DE60031766T2 - SURGICAL CLOSURE DEVICE - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a surgical fastening device assembly which combines a first bony part with a second bony part across a fracture site. <P>SOLUTION: This surgical fastening device assembly 10 includes an anchor 22 which has a first portion 46 with a male screw section arranged on the first bony part and a second portion which is arranged at least a part on the second bony part. At least one pin is combined with a first part of the anchor on working. When the pin is in a retreated position, it is arranged in the anchor. When the pin is in a protrusion position, at least a part of it protrudes outside the anchor. An actuator is arranged in the anchor and is combined with at least one pin on working. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

The The invention relates generally to a surgical fastener assembly for coupling a first and a second bone portion over a Fracture in between and in particular an in situ hip fixation (pinning) system for rigidly connecting a femoral head to the rest section of the femur and over a fracture in the area of the femoral neck.

One hip joint is a highly stressed, bearing bone joint in the human Body. in the Essentially, this is a ball joint through The upper part of the femur is formed in a pan-shaped acetabulum pivots at the base of the pelvis. If a break or fracture occurs adjacent to the upper part of the femur, the separate sections must of the femur during the healing are held together.

In In the past, a number of treatment techniques have come up Fractures of the proximal and distal end of the femur are used. In early Phases of this century were prescribed to patients for a long time bed rest or stretching bandages, which often leads to deformities or to Death led. In the 1930s, the Smith-Peterson nail was introduced for immediate fixation of hip fractures, earlier Mobilization of the patient and reduced morbidity and mortality. A Number of nails was for introduced a fracture fixation around the femur in its proximal end, including the Jewett's nail and in younger ones Years of dynamic compression devices that capture the most proximal fragments of the femur, intertrochanteric and compression subtrochanteric Fracture fragments, rigid fixation of the most proximal and distal Enable fragments and a sliding lag screw or anchor, the (himself) in a vaulted Side plate to enable further compression of fragments as the patient walks around and begins to strain the broken limb. Usually is the side plate on the bone fragment with a series of screws or attachments attached.

A rigid angle plate occurred both at the proximal end of the femur Fixation subtrochanteric Femur fractures as well as at the distal end for fixation supracondylar and intercondylar Fractures around the knee are used. Because the fixation of these fractures can be technically demanding, for several years one Dynamic compression screw used in many ways resembles a dynamic hip compression screw, but has a side plate design and an angle similar to an angle plate.

The Whole known technique, whether in the patient literature described above or in commercial devices, does not take into account the displacement the tension screw or anchor and its compression screw in the vault, when the fracture heals and the fragments move closer together. If this movement occurs, the compression screw can be removed from the Escape the lag screw and move away from the fracture and into the soft tissue, which causes discomfort, pain and a painful bursa. In osteogenic patients can yourself the dynamic hip compression screws Loosen or through the overhead bone of the head of the femur erode, which leads to joint penetration and destruction of the joint and Causes arthritis. This can be an additional intervention for removal the hip compression screw and to replace the hip be necessary by a prosthesis. Similarly, the use of a dynamic compression screw in osteogenic patients too inadequate Keep the pull screw thread in the bone lead. In case of loss of the stop the traction screw or anchor in the head of the femur is used to derive compressive forces, and the implanted device may fail, leading to a non-union or mismatching the bone debris leads. A similar loss of fixation can around the supracondylars and intercondylars Fractures of the distal femur occur in osteogenic patients.

Around To prevent fixation loss with compression and to a required Removal of the anchor pull screw in the femoral head in osteogenic patients To reduce some devices were modified to stop to increase the anchor pull screw in the femoral head by pulling the lag screw was enlarged or by an alternative means of fixation of the proximal Fragments with a expansion bolt concept was used. These The latter device is among surgeons in the United States States are not so accepted, as they are different from traditional screwdriving techniques to screw in the device that distinguishes the surgeon a certain "feeling" for the degree the stop of the lag screw in the bone and thus an idea from the degree in which the operator compresses the lag screw and the side plate assembly can without it to loss of fixation by "too strong compression "is coming.

As the lag screw slides in the camber of the side plate, it can stick out in patients who are cachectic. Often the compression screw exits once implanted, resulting in further protrusion of the device and possible erosion through the skin. This can lead to premature or unwanted extra surgery to remove the compression screw or device, reducing morbidity, infection rate, and Mortality caused by additional intervention is often increased in frail elderly patients who are least able to withstand additional surgical attacks on their body. That's why many surgeons remove the compression screw so it will not move out. However, if the compression screw is removed, it may result in possible disintegration of the device with resultant fracture fixation failure and other necessary surgical procedures. Some in situ hip fixation systems have been modified to prevent inadvertent disassembly of the lag screw and side plate, by limiting the degree to which the lag screw and side plate can separate, and by increasing the modularity of the side plate and lag screw components, thereby potentially reducing the risk of damage a smaller incision on the patient is possible. However, this modularity provides another theoretical variable of the potential loss of fixation of the side plate in the lag screw portions of the devices. Furthermore, the side plates may lose their hold from the distal fragments due to biological resorption with resultant fixation retention loss of the screws holding the side plate laterally to the femoral side. This can occur with dynamic compression screws or dynamic compression screws used around distal femoral fractures or for subtrochanteric fractures of the femur. Tighter placement of the screw holes in the side plate has been proposed, allowing more threads per unit length of the femur, or alternating the number and location of holes in the side plate with a wider side plate to reduce the frequency of loss of side plate support. The use of a distal compression screw allows more proximal compression in the longitudinal axis of the femur to increase compression at the fracture site.

Often relax as well the screws or fasteners that are lateral to holding the side plate used on the femur when bone around the external thread the screws is absorbed. As a result, the side plate often dissolves from the bone, causing the implant to fail and causing loss of fixation the fracture is coming.

Consequently There is a need for improved in situ fixation ("pinning") or surgical Mounting arrangement, the greater hold the lag screw in the femoral head of the hip bone allows while It gives the surgeon a "feeling" for the fixation when inserting the lag screw there. Such an in situ fixation system for one Fixation arrangement should also be designed so that a compression screw can remain permanently in place after surgery and thereby the degree of compression between the lag screw and side plate maintains. He wishes Further, the screws are solid for holding the side plate Relationship relative to the bone fragment can be used in loosening to prevent, making the side plate in a secure relationship relative to the bone to which it was originally attached.

WO 98/02105 describes an embodiment with a surgical fastener assembly for coupling a first and a second bone portion via a fracture therebetween with:
an anchor, the anchor having an external thread extending along a first portion thereof, and the anchor forming a longitudinal bore with a longitudinal axis and having an oblique or curved surface forming at least one slot;
at least one pin operatively associated with the first portion of the anchor, the at least one pin being formed of a deformable material, and wherein in a retracted position of the pin, the pin is disposed in the longitudinal bore of the anchor and has a curved or curved configuration; wherein in an extended position of the pin, at least a portion of the pin extends outwardly from the anchor and is deformed into a bent configuration by contact with the sloping or curved surface through the at least one slot;
an actuator which may be operatively coupled to the at least one pin such that upon actuation of the pin by the actuator, the pin extends upwardly through the at least one slot;
a guide, wherein the guide comprises a sleeve, wherein a second portion of the armature is received in the sleeve; and
a fastener, wherein the fastener threadingly engages the bore of the anchor and engages the guide.

The Invention is in the claims established.

Provided is a surgical fastener assembly for coupling a first and a second bone portion via a fracture therebetween. In one embodiment of the invention, the surgical fastener assembly includes an anchor having a first male threaded portion disposed in the first bone portion and a second portion at least partially disposed in the second bone portion. At least one pin is operatively associated with the first portion of the armature such that in a retracted position of the pin the pin is disposed in the armature and in an extended position of the pin at least a portion of the pin is disposed out of the armature extended to the outside. An actuator is disposed in the armature and operably coupled to the at least one pin. A guide is adapted to be attached to the second bone portion and has a sleeve. The second section of the anchor is received in the sleeve. An attachment is provided which has a head portion and a shaft portion with external thread. The shank portion engages threadedly with the anchor and the head portion engages the guide.

1 Figure 11 is a view of a surgical fastener assembly operatively associated with and extending along a condylar fracture;

2 is a partially sectioned enlarged view of the device of 1 ;

3 is an assembled perspective view;

4 is a disassembled side view of subcomponents of a mold;

5 is a longitudinal sectional view through an attachment;

6 is a 5 similar sectional view, but shows pins or barbs fastening in an extended position;

7 is a perspective view of the attachment of 5 and 6 ;

8th is an end view of the attachment according to 7 ;

9 is a sectional view on the line 9-9 of 8th ;

10 is another end view;

11 Figure 3 is an enlarged perspective view of a pin or barb forming part of the first embodiment of the surgical fastener assembly;

12 is a side view of the pen of 11 ;

13 is another side view of the pen or barb 11 ;

14 is an end view of the pen or barb 12 ;

15 is a sectional view on the line 15-15 of 12 ;

16 is a perspective view of a form of a compression screw;

17 is a side view of the compression screw of 16 ;

18 is a left end view of the compression screw of 17 ;

19 is a right end view of the compression screw of 17 ;

20 is a sectional view on the line 20-20 of 18 ;

21 is a perspective view of a holder, the part of the armature assembly of 2 forms;

22 is a side view of the holder of 21 ;

23 is a left end view of the holder of 22 ;

24 is a right end view of the holder of 22 ;

25 is a sectional view on the line 25-25 of 23 ;

25A shows the assembly of the surgical anchor assembly with the extended pins or barbs and a tool positioned to be inserted into the holder of FIG 21 to 25 engages;

25B similar 25A but further shows the assembly of the surgical anchor assembly with the extended pins or barbs and a tool for moving the holder of 21 to 25 in a surgical procedure with the cannulated compression fixation of 16 to 20 ;

26 Figure 3 is a perspective view of a driver forming part of the first embodiment of this surgical fastener assembly;

27 is a fragmentary side view of the drive of 26 ;

28 is a left end view of the drive of 27 ;

29 is a right end view of the drive of 27 ;

30 is a longitudinal sectional view on the line 30-30 of 28 ;

31 is a perspective view of an end stop;

32 is an enlarged side view of the end stop of 31 ;

33 is a left end view of the end stop of 32 ;

34 is a right end view of the end stop of 32 ;

35 is a sectional view on the line 35-35 of 33 ;

36 is a 12 similar view, but shows an alternative form of pen or barbs;

37 is an enlarged right end view of the pin or barb 36 ;

38 is a 5 similar view of the alternative form of pins or barbs, which are arranged in combination with the insert and in retracted positions relative thereto;

39 is a 38 similar view, but shows the alternative shape of the pins or barbs in an extended position;

40 is a 5 similar view, but shows a second embodiment;

41 Fig. 12 is a longitudinal sectional view of the components of the second embodiment exploded or disassembled relative to each other;

42 is a 40 similar view, which schematically illustrates the expansion of the pins or barbs relative to the anchor;

43 is a 42 similar view, but shows an alternative form of compression screw assembly, which is arranged in operational combination with the armature and a conventional side plate;

44 is a 43 similar view, but shows a drive of the compression screw assembly, which is arranged in a locking relationship relative to a compression screw;

45 Fig. 3 is a longitudinal sectional view of a third embodiment of a surgical anchor assembly having an alternative form of pins operatively associated therewith and in a retracted relationship thereto;

46 Fig. 12 is a fragmentary longitudinal sectional view of subcomponents of the third embodiment exploded or disassembled relative to each other;

47 Fig. 12 is a fragmentary longitudinal sectional view of an anchor or insert forming part of the third embodiment;

48 is a left end view of the armature of 47 ;

49 is a right end view of the anchor of 47 ;

50 Fig. 11 is a side view of a pin forming part of the third embodiment of the invention;

51 is a sectional view on the line 51-51 of 50 ;

52 Fig. 10 is a sectional view of a slider constituting a subcomponent of the third embodiment;

53 is a left end view of the slider of 52 ;

54 is a right end view of the slider of 52 ;

55 is a sectional view on the line 55-55 of 54 ;

56 Fig. 10 is a sectional view of an end cap forming part of the third embodiment;

57 is a left end view of the end cap of 56 ;

58 is a right end view of the end cap of 56 ;

59 is a side view of a tool for the extension and retraction of the pins in the third embodiment of the armature assembly according to 45 is used;

60 is a right end view of the tool of FIG 59 ;

61 is a sectional view of the tool of 59 and 60 disposed in operative combination with a slider assembly forming part of the third embodiment, and with the pins or barbs shown in retracted position relative to the armature;

61A is a sectional view on the line 61A-61A of 45 ;

62 is a 61 similar view, but shows the tool in operative relation with the slider of the slider assembly for forcibly extending the pins or barbs from the armature radially outward;

62A is a sectional view on the line 62A-62A of 62 ;

63 is a 45 similar longitudinal sectional view, but shows the arranged in an extended relationship relative to the armature pins;

64 Figure 11 is another form of surgical anchor assembly with an alternative form of compression screw assembly for holding the anchor and the guide in compression relation relative to each other;

64A is an enlarged sectional view of the in 64 circled compression screw assembly;

65 is a longitudinal sectional view of a compression screw, which is a subcomponent of the compression screw assembly of 64 and 64A forms;

66 is a left end view of the compression screw of 65 ;

67 is a right end view of the compression screw of 65 ;

68 is a side view of a drive, which in combination with the compression screw assembly of 65 to 67 is used;

69 is a left end view of the drive of 68 ;

70 is a right end view of the drive of 68 ;

71 is a partially sectioned schematic side view of the compression screw ( 65 ) and the drive ( 68 ) shown in exploded or disassembled relationship relative to each other;

72 is a schematic representation of the drive, which is illustrated in partial relation to the compression screw;

73 Figure 3 is a schematic representation of the drive illustrated in full relation to the compression screw;

74 is a 2 resembling reduced view;

75 is an enlarged view of the in 74 circled area;

76 shows subcomponents of an alternative form of screw assembly used to secure the guide to the bone, with their subcomponents shown in disassembled relation relative to each other;

77 is a sectional view of a compression screw according to 75 and 76 on the line 77-77 of 78 ;

78 is a left end view of the compression screw of 77 ;

79 is a right end view of the compression screw of 77 ;

80 is a side view of a drive, which in combination with the screw arrangement of 75 and 76 is used;

81 is a left end view of the drive of 80 ;

82 is a right end view of the drive of 80 ;

83 is a view showing the drive partially arranged in operational association with the compression screw;

84 Figure 3 is an exploded perspective view of a surgical fastener assembly in accordance with the principles of the invention;

85 is an exploded perspective view of the anchor assembly of 84 ;

86 is an exploded side view of the anchor order of 85 ;

87 is a perspective view of the mandrel assembly of 85 and 86 ,

88 is a front view of the mandrel assembly;

89 Figure 12 is a cross-sectional view of the anchor assembly with the spikes in a retracted position;

90 Figure 3 is a front view of the anchor assembly with the spikes in an extended position;

91 is a cross-sectional view of the armature assembly on the line 91-91 of 90 ;

92 Figure 3 is a perspective view of the mandrel assembly with the spikes in an extended position; and

93 is a perspective view of the compression screw with a holder which is arranged on the outer surface of the screw.

Even though the invention for execution in various forms are preferred embodiments The invention is illustrated in the drawings and in the following being understood, being understood that should be Revelation is to be understood as being illustrations of the Invention, which are not intended to embody the invention to limit the illustrated specific embodiments.

In the drawings, wherein like reference numerals designate like parts throughout the several views, there is shown 1 schematically a form of a fastening arrangement 10 used to compressively secure a first and a second broken bone fragment across the fracture therebetween. In the illustrated embodiment, the surgical fastener assembly is used 10 to accurately direct a condylar fracture along a fracture line 12 between a proximal and a distal section 14 respectively. 16 of a bone 18 lies.

As shown, the surgical fastener assembly has 10 via a guide, generally with the reference number 20 is designated, and an elongated anchor, generally with the reference number 22 is designated. According to 2 has the surgical anchor assembly 10 also via a compression screw or attachment 24 and a holder 26 for releasably locking the attachment 24 against rotation. According to 2 works a series of screws 28 in combination with the leadership 20 and serves it on the bone section 18 to fix.

According to 2 to 4 has the lead 20 a hollow sleeve 30 on top of a trochanteric plate 32 rigidly mounted at the correct angle. The proximal section 14 of the bone 18 is bored to the sleeve 30 take. The distal section 16 of the bone 18 is manipulated in the configuration so as to have an end portion of the sleeve 30 accommodates in it. As shown, the plate is 32 with several through holes 34 provided by the screws 28 can be traversed lengthways, reducing the lead 20 at the bone section 18 is attached. The sleeve 30 forms a through hole 36 which is open at its opposite ends. In a preferred form of the invention, the guide 20 made of a material selected from the class comprising titanium, a titanium alloy, stainless steel or cobalt-chromium alloy.

It should be noted that the through hole 36 with a cut 38 provided at one end thereof. In the illustrated embodiment, the countersink has 38 a larger diameter than the through hole 36 , Thus, a ring or radial stage 40 to one end of the through hole 36 educated.

According to 4 has the anchor 22 an oblong insert 44 preferably formed of a material selected from the class comprising titanium, a titanium alloy, stainless steel or cobalt-chromium alloy. The use 44 has an opposite first and second axially aligned end 46 respectively. 48 , The use 44 is sized so that when inserted in the bone the first end 46 on one side of the fracture line 12 lies while the second end 48 of the insert 44 on the opposite side of the fracture line 12 lies. It should be noted that cooperative aids 50 on the sleeve 30 the leadership 20 and on the insert 44 are formed. The purpose of the cooperating tools 50 is, axial movement of the sleeve 30 along one through the insert 44 fixed axis 52 to allow while rotating the sleeve 30 relative to the anchor 22 is prevented.

In the illustrated embodiment, and as known, the cooperating aids 50 preferably a pair of flats 54 on, extending axially along the second end 48 of the insert 44 and extend inside of it. The flats 54 are diametrically opposed and generally parallel to each other. According to 3 has the through hole 36 the sleeve 30 generally flat sides 56 which are arranged in opposite and generally parallel relationship relative to each other. The flat sides 56 the bore 36 allow the second end 48 the insert, sliding in it while the flats 54 with the flat sides 56 while preventing rotation of the sleeve 30 and thereby the leadership 20 relative to the anchor 22 interact. It is clear that other forms of cooperative means for facilitating axial longitudinal movement of the armature 22 relative to the leadership 20 while preventing rotation between them would be just as sufficient.

According to 5 and 6 has the anchor 22 the surgical fastening arrangement 10 also a series of elongated pins 60 that the first end 46 of the insert 44 to move between a retracted position ( 5 ) and a radially extended position ( 6 ) are assigned operationally. As shown, the pins 60 from use 44 for longitudinal and Radialverschie exercise relative to it. In the illustrated embodiment of the invention have four pins 60 an equal distance relative to each other for compulsory longitudinal movement in opposite directions between retracted and extended positions according to 5 respectively. 6 ,

A striking feature concerns the provision of a mechanism 64 for forcibly positioning the pins 60 relative to the surgical anchor 22 , That is, according to the later detailed description, the purpose of the mechanism 64 , the pencils 60 out of action 44 forcibly radially extend outward, whereby the attachment of the armature 22 reinforced in the bone ( 1 ). In addition, and in response to mechanical handling, the mechanism works 64 continue so that he has the pins 60 Forcibly in the surgical on ker 22 retracts what the operative removal of the anchor 22 as needed or when determined to be surgically necessary.

According to 7 to 10 forms the insert 44 of the anchor 22 an elongated hole 66 , preferably coaxially about the longitudinal axis 52 is arranged and extending to the first and second ends 46 respectively. 48 of the insert 44 opens. As shown, the first end 46 the attachment 44 preferably pointed to the insertion of the attachment 44 to facilitate in the bones.

As will be apparent to those skilled in the art, the exterior configuration of the insert 44 to accept countless shapes and forms. According to the invention according to 7 to 10 the oblong insert 44 preferably an external thread 68 which extends axially along it and from the pointed first end 46 leads to the back. As mentioned, promotes the pointed configuration of the insert 44 the insertion and in the illustrated embodiment, the self-cutting of the armature 22 in the substance of the bone. The external thread 68 along the outside of the insert 44 has a relatively rough slope to the retention and anchoring of the anchor 22 to amplify in the substance of the bone in response to rotational movements acting on the anchor 22 be exercised.

According to 9 is the second or rear end 48 of the insert 44 preferably configured to releasably receive a screwing tool (not shown) that supports the anchor 22 can translate into rotational movements. In a preferred form and according to 8th and 9 is the back or second end of the insert 44 with a slot-like opening 69 configured to releasably receive a distal end of a screwdriving tool. However, it will be understood that any suitable configuration, including a jack-like configuration, would equally suffice without limiting or departing from the spirit and scope of the invention.

According to 9 forms the insert 44 a series of axially elongate openings disposed in spaced circumferential relationship relative to each other. In the illustrated form of the invention is the use 44 with four openings 70 Mistake. As the openings 70 All are essentially similar, only one opening 70 although it should be understood that the other openings in use are similar to one another. Between positive ends of it cuts every opening 70 by the use 44 formed elongated hole 66 and opens to her. Preferably, each has an elongated opening 70 a blind configuration, but opens at one end to the outside of the insert 44 , As is clear, the openings are 70 around the axis 52 of the insert 44 generally arranged the same. In the form of the invention according to 9 has every elongated opening 70 a curved or bent configuration between opposite ends thereof. That is, in the illustrated form of the invention, each opening has 70 a bent configuration with a predetermined and substantially constant radius.

In 11 to 15 is an exemplary form of a pen 60 illustrated. Every pin 60 is shaped so that it is in use in each of the 44 formed openings 70 longitudinal sliding adapts. The shape and size of each pen 60 generally conforms to the shape and size of one through the insert 44 formed opening 70 , Preferably, each pin 60 formed from a substantially rigid material that is biocompatible with human bone tissue. That is, the pins 60 should be configured with sufficient strength to allow them to be inserted into and through bone tissue without substantial bending between their opposite ends. In a most preferred form of the invention, each pen is 60 made of a material selected from the class comprising titanium, a titanium alloy, stainless steel or a cobalt-chromium alloy.

In the embodiment according to 11 to 15 Every pen has it 60 a front end 74 and an opposite generally pointed end 76 , Each pen has between its ends 60 preferably a curved or curved configuration. In the illustrated form of the invention, each pin has 60 a curved arc having a predetermined radius substantially equal to the predetermined radius of each in use 44 formed opening 70 ( 9 ) and is close to the axis 52 of the insert 44 and extends away from it to the outside.

In a most preferred form of the invention, each pin forms 60 preferably an arc of about 80 degrees between its opposite ends, and the length of each pin 60 is selected so that when fully retracted front end 74 of the pen 60 in the attachment ( 5 ) the opposite pointed end 76 of the pen or barb 60 in the outer diameter of the insert 44 is positioned ( 5 ) to the insertion of the surgical anchor 20 in the bones of the patient easier. It should also be clear that the length of each barb or pin 60 is dimensioned so that when moving the pins 60 into its extended position ( 6 ) the front end 74 every pen 60 the mechanism 64 Operationally remains assigned to the pens 60 can be forcibly retracted from their extended positions if so desired or deemed necessary by the surgeon.

With renewed reference to 5 . 6 and 9 the elongated hole opens 66 of the insert 44 to its second or rear end 48 , The hole 66 forms a female thread section 78 that is from the second or rear end 48 of the insert 44 extends inwards. Preferably, the female threaded portion 78 the bore 66 a thread with a relatively fine pitch extending along it.

The compression and cannulated attachment 24 is in 16 to 20 illustrated schematically. The purpose of the cannulated attachment 24 is the bone fragments ( 1 ) in adjustable compression relationship relative to each other by the guide 20 at anchor 22 ( 2 ) Is fixed axially so that the guide 20 is prevented from getting off the anchor 22 to move away axially, but a movement of leadership 20 to the sharp or first end 46 of the anchor 22 is possible ( 2 ).

Preferably, the attachment 24 formed from a material biocompatible with bone tissue or a substance and preferably selected from the class comprising titanium, a titanium alloy, stainless steel or a cobalt-chromium alloy. Although not specifically mentioned herein, it will be understood that other unnamed materials may equally suffice without limiting or departing from the spirit and scope of the invention.

As shown, the attachment 24 with an elongated shaft portion 80 and an enlarged head portion 82 Mistake. The shaft section 80 the attachment 24 is with an external thread 84 provided, extending from a front end 86 the attachment 24 extends axially. The external thread 84 has a relatively fine pitch corresponding to the thread extending along the threaded portion 78 of the anchor 22 extends inside. The enlarged head section 82 the attachment 24 has a slightly smaller diameter than the diameter of the insert 44 formed subsidence 38 ( 2 ). As will become clear from an understanding of the invention, the axial length of the head section 82 be modified with respect to the illustrated, without limiting the spirit and scope of the invention or departing therefrom. That is, during surgery, the surgeon can have a collection of different fixings 24 to choose from, each anchor having a different length so as to have a proper relationship between the guide 20 and the anchor 22 is maintained. In particular, the enlarged head portion forms 82 a radial shoulder 88 relative to the shaft portion 80 ,

According to 18 and 20 is a back end 90 the attachment 24 preferably configured to releasably receive a screwing tool (not shown) securing the attachment 24 can translate into rotational movements. In a preferred form and according to 18 and 20 is the back end 90 the attachment 24 with a bush-like opening 92 configured to removably receive a distal end of a screwing tool. In a most preferred form of the invention, the socket or opening 92 as shown, a hexagonal cross-sectional configuration. It will be clear, however, that any suitable configuration, including an elongated slot, would also be sufficient. Furthermore, the cannulated attachment forms 24 an elongated hole 94 extending to the front and rear ends 86 respectively. 90 the attachment opens.

In the illustrated embodiment according to 2 becomes the anchor 22 in the bone fragment on one side of the fracture line 12 attached. As mentioned, the anchor is 22 configured so that the opposite or second end 48 of the anchor 22 to a counterpart of the fracture line 12 extends. After that, the lead 20 in cooperative relation relative to the anchor 22 arranged. As shown, the sleeve fits 30 the leadership 20 axially sliding over the free end of the armature 22 as well as along and pushed out on. The screws 28 serve to fasten the plate 32 the leadership 20 on the bone 18 , It can be observed that the cannulated compression fixation 24 afterwards in operational combination with the anchor 22 and the leadership 20 is arranged. That is, the front end 86 the compression screw 24 gets through the hole 36 the sleeve 30 inserted in succession so that the external thread extending therealong 84 an operational engagement with the internal thread 78 at the proximal end of the anchor 22 manufactures. By further turning the attachment 24 finally takes the radial shoulder 88 on the enlarged head section 82 the radial stop 40 , of the through the lowering 38 and the leadership 20 is formed. As can be seen, further rotation of the screw 24 causing the bone debris to be brought into compression relationship relative to one another. Furthermore, the compression screw allows 24 gives the surgeon the appropriate "feel" when tightening the screw, thereby bringing the bone fragments into compression relationship relative to each other.

A form of holder 26 is in 21 to 25 shown schematically. As shown, the holder has 26 an external thread 100 that runs along it between a front and a back end 102 respectively. 104 extends axially. Preferably, the holder 26 formed from a material biocompatible with bone tissue or substance, which is preferably extremely high molecular weight polyethylene. However, it should be clear that other unnamed materials would be just as good. In particular, this has along the outside of the holder 26 starting external threads 100 a fine pitch corresponding to the thread extending along the female thread section 78 of the insert 44 extends.

According to 23 . 24 and 25 is the holder 26 with a through hole 106 provided, extending to the opposite ends 102 and 104 of the holder opens. In a preferred form and according to 23 . 24 and 25 has a longitudinal portion of the through hole 106 a hexagonal cross-sectional configuration for releasably receiving a distal end of the screwing tool. However, it will be understood that any other suitable socket-like configuration as a hexagonal would equally suffice without limiting or departing from the spirit and scope of the invention.

When assembling the surgical fastener assembly 10 is according to 25A the holder 26 first in the female thread section 78 of the anchor 22 screwed. Thereafter, in the manner described above, the compression fastening 24 in operational assignment to the anchor 22 brought. After establishing the compression relationship between the guide 20 and the anchor 22 as a result of turning the compression screw 24 becomes a suitably elongated tool 95 through the hole 94 ( 20 ) of the cannulated attachment 24 and guided into releasable engagement with the bushing-like configuration formed in the throughbore 106 of the owner 26 is formed.

Thereafter, according to 25B by suitable turning of the holder 26 under the influence of the tool 95 the back end 104 in abutting relationship with the front end 86 the compression screw 24 moved what the compression screw 24 locks and thus preserves the compression relationship between the bone fragments. However, it will be clear that the bone fragments are due to the axial movement of the head section 82 over the length of the sinking 38 can move. The head section 82 the compression screw 24 but limits the moving away of the anchor 22 and the bone fragments attached to it from the bone 18 whereby the compression relationship between them is maintained.

The following is the mechanism 64 for forcing the pens 60 in opposite directions between retracted and extended positions ( 5 respectively. 6 ). As will be clear, the mechanism can forcibly move the pins 60 take countless different forms in opposite directions. One mechanism which has proven to be advantageous and quite effective involves equipping the anchor 20 with a manually operated screwdriver or drive 110 ( 5 and 6 ), the pins 60 is assigned so operationally that when handling the drive 110 the pencils 60 relative to the anchor 22 be moved longitudinally, thereby anchoring the surgical anchor 22 in the bone comes about.

26 to 30 show a form of a drive 110 for axial and appositive shifting of the pins 60 ( 5 and 6 ) of the surgical anchor in opposite directions. As shown, the drive has 110 over an axially elongated part 112 with an external thread 114 extending from a front end 116 to a rear end 118 extends axially to the rear. The drive part 112 is formed from a material biocompatible with bone tissue or a substance and preferably selected from the class comprising titanium, a titanium alloy, stainless steel or a cobalt-chromium alloy. However, it should be clear that other unnamed materials would be just as good. The outer diameter of the thread 114 of the part 112 is such that it passes through the oblong hole 66 Sliding through the insert 44 is formed ( 5 and 6 ), and for free rotation in each direction of rotation in the hole 66 of the insert 44 is included. Preferably, the external thread 114 on the part 112 a relatively fine slope. According to 26 . 28 . 29 and 30 has the part 112 preferably an elongated bore 120 extending to the front and rear ends 116 and 118 of the part 112 opens. The back end 118 of the part 112 is preferably configured to releasably receive a screwing tool (not shown) that drives 110 can translate into rotational movements. In a preferred form and according to 28 and 30 is the back end 118 of the part 112 with a bush-like opening 122 for releasably receiving the distal end of a screwing purpose moderately configured. In a most preferred form of the invention and according to 28 and 30 has the socket or opening 122 a hexagonal cross-sectional configuration. It will be clear, however, that any suitable configuration, including a square or triangular configuration, would also be sufficient.

As will be described later, the drive is 110 of the mechanism 64 so in operational assignment to each pen 60 in that a handling of the drive 110 forcible longitudinal displacement of the pins 60 in an extended or retracted position depending on the movements that leads to the drive 110 of the mechanism 64 be exercised. In the illustrated form of the invention and again with reference to 11 to 15 has any pin or barb 60 preferably an inner surface 124 that are the axis 52 ( 7 and 9 ) of the anchor 22 approaches when the pins 60 in the insert 44 are used, as well as an outer surface 126 , According to 11 to 15 has the inner surface 124 every pen 60 a series of vertically spaced teeth 128 thereon. The teeth 128 extend from the front end 74 and over a longitudinal distance to the pointed end 76 every pen 60 axially to the rear. In particular, the teeth 128 on every pen 60 for screwable engagement with the external thread 114 configured along the outer surface of the drive 110 extends axially. Thus, the drive is 110 in operational or operational association with each of the pens 60 this surgical anchor assembly.

According to 5 and 6 indicates the mechanism 64 for forcing the pens 60 between retracted and extended positions and vice versa also an end stop 134 for preventing axial displacement of the drive 110 when turning on. A shape of the end stop 134 is in 31 to 35 shown. Preferably, the end stop 134 made of a material that is biocompatible with human bone tissue. In a most preferred form of the invention is the end stop 134 made of a material selected from the class comprising titanium, a titanium alloy, stainless steel or a cobalt-chromium alloy. It is clear, however, that other materials would be just as sufficient. According to 31 to 35 indicates the end stop 134 preferably a hollow part 136 with an external thread 138 on that is between a front and a rear end 140 respectively. 142 extends from it. The external thread 138 has a relatively fine pitch corresponding to the thread extending along the female threaded portion 78 of the insert 44 at the second end 48 of the anchor 22 extends. The back end 142 the end stop 134 is preferably configured to releasably receive a screwing tool (not shown) that supports the end stop 134 can translate into rotational movements. In a preferred form and according to 31 . 32 and 33 is the back end 142 the end stop 134 with an elongated slot 148 provided for releasably receiving a distal end of the screwing tool. Furthermore, the end stop forms 134 a through hole 146 extending to the front and rear ends 140 respectively. 142 opens the end stop, thereby allowing a tool in a surgical engagement with the drive 110 to perform longitudinally.

An alternative form of pen 160 in operational combination with the anchor 22 is to be ordered is in 36 and 37 shown. The pencil 160 is essentially similar to the pen 60 who in 11 to 15 is illustrated and described in detail above. In the embodiment according to 36 and 37 Every pen has it 160 a front end 174 and an opposite end 176 , Each pen has between its ends 160 preferably a curved or curved configuration. In the illustrated form of the invention, each pin has a curved arc having a predetermined radius substantially equal to the predetermined radius of each aperture 170 is that in an insert 144 according to 38 is formed.

In the embodiment of the pin according to 36 each pen makes 160 Preferably, an arc of about 80 ° between its opposite ends, and the length of each pin is selected so that when fully retracted front end 174 of the pen 160 in the attachment or the anchor 22 the opposite end 176 of the pen or barb 160 in the outer diameter of the insert 144 is positioned.

In the illustrated embodiment, the end is 176 every pen 160 formed with a configuration that the configuration of the anchor or attachment 22 added. In the illustrated embodiment, the end is 176 every pen 160 with a channel 177 formed between two substantially similar projections 179 lies. Is according to 38 the pencil 160 fully retracted, complete a channel-like configuration and protrusions 179 on their opposite sides the external thread configuration, which extends along the attachment 22 extends axially. It should be noted that the length of each barb or pin 160 is dimensioned so that when moving the pins 160 in their extended position according to 39 the front end 174 every pen 160 in operational assignment to the mechanism 64 stay with the pins 160 can be forcibly retracted from their extended positions if the surgeon so desires or considers necessary.

According to 36 has any pen or Widerha ken 160 preferably an inner surface 184 according to 38 and 39 the axis 52 The anchor approaches when the pins are in use 144 are used, and an outer surface 186 , The inner surface 184 Each pin has a series of spaced teeth 188 extending from the front end 174 and over a longitudinal distance to the second or other end 176 every pen 160 extend axially to the rear. The teeth 188 on each pin are for threaded engagement in the external thread 114 configured along the outer surface of the drive 110 of the mechanism 64 extends axially, as previously described in more detail. Thus, the drive is 110 in operational engagement with or in operative association with each of the pens 160 this surgical anchor assembly.

40 schematically shows an alternative form of the surgical anchor assembly. This alternative form of surgical anchor assembly is generally indicated by the reference numeral 210 designated. According to 40 has the surgical anchor assembly 210 a generally with the reference number 220 designated leadership and a generally with the reference number 222 designated elongated anchor. According to 41 and the discussion below has the surgical fastener assembly 210 further via a compression fastening arrangement 224 to hold the leadership 220 in compressor relation relative to the anchor 222 ,

The leadership 220 is essentially similar to the previously described guide 20 , for which reason their detailed description is omitted. Mention is only that the leadership 220 a hollow sleeve 230 that of the previously discussed sleeve 30 is essentially similar. The sleeve 230 forms a through hole 236 which is open at its opposite ends. The through hole is with a countersink section 238 provided at one end. In the illustrated embodiment, the countersink has 238 a larger diameter than the through hole 236 , which is why a ring or radial stage 240 is formed in between.

The anchor 222 has an elongated insert 244 with a first and a second opposite end 246 and 248 on. Preferably, the insert 244 made from a material similar to that used to make the insert 44 used resembles. The use 244 is sized so that when inserted into the bone, the first end 246 lies on one side of a fracture line, while the second end 248 of the insert 244 lies on a opposite side of the fracture line.

According to 40 has the anchor 222 the surgical fastening arrangement 210 also over a series of elongated pins or barbs 260 in operational assignment to the first end 246 of the insert 244 to move between a retracted position ( 40 ) and a radially extended position ( 42 ). As shown, the pins 260 from use 244 for longitudinal and radial displacement relative to him carried. In the illustrated embodiment of the invention have four pins 260 an equal distance relative to each other for compulsory longitudinal movement in opposite directions between the retracted and extended positions according to 40 respectively. 42 ,

As will be apparent to those skilled in the art, the exterior configuration of the insert 244 to accept countless shapes and forms. According to 41 has the long use 244 preferably an external thread 268 which extends axially along it and from its front end 246 runs to the rear. The external thread 268 along the outside of the insert 244 has a relatively rough slope to the retention and anchoring of the anchor 222 to amplify in the substance of the bone in response to rotational movements acting on the anchor 222 be exercised.

From the second or rear end 248 of the insert 244 of the anchor 222 extends axially a constant, generally cylindrical configuration 249 extending to the end of the external thread 268 extends and has a slightly smaller outer diameter than the external thread 268 Has. In particular, the cylinder-like configuration 249 extending from the end 248 of the insert 244 axially forwardly extending, a diameter generally equal to the diameter of the throughbore 236 in the lead 220 is what the axial sliding movement of the anchor 222 in the sleeve 230 the leadership 220 facilitated. Although not specifically illustrated, conventionally cooperative aids are on the sleeve 230 the leadership 220 and on the insert 244 educated. As previously mentioned, the cooperating aids aim at axial movement of the anchor 222 relative to the sleeve 230 along one through the insert 244 fixed axis 252 to allow while rotating the sleeve 230 relative to the anchor 222 prevent.

According to 41 forms the insert 244 a lowering section 253 of constant diameter extending from the first end 246 of the insert 244 extends axially inwards. At an inner end forms the lowering section 253 a radial wall 254 , Between the end 246 and the wall 254 forms the insert 244 a series of axially elongate openings disposed in spaced circumferential relationship relative to each other. In the illustrated form of the invention is the use 244 with four openings 270 Mistake. Every opening 270 cuts through the insert 244 formed subsidence 253 and opens to her. According to 41 has an axial inward section 272 every opening 270 an inwardly slanted surface for purposes to be described later.

At an opposite end of the insert 244 there is another elongated hole 257 with a female thread section 255 and a countersink section 256 , The internal thread section 255 extends from the second or rear end 248 of the use inside. Preferably, the female threaded portion 255 the bore 257 a thread with a relatively fine pitch extending along it. It should be noted that the female thread section 255 a larger diameter than the countersink section 256 Has. Furthermore, the insert forms 244 a passage 258 that is between the sinking sections 253 and 256 extends.

According to 41 is the second or rear end 248 of the insert 244 further configured to releasably receive a screwing tool (not shown) that supports the anchor 222 can translate into rotational movements. In a preferred form and according to 41 is the back or second end of the insert 244 with a slot-like opening 269 configured to releasably receive a distal end of a screwdriving tool. However, it will be understood that any suitable configuration would equally suffice without limiting or departing from the spirit and scope of the invention.

According to 41 form the pins or barbs 260 in this form of the invention part of a carrier assembly 262 , Preferably, the carrier assembly 262 a slider 263 on, with one end of each pen 260 hinged, so that the pins 260 bend relative to the slider or can move folding while they remain operationally connected to him. As shown, the slider has 263 an outer surface configuration 264 with a diameter that is substantially equal to the diameter of the insert 244 formed sinking section 253 is. Further, the slider forms 263 a threaded opening 265 with a relatively fine pitch female thread extending along it. It should be noted that the free ends of the pins 260 are so biased that they are off the axis 252 Feather outward. In addition, the free end of each pen has 260 a cam-like surface 266 this for purposes to be described later.

According to 40 fits the carrier assembly 262 axially in through the insert 244 formed hole 253 for axial movement, with the pins 260 to the second end 248 of the insert 244 extend. After fitting the carrier assembly 262 into the hole 253 of the insert 244 becomes the open end of the insert 244 through an end cap 274 locked.

According to 41 has the end cap 274 preferably a reduced ring section 275 which is so dimensioned that it can be used in the open end of the open 244 formed hole 253 fits snugly. A suitable holding device, eg welding or scoring o. Ä., Secures the end cap 274 safe on the rest of the insert 244 , Preferably, the end cap 274 formed from a material biocompatible with bone tissue or human substance and preferably selected from the class comprising titanium or titanium alloy, stainless steel or cobalt-chromium alloy. However, it should be clear that other unnamed materials can be just as good. According to 41 forms the end cap 274 a central through-hole or a hole 276 that extends through it. In addition, the annular or peripheral surface of the end cap 274 preferably chamfered to the insertion of the anchor 222 to promote in the bones.

Is with renewed reference to 40 the carrier assembly 262 in the hole 253 of the insert 244 arranged, are the pins 260 biased outwardly in the tendency. The slots or openings 270 in use 253 are elongated so that a distal end of each pin 260 in the tendency radially outward into the slot 270 protrudes, with the beveled surface 266 is advantageously arranged so that it engages the sloping surface 272 at every opening 270 so makes and interacts with her so that the pins 260 according to 42 forcibly protrude radially outward.

The following is the mechanism 280 for forcing the pens 260 in opposite directions between retracted and extended positions ( 40 respectively. 42 ). The drive mechanism 280 preferably has a manually operated drive 282 on in working relationship with the carrier assembly 262 is arranged. As will be described later, manual activation of the drive mechanism is effected 280 an axial displacement of the carrier assembly 262 in the hole 253 of the insert 244 what a forced displacement of the pins 260 with the carrier assembly 262 pulls.

According to 41 has the drive 282 preferably an axially elongated and hollow part 284 with a section 286 with a reduced diameter coming from a first end 288 thereof axially projecting rearward. The drive 282 is formed of a material biocompatible with bone tissue or human substance and preferably selected from the class comprising titanium, titanium alloy, stainless steel or cobalt-chromium alloy. However, it should be clear that other unnamed Ma materials as well. The reduced diameter section 286 of the part 284 has a diameter equal to the diameter of the end cap 274 formed hole 276 is. At a second end 290 has the drive 282 an enlarged head section 292 , In a preferred form and according to 41 is the second end 290 configured to releasably receive a distal end of a screwing tool. In a most preferred form of the invention, the second or terminating end is 290 of the drive 282 with an elongated slot 294 configured to releasably receive a screwing tool. From its conclusion 290 axially spaced inward is the drive 282 with an axially extended shoulder 295 Mistake. Between the shoulder and the section 286 with reduced diameter is the drive 282 with an external thread 296 Mistake. That's about the length of the drive 282 extending male thread has a relatively fine pitch, which is the female thread section 265 of the slider 263 corresponds to the part of the carrier assembly 262 forms. In particular, the section 286 with reduced diameter and the male thread section 296 of the drive 282 so that they pass through the passage 258 can be inserted longitudinally through the insert 244 is formed. Besides, the shoulder section has 295 a diameter that is substantially equal to the passageway 258 is and is stored by him. Furthermore, the enlarged head portion 292 so specific that the diameter is larger than the passage 258 is what axial displacement or movement of the head section 292 at the passage 258 prevented over.

When assembling the surgical fastener assembly 210 become the section 286 with reduced diameter and the male thread section 296 through the passage 258 guided longitudinally, in use 244 of the anchor 222 is formed. The threaded section 296 of the drive 282 is also threadedly engaged with the slider 263 the carrier assembly 262 brought to the section 286 performed with reduced diameter along and through the periphery of the end cap 274 formed hole 276 can be stored. The section 286 of reduced diameter is sized so that a longitudinal portion thereof is longitudinal and over the end cap 274 can be carried out. After that, this will be the free end of the section 286 with reduced diameter deformed outwards or widened, causing axial displacement of the drive 282 in response to rotational movement exerted on him.

According to 42 are the pins 260 the carrier assembly 262 relative to the axis 252 in response to rotation of the drive 282 and displaced radially and forcibly in opposite directions as a function thereof. As shown, a suitable tool 297 lengthwise through the hole 236 the leadership 220 and through the hole 257 of the insert 244 in operative engagement with the slot 294 at the second end 290 of the drive 282 postponed. Subsequently, rotation of the drive leads 282 to axial or longitudinal displacement of the slider 263 as a result of the mutual screw connection between the internal thread 265 on the slider 263 and the external thread 296 at the drive 282 , As it becomes clear, make while pulling the pins 260 to the radial wall 254 the bore 253 the beveled surface configurations 266 then an engagement with the sloping surfaces to the outside 272 the openings ago, what the pins relative to the axis 252 Forcibly expelled radially outward. It is also clear that rotation of the tool 297 in the opposite direction to axial displacement of the carrier assembly 262 leads, but in the opposite direction to the previously discussed. As a result, the rotation or rotation of the drive causes 282 the retraction of the pins 260 when the slider assembly 262 in one to the end cap 274 leading direction is moved.

Another aspect of the invention relates to the surgical anchor assembly 210 with a compression screw assembly 224 to hold the leadership 220 and the anchor 222 in compression relationship relative to each other by the guide 220 at anchor 222 is axially fixed. In this embodiment according to 41 has the compression screw assembly 224 preferably a compression screw 300 and a drive 302 on. Both the compression screw 300 as well as the drive 302 are made of a material biocompatible with bone tissue or human substance and preferably selected from the class comprising titanium, a titanium alloy, stainless steel or cobalt-chromium alloy.

According to 41 is the compression screw 300 with a first and a second interconnected section 304 and 306 Mistake. The cuts 304 and 306 the compression screw 300 are by a collapsible section 308 joined or connected together, the rotations and torques between the sections 304 and 306 transfers. The first part 304 the compression screw 300 is with an elongated shaft portion 312 and an enlarged head portion 314 Mistake. The shaft section 312 of the first part 304 is with an external thread 316 provided along it. The external thread 316 has a relatively fine pitch, which is the internal thread 255 matches that along the bore 257 of the insert 244 extends. According to 43 has the enlarged head section 314 of the first part 304 the screw 300 egg slightly smaller diameter than the diameter of the guide 220 formed subsidence 238 , In particular, the head section 314 the screw 300 preferably configured to releasably receive a screwing tool comprising the screw section 304 can translate into rotational movements.

In a preferred form and according to 41 is the rear end of the screw section 304 with a slot 318 configured to removably receive a distal end of a screwing tool. In particular, the first part is 304 the screw 300 on the collapsible section 308 so fastened, that rotational movements on the screw section 304 be exerted equally on the collapsible section 308 Act.

Likewise, the second screw section 306 with the collapsible section 308 in axially spaced relationship relative to the screw section 304 connected. As shown, the screw section has 306 an external thread 326 which extends over its length. In particular, the external thread 326 on the screw section 306 with the external thread 316 on the screw section 304 identical.

The collapsible section 308 serves to transmit the movement of the screw section 304 to the screw section 306 , In addition, the second screw section forms 306 a female thread section 330 which extends along it. The threaded section 330 of the second screw section 306 has a thread with a relatively fine pitch that extends along it. It should be noted, however, that the thread that runs along the section 330 extends, a left-hand thread is while the external threads 316 and 326 on the screw sections 304 respectively. 306 Right-hand thread are. As can be seen, the threads along the screw section 330 and 316 . 326 Right-hand or left-hand thread. As an important aspect, it should be noted that the threads along the sections 330 and 316 . 326 are in opposite directions to each other.

According to 41 has the drive 302 the compression screw assembly 224 a shaft portion 334 and an enlarged head portion 336 on. The shaft section 334 of the drive 302 has a diameter which is dimensioned so that the shaft portion 334 in and through the middle interior of the screw 300 can fit longitudinally sliding. The shaft section 334 of the drive 302 has an external thread 340 up, extending from a free end 342 of the drive 302 extends axially. The head section 336 of the drive 302 is sized so that it is prevented from the inside of the screw 300 to go through. As will be apparent, the axial length or distance is the head portion 336 the screw 302 from her free end 342 separates, about equal to the distance, the head section 314 the screw 300 from the initial section of the internal thread 330 separates, the closest to the head section 314 lies.

In a preferred form and according to 41 is the rear end of the head section 336 of the drive 302 with a slot 344 configured to releasably receive the distal end of a screwing tool. It is clear that configurations other than a slot would also suffice.

When assembling the surgical fastener assembly 210 and according to 43 becomes the compression screw 300 the compression screw assembly 224 by turning into the internal thread 255 of the insert 244 screwed. A suitably configured tool 355 grabs the slot 318 and the head section 314 the screw 300 one to the first and second section 304 and 306 the screw 300 by turning screws until the enlarged head 314 to the radial wall 240 abuts that by lowering 238 is formed by the leadership 220 is formed. After that, the drive becomes 302 in operative engagement with the screw 300 brought. That is, according to 44 becomes the drive 302 through the center opening, through the screw 300 is formed, in threaded engagement with the internal thread 330 of the second section 306 the screw 300 brought. It should be noted, however, that the drive 302 turned in the opposite direction to that in which the screw 300 turned into the anchor for insertion. Here is a suitable tool 357 a releasable engagement with the slot 344 in the head area 336 of the drive 302 come to the drive 302 to turn. Turning the drive 302 is done until the cuts 304 and 306 connecting section 308 collapsed. By collapsing the middle section 308 opposite forces act on the external thread on the sections 304 . 306 and the internal thread 330 , which prevents the compression screw assembly 224 relative to the anchor 222 unintentionally turns.

45 schematically shows a generally with the reference number 422 designated alternative form of anchor that can be used as part of the surgical anchor assembly. The anchor 422 has an elongated insert 444 with a first and a second opposite end 446 and 448 on. Preferably, the insert 444 made from a material similar to that used in making the insert 44 is used. The use 444 is sized so that when inserted into the bone, the first end 446 lies on one side of a fracture line, while the second end 448 of the insert 444 lies on a opposite side of the fracture line.

According to 45 and 46 has the anchor 422 the surgical fastener assembly is also a series of elongate pins or barbs 460 on, the first end 446 of the insert 444 are assigned operationally. According to 45 and 63 are the pins or barbs 460 the anchor 422 to move between a retracted position ( 45 ) and a radially extended position ( 63 ) assigned operationally. As shown, the pins 460 from use 444 entrained relative to the longitudinal and radial displacement. In the illustrated embodiment of the invention, two pins are used 460 from the anchor 422 in diametrically opposite relationship relative to each other for forcibly longitudinal movement in opposite directions between the retracted and extended positions according to 45 respectively. 63 carried.

As 46 and 47 show, has the oblong insert 444 preferably an external thread 468 which extends axially along it and from its first end 446 leads to the back. The external thread 468 along the outside of the insert 444 has a relatively rough slope to the retention and anchoring of the anchor 422 to amplify in the substance of the bone in response to rotational movements acting on the anchor 422 be exercised.

From the second or rear end 448 of the insert 444 of the anchor 422 extends a constant, generally cylindrical configuration 449 axially forward, extending to the end of the external thread 468 extends and has a slightly smaller outer diameter than the external thread 468 Has. In particular, the cylinder-like configuration 449 extending from the end 448 of the insert 444 axially forwardly extending, a diameter generally equal to the diameter of the throughbore 36 ( 2 ) in which it is operationally associated guide, which is the axial sliding movement of the armature 422 facilitated in the sleeve of the guide. Although not specifically illustrated, conventional interfacing aids are the exterior configuration 449 of the insert 444 and the respective guide is formed to allow axial movement of the anchor 422 relative to the guide along one through the insert 444 fixed axis 451 allow while rotating the anchor 422 prevent relative to the respective leadership.

According to 47 forms the insert 444 a lowering section 452 of constant diameter extending from the first end 446 of the insert 444 extends axially inwards. At an inner end forms the lowering section 452 a radial wall 454 , Between the end 446 and the wall 454 The insert also forms a pair of beveled openings 470 which are arranged in diametrically opposite relationship relative to each other. Each opening cuts through the insert 444 formed subsidence 452 and opens to her. In addition, every opening opens 470 to the outside of the insert 444 ,

From the second or opposite end 448 of the insert 444 extends an elongated hole 455 axially forward, extending to the sinking section 452 opens. From the second end 448 inward points the hole 455 a female thread section 457 on. Preferably, the female threaded portion 457 the bore 455 a thread with a relatively fine pitch extending along it. As it should be clear, the internal thread corresponds 457 the external thread on the compression screw assembly (not shown) in operative combination with the insert 444 is arranged.

According to 47 is the second or rear end 448 of the insert 444 further configured to releasably receive a screwing tool (not shown) securing the armature 422 can translate into rotational movements. In a preferred form and as shown, the rear or second end 448 of the insert 444 with a slot-like opening 469 suitably configured for releasably receiving a distal end of a screwing tool. However, it will be understood that any suitable configuration would equally suffice without limiting or deviating from the spirit and scope of the invention.

According to 49 is the use 444 further with a suitable guide mechanism 475 for purposes to be described below. The guide mechanism 457 can take countless different forms. A form of leadership mechanism 475 is in 49 illustrated schematically. In the illustrated embodiment, the guide mechanism 475 a pair of diametrically opposed guide wedges 477 and 479 on, extending to a longitudinal section of the insert 444 formed subsidence 452 extend along. According to 49 stand the guide wedges 477 and 479 radially inward of each other. It should be noted that the distal end of each guide wedge 477 and 479 just before the first end 446 the attachment 444 ends, so that an axial space between the terminal end of the guide of each guide wedge 477 . 479 and the first end 446 of the insert 444 is available.

With renewed reference to 45 form the pins or barbs 460 in this form of the invention part of a carrier assembly 462 , The carrier arrangement 462 preferably has a slider 463 to which one end of each pin is so tightly connected that the pins 460 during axial movement of the slider 463 in the sink 452 of the insert 444 move forcibly.

According to 46 . 50 and 51 Every pen has it 460 a flexible wire-like configuration shaped to fit into and through a respective one of the insert 444 formed openings 470 longitudinal sliding adapts. To mention is only that each pin 460 is provided with sufficient strength to be inserted into and through the bone tissue without substantial bending between its opposite ends. In a most preferred form of the invention, each pen is 460 made of a material selected from the class comprising titanium, a titanium alloy, stainless steel or cobalt-chromium alloy.

In the embodiment according to 46 . 50 and 51 Every pen has it 460 a front end 461 and an opposite pointed end 466 , To the end 466 towards each pin preference, as a curved or curved configuration, so that the free ends 466 in and through the opening 470 extend. The length of each pen 460 is selected so that when fully retracted front end 461 of the pen 460 in the anchor 422 ( 45 ) the opposite pointed end 466 of the pen or barb 460 in the outer diameter of the insert 444 is positioned to facilitate the insertion of the surgical anchor assembly into the bone of the patient. It should also be clear that the length of each barb or pin 460 is dimensioned such that upon displacement of the pins in their extended position ( 63 ) the front end 461 every pen 460 the carrier assembly 462 Operational remains assigned to compulsory retraction of the pins 460 from their extended positions, as desired or deemed necessary by the surgeon.

As mentioned, the carrier assembly 462 also a slider 463 on. The configuration of the slider 463 is in 52 to 55 illustrated. As shown, the slider has 463 a generally cylindrical outer surface configuration having a diameter substantially equal to the diameter of the countersink portion 452 ( 46 ) of the attachment 444 is. The slider 463 an identical pair forms through-holes or openings arranged in diametrically opposite relation relative to one another. The diameter of the openings 481 . 483 is sized to be the end 461 of the pen 460 pick up and allow the ends 461 every pen 460 rigidly attached to it. In addition, the slider forms 463 a pair of diametrically opposed slots 485 and 487 which is in a relationship other than perpendicular to the openings 481 and 483 are arranged. In particular, the slots 485 . 487 so dimensioned that they make a guided movement of the slider 463 relative to the guide wedges 477 and 479 on the insert 444 ( 62 ) facilitate. In addition, the slider forms 463 a tool engagement cavity 491 passing longitudinally through the slider and recesses 493 and 495 on its opposite sides.

According to 45 fits the carrier assembly 462 axially in through the insert 444 formed hole 452 for axial movement, with the pointed ends 466 every pen 460 at least partially through the opening 470 extend, but not beyond the scope of attachment 444 out. After fitting the carrier assembly 462 into the hole 452 of the insert 444 becomes the open end of the mission 444 through an end cap 497 locked.

A preferred form of the end cap 497 is in 56 . 57 and 58 illustrated. As shown, the end cap 497 preferably a reduced ring section 498 which is so dimensioned that it can be used in the open end of the open 444 formed hole 452 fits snugly. A suitable holding device, for example, notching, welding or the like, secures the end cap 497 safe on the rest of the insert 444 , Preferably, the end cap 497 of material biocompatible with bone tissue or a human substance and preferably selected from the class comprising titanium, a titanium alloy, stainless steel or cobalt-chromium alloy. Other unnamed materials would be just as good. According to 56 to 58 forms the end cap 497 a central through-hole or a hole 499 , In addition, the exposed surface of the end cap 497 preferably chamfered to the insertion of the anchor 422 to promote in the bones.

59 and 60 schematically illustrate a tool that is configured to interfit with the carrier assembly 462 interacts and them in opposite directions in the hole 452 of the insert 444 moved axially, causing the pins 460 between retracted ( 45 ) and extended ( 63 ) Positions are forcibly moved. Preferably, the tool has 500 an elongated shaft 502 with axially spaced wedges 504 and 506 at a distal end thereof. The shaft 502 and the wedges 504 and 506 are configured to fit into the hole 455 of the insert 444 axially lengthwise fit and into an operational combination in the slider 463 the carrier assembly 462 extend. In particular, the wedge 506 configured so that it passes through the tool engagement cavity 491 so longitudinally fitted that the wedge 506 an operational intervention with the surfaces 493 and 495 can produce on the slider.

According to 45 are the guide slots 485 and 487 in the slider 463 not to the Füh approximately wedges 477 and 479 axially aligned, extending from the bore 452 extend radially inward. As those skilled in the art will appreciate, the guide wedges are 477 and 479 from the guide slots 485 respectively. 487 under the influence of the arrangement of the pins 460 and their orientation relative to the guide slots 485 and 487 offset radially. Consequently, the slider assembly 462 not inadvertently in the hole 452 be moved axially, and the pins 460 stay in the retracted positions.

To the pins or barbs 460 out of the hole 452 the attachment 444 Extending radially outwards becomes the tool 500 through the attachment 444 introduced. In particular, the wedges are replaced by the insert 444 inserted longitudinally and can go through it in a surgical engagement with the slider. After moving the wedges 504 and 506 in operative engagement with the slider becomes the tool 500 rotated to a rotation of the slider 463 to do what with arrows in 62 and 62A is shown. The rotation of the slider is possible 463 by the elasticity of the length of the pins 460 , The slider 463 is turned until the slots 485 and 487 to the guide wedges 477 and 479 aligned, after which the tool 500 to the left according to 62 is moved to the pins 460 Relative to the use 444 forcibly push outward, causing the attachment of the surgical anchor 422 reinforced in the bone. If necessary, the tool can also be in operative engagement with the slider 462 used to the pins 460 in the position according to 45 forcibly retract. That is, the wedges are back in operative engagement with the slider 463 arranged, and the tool 500 is pushed and twisted or rotated to forcibly retract the pins and to facilitate the removal of the anchor assembly when considered necessary or desirable by the surgeon.

Yet another alternative form of compression screw assembly, generally indicated by the numeral 600 is designated show 64 and 64A , The compression screw assembly 600 The purpose is a tour 620 and an anchor 622 in compression relationship relative to each other by holding the guide 620 at anchor 622 is fixed. For this description, the leadership are similar 620 and the anchor 622 essentially the leadership 20 and the anchor 22 that were previously described. Therefore, there is no further description here.

Preferably, the compression screw assembly 600 a compression screw 630 and a drive 650 on. Both the compression screw 630 as well as the drive 650 are made of a material that is biocompatible with bone tissue or human substance.

According to 65 is the compression screw 630 with an elongated shaft portion 632 and an enlarged head portion 633 Mistake. The shaft section 632 the compression screw 630 is with an external thread 634 provided, extending from a front end 635 the screw 630 extends axially. The external thread 634 has a relatively fine pitch, which corresponds to the internal thread, extending along an internally threaded hole 678 of the anchor 622 extends axially. The enlarged head section 633 the screw 630 has a diameter that is slightly smaller than the diameter of one in the guide 620 formed subsidence 688 is that of lowering 38 in the lead 20 ( 2 ) is substantially similar.

According to 65 and 66 is a back end 636 the screw 630 preferably configured to releasably receive a screwing tool (not shown) holding the screw 630 can translate into rotational movements. In a preferred form and as shown, the rear end 636 the screw 630 with a bush-like opening 637 with a floor 638 configured. The bush-like opening 637 is configured to releasably receive a distal end of a screwing tool. In a most preferred form of the invention and as shown, the socket or opening has 637 a hexagonal cross-sectional configuration. It will be clear, however, that any suitable configuration, including an elongated slot, would equally suffice without limiting or departing from the spirit and scope of the invention.

Furthermore, the screw forms 630 an elongated hole 640 , which are at opposite ends to the socket 637 and to the front end 635 the screw 630 opens. As shown, the opening has 640 an internal thread 642 extending over its length. According to 65 and 67 is the distal or front end 635 the screw 630 with a sequence of radial passage slots 643 . 644 . 645 and 646 provided in generally perpendicular relationship relative to each other and extending from the free or distal end 635 extend axially inwardly over a predetermined distance.

According to 65 also narrow the inner bore 640 and the internal thread 642 to the free or distal end 635 the screw 630 in the area of the slots 643 . 644 . 645 and 646 ,

As previously mentioned, the compression screw assembly 600 also a drive 650 on, in combination with the screw 630 to arrange is. The drive 650 is in 68 . 69 and 70 illustrated. The drive 650 has a shaft portion 652 and an enlarged head portion 654 on. The shaft section 652 of the drive 650 is with an external thread 656 provided, extending from a front end 658 of the drive 650 extends axially. The external thread 656 has a relatively fine pitch, which is the internal thread 642 corresponds to that in the hole 640 the screw 630 is provided. The enlarged head section 654 of the drive 650 has a slightly smaller diameter than the one in the socket 637 the screw 630 can be taken longitudinally. As from an understanding of the compression screw assembly 630 becomes clear, is the length of the shaft portion 652 so sufficient that the distal or free end 658 to the slot end of the screw 630 and extends through this operationally when the head section 654 down on the floor 638 the socket 637 seated.

As from an understanding of the compression screw assembly 600 shows, the compression screw 630 in the anchor arrangement 622 according to 64 screwed to the lead 620 in a compression relationship relative to the anchor 622 to draw. After that, the drive becomes 650 into engagement with the internal thread 642 the screw 630 screwed. It should be noted that the outer diameter of the shaft portion 632 the screw 630 is essentially constant as long as the drive 650 not engaged with the slot end 635 the screw 630 stands. Once the appropriate compression between the guide 620 and the anchor 622 reached is the drive 650 Continue with the compression screw according to 73 engaged. As a result, the slot end becomes 635 the screw 630 expanded radially outward, which provides a compression seat, which prevents the compression screw assembly 600 relative to the anchor 622 turns, and thus the compression relationship between the guide 620 and the anchor 622 maintains.

As previously mentioned and in 74 shown schematically, comes a sequence of screws 28 used to the plate 32 the leadership 20 on the bone fragment 18 to fix. Another aspect of the invention relates to a preferred form of construction for the screws 28 for fixing the plate 32 the leadership 20 on the bone fragment 18 be used.

In the preferred embodiment and according to 75 shows the screw 28 an oblong cannulated attachment 700 and a drive 702 on. As it becomes clear, the attachment is 700 made of a material which is biocompatible with bone tissue, and has a shaft portion 710 and an enlarged head portion 712 on. The shaft section 710 the attachment 700 is with an external thread 714 provided, extending from a front end 716 the attachment 700 extends axially. The external thread 714 has a slope that holds and attaches the fixture 700 supported in the bone substance. The enlarged head section 712 the attachment 700 is configured to match the shape of the through-hole 34 in the plate 32 the leadership 20 interacts. In the illustrated embodiment, the head portion 712 the attachment 700 a frusto-conical configuration with a recessed configuration or recess in the through hole 34 interacts with the plate 32 on the bone 18 to fix. However, it will be understood that shapes other than those illustrated for the head section 712 and the through hole 34 would be enough.

According to 76 is a back end 718 the attachment 700 preferably configured to releasably receive a screwing tool (not shown) securing the attachment 700 can translate into rotational movements. In a preferred form and as shown, the rear end 718 the attachment 700 with an elongated slot or opening 720 configured. The slot 720 is configured to releasably receive a distal end of a screwing tool. However, as will be appreciated, any suitable configuration, including a bushing, would equally suffice for releasably receiving a distal end of a screwing tool.

Furthermore, the cannulated attachment forms 700 an elongated hole 722 that are at opposite ends 716 . 718 the attachment 700 opens. According to 76 and 77 has the hole or opening 722 a first part 724 that is the first end 716 the attachment 700 opens and has a first diameter, and a second countersink portion 726 that goes to the rear or second end 718 the attachment 700 opens and has a second diameter. In particular, the diameter of the hole 726 larger than the diameter of the hole or opening 722 , which is why a radial wall or ring shoulder 727 is formed by the diameter differences between them. According to 77 and 79 is the distal or front end 716 the attachment 700 with a sequence of radial passage slots 728 . 730 . 732 and 734 provided in generally perpendicular relationship relative to each other and extending from the first or distal end 716 the attachment 700 extend axially inwardly over a predetermined distance. As shown and for purposes described below narrows or reduces the diameter of the first section 724 the bore 722 in the area of the slots 728 to 734 while the outer diameter of the attachment remains substantially constant.

As understood from an understanding of this embodiment, the axial length of the shaft portion 710 the attachment 700 so that when performing the attachment through the through hole 34 in the plate 32 the leadership 20 and fixing in the bone 18 the Axiallängsabschnitt the shaft 710 with the slits formed in it over the bone 18 extends at a distance approximately equal to the length of the slots 728 to 734 is. Of course, during surgery, a surgeon may have a selection of different fixings to choose from, each attachment having a different length, so that a proper relationship of attachment to bone thickness is easily obtainable for the surgeon.

As previously mentioned, this shape of the screw 28 also a drive 702 on, in combination with the attachment 700 is arranged. A preferred form of the drive 702 is in 80 to 82 shown. As shown, the drive points 702 preferably a one-piece part 750 made of a material which is biocompatible with human bone tissue and human bone substance. The drive part 750 has a first section 752 having a substantially constant diameter along its length and an axially aligned second portion 754 with a substantially constant diameter over its length. The second part 754 has a larger diameter than the first part 752 , which is why a radial wall or ring shoulder 757 is formed in between.

In the illustrated embodiment corresponds to the annular shoulder or ring wall 757 at the drive 702 generally by the attachment 700 formed radial wall or annular shoulder 727 , It is important to note, however, that the axial length of the first section 752 extending between the radial wall or ring shoulder 757 and the free end of the drive part 750 extends, generally equal to the distance that the radial wall or annular shoulder 727 from the distal or free end 716 the attachment 700 separates. In addition, the first part is 752 of the drive 702 so that it fits a sliding fit in the first section 724 the by the attachment 700 formed hole 722 manufactures. In a most preferred form of the invention, the second portion is 754 of the drive 702 so dimensioned that there is a sliding fit in the second section 726 the by the attachment 700 formed hole 722 manufactures.

As if from an understanding of the screw 28 and according to 75 will be the first or the front end 716 the attachment 700 lengthwise through the through hole 34 in the plate 32 the leadership 20 guided, and the shaft portion 710 is done by turning the head section 712 in the bones 18 screwed. Finally, the head section touches 712 the plate 32 and pull the lead 620 in a fastened relationship relative to the bone. At this point, the free slot end of the attachment extends 700 over the bone 18 on the side of it, opposite to the plate 32 the leadership 20 lies. It should be noted that when attaching the attachment 700 in the bone 18 the outer diameter of the shaft portion 710 the screw 700 is essentially constant as long as the drive 702 not engaged with the attachment 700 comes. Once the appropriate fastening between the guide 620 and the cannulated attachment 700 reached is the drive 702 through the hole 722 the attachment 700 according to 83 screwed. Is the drive 702 completely in the attachment 700 introduced what is then the case when the shoulder 757 on the drive part 750 an engagement with the shoulder 727 at the attachment 700 makes the slot end 716 the attachment 700 radially outwardly widened, causing unintentional rotation of the attachment 700 prevents the fixed relationship between the leadership 20 and the bone 18 according to 75 is maintained.

84 illustrates an additional alternative embodiment for a surgical fastener assembly 800 according to the principles of the invention. As 84 can be seen, has the surgical fastening arrangement 800 as previously disclosed embodiments via an anchor assembly 810 , a guide 850 , a fastening or compression screw 860 as well as screws 880 of which one in 84 is shown. The surgical fastening arrangement 800 is used in the same way as previously disclosed embodiments. A first section 822 the anchor arrangement 810 is screwed into a first bone section, and a second section 824 the anchor arrangement 810 is disposed through a second bone portion with a fracture extending between the first bone portion and the second bone portion. mandrels 834 run from the anchor assembly 810 , wherein they extend into the first bone section. A sleeve 852 the leadership 850 becomes the second section 824 the anchor arrangement 810 positioned. The attachment 860 will be in and by the leadership 850 used, with the attachment 860 a threaded engagement with the armature assembly 810 manufactures and with the leadership 850 operationally coupled. By fastening the screws 860 in the anchor arrangement 810 will be the lead 850 , which is attached to the second bone portion, in a compression relationship with the anchor assembly 810 pulled, whereby the first bone portion is compressed with the second bone portion. A closer explanation of the operation and use of the surgical fastener assembly 800 will be done later in this description.

As will also be described in more detail later, the armature arrangement 810 an anchor 820 , a spine or pin arrangement 830 and an actuator 840 on that in 84 not visible, but in 85 you can see.

Describes the leadership 850 closer, according to 84 and the description in conjunction with other disclosed embodiments, the guide 850 a sleeve 852 and a plate 854 on. The sleeve 852 is at a first end 855 the plate 854 , The plate 854 has several screw holes 857 on, through the screws 880 be included, which serve the plate 854 to attach to the second bone section. The sleeve 852 forms a longitudinal bore in its interior. The second unthreaded section 824 of the anchor 820 placed in the second bone section becomes in the bore of the sleeve 852 added.

According to 84 is a screw-tool receiving slot 824A in the second section 824 of the anchor 820 intended. The screwing tool receiving slot 824A takes in its interior the structure of a screwing tool, which is used to rotate the armature assembly 810 and thus the anchor 820 is used to anchor the arrangement 810 in the first bone section to screw.

How out 84 further will be apparent, the second section 824 of the anchor 820 also two flat spots 824B (of which only one in 84 visible) on the outer periphery of the second section 824 on. The flats 824B lie on opposite sides of the second section 824 and thus 180 ° around the circumference of the second section 824 apart. Every flat 824B forms a non-conforming surface (in view of the circular non-flat portion of the periphery of the second portion 824 ) on the perimeter of the second section 824 , The inner bore of the sleeve 852 the leadership 850 is in a complementary configuration with respect to the second section 824 designed so that when receiving the second section 824 in the sleeve 852 the flats 824B with the bore of the sleeve 852 cooperating complementary surfaces to rotate the armature assembly 810 in the sleeve 852 to prevent. Two flat spots 824B are spaced 180 ° apart to allow easy alignment of the second section 824 for positioning in the sleeve 852 to care. If only one flat area were provided, the second section could be 824 only be positioned in one orientation so that it is in the sleeve 852 could be included. However, the invention may utilize different numbers and configurations for the flats 824B be practiced. Moreover, the invention is not limited to the exclusive use of the structure previously described for preventing rotation of the armature assembly 810 in the sleeve 852 limited. Many other configurations for paired structures on the anchor assembly and sleeve could be used.

The leadership 850 further forms a mounting opening 856 through which the attachment 860 extends when connected to the anchor assembly 810 is paired by screwing. As disclosed in the discussion of previous embodiments, when mounting the fixture engages 860 through the mounting hole 856 the threaded shaft 864 the attachment 860 in the internal thread, the second section 824 of the anchor 820 belongs. The head 862 the attachment 860 engages in building the leadership 850 one, the attachment hole 856 forms, so that when screwing in the attachment 860 in the second section 824 of the anchor 820 the leadership 850 in a compression relationship with the armature assembly 810 is pulled.

As discussed later in this description, the attachment points 860 a holder 870 on her threaded shaft section 864 on. Is the attachment 860 in the anchor arrangement 810 screwed in, locks the holder 870 the attachment 860 and the anchor assembly 810 so together that without a force that is specifically exercised to consolidate the loading 860 from the anchor assembly 810 to pull out the fastening 860 not from the anchor arrangement 810 exit. Unintentional moving out of the attachment 860 from the anchor assembly 810 would reduce the compressive force that joins the first bone portion to the second bone portion.

85 and 86 illustrate the anchor assembly 810 , As previously described, the anchor assembly 810 the anchor 820 , the mandrel arrangement 830 and the actuator 840 on. Each of these components will be described below. The anchor 820 has an elongated structure which forms a hollow bore extending through the armature 820 extends longitudinally. The anchor 820 has a first male threaded portion 822 and a second section 824 on. As previously explained, the first male threaded portion becomes 822 screwed into the first bone section, and the second section 824 is placed in the second bone section. The first paragraph 822 of the anchor 820 has an open end 821 on, through which the mandrel assembly 830 is used, as will be explained. In addition, the first section forms 822 several slots 826 , which completely through the structure of the anchor 820 extend so that openings in the first section 822 are present, extending from the bore of the anchor 820 by the external structure of the anchor 820 extend. In the anchor 820 is a slot 826 for each of the spines 834 provided that to the mandrel arrangement 830 belong.

The mandrel arrangement 830 has a circular base section 832 and several spines 834 on that are different from the base 832 extend. The base 832 forms a bore that extends through it and has an internal thread. The spines 834 extend from the base 832 and although the embodiment shown has four mandrels, any number of mandrels can be used in the invention. If a different number than four spikes were used, it is understandable that an equal number of slots 826 in the anchor 820 would be provided.

87 and 88 illustrate the mandrel assembly 830 closer. As shown, each mandrel 834 an inside chamfered surface 834A and externally chamfered surfaces 834B on. The operation of the mandrel assembly will be explained later in this specification.

The mandrel arrangement 830 is picked up in the hole by the anchor 820 is formed. When positioning the mandrel assembly 830 in the anchor 820 every thorn becomes 834 in one of the slots 826 positioned to the anchor 820 belong. The structure of the anchor 820 who has the slots 826 can form something in by the anchor 820 formed hole, so that when positioning the mandrels 834 in the slots 826 the arbor arrangement 830 not around its longitudinal axis in the anchor 820 can turn. The mandrel arrangement 830 can not anchor 820 turn, indicating the interaction of the structure, the slots 826 forms, with the thorns 834 is due. What the purpose is that the mandrel assembly 830 not in anchor 820 may turn later in this description.

The invention is not limited to a specific procedure, rotation of the mandrel assembly 830 in the anchor 820 to prevent. Any number of different structural configurations could be in the bore of the anchor 820 be provided. In addition, the spines could 834 be designed so that their ends slightly up in the slots 826 could extend to prevent rotation. The spines 834 would not fully move up through the slots 826 extend, but would have a sufficient distance in the slots 826 protrude so that they would touch the structure forming the slots to prevent their rotation.

After insertion of the mandrel assembly 830 in the anchor 820 becomes a cap 828 in the open end 821 of the anchor 820 fitted. The cap 828 can in the open end 821 be locked. The cap 828 serves to enclose the first section 822 of the anchor 820 for holding the mandrel assembly 830 in the anchor 820 if, for example, the actuator 840 not in the mandrel assembly 830 engages prevent material, such as bone particles, in the inner bore of the anchor 820 penetrates when the anchor assembly 810 is screwed into the first bone section, and to form a structure to allow the anchor assembly 810 easier to screw into the first bone section.

After insertion of the mandrel assembly 830 in the anchor 820 becomes the actuator 840 in the anchor 820 positioned. The actuator 840 has a head section 842 and a partially threaded shank portion 844 on. The head section 842 has a bore along its longitudinal axis so that, understandably, a screwing tool may be received in the bore to the actuating element 840 to turn. Thus, for example, a hexagonal bore may be provided which would receive in its interior a hexagonal screwing tool. As will be explained in more detail, the actuating element 840 in the anchor 820 used, wherein the threaded shaft portion 844 screwed into the internally threaded hole, which passes through the base 832 the arbor arrangement 830 is formed. Thus, the actuating element 840 not in by the anchor 820 screwed hole formed, but in the through the base 832 the arbor arrangement 830 screwed hole formed.

The following is the operation of the armature assembly 810 described in more detail. 89 is a cross-sectional view of the armature assembly 810 in which are the spines 834 in a retracted position in the anchor 820 are located. How out 89 emerges forms the anchor 820 a hole 825 in its interior, which has a section 825A larger diameter, which is not threaded and the mandrel assembly 830 in his interior, and a section 825B having a smaller diameter, of which a portion is threaded and the threaded shaft portion 864 the compression screw 860 in its interior. As shown, the mandrel assembly 830 in the hole 825A of the anchor 820 positioned. The base section 832 the arbor arrangement 830 is at a first end 822A the bore 825A , Is the base located 832 in this position, are the spines 834 in the anchor 820 retracted.

How out 89 also will be apparent is the actuator 840 in the hole 825 of the anchor 820 positioned. The threaded shaft section 844 of the actuating element 840 extends in the bore section 825A , and the head 842 of the actuating element 840 is in the bore section 825B added. As shown, a shoulder 820A in the anchor 820 formed, which interferes with the head 842 of the actuating element 840 manufactures. The shoulder 820A prevents the actuator 840 on it, further into the hole 825 Be inserted beyond the point where the shoulder 820A the head 842 touched. As can be seen, the threaded shank portion 844 in the base 832 the arbor arrangement 830 screwed.

In 89 is every thorn 834 in a slot 826 positioned and thus aligned. In this position for the mandrel assembly 830 the spines extend 834 but not through the slots 828 and thus are not on the outer surface of the anchor 820 in front. How out 89 also becomes clear, has a section of the structure of the anchor 820 who has the slots 826 forms a bevelled or curved surface 826A on. The curved surface 826A forms a rear end of each slot 826 , As shown, the inside chamfered surface 834A every thorn 834 Oriented to the curved surface 826A has.

90 and 91 illustrate the anchor assembly 810 in a configuration in which the spines 834 moved to a position where they left the anchor 820 protrude. Around the spines 834 from the anchor 820 a user would push a screwing tool through the hole 825 of the anchor 820 insert and the screwing tool with the head 842 of the actuating element 840 engage. The user would use the actuator 840 in the anchor 820 rotate clockwise. Thus, the actuating element 840 understandably free, in the hole 825 of the anchor 820 to turn. Since the threaded shaft section 844 of the actuating element 840 in the base 832 the arbor arrangement 830 is screwed when the actuator 840 Turned clockwise becomes the base 832 and hence the mandrel assembly 830 at the threaded shaft section 844 of the actuating element 840 along and to the second end 822B the bore 825A emotional. It is understood that when moving the mandrel assembly 830 to the second end 822B the chamfered ends 834A the spines 834 an engagement with the beveled surfaces 826A every slot 826 produce. Due to the complementary surfaces of the mandrels 834 and slits 826 are thus upon movement of the mandrel assembly 830 along the threaded shaft 844 of the actuating element 840 the spines 834 up through the slots 826 moved and out of the anchor 820 extended.

So that the thorns 834 through the slots 826 can be extended to the top, are the spines 834 Made of a deformable material. So can the spines 834 made of stainless steel or any other material that can deform when the spikes 834 through the slots 826 to be moved upwards. The spines 834 can be made of a variety of materials, taking into account that the mandrels 834 must be deformable so that they are out of the anchor 820 can extend to the outside. Nevertheless, the spines have to 834 Be firm enough to allow for hold between the anchor 820 and the first bone section. Thus, as described above, the spines 834 not preformed into a configuration in which they move in the anchor 820 due to its preformed configuration, eg in a curved shape, from the anchor 820 exit. Instead, in this embodiment, the mandrels 834 formed from a deformable material, and the movement of the mandrels 834 in the anchor 820 shape the spines so that they are out of the anchor 820 can extend.

How out 91 also shows, the construction of the anchor 820 that the bore 825 forms an engagement with the base 832 at the second end 822B the bore 825A so forth that the mandrel assembly 830 not over the second end 822B out in the hole 825A can move. This prevents the spikes 834 too far through the slots 826 extend, which could cause the spines 834 are not brought into a desired shape when they leave the anchor 820 are extended. Would eg the base 832 too far in the hole 825 moved, could the spines 834 bend backwards and thus do not reach the desired anchoring strength in the first bone section. Would also be the base 832 too far in the hole 825 moved, could the base 832 from the actuator 840 screw off. In the disclosed embodiment, however, it does not happen because the base 832 forms a bore having a diameter smaller than the diameter of the unthreaded portion of the shaft 844 is. Thus, the base can 832 the arbor arrangement 830 on the shaft 844 not over the threaded portion of the shaft 844 move out.

As explained above, therefore, a rotation of the actuating element moves 840 clockwise in the anchor 820 the arbor arrangement 830 in the anchor 820 , At the movement of the base 832 the arbor arrangement 830 to the second end 822B the bore 825A put the spines 834 an engagement with the curved upper surfaces 826A forth, the back of the slots 826 in the anchor 820 form so that the spines 834 through the slots 826 and from the anchor 820 exit. The interaction of the spines 834 and curved surfaces 826A deforms the spines 834 so that they are off the anchor 820 extend and be inserted into the first bone section.

92 shows the mandrel assembly 830 as they do after their movement in the anchor 820 would be configured to the spines 834 from the anchor 820 extend. Although this in the description of the mandrel assembly 830 previously not discussed, the Base 832 also a chamfered surface 833 on. The chamfered surface 833 is in 85 and 86 to see, and the purpose of the chamfered surface 833 is an engagement with the cap 828 to help prevent the end cap 828 when retracting the spikes in the anchor 820 is solved, which will be explained later. Thus, the chamfered surface wedged 833 the cap 828 in place in the anchor 820 ,

Around the spines 834 back in the anchor 820 to retract after the mandrels have been pushed out of the anchor as in the above description, the operator would be the actuator 840 turn counterclockwise. So the thorns 834 the arbor arrangement 830 are understandably embedded in the first bone section, is when turning the actuator 840 counterclockwise in the anchor 820 the actuator 840 from the base 832 moved out. This allows the actuator 840 completely out of the mandrel arrangement 830 and thus from the hole 825 of the anchor 820 be removed. To retract the spines 834 in the anchor 820 One possible approach is to base it 832 back to the first end 822A the bore 825A to screw. A possible method for screwing back the base 832 to the first end 822A is a tool in the hole 825 to introduce that interfere with the base 832 Would produce de, and sufficient force on the base 832 exercise to the base 832 to the first end 822A screw back so that the spines 834 back in the anchor 820 be confiscated. The screwing tool does not need to be in the base 832 instead, it is only necessary to make such an intervention with the base 832 Produce that enough power to the base 832 can be exercised to force her to the first end 822A to move. When screwing the base 832 to the first end 822A become the spines 834 pulled out of the first bone section and through the slots 826 retracted again. When retracting the spines 834 through the slots 826 the spines deform 834 thus again, so that they return substantially to their initial configuration, so that they in turn in the hole 825A of the anchor 820 can be included. Thus, the spines can 834 withstand at least one complete extension and retraction cycle without material failure.

Possible is the actuator 840 as a screwing tool for forcibly moving the base 832 the arbor arrangement 830 to the first end 822A the bore 825A to use as described above. After the actuator 840 by turning the actuator 840 completely counterclockwise out of the base 832 has been pulled out, the actuator can 840 back into the hole 825 be introduced so that it interferes with the base 832 manufactures. The actuator 840 does not necessarily need a threaded engagement with the base 832 but just so in building the base 832 intervene that force on the base 832 can be exercised to bring it to the first end 822A forcibly move back. The invention is not limited to a particular engagement methodology for making engagement of a screwing tool with the base 832 limited to the base 832 to the first end 822A to screw. Various intervention procedures can be used. Erfor is only that, that a screwing tool, which is the actuating element 840 could act, so in the base 832 engages that sufficient force on the base 832 can be exercised to drill them in the hole 825 to the first end 822A to move. Using the procedure described above to retract the mandrels 834 in the anchor 820 Therefore, no threaded engagement between a screwing tool and each individual mandrel is required.

Although previously a way to retract the spines 834 in the anchor 820 has been described, the invention is not limited to use only this approach. For example, is sufficient force on the actuator 840 exercised, could rotation of the actuator 840 counterclockwise while the threaded shaft section 844 still in the base section 832 screwed in, serve the spines 834 in the anchor 820 withdraw. In this way, a rotation of the actuating element 840 in the base 832 counterclockwise the base 832 to the first end 822A the bore 825A screw what in turn the spines 834 in the anchor 820 let go.

93 shows an embodiment for the attachment or compression screw 860 , As mentioned earlier, the compression screw points 860 a head section 862 and a threaded shaft portion 864 on. The head section 862 forms a hexagonal bore in its interior 863 which receives a screwing tool therein. As also described above, the threaded shank portion extends 864 through the mounting hole 856 in the lead 850 and is by screwing in the second section 824 of the anchor 820 added. The head section 862 makes an operational engagement with the leadership 850 so forth that upon further screwing the shaft portion 864 in the second section 824 of the anchor 820 the anchor arrangement 810 and leadership 850 be brought into a compression relationship with each other, whereby the first bone portion is joined to the second bone portion.

As previously mentioned, on the threaded shank portion 864 the attachment 860 a holder 870 intended. The holder 870 is constructed as an insert of ultra-high molecular weight polyethylene (UHMWPE) or any other material having similar properties, and is positioned in a bore that leads to the threaded shank portion 864 belongs. A section of the holder 870 extends over the outer periphery of the threaded shaft portion 864 out. It is understandable that when screwing the threaded shaft section 864 in the anchor arrangement 810 the holder 870 between the construction, the bore in the second section 824 of the anchor 820 forms, and the shaft portion 864 the attachment 860 is compressed. Because the holder 870 is formed of a deformable material, it deforms slightly so that the shaft portion 864 in the anchor arrangement 810 can be screwed, but provides additional frictional force between the armature assembly 810 and the shaft portion 864 , so that without a force that is specially exercised around the attachment 860 from the anchor assembly 810 to pull out the fastening 860 not from the anchor arrangement 810 moved out. Thus, the holder ensures 870 for a self-locking fortune for attachment 860 in the anchor arrangement 810 , Examples of other deformable materials for the holder 870 can be used are nylon, acetal, polytetrafluoroethylene (PTFE) and polyetheretherketone (PEEK). However, again, the invention is not limited to the exclusive use of these exemplary deformable materials for the holder 870 limited.

As understood from the above description, the surgical fastener assembly becomes 800 used for joining a first bone section with a second bone section where a fracture lies between them. When using the surgical fastener assembly 800 a user would have the male threaded section 822 of the anchor 820 screw into the first bone section. The leadership 850 is attached to the second bone section. The second section 824 of the anchor 820 will be in the sleeve 852 the leadership 850 added. As previously explained, the armature assembly is 810 to rotation in the sleeve 852 through the interaction of the flats 824B and the internal structure hindering the bore in the sleeve 852 forms.

When screwing in the anchor 820 in the first section of the bone are the spines 834 in a retracted position in the anchor 820 , The actuator 840 is threadedly engaged with the mandrel assembly 830 brought. A screwing tool is guided by the guide 850 which was attached to the second bone section, and through the second section 824 of the anchor 820 used in the sleeve 852 the leadership 850 was added to the actuator 840 to seize and the actuator 840 to turn clockwise. This rotation of the actuator 840 clockwise moves the mandrel assembly 830 in the anchor 820 and drive the spines 834 from the anchor 820 as described above. The spines 834 embed themselves in the first section of bone so that the hold between the anchor 820 and the first bone portion is reinforced.

After extending the mandrels 834 from the anchor 820 becomes the attachment 860 through the mounting hole 856 used, with the attachment 860 by screwing in the second section 824 of the anchor 820 is recorded. The head 862 the attachment 860 makes an operational engagement with the leadership 850 ago. Thus, with further screwing the attachment 860 in the anchor arrangement 810 the leadership 850 in a compression relationship with the armature assembly 810 pulled, so that the second bone portion is joined to the first bone section.

To the surgical fastening arrangement 800 To remove from the body of the patient, a user would be fixing 860 from the anchor assembly 810 decouple. After that, the guide 850 be removed from the second bone section by the screws 880 be removed from the second bone section. To remove the anchor assembly 810 become the spines 834 in the anchor 820 retracted by one of the methods described above. Once the spines 834 in the anchor 820 retracted, the anchor assembly 810 be unscrewed from the first bone section.

The disclosed embodiments illustrate the different ways how the invention can be practically implemented. The person skilled in the art may use other embodiments be realized without departing from the scope of the invention.

Claims (12)

Surgical fastening arrangement ( 800 ) for coupling a first and a second bone portion over a fracture therebetween, comprising: an anchor ( 820 ), wherein the anchor has an external thread extending along a first portion thereof, and the anchor has a longitudinal bore ( 825 ) forms with a longitudinal axis and an oblique or curved surface ( 826A ), which has at least one slot ( 826 ) forms; at least one pen ( 834 ), the first section of the anchor ( 820 ) is operationally assigned, wherein the at least one pin ( 834 ) Is formed of a deformable material and wherein in a driven position of the pin the pin in the longitudinal bore ( 825 ) of the armature and having a straight configuration parallel to the longitudinal axis of the bore, and wherein in an extended position of the pin at least a portion of the pin is extended outwardly from the armature and into contact with the oblique or curved surface through the at least one slot bent configuration is deformed; an actuator ( 840 ), wherein the actuating element in the bore of the armature ( 820 ) and operatively coupled to the at least one pin such that upon actuation of the pin by the actuator, the pin extends upwardly through the at least one slot; a leadership, the leadership ( 850 ) a sleeve ( 852 ), wherein a second section ( 824 ) of the armature is received in the sleeve; and a fastening ( 860 ), the attachment being threadedly engaged in the bore of the anchor and in operative engagement with the guide ( 850 ) stands. A surgical fastener assembly according to claim 1, wherein said at least one pin ( 834 ) from a base ( 832 ), the base ( 832 ) forms an internally threaded bore and the base is movably disposed in the longitudinal bore of the armature. Surgical fastening arrangement according to claim 2, wherein the actuating element ( 840 ) has an external thread along a first portion thereof and wherein the first portion of the actuator ( 840 ) in threaded coupling with the internally threaded bore of the base ( 832 ) stands. A surgical fastener assembly according to any one of claims 1 to 3, further comprising a retainer ( 870 ), wherein at least a portion of the holder is positioned between structures defining the longitudinal bore of the anchor ( 820 ) and the attachment ( 860 ) form. A surgical fastener assembly according to claim 4, wherein the retainer ( 870 ) in the attachment ( 860 ) and wherein the holder is formed of a deformable material. A surgical fastener assembly according to any one of claims 1 to 5, wherein the second portion of the anchor ( 820 ) has a flat portion on an outer circumference of the second portion, and wherein an inner surface forming a bore in the sleeve has a flat surface complementary surface, the flat portion being adapted to be received in the complementary surface when the second portion of the Anchor is received in the sleeve. A surgical fastener assembly according to any one of claims 1 to 6, wherein the at least one pin ( 834 ) has an internally chamfered surface and an outer beveled surface. A surgical fastener assembly according to any one of claims 1 to 7, further comprising a cap disposed at one end of the first portion of the anchor ( 820 ) is attached. A surgical fastener assembly according to any one of claims 1 to 8, wherein 820 ) formed a first portion and a second portion, wherein the first portion has a larger diameter than the second portion and wherein the at least one pin ( 834 ) is arranged in the first section of the bore and wherein the attachment ( 860 ) is threadedly engaged with the second portion of the bore. Surgical fastening arrangement according to one of claims 1 to 9, wherein a shoulder to the longitudinal bore of the anchor ( 820 ) and wherein the actuating element ( 840 ) makes an engagement with the shoulder. A surgical fastener assembly according to any one of claims 1 to 10, wherein a portion of the anchor ( 820 ), which has the at least one slot ( 826 ), which has a curved surface and wherein the internally chamfered surface of the at least one pin ( 834 ) makes engagement with the curved surface when the at least one pin ( 834 ) is moved from the retracted position to the extended position. Surgical fastening arrangement according to one of claims 3 to 11, wherein the actuating element ( 840 ) has a second non-threaded portion having a larger diameter than a diameter of the internally threaded bore of the base ( 832 ) Has.