WO1997020513A1 - Orthopädisches haltesystem - Google Patents
Orthopädisches haltesystem Download PDFInfo
- Publication number
- WO1997020513A1 WO1997020513A1 PCT/EP1996/005355 EP9605355W WO9720513A1 WO 1997020513 A1 WO1997020513 A1 WO 1997020513A1 EP 9605355 W EP9605355 W EP 9605355W WO 9720513 A1 WO9720513 A1 WO 9720513A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- holding
- head
- shaped
- bone
- holding system
- Prior art date
Links
- 230000008719 thickening Effects 0.000 claims abstract description 39
- 239000007943 implant Substances 0.000 claims abstract description 24
- 210000000988 bone and bone Anatomy 0.000 claims description 82
- 230000000399 orthopedic effect Effects 0.000 claims description 8
- 230000000295 complement effect Effects 0.000 claims description 3
- 238000003780 insertion Methods 0.000 abstract description 3
- 230000037431 insertion Effects 0.000 abstract description 3
- 239000000126 substance Substances 0.000 description 5
- 230000002093 peripheral effect Effects 0.000 description 3
- 239000012634 fragment Substances 0.000 description 2
- 208000006386 Bone Resorption Diseases 0.000 description 1
- 238000005452 bending Methods 0.000 description 1
- 230000024279 bone resorption Effects 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 239000013013 elastic material Substances 0.000 description 1
- 230000001771 impaired effect Effects 0.000 description 1
- 230000009916 joint effect Effects 0.000 description 1
- 230000001097 osteosynthetic effect Effects 0.000 description 1
- 230000000717 retained effect Effects 0.000 description 1
- 230000007704 transition Effects 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
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
- A61B17/8038—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers the additional component being inserted in the screw head
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
Definitions
- the invention relates to an orthopedic holding system with at least one implant part which has at least one push-through opening and with pin-shaped holding elements which are inserted into the push-through openings, the push-through openings having extensions which accommodate an elastically compressible head-shaped thickening of the holding elements, wherein the extensions have an outer diameter which is slightly smaller than the non-elastically compressed head-shaped thickening, and wherein the extensions have undercuts into which the head-shaped thickening engages elastically after insertion into the extension, and with a blind hole in the Area of the head-shaped thickening of the holding element, into which a core filling this can be inserted.
- Holding systems of this type are used to connect bone fragments and to fix skeletal parts. These can be, for example, bone plates which are screwed into the bone substance with bone screws and thereby pressed against the surface of the bone and fixed there. Systems from several implant parts that have to be connected to one another can also be involved, for example different bone plates or bone plates on the one hand and endoprostheses on the other hand.
- WO88 / 03781 describes an osteosynthetic device in which a bone screw can be elastically locked into a bone plate.
- the bone plate has an opening with undercuts, and the head of the bone screw can be compressed elastically so that it can be snapped into this undercut opening.
- the bone screw in this known construction is expanded by inserting a locking pin in such a way that the bone screw is held in a clamped fit in the through opening of the bone plate, ie it forms together after the locking pin has been inserted a rigid unit with the bone plate.
- This insertable core which does not push the parts of the head-shaped thickening apart, but only fills the blind hole without widening it, prevents the elastically bendable parts of the head-shaped thickening can be bent elastically radially inwards, so that only the insertion of this core locks the head-shaped thickening in the extension of the push-through opening when the head-shaped thickening engages in the undercut of the extension . Since the head-shaped thickening is not widened by this core, the head-shaped thickening remains freely rotatable in the widening, the locking takes place solely by the form-locking in the axial direction.
- the implant parts can have the most varied of shapes.
- these can be bone plates which are held on the bone by screwing with the aid of a holding element in the form of a bone screw and thereby fix bone fragments.
- Several implant parts can also be directly connected to one another by a holding element, for example two bone plates or one bone plate on the one hand and the shaft of an endoprosthesis on the other hand.
- the term "bone plate” does not only mean purely plate-shaped components, but also differently shaped implants which are used to fix and support the bone apparatus.
- bone screw not only includes holding pins that can be screwed into the bone substance in the actual sense, but also pin-shaped holding elements with a head-shaped thickening that penetrate the bone plates. These could also be fixed to the bone apparatus by means of a screwed-on nut or other traction means; they do not necessarily have to be anchored in the bone substance by their own threads.
- the head-shaped thickening is formed by a plurality of parts of the holding element which can be elastically bent radially inwards.
- the parts which can be elastically bent inward are sections of the holding element which are separated from one another by radially running incisions and are formed in one piece with the holding element. It is therefore sufficient in principle for a holding element made of elastic material to have one or more radially extending incisions in the area of the head-shaped extension, which allow the parts of the holding element to come slightly closer together in order to achieve the required compressibility.
- the blind hole narrows in stages towards the free end of the holding element.
- the blind hole can extend into the shaft of the holding element, the core then carrying a corresponding extension pin which essentially completely fills the blind hole.
- blind hole is of circular cylindrical design.
- the extension has a spherical ring-shaped inner surface and the head-shaped thickening has a complementary spherical ring-shaped outer surface, the largest diameter of which is arranged in the interior of the implant part at a distance from its outer surface.
- Such a configuration makes it possible to pivot the holding element in the expansion of the push-through opening over a certain angular range, so that it can be screwed in at an angle to the implant part. Nevertheless, the holding element remains held in the implant part. This also applies if a core is inserted into a blind hole, which locks the holding element against being pulled out of the implant part. However, there remains free rotation about the longitudinal axis of the holding element and about axes of rotation lying in the plane of the implant part fully preserved.
- the holding element is a bone screw.
- the holding element can be a screw with a machine thread.
- the bone screw is suitable for screwing into bone substance
- a holding element with a machine thread can be used to connect two implant parts to one another. It is then advantageous if one implant part has an internal thread into which the holding element can be screwed, while the other implant part has a push-through opening in the manner described with an undercut extension for the head of the holding element.
- two bone plates can be connected to one another in this way. It is also possible to connect the shaft of an endoprosthesis inserted into this bone to a bone plate lying on the outside of the bone on a tubular bone, the holding element then passing through the wall of the bone.
- FIG. 1 a side view of a bone plate and a bone screw with a core inserted in a push-through opening of the bone plate in a partial sectional view before the bone screw is pressed into the push-through opening;
- Figure 2 is a view similar to Figure 1 in the
- Bone plate pressed in but not locked in the axial direction of the bone screw of Figure 1 in the area of the bone plate and the head-shaped thickening in a section along line 2-2 in Figure 3;
- Figure 3 a plan view of the bone plate and the bone screw used in Figure 2 and
- FIG. 4 a view similar to FIG. 2 with the core inserted for locking the bone screw in the axial direction.
- the orthopedic holding system is described below using the example of a bone plate which is to be fixed to bone substance using bone screws.
- the invention is not limited to the use on bone plates and the use of bone screws, but rather is generally directed to orthopedic holding systems in which implant parts are to be fixed on the bone system or with one another with the aid of holding elements.
- the orthopedic holding system shown in the drawing comprises a metallic bone plate 1 with a plurality of through openings 2, of which only one is shown in the drawing.
- This push-through opening has a spherical ring-shaped inner wall 3, the area of the largest diameter of the push-through opening 2 is arranged approximately in the middle of the bone plate 1, so that the push-through opening 2 narrows towards the top 4 and bottom 5.
- the spherical ring-shaped inner wall 3 thus forms a bulge and thus an undercut 6.
- a bone screw 7 is inserted into the push-through opening 2, which can for example consist of an elastic plastic, in particular a resorbable plastic.
- This bone screw 7 has a shaft 8 with an external thread 9 and a head-shaped thickening 10, which is laterally delimited by a spherical ring-shaped peripheral surface 11, the dimensions of which essentially correspond to the dimensions of the likewise spherical inner wall 3 of the push-through opening 2.
- the peripheral surface 11 is thus complementary to the inner wall 3.
- a central blind hole 14 is machined into the bone screw 7 and extends into the shaft 8 stretched in and which has an enlarged area 15 in the area of the head-shaped thickening 10.
- This enlarged area 15 facilitates the elastic compression of the head-shaped thickening 10, in which the sections 13 are bent elastically inwards.
- This pressing together of the head-shaped thickening 10 makes it possible to reduce its outer diameter, so that the head-shaped thickening 10 can be inserted into the push-through opening 2, although this has an inner diameter at the narrower transition points to the top 4 and bottom 5 , which is smaller than the outside diameter of the undeformed, not compressed head-shaped thickening 10.
- this head-shaped thickening 10 When this head-shaped thickening 10 is pushed in, it is compressed elastically and, after being pressed in, elastically snaps apart again, the bulging peripheral surface 11 engaging in the undercut 6 of the through opening 2 .
- the bone screw 7 is fixed in the push-through opening 2 in the axial direction, without, however, impairing the free rotation of the bone screw about its longitudinal axis and also about pivot axes lying in the plane of the bone plate 1. A pivot-like connection between the bone screw 7 and the bone plate 1 is thus produced.
- the bone screw 7 can be rotated in a suitable manner by a tool, which can engage, for example, in the incisions 12 or in the blind hole 14, which for this purpose can have a non-circular cross section, for example a hexagonal cross section.
- a core 16 can be used, which is shaped so that it substantially completely fills the blind hole 14.
- the core 16 has an elongated pin 17 which engages in the lower part of the blind hole 14 arranged in the shaft 8, and a cylindrical thickening 18 which dips into the enlarged region 15 of the blind hole 14. The dimensions are chosen so that the core 16 enters the blind hole 14 without widening it.
- the complete filling of the enlarged area 15 of the blind hole 14 prevents the elastic bending of the sections 13 radially inwards, i.e. it is no longer possible to reduce the outside diameter of the head-shaped thickening 10 of the bone screw 7.
- the bone screw 7 is inserted into the push-through opening 2, it is therefore no longer possible to remove the head-shaped thickening 10 from the undercut 6, so that the bone screw 7 is locked in the bone plate 1 in this way without jamming.
- the bone screw remains freely rotatable and freely pivotable in the push-through opening 2, so that the rotary joint property of the connection between the bone screw 7 and the bone plate 1 is in no way impaired.
Abstract
Description
Claims
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP96941647A EP0865259B1 (de) | 1995-12-07 | 1996-12-03 | Orthopädisches haltesystem |
DE59607017T DE59607017D1 (de) | 1995-12-07 | 1996-12-03 | Orthopädisches haltesystem |
US09/098,921 US6117173A (en) | 1995-12-07 | 1998-05-29 | Orthopaedic fixing system |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE19545612.2 | 1995-12-07 | ||
DE19545612A DE19545612C2 (de) | 1995-12-07 | 1995-12-07 | Orthopädisches Haltesystem |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/098,921 Continuation US6117173A (en) | 1995-12-07 | 1998-05-29 | Orthopaedic fixing system |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1997020513A1 true WO1997020513A1 (de) | 1997-06-12 |
Family
ID=7779412
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/EP1996/005355 WO1997020513A1 (de) | 1995-12-07 | 1996-12-03 | Orthopädisches haltesystem |
Country Status (4)
Country | Link |
---|---|
US (1) | US6117173A (de) |
EP (1) | EP0865259B1 (de) |
DE (3) | DE29521456U1 (de) |
WO (1) | WO1997020513A1 (de) |
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JP2001140919A (ja) * | 1999-10-07 | 2001-05-22 | Howmedica Osteonics Corp | 茎用ねじアセンブリ及びそのための継手要素 |
US6251140B1 (en) | 1998-05-27 | 2001-06-26 | Nuvasive, Inc. | Interlocking spinal inserts |
US6290724B1 (en) | 1998-05-27 | 2001-09-18 | Nuvasive, Inc. | Methods for separating and stabilizing adjacent vertebrae |
WO2001091660A1 (en) | 2000-05-31 | 2001-12-06 | Vese, Silvana | Device for fixing a bone plate |
US6368325B1 (en) | 1998-05-27 | 2002-04-09 | Nuvasive, Inc. | Bone blocks and methods for inserting bone blocks into intervertebral spaces |
US6702817B2 (en) | 2001-01-19 | 2004-03-09 | Aesculap Ag & Co. Kg | Locking mechanism for a bone screw |
US8608804B2 (en) | 2004-03-29 | 2013-12-17 | Nuvasive, Inc. | Systems and methods for spinal fusion |
US8870960B2 (en) | 2005-07-28 | 2014-10-28 | Nuvasive, Inc. | Total disc replacement system and related methods |
US8920500B1 (en) | 2009-04-16 | 2014-12-30 | Nuvasive, Inc. | Methods and apparatus for performing spine surgery |
USD721808S1 (en) | 2011-11-03 | 2015-01-27 | Nuvasive, Inc. | Intervertebral implant |
USD731063S1 (en) | 2009-10-13 | 2015-06-02 | Nuvasive, Inc. | Spinal fusion implant |
US9101484B2 (en) | 2000-07-17 | 2015-08-11 | Nuvasive, Inc. | Stackable spinal support system |
USD741488S1 (en) | 2006-07-17 | 2015-10-20 | Nuvasive, Inc. | Spinal fusion implant |
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DE29701099U1 (de) * | 1997-01-23 | 1997-03-06 | Aesculap Ag | Stiftförmiges Halteelement für ein orthopädisches Haltesystem |
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US6290724B1 (en) | 1998-05-27 | 2001-09-18 | Nuvasive, Inc. | Methods for separating and stabilizing adjacent vertebrae |
US6368325B1 (en) | 1998-05-27 | 2002-04-09 | Nuvasive, Inc. | Bone blocks and methods for inserting bone blocks into intervertebral spaces |
JP2001140919A (ja) * | 1999-10-07 | 2001-05-22 | Howmedica Osteonics Corp | 茎用ねじアセンブリ及びそのための継手要素 |
JP4594509B2 (ja) * | 1999-10-07 | 2010-12-08 | ストライカー・スピン | 茎用ねじアセンブリ |
JP2010279719A (ja) * | 1999-10-07 | 2010-12-16 | Stryker Spine | 茎用ねじアセンブリのための継手要素 |
WO2001091660A1 (en) | 2000-05-31 | 2001-12-06 | Vese, Silvana | Device for fixing a bone plate |
CN1309351C (zh) * | 2000-05-31 | 2007-04-11 | 西尔瓦纳·韦塞 | 用来固定由于骨折所断裂的骨头片断的装置 |
US10390961B2 (en) | 2000-07-17 | 2019-08-27 | Nuvasive, Inc. | Stackable interlocking intervertebral support system |
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US8870960B2 (en) | 2005-07-28 | 2014-10-28 | Nuvasive, Inc. | Total disc replacement system and related methods |
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Also Published As
Publication number | Publication date |
---|---|
DE19545612A1 (de) | 1997-06-12 |
DE19545612C2 (de) | 2001-08-30 |
EP0865259A1 (de) | 1998-09-23 |
EP0865259B1 (de) | 2001-05-30 |
US6117173A (en) | 2000-09-12 |
DE59607017D1 (de) | 2001-07-05 |
DE29521456U1 (de) | 1997-05-07 |
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