CN105916469A

CN105916469A - Anchor having a controlled driver orientation

Info

Publication number: CN105916469A
Application number: CN201480073698.8A
Authority: CN
Inventors: S.M.博曼; A.R.小贝鲁贝; B.J.鲍奎; W.杨; M.E.豪斯曼; J.斯特龙塞克
Original assignee: Smith and Nephew Richards Inc
Current assignee: Smith and Nephew Inc
Priority date: 2013-11-20
Filing date: 2014-11-19
Publication date: 2016-08-31
Also published as: EP3071146A1; MX2016006587A; AU2014353044A1; RU2016124173A; WO2015077327A1; KR20160088314A; JP2016537120A

Abstract

The present disclosure relates to an interference screw having a body with a proximal end, distal end, and longitudinal axis extending between therein between. The screw further includes threads for fixing the screw into bone. The screw further includes a through bore defined by the body. The through bore extends between the proximal and distal ends along the longitudinal axis, and has a surface. The screw further includes a controlling member (440) formed by the through bore surface. To install the screw into bone, a surgeon turns the screw with a driver that engages with the controlling member. The driver only engages the controlling member when it is in a driving orientation with respect to the controlling member. Advantageously, with this "one-way" engagement the surgeon can control and confirm the orientation of the driver without seeing the driver and/or screw.

Description

There is the anchor log of controlled driver orientation

Technical field

The disclosure relates in general to medical treatment device and process, and more particularly relates to medical treatment device and the process of ligament.

Background technology

In many cases, ligament tears due to accident or ruptures.Therefore, various process is had been developed over to repair or to replace this type of damaged ligaments.

Such as, in human knee joint, anterior cruciate ligament and posterior cruciate ligament (that is, " ACL " and " PCL ") extend between the top and the bottom of femur of tibia.Generally, anterior cruciate ligament (that is, ACL) ruptures owing to such as moving relevant damage or tears.Therefore, various operation process is had been developed over for rebuilding ACL, in order to generally recover the normal function of knee.

In many cases, ACL can be rebuild by utilizing the tough ACL bringing replacement to rupture of transplanting.More specifically, in the process, generally in the top of tibia and the bottom of femur, it is respectively formed bone marrow road, the one end wherein transplanting ligament is positioned in femoral bone tunnel, and the other end transplanting ligament is positioned in tibial tunnel, and the mid portion wherein transplanting ligament crosses over the distance bottom femur and between tibia top.The two ends transplanting ligament are anchored in they corresponding bone marrow roads in various modes as known in the art, make to transplant ligament to extend between the bottom and the top of tibia of femur in the way of original ACL is substantially the same, and there is the function substantially the same with original ACL.Then, this transplanting ligament cooperates with surrounding anatomical structures, in order to generally recover the normal function of knee.

In some environment, transplanting ligament can be from the ligament obtained elsewhere in the patient or tendon, such as, attaches or do not attach Patella tendon, semitendinosus tendon and/or the Gracilis tendon of bone piece.

As it has been described above, be known in the art various method for being anchored in femoral bone tunnel and tibial tunnel at the two ends transplanting ligament.

May be used on that femur is fixed, tibia is fixed or in both known procedure a kind of, the end transplanting ligament is placed in bone marrow road, and it is in position then to use the without a head orthopedic screw being referred to as " intervention " screw in the art will transplant ligament.More specifically, use the method, the end transplanting ligament is placed in bone marrow road, and then intervention screw is advanced in bone marrow road so that intervene screw and be parallel to the extension of bone marrow road and simultaneously engage with transplanting ligament and the sidewall in bone marrow road.In this arrangement, intervention screw generally laterally drives transplanting ligament and engages with the opposing sidewalls in bone marrow road, thus uses so-called " interference fit " to be fastened in host's bone by transplanting ligament.Thereafter, As time goes on (such as, some months), together with transplanting ligament is grown at their contact point with host's bone, in order to provide between ligament with bone and firmly naturally engage.

In numerous applications, such as ACL reconstruction operations and anchoring of tendon of biceps, it has proved that intervening screw is to be fixed on the efficient apparatus in bone marrow road by transplanting ligament.But, to intervene screw self in bone marrow road, generally occupy big quantity space, this can be limited in transplants the surface area contact set up between ligament and bone marrow road sidewall.This again limit bone to the ingrown region of ligament, and therefore can affect the intensity of joint.By way of example but and nonrestrictive, it is estimated that, typical screw of intervening blocks the potential bone of about 50% calmodulin binding domain CaM to ligament.

Make great efforts in a large number to provide the intervention screw made by absorbable material to this end, made so that intervene screw can the most finally disappear, and bone to ligament growth can around osseous tunnel whole circumference generation.For this purpose it is proposed, have been developed over various absorbable intervention screw, it is made up of biocompatible biologically absorbable polymer, such as polylactic acid (PLA), polyglycolic acid (PGA) etc..These polymer generally provide and advance in place by intervening screw and be held in place required sizable mechanical strength, without being for good and all held in place when the growth of generation bone to ligament by transplanting ligament thereafter.

In general, it has proved that the intervention screw being made up of the biocompatible biologically absorbable polymer of this class is successfully clinically.But, these absorbable intervention screws yet suffer from some shortcomings.First, clinical evidence shows that the bone ingrown quality to ligament is somewhat different with the growth of natural bone to ligament, is aforesaid biologically absorbable polymer to tend to by fiber block and replaces rather than orderly periplast.Second, clinical evidence shows that absorption would generally take a significant amount of time, such as, and about about three years.Therefore, during this soak time, the growth of bone to ligament is still limited significantly owing to intervening the existence of screw.3rd, clinical evidence shows, for a lot of patients, absorbs and completes never so that the most heterogeneous piece remains in internal.This problem normally tends to quite big by absorbable intervention screw for some increases the weight of the fact that they offer sufficient intensities, such as, to intervene screw and be generally of diameter (that is, external diameter) and the length of 20 mm to 25 mm of 8 mm to 12 mm.

Accordingly, it would be desirable to intervention fixed system that is new and that improve, it (i) has and is held in place required intensity when occurring bone to the growth of ligament by transplanting ligament, and (ii) promotes that excellent bone is to the growth of ligament.

Summary of the invention

On the one hand, it relates to intervene screw.Described screw includes that main body, main body have near-end, far-end and the longitudinal axis extended between near-end and far-end.Described screw farther includes the screw thread extended between the near-end and far-end of main body in open spiral form.Described screw farther includes the through hole extended between the near-end and far-end of main body along longitudinal axis limited by main body.Through hole has surface, and control member is formed by this surface.When driver is in driving orientation about control member, this control member engages with driver.When driver is in the orientation different from driving orientation, control member does not engages with driver.

On the other hand, it relates to be used for intervening the method that screw is installed in bone.Described method includes removing driver from the main body intervening screw inserting bone.Master map has near-end, far-end and the longitudinal axis extended between near-end and far-end.Main body limited hole, through hole extends between near-end and far-end along longitudinal axis.Through hole has surface.The control member that described method farther includes to make to be formed by the surface of through hole engages with driver.When driver is in driving orientation about control member, control member engages with driver.When driver is in the orientation different from driving orientation, control member does not engages with driver.Described method farther includes, and confirms driver orientation in screw body based on control member with engaging of driver.

It yet still another aspect, it relates to for the another kind of method that screw is installed in bone will be intervened.Described method includes, driver is initially inserted in the through hole limited by the main body of the screw inserted in bone.Through hole extends between the near-end and far-end of main body along longitudinal axis, and longitudinal axis extends between the near-end and far-end of main body.Through hole has surface.Described method farther includes to make driver rotate in through hole around the longitudinal axis of main body, until driver engages the control member formed by the surface of through hole.Described joint confirms that driver is orientated about the driving of control member.Described method further includes in the case of driver is in driving orientation and is driven further in bone by screw.

The further field that the disclosure is suitable for will become obvious from detailed description provided below.Although should be appreciated that detailed description and concrete example indicate preferred embodiment of the present disclosure, but it is intended only for purpose that example states and is not intended to limit the scope of the present disclosure.

Accompanying drawing explanation

It is incorporated to and forms the accompanying drawing of this specification part show and embodiment of the disclosure and for explaining the principle of the disclosure, characteristic and feature together with the description write.In the accompanying drawings:

Fig. 1 illustrates the first embodiment of the delivery device of the disclosure.

Fig. 2 illustrates the side view of the axle of the delivery device of Fig. 1.

Fig. 2 A illustrates the exploded view of the far-end of the axle of Fig. 1.

Fig. 3 illustrates the sectional view of the axle of Fig. 2.

Fig. 4 illustrates the front view of the far-end of the axle of Fig. 2.

Fig. 5 illustrates the isometric view for the screw being used together with the axle of Fig. 2.

Fig. 6 illustrates the side view of the screw of Fig. 5.

Fig. 7 illustrates the sectional view of the screw of Fig. 6.

Fig. 8 illustrates the second embodiment of the axle of the disclosure.

Fig. 9 illustrates the side view of the internals of the axle of Fig. 8.

Fig. 9 A illustrates the exploded view of the far-end of the internals of Fig. 9.

Figure 10 illustrates the sectional view of the internals of Fig. 9.

Figure 11 illustrates the front view of the far-end of the internals of Fig. 9.

Figure 12 illustrates the isometric view of the external member of the axle of Fig. 8.

Figure 13 illustrates the sectional view of the external member of Figure 12.

Figure 14 and Figure 15 illustrates that external member is in the side view of the axle of Fig. 8 of diverse location.

Figure 16 illustrates the axle of the disclosure and the isometric view of the 3rd embodiment of screw for being used together with axle.

Figure 17 illustrates the isometric view of the axle of Figure 16.

Figure 18 illustrates the isometric view of the screw of Figure 16.

Figure 19 illustrates the side view of the screw of Figure 16.

Figure 20 illustrates the sectional view of the screw of Figure 19.

Figure 21 illustrates the axle of the disclosure and the isometric view of the 4th embodiment of screw for being used together with axle.

Figure 22 illustrates the isometric view of the screw of Figure 21.

Figure 23 illustrates the isometric view of the axle of Figure 21.

Figure 24 illustrates the axle of Figure 21 and for the isometric view substituting screw being used together with axle.

Figure 25 illustrates the side view of the screw of Figure 24.

Figure 26 illustrates the sectional view of the screw of Figure 24.

Figure 27 illustrates the side view intervening screw, and its whole length is supported by driver.

Figure 28 illustrates the side view intervening screw, and its whole length is not supported by driver.

Figure 29 illustrates the side view intervening screw the most structurally lost efficacy.

Figure 30 A to Figure 30 C illustrates the example intervening screw that control member is further inserted in bone.

Figure 31 illustrates the side view of the example intervening screw with control member.

Figure 32 illustrates the end-view of the example intervening screw with control member.

Figure 33 A illustrates the top view about the cross section intervening the driver that screw is in driving orientation.

Figure 33 B illustrates the top view being in the cross section driving the driver being orientated in different orientations from Figure 33 A.

Figure 34 A and Figure 34 B illustrates the example of control member.

Detailed description of the invention

The following description of one or more preferred embodiments is merely exemplary in nature, and is not intended to limit the disclosure, its application or use.

Fig. 1 illustrates the first embodiment of the delivery apparatus 10 of the disclosure.Equipment 10 includes Handleset 11 and is connected to the axle 12 of Handleset 11.Handleset 11 includes handle 11a and is connected to the adapter 11b of handle 11a.Adapter 11b has passage 11b ' and leads to the opening 11b of passage 11b ' ".Opening 11b " is the shape of " D ".It is interior that the near-end 12a of axle 12 is arranged on passage 11b '.

Fig. 2, Fig. 2 A and Fig. 3 to Fig. 4 illustrates axle 12.Axle 12 includes near-end 12a and far-end 12b.Near-end 12a is that the shape of " D " is to mate opening 11b " shape.Far-end 12b includes screw thread 12c, groove 12d and degree of depth block 12e.The partial-length of groove 12d outrigger shaft 12 and intersecting with screw thread 12c.Degree of depth block 12e, for being used together with the degree of depth block on screw, uses equipment 10 by screw placement to osseous tunnel at ligament reconstructive intra-operative.

Fig. 5 to Fig. 7 illustrates the screw 20 for being used together with the delivery device 10 of the disclosure.Screw 20 includes near-end 21 and far-end 22.The major part of screw 20 includes the screw thread 23 in open spiral winding form, i.e., the regular spaced wire turn (turn) of a series of continuous print the most proximally 21 extends to far-end 22 with spiral or helical form, is wherein limited aperture 24 by the space between the wire turn of coil.In other words, intervening screw 20 and can include limiting the open spiral winding of internal volume, wherein internal volume is by the interval between the wire turn of open spiral winding and the regional connectivity outside open spiral winding.Far-end 22 also includes the degree of depth block 25 extending the partial-length of screw 20.Degree of depth block 25 includes near-end 25a and far-end 25b.It addition, the chute 26 of multiple longitudinal extensions threadingly 23 inside extend.

The far-end 12b of axle 12 is placed in the inside of screw 20 via opening 27, until the near-end 25a of degree of depth block 25 engages the degree of depth block 12e of axle 12.Period, chute 26 engaged groove 12d and being contained in groove 12d in axle 12 is inserted into screw 20.As it is shown in figure 1, the far-end 12b of axle 12 also includes hash mark (hash mark) 12f, each and digital 12g in hash mark 12f is associated.Once screw 20 is placed on axle 12, and the near-end 21 of screw 20 just aligns with in hash mark/numeral 12f, thus indicates the length of screw 20.

Fig. 8, Fig. 9 to Fig. 9 A and Figure 10 to Figure 15 illustrate the axle 30 of the replacement of the disclosure.Axle 30 includes internals 31 and the external member 32 being arranged on internals 31.The near-end 31a of internals 31 is similar with the near-end 12a of axle 12 in shape.The far-end 31b of internals 31 includes screw thread 31c.Groove 31d extends along component 31 and intersects with screw thread 31c.It addition, screw thread 31e is between the near-end 31a and far-end 31b of component 31.External member 32 includes the first section 32a and the second section 32b.The diameter of the first section 32a is more than the diameter of the second section 32b.First section 32a also includes screw thread 32c on the inwall 32d of external member 32.

Once external member 32 is arranged on internals 31, and screw thread 32c just engages screw thread 31e, so that external member 32 moves relative to internals 31.External member 32 is made to move more or less the showing of far-end 31b allowing internals 31 relative to internals 31.Similar with the far-end 12b of axle 12, the far-end 31b of internals 31 includes hash mark/numeral (not shown), hash mark/numeral is alignd with the end 32b ' of the second section 32b, thus instruction is by the length of the screw 40 on the far-end 31b being arranged on internals 31.As shown in Figure 14 and Figure 15, external member 32 is positioned at different positions along the length of internals 31, to allow the screw 40 of different length to be loaded on the far-end 31b of internals 31.

The Handleset similar with Handleset 11 is connected to the near-end 31a of internals 31.Similar with screw 20, screw 40 includes near-end 41 and far-end 42.Screw 40 include the screw thread 43 in the open spiral winding form with inside and threadingly 43 the chute 45 of multiple longitudinal extensions of inside extension.Screw 40 is described more fully with in U.S. Patent Application Publication No. 20080154314, and the disclosure of which is integrally incorporated herein with it by quoting.Once external member 32 has moved to indicate screw length, and screw 40 is just loaded on far-end 31b so that the near-end 41 engagement end portion 32b ' of screw 40 and chute 45 engaged groove 31d, and is contained in groove 31d.

Figure 16 to Figure 20 illustrates the axle 50 of the disclosure and another alternate embodiment of screw 60.Axle 50 includes Part I 51 and Part II 52, and Part I 51 includes near-end 51a and far-end 51b, and Part II 52 includes first area 52a and second area 52b.Near-end 51a is constructed is connected to the Handleset similar with Handleset 11.But it is used as other Handlesets.The diameter of first area 52a is less than the diameter of Part I 51 so that there is the first degree of depth block 51b ' at the far-end 51b of Part I 51.The diameter of the second area 52b diameter less than first area 52a so that there is the second degree of depth block 52c between first area 52a and second area 52b.The end 52b ' of second area 52b is tapered, to allow more easily to be inserted in bone by anchor log 60 at ligament reconstructive intra-operative, as will be described further below.Part II 52 is additionally included between first area 52a and second area 52b the groove 53 extended.For the purpose of this disclosure, there are three grooves 53.But, Part II 52 can include greater or lesser number of groove 53.

Similar with the screw 20 shown in Fig. 5 to Fig. 7, screw 60 includes near-end 61 and far-end 62.The major part of screw 60 includes the screw thread 63 in open spiral winding form, i.e. the regular spaced wire turn of a series of continuous print the most proximally 61 extends to far-end 62 with spiral or helical form, is wherein limited aperture 64 by the space between the wire turn of coil.In other words, intervening screw 60 and can include limiting the open spiral winding of internal volume, wherein internal volume is by the interval between the wire turn of open spiral winding and the regional connectivity outside open spiral winding.Far-end 62 also includes the degree of depth block 65 extending the partial-length of screw 60.Degree of depth block 65 includes near-end 65a and far-end 65b.The open degree of depth block 25 of the screw 20 that illustrate the clearest from Fig. 5 is different, and the degree of depth block 65 of screw 60 is Guan Bi degree of depth block, as best illustrated in Figure 18.It addition, the chute 66 of multiple longitudinal extensions is along the inside extension of screw thread 63.

The Part II 52 of axle 50 is placed in the inside of screw 60 via opening 67, until the near-end 65a of degree of depth block 65 engages the second degree of depth block 52c of axle 50.Period, chute 66 engaged groove 53 and being contained in groove 53 in axle 50 is inserted into screw 60.Screw 60 can have various length.Such as, screw 60 can have the length of engageable first degree of depth block 51b ' of its near-end 61.

As mentioned above, at ligament reconstructive intra-operative, the end transplanting ligament is placed in osseous tunnel, and then via using axle 12,30,50 to be advanced in osseous tunnel by intervention screw 20,40,60 so that intervene screw 20,40,60 and be parallel to osseous tunnel extension and engage with the sidewall transplanting ligament and osseous tunnel simultaneously.Screw 20,40,60 can be used for femoral bone tunnel or tibial tunnel.Via using the method for screw 20,40,60 ligament further shown in illustrated above ' 314 disclosures.

Figure 21 to Figure 23 illustrates the screw 100 of the disclosure and another alternate embodiment of delivery device 200.Screw 100 includes near-end 101 and far-end 102.The major part of screw 100 includes the screw thread 103 in open spiral winding form, i.e., the regular spaced wire turn that a series of continuous print connect the most proximally 101 extends to far-end 102 with spiral or helical form, is wherein limited aperture 104 by the space between the wire turn of coil.In other words, intervening screw (interference screw) 100 and can include limiting the open spiral winding of internal volume, wherein internal volume is by the interval between the wire turn of open spiral winding and the regional connectivity outside open spiral winding.Far-end 102 also includes sewing up bridge 105, sews up bridge 105 and extends the partial-length of screw 100.Sew up bridge 105 and include near-end 105a and far-end 105b.Far-end 105b includes concave shape.Flexible member 110(such as suture) it is contained in screw 100 so that suture 110 extends around the far-end 105b of bridge 105.It addition, the chute 106 of longitudinal extension from sew up bridge 105 and threadingly 103 inside extend.For the purpose of this disclosure, there is the chute 106 of two longitudinal extensions.But, the chute more or less than two is all in the scope of the present disclosure.

Delivery device 200 includes far-end 201, and it has slit 202 and the groove 203 extended on every side of this equipment 200 from slit 202.As shown in figure 21, screw 100 is positioned on far-end 201 so that sew up in bridge 105 is contained in slit 202 and chute 106 is contained in groove 203.Delivery device 200 is intubated so that when screw 100 is positioned on equipment 200, suture ends 110a, 110b extend through pipe 204.

Figure 24 to Figure 26 illustrates the screw 300 similar with screw 100.But, screw 300 comprises additionally in the pointed tip 311 being positioned on far-end 302.Top 311 includes through hole 312.Hole 312 helps to be positioned in the inside of screw 300 suture 110.As shown in figure 24, screw 300 is positioned on the far-end 201 of delivery device 200 so that sew up in bridge 305 is contained in slit 202 and chute 306 is contained in groove 203.As it has been described above, delivery device 200 is intubated so that when screw 300 is positioned on equipment 200, suture ends 110a, 110b extend through pipe 204, as shown in figure 24.

For purposes of clarity, illustrate only the far-end 201 of equipment 200.But, equipment 200 can be similarly included near-end with the said equipment, and near-end can be connected to the Handleset similar with above Handleset 11.Screw 100,300 is used for repairing soft tissue, re-attaches bone especially for by tissue.One example of this reparation is when screw 100,300 is delivered in bone via the use of equipment 200, equipment 200 is removed from screw 100,300, tissue is placed on bone with adjacent with screw 100,300, suture ends 110a, 110b are drawn through described tissue, and then suture ends 110a, 110b are tied a knot.Before being inserted in bone by screw 100,300, hole can be formed in bone.But, screw 300 can insert in bone in the case of first forming hole in bone.In this case, use pointed tip 311 to start screw 300 to the insertion in bone, and rotary motion then can be used to complete screw 300 to the insertion in bone.It is used as making the additive method for repair tissue via these screws and delivery device.

The handle 11a of Handleset 11 is made of plastics, but is used as other nonmetal and metal materials.The shape and size of handle 11a can be to contribute to screw 20 inserts any shape and size required in bone.Coupling 11b is made up of metal material (such as rustless steel or titanium), but also can be enough to bear other metals of the power applied at intra-operative by intensity and nonmetallic materials are made.Coupling 11b is press-fitted into handle 11a, but can be connected to handle 11a in any other mode well known by persons skilled in the art.The size and dimension of coupling 11b can be to contribute to screw 20 is inserted in bone required any size and dimension.Passage 11b ' can be any length contributing to being connected to by axle 12 needed for coupling l1b, and opening 11b 〃 can be any shape contributing to being connected to by axle 12 needed for coupling l1b.

Axle 12 can be made up of metal material (such as rustless steel and titanium), but is used as bearing other metals and the nonmetallic materials of the power applied at intra-operative.The diameter of axle 12 can change.The near-end 12a of axle 12 can be to contribute to inserting and to any shape required in passage 11b ' end 12a through opening 11b 〃.The quantity of screw thread 12c and groove 12d can change, and groove 12d length also can change.The position of degree of depth block 12e may be based on the diameter of used axle 12 and the diameter of screw 20 and changes.Groove 12d, degree of depth block 12e and screw thread 12c can be formed by any method known to those skilled in the art.

Screw 20 is made up via method of moulding of polymeric material.It is also possible, however, to use screw 20 can be allowed to bear other materials and other manufacture methods of the power that intra-operative applies.Degree of depth block 25 is open-ended, and does not extend the whole internal diameter of screw 20.Degree of depth block 25 cover screw in mass runoff can change, and the length of degree of depth block 25 can diameter based on screw and change.The quantity of chute 26 and length also can change.Once screw 20 is positioned on axle 12, and the far-end 12b of axle 12 just extends from the far-end 22 of screw 20.Being inserted in bone period at screw 20, screw thread 12c produces screw thread in bone, thus produces the base for screw thread 23, as be described more fully with reference in ' 314 disclosures.The amount that the far-end 12b of axle 12 extends from the far-end 22 of screw 20 can change.

First section 32a of external member 32 and the diameter of the second section 32b can change, and the quantity of screw thread 32c also can change.The quantity of screw thread 31c, 31e and groove 31d can change and the length of groove 31d also can change.Internals 31 and external member 32 by metal material (such as rustless steel and titanium) and can be made via method known to those skilled in the art.But it is used as other materials.Screw 40 is made up by method of moulding of polymeric material.It is also possible, however, to use other materials and manufacture method.The quantity of chute 45 and length also can change.Once screw 40 is positioned on axle 30, and the far-end 31b of axle 30 just extends from the far-end 42 of screw 40.Inserting period in bone at screw 40, screw thread 31c produces screw thread in bone, thus produces the base for screw thread 43, as be described more fully with reference in ' 314 disclosures.The amount that the far-end 31b of axle 30 extends from screw 40 can change.

Axle 50 is made up of metal material (such as rustless steel or titanium), but also can be enough to bear by intensity and be applied to other metal materials of power of axle 50 or nonmetallic materials are made at intra-operative.Axle 50 can be made via method known to those skilled in the art.The diameter of Part I 51 and Part II 52 can change along with the quantity of groove 53 and length, and the position of degree of depth block 52c, 51b ' can diameter based on screw 60 or other factors and change.End 52b ' can otherwise be configured to allow for being easier to insert in bone by screw 60 rather than be tapered.Screw 60 is made up via method of moulding of polymeric material.It is also possible, however, to use the other materials of power that screw can be allowed to bear at intra-operative apply and other manufacture methods.The quantity of chute 66 and length also can change.Once screw 60 is positioned on axle 50, and the Part II 52 of axle 50 just extends from the far-end 62 of screw 60.The amount that Part II 52 extends from screw 60 can change.Additionally, the length of degree of depth block 65 may be based on the diameter of screw 60 or other factors and changes.

Delivery device 200 is made up of metal material (such as rustless steel or titanium), but also can be enough to bear the nonmetallic materials of the power being applied to equipment 200 at intra-operative by intensity and make.Delivery device 200 is made via method known to those skilled in the art.Screw 100,300 is made by polymeric material and via molding process, it is also possible, however, to use the other materials of the power that screw can be allowed to bear at intra-operative apply and other techniques well known by persons skilled in the art.Sew up bridge 105 and can have the far-end 105b that shape is not spill, and the length sewing up bridge 105, slit 202 and groove 203 can change.The size and dimension in hole 312 can change.

In the case of some intervene screw designs, it is necessary to utilize driver to carry out the length of supporting screw (or its major part), as shown in figure 27, in order to be appropriately interposed in bone by screw.When screw is made up of unstable and/or fragile material (such as bone guided material), and this needs are the strongest.When screw has window or the opening reducing screw bending (torsion) intensity, this is also universal.As shown in figure 28, it is inserted in bone when screw supports completely and may result in screw fail, as shown in figure 29.In the case of some screw designs, about the orientation of screw, driver determines that screw is supported the most completely.Therefore, in the designs, the orientation controlling driver about screw is needed.

Surgeon unlikely or is difficult to see that screw and/or driver and confirms the driver orientation about screw.Such as, when bolt portion is installed in bone, the surgical visual field can be blocked.Therefore, the orientation invisibly confirming driver about screw is needed further exist for.

Figure 30 A to Figure 30 C illustrates that surgeon is utilizing control member the example of screw 400 to be driven in bone 401.As indicated, screw 400 protrudes the surface being installed in bone 401.By driver 450 being inserted in screw 400, screw 400 is driven further in bone 401 by surgeon so that it flushes with bone surface and installs.Then, driver 450 is rotated in screw 400 by surgeon, until the control member of driver 450 joint screw 400.With engaging of control member, driver 450 confirms that driver 450 is in suitable " driving " orientation and provides confidence, screw 400 to be supported completely by driver 450 for surgeon.Then, screw 400 can be driven into and lose efficacy without having to worry about screw 400 in bone 401 by surgeon.

Figure 31 illustrates the example of the screw 400 with main body 504.Main body 405 includes near-end 410, far-end 415 and the longitudinal axis 420 extended between near-end 410 and far-end 415.Main body 405 can be made up of bioabsorbable material, not-bio-absorbable material, bone guided material or composite.The example of not-bio-absorbable material includes polyether-ether-ketone (PEEK), titanium and surgery stainless steel material.Screw 400 farther includes the screw thread 425 extended between the near-end 410 and far-end 415 of main body 405 in open spiral form.In some examples of screw 400, screw thread 425 is similar to the screw thread 63 above with reference to described in Fig. 5 to Fig. 7.

Figure 32 illustrates the main body 405 of limited hole 430.Through hole 430 extends between the near-end 410 and far-end 415 of main body along longitudinal axis 420.Through hole 430 has surface 435.Screw 400 includes the control member 440 formed by through-hole surfaces 435.When driver 450 is in driving orientation about screw 400, driver 450 Engagement Control component 440.When driver 450 is in the orientation different from driving orientation, driver 450 not Engagement Control component 440.

One example of the control member 440 shown in Figure 32 includes multiple chute 445, and chute 445 extends between the near-end 410 and far-end 415 of main body 405 along longitudinal axis 420.Three chutes (445a, 445b, 445c) are shown, but other multiple chutes are also possible (such as, two or four).Multiple chutes 445 are around the circumference spaced at equal intervals of through hole 430.Equal distance (d) (distance (d) measures to centrage) is there is from each centrage of such as chute between each in chute (445a, 445b, 445c).Chute (445a, 445b, 445c) can be described as arranging (outside from the page of accompanying drawing) around longitudinal axis 420 in a radial manner.Thus, each position in chute (445a, 445b, 445c) can be respectively depicted as into 0 ° (12 o'clock), becomes 120 ° (4 o'clock) and become 240 ° (8 o'clock).

One in multiple chutes has the shape different from other chutes and/or size.The example easily of control member 440 includes a chute (445a) with cross sectional shape based on rectangle and has other chutes (445b, 445c) of cross sectional shape based on semicircle.Other cross sectional shapes are also possible.In another example of control member 440, the one or more size (such as width and/or height) in chute (445a, 445b, 445c) changes along with the overall dimension of screw 400.Such as, the size of the first anchor log is more than the second anchor log.In the first anchor log, the height of chute is higher than the height of the chute being associated with the second anchor log.

Turning now to Figure 33 A to Figure 33 B, they are the view looked downwards in the cross section of driver 450.The driver 450 turning in bone 401 by screw 400 used by surgeon includes groove 455.Groove 455 has the contrary geometry of multiple chute 445.When in the driving orientation that driver 450 is in shown in Figure 33 A, corresponding driver groove 455 accommodates multiple chute 445, therefore, it is possible to make surgeon use driver 450 to rotate screw 400.When driver 450 is not in driving in orientation, as shown in Figure 33 B, then corresponding driver groove 455 does not accommodate multiple chute 445(and is expressed as dotted line in the accompanying drawings), and the unusable driver of surgeon 450 rotates screw 400.In the example shown in Figure 33 B, for making driver groove 455 accommodate multiple chute 445, driver turns to 9 o'clock position from 10 o'clock inverse position hour hands (on the direction of the arrow drawn).

Aforementioned arrangement provides " unidirectional " and engages, and " unidirectional " engages is favourable, because surgeon can control and confirm the orientation of driver 450 in the case of not seeing driver 450 and/or screw 400, i.e. this process can invisibly be carried out.If driver 450 is inserted in screw 400 by surgeon and it can be made to rotate freely through (that is, non-resistance), or can not insert in screw 400 by driver 450 completely, then surgeon is known that driver 450 is not in driving in orientation.Then, surgeon can make driver 450 rotate, until the control member 440 of driver 450 joint screw 400.Engagement Control component 440 makes screw 400 be driven in bone, and therefore, and surgeon must rotary driver 450 more hardy.Thus, some examples of screw 400 advantageously provide sense of touch feedback, and sense of touch feedback can make surgeon find suitable driver orientation.

Figure 34 A illustrates another example of control member 440, and it includes the multiple chutes 445 ' extended between the near-end 410 and far-end 415 of main body 405 along longitudinal axis 420.The plurality of chute 445 ' is non-uniformly spaced around the circumference of through hole 430.Chute 445 ' each between there is the different distance (d, d ', d ") (distance (d, d ', d ") each centrage from such as chute and measure to centrage).Position about the chute 445 ' that radial arrangement is described so that by unequal for separate for the position number of degrees.

Figure 34 B illustrates another example of control member 445, and it includes the multiple chutes 445 extended between the near-end 410 and far-end 415 of main body 405 along longitudinal axis 420 ".Multiple chutes 445 " circumference spaced at equal intervals around through hole 430.Example control member 440 further includes at the spaced apart tab 460 of adjacent pair chute (445a " and 445b ").Another example of control member 440 includes around multiple chutes that the circumference of through hole is non-uniformly spaced, wherein spaced apart at adjacent pair chute of tab.In some instances, tab 460 extends the part of length for screw 400 and different from chute.Although arranging with reference to above example and describe the unidirectional of screw 400 or " having key " feature, but those skilled in the art will readily appreciate that other layouts are also possible.

Other examples of screw 400 include degree of depth block, the open degree of depth block 25 such as described and the Guan Bi degree of depth block 65 described above with reference to Figure 18 above with reference to Fig. 5.Degree of depth block engages the degree of depth block of driver 450 so that the remote extension of driver exceedes the far-end of main body.In another other examples of screw 400, the near-end 410 of main body 405 aligns with the hash mark on driver far-end, and the length of the main body 405 of the quantity identity screw 400 being associated with hash mark.

Being installed in the instantiation procedure in bone 401 by screw 400, surgeon can will remove in the main body 405 of the driver 450 screw 400 from partial insertion bone 401.Driver 450 is reinserted in the main body 405 of screw 400 by surgeon, and makes it engage with control member 440.Surgeon's orientation engaging confirmation driver 450 based on control member 440 with driver 450.Engagement Control component 440 tells that surgeon's driver 450 is in driving orientation.Lack to engage and then tell that surgeon's driver 450 is in the orientation different from driving orientation.In the case of driver 450 not Engagement Control component 440 (such as, surgeon's rotary driver 450, but screw 400 does not rotates), surgeon makes driver 450 rotate in through hole 430, until driver 450 Engagement Control component 440(is such as, surgeon's rotary driver and screw rotate).

In instantiation procedure, when each surgeon removes driver 450 and is reinserted in screw, surgeon uses control member 440 to control and confirms the orientation of driver 450.This is favourable, because surgeon must may repeatedly remove and reinsert driver 450 during process, in order to be completely installed in bone 401 by screw 400.

Some examples of screw 400 can be a part for the screw system including above-mentioned driver 450.In example system, screw 400 can " prestrain " and be arranged on the far-end of driver 450.

As above with reference to described by correspondence diagram, due to exemplary embodiment can various modification can be adapted and without departing from the scope of the present disclosure, so all the elements that include in the foregoing written description and illustrated in the accompanying drawings are intended to be interpreted exemplary and nonrestrictive.Therefore, the range of the disclosure and scope should not be restricted by the restriction of any of the above-described exemplary embodiments, and should be according only to appended claims and equivalents thereof.

Claims

1. intervene a screw, comprising:

Main body, it has near-end, far-end and the longitudinal axis extended between described near-end and described far-end；

Screw thread, it extends between the described near-end and described far-end of described main body in open spiral form；

Through hole, it is limited by described main body, extends between the described near-end and described far-end of described main body along described longitudinal axis, and described through hole has surface；

Control member, it is formed by the described surface of described through hole, described control member engages with driver when described driver is in driving orientation about described control member, and does not engages with described driver when described driver is in from described driving in the orientation that orientation is different.

Intervene screw the most as claimed in claim 1, wherein, described control member includes multiple chute, the plurality of chute extends between the described near-end and described far-end of described main body along described longitudinal axis, the plurality of chute is around the circumference spaced at equal intervals of described through hole, and in the plurality of chute has the shape different from other chutes and/or size.

Intervening screw the most as claimed in claim 2, wherein, one chute has cross sectional shape based on rectangle, and other chutes described have cross sectional shape based on semicircle.

Intervene screw the most as claimed in claim 1, wherein, described control member includes multiple chute, and the plurality of chute extends between the described near-end and described far-end of described main body along described longitudinal axis, and the plurality of chute is non-uniformly spaced around the described circumference of described through hole.

Intervening screw the most as claimed in claim 4, wherein, in the plurality of chute has cross sectional shape based on rectangle, and other chutes have cross sectional shape based on semicircle.

Intervening screw the most as claimed in claim 1, wherein, described control member includes:

Multiple chutes, it extends between the described near-end and described far-end of described main body along described longitudinal axis, and the plurality of chute is around the circumference spaced at equal intervals of described through hole；And

Tab, it is spaced apart adjacent pair chute.

Multiple chutes, it extends between the described near-end and described far-end of described main body along described longitudinal axis, and the plurality of chute is non-uniformly spaced around the circumference of described through hole；And

Tab, it is spaced apart adjacent pair chute.

Intervening screw the most as claimed in claim 1, wherein, described main body is made up of bioabsorbable material, not-bio-absorbable material, bone guided material or composite.

Intervening screw the most as claimed in claim 8, wherein, described not-bio-absorbable material includes polyether-ether-ketone (PEEK), titanium and surgery stainless steel material.

Intervening screw the most as claimed in claim 1, wherein, described main body is made up of not-bio-absorbable material, and described screw thread is made up of bioabsorbable material.

11. intervene screw as claimed in claim 1, and wherein, described through hole is suitable to receive ingrown core.

12. intervene screw as claimed in claim 11, and wherein, described ingrown core is doped with skeletal growth factor, in order to strengthen the growth of bone.

13. intervene screw as claimed in claim 1, it farther includes degree of depth block, the partial-length of main body described in described degree of depth block longitudinal extension, described degree of depth block engages the degree of depth block of described driver so that the remote extension of described driver exceedes the described far-end of described main body.

14. intervene screw as claimed in claim 13, and wherein, described degree of depth block is the open degree of depth block of a part for the described far-end surrounding described main body.

15. intervene screw as claimed in claim 13, and wherein, described degree of depth block is the Guan Bi degree of depth block of the described far-end surrounding described main body.

16. intervene screw as claimed in claim 1, and wherein, the described near-end of described main body aligns with the hash mark on the far-end of described driver, and intervenes the length of the described main body of screw described in the Digital ID being associated with described hash mark.

17. 1 kinds of methods, comprising:

Driver is removed from the main body intervening screw inserted bone, described main body has near-end, far-end and the longitudinal axis extended between described near-end and described far-end, described main body limits the through hole extended between described near-end and described far-end along described longitudinal axis, and described through hole has surface；

The control member formed by the surface of described through hole is engaged with described driver, described control member engages with described driver when described driver is in driving orientation about described control member, and does not engages with described driver when described driver is in from described driving in the orientation that orientation is different；And

Described joint based on described control member Yu described driver, confirms the described driver described orientation in the described main body of described intervention screw.

18. methods as claimed in claim 17, it farther includes to make described driver rotate in described through hole around the described longitudinal axis of described main body about described control member, until described driver engages described control member.

19. methods as claimed in claim 17, wherein, described driver is inserted in described through hole, until the degree of depth block of described driver engages the degree of depth block of the partial-length of main body described in longitudinal extension so that the remote extension of described driver exceedes the described far-end of described main body.

20. methods as claimed in claim 14, wherein, described control member includes multiple chute, the plurality of chute extends between the described near-end and described far-end of described main body along described longitudinal axis, the plurality of chute is around the described circumference spaced at equal intervals of described through hole, and in the plurality of chute has the shape different from other chutes and/or size.

21. methods as claimed in claim 17, wherein, described control member includes multiple chute, and the plurality of chute extends between the described near-end and described far-end of described main body along described longitudinal axis, and the plurality of chute is non-uniformly spaced around the described circumference of described through hole.

22. 1 kinds of methods, comprising:

Driver is initially inserted in the through hole limited by the main body intervening screw being inserted in bone, described through hole extends between the near-end and far-end of described main body along longitudinal axis, described longitudinal axis extends between the described near-end and described far-end of described main body, and described through hole has surface；

Making described driver rotate in described through hole around the described longitudinal axis of described main body, until described driver engages the control member formed by the described surface of described through hole, described joint confirms that described driver is orientated about the driving of described control member；And

In the case of described driver is in described driving in orientation, described intervention screw is driven further in described bone.

23. methods as claimed in claim 22, it farther includes to be further inserted in described through hole described driver, until the degree of depth block of described driver engages the degree of depth block of the partial-length of main body described in longitudinal extension so that the remote extension of described driver exceedes the described far-end of described main body.

24. methods as claimed in claim 22, wherein, described control member includes multiple chute, the plurality of chute extends between the described near-end and described far-end of described main body along described longitudinal axis, the plurality of chute is around the described circumference spaced at equal intervals of described through hole, and in the plurality of chute has the shape different from other chutes and/or size.

25. methods as claimed in claim 22, wherein, described control member includes multiple chute, and the plurality of chute extends between the described near-end and described far-end of described main body along described longitudinal axis, and the plurality of chute is non-uniformly spaced around the described circumference of described through hole.