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CN106255474A - 在骨隧道中捕获至少一束软材料的端部的设备 - Google Patents

在骨隧道中捕获至少一束软材料的端部的设备 Download PDF

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CN106255474A
CN106255474A CN201480078578.7A CN201480078578A CN106255474A CN 106255474 A CN106255474 A CN 106255474A CN 201480078578 A CN201480078578 A CN 201480078578A CN 106255474 A CN106255474 A CN 106255474A
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screw
soft material
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longitudinal axis
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CN106255474B (zh
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约瑟·曼努埃尔·阿巴斯卡尔卢比奥
胡安·阿巴斯卡尔阿桑萨
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Aban SA Taco Naomi De Ltd
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    • AHUMAN NECESSITIES
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    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
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    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
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    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/8695Washers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
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    • A61F2/08Muscles; Tendons; Ligaments
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    • A61F2002/0817Structure of the anchor
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    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/08Muscles; Tendons; Ligaments
    • A61F2/0811Fixation devices for tendons or ligaments
    • A61F2002/0876Position of anchor in respect to the bone
    • A61F2002/0882Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone

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Abstract

本发明涉及用于在骨隧道(1)中捕获至少一束软材料(10)的端部的设备,包括:套圈(100)、螺钉(200)和垫圈(300),该套圈包括近侧上部周缘(140)和螺纹元件(150),螺纹元件具有相对于套圈的纵向轴线(101)倾斜α度的纵向轴线(151),和与螺钉的外螺纹(201)互补的内螺纹(152),该组件设计成使得当螺钉与垫圈一起拧入内螺纹(152)中时,垫圈(300)的外部面(301)接近近侧上部周缘(140)的内部面(142),上部通道形成在两者之间,软材料通过该上部通道突出,以这种方式被捕获。

Description

在骨隧道中捕获至少一束软材料的端部的设备
发明目标
本发明涉及创伤学领域,具体地涉及用于在骨隧道中捕获至少一束软材料的端部的设备。
本发明的目标是提供一种简单、精确且可靠的设备,该设备允许利用足够的保持力而不破坏软组织来在骨隧道中捕获至少一束软材料的端部。
发明背景
关节的软材料的撕裂是非常常见的,最常见的是撕裂膝的前十字韧带(ACL):移植物被用于其替换,该移植物的端部被插入胫骨和股骨隧道中。
与使用骨-腱-骨移植物相比,软材料移植物、自体移植物、同种异体移植物或合成移植物越来越多地被使用,在股骨水平的该移植物通过横向或悬挂设备固定,并且在胫骨水平,它们通过干涉螺钉或与经胫骨螺钉一起的垫圈固定,经胫骨螺钉与干涉螺钉相比具有使愈合周界自由并提供更大保持力的优点。
在单胫骨-股骨隧道手术技术中,其中一束软材料悬挂在股骨水平处,与单个经胫骨螺钉一起的垫圈在胫骨水平是非常可靠的解决方案;然而,在通过三个股骨隧道和三个胫骨隧道实现恢复原始十字韧带的螺旋解剖结构的新技术中,将需要使用三个长的经胫骨螺钉,这是不可接受的。
发明描述
为了能够提供用于借助于足够夹紧一束柔软材料(这些束中的每个都在其自身的骨隧道中)的垫圈和螺钉而不必使用长的经胫骨螺钉来捕获的设备,作者提出了一种新的设备,其用于借助于引入骨隧道的入口开口中的套圈进行捕获,该套圈为截头圆锥形螺钉提供螺纹元件,也为截头圆锥形的垫圈像套筒一样环绕螺钉的头部,该组件配置成使得当螺钉与垫圈一起拧入套圈中时,垫圈的外部面接近存在于套圈中的近侧上部周缘的近端内部面,软材料从中穿过,从而被坚固地捕获。
所提出的新的圆锥形夹紧构造允许在软材料上施加大的保持力,该保持力显著增加,一方面,这是由于套圈被设计成使得在软材料被固定之前,它被折叠在近侧上部周缘的内部面上,且另一方面,这是由于设想一旦软材料被拉紧并固定,则剩余的材料被切割并烧灼,形成残余部分。
本发明另外的目的是提供易于使用的用于捕获软材料的设备,该设备不会破坏软材料且不会从骨隧道的入口开口突出。
附图说明
为了补充该描述并且为了帮助更好地理解根据本发明的优选的实践实施方案的本发明的特征,附加一组附图作为所述描述的组成部分,其中描述了以下内容:
图1在用于捕获的设备的上部总体视图中;在捕获软材料束的设备的下部视图中。
图2是由套圈、螺钉和垫圈组成的用于捕获的设备的拆卸图。
图3是用于捕获的设备和至套圈被包围的骨隧道中的入口开口的埋头边缘的分解图。
图4是套圈的剖视图。
图5在螺钉和垫圈的上部剖视图中,在螺钉和具有周缘的垫圈的中心部分剖视图中;在螺钉和具有周缘并具有突出部的垫圈的下部剖视图中。
图6是包围在骨隧道中的套圈的剖视图,其中,螺钉和垫圈螺纹连接在一起,捕获软材料。
图7在铣削扳手的上部视图中,与骨隧道的入口开口相对;一旦其被引入骨中,则其在下部中。
图8在用于捕获的楔形件和套圈的上部视图中;在引入套圈中捕获软材料的楔形件的下部视图中。
发明的优选实施方案
本发明的优选的实施方案由用于在骨隧道(1)中捕获至少一束软材料(10)的端部的设备组成,该设备包括:具有类似于骨隧道的外径的外径的套圈(100)、螺钉(200)以及垫圈(300),该三个元件在图1的上部部分中示出为组装在一起,在图2中示出为拆卸的,该套圈存在:纵向轴线(101)、纵向管道(110)、远端(120)、近端(130)、近侧边缘(131)、近侧上部周缘(140)以及螺纹元件(150),螺纹元件(150)具有相对于套圈的纵向轴线(101)倾斜α度的纵向轴线(151)和与螺钉的外螺纹(201)互补的内螺纹(152),该组件配置成使得当螺钉与垫圈一起拧入内螺纹(152)中时,垫圈(300)的外部面(301)接近近侧上部周缘(140)的内部面(142),上部通道配置在所述外部面(301)和所述内部面(142)中的两者之间,由此软材料突出,所述软材料因此被捕获,如示出在图1的下部部分和图6的剖视图中的,套圈和螺钉以及垫圈均由一种或多种生物相容性材料制成;在优选的实施方案中,螺钉(200)的头部(210)和垫圈(300)均被构造成在60°和120°之间的优选90°的截头圆锥形状,垫圈(300)像套筒一样环绕所述螺钉的头部(210)的周界(211),近侧上部周缘(140)的内部面(142)以互补方式构造成拱形截头圆锥形状或截头圆锥体形状,其具有与螺纹元件(150)的纵向轴线(151)重合的纵向轴线(141),螺纹元件(150)的纵向轴线(151)反过来具有相对于套圈的纵向轴线(101)在30°和60°之间的倾斜度,优选地45°的倾斜度;垫圈(300)可选地延伸到至少一个突出部(320)中,该至少一个突出部与环绕至所述骨隧道中的入口的皮质骨邻接;在近侧上部周缘(140)的内部面(142)上具有槽(170),其用于加强软材料的捕获的目的;在套圈(100)的近侧边缘(131)的两侧上具有相应的凹入凹部(180),螺钉(200)的头部(210)的一部分穿过该凹入凹部(180)且垫圈(300)的一部分在最大夹紧位置中突出;在垫圈(300)和螺钉(200)的头部之间存在适配元件(310),防止垫圈(300)和螺钉(200)在它们放置时和当它们被抽出时分离,如在图5的下部部分中示出的;螺纹元件由构造在所述套圈(100)的内侧和下壁上的内螺纹(152)组成,该内螺纹在套圈上部截断,在螺钉中具有圆拱形尖端端部(202);所述套圈(100)的远端(120)具有倾斜端部,使得其更容易引入骨隧道中;对于每个套圈(100),存在具有手柄(410)、杆(420)和远端联接器(430)的铣削扳手(400),在远端联接器(430)中具有由管道(431)组成的铣削引导件,该铣削引导件保持相对于骨隧道的纵向轴线和骨隧道的埋头孔的相对位置与待使用的套圈(100)的纵向轴线(151)的相对位置相同;对于每个套圈,存在具有用于捕获软材料(10)的临时捕获楔(500),该临时捕获楔(500)由成锐角的远端(501)、与软材料接触的光滑背面(502)、具有包围在套圈(100)的内螺纹(152)的下部部分中的台阶(504)的腹面(503)以及具有夹持元件的近端(505)组成,其使软材料的临时固定以及软材料的抽出更容易处理,其代替螺钉和垫圈用于在膝盖的反复弯曲和伸展运动期间将软材料暂时固定在套圈中,膝盖的反复弯曲和伸展运动在借助于螺钉和垫圈最终拉紧并且捕获每一束之前进行;该设备优选地由无线电透明聚合物材料制成。
本领域的技术人员将理解,在本优选的实施方案中描述的用于捕获的设备的变体和/或修改是可能的,而不必偏离本发明的范围,因此,在任何情况下描述必须以说明性的和非限制性的方式考虑。

Claims (10)

1.一种用于捕获的设备,其用于在骨隧道(1)中捕获至少一束软材料(10)的端部,其特征在于,其包括:套圈(100)、螺钉(200)和垫圈(300),所述套圈(100)具有类似于骨隧道的外径的外径,在所述套圈中存在:纵向轴线(101)、纵向管道(110)、远端(120)、近端(130)、近侧边缘(131)、近侧上部周缘(140)以及螺纹元件(150),所述螺纹元件具有相对于所述套圈的所述纵向轴线(101)倾斜α度的纵向轴线(151),和与所述螺钉的外螺纹(201)互补的内螺纹(152),所述组件配置成使得当所述螺钉与所述垫圈一起拧入所述内螺纹(152)中时,所述垫圈(300)的外部面(301)接近所述近侧上部周缘(140)的内部面(142),上部通道配置在所述垫圈(300)的所述外部面(301)和所述近侧上部周缘(140)的所述内部面(142)两者之间,由此所述软材料突出,所述软材料由此被捕获,所述套圈和所述螺钉以及所述垫圈由一种或多种生物相容性材料制成。
2.根据权利要求1所述的用于捕获的设备,其特征在于,所述螺钉(200)的头部(210)和所述垫圈(300)均配置成60°和120°之间、优选地90°的截头圆锥形形状,所述垫圈(300)像套筒一样环绕所述螺钉的所述头部(210)的周界(211),所述近侧上部周缘(140)的所述内部面(142)以互补方式配置成拱形截头圆锥形形状或截头圆锥体形状,且具有与所述螺纹元件(150)的所述纵向轴线(151)重合的纵向轴线(141),所述螺纹元件的所述纵向轴线(151)反过来具有相对于所述套圈的所述纵向轴线(101)的在30°和60°之间的倾斜度,优选地45°的倾斜度;所述垫圈(300)可选地延伸到至少一个突出部(320)中。
3.根据权利要求1所述的用于捕获的设备,其特征在于,在所述近侧上部周缘(140)的所述内部面(142)上存在槽(170),为的是增强对所述软材料的捕获。
4.根据权利要求1所述的用于捕获的设备,其特征在于,在所述套圈(100)的所述近侧边缘(131)的两侧上存在相应的凹入凹部(180),所述螺钉(200)的所述头部(210)的一部分和所述垫圈(300)的一部分穿过所述凹入凹部突出,当所述垫圈接触所述套圈(100)的所述近端(130)的所述内部面时,达到最大夹紧位置。
5.根据权利要求1所述的用于捕获的设备,其特征在于,在所述垫圈(300)和所述螺钉(200)的所述头部之间存在适配元件(310),所述适配元件(310)防止所述垫圈(300)和所述螺钉(200)在其放置时和当其被抽出时分离。
6.根据权利要求1所述的用于捕获的设备,其特征在于,所述螺纹元件由构造在所述套圈(100)的内侧和下壁上的内螺纹(152)组成,所述内螺纹在所述套圈的上部中被截断,在所述螺钉中可选地具有中心纵向管道(202),引导件穿过所述中心纵向管道被引入以用于螺纹连接。
7.根据权利要求1所述的用于固定的设备,其特征在于,所述套圈(100)的所述远端(120)具有倾斜端部,使所述套圈更容易引入至骨隧道中。
8.根据权利要求1所述的用于捕获的设备,其特征在于,对于每个套圈(100),存在具有手柄(410)、杆(420)和远端联接器(430)的铣削扳手(400),在所述远端联接器中具有由管道(431)组成的铣削引导件,所述铣削引导件保持相对于骨隧道的所述纵向轴线以及骨隧道的埋头孔的相对位置与待使用的所述套圈(100)的所述纵向轴线(151)的相对位置相同。
9.根据权利要求1所述的用于捕获的设备,其特征在于,对于每个套圈,存在用于捕获软材料(10)的临时捕获楔(500),所述临时捕获楔(500)由锐角远端(501)、与所述软材料接触的光滑背面(502)、具有包围在所述套圈(100)的所述内螺纹(152)的下部部分中的台阶(504)的腹面(503)以及具有夹持元件的近端(505)组成,其使对于软材料的临时固定以及软材料的抽出更容易处理。
10.根据权利要求1所述的用于捕获的设备,其特征在于,所述设备由聚合物材料制成,优选地,由无线电透明聚合物材料制成。
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