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JP3692216B2 - Bioprosthesis - Google Patents

Bioprosthesis Download PDF

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Publication number
JP3692216B2
JP3692216B2 JP20632397A JP20632397A JP3692216B2 JP 3692216 B2 JP3692216 B2 JP 3692216B2 JP 20632397 A JP20632397 A JP 20632397A JP 20632397 A JP20632397 A JP 20632397A JP 3692216 B2 JP3692216 B2 JP 3692216B2
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Japan
Prior art keywords
bone
shaft portion
hole
auxiliary plate
bioprosthesis
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Fee Related
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JP20632397A
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Japanese (ja)
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JPH1147170A (en
Inventor
秀之 宮島
勝 上野
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Kyocera Corp
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Kyocera Corp
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/38—Joints for elbows or knees
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)

Description

【０００１】
【発明の属する技術分野】
本発明は事故や疾病等による骨欠損部、切除部を補綴するために用いる生体用補綴体に関するものである。
【０００２】
【従来の技術】
従来から用いられている天然骨と補綴部との結合体としての、人工補整器は主にＣｏ−Ｃｒ−Ｍｏ合金やステンレス、セラミック材でもって構成したものがある。
【０００３】
例えば、図４に示すように骨Ｂの髄腔ｂ中に軸部ａを挿入し、段部にて骨Ｂの端面を当接させ、かつセメントＣを用いて固定するようにした補綴体Ａがあった。
【０００４】
【従来技術の課題】
ところが、一般に骨置換による外科的処置の場合、骨は置換材に対して敏感に反応し、骨自体の性質が変化したり、さらに置換材には長期にわたってくり返し負荷が作用し、疲労による破壊強度が問題となる。セメントＣを用いた上記補綴体Ａでは、段部Ｄにおいて骨Ｂの端面が当接し、集中的に荷重が加わるなど、この結果、補綴体Ａでは折損事故が発生し易く、一方、骨においては角の集中荷重によって、骨が脆弱化したり、骨吸収が発生し、接合に用いられているセメントＣの剥離や破損をもたらし、その結果、骨との固定が維持できないという現象が生じていた。しかも補綴体を成す金属、セラミックなどは骨に比較し、剛性が非常に大きく、接合部において急激にその剛性が変化し、骨の変形に対し、ほとんど追従できない。そのため骨とセメント、セメントと挿入軸部との間で容易にズレが生じガタツキの原因となる。かかるガタツキが一旦生じると、補綴体のガタツキが益々大きなものとなり、ひいては骨を破壊に至らしめる。
【０００５】
【発明の目的】
上記従来技術の課題に鑑み、本発明はセメントを用いることなしに骨髄腔内に良好に固定することができ、かつ、機械強度が大きく生体内で安全な補綴体を提供することである。
【０００６】
【課題を解決するための手段】
しかるに、本発明は前記課題を解決するために、天然骨の髄腔中に挿入する軸部と天然骨の外表面に圧接して該軸部とで天然骨を挟持するための補助プレートを相対向させて上記軸部の下面に設けられた基端部に形成するとともに、上記補助プレートに貫通孔を穿設し、上記軸部は、底部が該軸部内に位置する有底ボルト穴を有し、上記貫通孔から天然骨を貫通して上記有底ボルト穴に固定用のボルトを螺合せしめることにより天然骨に固定し得ることを特徴とする生体用補綴体を提供するものである。
【０００７】
【作用】
相対向する軸部と補助プレート間で骨を挟むように軸部を骨髄腔内に挿入する。挿入後、位置決めをして補助プレートの貫通孔をガイドとして専用の器具を用いて骨に下孔を穿ける。この状態で、固定用ボルトを補助プレートの貫通孔を挿通して軸部の有底ボルト穴に螺合せしめる。これにより、セメントを用いずに生体用補綴体が骨に強固に固定され、その結果、基端部が骨の端部に固定される。
【０００８】
なお、本発明の生体用補綴体は、軸部に設けるボルト固定用の穴を有底としたことを特徴とする。このようにすることによって、ボルト穴の端部にかかる応力を大幅に削減できることを見いだした。したがって、機械的強度が大きく、破損し難いので、生体内での安全性が非常に高い。
【０００９】
本発明の生体補綴体の使用例として、例えば、人工膝関節の大腿骨部材の場合、基端部が関節摺動部として一体的に構成された形態がある。この場合、上記大腿骨部材を構成する。他方、基端部に他の部材を取り付け得る構造とし、別体の関節摺動部材を基端部に取付け、大腿骨コンポーネントを構成する。この場合、本発明の生体用補綴体は、大腿骨コンポーネントを構成するステム部材として作用する。
【００１０】
【発明の実施の形態】
以下、本発明の実施形態を図により詳述する。
【００１１】
図１には金属製の補綴体Ｐを骨への装着状態図を示し、１は骨の髄腔内へ挿入する軸部であり、この軸部１と一体を成した基端部２は、該軸部１と所望の間隔をもって相対向する補助プレート３を備えている。すなわち、上記軸部１、基端部２、補助プレート３が一体を成した構造である。
【００１２】
上記軸部１と補助プレート３の対応する部位には、貫通孔４と有底ボルト穴５が同軸状に穿設され、固定用ボルト６を補助プレート３の貫通孔４を挿通して軸部１の有底ボルト穴５に螺合せしめる。これにより、生体用補綴体Ｐが骨に強固に固定され、その結果、基端部２が骨Ｂの端部に固定できる構造となっている。
【００１３】
装着、固定方法としては、相対向する軸部１と補助プレート３間で骨Ｂを挟持するように軸部１を骨髄腔ｂ内に挿入した後、位置決めをして、補助プレート３の貫通孔４をガイドとして専用の器具を用いて骨に下孔を穿ける。そして、この状態で、固定用ボルト６を補助プレート３の貫通孔４を挿通して軸部１の有底ボルト穴５に螺合せしめる。
【００１４】
このように構成される生体用補綴体は、軸部１と補助プレート３が骨Ｂを挟持する力と固定用ボルト６による固定により、セメントを用いなくても、ガタツキや回動のない強固な固定が可能である。なお、補助プレート３の根元部位には図１中に拡大して示すように凹溝３ａを設け、骨Ｂを挟持するために適当な柔軟性、バネ性を持たしてもよい。また、位置決めにより骨Ｂと基端部２の間に若干の隙間を設けることにより、骨Ｂの端部が応力集中により脆弱化して骨吸収が発生するなどという問題を防止することができる。また、上記生体用補綴体Ｐでは、軸部１は、底部が該軸部内に位置する有底ボルト穴５を有したことを特徴とする。このようにすることによって、ボルト穴の端部にかかる応力を大幅に削減でき、機械的強度が大きく、破損し難いので、生体内での安全性が非常に高い。
【００１５】
なお、７５Ｋｇｆの静荷重を条件としたＦＥＭ解析を行ったところ、軸部１のボルト用穴を有底穴とした場合にの穴端部にかかる応力は７１．８４Ｋｇｆ／ｍｍ2 で、貫通孔４とした場合の９４．５８Ｋｇｆ／ｍｍ2 よりも大幅に減少することが確認された。なお、応力削減の効果を十分とするため、軸部１の有底ボルト穴５の穴下厚みｔは２ｍｍ以上であることが望ましい。他方、該有底ボルト穴５の深さｄとしては５ｍｍ以上であることが好ましい。これは、深さが５ｍｍ未満では固定用ボルト６の螺着力が不十分となる恐れがあるためである。
【００１６】
なお、骨Ｂとの結合力を高めるために、骨Ｂとの当接面に図中ハッチングで示す領域にハイドロキシアパタイト等のリン酸カルシウム材料をプラズマ溶射等の手段でもって被着せしめてもよい。ただし、この時に軸部１と補助プレート３の機械的強度を必要以上に劣化させないことが重要である。即ち、高温となる処理を施すと母材の強度劣化を起こすので前記軸部１と補助プレート３における前記基端部２との接合部位には上記のような溶射を行わないことが望ましい。
【００１７】
図２に本発明の生体補綴体を実施した一形態としてのステム部材ｆ１と、該ステム部材ｆ１を構成部分として成る人工膝関節の大腿骨コンポーネントＦを示し、該コンポーネントＦは中間部材ｆ２を介して別体の関節摺動部材ｆ３をステム部材ｆ１の基端部２に取付けるように構成されたものである。なお、同図において、ｆ４、ｆ５はそれぞれ固定用のネジおよびピンである。
【００１８】
また、図３に本発明の生体補綴体を実施した他形態としての骨折補整体Ｌを示し、この骨折補整体Ｌは基端部２を中心として左右対称にそれぞれ軸部１と補助プレート３を一体的に備えたものである。この骨折補整体Ｌは埋め込み式で長期間埋入しておくことを目的とし、従来のプレート等で治癒の難しい骨折箇所を補整するのに有効である。
【００１９】
【発明の効果】
叙上のように本発明の生体用補綴体は、天然骨の髄腔中に挿入する軸部と天然骨の外表面に当接する補助プレートとを相対向するべく基端部に形成するとともに上記補助プレートに貫通孔を穿設し、上記軸部に有底ボルト穴を穿設してなり、上記貫通孔から天然骨を貫通して上記有底ボルト穴に固定用のボルトを螺合せしめることにより天然骨に固定し得るように成したことにより、セメントを用いることなしに骨髄腔内に良好に固定することができる。また、軸部に設けるボルト固定用の穴を有底としたことにより、ボルト穴の端部にかかる応力を大幅に削減し、したがって、機械的強度が大きく、破損し難いので、生体内での安全性が非常に高いという優れた効果を併せ持つものである。
【図面の簡単な説明】
【図１】本発明の補綴体の骨への装着状態図である。
【図２】本発明の生体補綴体を実施した一形態としてのステム部材と、該ステム部材を構成部分として成る人工膝関節の大腿骨コンポーネントの分解斜視図である。
【図３】本発明の生体補綴体を実施した他形態としての骨折補整体の斜視図である。
【図４】従来の補綴体の骨への装着状態図である。
【符号の説明】
１ 軸部
２ 基端部
３ 補助プレート
４ 貫通孔
５ 有底ボルト穴
６ 固定用ボルト
Ｐ 生体補綴体
Ｂ 骨
ｂ 骨髄腔
ｓ 隙間
Ｆ 大腿骨コンポーネント
Ｌ 骨折補整体[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a bioprosthesis used for prosthesis of a bone defect part and an excision part due to an accident or a disease.
[0002]
[Prior art]
Conventionally used artificial prosthesis as a combined body of natural bone and prosthetic part is mainly composed of a Co—Cr—Mo alloy, stainless steel, or ceramic material.
[0003]
For example, as shown in FIG. 4, a prosthesis A in which a shaft portion a is inserted into the medullary cavity b of the bone B, the end surface of the bone B is brought into contact with the stepped portion, and is fixed using the cement C. was there.
[0004]
[Prior art issues]
However, in the case of surgical procedures using bone replacement, in general, bone reacts sensitively to the replacement material, the properties of the bone itself change, and the replacement material is subjected to repeated loads over a long period of time, resulting in fatigue strength due to fatigue. Is a problem. In the prosthesis A using the cement C, the end face of the bone B comes into contact with the stepped portion D and a load is applied intensively. As a result, the prosthesis A is likely to be broken, whereas in the bone, Due to the concentrated load at the corners, the bone is weakened or bone resorption occurs, resulting in peeling or breakage of the cement C used for joining, and as a result, the phenomenon that the fixation with the bone cannot be maintained has occurred. In addition, the metal, ceramic, etc. constituting the prosthesis have a very large rigidity compared to the bone, and the rigidity changes abruptly at the joint and hardly follows the deformation of the bone. For this reason, a gap is easily generated between the bone and the cement, and between the cement and the insertion shaft portion, which causes backlash. Once such backlash occurs, the backlash of the prosthesis becomes increasingly large and eventually leads to bone destruction.
[0005]
OBJECT OF THE INVENTION
In view of the above-described problems of the prior art, the present invention is to provide a prosthesis that can be well fixed in the bone marrow cavity without using cement and has high mechanical strength and is safe in vivo.
[0006]
[Means for Solving the Problems]
However, in order to solve the above-mentioned problem, the present invention provides a shaft part inserted into the medullary cavity of the natural bone and an auxiliary plate for pressing the outer surface of the natural bone and sandwiching the natural bone between the shaft part. Yes by countercurrent and forming a proximal end portion provided on the lower surface of the shaft portion, drilled through holes in the auxiliary plate, the shaft portion, a bottomed bolt hole bottom is positioned in the shaft portion Then, the present invention provides a living body prosthesis which can be fixed to natural bone by passing natural bone through the through hole and screwing a fixing bolt into the bottomed bolt hole.
[0007]
[Action]
The shaft portion is inserted into the bone marrow cavity so that the bone is sandwiched between the opposite shaft portion and the auxiliary plate. After insertion, positioning is performed, and a pilot hole is made in the bone using a dedicated instrument with the through hole of the auxiliary plate as a guide. In this state, the fixing bolt is inserted through the through hole of the auxiliary plate and screwed into the bottomed bolt hole of the shaft portion. Thereby, the prosthetic body for living body is firmly fixed to the bone without using cement, and as a result, the proximal end portion is fixed to the end portion of the bone.
[0008]
The living body prosthesis according to the present invention is characterized in that a bolt fixing hole provided in the shaft portion has a bottom. By doing so, it was found that the stress applied to the end of the bolt hole can be greatly reduced. Therefore, since the mechanical strength is large and it is difficult to break, the safety in the living body is very high.
[0009]
As an example of use of the bioprosthesis of the present invention, for example, in the case of a femoral member of an artificial knee joint, there is a form in which the proximal end portion is integrally configured as a joint sliding portion. In this case, the femoral member is configured. On the other hand, another member can be attached to the proximal end, and a separate joint sliding member is attached to the proximal end to constitute the femoral component. In this case, the living body prosthesis of the present invention acts as a stem member constituting the femoral component.
[0010]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
[0011]
FIG. 1 is a view showing a state in which a metal prosthesis P is attached to a bone. Reference numeral 1 denotes a shaft portion that is inserted into the medullary cavity of a bone. A proximal end portion 2 that is integrated with the shaft portion 1 is: An auxiliary plate 3 facing the shaft portion 1 at a desired interval is provided. That is, the shaft portion 1, the base end portion 2, and the auxiliary plate 3 are integrated.
[0012]
A through hole 4 and a bottomed bolt hole 5 are formed coaxially in corresponding portions of the shaft 1 and the auxiliary plate 3, and the fixing bolt 6 is inserted through the through hole 4 of the auxiliary plate 3 to form the shaft. 1 is screwed into the bottomed bolt hole 5. Thus, the living body prosthesis P is firmly fixed to the bone, and as a result, the proximal end 2 can be fixed to the end of the bone B.
[0013]
As a mounting and fixing method, the shaft portion 1 is inserted into the bone marrow cavity b so as to sandwich the bone B between the opposite shaft portion 1 and the auxiliary plate 3, and then positioned, and the through-hole of the auxiliary plate 3 is inserted. Using 4 as a guide, drill a pilot hole in the bone using a special instrument. In this state, the fixing bolt 6 is screwed into the bottomed bolt hole 5 of the shaft portion 1 through the through hole 4 of the auxiliary plate 3.
[0014]
The living body prosthesis constructed in this way is strong without rattling or rotation without using cement due to the force by which the shaft portion 1 and the auxiliary plate 3 clamp the bone B and the fixing with the fixing bolt 6. It can be fixed. In addition, a concave groove 3a may be provided in the root portion of the auxiliary plate 3 as shown in FIG. 1 so as to have appropriate flexibility and springiness for sandwiching the bone B. Further, by providing a slight gap between the bone B and the base end portion 2 by positioning, it is possible to prevent a problem that the end portion of the bone B becomes weak due to stress concentration and bone resorption occurs. Moreover, in the said bioprosthesis P , the axial part 1 has the bottomed bolt hole 5 in which a bottom part is located in this axial part, It is characterized by the above-mentioned. By doing in this way, the stress concerning the edge part of a bolt hole can be reduced significantly, mechanical strength is large, and it is hard to break | damage, Therefore In-vivo safety | security is very high.
[0015]
When FEM analysis was performed under the condition of a static load of 75 kgf, the stress applied to the hole end when the bolt hole of the shaft 1 was a bottomed hole was 71.84 kgf / mm 2 , and the through hole 4 was confirmed to be significantly lower than 94.58 kgf / mm 2 . In addition, in order to make the effect of stress reduction sufficient, it is desirable that the under-hole thickness t of the bottomed bolt hole 5 of the shaft portion 1 is 2 mm or more. On the other hand, the depth d of the bottomed bolt hole 5 is preferably 5 mm or more. This is because if the depth is less than 5 mm, the screwing force of the fixing bolt 6 may be insufficient.
[0016]
In order to increase the bonding force with the bone B, a calcium phosphate material such as hydroxyapatite may be applied to the contact surface with the bone B in a hatched area in the figure by means such as plasma spraying. However, at this time, it is important not to deteriorate the mechanical strength of the shaft portion 1 and the auxiliary plate 3 more than necessary. In other words, since the strength of the base material is deteriorated when a high temperature treatment is performed, it is desirable not to perform the above-described spraying on the joint portion between the shaft portion 1 and the base end portion 2 of the auxiliary plate 3.
[0017]
FIG. 2 shows a stem member f1 as an embodiment in which the bioprosthesis of the present invention is implemented, and a femoral component F of an artificial knee joint having the stem member f1 as a constituent part. The component F is interposed via an intermediate member f2. Thus, a separate joint sliding member f3 is configured to be attached to the proximal end portion 2 of the stem member f1. In the figure, f4 and f5 are fixing screws and pins, respectively.
[0018]
FIG. 3 shows a fracture repair body L as another embodiment in which the bioprosthesis of the present invention is implemented. The fracture repair body L has a shaft portion 1 and an auxiliary plate 3 symmetrically about the proximal end portion 2. It is an integral unit. The fracture repair body L is an implantable type and is intended to be embedded for a long period of time, and is effective for repairing a fracture site that is difficult to heal with a conventional plate or the like.
[0019]
【The invention's effect】
As described above, the biological prosthesis of the present invention is formed at the proximal end portion so that the shaft portion inserted into the medullary cavity of the natural bone and the auxiliary plate contacting the outer surface of the natural bone are opposed to each other. A through hole is drilled in the auxiliary plate, a bottomed bolt hole is drilled in the shaft portion, natural bone is passed through the through hole, and a fixing bolt is screwed into the bottomed bolt hole. Therefore, it is possible to satisfactorily fix the bone marrow cavity without using cement. In addition, the bolt fixing hole provided in the shaft portion has a bottom, so that the stress applied to the end of the bolt hole is greatly reduced, and therefore, the mechanical strength is large and it is difficult to break. It also has the excellent effect that safety is very high.
[Brief description of the drawings]
FIG. 1 is a view showing a state in which the prosthesis of the present invention is attached to a bone.
FIG. 2 is an exploded perspective view of a stem member as an embodiment implementing the bioprosthesis of the present invention, and a femoral component of an artificial knee joint including the stem member as a constituent part.
FIG. 3 is a perspective view of a fracture prosthesis as another embodiment in which the bioprosthesis of the present invention is implemented.
FIG. 4 is a view showing a state in which a conventional prosthesis is attached to a bone.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Shaft part 2 Base end part 3 Auxiliary plate 4 Through-hole 5 Bottomed bolt hole 6 Fixing bolt P Bioprosthesis B Bone bone marrow cavity s Gap F Femoral component L Fracture repair body

Claims (3)

天然骨の髄腔中に挿入する軸部と天然骨の外表面に圧接して該軸部とで天然骨を挟持するための補助プレートを相対向させて上記軸部の下面に設けられた基端部に形成するとともに、上記補助プレートに貫通孔を穿設し、上記軸部は、底部が該軸部内に位置する有底ボルト穴を有し、上記貫通孔から天然骨を貫通して上記有底ボルト穴に固定用のボルトを螺合せしめることにより天然骨に固定し得ることを特徴とする生体用補綴体。 A base provided on the lower surface of the shaft portion with a shaft portion inserted into the medullary cavity of the natural bone and an auxiliary plate for pressurizing the outer surface of the natural bone and sandwiching the natural bone with the shaft portion. The auxiliary plate is formed with a through hole, and the shaft portion has a bottomed bolt hole whose bottom is located in the shaft portion, and penetrates the natural bone from the through hole and A bioprosthesis which can be fixed to natural bone by screwing a fixing bolt into a bottomed bolt hole. 前記有底ボルト穴の深さが５ｍｍ以上であり且つその穴下厚みが２ｍｍ以上であることを特徴とする請求項１の生体用補綴体。2. The bioprosthesis according to claim 1, wherein the bottomed bolt hole has a depth of 5 mm or more and a thickness below the hole of 2 mm or more. 前記軸部と補助プレートにおける前記基端部との接合部位を除く骨との当接面にリン酸カルシウム系材料を被着せしめてなる請求項１乃至２の生体用補綴体。The bioprosthesis according to claim 1 or 2, wherein a calcium phosphate material is attached to a contact surface between the shaft portion and a bone excluding a joint portion between the proximal end portion of the auxiliary plate.
JP20632397A 1997-07-31 1997-07-31 Bioprosthesis Expired - Fee Related JP3692216B2 (en)

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Cited By (1)

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US20040153073A1 (en) 2000-02-01 2004-08-05 Hand Innovations, Inc. Orthopedic fixation system including plate element with threaded holes having divergent axes
US7425213B2 (en) 2002-12-10 2008-09-16 Depuy Products, Inc. Method of endosteal nailing
EP1827271B1 (en) * 2004-12-23 2009-12-02 Hans Ulrich Stäubli Bone fixing device
JP6562596B2 (en) * 2014-05-21 2019-08-21 ディトマール・ヴォルター Osteosynthesis system for multi-directional, angle-stable treatment of tubular fractures with intramedullary nails and bone screws
CN105581859A (en) * 2015-12-18 2016-05-18 胡永成 Multifunctional fixed upper limb backbone prosthesis
JP6450996B2 (en) * 2016-09-01 2019-01-16 ヤマウチマテックス・エンジニアリング株式会社 Artificial bone shaft
JP6573263B2 (en) * 2018-10-11 2019-09-11 ヤマウチマテックス・エンジニアリング株式会社 Artificial bone shaft

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JP2017140400A (en) * 2010-11-15 2017-08-17 シンセス ゲゼルシャフト ミット ベシュレンクテル ハフツングＳｙｎｔｈｅｓ Ｇｍｂｈ Graft collection and containment system for bone defects
US9782259B2 (en) 2010-11-15 2017-10-10 DePuy Synthes Products, Inc. Graft collection and containment system for bone defects

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