JP6296332B2 - Anchor fastener - Google Patents

Description

  The present invention relates to an anchor fastener.

  2. Description of the Related Art A suture anchor comprising a shaft that detachably attaches an anchor having a hexagonal head on the proximal end side of a screw portion to a hexagon socket at the distal end, and a handle that is provided on the proximal end side of the shaft and applies a rotational force to the shaft An inserter is known (for example, refer to Patent Document 1). This suture anchor inserter is adapted to fasten the anchor to the bone by pressing the screw portion of the anchor attached to the tip of the shaft against the bone surface and rotating the handle by rotating the handle.

Special table 2012-502737 gazette

However, the suture anchor inserter of Patent Document 1 has a disadvantage in that it is difficult to recognize the screwing amount of the anchor attached to the tip of the shaft into the bone. For this reason, there is a problem that it is difficult to adjust the fastening depth properly because the anchor is fastened to the bone deeply or the fastening is shallow and the fixation to the bone becomes unstable.
This invention is made | formed in view of the situation mentioned above, Comprising: It aims at providing the anchor fastener which can adjust the fastening depth to the to-be-fastened object of an anchor appropriately.

In order to achieve the above object, the present invention provides the following means.
One embodiment of the present invention includes a screw part, a head provided on the base end side of the screw part and formed in a columnar shape having a non-circular cross section, and a flat plate shape extending in the longitudinal direction on the base end side of the head part In the state in which the head portion of the anchor having the protruding portion is fitted in a detachable manner in the axial direction and engaged in the circumferential direction, and the head portion is fitted in the concave portion, the screw portion A shaft portion having a projecting portion disposed at a position projecting outward from the maximum diameter of the screw portion at a position proximal to the distal end; and connected to the proximal end side of the shaft portion; A grip portion for supplying a torque for rotating the shaft portion around the longitudinal axis , wherein the abutting portion is provided on the proximal end side with respect to the distal end of the shaft portion, and the distal end side of the shaft portion with respect to the abutting portion Has an outer diameter smaller than the maximum diameter of the screw part. Length from the abutting portions in the longitudinal direction of the shaft portion to the distal end of the shaft portion provides a small anchor fasteners than the length of the protrusion in the longitudinal direction of the anchor.

  According to this aspect, when the user presses the tip of the screw portion of the anchor against the surface of the object to be fastened and rotates the grip portion with the anchor head fitted in the recess, the grip portion is added. The shaft portion is rotated around the longitudinal axis by the applied torque, and the anchor fitted in the concave portion of the shaft portion is rotated around the longitudinal axis. Then, when the screw part of the anchor meshes with the object to be fastened, the fastening of the screw part to the object to be fastened is started, the fastening proceeds with the rotation of the screw part, and the anchor and the anchor fastener are integrated. And proceed in the depth direction of the object to be fastened.

When the anchor advances in the depth direction, the abutting portion disposed on the base end side with respect to the distal end of the screw portion abuts against the surface of the object to be fastened, and the progression of the shaft portion stops. If the rotation of the shaft portion is continued in this state, the anchor to which torque is supplied by the fitting of the head and the recess continues to advance in the depth direction of the object to be fastened, so the head moves from the recess to the longitudinal direction. When it is extracted and relatively moved by the fitting length, the fitting between the head and the recess is released. Therefore, even if the user continues to rotate the grip portion, no torque is supplied to the head portion, so that further fastening of the anchor is prevented.
That is, it is possible to appropriately adjust the fastening depth of the anchor to the fastening target object by simply setting the position of the abutting portion without the user being aware of the fastening depth during fastening. .

In the reference example of the above aspect, the abutting portion is formed in a cylindrical shape surrounding the periphery of the concave portion, and the abutting portion has a width dimension slightly larger than the thickness of the projecting portion along the longitudinal direction from the distal end thereof. A slit may be provided.

  In this way, once the anchor is fastened to the object to be fastened and the fitting between the head and the recess is released, the recess and the head cannot be fitted again. Although it is impossible to remove the anchor using the anchor, the torque applied to the grip part is supplied to the anchor through the slit and the protruding part inserted into the slit by inserting the protruding part of the anchor into the slit of the abutting part. It becomes possible to do. Therefore, the anchor can be removed from the object to be fastened by applying torque to the grip portion in the direction opposite to that when the anchor is fastened in a state where the protrusion is inserted into the slit.

In the above aspect, the protrusion is provided with a hole penetrating in the thickness direction, and a thread member is attached through the hole, and the head portion is attached to the shaft portion on the proximal end side of the recess. There may be provided a housing portion in which the protrusion is housed when fitted into the recess, and a through-hole penetrating from the outer surface of the shaft portion to the housing portion.
By doing in this way, the user can take out a thread | yarn member easily from the through-hole of a shaft part.

In the reference example of the above aspect, the abutting portion may have a shape that protrudes from the distal end of the shaft portion over the entire circumference in the radially outward direction.
Thereby, the front end surface of the abutting portion can be widened, the surface area of contact with the surface of the object to be fastened can be increased, and the contact pressure applied to the surface of the object to be fastened can be reduced.

In the said aspect, the said abutting part may be comprised with transparent resin.
By doing in this way, even if the abutting part hits the surface of the object to be fastened and covers the outer periphery of the anchor, the state of the anchor or the object to be fastened is passed through the abutting part made of a transparent resin. It can be visually recognized.

In the reference example of the above aspect, the abutting portion may have a cutout and / or a cutout that is at least partially connected to the proximal end surface of the abutting portion and intersects the distal end surface.
By doing in this way, the state of an anchor or a to-be-fastened object can be visually recognized through the position where the notch and / or cut-out were formed in the abutting part.

In the said aspect, the said abutting part may be formed with the silicone rubber.
By doing in this way, the contact part which contacts the surface of a to-be-fastened object can contact the surface of a to-be-fastened object with a softness | flexibility by silicone rubber, and can reduce a contact pressure.

In the said aspect, the front end surface of the said abutting part may be comprised by the curved surface convex to a front end direction.
By doing in this way, the contact part which contacts the surface of a to-be-fastened object can contact the surface of a to-be-fastened object by the curved surface which does not have an edge, and can reduce a contact pressure.

  There exists an effect that the fastening depth to the to-be-fastened object of an anchor can be adjusted appropriately.

1 is an overall view of an anchor fastener according to an embodiment of the present invention. It is a longitudinal cross-sectional view of the A section of FIG. 1 in a state where the anchor is fitted to the anchor fastener of FIG. It is a longitudinal cross-sectional view of the A section of FIG. 1 in the state where the abutting part of the anchor fastener of FIG. 1 is in contact with the bone. FIG. 2 is a longitudinal sectional view of a portion A of FIG. 1 in a state where only the anchor of the anchor fastener of FIG. 1 is progressing in the depth direction of the bone. It is a longitudinal cross-sectional view of the A section of FIG. 1 of the state by which the fitting with the anchor fastener of FIG. 1 and the anchor was cancelled | released. It is the detailed view which looked at the anchor used for the anchor fastener of FIG. 1 from (a) the base end side, and (b) the detailed view seen from the direction substantially orthogonal to a longitudinal axis. FIG. 2 is an overall view showing a state in which a suture is exposed and held on an outer peripheral portion of a shaft portion through a through hole of the anchor fastener of FIG. 1. FIG. 2 is an overall view showing a state in which a suture thread is held through the shaft portion of the anchor fastener of FIG. 1. (A) Cross section of the abutting portion having a slit penetrating in the radial direction of the anchor fastener according to the first modification of the embodiment of the present invention, (b) Abutting portion having a slit not penetrating in the radial direction FIG. It is a longitudinal cross-sectional view of the A section of FIG. 1 of the state which made the projection part of the anchor fit to the slit of the anchor fastener of FIG. It is a longitudinal cross-sectional view of the A section of FIG. 1 which shows the relationship between the through-hole of the state which made the anchor fit to the anchor fastener which concerns on the 2nd modification of one Embodiment of this invention, and a hole part. It is a longitudinal cross-sectional view of the A section of FIG. 1 of the state which provided the notch in the abutting part of the anchor fastener which concerns on the 3rd modification of one Embodiment of this invention. It is a longitudinal cross-sectional view of the A section of FIG. 1 of the state which provided the cut-out in the abutting part of the anchor fastener which concerns on the 4th modification of one Embodiment of this invention. It is a longitudinal cross-sectional view of the A section of FIG. 1 of the anchor fastener which concerns on the 5th modification of one Embodiment of this invention. It is a longitudinal cross-sectional view of the A section of FIG. 1 of the anchor fastener which concerns on the 6th modification of one Embodiment of this invention. FIG. 16 is a longitudinal sectional view of a portion A in FIG. 1 in a state where the coupling between the anchor fastener and the anchor in FIG. 15 is released (when H <L1). It is a longitudinal cross-sectional view of the A section of FIG. 1 in the state (when H = L1) in which the anchor fastener and the anchor of FIG. 15 are released. FIG. 16 is a longitudinal sectional view of a portion A in FIG. 1 in a state where the coupling between the anchor fastener and the anchor in FIG. 15 is released (in the case of L1 <H <L1 + L2).

An anchor fastener 1 according to an embodiment of the present invention will be described below with reference to the drawings.
An anchor fastener 1 according to the present embodiment is a tool for fastening an anchor 2 to the surface of a bone (object to be fastened) P and, as shown in FIG. A portion 3 and a grip portion 4 fixed to the proximal end side of the shaft portion 3 are provided.

As shown in FIG. 6 (b), the anchor 2 includes a head 6 provided on the proximal end side of a screw part 5 in which a spiral cutting edge is formed on a conical outer surface, and the head 6 And a protrusion 7 provided on the base end side.
As shown in FIGS. 6A and 6B, the head 6 is formed in a hexagonal columnar shape arranged coaxially with the screw portion 5, and the maximum diagonal length of the cross section is the screw portion 5. It is set smaller than the outer diameter dimension of the base end. Thereby, a shoulder portion 5 a extending radially outward from the head portion 6 is provided at a boundary position between the screw portion 5 and the head portion 6.

As shown in FIG. 6A, the protrusion 7 is formed in a flat plate shape extending from the base end surface of the head 6 in the direction along the longitudinal axis of the head 6. The width dimension of the protrusion 7 is set to be approximately equal to the two-surface width of the head 6. The protrusion 7 is provided with a hole 8 that penetrates in the thickness direction.
As shown in FIGS. 6A and 6B, the hole portion 8 has an inner diameter dimension larger than the diameter dimension of the suture thread 9 so that the suture thread (thread member) 9 can pass therethrough. Yes.

  As shown in FIG. 8, the suture thread 9 is inserted through the hole portion 8 and into the shaft portion 3. As shown in FIG. 8, the suture thread 9 is held by a stopper portion 19 provided through the grip portion 4 in a direction intersecting the longitudinal axis of the shaft portion 3.

As shown in FIG. 2, the shaft portion 3 is formed in a round bar shape, and a hexagonal hole-like recess portion 10, which can removably fit the head 6 of the anchor 2 along its axial direction, at the tip thereof. And a receiving portion 11 which is continuous with the base end side of the recess 10 and can receive the protruding portion 7.
Further, as shown in FIG. 2, a cylindrical abutting portion 12 that extends further from the distal end surface of the recess 10 toward the distal end side is provided at the distal end of the shaft portion 3. The abutting portion 12 has a larger inner diameter than the maximum diameter of the screw portion 5 of the anchor 2.

As a result, an abutting surface 13 is formed between the abutting portion 12 and the recessed portion 10 to abut against the shoulder portion 5a of the anchor 2 when the head 6 of the anchor 2 is fitted into the recessed portion 10. The abutting portion 12 has a length dimension that extends to a midway position in the longitudinal direction of the screw portion 5 when the head portion 6 is fitted into the recess 10 until the shoulder portion 5a abuts against the abutting surface 13. Yes.
The grip part 4 has a larger outer diameter than the shaft part 3 so that the user can grip and apply torque.

The operation of the anchor fastener 1 according to this embodiment configured as described above will be described below.
In order to fasten the anchor 2 to the bone P using the anchor fastener 1 according to this embodiment, the anchor 2 is inserted into the abutting portion 12 from the protruding portion 7 side as shown in FIG. The head portion 6 is fitted into the recess portion 10 until the shoulder portion 5a of the screw portion 5 abuts against the abutting surface 13.
As a result, the anchor 2 is accommodated in the accommodating portion 11, the head 6 is fitted in the recess 10, and the tip of the screw portion 5 partially protrudes from the tip of the abutting portion 12. , Attached to the tip of the shaft portion 3.

  In this state, when the user applies torque around the longitudinal axis while pushing the tip of the screw portion 5 against the surface of the bone P and pushing the grip portion 4 toward the tip of the shaft portion 3, the applied torque causes the shaft portion 3 to move. The head 6 of the anchor 2 that is transmitted to the concave portion 10 and engaged with the concave portion 10 in the circumferential direction is rotated around the longitudinal axis. Then, when the screw part 5 of the anchor 2 meshes with the bone P, the fastening of the screw part 5 to the bone P is started, and the fastening proceeds as the screw part 5 rotates.

  When the fastening of the anchor 2 proceeds and the abutting portion 12 of the shaft portion 3 abuts against the surface of the bone P as shown in FIG. 3, further progression of the shaft portion 3 is stopped. After that, when the user continues to apply torque to the grip portion 4, the shaft portion 3 is rotated around the longitudinal axis on the spot.

  On the other hand, when the rotation of the shaft portion 3 is continued, the rotation of the anchor 2 is also continued, so that the fastening of the screw portion 5 to the bone P continues to proceed. For this reason, as shown in FIG. 4, the head 6 of the anchor 2 moves relative to the recess 10 in the direction in which it is extracted in the longitudinal direction. When the anchor 2 moves relative to the shaft portion 3 by the fitting length, the fitting between the head 6 and the recess 10 is released as shown in FIG.

Thereby, even if the user continues to apply torque to the grip portion 4 thereafter, the torque is not transmitted to the anchor 2, so that further fastening is prevented.
That is, according to the anchor fastener 1 according to the present embodiment, the anchor 2 can be attached to the bone P by simply setting the position of the abutment portion 12 without the user being aware of the fastening depth during fastening. There is an advantage that it can be fastened to an appropriate depth without excess or deficiency.

  In the embodiment described above, the abutting portion 12 has a width dimension slightly larger than the plate thickness of the protruding portion 7 along the longitudinal direction from the tip, as shown in FIG. 9A. 9 or a groove-like slit 14 that does not penetrate in the radial direction and extends in the longitudinal direction may be provided on the outer surface of the protrusion 7 as shown in FIG.

  As shown in FIG. 5, once the anchor 2 is fastened to the bone P and the fitting between the head 6 and the recess 10 is once released, the recess 10 and the head 6 can be fitted again. Can not. In this case, as shown in FIG. 10, by inserting the projection 7 into the slit 14, the torque applied to the grip 4 is applied to the anchor 2 through the engagement between the slit 14 and the projection 7. Can communicate. Therefore, in this state, the anchor 2 can be removed from the bone P by applying torque to the grip portion 4 in the direction opposite to that when the anchor 2 is fastened.

Further, in the above-described embodiment, as illustrated in FIG. 11, the through hole 15 may be provided through the housing portion 11 from the outer surface of the shaft portion 3.
By doing in this way, there exists an advantage that a user can take out the suture 9 easily from the through-hole 15 of the shaft part 3. FIG.

Moreover, the through-hole 15 may be provided with two or more and may be single.
Moreover, in embodiment mentioned above, as FIG. 8 showed, the suture thread 9 illustrated the aspect which penetrates the inside of the shaft part 3, However, It is not restricted to this. For example, as shown in FIG. 7, the shaft portion 3 may include a through hole 15. At this time, as shown in FIG. 7, the suture thread 9 is passed through the hole 8, exposed to the outer peripheral portion of the shaft portion 3, extended to the grip portion 4 side, and held by the stopper portion 19.

Moreover, in embodiment mentioned above, as shown in FIG. 12 and FIG. 13, as for the anchor fastener 1, the abutting part 16 protrudes in the front-end | tip of the shaft part 3 over the perimeter to radial direction outward. You may have a shape.
Thereby, the front end surface 16a of the abutting portion 16 can be widened, the surface area of contact with the surface of the bone P can be increased, and the contact pressure applied to the surface of the bone P can be reduced.

In the embodiment described above, the abutting portions 12 and 16 may be made of a transparent resin material.
In this case, as shown in FIGS. 3 to 5 and 11, the abutting portions 12 and 16 abut against the surface of the bone P and cover the outer periphery of the anchor 2. The state of the anchor 2 and the bone P can be visually recognized through the abutting portions 12 and 16 to be performed.

In the above-described embodiment, the abutting portion 16 has a notch 17 that at least partially connects to the base end surface of the abutting portion 16 and intersects the distal end surface 16a, as shown in FIGS. And / or have cutouts 18.
Thereby, the state of the anchor 2 and the bone P can be visually recognized through the position where the notch 17 and / or the cutout 18 is formed in the abutting portion 16.

Further, in the above-described embodiment, the abutting portions 12 and 16 are configured by curved surfaces whose front end surfaces 12a and 16a are convex in the front end direction, as shown in FIGS. 2 to 5 and 10 to 13. May be.
By doing in this way, the contact parts 12 and 16 which contact the surface of the bone P can contact the surface of the bone P by the curved surface which does not have an edge, and can reduce a contact pressure.

  Moreover, in embodiment mentioned above, although the head 6 of the anchor 2 which consists of hexagonal columns was illustrated, it replaces with this and can be fitted to the recessed part 10 of the shaft part 3 so that attachment or detachment is possible in an axial direction, and an anchor Any columnar structure having a non-circular cross section that can transmit torque with the two heads 6 fitted may be employed.

  In the above-described embodiment, the stopper portion 19 is exemplified as being fixed to the grip portion 4 in a penetrating state. However, the stopper portion 19 is not limited to this as long as the suture thread 9 can be held. For example, the stopper portion 19 is formed such that a part of the surface of the grip portion 4 is concave or convex in a direction intersecting the longitudinal axis of the shaft portion 3 so that the suture thread 9 is fixed to the grip portion 4 in a non-penetrating state. It may be.

In the above-described embodiment, the abutting portions 12 and 16 may be made of a material having both flexibility and biocompatibility such as silicone rubber.
By doing in this way, as shown in FIGS. 3 to 5 and FIG. 11, when the distal end surface 12 a of the abutment portion 12 abuts against the surface of the bone P, the contact pressure is reduced to the bone P. Impact can be mitigated.

  Further, in the above-described embodiment, as the abutting portion 12, as illustrated in FIGS. 2 to 5 and 11, the one extending to a middle position in the longitudinal direction of the screw portion 5 is exemplified. It is not limited to. For example, as shown in FIG. 14, the abutting surface 13 may be the distal end surface 12 a of the shaft 3 positioned at the proximal end of the screw portion 5 in a state where the head 6 is fitted in the recess 10. By doing in this way, when the anchor 2 is advanced in the depth direction of the bone P while the shoulder portion 5a of the screw portion 5 is in contact with the distal end surface 12a, the distal end surface 12a is in contact with the surface of the bone P. The advancement of the shaft portion 3 stops, and the anchor 2 can be inserted into the bone P until the fitting between the head 6 and the recess 10 is released.

  Further, as shown in FIG. 15, the portion of the screw portion 5 that abuts against the shoulder portion 5a has an outer diameter that is smaller than the maximum diameter of the screw portion 5, and the maximum portion of the screw portion 5 is located closer to the base end side than the distal end surface 12a. You may provide the abutting part 12 which consists of the level | step-difference part 20 of an outer diameter dimension larger than a diameter. By doing in this way, when the head 6 and the recessed part 10 of the anchor 2 are fitted, the shoulder part 5a of the screw part 5 and the front end surface 12a of the shaft part 3 are in contact with each other.

In this state, when the anchor 2 is fastened and the anchor 2 is advanced in the depth direction of the bone P, the distal end portion of the shaft portion 3 is partially in the bone P as shown in FIGS. At the entered position, the stepped portion 20 contacts the surface of the bone P, the advancement of the shaft portion 3 stops, and the anchor 2 can be inserted into the bone P until the fitting between the head 6 and the recess 10 is released. it can.
Here, depending on the relationship between the length L1 of the protrusion 7 in the longitudinal direction of the anchor 2, the length L2 of the head 6, and the length H from the stepped portion 20 to the distal end surface 12a in the longitudinal direction of the shaft 3, The position of the anchor 2 when the fitting between the portion 6 and the recess 10 is released differs in the depth direction.

Specifically, when H <L1, as shown in FIG. 16, when the anchor 2 is inserted into the bone P until the fitting between the head 6 and the recess 10 is released, the protrusion 7 At least a portion of the bone P is exposed to the outside of the bone P.
When H = L1, as shown in FIG. 17, when the anchor 2 is inserted into the bone P until the fitting between the head 6 and the recess 10 is released, the proximal end surface of the projection 7 7a coincides with the surface of the bone P.

  In the case of L1 <H <L1 + L2, as shown in FIG. 18, when the anchor 2 is inserted into the bone P until the fitting between the head 6 and the recess 10 is released, the entire anchor 2 is It is placed in the bone P.

DESCRIPTION OF SYMBOLS 1 Anchor fastener 2 Anchor 3 Shaft part 4 Grip part 5 Screw part 6 Head part 7 Projection part 8 Hole part 9 Suture thread (thread member)
DESCRIPTION OF SYMBOLS 10 Concave part 11 Storage part 12,16 Abutting part 14 Slit 15 Through-hole 17 Notch 18 Cutout

Claims (5)

An anchor having a screw portion, a head portion provided on the base end side of the screw portion and formed in a columnar shape having a non-circular cross section, and a flat projection extending in the longitudinal direction on the base end side of the head portion The head of the screw is detachably fitted in the axial direction and is engaged in the circumferential direction, and the head is fitted to the recess and is closer to the proximal side than the tip of the screw part. A shaft portion having an abutting portion disposed at a position protruding outward from the maximum diameter of the screw portion at a position;
A grip portion connected to a proximal end side of the shaft portion and for supplying torque for rotating the shaft portion around a longitudinal axis ;
The abutting portion is provided on a proximal end side with respect to the distal end of the shaft portion, and a portion on the distal end side of the abutting portion of the shaft portion has an outer diameter dimension smaller than the maximum diameter of the screw portion,
An anchor fastener, wherein a length from the abutting portion in the longitudinal direction of the shaft portion to a tip of the shaft portion is smaller than a length of the protruding portion in the longitudinal direction of the anchor. The protrusion is provided with a hole penetrating in the thickness direction, and a thread member is attached through the hole,
A receiving portion in which the protrusion is received when the head is fitted in the recess on a proximal end side of the recess, and a penetration that penetrates from the outer surface of the shaft portion to the receiving portion; anchor fastener according to claim 1 and holes are al provided. The anchor fastener according to claim 1 or 2 , wherein the abutting portion is made of a transparent resin. The anchor fitting according to any one of claims 1 to 3 , wherein the abutting portion is formed of silicone rubber. The anchor fastener according to any one of claims 1 to 4 , wherein a distal end surface of the abutting portion is configured by a curved surface convex in the distal end direction.

Images