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CN1750793A - 用于髓内钉的锁紧螺钉 - Google Patents

用于髓内钉的锁紧螺钉 Download PDF

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CN1750793A
CN1750793A CNA038261138A CN03826113A CN1750793A CN 1750793 A CN1750793 A CN 1750793A CN A038261138 A CNA038261138 A CN A038261138A CN 03826113 A CN03826113 A CN 03826113A CN 1750793 A CN1750793 A CN 1750793A
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groove
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P·森
A·施林格
M·比特勒
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AO Technology AG
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    • A—HUMAN NECESSITIES
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
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    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary devices, e.g. pins or nails
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A—HUMAN NECESSITIES
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B2017/8655—Pins or screws or threaded wires; nuts therefor with special features for locking in the bone

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Abstract

锁紧螺钉(1)确定用于具有至少一个横向孔(3)的髓内钉(2)，其中锁紧螺钉(1)具有一纵向轴线(7)、一螺钉杆部(4)和一螺钉头部(6)，所述螺钉杆部至少局部设有外螺纹(5)。螺钉头部(6)的直径大于外螺纹(5)的外径，并且螺钉头部(6)具有一基本上平行于纵向轴线(7)和外螺纹(5)延伸的通道(8)，用来安装纵长楔紧元件(9)。由此可以消除锁紧螺钉(1)和髓内钉(2)之间存在的间隙，并将锁紧螺钉(1)楔紧在髓内钉(2)的横向孔(3)内。

Description

   用于髓内钉的锁紧螺钉
技术领域
本发明涉及一种按权利要求1前序部分的锁紧螺钉。
背景技术
髓内钉的锁紧属于现有技术。或者借助于图像确定法(X光检验)或者借助于一种或多或少复杂的瞄准装置实现将锁紧螺钉插入髓内钉的横向孔内。在这两种情况下无法避免一定的目标精确度，亦即螺钉尖不能精确同心地对准横向孔中心线，而是与它偏离一定的量。为了尽管存在目标误差仍能使锁紧螺钉通入横向孔，并穿过它，螺钉的外径与横向孔的直径相比尺寸选择较小。如果目标精度保持在这个尺寸差范围之内，那么尽管存在目标误差锁紧螺钉仍能穿过横向孔，然而现在锁紧螺钉—由于尺寸减小—与横向孔相比具有一定的间隙。
这个间隙确定，借助于锁紧螺钉固定在相应的锁紧孔内的主碎骨相对于钉，并由此因为钉的刚性也相对于用同一个钉固定的其他主碎骨可以运动多大的量。该间隙与材料和整个装置的柔性累积在一起具有一尺寸，该尺寸妨碍有效愈合或决定性地将其延迟。为了保证锁紧装置对于外科手术的可使用性，这个间隙虽然不可避免，但是在一定的适应症时(例如在干骺端的(metaphysren)碎片的情况下)这对于临床是不希望的。
具有实心横截面的在锁紧孔内可以具有内螺纹的钉本身也不是无间隙的。内螺纹仅仅防止钉会沿锁紧螺钉轴向运动。
发明内容
这里本发明制造一种解决方法。本发明的目的是，创造一种锁紧螺钉，用它可以消除它和髓内钉之间存在的间隙，并且锁紧螺钉可以楔入髓内钉的横向孔内。
本发明用具有权利要求1特征的锁紧螺钉实现所提的目的。
通过本发明达到的优点主要在于，由于按本发明的锁紧螺钉可以消除髓内钉和锁紧螺钉之间的间隙。但是本发明也允许在第一阶段以一定间隙插入螺钉，并在以后才消除间隙。另一个优点是，尽管消除了间隙但没有锁定锁紧螺钉可旋转性，保持旋转可能性的优点是多方面的：
—在间隙减小的状态下，锁紧螺钉也能拧入拧出(轴向自由度)；和
—在锁紧螺钉损坏的情况下可以用螺距技术拔出锁紧螺钉(通过敲出或拉出)。
在本发明一种特殊实施形式中螺钉杆部具有一沿通道方向延伸的第一凹槽，它尤其是具有一部分圆形或多边形横截面。这种结构节省位置，需要较小的压入力，并保证锁紧元件良好的导向。
在另一种实施形式中螺钉杆部具有一基本上平行于第一凹槽设置的、径向错开一旋转角α的第二凹槽，它比第一凹槽深。这里在螺钉杆部上的通道做成长孔，通入两条凹槽中，在两条凹槽之间做一个从第一凹槽上升到第二凹槽的斜坡。旋转角α可以具有一从40°至120°，尤其是从60°至90°的数值。
在这种实施形式中有这样的优点，即可以较迅速地进行楔紧，并且也可以较迅速地松开。在花费(较)小的力时，楔紧力显著提高，因为斜坡为一种传动的形式。因为通过扭矩施加楔紧力，使用者只需要花费较小的力。
在另一种实施形式中随着离螺钉头距离的增加凹槽的横截面尤其是锥形地越来越小。由此一方面产生较快的楔紧或间隙减小，另一方面它又可以较快地松开。
在另一种实施形式中凹槽相对于锁紧螺钉的纵向轴线具有一尤其是小于5°的角度。
凹槽可以具有一相当于螺钉杆部直径1％至50％，尤其是2％至20％之间的深度。
本发明的锁紧螺钉适宜于插入一髓内的骨髓钉(Marknagel)的横向孔内，其中横向孔的直径大于其外螺纹的外径。在纵长的楔紧元件插入通道时锁紧螺钉楔紧在锁紧螺钉杆部和髓内钉横向孔内表面之间。
纵长楔紧元件可以是一尤其是具有横截面逐渐变细的末端的钢丝。锁紧螺钉的通道适宜于具有一与钢丝横截面相对应的孔。
作为另一种选择纵长楔紧元件可以具有一做得与通道横截面相对应和尤其是楔形的横截面轮廓。通道可以做成基本上圆形，具有一0.5至2.0mm，尤其是0.8-1.2mm的直径。纵长楔形件通常具有至少相当于螺钉杆部2/3的长度。纵长的楔紧元件在其一个末端上可以具有一用于螺钉头的止挡。从而防止楔紧元件穿透通道。
通道也可以设有内螺纹。纵长的楔紧元件同样可以带一外螺纹，它与通道的内螺纹相配。
附图说明
下面借助于多个实施例的部分示意图更详细地说明本发明和本发明的改进结构。
附图表示：
图1一带有在螺钉头上的通道和一锁紧元件的锁紧螺钉的透视图；
图2在其横向孔内装入按图1的锁紧螺钉的髓内钉的纵剖图；
图3按图2的髓内钉在其横向孔区域内的转置90°的纵剖面；
图4一变型的带一在螺钉头上的孔和一在螺钉杆部上的纵向槽的锁紧螺钉的透视图；
图5按图4的锁紧螺钉连同一插入螺钉头内的纵长楔紧元件的透视图；
图6按图4的变型锁紧螺钉的放大纵剖视图；
图7按图4的变型锁紧螺钉在髓内钉横向孔区域内的横截面图；
图8带一钥匙形通道和一钥匙形锁紧元件的变型锁紧螺钉的透视图；
图9带两条凹槽的变型锁紧螺钉的透视图；
图10按图9的锁紧螺钉在未楔紧的第一位置时的横截面图；
图11按图9的锁紧螺钉在楔紧的第二位置时的横截面图；
图12按图9的锁紧螺钉连同锁紧螺钉的第一和第二位置的示意横截面图。
具体实施方式
在图1中所示的锁紧螺钉，用来锁紧在图2中所示的髓内钉2，髓内钉具有多个横向孔3。锁紧螺钉1具有一纵向中心线7，并包括一配备外螺纹5的螺钉杆部4以及一带内六角14的螺钉头6，以便能够将锁紧螺钉1拧入髓内钉2的横向孔3内。
螺钉头6的直径大于外螺纹5的外径，其中螺钉头6具有一基本上平行于纵向中心线7和外螺纹5延伸的带有内螺纹15的圆孔形式的通道8，以安装一带有局部外螺纹16和头部一侧的止挡13的锥形收缩的销钉形式的纵长楔紧元件9，其中外螺纹16和内螺纹15相配。楔紧元件9具有大致相当于螺钉杆部4长度2/3的长度。
在图3中表示，楔紧元件9如何能楔紧在横向孔3内表面11和锁紧螺钉1外螺纹5的外径之间。其前提是这样的状况，即外螺纹5的外径小于横向孔3的直径。
如图2和5中所示，纵长楔紧元件9在其后端具有一止挡13，因此不能将其继续推入螺钉头6内。由此防止，楔紧元件9进入髓内钉内。
在图4至7中表示锁紧螺钉1的一种变型方案，其中螺钉杆部4具有一与通道8(具有通常为1mm直径的圆孔的形式)对齐的具有部分圆形横截面的凹槽10，凹槽10随着离螺钉头6的距离的增加锥形缩小。凹槽10具有一相当于螺钉杆直径5％的深度。在这个变型方案中同样锥形收缩的楔紧元件9在横向孔3内表面11和凹槽10的内表面之间楔紧。
图8中表示锁紧螺钉1的另一种变型方案，其中通道8以钥匙形槽的形式实现，以安装一杆形式的纵长楔紧元件9，该杆在其头部一侧的末端具有一钥匙形轮廓22，它相应于钥匙形槽。由于钥匙形轮廓22的形状防止楔紧元件9相对于通孔8旋转。
在图9至12中表示锁紧螺钉1的另一种实施形式。在这种变型方案中螺钉杆部4除了第一凹槽10以外还具有一平行于第一凹槽10延伸的、径向错开一50°的旋转角度α的第二凹槽16，它比第一凹槽10更深。这里第一凹槽10通过一楔形斜坡18与第二凹槽16连接。这里螺钉头6上的通道8做成相应于斜坡18几何形状的长孔，两条凹槽10、16通入此长孔内，使得纵长锁紧元件9既可以定位在第一凹槽10又可以定位在第二凹槽16内。
通过锁紧螺钉1沿箭头17方向(顺时针)旋转，位于第二凹槽16内的纵长锁紧元件9(图10中的未楔紧位置)沿比较平的楔形斜坡18滑动直至该锁紧元件陷入较浅的第一凹槽10内(图11中的楔紧位置)。通过比较陡的轮廓19和相对于两条凹槽10、16之间的两个位置20和21的升高防止纵长锁紧元件从第一凹槽10滑回第二凹槽16。这时纵长锁紧元件9在长孔8内的位置21向位置20运动(图9)。
通过锁紧螺钉1沿箭头23方向(逆时针)旋转，位于第一凹槽10中的纵长锁紧元件9(图11中的楔紧位置)重新掉入第二凹槽16(图10中的未楔紧位置)，因此重新消除锁紧螺钉1的夹紧。
如图12中所示，各个构件的尺寸选择最好应该如下：
—在位置21(虚线)纵长锁紧元件9的中点和螺钉杆部4的中点之间的距离为r1；
—在位置20(细实线)纵长锁紧元件9的中点和螺钉杆部4的中点之间的距离为r2，r2＞r1；
—纵长锁紧元件9的直径为dp；
—螺钉杆部4外螺纹5的半径为rs；
—横向孔3的直径为rb，其中rb≥rs；
—如果和值[(rs-N2t+dp)+rs]大于或等于2rb，其中N2t表示在位置20时的槽深，那么便得到所希望的压配合，或者在螺钉杆部4的外螺纹5、纵长锁紧元件9和髓内钉的横向孔3之间的间隙减小。

Claims (18)

1.一种用于带至少一个横向孔(3)的髓内钉(2)的锁紧螺钉(1)，其中锁紧螺钉(1)具有一纵向轴线(7)并包括以下部分：
A)一螺钉杆部(4)，它至少局部地设有外螺纹(5)；以及
B)一螺钉头部(6)，其直径大于外螺纹(5)的外径，
其特征为：
C)螺钉头部(6)具有一基本上平行于纵向轴线(7)和外螺纹(5)延伸的通道(8)，用来安装一纵长楔紧元件(9)。
2.按权利要求1的锁紧螺钉(1)，其特征为：螺钉杆部(4)具有一沿通道(8)方向延伸的、尤其是具有部分圆形或多边形横截面的第一凹槽(10)。
3.按权利要求2的锁紧螺钉(1)，其特征为：螺钉杆部(4)具有一基本上平行于第一凹槽(10)设置的、径向错开一旋转角α的第二凹槽(16)，该第二凹槽比第一凹槽(10)深，并且在螺钉头部(6)的通道(8)做成长孔，两条凹槽(10，16)通入此长孔内。
4.按权利要求3的锁紧螺钉(1)，其特征为：旋转角α具有40°至120°，尤其是60°至90°的值。
5.按权利要求3或4的锁紧螺钉(1)，其特征为：在两条凹槽(10，16)之间设置一从第一凹槽(10)上升到第二凹槽(16)的斜坡(18)。
6.按权利要求1至5之任一项的锁紧螺钉(1)，其特征为：凹槽(10，16)随着离螺钉头部(6)距离的增加在横截面上尤其是锥形地缩小。
7.按权利要求1至6之任一项的锁紧螺钉(1)，其特征为：凹槽(10，16)相对于纵向轴线(7)具有一角度，该角度最好小于5°。
8.按权利要求1-7之任一项的锁紧螺钉(1)，其特征为：该锁紧螺钉插入一髓内钉(2)的横向孔(3)内，其外螺纹(5)的外径小于横向孔(3)的直径。
9.按权利要求8的锁紧螺钉(1)，其特征为：在该锁紧螺钉的通道(8)内插入一纵长楔紧元件(9)，该楔紧元件可在锁紧螺钉(1)的螺钉杆部(4)和髓内钉(2)横向孔(3)的内表面(11)之间楔紧。
10.按权利要求9的锁紧螺钉(1)，其特征为：纵长楔紧元件(9)是一尤其是具有横截面逐渐减小的末端(12)的钢丝，并且通道(8)是一尤其是与钢丝横截面相对应的孔。
11.按权利要求9或10的锁紧螺钉(1)，其特征为：纵长楔紧元件(9)具有与通道(8)横截面轮廓相对应的横截面轮廓，并最好做成楔形。
12.按权利要求1至11之任一项的锁紧元件(1)，其特征为：通道(8)基本上做成圆形，并具有0.5-2.0mm，尤其是0.8-1.2mm的直径。
13.按权利要求9至12之任一项的锁紧螺钉(1)，其特征为：纵长楔紧元件(9)具有相当于螺钉杆部(4)的至少2/3的长度。
14.按权利要求9至13之任一项的锁紧螺钉(1)，其特征为：纵长楔紧元件(9)在其一个末端上具有一用于螺钉头部(6)的止挡(13)。
15.按权利要求1至14之任一项的锁紧螺钉(1)，其特征为：第一凹槽(10)具有相当于螺钉杆部(4)直径1％至50％，尤其是2％至20％之间的深度。
16.按权利要求1至15之任一项的锁紧螺钉(1)，其特征为：槽的深度N1t这样确定，使纵长楔紧元件(9)相对于横向孔(3)可以一定间隙插入第二凹槽(16)内。
17.按权利要求1至16之任一项的锁紧螺钉(1)，其特征为：所述通道(8)设有内螺纹(15)。
18.按权利要求9至17之任一项的锁紧螺钉(1)，其特征为：纵长楔紧元件(9)带一与通道(8)的内螺纹(15)相配的外螺纹(16)。
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CN108488191A (zh) * 2018-06-27 2018-09-04 浙江洪扬汽车零部件有限公司 一种防松横孔螺母
CN108488191B (zh) * 2018-06-27 2024-02-06 浙江洪扬汽车零部件有限公司 一种防松横孔螺母
CN118750128A (zh) * 2024-07-23 2024-10-11 山东迈尔医疗科技有限公司 一种骨科创伤用颅颌面接骨螺钉

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US20060064095A1 (en) 2006-03-23
BR0318151A (pt) 2006-02-21
AU2003206600B2 (en) 2007-08-23
KR100982598B1 (ko) 2010-09-15
JP2006514238A (ja) 2006-04-27
EP1601297B1 (de) 2013-07-17
CA2518319A1 (en) 2004-09-16
JP4579697B2 (ja) 2010-11-10
EP1601297A1 (de) 2005-12-07
CA2518319C (en) 2011-05-10
WO2004078049A1 (de) 2004-09-16
US8888779B2 (en) 2014-11-18
EP2263584A3 (de) 2011-04-27
NZ542173A (en) 2008-01-31
EP2263584A2 (de) 2010-12-22
AU2003206600A1 (en) 2004-09-28
EP2263584B1 (de) 2012-09-05
CN100384384C (zh) 2008-04-30

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