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TW477687B - Bone plating system - Google Patents

Bone plating system Download PDF

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Publication number
TW477687B
TW477687B TW089118602A TW89118602A TW477687B TW 477687 B TW477687 B TW 477687B TW 089118602 A TW089118602 A TW 089118602A TW 89118602 A TW89118602 A TW 89118602A TW 477687 B TW477687 B TW 477687B
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Taiwan
Prior art keywords
bone
bone plate
screw
plate
patent application
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TW089118602A
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English (en)
Inventor
Paul C Weaver
Jeff W Mast
Keith A Mayo
Brett R Bolhofner
David Little
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Synthes Ag
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8052Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
    • A61B17/8057Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded the interlocking form comprising a thread
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/8625Shanks, i.e. parts contacting bone tissue
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S606/00Surgery
    • Y10S606/902Cortical plate specifically adapted for a particular bone

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Molecular Biology (AREA)
  • Public Health (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Neurology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Apparatus For Radiation Diagnosis (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Prostheses (AREA)
  • Laminated Bodies (AREA)
  • Medicines Containing Material From Animals Or Micro-Organisms (AREA)

Description

477687 經濟部智慧財產局員工消費合作社印製 A7 B7 五、發明說明(丨) 本發明係針對用於骨折固定之用的一個骨板連結系統 ,且特別是包含一個骨板的一個系統,該骨板係具有用於 鎖合及非鎖合螺絲用的板孔。 用於骨折的內固定法的骨板及螺絲系統的成效在臨床 上被證實。然而,某些骨折的治療,例如關節周緣的骨折 ’其需要在骨板及螺絲間保持一個固定的角度,仍有問題 的。 用於治療這些骨折的固定角度裝置是可購得的,且包 含動態課關節螺絲系統可自Synthes (USA) of Paoli,PA購 得及各式的肩胛骨骨板。這些所有裝置需要高階的外科技 能’適當的骨量及骨質,及一個與該裝置相符的骨折型式 〇 如果無法滿足這些的需求時,例如:嚴重粉碎性骨折 或遺失的骨碎片,傳統的骨板及螺絲系統必須被使用。雖 然這些傳統的系統特別地適用於提昇骨折的修復,其係藉 ) ^ 由一倂壓緊該骨折斷面及將骨拉近與其它碎片及該骨板同 列處,介於骨板及螺絲間的角度關係並不固定且於手術後 會改變。上述會導致失準與不良之臨床效果 用於改變角度的主要機構係與能量的儲存有關。如上 所述,一個鑽入骨內的骨釘將骨壓在骨板上。該壓力導致 於骨內的高應力且,因此產生能量的儲存。由於生理況態 下導致的動態負荷下,可能產生骨板及螺絲的鬆動及儲存 能量的損失。 固定在骨板的該螺絲提供一個介於骨板及螺絲間的固 4 本紙張尺度適用中國國家標準(CNS)A4規格(210 X 297公釐) ^-------^---------^ (請先閱讀背面之注意事項再填寫本頁) 477687 A7 B7 五、發明說明(V) 定角度關係,以及降低鬆動的發生率。固定骨板上的螺絲 的方法,係與所謂的“鎖合螺絲”的使用相關。一個鎖合 (請先閱讀背面之注意事項再填寫本頁) 螺絲頭的外表面具有螺紋,其與在板孔表面對應的螺紋是 相配合的,以使螺絲鎖住骨板。具有螺孔的骨板係爲配合 已知的鎖合螺絲。例如,德國專利申請案編號43 43 1 17 揭露一用於鎖定螺絲之帶有螺孔的骨板。當鎖合螺絲及板 間的關係被固定時,鎖合螺絲提供一個對剪力及扭力的高 抵抗力。然而,鎖合螺絲對於壓住骨碎片的能力是有限的 〇 41之,傳統骨螺絲,即該螺絲無法固定骨板,使得於 該骨板與該螺絲之間維持在一個固定的角度關係(以下稱 “非鎖合螺絲”)且有效地壓住骨碎片,然而其對導致螺 絲鬆動的剪力具有低抵抗力。鎖合螺絲對於剪力具有高抵 抗力,以確保骨螺絲/板孔界面的穩定性,但是對於壓住 骨碎片的能力是有限的。於是,一骨板連結系統結合非鎖 合螺絲及鎖合螺絲,用於某些臨床狀況可能是較理想的。 經濟部智慧財產局員工消費合作社印製 美國專利編號5,601,553揭露一個鎖合板及骨螺絲。 該板具有複數個螺孔以容納鎖合螺絲。該板亦具有用於容 納臨時螺絲的非螺紋板孔,當鎖合螺絲插入時,以保持該 板於適當位置。在該鎖合螺絲被插入後,該臨時螺絲才被 移去。至此,將非鎖合螺絲結合鎖合螺絲的長期效益尙未 得到。 美國專利編號5,709,686揭露一個具有部份螺紋孔的 骨板。該部份螺紋孔容許使用非鎖合螺絲及鎖合螺絲。因 5 本紙張尺度適用’中國國家標準(CNS)A4規格(210 X 297公爱) 經濟部智慧財產局員工消費合作社印製 477687 、 A7 B7 五、發明說明(々) 爲該板孔僅具有部份的螺紋,使用的該鎖合螺絲在承受生 理負荷下,可能無法保持介於螺該絲及骨板間的固定角度 關係。特別地,在該板內的鎖合螺絲僅有部份被控制,且 因此僅部份置於螺紋中。在承受高應力及負荷狀況下,該 鎖含板孔可能被扭曲且容許介於該鎖合螺絲及該骨板間的 固定角度被改變。此將導致裝置的損壞或已完成的手術內 骨板方位的破壞。另外地,因爲骨板孔的幾何形狀,具有 非鎖合螺絲的骨板的轉動被僅限於一個方向。此可能在降 低及操控骨碎片的一個缺點。因此,爲了改進骨板連結系 統之需要,其必須克服之前技能的不足。 依據本發明,用於固定骨的骨板連結系統包含一個骨 板,其包含一骨板,該骨板具有一個上表面、一個骨接觸 面、至少一個穿過上表面至骨接觸面且具有螺紋的第一孔 、及至少一個穿過上表面至骨接觸面的第二孔。骨板連結 系統亦包含一個第一螺絲,該第一螺絲具有一用於連接骨 的帶有螺紋的軸,及一個具有螺紋的頭,其螺紋的形狀與 尺寸與第一孔的螺紋相合,及一個第二螺絲,該第二螺絲 具有一用於連骨的帶有螺紋的軸及一個頭。實質上,只要 骨板被植入時,該第一及第二螺絲仍位於其相對螺孔。較 佳地,該骨板包含:一複數個第一及第二孔,且提供一複 數個相對應的第一及第二螺絲。 爲了順利插入,該第一及第二螺絲可能是一個自攻螺 絲。這些螺絲亦可能爲一自鑽孔螺絲。另外,該第一及第 二螺絲可能被插入導線以控制螺絲的位置。該第一板孔可 6 本紙張尺度適用中國國家標準(CNS)A4規格(210 X 297公釐) ------------.· J—------訂---------線 (請先閱讀背面之注意事項再填寫本頁) 477687 經濟部智慧財產局員工消費合作社印製 A7 五、發明*說明(+) 能具有一個帶有雙導螺紋大致爲圓錐形狀。 在一個實例說明中,該骨板在介於該第一及第 間的區域具有一個梯形的橫斷面,係爲使骨與該骨接觸面 最小化。另外,該第二板孔至少其中之一是縱向延長的, 且具有一個斜邊,其角度自上表面朝向骨接觸面,當第二 螺絲頭被鎖合時,用於移開骨板。 ,在一個較佳實例說明中,該骨板包含:一個形狀與尺 寸與骨幹后端相合的頭部,及一個形狀及尺寸與骨幹相合 的軸部。該頭部僅具有第一板孔,並且該軸部具有第一及 第二板孔。頭部具有一個彎曲表面,包含:大致與該軸部 的前面平行的一個前叉,及包含自該軸部的後面延伸出來 的一個後叉。 依據本發明,該骨折固定裝置的方法包含的步驟爲: 降低骨折以將骨碎片帶至同位處;將一骨板壓在具有至少 一個第一固定器的骨上以保持骨折復原;且固定至少一個 第二固定器相對於骨板成一個固定的角度關係。第一固定 器在該第二固定器之前被插入,且只要骨板被植入時,該 第一及第二固定器兩者實際上仍在骨內。 主要圖示之說明 圖示1係依據本發明之一個非鎖合螺絲的實例說明的 側視圖。 圖示2係依據本發明之一個鎖合螺絲的實例說明的側 視圖。 * , 圖示3係依據本發明之一個骨板部分的透視圖。 7 本紙張尺度適用中國國家標準(CNS)A4規格(210 X 297公釐) fi — (請先閱讀背面之注意事項再填寫本頁) 訂---------線乂 477687 經濟部智慧財產局員工消費合作社印製 A7 B7 五、發明說明(>) 圖示4爲圖示3之其中一個第一板孔的剖面視圖。 s圖示5爲圖示3.之其中一個第二板孔的剖面視圖。 圖示6爲圖示5之第二板孔的另一個剖面視圖。 圖示7係依據本發明設計用於股骨未端的一個骨板的 實例說明的上視圖。 圖示8爲圖示7的骨板的側視圖° 圖示9爲圖示7植入股骨未端處的骨板的透視圖。 圖示1〇爲具有各種橫斷面標示之圖示7的骨板的上 視圖。 ‘圖示1 1爲圖示7中剖線A-A的骨板的剖面圖。 .圖示1 2爲圖示7中剖線B-B的骨板的剖面圖。 圖示1 3爲圖示7中剖線C-C的骨板的剖面圖。 圖示1 4爲圖示7中剖線D-D的骨板的剖面圖。 圖示1 5爲圖示7中剖線E-E的骨板的剖面圖。 圖示1 6爲圖示7中剖線F-F的骨板的剖面圖。 圖示1 7爲圖示7中剖線G-G的骨板的剖面圖。 圖示1 8爲圖示7中剖線H-H的骨板的剖面圖;及 *圖示1 9爲圖示7中剖線I-Ι的骨板的剖面圖。 元件圖號說明 10 鎖合螺絲 12 無螺紋頭 1 4 .軸 ι/ 16 尖端 .· ^---------------- (請先閱讀背面之注意事項再填寫本頁) 本紙張尺度適用中國國家標準(CNS)A4規格(210 X 297公釐) 477687 、 A7 B7 經濟部智慧財產局員工消費合作社印製 五、發明說明( 2 0 2 2 2 4 2 6 2 8 3 0 3 2 3 4 3 6 3 8 4 0 4 2 4 4 5 0 5 2 5 4 5 6a 5 6、 6 0 6 2 6 4 6 6 6 8 7 0 鎖合螺絲 螺絲頭 螺紋 軸 尖端 骨板\ 上表面 骨接觸面 第一板孔 第二板孔 邊 斜坡 骨板 上表面 骨接觸面 、5 6 b、5 6 c 58 非螺紋板孔 頭部 軸部 前叉 前側面 後叉 後面
螺紋板孔 (請先閱讀背面之注意事項再填寫本頁) 本紙張尺度適用中國國家標準(CNS)A4規格(210 X 297公釐) 477687 經濟部智慧財產局員工消費合作社印製 A7 B7 五、發明說明(q ) 7 2 尾端 較佳實例說明 依據本發明之骨板連結系統包含:一個骨板、非鎖合 螺絲、及鎖合螺絲。圖示1爲一個非鎖合螺絲1 〇的範例 ,其被本發明所利用。一般而言及如下詳述,任何手術用 螺豨係爲配合所選擇的骨板的板孔,其具有一個適當的尺 寸及形狀的無螺紋頭1 2。非鎖合螺絲1 0具有一個軸1 4,其至少有部份螺紋用於連骨之用。軸1 4的長度及軸 螺紋的形狀可能因特別的應用上而選定。如熟知的先前技 藝中,該螺紋及一個尖端1 6可被製成自攻螺紋及/或自 動鑽孔,以順利移植。軸1 4亦可被插入一個導管,係用 於容納一條導線以協助其位於適當的位置。 圖不2爲本發明所用之一個鎖合螺絲2 0的範例。一 般两言及如下所詳述,任何手術用的具有一帶有螺紋2 4 的螺絲頭2 2之螺絲係可被使用的,只要螺絲頭2 2的尺 寸及形狀適於所選擇的該骨板的板孔,且螺紋2 4與該板 孔的螺紋相合。鎖合螺絲2 0具有一個軸2 6,其至少部 分的螺紋以用於連骨之用。軸2 6的長度及軸螺紋的形狀 可爲了特別的應用而作選擇。如熟知的先前技藝中,該螺 紋及一個尖端2 8可被製成自攻螺紋及/或自動鑽孔’以 順利移植。軸2 6可被插入導管,以容納一條導線。 圖示3係依據本發明所示之骨板3 0的一個部分。骨 板3 0可被製成不同的形狀及尺寸以使用於各種臨床的應 10 本紙張尺度適用中國國家標準(CNS)A4規格(210 X 297公釐) ;τ------訂---------線 (請先閱讀背面之注意事項再填寫本頁) 477687 經濟部智慧財產局員工消費合作社印製 A7 B7 五、發明說明u ) 用中。骨板3 0包含一個上表面3 2及一個骨接觸面3 4 。骨板3 0具有一複數個第一板孔3 6及一複數個第二板 孔3 8。每個第一及第二板孔3 6、3 8橫穿過上表面3 2與骨接觸面3 4。每個第一板孔3 6具有螺紋4 0,該 螺紋4 0與在鎖合螺絲2 0的頭2 2上的螺紋2 4相合, 以固定鎖合螺絲2 0與骨板3 0在一個暫時地固定的角位 置。第二板孔3 8不具螺紋,且容納帶有無螺紋螺絲頭1 2的非鎖合螺絲1 〇。非鎖合螺絲1 〇插入第二板孔3 8 ,將骨拉向骨接觸面3 4以壓住骨。因此,在第二板孔3 8中的非鎖合螺絲1 〇的定位,將骨壓在骨接觸面3 4, 且在第一板孔3 6的鎖合螺絲2 0的定位,固定螺絲頭2 2及骨板3 0,以在鎖合螺絲2 0及骨板3 0間維持一個 固定角度關係。骨板3 0同時使用非鎖合螺絲及鎖合螺絲 1 0、2 0,只要骨板3 0被植入時,提供在螺絲與骨板 之間及骨板與骨之間的穩定性。當非鎖合螺絲1 0 —般被 固定在鬆質骨中時,在軸1 4的該螺紋上一般較鎖合螺絲 2 0的軸2 6上的螺紋長。 ‘較佳地,第一板孔3 6形狀係爲圓錐形。如圖示4所 示,較佳地,在第一板孔3 6上的螺紋4 0亦是雙導螺紋 。當維持一個較低的位置時,該圓錐形雙導螺紋與多螺紋 嚙合。另外,該圓錐形雙導螺紋比其他的螺紋較不易接受 橫向螺紋,例如,圓柱螺紋裝置。 如最佳圖示5及6中,較佳地,第二板孔3 8是動態 壓縮裝置(SCU )螺孔,實際上類似美國專利案編號 11 > , 紙張尺度適用中國國家標準(CNS)A4規格(210 X 297公 .· ^-------訂---------線 (請先閱讀背面之注意事項再填寫本頁) 經濟部智慧財產局員工消費合作社印製 477687 A7 _____B7___ 五、發明說明(1 )
Re.31,628由Allgower等人所揭露的螺孔,其內容於此被 倂入參考。該動態壓縮裝置(DCU)螺孔藉由將骨碎片一 起壓擠以提高骨的復原。簡言之,第二板孔3 8具有一個 邊4 2,該邊4 2包含一個斜部或是具有一個傾角的斜坡 4 4,使得當該斜坡4 4與非鎖合螺絲1 0的頭1 2的內 側接合,骨板3 0被推向一側以移動斜坡4 4遠離非鎖合 螺絲1 0,且引起骨板3 0施壓於支撐骨折碎片成緊密的 接合狀態。 在骨板3 0上的骨接觸面3 4被塑成與骨的接觸面最 小化。在骨板及骨間有限的接觸具有許多的生理的及機械 的優點,包含降低對血液供給的損害及較易於骨板的移除 。提供具有梯形橫斷面(圖示1 1 )的骨板3 0在介於第 一及第二板孔3 4、3 6之間的區域,是使接觸最小化的 一種方法。其他於美國專利編號5,151,103、5,053,036、 5,〇〇2,544、及4,838,252中被揭露的方法。這些專利的內 容於此被一倂參考。 藉由結合鎖合螺絲及非鎖合螺絲在同一個骨板上,本 發明提供一個新型的混合式固定。使用該非鎖合螺絲,骨 折復原係由骨板與骨間的摩擦所抑制。該摩擦係由鎖緊骨 內的非鎖合螺絲而產生。然而,在非鎖合螺絲及骨間的微 動作導致骨的耗損及復原降低。另外,非鎖合螺絲的插入 需要骨忍受螺絲鎖緊的應力。此將導致骨內非鎖合螺絲周 緣處的高應力。一般地,高應力可能引起非鎖合螺紋磨損 (骨內螺紋被剪力破壞)且/或在骨內潛變(因骨爲黏彈 12 本紙張尺度適用中國國家標準(CNS)A4規格(210 X 297公釐) €衣··:-------訂---------線^|^· (請先閱讀背面之注意事項再填寫本頁) 477687 經濟部智慧財產局員工消費合作社印製 A7 五、發明說明(β ) 性物質)。這些現象亦將降低復原。 藉由增加至少一個鎖合螺絲,復原的損失藉由本昼明 將被減至最小或裹刪除。特別地,藉由固定鎖合螺絲與骨 板而非骨’㈢的黏彈性行爲的影響被降低,螺紋不會磨損 ’且可避免微動作。.介於鎖合螺絲及骨板間有堅固的連結 ’其鎖合螺絲必須由側向切穿骨頭而遭破壞。 某些關節周緣骨折的裝置一般與螺絲插入後相對於骨 板的角度有關’且非常需要維持在各個螺絲及骨板間該起 始角度的關係,依據本發明之骨板連結系統特別適用於這 些臨床應用。圖示7 - 1 9係依據本發明特別設計用於股 骨未端的一個骨板5 〇。骨板5 〇主要用於,但是不限定 ,嚴重的粉碎性骨折,包含Hoffa型骨折。 *骨板5 0具有一個上表面5 2及一個骨接觸面5 4。 骨板5 0具有複數個用於容納鎖合螺絲2 〇的螺紋板孔5 6 a、5 Θ b、5 6 c (統稱爲螺紋板孔5 6 ),及複數 個用於容納非鎖合螺絲1 〇的非鎖合螺紋板孔5 8。每個 螺紋板孔及非螺紋板孔5 6、5 8穿過上表面5 2及骨接 觸面5 4。當用於骨板3 〇的例子中,於板孔5 6的螺紋 與鎖合螺絲2 0的螺紋頭2 2相合,以固定鎖合螺絲2 0 與骨板5 Q成一個暫時地固定角位置,且非鎖合螺絲1 〇 插入無螺紋板孔5 8時,將骨拉向骨接觸面5 4以壓迫骨 〇 骨板5 0包含一個形狀與尺寸與股骨未端的骨髁相合 的頭部6 0,及一個形式與尺寸與骨的骨幹相合的軸部6 13 .· ^-------^---------^ Awl ----r (請先閱讀背面之注意事項再填寫本頁) 本紙張尺度適用中國國家標準(CNS)A4規格(210 X 297公爱) 經濟部智慧財產局員工消費合作社印製 477687 A7 B7 五、發明說明(Λ ) 2。由圖示8中可最淸楚看出,頭部6 0的骨接觸面5 4 是曲面,其與股骨東端的輪廓面吾。頭部6 〇包含大 致與軸部份6 2的前側面6 6平行的前叉6 4,及一個自 軸部份6 2的後面7 0側向延伸出來的後叉6 8。 較佳地,非鎖合板孔5 8是動態壓縮裝置(DCU)螺孔 ,實際上與第二板孔3 8相似。軸部份6 2具有螺紋板孔 5 6 a及非螺紋板孔5 8兩者,使得鎖合螺絲及非鎖合螺 絲Μ者可被使用於軸部6 2。使用在軸部份6 2的鎖合螺 絲是特別有益的,當骨幹的遠端皮質部份不見或嚴重的損 壞因此由於遠端皮質的狀態而用非鎖合螺絲固定係有問題 的。在圖示1 1中最淸楚看出,在螺紋板孔及非螺紋板孔 5 6 a、5 8間之區域具有一個梯形的橫斷面,其接觸僅 限於在軸部分6 2的骨接觸面5 4及股骨之間。軸部分6 2結束於一個漸減的尾端72(圖示19)。 比照軸部分6 2,頭部6 0僅含螺孔5 6。特別地, 螺板孔5 6 b圍繞著一個中心位置的螺紋板孔5 6 c。螺 紋板孔5 6 c相較於螺紋孔5 6 b具有一個大直徑,以容 納一個具有大直徑的鎖合螺絲,例如,螺紋板孔5 6 b具 有5公厘的直徑及螺紋板孔5 6 c具有7.3公厘的直徑。 圖不12 — 18係爲各螺紋孔56b、56c的各種夾角 方位。一般而言,螺孔5 6 b、5 6 c的排列,使得插入 的鎖合螺絲集中朝向彼此。需要注意,如果外科醫師決定 ,非鎖合螺絲可能被用於任意的螺紋板孔5 6。最後,需 要注意其骨板5 0具有許多的構造,與自美國賓州Synthes 14 本紙張尺度適用中國國家標準(CNS)A4規格(210 x 297公釐) '· ^-------^---------線: (請先閱讀背面之注意事項再填寫本頁) 477687 A7 Γ37 五、發明說明(lv) of Paoli購得的骨髁支持板是不同。例如,骨髁支持板的頭 的外形分爲於縱向及橫向兩種,蕾骨板5 〇的頭部 於縱向的輪廓,以用於較多的結構上的配合。另外,尾端 7 2具有一個高起的端部,以深入組織的底下。 雖然明顯地本發明於此所揭露的圖示實施例說明達成 上述的目標,但是可以瞭解有許多的修正及其他的實施例 對熟悉該項技藝之人士可以被想出。例如,對於一些骨折 僅需要一個第一板孔及第二板孔,雖然至少各兩個是有利 的。而且’附加的無螺紋的板孔可能出現在骨板上,若有 其需要時’可使外科醫師在使用上更具彈性。因此,可以 瞭解所附之申請專利範圍企圖將含括所有修正及實施例, 其將在本發明的範圍內。 (請先閱讀背面之注意事項再填寫本頁) --訂---------線 經濟部智慧財產局員工消費合作社印製 本紙張尺度適用+國國家標準(CNS)A4規袼(21〇 χ 297公釐)

Claims (1)

  1. 477687 經濟部智慧財產局員工消費合作社印製 A8 S D8 六、申請專利範圍 1、一個用於固定骨的骨板連結系統,其包含: 一個骨板(3 0 ; 5 o r具有: 一個上表面(3 2 ; 5 2 ); 一個骨接觸面(3 4 ; 5 4); i .."" · 至少一個第一孔(3 6 ; 5 6 )其穿過上表面及骨接 觸面(32;52;3 4;54)且具有螺紋;且 至少一個第二孔(3 8 ; 5 8 )其穿過上表面及骨接 觸面(32;52;34;54); 一個用於連結骨的具有螺紋的軸(14)的第一螺絲 ,及一個帶有螺紋的頭,其螺紋的形狀及尺寸與第一孔( 3 6 ; 5 6)的螺紋相合;且 一個第二螺絲具有用於連骨的螺紋的軸(1 4),及 一個頭(1 2), 其中第一及第二螺絲仍位於其各別的孔內(3 6 ; 5 6 ; 3 8 ; 5 8),用於實際上該骨板被植入時。 立、如电請專利範圍第1項的i:t板連結系統,其中骨板( 3 0 ; 5 0)包含一複數個第一及第二孔(3 6 ; 5 6 ; 3 8 ; 5 8),且提供一複數個相對應的第一及第二螺絲 〇 3、 如申請專利範圍第1項的骨板連結系統,其中該第_ 螺絲爲一個自攻螺絲。 4、 如申請專利範圍第3項的骨板連結系統,其中該第_ 螺絲爲一個自動鑽孔螺絲。 5、 如申請專利範圍第1項的骨板連結系統,其中該第_ __ 1 本G張尺度適用中國國家標準(CNS ) A4規格(210X297公釐) ' ----- (請先閱讀背面之注意事項再填寫本頁) € 訂 線 477687 A8 B8 C8 D8 六、申請專利範圍 螺絲被導管插入用於插入導線,以導引螺絲的配置。 6、 如申請專利範圍第Γ項时曹板連結系兢,-其中該第二 螺絲是一個自攻螺絲。 7、 如申請專利範圍第1項的骨板連結系統,其中該第一 板孔(3 6 )具有一大致爲圓錐的形狀。 8 '如申請專利範圍第7項的骨板連結系統,其中該第一 板孔(3 6 ; 5 6 )具有一個雙導螺紋。 9、如申請專利範圍第1項中骨板連結系統,其中該骨板 (3 0 ; 5 0 )在第一板孔及第二板孔(3 6 ; 5 6 ; 3 8 ; 5 8 )間的區域具有一個梯形的橫斷面,以使骨與骨 接觸面(3 4 ; 5 4)間的接觸最小化。 1 〇、如申請專利範圍第2項的骨板連結系統,其中該第 二骨板孔(3 8 ; 5 8)至少其中之一是縱向延長的且具 有一邊(4 1 )由上表面傾向骨接觸面形成一個斜角,當 連結一個第二骨螺絲的頭時,用於移開該骨板(3 0 ; 5 0 )之用。 1 1、如申請專利範圍第2項的骨板連結系統,其中該骨 板(5 0 )包含一個形狀及尺寸與骨髁后相合的頭部(6 0),及一個形狀與尺寸與骨幹相合的軸部(6 2)。 1 2、如申請專利範圍第1 1項的骨板連結系統,其中該 頭部份(6 0)僅具有第一板孔(5 6)。 1 3、如申請專利範圍第1 1項的骨板連結系統,其中該 軸部(6 2)具有第一及第二板孔(5 6 ; 5 8)兩者。 1 4、如申請專利範圍第1 1項的骨板連結系統,其中該 2 本紙張尺度適用中國國家標準(CNS ) A4規格(210X297公釐) (請先閱讀背面之注意事項再填寫本頁) 訂 線 經濟部智慧財產局員工消費合作社印製 477687 Λ8 B8 C8 D8 六、申請專利範圍 頭部(6 Ο )具有一個曲面,包含大致與軸部(6 2 )的 前側平行的一個前叉,及包含自軸部(6 2 )的後惻延伸 出來的一個後叉。 1 5、如申請專利範圍第1 1項的骨板連結系統,其中該 軸在第一及第二螺孔(5 6 ; 5 8 )間的區域具有一個梯 形的橫斷面,用於使骨與骨接觸面(5 4 )間的接觸最小 化。 一 1 、一種用於量近里定的^^,其包含的步驟爲: 同一位置上減少骨折所導致的骨碎片; 將骨板(3 0 ; 5 0 )壓在具有至少一個第一固定器 的骨上,以支撐骨拆 固定至少一個 成一個固定角度 其中至少一個 ^第
    :且 定器,其與骨板(3 0 ; 5 0 ) 定器在至少一個第二固定器之前 被插入,且至少一個第一固定器及至少一個第二固定器維 持在骨內,以實際上只要骨板(3 0 ; 5 0)被植入時。 經濟部智慧財產局員工消費合作社印製 3 本紙張尺度適用中國國家標準(CNS ) A4規格(210X 297公釐)
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US20040059335A1 (en) 2004-03-25
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