CN1764418B - 锁定接骨板 - Google Patents

锁定接骨板 Download PDF

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CN1764418B
CN1764418B CN2004800081713A CN200480008171A CN1764418B CN 1764418 B CN1764418 B CN 1764418B CN 2004800081713 A CN2004800081713 A CN 2004800081713A CN 200480008171 A CN200480008171 A CN 200480008171A CN 1764418 B CN1764418 B CN 1764418B
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罗伯特·艾伦·扬
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Gray Baki medical Limited by Share Ltd
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    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1728—Guides or aligning means for drills, mills, pins or wires for holes for bone plates or plate 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
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
    • A61B17/8057—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded the interlocking form comprising a thread
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B50/00—Containers, covers, furniture or holders specially adapted for surgical or diagnostic appliances or instruments, e.g. sterile covers
    • A61B50/30—Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments

Abstract

提供一种接骨板，具有纵向轴线、接触骨头的底侧和顶侧。交叠孔组从顶侧至底侧接骨板连通。该交叠孔具有多层面表面，如螺纹表面或系列同轴环形槽。交叠孔组适于接纳具有螺钉头和骨-接合螺纹的骨螺钉。

Description

锁定接骨板
技术领域
本发明涉及在整形外科中使用的装置、移入植物和假体，具体地，涉及用于加固骨折骨骼从而促进愈合的接骨板。
背景技术
加压螺丝系统，也是熟知的DCS系统，是多年来用于外伤手术的接骨板系统。使用该系统的过程由AO研究所很好地证实了，该研究所正将其作为新的整形外科手术促进的目标之一。该系统包括具有贯通狭槽的接骨板。狭槽的槽脊在一端是宽的，该端限定邻接狭槽的部位的梯状表面延伸通过接骨板。梯状表面通常是由球形滚轧机切割而成的，这样可以造成球形梯状表面。
在进一步的改进中，接骨板已改进成沿接骨板长度方向散布有独立螺纹孔和无螺纹的孔。在本设计和其它设计中，孔之间的距离变成标准的。虽然上述插件有一定的改进，但连接位置是预先设定的，所以只能在有限的范围内定位，从而降低了外科手术的灵活性。在另一个变形的产品中，可延伸，可锁定的插件插入标准接骨板的狭槽，当骨螺钉穿过插件中的一个并旋扭下时，插件延伸并在适当的位置锁定螺钉。然而，锁定该插件是在第二个操作。这是不希望的，因为这需要更多的操作时间和增加了手术的复杂性。而且，插件在接骨板安到骨骼上之前就要放到特定的位置且基本上不能嵌入的。这限制了在手术期间如果需要时位置的选择。
而且，上述插件的设计是依赖于两接触表面之间的摩擦力锁定的。摩擦力锁定不可靠且比螺丝锁定孔容易松脱。这种设计的效果比下面讨论的螺纹骨板和螺钉的设计差。
在Klaue等人的美国专利5002544中，显示了一种骨接合术用的加压骨板，该骨板具有横切骨板纵轴线的截面，至少一点其对底侧比对上表面宽，骨板在底侧有凹槽，这样在应用时骨在骨与骨板之间就有一空间。在螺孔之间的截面减少，优选地其限度使骨板在该区域的弯曲抵抗力小于在孔的区域。因为减低孔之间区域的弯曲抵抗力，骨板可更容易适应骨的解剖结构的变化。另外，这样做可使孔不变形，其结果减小了疲劳应力的丢失和螺丝头的松脱。
进一步，Takos等人的美国专利5709686描述一种接骨板，它在螺纹孔之间具有凹槽或在其侧面有降低的厚部件。虽然其目的没有具体描述，这些凹槽明显的作用是在接骨板弯曲时防止螺纹部件翘曲。然而，这样的接骨板与骨骼固定时，这些不连续的凹槽是暴露的且可潜在地会与肌肉组织接触并造成潜在地损伤。
更进一步，Tepic等人的美国专利5733287显示(在图4中)，骨板在底侧有横向的切口13和纵向的切口14来减低骨板与骨的接触。由于横向下切口13，在孔之间的截面15已经显著降低而因此无需如根据图3的实施例那样，通过上表面6上附加凹槽10来进一步降低。为了防止截面太薄，上表面6上的凹槽10由不连续的短阶的凹槽16构成，以提供光滑进入和移出孔8。
在另一个解决方案中，PCT申请WO01/54601包括了上述讨论的DCS系统的特征的锁定螺丝。这种已知的系统如复合-狭槽。在该设计中，狭槽的阶梯表面通常是斜坡或锥形的以至一端要比另一端深。这样可对接骨板定位和选择性的加固以便将由楔作用预置的两个骨断片加压在一起。用此方式，骨骼放置在外科医生确信能最好快速愈合的位置上。
进一步，该复合-孔包括在单个狭槽内两个不同的搭接部件。狭槽的一个部件适合接受标准骨螺钉。而另一个部件适合接受导向垂直于接骨板的顶表面的螺纹螺钉。而且，复合-孔通常导向有结合体最内端的螺纹部件和定向到接骨板的端部的非螺纹部件。该改进提高了使用该装置的整形外科医生选择的灵活性，该装置更可能将孔放在接骨板内适合的锚定点。然而，经常有螺纹部件最适合损伤的位置在接骨板的末端和/或在整个骨板不同位置。另外，有时没有特殊中心点的成品一在这种状态下，复合-孔设计的使用受到限制。
专利申请WO01/54601已经得到证明的优点是因为螺钉可锁定住骨板，而非螺纹狭槽的存在限制了使用者多方向定位螺钉的能力。
在进一步的改进中，AO研究所已经研究并实现了端钉的使用，它是刚性固定在接骨板的末端。这样的排列显示它比单独用骨螺钉可更好的抵抗骨骼的弯曲。弯曲很显然在其它接骨板系统中可时骨和接骨板的连接松动。
在另一个的改进中，公开于1995年6月14日的德国专利DE4341980A1描述了具有延长狭槽8的接骨板2，其中狭槽长边的边壁不平行且进一步具有内部螺纹9。相应的骨螺钉3或插件6有带外锥形4的钉头5，这样可以钉入沿长度方向的任何点，但可穿透不同深度。这样，最后固定的结构是不确定的，这是由于在插件或螺钉和狭槽的螺纹之间的接触数量少，同样，还有螺钉会在一个方向上滑脱的事实，该设计显然导致自身固定是不可靠的。
美国专利5324290公开了一种复杂的接骨板，它有在沿狭槽中间有锥形圆形凹槽扩孔的狭槽(如美国专利4696290相似的排列)。它进一步显示了接骨板转矩于骨骼以使至少在边上与骨骼形状相配(见图2)。其它感兴趣的专利包括美国专利3,716,050，3,659,595，5,681,311，5,261,910，和5,364,399，都公开了常规狭槽和凹槽的结合体，而没有完全提供带螺纹头的骨螺钉。
发明内容
和上述组合-孔的设计和摩擦锁定设计比较起来，需要一种能给外科医生选择提供更大灵活性的接骨板。更具体地，需要提供一种能对骨板位置选择，同时在任何孔的位置能可靠地，永久地固定接骨板和骨碎片的接骨板。
需要一种能给外科医生选择提供更大灵活性的接骨板，在接骨板中有对锁定螺钉和骨板位置的多种导向，并且同时在任何孔的位置能可靠地和永久地固定接骨板和骨碎片。
另外，需要一种具有凹槽的万能的接骨板，确定接骨板弯曲的位置，以防止在任意孔中的螺纹弯曲或翘曲，使其保持一平滑的外表面。
最后，需要一种带有造成半-定向加压孔的接骨板。
本发明提供一种接骨板，具有纵向轴线、接触骨头的底侧，和顶侧，该顶侧和底侧具有至少一组交叠孔，该组交叠孔从顶侧至底侧穿过接骨板连通，所述接骨板的特征在于，所述交叠孔包括两个相邻螺纹孔。交叠孔组适于接纳具有螺钉头和骨-接合螺纹的骨螺钉。
本发明的目的是给整形外科医生提供更灵活的选择，从而使可牢固固定的螺纹栓能够沿接骨板定位在任何中间位置，包括在末端。
本发明还提供一套整形外科的成套用具，包括：具有纵向轴线、接触骨头的底侧，和顶侧，该顶侧和底侧具有至少一组交叠多层面孔，该组交叠多层面孔从顶侧至底侧穿过接骨板连通，其中该交叠多层面孔限定具有多层面表面的螺纹孔；以及与接骨板接合的至少一个骨螺钉。
本发明还提供一种接骨板，具有纵向轴线、接触骨头的底侧，和顶侧，该底侧和顶侧具有多组交叠多层面孔，每组包括两个相邻螺纹孔，所述两个相邻螺纹孔从顶侧至底侧穿过接骨板连通，其中所述两个相邻螺纹孔中的每一个都具有螺纹，适于接纳具有螺纹头和骨接合螺纹柄的骨螺钉。
本发明还提供一种接骨板，具有纵向轴线、接触骨头的底侧，和顶侧，该顶侧和底侧具有多组交叠多层面孔，每组包括两个相邻螺纹孔，所述两个相邻螺纹孔从顶侧至底侧穿过接骨板连通，所述两个相邻螺纹孔中的每一个都具有螺纹表面，适于接纳具有螺纹头和骨接合螺纹柄的骨螺钉，其中该交叠多层面孔的中心沿接骨板纵轴线排成一线。
本发明还提供一种接骨板，具有纵向轴线、接触骨头的底侧，和顶侧，该顶侧和底侧具有多组螺纹孔，所述螺纹孔从顶侧至底侧穿过接骨板连通，至少一个包括交叠多层面孔的螺纹孔具有螺纹表面，该螺纹表面适于接纳具有螺钉头和骨接合螺纹的骨螺钉，而且该交叠多层面孔的中心基本围绕接骨板纵轴线交错排列。
本发明还提供一种接骨板，具有纵向轴线、具有总面积并接触骨头的底侧，和顶侧，该顶侧和底侧具有多个螺纹孔，所述螺纹孔从顶侧至底侧穿过接骨板连通，至少一个螺纹孔是一组交叠多层面孔，其中交叠多层面孔具有多层面表面，而其中底侧包括凹槽，该凹槽定位在相邻的螺纹孔之间且仅定位在底侧上，该凹槽有合适的尺寸从而限定横向于纵轴线且横跨凹槽的截面，这样保证了穿横跨凹槽的弯曲屈服强度比横跨螺纹孔的弯曲屈服强度小。
附图说明
图1a是接骨板的透视图，其中交叠孔沿接骨板的纵轴线排成一线。
图1b是接骨板的平面俯视图，其中交叠孔沿接骨板的纵轴线排成一线。
图1c是接骨板的纵向剖视图，其中交叠孔沿接骨板的纵轴线排成一线。
图1d是单组交叠孔的平面俯视图。
图2a是一组两个的有螺纹表面的交叠孔的透视图。
图2b是一组两个的交叠孔的透视图，其中每个孔的表面为同轴的系列环形槽。
图3是纵向剖视图，其中某些交叠孔与接骨板的顶侧垂直。
图4是纵向剖视图，其中所有的交叠孔从接骨板顶侧的垂直线偏移一个角度。
图5是接骨板的平面俯视图，其中交叠孔沿接骨板的纵轴线交错排列。
图6a是接骨板的平面俯视图，显示出了一组三个的交叠孔。
图6b是纵向剖视图，显示出了三个交叠孔的组，其中所有孔都与接骨板的顶表面垂直排成一线。
图6c是纵向剖视图，显示出了三个交叠孔的组，其中某些孔与接骨板的顶表面垂直排成一线。
图6d是纵向剖视图，显示出了三个交叠孔的组，其中所有孔都从接骨板顶表面的垂线偏移一个角度排成一线。
图7a是本发明的整形外科成套用具的平面图，包括箱子、接骨板、各种骨螺钉和各种长度的螺纹栓。
图7b是本发明的整形外科的成套用具的透视图，包括箱子、接骨板、各种骨螺钉和钻导子。
图8是骨螺钉的侧视图，该螺钉具有螺钉头和骨接合螺纹。
图9a是具有较浅凹槽的接骨板的可选实施例的透视图。
图9b是该接骨板的可选实施例的第二个透视图。
图9c是该接骨板的可选实施例的侧视图。
图10a是另一个可选实施例的透视图，显示了接骨板上的较浅凹槽。
图10b是该接骨板的可选实施例的仰视图。
图10c是该接骨板的可选实施例的侧视图。
具体实施方式
现在参照图1a至图1d，具有纵轴线12的接骨板10有接触骨头的底侧14和顶侧16。交叠孔22的多个组20从顶侧16至底侧14贯通穿过接骨板10。交叠孔22适于接纳骨螺钉24，该骨螺钉24具有：带有螺纹30的螺钉头26，和在相对端32、具有骨接合螺纹34的钉身(如图8所示)。
交叠孔22的多个组20在外科手术中定位接骨板10时允许有进一步的可调性和灵活性。交叠孔22与接骨板10的顶侧16垂直(如图1c和1d所示)。
现在参照图2a和2b，交叠孔22具有多层面表面36。在一个实施例中，多层面表面36是螺纹表面40(如图2a所示)。在另一个实施例中，多层面表面36是系列同轴环形槽42(如图2b所示)。
交叠孔22各自从接骨板10上表面16的垂线偏移角度φ。这样允许外科医生关于在哪里和如何固定接骨板10的选择上有进一步的可调性。仍然参照图1c和1d，其中这些交叠孔22垂直于接骨板10的顶侧16定位，外科医生可以选择以常规的方式固定接骨板，即垂直于接骨板的顶侧。
现在参照图3，在一个优选实施例中，某些交叠孔22与接骨板10的顶侧16垂直。
可选的，如图4所示，所有的交叠孔22都从接骨板10的顶侧16的垂线偏移一个角度φ。
现在参照图5，交叠孔22可以以交错的方式偏移于接骨板10的纵轴线12。
现在参照图6a至6d，在一个可选实施例中，接骨板10可包括三个交叠孔22的多个组20。详细参照图6b，其中这些交叠孔22垂直于接骨板10的顶侧16定位，外科医生可以选择以常规的方式固定接骨板。
详细参照图6c，在一个优选实施例中，某些交叠孔22与接骨板10的顶侧16垂直。
或者，如图6d所示，所有的交叠孔22与接骨板10的顶侧16的垂线偏移一个角度φ。
现在参照图7a和7b，在另一个实施例中，提供的整形外科成套用具44包括箱子46、接骨板10、各种骨螺钉24，各种长度的螺纹栓50和钻导子52。钻导子52有一螺纹端54，旋入交叠孔22的螺孔40中。钻导子52有一主钻导向面56，以安全的将钻导子相对于接骨板10保持在需要的方向上，以使在整形外科手术中使用的钻(未示出)保持平稳。
现在参照图9a至9c，接骨板10’的可选实施例设置有较浅的矩形凹槽66，横向的延伸横跨接骨板。这些凹槽66优选地以规则的间隔延纵轴线定位于在螺纹孔62之间。这些凹槽66是为了减小接骨板10’的底面14与骨头之间的接触面积，同时防止接骨板在螺纹孔62上弯曲(从而防止螺纹36歪曲)。由于凹槽66而从底侧14上去除的总面积优选地小于或等于底侧总的表面积的25％。
凹槽66基本上仅定位于底侧14上，并有合适的尺寸以限定横向于纵轴线且横跨凹槽的截面64。这样保证了横跨凹槽66的弯曲屈服强度小于横跨螺纹孔62的弯曲屈服强度，从而防止在接骨板与骨的曲面形成紧密配合时损害螺纹。
现在参照图10a至10c，显示了第二个接骨板10”的优选实施例，该实施例具有较浅凹槽66的另一种形式。这些凹槽66不延伸横跨接骨板10”的底侧14，而是从接骨板的一侧70向接骨板的中线12伸出一小段距离，但并不横跨中线。
注意本发明中使用的螺纹孔提供了位于特定位置的孔中心(不同于形状似狭缝的孔)。使用中心位于特定点的螺纹允许骨螺钉固定在特定位置，在该位置外科医生可以判断骨结构以选择最适宜支持该骨螺钉的位置。与使用狭缝的设计不同，本发明中的孔消除了螺钉在孔中的滑移。这进一步使得在特定位置的放置支持和/或牢固固定在中和的螺钉载荷区域中。
在另一个特征中，锁定骨栓(未显示出)与螺纹孔连接。这些骨栓头中切出的螺纹设计成与螺纹孔锁定，以便更好地确保当使用没有螺纹的栓身时结构的刚性固定。所使用锁定特性可以是通过机械装置的任何已知锁闭螺纹方法。
在本方明的一个优点中，对于外科医生来说，这种接骨板10有更大的选择灵活性，因为它提供牢固固定的螺纹栓可以安放在沿接骨板的任何中间位置，包括其末端。
在另一个优点中，接骨板10通过提供如下定位的多个交叠孔22而具有更大的选择灵活性，其中交叠孔22的定位方式包括(1)沿接骨板的纵轴线12方向，(2)与纵轴线成一个角度φ，和(3)沿该轴线交错排列。
还有另一个优点，接骨板10的螺纹孔40有垂直于接骨板顶侧16的螺纹，也有与垂线成一个角度φ的螺纹。
在此描述的本发明的实施例可以有多种变化和修改。尽管本发明的某些说明性的实施例在此显示和说明，很多的修改、改变和替代在之前的公开中有考虑。在某些示例中，本发明的某些特征可以不与其它特征共同使用。因此，应该理解先前被广泛叙述和理解的仅以说明和例子给出的叙述，本发明的精神和保护范围限于所附权利要求书的范围内。

Claims (33)

1.一种接骨板，具有纵向轴线、接触骨头的底侧，和顶侧，该顶侧和底侧具有至少一组交叠孔，该组交叠孔从顶侧至底侧穿过接骨板连通，所述接骨板的特征在于，所述交叠孔包括两个相邻螺纹孔。
2.根据权利要求1所述的接骨板，其中所述交叠孔与接骨板的顶侧垂直。
3.根据权利要求1所述的接骨板，其中所述交叠孔从接骨板顶侧的垂线偏移一个角度。
4.根据权利要求1所述的接骨板，其中所述一组交叠孔中的一个螺纹孔与接骨板的顶侧垂直，而所述一组交叠孔中的另一个螺纹孔从接骨板顶侧的垂线偏移一个角度。
5.根据权利要求1所述的接骨板，其中所述接骨板的顶侧和底侧包括多组交叠孔。
6.根据权利要求5所述的接骨板，其中所述交叠孔与接骨板的顶侧垂直。
7.根据权利要求5所述的接骨板，其中所述交叠孔从接骨板顶侧的垂线偏移一个角度。
8.根据权利要求5所述的接骨板，其中所述一组交叠孔中的一个螺纹孔与接骨板的顶侧垂直，而所述一组交叠孔中的另一个螺纹孔从接骨板顶侧的垂线偏移一个角度。
9.根据权利要求5所述的接骨板，其中所述多组交叠孔在该纵向轴线上排成一线。
10.根据权利要求5所述的接骨板，其中所述多组交叠孔以从该纵向轴线交错排列的方式定位。
11.根据权利要求10所述的接骨板，其中所述交叠孔与接骨板的顶侧垂直。
12.根据权利要求10所述的接骨板，其中所述交叠孔从接骨板顶侧的垂线偏移一个角度。
13.根据权利要求10所述的接骨板，其中所述一组交叠孔中的一个螺纹孔与接骨板的顶侧垂直，而所述一组交叠孔中的另一个螺纹孔与接骨板顶侧的垂线偏移一个角度。
14.根据权利要求1所述的接骨板，其中该组交叠孔适于接纳具有螺钉头和骨接合螺纹的骨螺钉。
15.根据权利要求14所述的接骨板，其中骨螺钉的螺钉头具有板接合螺纹。
16.根据权利要求14所述的接骨板，其中所述交叠孔与接骨板的顶侧垂直。
17.根据权利要求14所述的接骨板，其中所述交叠孔从接骨板顶侧的垂线偏移一个角度。
18.根据权利要求14所述的接骨板，其中所述一组交叠孔中的一个螺纹孔与接骨板的顶侧垂直，而所述一组交叠孔中的另一个螺纹孔与接骨板顶侧的垂线偏移一个角度。
19.根据权利要求1所述的接骨板，其中该组交叠孔还包括另外一个螺纹孔。
20.根据权利要求19所述的接骨板，其中所述交叠孔与接骨板的顶侧垂直。
21.根据权利要求19所述的接骨板，其中所述交叠孔与接骨板顶侧的垂线偏移一个角度。
22.根据权利要求19所述的接骨板，其中所述一组交叠孔中的至少一个螺纹孔与接骨板的顶侧垂直，而所述一组交叠孔中的至少另一个螺纹孔从接骨板顶侧的垂线偏移一个角度。
23.一套整形外科的成套用具，包括：
a.接骨板，具有纵向轴线、接触骨头的底侧，和顶侧，该顶侧和底侧具有至少一组交叠多层面孔，该组交叠多层面孔从顶侧至底侧穿过接骨板连通，其中该交叠多层面孔限定具有多层面表面的螺纹孔；以及
b.与接骨板接合的至少一个骨螺钉。
24.根据权利要求23所述的成套用具，进一步包括具有主钻导向面和相对端部的钻导子，它的一端部可牢固地与接骨板内的孔的多层面表面接合，从而使钻导子相对于接骨板牢固地保持在需要的方向上，以便在整形外科手术过程中使所用的钻保持平稳。
25.一种接骨板，具有纵向轴线、接触骨头的底侧，和顶侧，该底侧和顶侧具有多组交叠多层面孔，每组包括两个相邻螺纹孔，所述两个相邻螺纹孔从顶侧至底侧穿过接骨板连通，其中所述两个相邻螺纹孔中的每一个都具有螺纹，适于接纳具有螺纹头和骨接合螺纹柄的骨螺钉。
26.一种接骨板，具有纵向轴线、接触骨头的底侧，和顶侧，该顶侧和底侧具有多组交叠多层面孔，每组包括两个相邻螺纹孔，所述两个相邻螺纹孔从顶侧至底侧穿过接骨板连通，所述两个相邻螺纹孔中的每一个都具有螺纹表面，适于接纳具有螺纹头和骨接合螺纹柄的骨螺钉，其中该交叠多层面孔的中心沿接骨板纵轴线排成一线。
27.一种接骨板，具有纵向轴线、接触骨头的底侧，和顶侧，该顶侧和底侧具有多个螺纹孔，所述螺纹孔从顶侧至底侧穿过接骨板连通，至少一个包括交叠多层面孔的螺纹孔具有螺纹表面，该螺纹表面适于接纳具有螺钉头和骨接合螺纹的骨螺钉，而且该交叠多层面孔的中心围绕接骨板纵轴线交错排列。
28.一种接骨板，具有纵向轴线、具有总面积并接触骨头的底侧，和顶侧，该顶侧和底侧具有多个螺纹孔，所述螺纹孔从顶侧至底侧穿过接骨板连通，至少一个螺纹孔是一组交叠多层面孔，其中所述一组交叠多层面孔具有多层面表面，而其中底侧包括凹槽，该凹槽定位在相邻的螺纹孔之间且仅定位在底侧上，该凹槽有合适的尺寸从而限定横向于纵向轴线且横跨凹槽的截面，这样保证了穿横跨凹槽的弯曲屈服强度比横跨螺纹孔的弯曲屈服强度小。
29.根据权利要求28所述的接骨板，其中凹槽是矩形的形状。
30.根据权利要求28所述的接骨板，其中凹槽沿纵向轴线是等间隔的。
31.根据权利要求28所述的接骨板，其中由于凹槽而从底侧除去的总面积小于或等于底侧总表面积的50％。
32.根据权利要求28所述的接骨板，其中凹槽是横向的并延伸横跨接骨板的宽度。
33.根据权利要求28所述的接骨板，其中凹槽从接骨板的一侧横向地向纵向轴线延伸但不横跨该纵向轴线。
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KR101104660B1 (ko) 2012-01-13
WO2004084701A2 (en) 2004-10-07
JP4427056B2 (ja) 2010-03-03
EP1610700A2 (en) 2006-01-04
JP2006521149A (ja) 2006-09-21
KR20060012268A (ko) 2006-02-07
JP5044773B2 (ja) 2012-10-10
US20080058815A1 (en) 2008-03-06
CN1764418A (zh) 2006-04-26
DE602004028451D1 (de) 2010-09-16
BRPI0408769A (pt) 2006-03-28
US7695472B2 (en) 2010-04-13
US20060264946A1 (en) 2006-11-23
EP1610700A4 (en) 2006-05-17
WO2004084701A3 (en) 2005-02-10
EP1610700B1 (en) 2010-08-04
ATE476149T1 (de) 2010-08-15
JP2010022866A (ja) 2010-02-04

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