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CN100400008C - 骨板 - Google Patents

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CN100400008C
CN100400008C CNB2003801105655A CN200380110565A CN100400008C CN 100400008 C CN100400008 C CN 100400008C CN B2003801105655 A CNB2003801105655 A CN B2003801105655A CN 200380110565 A CN200380110565 A CN 200380110565A CN 100400008 C CN100400008 C CN 100400008C
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F·伯泰
A·阿彭策勒
F·奇科伊拉
R·弗里格
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AO Technology AG
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    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
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    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
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    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
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    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • 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
    • A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
    • A61B17/8057—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded the interlocking form comprising a thread
    • A—HUMAN NECESSITIES
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    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • 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
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
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    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1725—Guides or aligning means for drills, mills, pins or wires for applying transverse screws or pins through intramedullary nails or pins
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    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
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    • A—HUMAN NECESSITIES
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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Abstract

一种骨板(1)，具有一顶面(2)、一骨侧的底面(3)、一第一端(11)、一第二端(12)和多个在这两端(11、12)之间设置的、连接顶面(2)与底面(3)的用于安装骨螺钉的板孔(4)。两个板孔(4)由两个不同形式的部分搭接的第一孔(5)和第二孔(6)的组合构成。两孔中的第一孔(5)构成为圆柱形的，带有内螺纹(7)并具有圆柱轴线(9)。两孔中的第二孔(6)具有圆锥轴线(10)并且从顶面(2)向底面(3)成截锥形逐渐缩小。两孔中的第二孔(6)具有内螺纹(8)。圆柱轴线(9)相对于圆锥轴线(10)具有不同于零的间距A。

Description

骨板
技术领域
本发明涉及一种骨板。
这种骨板首先拟用于固定前脚切骨术、特别是远侧的拇外翻切骨术。这样的切骨术或其固定应按以下准则实现：
旋转稳定的；对相应的矫正尺寸是匹配的；最小侵入的。
背景技术
由WO 00/06036和实用新型公开文本AT 000937U2已知一种夹具形式的植入物，其在髓内应用。该夹具对于髓内的固定只具有最小侵入的优点。而没有来自植入物本身的旋转稳定性。矫正时根据不同的折弯由其提供夹具。因此夹具是最小侵入的，但不可能固定小的矫正。
FRIGG的专利WO 01/54601公开一种骨板，它具有一组合孔，即两个穿通的板孔。在该组合孔中不利的是，两板孔中只有一个具有一个部分的内螺纹，从而只在该一个板孔中能实现骨螺钉的角度稳定的刚性的锚定。
发明内容
在这里本发明将消除这些弊端。本发明的目的在于，提供一种不仅可在髓内而且可在髓外应用的骨板，借其可实现小的及大的矫正的旋转稳定的(rotationsstabile)和最小侵入的固定。
本发明利用具有以下特征的骨板达到所提出的目的。
按本发明的骨板，包括一顶面、一骨侧的底面、一第一端、一第二端和多个在这两端之间设置的、连接顶面与底面的用于安装骨螺钉的板孔，其中至少一个板孔由不同形式的且部分搭接的一第一孔和一第二孔的组合构成，并且第一孔构成为圆柱形的，至少部分地带有一内螺纹并具有一圆柱轴线；其特征在于，
A)第二孔具有一圆锥轴线并且从顶面向底面成截锥形逐渐缩小；
B)第二孔至少部分地带有一内螺纹；以及
C)圆柱轴线相对于圆锥轴线具有不同于零的间距A。
该骨板满足全部上列要求，即：
a)旋转稳定性：
通过在胫骨中的两孔和在跖骨1的头部区域内的两孔，骨板在两边是足够旋转稳定的。通过在胫骨区域内在板内的两个圆柱形螺纹以及该板用两螺钉的锁定，也防止板在髓腔中的扭转和移动。
b)匹配于相应的矫正尺寸的固定：
这借助于瞄准架来实现。将MT小头按照相应的尺寸的要求向侧面移动。然后沿小头插入或楔入板并接着用螺钉拧紧。
c)最小侵入的：
通过一切口进行锯切，该切口的大小刚好够通过锯片。但该切口足以插入板。然后可以穿过皮肤钻出各个孔，用来将板拧紧于胫骨区域内。
d)小的矫正也是可能的：
小的矫正，其不超出髓腔的皮层边缘，可以用该板在髓外进行固定。在这方面将板按照矫正轻微弯曲并推进到皮肤之下。孔的第二部分，其拟用于锁定胫骨，设有圆锥螺纹并且拟用于髓外的角度稳定的固定。在将板推进皮肤之下时可以摸到各孔。在两者之间的切口足以达到两孔。
借助于本发明的骨板的“组合孔”，其中优选在骨板的下面的近侧的部分中设置两个孔，该骨板可以不仅在髓内而且在髓外应用。
“组合孔”包括一圆柱形和一圆锥形的分别设有一至少部分的螺纹的部分。圆柱形部分应用于髓内的固定并且用一骨螺钉的胫骨螺纹锁定。圆锥形部分在骨板的髓外的应用中同样用于锁定骨板，在这种情况下采用一螺纹头螺钉，从而产生一所谓“内部的固定器”。由于跖骨小头是被移动的部分，在这里固定(髓内的/髓外的)的选择并不是重要的。因此在骨板的上面的远侧的部分中的两个板孔相当于通用的角度稳定的板孔(具有内螺纹的圆柱形或圆锥形孔)。
为了本发明骨板的髓内的固定，需要一瞄准器，其使得能够将骨板精确地锁定于骨中。但该瞄准器应该同时可使骨板精确地定位并用作为楔入工具。
对于髓外的固定不需要瞄准器，因为可以摸到在皮肤之下的骨板的各孔。两个优选在骨板的近侧端设置的“组合孔”这样相互靠近，使得通过一切口和皮肤的移动可以达到该两个“组合孔”。
内螺纹不仅应该被理解为螺旋形的结构，而且理解为筋状的结构，其可以实现如螺纹同样的功能。
骨板如其所确定的那样具有优点，即制造时产生较少的材料消耗。第二优点在于，骨板的缩短是可能的，这产生较小的侵入作用的结果。
在一特别的实施形式中，接近骨板的第一端处设置由两个搭接的孔构成的板孔。
在一优选的实施形式中，骨板的第一端逐渐缩小。借此其可更容易地插入骨腔内并且在髓外的应用中更容易推进到皮肤之下。
在另一实施形式中，第一孔的内螺纹构成为多线的、优选双线的。借此在拧入一螺纹头螺针时可以较快地咬住。第二孔的内螺纹也可以构成为多线的、优选双线的。
在另一实施形式中，两个搭接的孔的圆柱轴线和圆锥轴线基本上相互平行延伸。优选圆柱轴线与圆锥轴线彼此间具有一间距A＞0.1mm。
在一特别的实施形式中，骨板具有至少两个板孔，其由两个不同的部分地搭接的孔的组合构成。优选在其上邻接至少另一板孔，其不由两个部分地搭接的孔构成。邻接于组合孔的板孔可以构成为具有或没有内螺纹的圆柱形或圆锥形的。
在另一实施形式中，骨板具有一压缩孔。
在另一实施形式中，骨板的第二端构成为Y形的。为了用两个连续的孔进行固定，待固定的断片可能是过短的。在这种情况下骨板的Y形端具有优点，即分别在一个Y枝上设有一个孔。
其中优选Y形端的两枝的一个(或两个)具有一压缩孔。也可以采用一组合孔，亦即一压缩孔与一锁定孔的组合。但也可以采用两种型式孔(压缩孔或锁定孔)中的一个。
一压缩孔与一锁定孔的组合在“Y”的另一臂上的优点是，在经由第二孔角度稳定地固定以前可以经由骨板进行压缩。
在另一实施形式中，骨板的顶面和底面构成弧形的。弧形的顶面和底面典型地基本上相当于两圆柱体的侧表面K顶面和K底面。
优选顶面2和底面3具有不同的曲率。当将板既用于髓内或用于髓外时，利用顶面和底面的不同的曲率一方面可以最好地匹配于髓腔的髓内表面而另一方面可以最好地匹配于骨的髓外的表面。
在一特别的实施形式中，圆柱体K顶面的半径R顶面为圆柱体K底面的半径R底面的至多50％、优选至多40％。
附图说明
以下借助多个实施例的部分的示意图还要更详细地说明本发明和本发明的进一步构成。其中：
图1按照本发明具有两个组合孔的骨板的正视图；和
图2按图1的骨板在一组合孔的区域内的纵剖面图。
具体实施方式
图1和2中所示的骨板1具有一顶面2、一骨侧的底面3、一第一端11、一第二端12和四个在两端11、12之间设置的、连接顶面2与底面3的用于安装骨螺钉的板孔4。
两个邻近第一端11的板孔4由两个不同形式的部分搭接的孔5、6构成。其中两孔中的第一孔5构成为圆柱形的，它具有圆柱轴线9和内螺纹7。两孔中的第二孔6从顶面2向底面3成截锥形逐渐缩小并且具有圆锥轴线10和内螺纹8。圆柱轴线9和圆锥轴线10相互平行延伸并且具有2mm的间距A。
所述两个由两个搭接的孔5、6构成的板孔4中的终端的那个接近骨板1的第一端11设置，其是逐渐缩小的。
邻接于组合孔的板孔4构成为具有内螺纹8的圆锥形的和角度稳定的。

Claims (16)

1.一种骨板(1)，包括一顶面(2)、一骨侧的底面(3)、一第一端(11)、一第二端(12)和多个在这两端(11、12)之间设置的、连接顶面(2)与底面(3)的用于安装骨螺钉的板孔(4)，其中至少一个板孔(4)由不同形式的且部分搭接的一第一孔(5)和一第二孔(6)的组合构成，并且第一孔(5)构成为圆柱形的，至少部分地带有一内螺纹(7)并具有一圆柱轴线(9)；其特征在于，
A)第二孔(6)具有一圆锥轴线(10)并且从顶面(2)向底面(3)成截锥形逐渐缩小；
B)第二孔(6)至少部分地带有一内螺纹(8)；以及
C)圆柱轴线(9)相对于圆锥轴线(10)具有不同于零的间距A。
2.按照权利要求1所述的骨板(1)，其特征在于，所述由两个搭接的孔(5、6)构成的板孔(4)接近骨板(1)的第一端(11)设置。
3.按照权利要求1或2所述的骨板(1)，其特征在于，骨板(1)的第一端(11)逐渐缩小。
4.按照权利要求1或2所述的骨板(1)，其特征在于，第一孔(5)的内螺纹(7)构成为多线的。
5.按照权利要求1或2所述的骨板(1)，其特征在于，第二孔(6)的内螺纹(8)构成为多线的。
6.按照权利要求1或2所述的骨板(1)，其特征在于，圆柱轴线(9)和圆锥轴线(10)基本上相互平行延伸。
7.按照权利要求1或2所述的骨板(1)，其特征在于，圆柱轴线(9)和圆锥轴线(10)彼此间具有间距A＞0.1mm。
8.按照权利要求1所述的骨板(1)，其特征在于，至少其中两个板孔(4)由彼此不同形式的且部分搭接的一第一孔(5)和一第二孔(6)构成。
9.按照权利要求8所述的骨板(1)，其特征在于，该骨板具有至少一个另外的板孔(4)，该板孔不由两个部分搭接的孔(5、6)构成。
10.按照权利要求1所述的骨板(1)，其特征在于，第二端(12)构成Y形的。
11.按照权利要求1所述的骨板(1)，其特征在于，该骨板具有一压缩孔。
12.按照权利要求11所述的骨板，其特征在于，Y形端(12)的两个枝之一具有一压缩孔。
13.按照权利要求1所述的骨板(1)，其特征在于，顶面(2)和底面(3)是弧形的。
14.按照权利要求13所述的骨板(1)，其特征在于，所述骨板的顶面(2)和底面(3)相当于两个圆柱体的侧表面K顶面和K底面。
15.按照权利要求13或14所述的骨板(1)，其特征在于，顶面(2)的曲率和底面(3)的曲率是不同的。
16.按照权利要求15所述的骨板(1)，其特征在于，圆柱体K顶面的半径R顶面为圆柱体K底面的半径R底面的至多50％。
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US8246661B2 (en) 2012-08-21
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US20070016205A1 (en) 2007-01-18
KR101136203B1 (ko) 2012-04-17
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CN1859880A (zh) 2006-11-08
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BR0318585B1 (pt) 2012-05-02
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AU2003271507B2 (en) 2009-04-09
ATE428362T1 (de) 2009-05-15

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