WO2003047443A1 - Compressive bone anchoring device - Google Patents

Compressive bone anchoring device Download PDF

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Publication number
WO2003047443A1
WO2003047443A1 PCT/FR2002/004194 FR0204194W WO03047443A1 WO 2003047443 A1 WO2003047443 A1 WO 2003047443A1 FR 0204194 W FR0204194 W FR 0204194W WO 03047443 A1 WO03047443 A1 WO 03047443A1
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WO
WIPO (PCT)
Prior art keywords
anchoring device
bone
bone anchoring
anchor
fixing anchor
Prior art date
Application number
PCT/FR2002/004194
Other languages
French (fr)
Inventor
Philippe Crepin
Adil Trabelsi
Renaud Duche
Original Assignee
Sud Implant Chirurgie
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Sud Implant Chirurgie filed Critical Sud Implant Chirurgie
Priority to AU2002364318A priority Critical patent/AU2002364318A1/en
Publication of WO2003047443A1 publication Critical patent/WO2003047443A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7216—Intramedullary pins, nails or other devices for bone lengthening or compression
    • A61B17/7225—Intramedullary pins, nails or other devices for bone lengthening or compression for bone compression
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A61B17/7258—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone
    • A61B17/7266—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone with fingers moving radially outwardly
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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, setting implements or the like
    • 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
    • A61B17/8605—Heads, i.e. proximal ends projecting from bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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, setting implements or the like
    • 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
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue
    • A61B17/8635—Tips of screws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • 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, setting implements or the like
    • 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
    • A61B17/8665—Nuts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00004—(bio)absorbable, (bio)resorbable, resorptive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/037—Automatic limiting or abutting means, e.g. for safety with a frangible part, e.g. by reduced diameter
    • 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
    • A61F2/42—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes
    • A61F2/4225—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for feet, e.g. toes
    • A61F2002/4233—Joints for wrists or ankles; for hands, e.g. fingers; for feet, e.g. toes for feet, e.g. toes for metatarso-phalangeal joints, i.e. MTP joints

Definitions

  • the present invention relates to a bone anchoring device allowing the connection of bone fragments between them and / or the immobilization of small joints during bone arthrodesis.
  • Bone anchoring devices which allow the fixation of osteotomies of the metatarsophalangeal joint of the big toe, and comprising self-breaking compression screws onto which an ankle provided with hooks is screwed.
  • This type of device has dowels which move apart when the screw is inserted outside the bone and not inside.
  • suture anchors provided with elements which move apart inside the bone during the introduction of a compression screw. Note that the suture anchor before deformation has the shape of a cylinder which is not retained in rotation.
  • the bone anchoring device according to the present invention is intended to respond to the problems of rotation of the anchoring elements under the force of tightening the compression screws, in order to ensure lasting compression of the bone elements between them.
  • the bone anchoring device comprises a compression screw and a fixing anchor comprising retaining means which consist of a first anchoring part and a second connecting part, said part of anchoring being on the one hand formed of fins which can deviate from the axis XX 'of the anchor and on the other hand of anti-rotation means for locking the anchor in rotation.
  • the bone anchoring device comprises a first anchoring part which has fins separated from each other by slots, which are arranged parallel to the longitudinal axis XX 'of the fixing anchor.
  • the bone anchoring device comprises fins, each of which consists of a deformation zone making it possible to connect the first anchoring part to the second connecting part of the fixing anchor.
  • the bone anchoring device according to the present invention comprises on each fin teeth which extend perpendicular to the axis XX 'and in the direction of the exterior of the fixing anchor.
  • the bone anchoring device comprises teeth which are arranged perpendicular to one another around the periphery of the fixing anchor.
  • the bone anchoring device comprises teeth which are provided on 2/3 of the height of the fins and which have a flared external profile, the less thick part of which is directed towards the outside of the fixing anchor.
  • the bone anchoring device comprises a first anchoring part and the second connecting part which are pierced with an internal bore coaxial with the longitudinal axis XX 'and emerging at each end of the fixing anchor , said bore having on the one hand of the first anchoring part a smooth internal surface and on the other hand of the second connecting part a threaded surface.
  • the bone anchoring device comprises a compression screw which consists of a first anchoring part and a second driving part capable, under a determined tightening torque, of separating from the first part.
  • the bone anchoring device comprises a first part of the screw which comprises a head with a flared profile secured to a smooth, cylindrical body which is extended by a threaded profile of diameter smaller than that of said body, said head being secured opposite the body from a breakable rupture zone which is extended by a drive body.
  • the bone anchoring device comprises a positioning aid which consists of a cylindrical and smooth rod secured to a maneuvering handle, said rod comprising on the one hand opposite the handle a threaded part. whose external diameter is less than that of the rod and on the other hand between the handle and the threaded part of the pins.
  • Figure 1 is a perspective view illustrating the placement aid and the bone anchoring device according to the present invention.
  • Figure 2 is a perspective view showing the compression screw of the bone anchoring device according to the present invention.
  • Figures 3 to 5 are views showing the anchor of the bone anchoring device according to the present invention.
  • Figures 6 to 8 are views illustrating an example of bone arthrodesis and the different stages of setting up the bone anchoring device according to the present invention.
  • FIGS. 1 to 5 show a bone anchoring device 1 comprising a compression screw 2, a fixing anchor 3 playing the same role as a nut and a setting aid 4.
  • the bone anchoring device 1 comprises a compression screw 2 which consists of a first anchoring part 5 and a second driving part 6, capable of separating from the first part under a determined tightening torque. (figure 2).
  • the first part 5 of the screw 2 comprises a head 7 with a flared profile secured to a smooth and cylindrical body 8, which is extended by a threaded profile 9 of diameter less than that of said body (FIG. 2).
  • the head 7 of the compression screw 2 is integral opposite the body 8 of the drive part 6 which is, for example, made up of a breakable rupture zone 10 and a drive body 11 of which the external profile allows its cooperation with a tool not shown ( Figure 2).
  • the bone anchoring device 1 comprises a fixing anchor 3 which consists of a first anchoring part 12 and a second connecting part
  • the first part 12 and the second part 13 are pierced with an internal bore
  • the bore 14 has, on the one hand, the first anchoring part 12, a smooth internal surface 15 and, on the other hand, the second connecting part 13, a threaded surface 16.
  • the first anchoring part 12 comprises fins 17 separated from each other by slots 18 which are arranged parallel to the longitudinal axis XX 'of the fixing anchor 3.
  • Each fin 17 consists of a deformation zone 19 making it possible to connect the first anchoring part 12 to the second connecting part 13 of the fixing anchor 3.
  • the deformation zones 19 allow, under a determined external force and in their elastic capacities, the fins 17 to be able to move apart towards the outside of the fixing anchor 3.
  • Each fin 17 comprises in the extension of the deformation zone 19 teeth 20 which extend perpendicular to the axis XX 'and in the direction of the outside of the fixing anchor 3, to constitute, during the elastic deformation fins, the anchoring of the latter in the bone tissue.
  • the teeth 20 are arranged perpendicularly to each other around the periphery of the fixing anchor 3.
  • the teeth 20 are provided approximately on 2/3 of the height of the fins 17 to constitute a sufficient width of anchoring in the bone tissues.
  • the teeth 20 have a flared external profile, the thinest part of which is directed towards the outside of the fixing anchor 3, to constitute better penetration of the latter into the bone tissue.
  • the second connecting part 13 of the fixing anchor 3 has a complex external profile for creating with the teeth 20 anti-rotation means during the introduction of the anchor 3.
  • the ancillary fitting 4 consists of a cylindrical and smooth rod 21 integral with an operating handle 22.
  • the rod 21 has, opposite the handle 22, a threaded portion 23 whose external diameter is less than that of the stem.
  • the rod 21 has between the handle 22 and the threaded part 23 marks 24 allowing the surgeons to measure the depression of the ancillary 4 to determine the length of the compression screw 3 to be used.
  • Figures 6 to 8 we have shown the different stages of implementation of the bone anchoring device 1 during, for example, an arthrodesis of a small joint and more particularly an arthrodesis of the finger.
  • surgeon proceeds on each of the bones 25 and 26, to ablate the articular parts to form two osseous surfaces 27 and 28 plane and substantially parallel. Then, the surgeon pierces a channel 29 inside the two bones 25 and 26.
  • the surgeon screws the fixing anchor 3 onto the threaded part 24 of the ancillary 4 before its introduction into the cancellous bone. Then the surgeon introduces the fixing anchor 3 using the ancillary 4 inside the channel 29 until it comes into the cancellous part of the bone 26 (FIG. 6).
  • the surgeon proceeds with the aid of the ancillary 4, to deform the fins 17 so that the teeth 20 deviate from the center of the fixing anchor 3 and that they come to hang in the internal cortical part of the bone 26.
  • the deformation of the fins 17 is obtained by tightening the ancillary 4 inside the anchor 3, and more particularly by means of the shoulder located between the threaded part 24 and the smooth rod 21 (FIG. 7).
  • this shoulder is of a larger diameter than that of the internal bore 14 allowing progressively the tightening of the ancillary 4 in the anchor 3 to separate the fins 17 from the 'axis XX' by the deformation of the zones 19.
  • the teeth 20 form a retaining means which opposes the rotational drive imposed by the ancillary device 4 when the latter is tightened inside the anchor 3.
  • the fixing anchor 3 is not rotated inside the bone 26, preventing the degradation of its spongy part under the clamping force.
  • the surgeon notes the reference of the mark 24 visible outside the channel 29, in order to know the depression of the ancillary 4. This measurement will allow the surgeon to know the length of the compression screw 2 to choose, and more particularly the length of the threaded part 9, to perform the bone arthrodesis. After reading the marks, the surgeon removes the ancillary device 4 to release the channel 29 (FIG. 7).
  • the surgeon proceeds to place the compression screw 2 in the channel 29 to screw the threaded part 9 inside the threaded surface 16 of the fixing anchor 3.
  • the tightening of the screw 2 inside the anchor 3 is made until the surfaces 27 and 28 of the bones 25 and 26 are in effective and lasting compression to obtain the bone arthrodesis.
  • the head 7 of the compression screw 2 will be separated from its positioning tool 6 when the tightening torque is greater than the resistance of the rupture zone 10.
  • the fixing anchor 3 plays the role of a nut which is perfectly immobilized inside the bone 26 due to the deformation of the fins 17 and the penetration of anti-rotation teeth 20 in the parts bones making up the bone 26.
  • the compressive bone anchoring device according to the present invention is made of a material such as metal, or of the alloy, or of a bio-absorbable material or any other biocompatible material.

Abstract

The invention relates to a compressive bone anchoring device consisting of a compression screw (2) and a fixing anchor (3) comprising support means. The aforementioned support means include a first anchoring part (12) and a second connecting part (13). Said anchoring part (12) comprises: (i) winglets (17) which can diverge from axis XX' of the anchor (3); and (ii) anti-rotation means (20) which are used to block the anchor (3) in rotation.

Description

DISPOSITIF D'ANCRAGE OSSEUX COMPRESSIF COMPRESSIVE BONE ANCHORING DEVICE
La présente invention est relative à un dispositif d'ancrage osseux permettant la liaison de fragments osseux entre eux et/ou l'immobilisation de petites articulations lors d'arthrodèses osseuses.The present invention relates to a bone anchoring device allowing the connection of bone fragments between them and / or the immobilization of small joints during bone arthrodesis.
On connaît des dispositifs d'ancrage osseux permettant la fixation des ostéotomies de l'articulation métatarso-phalangienne du gros orteil, et comportant des vis de compression auto-sécables sur lesquelles vient se visser une cheville munie de crochets.Bone anchoring devices are known which allow the fixation of osteotomies of the metatarsophalangeal joint of the big toe, and comprising self-breaking compression screws onto which an ankle provided with hooks is screwed.
Ce genre de dispositif présente des chevilles qui s'écartent lors de l'introduction de la vis à l'extérieur de l'os et non à l'intérieur.This type of device has dowels which move apart when the screw is inserted outside the bone and not inside.
On connaît également des ancres de suture pourvues d'éléments qui s'écartent à l'intérieur de l'os lors de l'introduction d'une vis de compression. On note que l'ancre de suture avant déformation présente la forme d'un cylindre qui n'est pas retenu en rotation.There are also known suture anchors provided with elements which move apart inside the bone during the introduction of a compression screw. Note that the suture anchor before deformation has the shape of a cylinder which is not retained in rotation.
Cet inconvénient oblige le chirurgien à une certaine habilité pour ne pas détruire l'os spongieux, du fait de l'entraînement en rotation de l'ancre de suture lors du vissage de la vis de compression.This drawback requires the surgeon to have a certain skill not to destroy the cancellous bone, due to the rotational driving of the suture anchor during the screwing of the compression screw.
Le dispositif d'ancrage osseux suivant la présente invention est prévu pour répondre aux problèmes de rotation des éléments d'ancrage sous l'effort de serrage des vis de compression, afin d'assurer une compression durable des éléments osseux entre eux.The bone anchoring device according to the present invention is intended to respond to the problems of rotation of the anchoring elements under the force of tightening the compression screws, in order to ensure lasting compression of the bone elements between them.
Le dispositif d'ancrage osseux suivant la présente invention comprend une vis de compression et une ancre de fixation comportant des moyens de retenue qui sont constitués, d'une première partie d'ancrage et d'une seconde partie de liaison, ladite partie d'ancrage étant d'une part formée d'ailettes qui peuvent s'écarter de l'axe XX' de l'ancre et d'autre part de moyens anti-rotation pour bloquer l'ancre en rotation.The bone anchoring device according to the present invention comprises a compression screw and a fixing anchor comprising retaining means which consist of a first anchoring part and a second connecting part, said part of anchoring being on the one hand formed of fins which can deviate from the axis XX 'of the anchor and on the other hand of anti-rotation means for locking the anchor in rotation.
Le dispositif d'ancrage osseux suivant la présente invention comprend une première partie d'ancrage qui comporte des ailettes séparées les unes des autres par des fentes, qui sont disposées parallèlement à l'axe longitudinal XX' de l'ancre de fixation.The bone anchoring device according to the present invention comprises a first anchoring part which has fins separated from each other by slots, which are arranged parallel to the longitudinal axis XX 'of the fixing anchor.
Le dispositif d'ancrage osseux suivant la présente invention comprend des ailettes dont chacune est constituée d'une zone de déformation permettant de relier la première partie d'ancrage à la seconde partie de liaison de l'ancre de fixation. Le dispositif d'ancrage osseux suivant la présente invention comprend sur chaque ailette des dents qui s'étendent perpendiculairement à l'axe XX' et en direction de l'extérieur de l'ancre de fixation.The bone anchoring device according to the present invention comprises fins, each of which consists of a deformation zone making it possible to connect the first anchoring part to the second connecting part of the fixing anchor. The bone anchoring device according to the present invention comprises on each fin teeth which extend perpendicular to the axis XX 'and in the direction of the exterior of the fixing anchor.
Le dispositif d'ancrage osseux suivant la présente invention comprend des dents qui sont disposées perpendiculairement les unes par rapport aux autres sur le pourtour de l'ancre de fixation.The bone anchoring device according to the present invention comprises teeth which are arranged perpendicular to one another around the periphery of the fixing anchor.
Le dispositif d'ancrage osseux suivant la présente invention comprend des dents qui sont prévues sur les 2/3 de la hauteur des ailettes et qui présentent un profil externe évasé dont la partie de moindre épaisseur est dirigée en direction de l'extérieur de l'ancre de fixation.The bone anchoring device according to the present invention comprises teeth which are provided on 2/3 of the height of the fins and which have a flared external profile, the less thick part of which is directed towards the outside of the fixing anchor.
Le dispositif d'ancrage osseux suivant la présente invention comprend une première partie d'ancrage et la seconde partie de liaison qui sont percées d'un alésage interne coaxial à l'axe longitudinal XX' et débouchant à chaque extrémité de l'ancre de fixation, ledit alésage présentant au niveau d'une part de la première partie d'ancrage une surface interne lisse et d'autre part de la seconde partie de liaison une surface filetée.The bone anchoring device according to the present invention comprises a first anchoring part and the second connecting part which are pierced with an internal bore coaxial with the longitudinal axis XX 'and emerging at each end of the fixing anchor , said bore having on the one hand of the first anchoring part a smooth internal surface and on the other hand of the second connecting part a threaded surface.
Le dispositif d'ancrage osseux suivant la présente invention comprend une vis de compression qui est constituée d'une première partie d'ancrage et d'une seconde partie d'entraînement susceptible sous un couple de serrage déterminé de se séparer de la première partie.The bone anchoring device according to the present invention comprises a compression screw which consists of a first anchoring part and a second driving part capable, under a determined tightening torque, of separating from the first part.
Le dispositif d'ancrage osseux suivant la présente invention comprend une première partie de la vis qui comporte une tête à profil évasé solidaire d'un corps lisse et cylindrique qui se prolonge par un profil fileté de diamètre inférieur à celui dudit corps, ladite tête étant solidaire à l'opposé du corps d'une zone de rupture sécable qui se prolonge par un corps d'entraînement.The bone anchoring device according to the present invention comprises a first part of the screw which comprises a head with a flared profile secured to a smooth, cylindrical body which is extended by a threaded profile of diameter smaller than that of said body, said head being secured opposite the body from a breakable rupture zone which is extended by a drive body.
Le dispositif d'ancrage osseux suivant la présente invention comporte un ancillaire de pose qui est constitué d'une tige cylindrique et lisse solidaire d'une poignée de manœuvre, ladite tige comprenant d'une part à l'opposé de la poignée une partie filetée dont le diamètre externe est inférieur à celui de la tige et d'autre part entre la poignée et la partie filetée des repères.The bone anchoring device according to the present invention comprises a positioning aid which consists of a cylindrical and smooth rod secured to a maneuvering handle, said rod comprising on the one hand opposite the handle a threaded part. whose external diameter is less than that of the rod and on the other hand between the handle and the threaded part of the pins.
La description qui va suivre en regard des dessins annexés, donnés à titre d'exemples non limitatifs, permettra de mieux comprendre l'invention, les caractéristiques qu'elle présente et les avantages qu'elle est susceptible de procurer :The description which follows with reference to the appended drawings, given by way of nonlimiting examples, will make it possible to better understand the invention, the characteristics which it presents and the advantages which it is capable of providing:
Figure 1 est une vue en perspective illustrant l' ancillaire de pose et le dispositif d'ancrage osseux suivant la présente invention.Figure 1 is a perspective view illustrating the placement aid and the bone anchoring device according to the present invention.
Figure 2 est une vue en perspective montrant la vis de compression du dispositif d'ancrage osseux suivant la présente invention. Figures 3 à 5 sont des vues représentant l'ancre du dispositif d'ancrage osseux suivant la présente invention.Figure 2 is a perspective view showing the compression screw of the bone anchoring device according to the present invention. Figures 3 to 5 are views showing the anchor of the bone anchoring device according to the present invention.
Figures 6 à 8 sont des vues illustrant un exemple d'arthrodèse osseuse et les différentes étapes de mise en place du dispositif d'ancrage osseux suivant la présente invention.Figures 6 to 8 are views illustrating an example of bone arthrodesis and the different stages of setting up the bone anchoring device according to the present invention.
On a représenté en figures 1 à 5 un dispositif d'ancrage osseux 1 comportant une vis de compression 2, une ancre de fixation 3 jouant le même rôle qu'un écrou et un ancillaire de pose 4.FIGS. 1 to 5 show a bone anchoring device 1 comprising a compression screw 2, a fixing anchor 3 playing the same role as a nut and a setting aid 4.
Le dispositif d'ancrage osseux 1 comporte une vis de compression 2 qui est constituée d'une première partie d'ancrage 5 et d'une seconde partie d'entraînement 6, susceptibles sous un couple de serrage déterminé de se séparer de la première partie (figure 2).The bone anchoring device 1 comprises a compression screw 2 which consists of a first anchoring part 5 and a second driving part 6, capable of separating from the first part under a determined tightening torque. (figure 2).
La première partie 5 de la vis 2 comporte une tête 7 à profil évasé solidaire d'un corps 8 lisse et cylindrique, qui se prolonge par un profil fileté 9 de diamètre inférieur à celui dudit corps (figure2).The first part 5 of the screw 2 comprises a head 7 with a flared profile secured to a smooth and cylindrical body 8, which is extended by a threaded profile 9 of diameter less than that of said body (FIG. 2).
La tête 7 de la vis de compression 2 est solidaire à l'opposé du corps 8 de la partie d'entraînement 6 qui est, par exemple, constituée d'une zone de rupture sécable 10 et d'un corps d'entraînement 11 dont le profil externe permet sa coopération avec un outil non représenté (figure 2).The head 7 of the compression screw 2 is integral opposite the body 8 of the drive part 6 which is, for example, made up of a breakable rupture zone 10 and a drive body 11 of which the external profile allows its cooperation with a tool not shown (Figure 2).
Le dispositif d'ancrage osseux 1 comporte une ancre de fixation 3 qui est constituée d'une première partie d'ancrage 12 et d'une seconde partie de liaisonThe bone anchoring device 1 comprises a fixing anchor 3 which consists of a first anchoring part 12 and a second connecting part
13 coopérant soit avec la vis de compression 2, soit avec Pancillaire 4.13 cooperating either with the compression screw 2 or with Pancillary 4.
La première partie 12 et la seconde partie 13 sont percées d'un alésage interneThe first part 12 and the second part 13 are pierced with an internal bore
14 coaxial à l'axe longitudinal XX' et débouchant à chaque extrémité de l'ancre de fixation 3.14 coaxial with the longitudinal axis XX ′ and emerging at each end of the fixing anchor 3.
L'alésage 14 présente au niveau d'une part de la première partie d'ancrage 12 une surface interne lisse 15 et d'autre part de la seconde partie de liaison 13 une surface filetée 16.The bore 14 has, on the one hand, the first anchoring part 12, a smooth internal surface 15 and, on the other hand, the second connecting part 13, a threaded surface 16.
La première partie d'ancrage 12 comporte des ailettes 17 séparées les unes des autres par des fentes 18 qui sont disposées parallèlement à l'axe longitudinal XX' de l'ancre de fixation 3.The first anchoring part 12 comprises fins 17 separated from each other by slots 18 which are arranged parallel to the longitudinal axis XX 'of the fixing anchor 3.
Chaque ailette 17 est constituée d'une zone de déformation 19 permettant de relier la première partie d'ancrage 12 à la seconde partie de liaison 13 de l'ancre de fixation 3. Les zones de déformation 19 permettent, sous un effort extérieur déterminé et dans leurs capacités élastiques, que les ailettes 17 puissent s'écarter en direction de l'extérieur de l'ancre de fixation 3.Each fin 17 consists of a deformation zone 19 making it possible to connect the first anchoring part 12 to the second connecting part 13 of the fixing anchor 3. The deformation zones 19 allow, under a determined external force and in their elastic capacities, the fins 17 to be able to move apart towards the outside of the fixing anchor 3.
Chaque ailette 17 comporte dans le prolongement de la zone de déformation 19 des dents 20 qui s'étendent perpendiculairement à l'axe XX' et en direction de l'extérieur de l'ancre de fixation 3, pour constituer, lors de la déformation élastique des ailettes, l'ancrage de cette dernière dans le tissu osseux.Each fin 17 comprises in the extension of the deformation zone 19 teeth 20 which extend perpendicular to the axis XX 'and in the direction of the outside of the fixing anchor 3, to constitute, during the elastic deformation fins, the anchoring of the latter in the bone tissue.
Les dents 20 sont disposées perpendiculairement les unes par rapport aux autres sur le pourtour de l'ancre de fixation 3.The teeth 20 are arranged perpendicularly to each other around the periphery of the fixing anchor 3.
Egalement, les dents 20 sont prévues approximativement sur les 2/3 de la hauteur des ailettes 17 pour constituer une largeur suffisante d'ancrage dans les tissus osseux.Also, the teeth 20 are provided approximately on 2/3 of the height of the fins 17 to constitute a sufficient width of anchoring in the bone tissues.
Les dents 20 présentent un profil externe évasé dont la partie de moindre épaisseur est dirigée en direction de l'extérieur de l'ancre de fixation 3, pour constituer une meilleure pénétration de ces dernières dans le tissu osseux.The teeth 20 have a flared external profile, the thinest part of which is directed towards the outside of the fixing anchor 3, to constitute better penetration of the latter into the bone tissue.
La seconde partie de liaison 13 de l'ancre de fixation 3 présente un profil externe complexe pour créer avec les dents 20 des moyens anti-rotation lors de l'introduction de l'ancre 3.The second connecting part 13 of the fixing anchor 3 has a complex external profile for creating with the teeth 20 anti-rotation means during the introduction of the anchor 3.
L' ancillaire de pose 4 est constitué d'une tige 21 cylindrique et lisse solidaire d'une poignée de manœuvre 22. La tige 21 comporte à l'opposé de la poignée 22 une partie filetée 23 dont le diamètre externe est inférieur à celui de la tige.The ancillary fitting 4 consists of a cylindrical and smooth rod 21 integral with an operating handle 22. The rod 21 has, opposite the handle 22, a threaded portion 23 whose external diameter is less than that of the stem.
La tige 21 présente entre la poignée 22 et la partie filetée 23 des repères 24 permettant aux chirurgiens de mesurer l'enfoncement de l' ancillaire 4 pour déterminer la longueur de la vis de compression 3 à utiliser.The rod 21 has between the handle 22 and the threaded part 23 marks 24 allowing the surgeons to measure the depression of the ancillary 4 to determine the length of the compression screw 3 to be used.
En figures 6 à 8 on a montré les différentes étapes de mise en place du dispositif d'ancrage osseux 1 lors, par exemple, d'une arthrodèse d'une petite articulation et plus particulièrement d'une arthrodèse du doigt.In Figures 6 to 8 we have shown the different stages of implementation of the bone anchoring device 1 during, for example, an arthrodesis of a small joint and more particularly an arthrodesis of the finger.
On note en premier lieu que le chirurgien procède sur chacun des os 25 et 26, à une ablation des parties articulaires pour former deux surfaces osseuses 27 et 28 planes et sensiblement parallèles. Ensuite, le chirurgien perce un canal 29 à l'intérieur des deux os 25 et 26.It is noted first of all that the surgeon proceeds on each of the bones 25 and 26, to ablate the articular parts to form two osseous surfaces 27 and 28 plane and substantially parallel. Then, the surgeon pierces a channel 29 inside the two bones 25 and 26.
En second lieu, le chirurgien visse l'ancre de fixation 3 sur la partie filetée 24 de l'ancillaire 4 avant son introduction dans l'os spongieux. Ensuite le chirurgien introduit l'ancre de fixation 3 à l'aide de l'ancillaire 4 à l'intérieur du canal 29 jusqu'à venir dans la partie spongieuse de l'os 26 (figure 6). En troisième lieu, le chirurgien procède à l'aide de l'ancillaire 4, à la déformation des ailettes 17 pour que les dents 20 s'écartent du centre de l'ancre de fixation 3 et qu'elles viennent s'accrocher dans la partie corticale interne de l'os 26. La déformation des ailettes 17 est obtenue par le serrage de l'ancillaire 4 à l'intérieur de l'ancre 3, et plus particulièrement au moyen de l'épaulement se trouvant entre la partie filetée 24 et la tige lisse 21 (figure 7).Secondly, the surgeon screws the fixing anchor 3 onto the threaded part 24 of the ancillary 4 before its introduction into the cancellous bone. Then the surgeon introduces the fixing anchor 3 using the ancillary 4 inside the channel 29 until it comes into the cancellous part of the bone 26 (FIG. 6). Thirdly, the surgeon proceeds with the aid of the ancillary 4, to deform the fins 17 so that the teeth 20 deviate from the center of the fixing anchor 3 and that they come to hang in the internal cortical part of the bone 26. The deformation of the fins 17 is obtained by tightening the ancillary 4 inside the anchor 3, and more particularly by means of the shoulder located between the threaded part 24 and the smooth rod 21 (FIG. 7).
En effet, cet épaulement est d'un plus grand diamètre que celui de l'alésage interne 14 permettant au fur et à mesure de l'augmentation du serrage de l'ancillaire 4 dans l'ancre 3 d'écarter les ailettes 17 de l'axe XX' par la déformation des zones 19.Indeed, this shoulder is of a larger diameter than that of the internal bore 14 allowing progressively the tightening of the ancillary 4 in the anchor 3 to separate the fins 17 from the 'axis XX' by the deformation of the zones 19.
On constate que les dents 20 forment un moyen de retenue qui s'oppose à l'entraînement en rotation imposé par l'ancillaire 4 lors du serrage de ce dernier à l'intérieur de l'ancre 3. Ainsi, l'ancre de fixation 3 n'est pas entraînée en rotation à l'intérieur de l'os 26, empêchant la dégradation de sa partie spongieuse sous l'effort de serrage.It can be seen that the teeth 20 form a retaining means which opposes the rotational drive imposed by the ancillary device 4 when the latter is tightened inside the anchor 3. Thus, the fixing anchor 3 is not rotated inside the bone 26, preventing the degradation of its spongy part under the clamping force.
Lorsque l'ancre 3 est parfaitement immobilisée et fixée à l'intérieur de l'os 26, le chirurgien relève la référence du repère 24 visible à l'extérieur du canal 29, afin de connaître l'enfoncement de l'ancillaire 4. Cette mesure permettra au chirurgien de connaître la longueur de la vis de compression 2 à choisir, et plus particulièrement la longueur de la partie filetée 9, pour réaliser l'arthrodèse osseuse. Après le relevé des repères, le chirurgien retire l'ancillaire 4 pour libérer le canal 29 (figure7).When the anchor 3 is perfectly immobilized and fixed inside the bone 26, the surgeon notes the reference of the mark 24 visible outside the channel 29, in order to know the depression of the ancillary 4. This measurement will allow the surgeon to know the length of the compression screw 2 to choose, and more particularly the length of the threaded part 9, to perform the bone arthrodesis. After reading the marks, the surgeon removes the ancillary device 4 to release the channel 29 (FIG. 7).
En quatrième lieu, le chirurgien procède à la mise en place de la vis de compression 2 dans le canal 29 pour venir visser la partie filetée 9 à l'intérieur de la surface filetée 16 de l'ancre de fixation 3. Le serrage de la vis 2 à l'intérieur de l'ancre 3 est réalisé jusqu'à ce que les surfaces 27 et 28 des os 25 et 26 soient en compression efficace et durable pour obtenir l'arthrodèse osseuse. La tête 7 de la vis de compression 2 sera séparée de son outil de mise en place 6 lorsque le couple de serrage sera supérieur à la résistance de la zone de rupture 10.Fourthly, the surgeon proceeds to place the compression screw 2 in the channel 29 to screw the threaded part 9 inside the threaded surface 16 of the fixing anchor 3. The tightening of the screw 2 inside the anchor 3 is made until the surfaces 27 and 28 of the bones 25 and 26 are in effective and lasting compression to obtain the bone arthrodesis. The head 7 of the compression screw 2 will be separated from its positioning tool 6 when the tightening torque is greater than the resistance of the rupture zone 10.
On note que l'ancre de fixation 3 joue le rôle d'un écrou qui est parfaitement immobilisé à l'intérieur de l'os 26 du fait de la déformation des ailettes 17 et de la pénétration de dents anti-rotation 20 dans les parties osseuses composant l'os 26.It is noted that the fixing anchor 3 plays the role of a nut which is perfectly immobilized inside the bone 26 due to the deformation of the fins 17 and the penetration of anti-rotation teeth 20 in the parts bones making up the bone 26.
Le dispositif d'ancrage osseux compressif suivant la présente invention est réalisé dans un matériau tel que du métal, ou de l'alliage, ou dans une matière bio- résorbable ou tout autre matériau biocompatibleThe compressive bone anchoring device according to the present invention is made of a material such as metal, or of the alloy, or of a bio-absorbable material or any other biocompatible material.
Il doit d'ailleurs être entendu que la description qui précède n'a été donnée qu'à titre d'exemple et qu'elle ne limite nullement le domaine de l'invention dont on ne sortirait pas en remplaçant les détails d'exécution décrits par tout autre équivalent. It should moreover be understood that the foregoing description has been given only by way of example and that it in no way limits the field of the invention from which one would not depart by replacing the execution details described by any other equivalent.

Claims

REVENDICATIONS
1. Dispositif d'ancrage osseux permettant la liaison de fragments osseux entre eux et/ou l'immobilisation de petites articulations lors d'arthrodèses osseuses caractérisé en ce qu'il comprend une vis de compression (2) et une ancre de fixation (3) comportant des moyens de retenue qui sont constitués d'une première partie d'ancrage (12) et d'une seconde partie de liaison (13), ladite partie d'ancrage (12) étant d'une part formée d'ailettes (17) qui peuvent s'écarter de l'axe XX' de l'ancre (3), et d'autre part de moyens anti-rotation (20) pour bloquer l'ancre (3) en rotation.1. A bone anchoring device allowing the connection of bone fragments to one another and / or the immobilization of small joints during bone arthrodesis, characterized in that it comprises a compression screw (2) and a fixing anchor (3 ) comprising retaining means which consist of a first anchoring part (12) and a second connecting part (13), said anchoring part (12) being on the one hand formed of fins ( 17) which can deviate from the axis XX 'of the anchor (3), and on the other hand anti-rotation means (20) for locking the anchor (3) in rotation.
2. Dispositif d'ancrage osseux suivant la revendication 1, caractérisé en ce que la première partie d'ancrage (12) comporte des ailettes (17), séparées les unes des autres par des fentes (18), qui sont disposées parallèlement à l'axe longitudinal XX' de l'ancre de fixation (3).2. bone anchoring device according to claim 1, characterized in that the first anchoring part (12) comprises fins (17), separated from each other by slots (18), which are arranged parallel to the 'longitudinal axis XX' of the fixing anchor (3).
3. Dispositif d'ancrage osseux suivant la revendication 1, caractérisé en ce que chaque ailette (17) est constituée d'une zone de déformation (19) permettant de relier la première partie d'ancrage (12) à la seconde partie de liaison (13) de l'ancre de fixation (3).3. bone anchoring device according to claim 1, characterized in that each fin (17) consists of a deformation zone (19) making it possible to connect the first anchoring part (12) to the second connecting part (13) of the fixing anchor (3).
4. Dispositif d'ancrage osseux suivant la revendication 1, caractérisé en ce que chaque ailette (17) comporte des dents (20) qui s'étendent perpendiculairement à l'axe XX' et en direction de l'extérieur de l'ancre de fixation (3).4. bone anchoring device according to claim 1, characterized in that each fin (17) has teeth (20) which extend perpendicular to the axis XX 'and in the direction of the outside of the anchor. fixing (3).
5. Dispositif d'ancrage osseux suivant la revendication 4, caractérisé en ce que les dents (20) sont disposées perpendiculairement les unes par rapport aux autres sur le pourtour de l'ancre de fixation (3).5. A bone anchoring device according to claim 4, characterized in that the teeth (20) are arranged perpendicularly to each other around the periphery of the fixing anchor (3).
6. Dispositif d'ancrage osseux suivant la revendication 4, caractérisé en ce que les dents (20) sont prévues sur les 2/3 de la hauteur des ailettes (17) et présentent un profil externe évasé dont la partie de moindre épaisseur est dirigée en direction de l'extérieur de l'ancre de fixation (3).6. bone anchoring device according to claim 4, characterized in that the teeth (20) are provided on 2/3 of the height of the fins (17) and have a flared external profile, the thinest part of which is directed. towards the outside of the fixing anchor (3).
7. Dispositif d'ancrage osseux suivant la revendication 1, caractérisé en ce que la première partie (12) et la seconde partie (13) sont percées d'un alésage interne (14) coaxial à l'axe longitudinal XX' et débouchant à chaque extrémité de l'ancre de fixation (3), ledit alésage (14) présentant au niveau d'une part de la première partie d'ancrage (12) une surface interne lisse (15), et d'autre part de la seconde partie de liaison (13) une surface filetée (16). 7. bone anchoring device according to claim 1, characterized in that the first part (12) and the second part (13) are pierced with an internal bore (14) coaxial with the longitudinal axis XX 'and opening out at each end of the fixing anchor (3), said bore (14) having on the one hand of the first anchoring part (12) a smooth internal surface (15), and on the other hand of the second connecting part (13) a threaded surface (16).
8. Dispositif d'ancrage osseux suivant la revendication 1, caractérisé en ce que la vis de compression (2) est constituée d'une première partie d'ancrage (5) et d'une seconde partie d'entraînement (6) susceptibles, sous un couple de serrage déterminé, de se séparer de la première partie. 8. A bone anchoring device according to claim 1, characterized in that the compression screw (2) consists of a first anchoring part (5) and a second drive part (6) capable of, under a determined tightening torque, to separate from the first part.
9. Dispositif d'ancrage osseux suivant la revendication 7, caractérisé en ce que la première partie (5) de la vis (2) comporte une tête (7) à profil évasé solidaire d'un corps (8) lisse et cylindrique qui se prolonge par un profil fileté (9) de diamètre inférieur à celui dudit corps, ladite tête (7) étant solidaire à l'opposé du corps (8) d'une zone de rupture sécable (10) qui se prolonge par un corps d'entraînement (11).9. bone anchoring device according to claim 7, characterized in that the first part (5) of the screw (2) comprises a head (7) with flared profile secured to a smooth (cylindrical) body (8) which extends by a threaded profile (9) of diameter smaller than that of said body, said head (7) being secured opposite the body (8) of a breakable rupture zone (10) which is extended by a body of drive (11).
10. Ancillaire pour la pose d'un dispositif d'ancrage osseux suivant la revendication 1 , caractérisé en ce qu'il est constitué d'une tige (21) cylindrique et lisse solidaire d'une poignée de manœuvre (22), ladite tige (21) comprenant d'une part à l'opposé de la poignée (22) une partie filetée (23) dont le diamètre externe est inférieur à celui de la tige et d'autre part entre la poignée (22) et la partie filetée (23) des repères (24). 10. Ancillary device for placing a bone anchoring device according to claim 1, characterized in that it consists of a cylindrical and smooth rod (21) secured to an operating handle (22), said rod (21) comprising on the one hand opposite the handle (22) a threaded part (23) whose external diameter is less than that of the rod and on the other hand between the handle (22) and the threaded part (23) marks (24).
PCT/FR2002/004194 2001-12-07 2002-12-05 Compressive bone anchoring device WO2003047443A1 (en)

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AU2002364318A AU2002364318A1 (en) 2001-12-07 2002-12-05 Compressive bone anchoring device

Applications Claiming Priority (2)

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FR0115833A FR2833152B1 (en) 2001-12-07 2001-12-07 COMPRESSIVE BONE ANCHORING DEVICE
FR01/15833 2001-12-07

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2397545A (en) * 1945-02-13 1946-04-02 Mervyn G Hardinge Self-adjusting fracture reducing device
US3678925A (en) * 1969-10-03 1972-07-25 Artur Fischer Connector for fractured bones
US4275717A (en) * 1979-07-27 1981-06-30 Zimmer Usa, Inc. Intramedullary fixation device for fractured tubular bones
US5759184A (en) * 1993-07-23 1998-06-02 Santangelo; Massimo Device for preventive support of the femur
US5772662A (en) * 1986-06-23 1998-06-30 Howmedica Inc. Femoral fixation system

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2397545A (en) * 1945-02-13 1946-04-02 Mervyn G Hardinge Self-adjusting fracture reducing device
US3678925A (en) * 1969-10-03 1972-07-25 Artur Fischer Connector for fractured bones
US4275717A (en) * 1979-07-27 1981-06-30 Zimmer Usa, Inc. Intramedullary fixation device for fractured tubular bones
US5772662A (en) * 1986-06-23 1998-06-30 Howmedica Inc. Femoral fixation system
US5759184A (en) * 1993-07-23 1998-06-02 Santangelo; Massimo Device for preventive support of the femur

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FR2833152A1 (en) 2003-06-13
AU2002364318A1 (en) 2003-06-17
FR2833152B1 (en) 2004-07-02

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