CN1171923A - Fixation tools for osteosynthesis - Google Patents

Abstract

The invention relates to a bone-knitting device in orthopedic surgery. The invention relates to a spiral body for fixing two bones in BTB tendon transplantation plastic surgery and a fixing tool for installing the spiral body. The fixing tool comprises a hexagonal transmission shaft matched with the shaft hole of the hexagonal section of the spiral body, and the transmission shaft completely passes through the shaft hole of the spiral body, so that the torsion can be correctly transmitted to the spiral body when the spiral body rotates, and the spiral body can be correctly guided to be positioned. The transmission shaft and the handle are connected into a whole, so the handle can drive the transmission shaft to axially slide or integrally rotate.

Description

Fixation tools for osteosynthesis

The invention relates to an appliance for bone setting in orthopedic surgery.

The well-known BTB (Bore-Tedon-Bone) method in the field of orthopedic surgery is used to restore damaged tendon tissue (as shown in Figure a-c). Connects the kneecap to the adjacent tibia with the suture 3 passing through the lateral hole of the bone fragment 2; when the tendons connecting the femur 4 and the tibia 5 through the drill holes 6 and 7 are ruptured or damaged, they must be reattached , the method is to use suture 3 to make the joint bone piece 2 pass through the drill holes 6 and 7 of the femur 4 and the tibia 5 along the joint tendon 1, and then screw the spiral body 9 into the hole 7 of the tibia 5 by means of a fixing tool 8, Likewise, another helical body 9 is screwed into the opposite inner wall between the hole 6 of the leg bone 4 and the bone piece 2 . This operation can make the bone piece 2 firmly fixed on the leg bone 4 and the tibia 5, and the damaged tendon between the leg bone 4 and the tibia 5 can extend between the two bone pieces 2 at the tendon 1 to make the leg bone 4 and the tibia 5 The tibia 5 heals on its own when it comes together. In this kind of tendon reconstruction operation, the spirochetes 10, 11, 12 (Fig. 2-4) are used in conjunction with the fixing tool 13, which can be formed into a more convenient way of use as shown in Fig. 5 .

The spiral body 10 of Fig. 2 is a screw rod 15, and its one end has a load-bearing hole 14 that can be inserted into the fixing tool 13, and the other end of the screw rod 15 is a tapered thread, and a pair of inner guide holes 16 are arranged in the center. The spiral body 11 of Fig. 3 has a screw head 17, also has a load-bearing hole 18 that can be inserted into the tip of the fixing tool 13 in it, and its screw rod 19 head is also a tapered thread, and its center also has an inner guide hole 20 that passes through. The spiral body 12 of Fig. 4, its main body is a screw rod 21, and its end is a garden conical convex body 22, and its other end has coaxial reverse internal screw holes of different sizes, and the large internal screw hole 23 can be used as the device spiral body 12 , the reverse small inner screw hole 24 is used for dismantling the spiral body 12 . Fig. 5 is the fixed tool 13 of prior art, and it has a manual screwdriver 25 and a drive shaft 26 that is contained on the screwdriver 25, and the end cone of this shaft is used for putting the component into and combining it. A through shaft hole 27 is located in the screwdriver 25 and the transmission shaft 26, and the guide wire 28 can pass through the shaft hole 27 and easily penetrate into the spiral body. Because the typical spiral body 10,11 all includes a hexagonal bearing hole 14,18 and an inner guide hole 16,20. A guard 29 may also be provided on the delivery shaft 26 to protect the surrounding tissue and tendons from damage.

The fixation tool and helix used above have well-known problems to be solved. For example, in order to bear the torque introduced by the awl head of the fixation tool 13, the load-bearing holes 14 and 18 appear to be too shallow, so that the helix is screwed into the two adjacent bone slices. The required torque cannot be effectively transmitted to the screw body, especially when the straight screw rod is lengthened to increase the fixing force, it is necessary to use considerable force to turn the screw body, so that the end of the fixing tool 13 may come out of the bearing hole and damage the adjacent bone fragments. In addition, since the central axis of the helicoid may be slippery during insertion, this deviation may cause the joint bone piece 2 to be unable to be positioned correctly and have sufficient tightness to restore the tendon after surgery.

When using the spiral body 12 of Fig. 4, be that fixing tool 13 is inserted in two coaxial bigger and smaller inner screw holes 23,24 in the spiral body, need two separate tools to screw the spiral body 12 into or To unscrew, when the small internal screw hole 24 is utilized to unscrew the helix, the screw thread may not be able to bear the large torsion force of the unscrewed helix 13.

When using the spiral body 10, 11, the end of the screw rod has a tapered thread, if the spiral body is screwed into the gap between the two bone fragments or the reforming hole of the injured bone is too deep, then the pointed end of the spiral body will injure the surrounding tissue Even if it is appropriate for the helical body to screw into the two bone fragments, this error may occur, because the fixation of the helical body is ineffective in the tapered part, and the effective part is limited to the straight helical part, so it cannot provide sufficient fixation to the bone force. This will allow the patient to prolong the recovery time, and more importantly, the joint bone piece 2 taken off from the human kneecap generally has a length of no more than 20mm-25mm, and the effective length of the helix should be similar to it to maximize the bonding force. But the helix of the prior art is limited to the taper of the end or the cone-convex body so that its effective length is insufficient to weaken its binding force. In order to lengthen the effective length of the helix, its total length will be larger and the helix will be closer to the joint tendon , resulting in an increased likelihood of tendon damage.

Since the effective length of the spiral body is limited to the straight thread part, it is desirable to shorten the taper part as much as possible to achieve the maximum fastening force. However, this will make the spiral body screw into the gap of bone fragments and cause great difficulty in guiding due to the large lead angle of the free end. Of course, it can be used. Slight improvement is made by increasing the thickness of the guide wire, which allows the helix to be used without any taper, but the original guide wire still inevitably has two problems, namely, one, because the hole for the guide wire passes It is located on the front cone of the fixed tool. At this time, the large shaft hole will inevitably reduce the structural strength of the cone to an unacceptable level. Second, in order to reduce the size of the guide wire to be smaller than the cone, then There will be a circular step between the end of the spirochete and the guide wire, which will greatly hinder the smooth entry of the spirochete.

In view of the many problems that still exist in the prior art, the object of the present invention is to:

1. Provide a new fixation tool, which can firmly embed the joint bone into the bone hole;

2. Provide a new fixing tool, which can conveniently screw the spiral body into the gap between the two bone pieces;

3. Provide a series of new spirochetes, which have sufficient bonding force when screwed into bone fragments;

4. Provide a series of new spirochetes, which will not cause damage to joint tendons and surrounding tissues when they are screwed into bone fragments.

The present invention is accomplished in this way. The present invention includes two parts of a fixing tool and a spiral body. The fixing tool is composed of a rotary screwdriver and a transmission shaft mounted on the screwdriver. One end of the transmission shaft is inserted into the middle hole of the screw body that can be embedded in the bone to drive the screw body. Synchronized rotation for placement between bone fragments, characterized by:

The fixing tool of the present invention comprises a handle of the rotary screwdriver and the front end and the middle section of the conical head driven by the handle. The torque is transmitted to the transmission shaft of the helical body. The helix is a straight screw with a middle hole, and its outer circle is a helical thread. The torsion force of a pair of helixes can be generated in the middle section of the transmission shaft by turning the handle by hand to drive the transmission shaft to rotate.

Because the helix is a complete straight thread without any tapered thread, and the required guiding action is completed by the conical head of the transmission shaft passing through the helix, the entire length of the helix can be screwed with the joint bone, so The helix with the same length can achieve the maximum binding force. Since the front end of the helix has no taper thread or protruding head, it will not touch the tendon when the force on the joint bone fragment reaches the maximum, causing damage to the joint bone and surrounding tissues.

Since the hole in the screw body and the transmission shaft are perfectly matched and combined in the same polygon, and the transmission shaft passes through the entire length of the screw body, the screw body is driven to rotate by the transmission shaft and effectively transmits the rotational torque to the screw body, so that the screw body can be firmly screwed. Into the gap, at the same time, because the transmission shaft has provided an ideal guiding action, it can also avoid deformation of the components produced by inserting the bone chip when the tapered head is withdrawn from the transmission shaft.

The transmission shaft can provide a shaft hole for the guide wire to pass through. Since there is a taper at the end of the helix, a relatively large-diameter transmission shaft can extend from the end of the helix to give a considerable guiding effect, so the guide wire can be greatly thickened. It is beneficial for guidance and minimizes the displacement and deflection of the helix on the insertion path.

The rotary screwdriver of the present invention comprises a handle, a rotating tube directly connected to the handle, the full length of the handle and the rotating tube has a polygonal shaft hole for the middle section of the transmission shaft to move axially or rotate, the end of the rotating tube and one end of the helix close to each other.

A rotary screwdriver with another structure of the present invention includes a handle and a base end of the transmission shaft directly connected to the handle. There is an adjustable adjustment tube outside the transmission shaft that can slide axially and rotate. at one end of the spiral.

The rotary screwdriver of the third structure of the present invention comprises a handle and a base end of the transmission shaft directly connected to the handle. There is a cylindrical body with a diameter greater than the diameter of the circumscribed circle of the middle section between the handle and the middle section of the transmission shaft, which forms an annular step with the middle section. .

Compared with the prior art, the present invention has the advantages of:

1. The transmission shaft is fully matched with the entire length of the inner wall of the spiral, so the torque is effectively transmitted to the spiral, so that the spiral can be firmly fixed in the gap;

2. Since the spirochete can pass through the transmission shaft and be firmly supported, the joint bone fragment can be easily and reliably set at the predetermined position without causing damage to the joint tendon and surrounding tissues;

3. Since the spirochete is a straight thread without taper, the spirochete is screwed together with the bone plate at the maximum allowable length, and its front end has no taper protruding to the joint tendon, so when the joint force with the bone plate is the largest, Also can not damage joint tendon or surrounding tissue like prior art;

4. Since there is no taper at the end of the helix, it is allowed to use a thicker guide wire, which can avoid the displacement deviation of the guide path.

Description of drawings:

Figures 1a-c are schematic diagrams of tendon and tendon transplantation with bone fixation tools in the prior art.

Fig. 2 is a cross-sectional view of a prior art helix for mounting a bone fragment to a bone.

Fig. 3 is a sectional view of another spiral body.

Fig. 4 is a sectional view of another spiral body.

Figure 5 is a front view of a prior art bone fixation tool.

Fig. 6a-c are structural diagrams of the transmission shaft and the spiral body used in the bone fixation tool of the present invention.

Fig. 7 is a diagram of the tool transmission shaft and the helical body of the structure shown in Fig. 6 being screwed into the bone joint in the bone suture.

Fig. 8 is a perspective view of the handle of the bone fixation tool of the present invention.

Fig. 9 is a diagram of another bone fixation tool of the present invention.

Fig. 10 is a diagram of another bone fixation tool of the present invention.

Figures 11a-c are the combination of the transmission shaft and the screw body of the bone fixation tool in Figure 10 corresponding to Figure 6 .

Fig. 12 is another embodiment diagram of the combination of the spiral body and the plunger.

The accompanying drawings are illustrated below in conjunction with the embodiments:

As shown in Figure 6, the bone fixation tool of the present invention is a rotary screwdriver 36 and a hexagonal transmission shaft 34 whose periphery is formed, and utilizes the bone fixation tool to screw the spiral body 30 into the wall of the hole 7 of the bone chip 2 and the tibia 5. Rotary screwdriver 36 is made up of a handle 41 and the rotating pipe 42 that is fixed on handle 41, (Fig. 7, 8) the center of rotary screwdriver 36 has the hexagonal shaft hole that runs through, transmission shaft 34 is a hexagonal shaft with rotary screwdriver 36 center The hexagonal rod that matches the hole and can slide and rotate as a whole in the shaft hole has a conical head 32 at its end, and a straight screw with a middle hole. 40 is a hexagon that matches the transmission shaft 34 and is sleeved on the transmission shaft 34 for use. The conical head 32 passes through and extends beyond the spiral body 30 to play a guiding role. The transmission shaft 34 may have a shaft hole 49 for passing a guide wire. The rotary screwdriver 36 is operated by rotating it by hand, and the transmission shaft 34 matched with it drives the screw body 30 to rotate. The end of the rotating tube 42 on the rotary screwdriver 36 pushes against the rear end of the helix 30, and the conical head 32 of the transmission shaft 34 protrudes from the end of the helix 30. During use, the conical head 32 of the transmission shaft 34 is first inserted into the two bones. The gap between the sheets 2 and provide a guiding action, and then push the spiral body 36 into the gap, and rotate the handle 41 to gradually screw the spiral body into the gap. Since the transmission shaft 34 passes through the spiral body 36 in the axial direction, it can prevent the spiral body 36 from The deflection that occurs when placed into the gap is correctly guided into the gap. When the screw body 30 is screwed into the gap for a specified distance, the transmission shaft 34 and the rotary screwdriver 36 can be pulled out from the screw body 30 to keep the screw body 30 in the gap.

The material of the spirochete is an alloy or suitable plastic that can be absorbed by living tissues in the body.

Fig. 9 is the second embodiment of the present invention, the base end of the transmission shaft 34 is fixedly connected with the handle 43 of the rotary screwdriver 37, and the outer cover of the transmission shaft 34 is an optional interchangeable adjustment tube with different lengths. 44. Its operation and function are the same as those of the first embodiment.

Fig. 10, 11 is the third embodiment of the present invention, the transmission shaft 35 of this osteosynthesis fixation tool is connected with the handle 45 of rotary screwdriver 38 equally, and the upper end 35a of transmission shaft 35 is a garden cylinder, and the middle section 35b is hexagonal. For transmitting torque, the end 33 is a conical head, which has the same guiding function as the first and second embodiments. The outer diameter of the upper end 35a is larger than the diameter of the hexagonal circumscribed circle of the middle section 35b, so there is an annular step 35c between them. Spiral body 39 is also an outer stud 46, the center of which is two concentric shaft holes 47 and 47a of different sizes, large hole 47a is a garden hole, matches with the upper end 35a of transmission shaft 35, and small hole 47 is a hexagonal hole , cooperate with the middle section 35b of the transmission shaft 35 to transmit torque. There is an annular step between the small hole 47 and the large hole 47a, just in time with the annular step 35c between the upper end 35a of the transmission shaft 35 and the middle section 35b. The spiral body 31 is inserted into the transmission shaft 35 and the middle section 35b of the transmission shaft 35 drives the small hole 47b, and the annular step 47c is supported by the annular step 35e. Its operation and function are similar to those of the first and second embodiments.

Since the spirochetes are made of materials that can be absorbed by active tissues in the body, the spirochetes do not need to be taken out after the head is completely restored. As the spirochete is absorbed, the wall of the spirochete will gradually become thinner. For example, the original wall of the spirochete is thin or absorbed too fast; the spirochete will gradually collapse under the pressure of the surrounding bone growth. After being tight on the bone chip, a plunger 50 made of a material that can be gradually absorbed by active tissues can be inserted into the central hole of the helix, so that the helix can maintain sufficient strength to resist external pressure.

In Fig. 6a, the plunger 50 is plugged in the shaft hole 40 of the spiral body 30; Fig. 12 is another form of plunger 51 inserted in the spiral body 52, at this time, the threaded part of the plunger 51 and the internal thread 53a of the spiral body 52 Screwed together, the plunger 51 is fixed in the central hole 53 of the spiral body 52 at the same time.

The combination between the helix and the drive shaft must be such that the two parts can slide axially against each other and be guaranteed to rotate synchronously while turning to transmit the full torque.

Like the prior art, the center of the transmission shaft of the fixed tool is provided with through central holes 49, 50 (as shown in Figures 6c and 11c), but because the helix does not have a tapered end, the transmission shaft is allowed to have a larger shaft hole to pass through a larger shaft. Thick guide lines.

Claims (6)

1, a kind of setting tool of synthetism operation, comprise setting tool and spirillum two parts, setting tool is made up of Rotating opener and the transmission axle that is contained on the bottle opener, one end of transmission axle inserts to be embedded in and drives the synchronous rotation of spirillum in the interior spirochetal mesopore of bone with before being placed in osteocomma, it is characterized in that:

1. the transmission axle (34) that is driven by the handle (41) of Rotating opener (36) is to be transferred to the stage casing of spirillum (30) by the conical head (32) that a guiding action is provided with the torsion that can provide that spirillum (30) mesopore is complementary;

2. spirillum () is a straight screw rod of hollow, and its outer garden is a threaded line, and its center is to be complementary to transmit the hexagonal axis hole of torsion with transmission axle (34).

2, the setting tool of synthetism operation according to claim 1 is characterized in that Rotating opener includes a handle (41), also has:

The tube (42) that one and handle (41) fuse and one pass handle (41) and tube (42) so that transmission axle (34) axial slip and integrally rotated axis hole within it to be provided, and the upper end of spirillum (30) is close in the open end of tube (42);

3, the setting tool of synthetism operation according to claim 1, it is characterized in that Rotating opener includes a handle (41), can also be the transmission axle (34) that and handle (43) fuse, transmission axle (34) is outer also to be with a length and optionally to adjust pipe (44);

4, the setting tool of synthetism operation according to claim 1, it is characterized in that Rotating opener includes a handle (41), it can also be the transmission axle (35) that and handle (45) fuse, transmission axle (35) is a Cylinder (35a) near the upper end of handle (45), its diameter is greater than footpath, stage casing (35b) hexagonal external garden, the upper end and in intersegmental a ring-shaped step (35c) arranged.

5, according to the setting tool of claim 1 and 2 described synthetisms operation, the endoporus (47) that it is characterized in that a kind of spirillum (31) is divided into two sections, and one section for the bigger upper end hole (47a) that is complementary with transmission axle (35) upper end Cylinder (35a) of diameter and one section is and transmission axle hexagon stage casing (35b) middle sector hole that be complementary, transmission torque (47b).

6, the setting tool of synthetism according to claim 1 operation is characterized in that there is an axis hole (50) that can pass guide wire at transmission axle (34) center.

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