bore which I¦ h~ a smaller diameter in said leading portion than that in said ¦I trailing portion.
¦l A portion of said internal bore made in said trailing ! portion may be slightly small~r in diameter than the outer diamete'r ll of the thread of said screw and the diameter of a portion of il said internal bore~made in said leading portion,is smaller than ~
a core diameter of said screw. l;
The different degrees of expansion in the two end Il regions of the plug sleeve are achieved due to the fact that I' the internal diameter in the trailing portion is noticeably , larger than the internal diameter in the leading portion.
l l l , The expansion means at said leading portion may be ,I formed by at least one first longitudinal slot extending from a ¦
,' leading end of said sleeve over a part of its length and the ,l expansion means at said trailing portion may be formed by at ,1 . I
,l -5- ' I
li l ,. . I
1~ 867 I .
I ., ', 1 1l least one second longitudinal slot extending from a trailing endj I¦ of said sleeve over a part of its len~th and being shorter than ¦I said first longitudinal slot.
¦~ The plug sleeve preerably has at each of its two ends 5 ¦I two opposlng longitudinal slot5 which allow expansion when the ¦ screw is introduced. In the trailing region the length of the slot can constitute, for example, between 1/10 and 1/5 of the :¦
length of the plug sleeve, whilst in the leading portion the ', longitudinal slots extend, for example, as far as the center of ll the plug sleeve.
After the bore has been made in the bone fra~ments and ¦
the thread for the plug sleeve has been made by means Of a threa~
tap, the plug sleeve can be screwed into the bore with a screwdr~ver.
~ A stop may be provided at a transition between the `i portion of said internal bore in said leading portion and the portion of the internal bore in said trailing portion, said internal bore having a shaped portion for receiving therein a 1' screwdriver of a corresponding shape, said shaped portion 1 extending via a defined distance up to said stop against which ., a tip of the screwdriver rests whe~ the plug sleeve is screwed i~.
~ The plug sleeve may be of such a length that the tip of the screwdriver can be pushed into the sleeve exactly as far as a leading end thereof.
. The screwdriver for screwing in the plug sleeve may have~
~, a shaft provided wi~h a length measuring scale which indicates t~e l'i ,, '.
, !
1, , t;7 distance at least to the tip of the screwdriver and to the leading end of the plug sleeve.
The shaped portion of the sleeve bore may be a hexagonal Il socket. While being inserted into the sleeve the screwdriver 1l obtains a defined position in the p:Lug sleeve, so that the length measuring scale provided on the screwdriver shaft indicates Il exactly the distan~e to the above mentioned stop or, if the ¦, scale is adapted accordingly, the distance to the leading end of Il, the plug sleeve. The insertion depth of the plug sleeve can in ¦¦ this manner be read out on the length measuring scale when the I¦ plug sleeve is screwed in. Furthermore, lt is also possible to ¦I follow the insertion of the plug sleeve by means of an X-ray apparatus, since the position of the tip of the screwdriver can ,' ~ be followed. As a result of the defined position of the tip of ~I the screwdriver inside the plug sleeve, it is possible to concludlie the correspondingly exact position of the plug sleeve.
The screwdriver shaft can, in the leading region, be matched to the entire internal shaped portion of the plug sleeve, l so that the tip of the screwdriver lies exactly at the leading l~ end of the plug sleeve when the plug sleeve is screwed in. ' In order to follow the exact position of the plug sleeve¦
on the screen of an X-ray apparatus, the plug sleeve can also be ¦
at least partially metallized. ~his can be obtained by applying ~ a ooa ~ g to a part of the outer sur~ace o~ the plug sleeve.
The plug sleeve, consisti- for example, of a polyethylene of !
1 ! ul~rahigh molecuiar weight, cannot be det~cted in an X-ray image.
The metal sheathing, formed of a stainless steel, is used in order to be able to monitor the fit.tin~ of the plug sleeve or I¦ to locate the plug sleeve, and it can be applied to the non-S ¦¦ expanding part of the plug sleeve either in the form of ~ sleeve'Il or by vacuum evaporation.
! i The thread crests and the thread troughs of the plug ¦l sleeve thread may be rounded. Rounding the thread profile protects the bone tissue against damage as the plug sleeve is 1', screwed in.
The novel features which are considered as character-istic for the invention are set forth in part:Lcular in the a~pend-ed claims. The invention itself, however, both as to its construc-1l tion and its method of operation, together with additional .
li objects and advantages thereof, will be best understood from the. following description of specific embodiments when read in 1' connection with the accompanying drawing.
I, . I
',1 1 Il , . .
Il ~.ZSg867 BRIEF DESCRIPTION_OF THE DRAWING
Fig. 1 shows an exploded vi.ew of the connector according to the in~enkion;
Fig. 2 illustrates a screwdriver for drawing in the plug sleeve of the connector shown in Fig. 1;
Fiy. 3 is the connector in the assembled condition, anchored in the bone;
Fig. 4 is a sectional view on line IV-IV of Fig. 1;
and Fig. 5 is a portion V of the conneckor of Fig. 1, on enlarge~ scale.
' :
il6C7 DESCRIPTION OF THE PRE,FERRED EMBODIMENT
:
Referring now to the drawings in detail the connector for fractured bones according to the invention - comprises an expander or draw-in screw 1 of stainless steel and a plug sleeve 2 which is formed of a tissue-compatible plastic, for example polyethylene of ultrahigh molecular weight. Sleeve 2 has an internal bore 3 the rear portion of which has the diameter which is slightly smaller than the external diameter of the thread of expander screw 1. The thread crests therefore cut slightly into the inner wall of the plug sleeve 2 when screw 1 is screwed into the sleeve. At the same time, a slight opening out or expansion is provided in the region of the trailing portion 2a of the plug sleeve.
The plug sleeve thus has in that region of the trailing portion 2a two opposing longitudinal slots 4 which allow opening out or expansion of the plug sleeve 2.
The internal bore 3 o the sleeve further has a portion 3a which is provided with a hexagonal socket 5 which serves the purpose of the placement of a hexagonal key or a screwdriver of corresponding shape. From the portion 3a, the internal bore 3 tapers to a diameter that is smaller than the core diameter o~ the screw 1. This smaller portion of bore 3 is designated at 36. In ~he region of a leading portion 2b of the plug sleeve 2, the plug sleeve has two opposing longitudinal slots 6 which extend approximately over half the length of the plug sleeve 2, so that this region is expanded when the screw 1 is screwed in. Since the longitudinal slots 6 are significantly 10~
1 ; longer tha the longitudinal slot~ 4 a~ the rear end of the plug sleeve and since the internal diameter of the sleeve in the regio~
of the longitudinal slots 6 is substantially smaller than that ¦¦ in the region of the longitudinal slots 4 there is a significantl~
¦¦ greater ex~ansion at the forward portion 2b than that in the j trailing portion 2a when the screw 1 is screwed into the plug sleeve 2. This opening out or expansion, in the region of Il the trailing portion 2a serves to secure the plug sleeve 2 ii agains~ undesired twisting when the screw 1 is screwed in, whilst ¦ the opening out in the region of the leading portion 2b effects the actual clamping of the plug sleeve 2 in khe bone, so that the plug sleeve 2 is still held securely in the bone even in the ¦ case of strong tightening of the screw 1 and the resulting high tensile forces.
¦! The outer surf~ce of the plug sleeve 2 is provided ¦1 over its entire length with a thread 7,the thread crests and thread troughs o which are rvunded. The plug sleeve 2 can have an unthreaded portion ~not shown here) to which a metal coating , is applied which enables the pluy sleeve to be detected ih an j X-ray image.
~I To fix the connector or fastening element in the bone Il first of all,a bore corresponding approximately to the core diameter of the plug sIeeve 2 is drilled. Using a khread tap, a ~ll thread,which corresponds to the thread 7 of the plug sleeve 2,is !I then~made in the bone tissue. In order to keep destruction of I¦ the bone kissue to a minim~m, the thread tap has a leading ¦¦ cutting portion and an adjoining, thread-shaping portion. Such a ¦¦ thread kap is described in German Patent Application P 35 24 946. 3.
I' .
',, --1 1--' . ' 1~7 !l I
1 ,~Using the screwdriver shown in Figure 2, the plug sleeve
2 can be screwed into a threaded bore 8, as shown in Figure 3.
For this purpose the screwdriver has a hexagonal shaped portion 9 which corresponds to the hexagonal socket 5 formed in ~he plug 'I sleeve 2. At the forward end 10 the screwdriver merges into a ii rod-shaped end piece 11 the diameter of which matches the internal diameter o~ leading portion 2b of the plug sleeve. The , screwdriver can then be inserted into the plug sleeve 2 unless a¦
1l transition portion 12, which borders the hexagonal shaped portio~
1l 9, rests against a corresponding stop 13 provided in the plug ¦ sleeve 2. The tip 14 of the screwdriver then lies in the same plane as the forw~rd end of the plug sleeve 2. Since the screw-Il driver is made of metallic material, the position of the plug I sleeve when the latter is.screwed~in,can all the time be followed on an X-ray screen. The tip 14 of the screwdriver at the same time indicates the position of the leading end of the plug sleev~
2. In addition, it is possible to provide on a shaft 15 of the , screwdriver a measuring scale on which the particular insertion ¦
depth of the p~ug sleeve 2 can ~e read out.
¦ The screwdriver can also be manufactured without the rod-shaped portion 11, then it would be possible for the measurir g ! scale to be arranged on the shaft 15 in such a manner that the ¦ length measuring scale would indicate the distance to the forwar~
! end of the plug sleeve.
25 1'l Figure 3 shows the position of the plug sleeve 2 in a , . .
., I
bone fragrnent 16 on the far side of the fracture, whilst the head 17 of the screw rests against a bone fragment 18 on the near side of the fracture. The plug sleeve 2 is located in a through bore and is anchored securely in the bone fragment 16, especially as a result of the expansion pressure in the leading portion 2b. By using such a plug sleeve it is possible to achieve a high bearing pressure in the region of the ~racture surface 19.
When the fractture has mended, the screw 1 is unscrewed again, so that, again, using a suitable screwdriver or hexagonal k~ey, the plug sleeve 2 can be unscrewed from the threaded bore formed in the bone. The plug sleeve 2 is partially covered with a metal coating 20, as shown in FIG. 5.
It will be understood that each of the elements described above, or two or ~ore together, may also find a useful application in other types of connectors for fractured ~: bones differing from the types described above.
While the invention has been illustrated and described as embodied in a connector for fractured bones, it is not intended to be limited to the details shown, since various modifications and structural changes may be made without departing in any way from the spirit of the present invention.
Without further analysis, the foregoing will so fully reveal the gist of the present invention that others can, by applying current knowledge, readily adapt it or various applications withoutt omitting features thatl from the standpoint of prior art, fairly constitute essential char-acteristics of the generic or specific aspects o:f this
For this purpose the screwdriver has a hexagonal shaped portion 9 which corresponds to the hexagonal socket 5 formed in ~he plug 'I sleeve 2. At the forward end 10 the screwdriver merges into a ii rod-shaped end piece 11 the diameter of which matches the internal diameter o~ leading portion 2b of the plug sleeve. The , screwdriver can then be inserted into the plug sleeve 2 unless a¦
1l transition portion 12, which borders the hexagonal shaped portio~
1l 9, rests against a corresponding stop 13 provided in the plug ¦ sleeve 2. The tip 14 of the screwdriver then lies in the same plane as the forw~rd end of the plug sleeve 2. Since the screw-Il driver is made of metallic material, the position of the plug I sleeve when the latter is.screwed~in,can all the time be followed on an X-ray screen. The tip 14 of the screwdriver at the same time indicates the position of the leading end of the plug sleev~
2. In addition, it is possible to provide on a shaft 15 of the , screwdriver a measuring scale on which the particular insertion ¦
depth of the p~ug sleeve 2 can ~e read out.
¦ The screwdriver can also be manufactured without the rod-shaped portion 11, then it would be possible for the measurir g ! scale to be arranged on the shaft 15 in such a manner that the ¦ length measuring scale would indicate the distance to the forwar~
! end of the plug sleeve.
25 1'l Figure 3 shows the position of the plug sleeve 2 in a , . .
., I
bone fragrnent 16 on the far side of the fracture, whilst the head 17 of the screw rests against a bone fragment 18 on the near side of the fracture. The plug sleeve 2 is located in a through bore and is anchored securely in the bone fragment 16, especially as a result of the expansion pressure in the leading portion 2b. By using such a plug sleeve it is possible to achieve a high bearing pressure in the region of the ~racture surface 19.
When the fractture has mended, the screw 1 is unscrewed again, so that, again, using a suitable screwdriver or hexagonal k~ey, the plug sleeve 2 can be unscrewed from the threaded bore formed in the bone. The plug sleeve 2 is partially covered with a metal coating 20, as shown in FIG. 5.
It will be understood that each of the elements described above, or two or ~ore together, may also find a useful application in other types of connectors for fractured ~: bones differing from the types described above.
While the invention has been illustrated and described as embodied in a connector for fractured bones, it is not intended to be limited to the details shown, since various modifications and structural changes may be made without departing in any way from the spirit of the present invention.
Without further analysis, the foregoing will so fully reveal the gist of the present invention that others can, by applying current knowledge, readily adapt it or various applications withoutt omitting features thatl from the standpoint of prior art, fairly constitute essential char-acteristics of the generic or specific aspects o:f this
3~ invention.
What is claimed as new and desired to be protected by Letters Patent is set forth in the appended claims.
What is claimed as new and desired to be protected by Letters Patent is set forth in the appended claims.
Claims (10)
1. A connector for fracture bones, comprising a plug sleeve adapted for inserting into a bore formed in a fractured bone for bridging the fracture thereof, and having leading portion adapted to be located in one bone fragment and a trailing portion adapted to communicate with the other bone fragment; an expander screw insertable and engageable in said plug sleeve, said plug sleeve having an outer surface having shape of a thread, said sleeve being expandable at said leading portion and at said trailing portion, said screw having a head which is faced by said trailing portion in assembly; and expansion means provided at said trailing portion and said leading portion, respectively, the expansion means at said trailing portion being able to open said trailing portion to a lesser degree that the expansion means at said leading portion.
2. The connector as defined in claim 1, wherein said plug sleeve has an internal through bore which has a smaller diameter in said leading portion than that in said trailing portion.
3. The connector as defined in claim 2, wherein a portion of said internal bore, made in said trailing portion is slightly smaller in diamter than an outer diamter of the thread of said screw, and the diameter of a portion of said internal bore made in said leading portion is smaller than a core diameter of said screw.
4. The connector as defined in claim 1, wherein the expansion means at said leading portion are formed by at least one first longitudinal slot extending from a leading end of said sleeve over a part of its length, and the expansion means at said trailing portion are formed by at least one second longitudinal slot extending from a trailing end of said sleeve over a part of its length and being shorter than said first longitudinal slot.
5. The connector as defined in claim 3, wherein a stop is provided at a transition between the portion of said internal bore in said leading portion and the portion of the internal bore in said trailing portion, said internal bore having a shaped portion for receiving therein a screwdriver of a corresponding shape, said shaped portion extending via a defined distance up to said stop against which a tip of the screwdriver rests when the plug sleeve is screwed in.
6. The connector as defined in claim 5, wherein said shaped portion is a hexagonal socket.
7. The connector as defined in claim 1, wherein said plug sleeve is formed of viscoplastic tissue-compatible plastics.
8. The connector as defined in claim 7, wherein said plug sleeve is at least partially covered with metal coating.
9. A connector for fractured bones, comprising a plug sleeve adapted for inserting into a bore formed in a fractured bone for bridging the fracture thereof, and having a leading portion adapted to be located in one bone fragment and a trailing portion adapted to communicate with the other bone fragment; an expander screw insertable and engageable in said plug sleeve, said plug sleeve having an outer surface having a shape of a thread, said sleeve being expandable at said leading portion and at said trailing portion, said screw having a head which is faced by said trailing portion in assembly; and expansion means provided at said trailing portion and said leading portion, respectively, the expansion means at said trailing portion being able to open said trailing portion to a lesser degree that the expansion means at said leading portion, the expansion means at said leading portion being formed by at least one first longitudinal slot extending from a leading end of said sleeve over a part of its length, and the expansion means at said trailing portion being formed by at least one second longitudinal slot extending from a trailing end of said sleeve over a part of its length and being shorter than said first longitudinal slot.
10. A connector for fractured bones, comprising a plug sleeve adapted for inserting into a bore formed in a fractured bone for bridging the fracture thereof, and having a leading portion adapted to be located in one bone fragment and a trailing portion adapted to communicate with the other bone fragment, an expander screw insertable and engageable in said plug sleeve, said plug sleeve having an outer surface having a shape of a thread, said sleeve being expandable at said leading portion and at said trailing portion, said screw having a head which is faced by said trailing portion in assembly; and expansion means provided at said trailing portion and said leading portion, respectively, the expansion means at said trailing portion being able to open said trailing portion to a lesser degree that the expansion means at said leading portion, the expansion means at said leading portion being formed by two opposing first longitudinal slots extending from a leading end of said sleeve over a part of its length, and the expansion means at said trailing portion being formed by two opposing second longitudinal slots extending from a trailing end of said sleeve over a part of its length and being shorter than said first longitudinal slots.
Applications Claiming Priority (4)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DEG8520206.1 | 1985-07-12 | ||
| DE19858520206 DE8520206U1 (en) | 1985-07-12 | 1985-07-12 | Fixing element for osteosynthesis |
| DE19853538238 DE3538238A1 (en) | 1985-03-11 | 1985-10-28 | Osteosynthesis fixing element |
| DEP3538238.4 | 1985-10-28 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1259867A true CA1259867A (en) | 1989-09-26 |
Family
ID=25837361
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000513363A Expired CA1259867A (en) | 1985-07-12 | 1986-07-09 | Connector for fractured bones |
Country Status (5)
| Country | Link |
|---|---|
| US (1) | US4760843A (en) |
| EP (1) | EP0209685A3 (en) |
| CN (1) | CN1008144B (en) |
| CA (1) | CA1259867A (en) |
| SU (1) | SU1753935A3 (en) |
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-
1986
- 1986-06-04 EP EP86107559A patent/EP0209685A3/en not_active Withdrawn
- 1986-07-02 US US06/884,103 patent/US4760843A/en not_active Expired - Fee Related
- 1986-07-07 CN CN86104508A patent/CN1008144B/en not_active Expired
- 1986-07-09 CA CA000513363A patent/CA1259867A/en not_active Expired
- 1986-07-09 SU SU864027817A patent/SU1753935A3/en active
Also Published As
| Publication number | Publication date |
|---|---|
| EP0209685A2 (en) | 1987-01-28 |
| CN1008144B (en) | 1990-05-30 |
| CN86104508A (en) | 1987-01-07 |
| EP0209685A3 (en) | 1988-11-09 |
| SU1753935A3 (en) | 1992-08-07 |
| US4760843A (en) | 1988-08-02 |
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