JP2007090094A - Surgical fastener assembly - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a surgical fastener assembly for coupling first and second bone portions across a fracture therebetween. <P>SOLUTION: The surgical fastener assembly includes an elongated anchor 10 that has a bone threaded portion 10 inserted in the first bone portion, wherein one end portion of the anchor is disposed on one side of the fracture while a second end portion of the anchor 10 is on an opposite side of the fracture. A guide member 20 having a sleeve-like projection 30 is fixedly secured to the second bone portion. The sleeve-like projection 30 moves slidably along and is guided by the second end portion of the anchor 10. A compression screw assembly 24 serves to operably secure the guide member to the anchor such that the bone portions secured to each are maintained in compressive relationship relative to each other. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates generally to a surgical fastener assembly for joining a first bone portion and a second bone portion across a fracture therebetween, and more particularly, a femoral head to a femur. And a restraining device for firmly connecting the fractures of the femoral neck region across the fracture to each other.

  The hip joint is a load-bearing bone joint of the human body that can be subjected to strong pressure. In essence, the hip joint is a ball joint formed by the upper part of the femur that pivots in the cup-shaped acetabulum at the base of the pelvis. When a break, i.e., a fracture, occurs near the upper part of the femur, the separated parts of the femur must be held together while healing occurs. A number of methods have historically been used to treat fractures of the proximal and distal ends of the femur. In the early part of this century, patients were simply laid down on a bed or tow for a long period of time, and in many cases they were deformed or died. In the 1930s, Smith-Peterson nails were introduced, resulting in rapid fixation of hip fractures, mobilization of patients, reduced morbidity and mortality. A number of nails are introduced for fracture fixation at the proximal end near the femur, which is the Jewett nail, the most proximal of the femur for the last few years. A dynamic compression device that enables the capture of the part of the body, compression of the intertrochanteric and subtrochanteric fractures, secure fixation of the most proximal and distal parts, the limb on which the patient is moving and fractured It includes a sliding lag screw or anchor that fits into the barrel side plate to allow further compression of the fractured portion when supporting weight. The side plates are typically fastened to the bone portion with a set of screws or fasteners.

  The use of a stiff wing plate at both the proximal end of the femur for fixation of the subtrochanteric femoral fracture and the distal end for fixation of the epicondylar and intercondylar fractures near the knee Has been used. Because these fractures can be technically fixed, dynamic compression screws are similar to many dynamic hip compression screws, except when the side plate design and angle are similar to the wing plates. And has been used for several years.

  All known prior art, whether in the patient literature as described above or in a commercial device, includes a lag screw or anchor in a cylinder that heals as the fracture heals and the fracture portion approaches The position change of the compression screw is not taken into consideration. When this movement occurs, the compression screw retracts from the lag screw and moves away from the fracture and into soft tissue, causing discomfort, pain, and creating a painful sac. In the case of osteopenia patients, the dynamic hip compression screw may loosen or erode in the upper bone of the femoral head, causing joint invasion and joint destruction, resulting in arthritis. This requires additional surgery for removal of the hip compression screw and replacement of the femoral hip with an artificial joint. Similarly, the use of dynamic compression screws in osteopenia patients may result in improper purchase of lag screw threads in bone, where the compression screws are proximate to the lag screws and, consequently, the lateral plate. When used to compress the fixed bone and the bone fixed distally, it results in a loss of fixation. Loss of foothold at the femoral head of the lag screw or anchor eliminates the compressive force and causes the implant device to fail, resulting in inability to adhere to the fracture or deformation healing. In patients with osteopenia, similar fixation loss occurs near the epicondylar and intercondylar fractures of the distal femur.

  To prevent loss of fixation in compression and to reduce the required removal of fixation lag screws at the femoral head of patients with osteopenia, either by increasing the lag screw or by molly bolt By means of alternative proximal part fixation in this way, several devices have been modified to improve the anchoring of the fixation lag screw in the femoral head. This latter device differs from the conventional lag screw footing of screw tightening in the device, and the degree of lag screw footing and the lag screw and side plate assembly without the loss of fixation by the surgeon "over compression" In the United States, surgeons were not widely accepted enough to give the surgeon the ideal “feel” that could compress the solid.

  If the lag screw slides on the cylinder of the side plate, it may protrude to the unhealthy patient side. In many cases, once the compression screw is implanted, it can retract, leading to further protrusion and eroding the skin. This can lead to occasional or undesired additional surgery for removal of compression screws or devices, and in older patients who cannot tolerate additional surgical damage to the human body, Often increases morbidity, the rate of infection and death caused by additional surgery. Many surgeons remove the compression screw for this very reason to prevent the compression screw from retracting. However, if the compression screw is removed, device disassembly can occur, along with failure as a result of fracture fixation and the need for further surgery. Modified hip restraint by reducing the degree to which the lag screw and side plate can be separated and by increasing the degree of modularization of the side plate and lag screw element to prevent unintentional disassembly of the lag screw and side plate There are also devices, possibly allowing the patient's incision to be made smaller. However, this degree of modularity introduces other theoretical variables of the potential loss of fixation of the side plate of the lag screw portion of the device. Furthermore, the side plate may loosen the foothold from the distal portion by biological resorption with consequential loss of the screw anchorage foothold that holds the side plate to the side of the femur. This can occur in either a dynamic hip compression screw or a dynamic compression screw used near the distal condylar fracture of the femur or used for a subtrochanteric fracture of the femur. To reduce the incident of loss of side plate footing, allow more screws per femoral length unit or replace screw holes in the side plate to replace the number and location of holes in the side plate with wider side plates. Closer arrangements have been supported. The use of a distal compression screw allows closer compression of the longitudinal axis of the femur and increases compression at the fracture site.

  Furthermore, the screws or fasteners used to secure the side plate to the lateral femur often become loose as the bone is resorbed around the outer thread of the screw. Thus, the side plate is often left away from the bone, causing graft failure and loss of fracture fixation.

  Thus, an improved hip restraint or device that allows for better footing of the lag screw at the femoral head of the hip and provides a “feel” of fixation to the surgeon upon insertion of the lag screw or There is a need and desire for a surgical fastener assembly. Such a restraining device for a fixation assembly should further be designed so that the compression screw remains permanently in place after the operation and maintains the degree of compression between the lag screw and the side plate. . It is further desirable to prevent the screws used to keep the side plate in a fixed relationship to the bone portion from loosening, thereby maintaining the side plate in an attached relationship to the initially installed bone.

  In view of the above, the present invention provides an improved surgical fastener assembly for joining a first bone portion and a second bone portion across a fracture therebetween. The surgical fastener assembly can be inserted into the first bone such that one end is located on one side of the fracture and the second end is located on the opposite side of the fracture With an elongate anchor or bone screw. A guide member having a sleeve-like protrusion is fixedly secured to the second bone. The sleeve-like protrusion of the guide member moves slidably along the second end portion of the anchor and is guided by the second end portion. The compression screw assembly serves to operably secure the guide member to the anchor. According to one form of the invention, the compression screw assembly includes an inserted compression screw having an enlarged head portion and a shank portion that is threaded outward. The shank portion of the inserted compression screw extends until it is threadedly engaged with the anchor, and the head portion of the inserted compression screw is moved against the other with the rotation of the fastener attracting the first and second bones. The guide member is operatively engaged so as to be in a compressive relationship. The compression screw to be inserted defines an axial opening that is open to both ends. This form of compression screw assembly operates with the second end of the compression screw to releasably lock the compression screw to the anchor, thereby preventing movement of the guide member in the direction away from the axial anchor. It further includes a retainer that is operatively coupled and positionable relative to the compression screw.

  Preferably, both the anchor and the guide member are formed from a material that is biocompatible with the bone tissue. In the most preferred form of the invention, the anchor is formed from a material selected from the set consisting of titanium, titanium alloy, stainless steel, or cobalt chromium alloy. Similarly, the guide member is preferably formed from a material selected from the set consisting of titanium, titanium alloy, stainless steel, or cobalt chromium alloy.

  In order to improve the scaffolding within the bone of the surgical fastener assembly, the anchor is preferably an outer screw extending along the coaxial length over the axial length to secure the anchor to the first bone. It has a mountain. Preferably, the second end of the anchor detachably accommodates a driving tool capable of transmitting rotational movement to the anchor such that the outer thread of the anchor engages the bone quality of the first bone. It is formed.

  The inserted shape of the compression screw allows the tool to be inserted therethrough. In this form of the invention, the retainer is threadably coupled to the second end of the anchor. The retainer is preferably configured to operably and detachably engage a tool that can extend through the insertion compression screw. Thus, when an appropriate compression relationship or “feel” is created by the surgeon between the guide member and the anchor, for example by rotating the compression screw, the surgeon may lock the retainer into a locked relationship with the compression screw. To keep the compression screw in place, thereby preventing rotation of the compression screw relative to the anchor.

  The guide member preferably defines a recess having an open end that is sized to accommodate the head portion of the compression screw therein. The recess is formed such that after the guide member is placed in operative connection with the anchor, the compression screw has no portion extending axially beyond the guide member, thereby preventing damage to the patient.

  The present invention is particularly effective as a part of a hip joint pressing device for compressing and joining a first fractured bone part and a second fractured bone part to each other. The hip joint restraining device according to the present invention is preferably arranged such that the front end portion of the bone screw is arranged on one side of the fractured portion so as to vertically hold the front end portion of the bone screw to the first bone portion. And an axially elongated bone screw having an outer thread defining an elongated axis and extending axially along the coaxial line. The rear end portion of the bone screw is disposed on the opposite side of the fracture. The bone screw defines an elongated axial bore extending along the length. The guide member is suitable for being fixedly fastened to the bone screw. The protrusion of the guide member is guided along the second end portion by the second end portion of the bone screw. Further included as part of the hip restraining device is a compression screw assembly including a compression screw having a head portion that is enlarged and a shank portion that is threaded outwardly. The shank portion of the compression screw extends until it threadably engages the rear end portion of the bone screw. The head portion of the compression screw is operatively engaged with the guide member such that rotation of the compression screw attracts the first and second bone portions.

  To help create a foothold within the bone portion of the bone screw, a set of fasteners or pins are placed in combination with the bone screw. Each fastener is moved by a bone screw and can actively move between a contracted position and an extended position. When in the retracted position, the fastener does not provide an effective fixation effect on the bone tissue against the bone screw. However, when the fastener or pin is in the extended position, the pin extends outwardly from the bone screw while remaining operatively coupled to the bone screw to secure the fastener or bone screw to the bone. The present invention further includes a mechanism for actively moving the fastener from the retracted position to the extended position disposed in operative connection with the fastener. Preferably, the fastener is movable longitudinally with respect to the insertion member. Another feature of the present invention relates to the ability to operate in a situation where it is necessary such that the fastener can be actively retracted from the extended position to the retracted position.

  The mechanism for actively moving the fastener or pin in both directions can be of any suitable type that is manually manipulated to allow the surgeon to control the movement of the fastener. In one form of the invention, the mechanism comprises a driver that is mounted for rotation in a cavity defined by a bone screw. The driver has an outer thread that extends along an axial portion to engage each serrated tooth of the fastener, whereby each fastener is either determined by the direction of rotation of the driver. Actively moved vertically in the direction of movement.

  In another form of the invention, the mechanism for moving the fasteners outward relative to the bone screw and thereby assisting in attaching the bone screw to the bone material moves axially and longitudinally relative to the bone screw. With a drive that is possible. The driver is selectively engagable with the fastener such that the longitudinal movement of the driver corresponds to cause an active longitudinal movement of the fastener relative to the bone screw.

  According to another aspect of the invention, a compression screw assembly of a surgical anchor assembly includes a multi-part assembly that includes an elongate compression screw and a driver. The compression screw preferably has a shape to be inserted. An outer thread extending radially along the compression screw serves to allow the shank portion of the compression screw to engage the second end of the anchor and the head portion of the compression screw operates with the guide member. Engage possible. At the distal end, the compression screw is provided with an extensible locking flange. When the compression screw is placed in operative connection with the anchor of the surgical fastener assembly, the driver is inserted in operative relationship with the compression screw, thereby forcing the flange to extend, thereby causing the bone screw Alternatively, the compression screw is fixed in the axial direction in a predetermined relationship with the second end of the anchor.

  According to another aspect of the present invention, a set of fasteners or screws are used to secure the surgical fastener assembly guide member to one of the bones. As is conventional, the guide member comprises a set of holes or openings that allow the fasteners or screws to pass straight through. In one form, each fastener or screw for fastening the guide member to the bone comprises an insertion screw having a shank portion and a head portion. The shank portion is sized to extend straight through the opening of the guide member and the bone to which the guide member is fastened. Thus, as can be seen, various sized screws may be provided to allow the surgeon to individually tailor the screw to the patient undergoing surgery. The shank portion of the screw is sized so that the distal end of the shank ends near the opposite side of the bone guide member. In addition, the shank portion has an outer thread extending axially from the distal portion toward the head portion to help create a foothold in the bone quality of the screw assembly. The head portion of the screw is formed into a shape suitable for cooperating with the guide member and for mounting the guide member about the elongated axis of the screw.

  A lock is provided at the end of the screw. The lock is formed to extend outward as it is inserted through an axial opening defined by a screw into which the driver is inserted. Thus, the screw passes through the guide member and is fastened to the bone such that the distal end of the screw approaches the surface of the bone opposite the screw head. A lock is operatively coupled to the screw head and extends axially beyond the bone opposite the screw head. In a preferred form, a lock is placed at the distal end of the screw. The driver is then inserted into the lock through the screw. Axial movement of the driver operably coupled with the lock through the screw causes the lock to radially expand, causing the screw to rotate unexpectedly away from the guide member. To prevent.

  With regard to the present invention, regardless of which embodiment is utilized, the surgeon is provided with the ability to compress each bone portion into a predetermined compressive relationship with each other. The lag screw or anchor can be inserted into the bone until the proper “feel” is given to the surgeon. The lock coupled with the insertion compression screw is then manipulated to maintain the compressive relationship between the guide member and the bone screw. Thus, while maintaining the proper compression relationship between each bone portion, the lock or retainer prevents the compression screw from rotating unexpectedly and thereby away from the opposite end of the bone screw or anchor. This prevents the guide member from moving in the axial direction.

  In order to improve the anchoring of the anchor or bone screw in the bone, another feature of the present invention is actuated in response to a drive mechanism that is moved by the bone screw or anchor and actively moves the fastener in both longitudinal directions. Regarding the ability to provide a set of fasteners that are possible. The ability to actively move the fasteners radially outward from the bone screw improves the footing in the bone quality of the bone screw.

  Another object of the present invention is to improve the attachment of the guide member to the bone. In this regard, the screw comprises a lock that is extensible in response to the driver being inserted vertically through the insertion screw.

  These and other objects, aims and advantages of the present invention will be readily apparent from the following detailed description, drawings, and claims.

  While this invention may be embodied in various forms, this disclosure is to be considered as exemplary of the invention, and the example shown is intended to be limited to the specific embodiments described. With the understanding that this is not the case, the preferred embodiment of the present invention is illustrated in the drawings and further described below.

  Referring to the drawings, wherein like reference numerals refer to like parts throughout the several views, the fractured first and second bone parts are fixed by pressing across the fracture between them. One form of fastener assembly 10 used to do so is schematically illustrated in FIG. In the illustrated embodiment, the surgical fastener assembly 10 is used to accurately place a condylar fracture along the fracture line 12 disposed between the proximal portion 14 and the distal portion 16 of the bone 18. Is used.

  As shown, the surgical fastener assembly 10 includes a guide member, generally designated by reference numeral 20, and an elongated anchor, generally designated by reference numeral 22. As shown in FIG. 2, the surgical fastener assembly 10 further comprises a compression screw or fastener 24 and a retainer 26 for releasably locking the fastener 24 against rotation. As shown in FIG. 2, a set of screws 28 function in conjunction with the guide member 20 to serve to secure the guide member 20 to the bone portion 18.

  As shown in FIGS. 2 to 4, the guide member 20 includes a hollow sleeve 30 that is rigidly attached to the trochanter plate 32 at an appropriate angle. Proximal portion 14 of bone 18 is perforated to receive sleeve 30. The distal portion 16 of the bone 18 is geometrically processed to accommodate the end portion of the sleeve 30 therein. As shown, the trochanter plate 32 includes a plurality of through holes 34 that allow the screws 28 to pass vertically, thereby securing the guide member 20 to the bone portion 18. The sleeve 30 defines through-holes 36 that are open at both ends. In a preferred form of the invention, the guide member 20 is formed from a material selected from the group consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy.

  In particular, the through-hole 36 has a counterbore 38 at one end thereof. In the embodiment shown, the counterbore 38 has a larger diameter than the through bore 36. Accordingly, an annular or radial step 40 is defined towards one end of the through bore 36.

  As shown in FIG. 4, the anchor 22 includes an elongated insertion member 44 that is preferably formed from a material selected from the set consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy. The insertion member 44 has a first end 46 and a second end 48 that are in opposite positions and are axially aligned. When the insertion member 44 is inserted into the bone, the first end 46 is disposed on one side of the fracture line 12 while the second end 48 of the insertion member 44 is opposite the fracture line 12. It is sized to be placed in In particular, a cooperating means 50 is defined on the sleeve 30 and the insertion member 44 of the guide member 20. The purpose of the cooperating means 50 is to prevent the rotational movement of the sleeve 30 relative to the anchor 22 and to allow the sleeve 30 to move axially along an axis 52 defined by the insertion member 44.

  In the illustrated embodiment, as is well known, the cooperating means 50 preferably includes a pair of axially extending along the second end 48 of the insertion member 44 and inwardly from the second end 48. A flat portion 54 is provided. The pair of flat portions are opposite to each other and are substantially parallel to each other. As shown in FIG. 3, the through-bore 36 of the sleeve 30 includes generally flat sides 56 that are opposed and arranged in a generally parallel relationship with each other. The flat side 56 of the through bore 36 allows the second end 48 of the insert member to slidably move inward while preventing rotation of the sleeve 30 relative to the anchor 22 and thereby rotation of the guide member 20. In doing so, the flat 54 cooperates with the flat side 56. It has been found that other forms of cooperating means that allow straight axial movement of the anchor 22 relative to the guide member 20 and prevent rotational movement between the anchor 22 and the guide member 20 are equally satisfactory. Is included within the spirit and scope of the invention.

  As shown in FIGS. 5 and 6, the anchor 22 of the surgical fastener assembly 10 is inserted for movement between a retracted position (FIG. 5) and a radially extended position (FIG. 6). It further includes a set of elongated pins operably coupled toward the first end 46 of the member 44. As shown, the pin 60 is moved by the insert member 44 to provide a longitudinal radial movement relative to the insert member 44. In the illustrated embodiment of the invention, the four pins 60 are relative to each other such that each moves actively longitudinally in both directions between the retracted and extended positions shown in FIGS. Provided at equal distances.

  A feature of the present invention relates to providing a mechanism 64 for actively positioning the pin 60 relative to the surgical anchor 22. That is, as described in detail below, the purpose of this mechanism 64 is to actively extend the pin 60 radially outward from the insertion member 44, thereby improving the ability of the anchor 22 to attach to the bone. (FIG. 1). Further, in response to mechanical manipulation, the mechanism 64 further operates to actively retract the pin 60 to the surgical anchor 22 so that it is found when desired or surgically necessary. Facilitates surgical removal of the anchor 22.

  With reference to FIGS. 7 to 10, the insertion member 44 of the anchor 22 is preferably disposed coaxially about the longitudinal axis 52 and the first end 46 and the second end 48 of the insertion member 44. Are defined as elongated inner holes 66 each opening. As shown, the first end 46 of the fastener 44 is preferably sharpened to facilitate insertion of the fastener 44 into the bone.

  As will be appreciated by those skilled in the art, the outer contour shape of the insertion member 44 can take a myriad of shapes and forms. According to the present invention, as shown in FIGS. 7 to 10, the elongated insertion member 44 preferably extends axially along the insertion member 44 from the sharpened first end 46 to the rear. With outer thread 68 leading to it. As previously described, the sharp profile of the insertion member 44 assists in insertion and self tapping of the anchor 22 to the bony in the illustrated embodiment. The outer threads 68 along the outside of the insert member 44 have a relatively coarse pitch to improve the ability to create a foothold and anchor the anchor 22 to bone quality in response to the rotational motion transmitted to the anchor 22. .

  As shown in FIG. 9, the second or rear end 48 of the insertion member 44 is preferably detachable from a drive tool (not shown) that can transmit rotational motion to the anchor 22. It is made into the shape accommodated in. In the preferred embodiment, as shown in FIGS. 8 and 9, the rear end or second end of the insertion member 44 has a slot-like opening for removably receiving the distal end of the drive tool. Are properly formed. However, it will be appreciated that any suitable shape, including a socket-like shape, is equally satisfactory without detracting from or departing from the spirit and scope of the present invention.

  As shown in FIG. 9, the insert member 44 further defines a set of axially elongated openings that are spaced circumferentially relative to each other. In the illustrated form of the invention, the insert member 44 includes four openings 70. Since all the openings 70 are substantially the same, only one opening is described in detail, provided that the remaining openings of the insert are similar. Each opening 70 intersects and is open to the elongate inner hole 66 defined by the insertion member 44 in the middle of its actual end. Preferably, each elongated opening 70 has a shape that is not visible, but is open to the outside of the insertion member 44 at one end. As can be seen, the openings 70 are arranged at substantially equal intervals around the axis 52 of the insertion member 44. In the form of the present invention shown in FIG. 9, each elongated opening 70 has a curved or arcuate shape between its ends. That is, in the illustrated embodiment of the present invention, each opening 70 has an arcuate shape having a predetermined substantially constant radius.

  Exemplary forms of pins 60 are shown in FIGS. Each pin 60 is shaped so as to be slidably fitted with its end in one of the openings 70 formed in the insertion member 44. The shape and size of each pin 60 substantially match the shape and size of the opening 70 defined by the insertion member 44. Preferably, each pin 60 is formed from a substantially rigid material that is biocompatible with human bone tissue. That is, the pin 60 should be formed with sufficient strength so that it can be inserted and penetrated into bone tissue without substantially bending between the ends. In the most preferred form of the invention, each pin 60 is formed from a material selected from the group consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy.

  In the embodiment shown in FIGS. 11-15, each pin 60 has a front end 74 and a generally sharpened end 76 on the opposite side. In the middle of these ends, each pin 60 is preferably curved or arcuate. In the illustrated form of the invention, each pin 60 is a curvilinear arc having a predetermined radius approximately equal to the predetermined radius of each opening 70 (FIG. 9) formed in the insert member 44. The arc extends away from near the axis 52 of the insertion member 44 outward.

  In the most preferred form of the invention, each pin 60 preferably forms an arc of about 80 degrees between the ends, and the length of each pin 60 is such that the tip 74 of the pin 60 is a fastener. The sharpened end 76 opposite the pin or barb 60 when fully retracted is selected to lie inside the outer diameter of the insertion member 44 and the surgical anchor 20 into the patient's bone. Easy to insert. Further, the length of each barb or pin 60 is such that the front end 74 of each pin 60 is operably coupled to the mechanism 64 when the pin 60 is moved to the extended position (FIG. 6). It can be seen that it is dimensioned to allow active contraction from the extended position of the pin 60 when desired or deemed necessary by the surgeon.

  An insertion compression fastener 24 is shown schematically in FIGS. The purpose of the insertion fastener 24 is to maintain each bone portion (FIG. 1) in an adjustable compressive relationship relative to each other, for example by axially fixing the guide member 20 to the anchor 22 (FIG. 2). is there. Returning to FIGS. 5, 6, and 9, the elongated inner hole 66 of the insertion member 44 is open to the second end or the rear end 48 of the insertion member 44. The inner hole 66 defines a portion 78 threaded inwardly extending from the second end or rear end 48 of the insertion member 44 toward the inside. Preferably, the portion threaded inside the bore 66 has a relatively fine pitch thread extending along that portion.

  An insertion compression fastener 24 is shown schematically in FIGS. The purpose of the insertion fastener 24 is, for example, that the guide member 20 is prevented from moving axially away from the anchor 22 but the movement of the guide member 20 towards the sharpened end or first end 46 of the anchor 22. By maintaining the guide member 20 axially fixed to the anchor 22 (FIG. 2) so as to allow (FIG. 2), each bone portion (FIG. 1) is maintained in an adjustable compressive relationship relative to each other. It is.

  The fastener 24 is preferably formed from a material that is biocompatible with bone tissue or bone quality and is preferably selected from the group consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy. As will be appreciated, although not specifically described herein, other non-specific materials can equally be satisfied without departing from or departing from the spirit and scope of the present invention.

  As shown, the fastener 24 includes an elongated shank portion 80 and an enlarged head portion 82. The shank portion 80 of the fastener 24 includes an outer thread 84 that extends axially from the front end 86 of the fastener 24. The outer threads 84 have a relatively fine pitch that coincides with threads that extend inwardly along the threaded portion 78 of the anchor 22. The enlarged head portion 82 of the fastener 24 has a diameter that is slightly smaller than the diameter of the counterbore 38 defined by the insertion member 44 (FIG. 2). As will be appreciated by an understanding of the present invention, the axial length of the head portion 82 can be varied from the length shown without detracting from or departing from the spirit and scope of the present invention. That is, during surgery, the surgeon may have a collection of various fasteners 24 to select, with each anchor having a different length so that the proper relationship is maintained between the guide member 20 and the anchor 22. Have In particular, the enlarged head portion 82 defines a radial shoulder 88 relative to the shank portion 80.

  As shown in FIGS. 18-20, the rear end 90 of the fastener 24 is preferably detachable from a drive tool (not shown) that can transmit rotational motion to the fastener 24. It is formed to accommodate. In a preferred form, as shown in FIGS. 18-20, the rear end 90 of the fastener 24 is formed with a socket-like opening 92 for removably receiving the distal end of the drive tool. Is done. In the most preferred form of the invention, as shown, the socket or opening 92 has a hexagonal cross-sectional shape. However, it will be appreciated that any suitable contour shape, including an elongated slot, is equally satisfactory without detracting from or departing from the spirit and scope of the present invention.

  The insertion fastener 24 further defines an elongated inner bore 94 that is open to the front end 86 and the rear end 90 of the fastener, respectively.

  In the embodiment shown in FIG. 2, the anchor 22 is fastened to the bone portion on one side of the fracture line 12. As described above, the anchor 22 is positioned such that the opposite end or second end 48 of the anchor 22 extends to the opposite side of the fracture line 12. The guide member 20 is then placed in a cooperative relationship with the anchor 22. As shown, the sleeve 30 of the guide member 20 fits slidably over it telescopingly straight along the free end of the anchor 22. Screws 28 are used to secure the plate 32 of the guide member 20 to the bone 18. The insertion compression fastener 24 is then arranged to operably couple the anchor 22 and the guide member 20. That is, the front end 86 of the compression screw 24 is inserted into the bore 36 of the sleeve 30 and the outer thread 84 extending along the compression screw 24 is operatively associated with the inner thread 78 at the proximal end of the anchor 22. Come together. The continued rotation of the fastener 24 eventually engages the radial shoulder 88 of the enlarged head portion 82 with the radial stop 40 and the guide member 20 defined by the counterbore 38. As can be seen, the continued rotation of the screw 24 causes each bone portion to be in a compressive relationship relative to each other. The compression screw 24 further allows the surgeon to “feel” properly when the screw is tightened into a compressive relationship with each other.

  One form of retainer 26 is schematically illustrated in FIGS. As shown, the retainer 26 has an outer thread 100 extending axially along the retainer 26 between its front end 102 and rear end 104. The retainer 26 is preferably formed from a material that is biocompatible with bone tissue or quality and is preferably ultra high molecular weight polyethylene. However, it will be appreciated that other unspecified materials are equally satisfactory without detracting from or departing from the spirit and scope of the present invention. In particular, the outer threads 100 that extend along the outside of the retainer 26 have a fine pitch that matches the threads that extend along the portion 78 threaded inside the insert member 44.

  As shown in FIGS. 23, 24, and 25, the holder 26 includes a through-hole 106 that opens to both ends 102 and 104 of the holder. In the preferred form, as shown in FIGS. 23, 24 and 25, the elongated portion of the through bore 106 has a hexagonal cross-sectional shape to removably accommodate the distal end of the drive tool. However, it will be appreciated that any suitable socket-like profile other than a hexagon will be equally satisfactory without detracting from or departing from the spirit and scope of the present invention.

When the surgical fastener assembly 10 is assembled, the retainer 26 is first screwed into the portion 78 threaded into the anchor 22 as shown in FIG. 25A. Thereafter, the compression fastener 24 is operatively coupled to the anchor 22 as described above. After the compressive relationship between the guide member 20 and the anchor 22 is established, as a result of rotating the compression screw 24, a suitable elongated tool 95 passes through the bore 94 (FIG. 20) of the insertion fastener 24. And is detachably engaged with a socket-like shape defined in the through hole 106 of the holder 26.
As shown in FIG. 25B, proper rotation of the retainer 26 due to the force of the tool 95 then moves the rear end 104 into abutting relationship with the front end 86 of the compression screw 24, thereby compressing it. Screws 24 are locked to maintain the compressive relationship between each bone portion. However, it will be appreciated that the axial movement of the head portion 82 along the length of the counterbore 38 allows each bone portion to be repositioned. However, the head portion 82 of the compression screw 24 limits the movement of the anchor 22 and each bone portion fastened by the anchor 22 away from the bone 18, thereby compressing the relationship between the anchor 22 and each bone portion. To maintain.

  A mechanism 64 for actively moving the pin 60 in both directions between a retracted position and an extended position (FIGS. 5 and 6, respectively) will now be described. As can be appreciated, the mechanism for actively moving the pin 60 in both directions can take a myriad of different forms without detracting from or departing from the spirit and scope of the present invention. One mechanism that has been found to be advantageous and extremely effective includes mounting the anchor 20 with a manually actuated driver 110 (FIGS. 5 and 6) operably coupled to the pin 60; Operation of the driver 110 causes the pin 60 to move longitudinally relative to the anchor 22, thereby achieving fixation of the surgical anchor 22 to the bone.

  FIGS. 26-30 show one form of driver 110 for moving the surgical anchor pin 60 (FIGS. 5 and 6) in both directions by the same amount in the axial direction. As shown, the driver 110 includes an axially elongated member 112 having an outer thread 114 extending axially rearward from the front end 116 toward the rear end 118. The driver member 112 is formed from a material that is biocompatible with bone tissue or bone quality, preferably selected from a set consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy. However, it is to be understood that other unspecified materials are equally satisfactory without detracting from or departing from the spirit and scope of the present invention. The outer diameter of the outer thread 114 of the driver member 112 fits slidably straight within an elongated inner hole 66 defined by the insert member 44 (FIGS. 5 and 6) and the inner hole 66 of the insert member 44. It is accommodated so as to freely rotate in either direction of rotation. Preferably, the outer threads 114 of the driver member 112 have a relatively fine pitch. As shown in FIGS. 26, 28, 29, and 30, the driver member 112 is preferably an elongated inner opening that opens to the front end 116 and the rear end 118 of the driver member 112. It has a hole 120. The rear end portion 118 of the driving body member 112 is preferably shaped to removably receive a driving tool (not shown) that can transmit rotational motion to the driving body 110. In the preferred form, as shown in FIGS. 28 and 30, the rear end 118 of the driver member 112 is suitably shaped with a socket-like opening 122 for removably receiving the distal end of the drive tool. Has been. In the most preferred form of the invention, as shown in FIGS. 28 and 30, the socket or opening 122 has a hexagonal cross-sectional shape. However, it will be appreciated that any suitable shape, including square or rectangular shapes, is equally satisfactory without detracting from or departing from the spirit and scope of the present invention.

  After this, as will be described in detail below, the active motion of the pin 60 toward either the extended or retracted position is effected by the motion imparted to the mechanism 64 and the driver 110 as will be described in detail below. A driver 110 of mechanism 64 is operably coupled with each pin 60 to cause directional movement. In the illustrated form of the invention, returning to FIGS. 11-15, each pin or barb 60 is preferably an axis 52 (see FIGS. 7 and 7) of the anchor 22 when the pin 60 is inserted into the insertion member 44. 9) with an inner surface 124 and an outer surface 126. As shown in FIGS. 11-15, the inner surface 124 of each pin 60 has a series of serrated notches 128 that are axially spaced. The saw-shaped notch 128 extends from the front end 74 toward the rear end in the axial direction for a long distance toward the sharpened end 76 of each pin 60. In particular, the serrated notch 128 of each pin 60 is configured to threadably engage an outer thread 114 that extends axially along the outer surface of the driver 110. In this manner, the driver 110 is operatively engaged or coupled with each of the pins 60 of the surgical anchor assembly.

  As shown in FIGS. 5 and 6, the mechanism 64 for actively moving the pin 60 between the retracted position and the extended position and vice versa reduces the axial displacement of the driver 110 when rotated. It further includes a limit stop member 134 for preventing. One form of limit stop member 134 is shown in FIGS. Preferably, the limit stop member 134 is formed from a material that is biocompatible with human bone tissue. In the most preferred form of the invention, the limit stop member 134 is formed from a material selected from the group consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy. However, it will be appreciated that other materials are equally satisfactory without detracting from or departing from the spirit and scope of the present invention. As shown in FIGS. 31-35, the limit stop member 134 preferably includes a hollow member 136 having an outer thread 138 extending between the front end 140 and the rear end 142. The outer thread 138 has a relatively fine pitch that coincides with a thread extending along a portion 78 threaded inside the insertion member 44 at the second end 48 of the anchor 22. The rear end 142 of the limit stop member 134 is preferably configured to removably receive a drive tool (not shown) that can transmit rotational motion to the limit stop member 134. In a preferred form, as shown in FIGS. 31, 32 and 33, the rear end 142 of the limit stop 134 includes an elongated slot 148 for removably receiving the distal end of the drive tool. is doing. Further, the limit stop member 134 defines a through bore 146 that is open to the front end portion 140 and the rear end portion 142 of the limit stop member, respectively, so that the tool passes straight through it and is driven. Allowing operative engagement with the body 110.

  An alternative form of pin 60 that is arranged to operably couple with anchor 22 is shown in FIGS. Pin 160 is shown in FIGS. 11-15 and is generally similar to pin 60 described in detail above. In the embodiment shown in FIGS. 36 and 37, each pin 160 has a front end 174 and an opposite end 176. In the middle of both ends, each pin 160 preferably has a curved or arcuate shape. In the illustrated form of the invention, each pin has a curved arc having a predetermined radius substantially equal to the predetermined radius of each opening 170 formed in the insert member 144, as shown in FIG.

  In the pin embodiment shown in FIG. 36, each pin 160 preferably forms an arc of about 80 degrees between its ends, and the length of each pin is the front end of pin 160. The end 176 opposite the pin or barb 160 is selected to lie within the outer diameter of the insert member 144 when the 174 is retracted into the fastener or anchor 22.

  In the embodiment shown, the end 176 of each pin 160 is formed in a shape that complements the aligned shape of the anchor or fastener 22. In the illustrated embodiment, the end 176 of each pin 160 is formed with a groove 177 disposed between two generally similar protrusions 179. As shown in FIG. 38, when the pin 160 is completely contracted, the groove-like shape and the protrusions 179 on both sides are fused to an outwardly threaded shape extending in the axial direction along the fastener 22. Each barb or pin 160 length maintains the front end 174 of each pin 160 operably coupled to the mechanism 64 when the pin 160 is moved to the extended position as shown in FIG. And is dimensioned to allow the pin 160 to be actively retracted from the extended position when desired or deemed necessary by the surgeon.

  As shown in FIG. 36, each pin or barb 160 is preferably an inner side that comes close to the anchor axis 52 when the pin is inserted into the insert member 144 as shown in FIGS. It has a surface 184 and an outer surface 186. The inner surface 184 of each pin has a series of spaced serrated teeth 188 that extend axially rearward from the front end 174 for a long distance toward the second end or the other end 176 of each pin 160. Have. The serrated teeth 188 of each pin are threadedly engaged with an outer thread 114 that extends axially along the outer surface of the driver 110 of the mechanism 64 as described in detail above. It is configured. In this manner, the driver 110 is operatively engaged or coupled with each of the pins 160 of the surgical anchor assembly.

  FIG. 40 schematically illustrates an alternative form of surgical anchor assembly. This alternative form of surgical fastener assembly is indicated generally by the reference numeral 210. As shown in FIG. 40, the surgical fastener assembly 210 comprises a guide member generally represented by reference numeral 220 and an elongated anchor generally represented by reference numeral 222. As shown in FIG. 41 and described in detail below, the surgical fastener assembly 210 further includes a compression fastener assembly 224 for holding the guide member 220 in a compressive relationship with respect to the anchor 222. Prepare.

  The guide member 220 is generally similar to the guide member 20 described in detail above, and therefore need not be described in detail. Suffice it to say that the guide member 220 comprises a hollow sleeve 230 that is substantially similar to the sleeve 30 described above. The sleeve 230 defines a through-bore 236 that is open at both ends thereof. The through hole has a counterbore portion 238 at one end thereof. In the illustrated embodiment, the counterbore 238 has a larger diameter than the through bore 236 and thus an annular or radial step 240 is defined therebetween.

  Anchor 222 includes an elongated insertion member 244 having a first end 246 and a second end 248 located on opposite sides. The insert member 244 is preferably formed from a material similar to the material used to form the insert member 44. When the insertion member 244 is inserted into the bone, the first end 246 is disposed on one side of the fracture line and the second end 248 of the insertion member 244 is disposed on the opposite side of the fracture line. The dimensions are as follows.

  As shown in FIG. 40, the anchor 222 of the surgical fastener assembly 210 is for movement between a retracted position (FIG. 40) and a radially extended position (FIG. 42). It further comprises a series of elongated pins or barbs 260 operatively coupled toward the first end 246 of the insert member 244. As shown, the pin 260 is moved by the insert member 244 to move radially in the longitudinal direction relative to the insert member 244. In the illustrated embodiment of the present invention, the four pins 260 are connected to each other such that they actively move longitudinally in both directions between the retracted and extended positions shown in FIGS. 40 and 42, respectively. In contrast, they are spaced equidistantly.

  As will be appreciated by those skilled in the art, the outer form of the insertion member 244 can take a myriad of shapes and forms. In accordance with the present invention, as shown in FIG. 41, the elongated insertion member 244 is preferably an outer thread that extends axially along the insertion member 244 and leads rearwardly from the first end 246. 268. The outer threads 268 along the outside of the insertion member 244 have a relatively coarse pitch to improve the ability to create a foothold in response to the rotational motion transmitted to the anchor 222 and the ability to secure the anchor 22 to the bone.

  The insertion member 244 of the anchor 222 extends axially forward from the second or rear end 248, extends to the end of the outer thread 268 and is slightly smaller than the outer diameter of the outer thread 268. It has a constant generally cylindrical shape 249 having a diameter. In particular, the cylindrical shape 249 extending axially forward from the terminal end 248 of the insertion member 244 has a diameter that is approximately equal to the diameter of the through bore 236 of the guide member 220, thereby causing the guide member 220 of the anchor 222 to move. Facilitates axial sliding movement within the sleeve 230. Although not specifically shown, cooperating means are formed on the sleeve 230 and the insertion member 244 of the guide member 220 as is conventional. As described above, the purpose of the cooperating means is to allow axial movement of the anchor 222 relative to the sleeve 230 along the axis 252 defined by the insertion member 244 and prevent rotational movement of the sleeve 230 relative to the anchor 222. That is. As shown in FIG. 41, the insertion member 244 defines a counterbore portion 253 having a constant diameter that extends inward in the axial direction from the first end 246 of the insertion member 244. At the inner end, the counterbore portion 253 defines a radial wall 254. Between the first end 246 and the radial wall 254, the insertion member 244 defines a series of axially elongated openings that are spaced circumferentially relative to each other. In the illustrated form of the invention, insert member 244 includes four openings 270. Each opening 270 intersects the end hole 253 defined by the insertion member 244 and opens with respect to the end hole 253. As shown in FIG. 41, the axially inner portion 272 of each opening 270 has an inwardly inclined surface for purposes described in detail below.

  At the opposite end of the insert member 244 is another elongated inner hole 257 having a portion 255 threaded inwardly and a counterbore 256. An inwardly threaded portion 255 extends inwardly from the second or rear end 248 of the insertion member. Preferably, the portion 255 threaded inside the bore 257 has a relatively fine pitch thread extending along the threaded portion 255. In particular, the inwardly threaded portion 255 has a larger diameter than the counterbore portion 256. The insert member 244 further defines a passage 258 extending between the counterbore portions 253 and 256.

  As shown in FIG. 41, the second end portion and the rear end portion 248 of the insertion member 244 further removably receive a driving tool (not shown) that can transmit rotational motion to the anchor 222. Is configured to do. In a preferred form, as shown in FIG. 41, the rear or second end of the insert member 244 has a suitable shape with a slotted opening 269 for removably receiving the distal end of the drive tool. Has been. However, it will be appreciated that any suitable profile is equally satisfactory without departing from or departing from the spirit and scope of the present invention.

  As shown in FIG. 41, this form of the pin or barb 260 of the present invention forms part of the carrier assembly 262. The carrier assembly 262 preferably includes a sliding member 263, one end of each pin 260 is articulated to the sliding member 263, and the pin 260 is operably connected to the sliding member. It is possible to bend or move in a hinged manner with respect to the sliding member while maintaining the state of being held. As shown, the sliding member 263 has an outer surface shape 264 having a diameter approximately equal to the diameter of the counterbore portion 253 defined by the insertion member 244. The sliding member 263 further defines a threaded opening 265 having a relatively fine pitch thread extending along the sliding member 263. In particular, the free end of the pin 260 is biased to warp away from the axis 252 outward.

  As shown in FIG. 40, the transport body assembly 262 is axially housed in an inner hole 253 defined by the insertion member 244 so as to move axially, and the pin 260 is a second end 248 of the insertion member 244. It extends toward. After the carrier assembly 262 is inserted into the inner hole 253 of the insertion member 244, the open end of the insertion member 244 is closed by the end cap 274.

  As shown in FIG. 41, the end cap 274 preferably includes a reduced annular portion 275 that is sized to fit snugly within the free open end of the bore 253 defined by the insert member 244. . The end cap 274 is secured to the rest of the insertion member 244 with suitable retaining means such as welding, caulking, or similar means. The end cap 274 is preferably formed from a material that is biocompatible with bone tissue or body material and is preferably selected from the set consisting of titanium or titanium alloy, stainless steel, or cobalt-chromium alloy. Is done. However, it will be appreciated that other unspecified materials are equally satisfactory without detracting from or departing from the spirit and scope of the present invention. As shown in FIG. 41, end cap 274 defines a central through bore or hole 276 extending therethrough. Further, the annular or circumferential surface of the end cap 274 is preferably chamfered to aid insertion of the anchor 222 into the bone.

  Returning to FIG. 40, when the transport body 262 is attached in the inner hole 253 of the insertion member 244, the pin 260 tends to be biased outward. The slot or opening 270 of the insertion member 253 is elongated so that the distal end of each pin 260 has a tendency to protrude radially outward into the slot 270, and the inclined surface 266 is advantageously shown in FIG. As shown, the pins 260 are arranged to engage and cooperate with the inclined surface 272 of each opening 270 so as to project radially outwardly.

  A mechanism 280 for actively moving the pin 260 in both directions between the retracted and extended positions (FIGS. 40 and 42, respectively) is described. The drive mechanism 280 preferably includes a manually operated drive 282 that is arranged in a working relationship with the transport assembly 262. As described below, manual actuation of the drive mechanism 280 affects the axial movement of the transport assembly 262 in the inner bore 253 of the insert member 244, thereby causing the transport assembly 262 to move. Causes pin 260 to actively move.

  Referring to FIG. 41, the driver 282 preferably includes an axially elongated hollow member 284 having a reduced diameter portion 286 that protrudes axially rearward from the first end 288. The driver 282 is formed from a material that is biocompatible with bone tissue or human body material and is preferably selected from the set consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy. Of course, other unspecified materials will also be equally satisfactory without detracting from or departing from the spirit and scope of the present invention. The reduced diameter portion 286 of the hollow member 284 has a diameter equal to the diameter of the inner bore 276 defined by the end cap 274. At the second end 290, the driver 282 has a head portion 292 that is enlarged. In a preferred form, as shown in FIG. 41, the second end 290 is formed to removably accommodate the distal end of the drive tool. In the most preferred form of the invention, the second end or end 290 of the driver 282 includes an elongated slot 294 that is configured to removably receive a drive tool. The drive body 282 is provided with a shoulder 295 extending in the axial direction, spaced from the end portion 290 inward in the axial direction. Between the shoulder and the reduced diameter portion 286, the driver 282 includes an outer thread 296. The outer threads that extend long along the driver 282 have a relatively fine pitch that coincides with the portion 265 threaded inside the sliding member 263 that forms part of the carrier assembly 262. In particular, the reduced diameter portion 286 of the driver 282 and the outwardly threaded portion 296 are sized to permit longitudinal insertion through the passage 258 defined by the insert member 244. Furthermore, the shoulder portion 295 has a diameter approximately equal to the passageway 258 and is thereby journaled. Furthermore, the enlarged head portion 292 is particularly sized to have a larger diameter than the passageway 258, thereby preventing axial movement or movement of the head portion 292 past the passageway 258.

  Upon assembly of the surgical fastener assembly 210, the reduced diameter portion 286 and the outwardly threaded portion 296 are passed straight through the passage 258 defined in the insertion member 244 of the anchor 222. The threaded portion 296 of the driver 282 is similarly threaded with the sliding member 263 of the transport assembly 262, and the reduced diameter portion 286 passes straight through the inner bore 276 and is defined by the end cap 274. It allows journal bearings to be received around the inner hole 276. The reduced diameter portion 286 is sized to allow a long portion to pass straight through the end cap 274 and beyond the end cap 274. Its free end of the reduced diameter portion 286 is then upset or expanded outward to prevent axial movement of the driver 282 in response to the transmitted rotational motion.

  Referring to FIG. 42, the pins 260 of the carrier assembly 262 are actively moved in both directions in the radial direction relative to the axis 252 as a function of rotation as the driver 282 rotates. As shown, a suitable tool 297 is vertically engaged to operably engage the slot 294 of the second end 290 of the driver 282 through the inner hole 236 of the guide member 220 and the inner hole 257 of the insertion member 244. Moved in the direction. Thereafter, the rotation of the drive member 282 causes axial or longitudinal movement of the slide member 263 as a result of a threaded interconnection between the inner thread 265 of the slide member 263 and the outer screw thread 296 of the drive member 282. Give rise to As can be seen, when the pin 260 is attracted toward the radial wall 254 of the bore 253, the inclined surface feature 266 of the pin 260 engages the surface 272 that is inclined outward of the opening, thereby To forcibly advance the pin radially outward relative to the axis 252. As can be seen, the rotation of the tool 297 in the opposite direction causes the axial movement of the carrier assembly 262 as well, except in the opposite direction as previously described. As a result, the rotation or rotation of the driver 282 affects the contraction of the pin 260 as the sliding member assembly 262 is moved in a direction toward the end cap 274.

  Another aspect of the present invention is a surgical having a compression screw assembly 224 for maintaining the guide member 220 and anchor 222 in a compressive relationship relative to each other, for example, by axially securing the guide member 220 to the anchor 222. The present invention relates to the anchor assembly 210. In the embodiment shown in FIG. 41, the compression screw assembly 224 preferably includes a compression screw 300 and a driver 302. Both compression screw 300 and driver 302 are from a material that is biocompatible with bone tissue or human body material and preferably selected from a set consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy. It is formed.

  As shown in FIG. 41, compression screw 300 includes a first portion 304 and a second portion 306 that are coupled together. A first portion 304 and a second portion 306 of the compression screw 300 are coupled or connected to each other by a collapsible portion 308 that transmits rotation and torque between the first portion 304 and the second portion 306. The first portion 304 of the compression screw 300 includes an elongated shank portion 312 and an enlarged head portion 314. The shank portion 312 of the first portion 304 includes an outer thread 316 along the shank portion 312. The outer thread 316 has a relatively fine pitch that coincides with the inner thread 255 extending along the inner bore 257 of the insertion member 244. As shown in FIG. 43, the enlarged head portion 314 of the first portion 304 of the compression screw 300 has a diameter that is slightly smaller than the diameter of the counterbore 238 defined by the guide member 220. In particular, the head portion 314 of the compression screw 300 is preferably formed to removably receive a driving tool capable of transmitting rotational motion to the first screw portion 304.

  In a preferred form, as shown in FIG. 41, the rear end of the first threaded portion 304 is formed with a slot 318 for removably receiving the distal end of the drive tool. In particular, the first portion 304 of the compression screw 300 is secured to the collapsible portion 308 such that the rotational motion transmitted to the first screw portion 304 is transmitted to the collapsible portion 308 as well. .

  The second threaded portion 306 is similarly coupled to a collapsible portion 308 in an axially spaced relationship with respect to the first threaded portion 304. As shown, the second threaded portion 306 includes an outer thread 326 extending along the length. In particular, the outer thread 326 of the second threaded portion 306 is similar to the outer thread 316 of the first threaded portion 304.

  The collapsible portion 308 serves to transmit the movement of the first screw portion 304 to the second screw portion 306. Further, the second threaded portion 306 defines an inwardly threaded portion 330 that extends along the second threaded portion 306. The threaded portion 330 of the second threaded portion 306 has a relatively fine pitch thread extending along the threaded portion 330. In particular, however, the threads extending along the threaded portion 330 are counterclockwise threads, while the outer threads 316 and 326 of the first screw portion 304 and the second screw portion 306, respectively, are on the right. Around. As can be appreciated, the threads, threads 316 and 326 along threaded portion 330 can be clockwise and counterclockwise, respectively, without detracting from or departing from the spirit and scope of the present invention. An important aspect to note is that the threads along threads 330, threads 316 and 326, are reversed from each other.

  As shown in FIG. 41, the driver 302 of the compression screw assembly 224 includes a shank portion 334 and an enlarged head portion 336. The shank portion 334 of the driver 302 has a diameter sized to allow the shank portion 334 to slidably fit longitudinally inward of the center of the screw 300. The shank portion 334 of the driver 302 includes an outer thread 340 that extends axially from the free end 342 of the driver 302. The head portion 336 of the driver 302 is sized to prevent the head portion 336 from passing through the inside of the screw 300. As can be seen, the axial length or distance separating the head portion 336 of the screw 302 from the free end 342 is such that the head portion 314 of the screw 300 is at the beginning of the inner thread 330 adjacent the head portion 314 closest. It is approximately equal to the distance separating the part. In a preferred form, as shown in FIG. 41, the rear end of the head portion 336 of the driver 302 is formed with a slot 344 for removably receiving the distal end of the drive tool. As can be appreciated, configurations other than slots are equally satisfactory without detracting from or departing from the spirit and scope of the present invention.

  When the surgical fastener assembly 210 is assembled, the compression screw 300 of the compression screw assembly 224 is rotatably threaded to engage the inner thread 255 of the insertion member 244, as shown in FIG. A suitably shaped tool 355 engages the slot 318 and head portion 314 of the compression screw 300 until the enlarged head 314 abuts the radial wall 240 defined by the counterbore 238 defined by the guide member 220. The first part 304 and the second part 306 of the compression screw 300 are rotated to drive. Thereafter, the driver 302 is operatively engaged with the compression screw 300. That is, as shown in FIG. 44, the driver 302 is inserted into the central opening defined by the compression screw 300 and threadedly engaged with the inner thread 330 of the second portion 306 of the compression screw 300. In particular, however, the driver 302 is rotated in the opposite direction that the compression screw 300 was rotated for insertion into the anchor. In this regard, a suitable tool 357 releasably engages the slot 344 in the head portion 336 of the driver 302 and rotates the driver 302. The driver 302 is rotated until the collapsible portion 308 connecting the first portion 304 and the second portion 306 is collapsed. The collapse of the central collapsible portion 308 causes opposite forces acting on the outer and inner threads 330 of the first and second portions 304, 306, thereby causing the compression screw assembly The solid 224 is prevented from inadvertently rotating with respect to the anchor 222.

  FIG. 45 schematically illustrates another form of anchor, generally designated by reference numeral 422, which can be used as part of a surgical anchor assembly. Anchor 422 includes an elongated insertion member 444 having a first end 446 and a second end located on opposite sides. The insert member 444 is preferably formed from a material similar to that used to form the insert member 44. When the insertion member 444 is inserted into the bone, the first end 446 is disposed on one side of the fracture line, and the second end 448 of the insertion member 444 is disposed on the opposite side of the fracture line. It is sized like this.

  As shown in FIGS. 45 and 46, the surgical fastener assembly further includes a set of elongated pins or barbs 460 that are operably coupled toward the first end 446 of the insertion member 444. 45 and 63, the pin or barb 460 is operably coupled to the anchor 422 so that it moves between a retracted position (FIG. 45) and a radially extended position (FIG. 63). Is done. As shown, pin 460 is moved by insert member 444 for longitudinal radial movement relative to insert member 444. In the illustrated embodiment of the present invention, the two pins 460 move relative to each other for active longitudinal movement in both directions between the retracted and extended positions shown in FIGS. 45 and 63, respectively. And are moved by the anchor 422 in a completely opposite relationship.

  In accordance with this aspect of the invention, as shown in FIGS. 46 and 47, the elongated insertion member 444 preferably extends axially along the insertion member 444 and leads rearwardly from the first end 446. Outer threads 468 to The outer threads 468 along the outside of the insertion member 444 have a relatively coarse pitch to enhance the ability to build and anchor the anchor to bone quality in response to the rotational movement transmitted to the anchor 422.

  The insertion member 444 of the anchor 422 extends axially forward from the second or rear end 448, extends to the end of the outer thread 468, and has an outer diameter that is slightly smaller than the outer thread 468. It has a cylindrical shape 449. In particular, the cylindrical shape 449 extending axially forward from the end portion 448 of the insertion member 444 has a diameter that is approximately equal to the diameter of the through-hole 36 (FIG. 2) of the guide member that is operatively coupled to the insertion member 444. Thereby facilitating axial sliding movement of the guide member of the anchor 422 into the sleeve. Although not specifically shown, as in the prior art, cooperating means are defined on the outer shape 449 of the insert members 444 and the respective guide members, and anchors to the guide members along an axis 451 defined by the insert members 444. While allowing the axial movement of the 422, the rotational movement of the anchor 422 relative to each guide member is prevented.

  As shown in FIG. 47, the insertion member 444 defines a constant diameter counterbore portion 452 extending axially inward from the first end 446 of the insertion member 444. At the inner end, a counterbore portion 452 defines a radial wall 454. Between the first end 446 and the radial wall 454, the insertion member further defines a pair of slanted openings 470 disposed in a diametrically opposed relationship with respect to each other. Each opening intersects an end hole 452 defined by the insertion member 444 and opens to the end hole 452. Each opening 470 is open to the outside of the insertion member 444.

  The insertion member 444 defines an elongated inner bore 455 that extends axially forward from the second or opposite end 448 and opens to the counterbore portion 452. The inner hole 455 includes a portion 457 that extends inwardly from the second end portion 448 and is threaded inwardly. Preferably, the portion 457 threaded inside the bore 455 has a relatively fine pitch thread extending along the threaded portion 457. As can be seen, the inner thread 457 corresponds to the outer thread of a compression screw assembly (not shown) that is operatively coupled to the insert member 444.

  As shown in FIG. 47, the second or rear end 448 of the insertion member 444 further removably accommodates a drive tool (not shown) that can transmit rotational motion to the anchor 422. To be formed. In the preferred form, as shown, the rear end or second end 448 of the insert member 444 is formed into a suitable shape having a slotted opening 469 for removably receiving the distal end of the drive tool. Is done. However, it will be appreciated that any suitable shape will be equally satisfactory without departing from or departing from the spirit and scope of the invention.

  Referring to FIG. 49, the insertion member 444 further includes a suitable guide mechanism 475 for purposes described below. The guide mechanism 475 can take a myriad of different forms without detracting from or departing from the spirit and scope of the present invention. One form of guide mechanism 475 is schematically illustrated in FIG. In the illustrated embodiment, the guide mechanism 475 includes a pair of guide keys 477 and 479 in opposite positions that extend along a long portion of the counterbore 452 defined by the insert member 444. As shown in FIG. 49, the guide keys 477 and 479 protrude radially inward toward each other. In particular, the end of each guide key 477 and 479 ends without reaching the first end 446 of the fastener 444, and the guide end of each guide key 477, 479 and the first end 446 of the insertion member, There is a gap in the axial direction between them. Referring to FIG. 45, this form of the pin or barb 460 of the present invention forms part of the carrier assembly 462. The carrier assembly 462 preferably includes a sliding member 463, with one end of each pin fixedly coupled to the sliding member 463, and the pin 460 is a counterbore 452 in the insertion member 444 of the sliding member 463. It is designed to move actively during the axial movement to.

  Referring to FIGS. 46, 50, and 51, each pin 460 is formed to be slidably accommodated in a longitudinal direction within one of the openings 470 defined in the insertion member 444. It has a wire shape. Suffice it to say that each pin 460 has sufficient strength to allow it to penetrate through bone tissue without substantially bending between the ends. In the most preferred form of the invention, each pin 460 is formed from a material selected from the group consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy.

  In the embodiment shown in FIGS. 46, 50, and 51, each pin 460 has a front end 461 at the opposite sharpened end 466. At the sharpened end 466, each pin is preferably in a curved or arcuate shape, with the free end 466 extending therethrough to the opening 470. The length of each pin 460 is such that when the front end 461 of the pin 460 is fully retracted into the anchor 422 (FIG. 45), the sharpened end 466 opposite the pin or barb 460 is the outer diameter of the insertion member 444. Is selected to be located within to facilitate insertion of the surgical anchor assembly into the patient's bone. Further, each barb or pin 460 length is such that the front end 461 of each pin 460 is operably coupled to the carrier assembly 462 when the pin is moved to the extended position (FIG. 63). It will be appreciated that the pins 460 are maintained and sized to allow the pins 460 to actively retract from the extended position when desired or deemed necessary by the surgeon.

  As described above, the carrier assembly 462 further includes a sliding member 463. The shape of the sliding member 463 is shown in FIGS. As shown, the sliding member 463 has a generally cylindrical outer surface shape having a diameter approximately equal to the diameter of the counterbore portion 452 (FIG. 46) of the fastener 444. The sliding member 463 defines a pair of identical through-holes or counterbore holes that are arranged in a relationship that is diametrically opposed to each other. The diameters of the openings 481, 483 are sized to receive the front end 461 of the pin 460 and allow the front end 461 of each pin 460 to be securely fastened to the opening. In addition, the sliding member 463 defines a pair of diametrically opposed slots 485 and 487 that are disposed in a manner other than perpendicular to the openings 481 and 483. In particular, the slots 485, 487 are sized to facilitate guided movement of the sliding member 463 relative to the guide keys 477 and 479 of the insertion member 444 (FIG. 62). Further, the sliding member 463 defines a tool engagement hole 491 that passes straight through the sliding member and has indentations 493 and 495 on both sides.

  As shown in FIG. 45, the carrier assembly 462 is axially housed in an inner hole 452 defined by the insertion member 444 for axial movement, and the sharpened end 466 of each pin 460. Extends at least partially through the opening 470 but does not extend around the perimeter of the fastener 444. After the carrier assembly 462 is attached to the inner hole 452 of the insertion member 444, the open end of the insertion member 444 is closed by the end cap 497.

  A preferred form of end cap 497 is shown in FIGS. As shown, the end cap 497 preferably includes a reduced annular portion 498 that is sized to fit within the free open end of the bore 452 defined by the insert member 444. The end cap 497 is secured to the rest of the insert member 444 by suitable holding means such as caulking, welding, or similar means. The end cap 497 is preferably formed from a material that is biocompatible with bone tissue or human body material and is preferably selected from a set consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy. The However, other unspecified materials will be equally satisfactory without detracting from or departing from the spirit and scope of the present invention. As shown in FIGS. 56-58, end cap 497 defines a central through bore or hole 499. Further, the exposed surface of end cap 497 is preferably chamfered to aid in insertion of anchor 422 into the bone.

  59 and 60 cooperate with the transport assembly 462, and move the transport assembly 462 in both directions in the axial direction by the inner hole 452 of the insertion member 444, so that the retracted position (FIG. 45) and the extended position are moved. FIG. 63 shows a tool configured to actively move the pin 460 to / from (FIG. 63). Tool 500 preferably includes an elongated shank 502 having keys 504 and 506 spaced axially at the distal end. The shank 502 and keys 504 and 506 are formed to extend axially into the inner bore 455 of the insertion member 444 and to operably couple within the sliding member 463 of the carrier assembly 462. More specifically, the key 506 is specifically configured to fit straight through the tool engagement hole 491 so that the key 506 can operatively engage the slide member surfaces 493 and 495.

  As shown in FIG. 45, the guide slots 485 and 487 of the sliding member 463 are not axially aligned with the guide keys 477 and 479 extending radially inward from the inner hole 452. As will be appreciated by those skilled in the art, guide keys 477 and 479 are radially offset from guide slots 485 and 487, respectively, by pin 460 placement and orientation relative to guide slots 485 and 487, respectively. Therefore, the transport body assembly 462 cannot be inadvertently moved in the axial direction within the inner hole 452, and the pin maintains the contracted position.

  The tool 500 is inserted into the fastener 444 to cause the pin or barge 460 to extend radially outward from the inner bore 452 of the fastener 444. More particularly, the key is inserted straight into the insertion member 444 so that it can penetrate and operably engage the sliding member. After moving the keys 504 and 506 into operative engagement with the sliding member, the tool 500 is rotated to provide rotation of the sliding member 463 as shown by the arrows and FIGS. 62 and 62A. The rotation of the sliding member 463 is allowed by the elasticity of the length of the pin 460. The slide member 463 is rotated until the slots 485 and 487 are aligned with the guide key 477, after which the tool 500 is moved to the left as shown in FIG. 62 to move the pin 460 outward relative to the insert member 444. Forces advancement, thereby increasing the ability of the surgical anchor 422 to attach to the bone. When desired, the tool may also be used in operative engagement with the sliding member 466 to force the pin 460 to retract to the position shown in FIG. That is, the key is operably engaged with the sliding member and repositioned to force the pin to retract to facilitate removal of the anchor assembly when deemed necessary or desired by the surgeon. To do this, the tool 500 is pushed and turned or rotated.

  Yet another alternative form of compression screw assembly, generally designated by reference numeral 600, is shown in FIGS. 64 and 64A. The purpose of the compression screw assembly 600 is to maintain the guide member 620 and the anchor 622 in a compressive relationship relative to each other, for example, by securing the guide member 620 to the anchor 622. For the purposes of this description, the guide member 620 and anchor 622 are substantially similar to the guide member 20 and anchor 22 described above. This time, therefore, there is no need for further detailed explanation.

  The compression screw assembly 600 preferably includes a compression screw 630 and a drive body 6650. Both compression screw 630 and driver 650 are formed from a material that is biocompatible with bone tissue or human body material.

  As shown in FIG. 65, compression screw 630 includes an elongated shank portion 632 and a head portion 633 that is enlarged. The shank portion 632 of the compression screw 630 includes an outer thread 634 that extends axially from the front end 635 of the compression screw 630. The outer thread 634 has a relatively fine pitch that coincides with the inner thread extending axially along an inner bore 678 threaded inside the anchor 622. The enlarged head portion 633 of the compression screw 630 has a diameter slightly smaller than the diameter of the counterbore 688 formed in the guide member 620 and substantially similar to the counterbore 38 (FIG. 2) of the guide member 20. Have

  As shown in FIGS. 65 and 66, the rear end 636 of the compression screw 630 is preferably detachable from a drive tool (not shown) that can transmit rotational motion to the compression screw 630. Formed to accommodate. In the preferred form, as shown, the rear end 636 of the compression screw 630 is formed with a socket-like opening 637 having a bottom 638. The socket-shaped opening 637 is formed so as to detachably accommodate the distal end portion of the driving tool. In the most preferred form of the invention, as shown, the socket or opening 637 has a hexagonal cross-sectional shape. However, it will be appreciated that any suitable shape including elongated slots is equally satisfactory without detracting from or departing from the spirit and scope of the present invention.

  The compression screw 630 further defines an elongated inner bore 640 that is open on both sides with respect to the socket 637 and the front end 635 of the compression screw 630. As shown, the opening 640 has an inner thread 642 that extends along its length. As shown in FIGS. 65 and 67, the distal or front end 635 of the compression screw 630 includes a set of radial through slots 643, 644, 645, and 646 that are relative to each other. They are arranged in a generally vertical relationship and extend axially inward for a predetermined distance from the scraped location or end 635. In addition, as shown in FIG. 65, the bore 640 and the inner thread 642 may be scraped of the compression screw 630 in the region of slots 643, 644, 645, and 646 for purposes described below. Or narrower toward the end 635.

  As described above, the compression screw assembly 600 further includes a driver 650 disposed in combination with the compression screw 630. The driver 650 is shown in FIGS. 68, 69, and 70. FIG. The driver 650 includes a shank portion 652 and an enlarged head portion 654. The shank portion 652 of the driver 650 includes an outer thread 656 that extends axially from the front end 658 of the driver 650. The outer thread 656 has a relatively fine pitch that matches the inner thread 642 provided in the inner bore 640 of the compression screw 630. The enlarged head portion 654 of the driver 650 has a diameter that is slightly smaller than the diameter that can be received straight into the socket 637 of the compression screw 630. As can be seen from an understanding of the compression screw assembly 630, the length of the shank portion 652 is such that the distal or free end 658 provides a slot for the compression screw 630 when the head portion 654 touches the bottom at the floor 638 of the socket 637. Is sufficient to extend to the end of the slot and through the slot.

  As can be seen from an understanding of compression screw assembly 600, compression screw 630 is threaded into anchor assembly 622 as shown in FIG. 64 and pulls guide member 620 into a compressed relationship with respect to anchor 622. Thereafter, the drive body 650 is screwed into engagement with the inner thread 642 of the compression screw 630. In particular, the outer diameter of the shank portion 632 of the compression screw 630 is substantially constant as long as the driver 650 remains in engagement with the end 635 provided with the slot of the compression screw 630. When proper compression is achieved between the guide member 620 and the anchor 622, the driver 650 is further engaged with the compression screw as shown in FIG. As a result, the slotted end 635 of the compression screw 630 is expanded radially outward to provide a compression fit that prevents the compression screw assembly 600 from rotating relative to the anchor 622, thereby providing a compression fit. The compressive relationship between guide member 620 and anchor 622 is maintained.

  As described above and shown schematically in FIG. 74, a set of screws 28 is used to secure the plate 32 of the guide member 20 to the bone portion 18. Another aspect of the present invention relates to a preferred form of configuration for the screw 28 used to secure the plate 32 of the guide member 20 to the bone portion 18.

  In a preferred embodiment, as shown in FIG. 75, the screw 28 comprises an elongate fastener 700 and a driver 702 to be inserted. As can be seen, the fastener 700 is formed from a material that is biocompatible with bone tissue and includes a shank portion 710 and an enlarged head portion 712. The shank portion 710 of the fastener 700 includes an outer thread 714 that extends axially from the front end 716 of the fastener 700. The outer thread 714 has a pitch that improves the ability to build and attach a firm foothold in the bone quality of the fastener 700. The enlarged head portion 712 of the fastener 700 is formed to cooperate with the shape of the through hole 34 in the plate 32 of the guide member 20. In the embodiment shown, the head portion 712 of the fastener 700 has a frustoconical shape that cooperates with the countersunk shape or recess of the through hole 34 to secure the plate 32 to the bone 18. However, it will be appreciated that shapes other than those shown for the head portion 712 and the through hole 34 are equally satisfactory without detracting from or departing from the spirit and scope of the present disclosure.

  As shown in FIG. 76, the rear end 718 of the fastener 700 preferably removably accommodates a drive tool (not shown) that can transmit rotational motion to the fastener 700. Formed. In the preferred form, as shown, the rear end 718 of the fastener 700 is formed with an elongated slot or opening 720. A slit 720 is formed to removably accommodate the distal end of the driving tool. However, as will be appreciated, any suitable shape including a socket is equally satisfactory for removably receiving the distal end of the drive tool without detracting from or departing from the spirit and scope of the present invention.

  The fastener 700 that is inserted further defines an elongated inner bore 722 that opens at both ends 716, 718 of the fastener 700. As shown in FIGS. 76 and 77, the inner hole or opening 722 is open to the first end 716 of the fastener 700 and has a first portion 724 having a first diameter and the rear of the fastener 700. A second end bore portion 726 that is open to the end or second end 718 and has a second diameter. In particular, the diameter of the inner hole 726 is larger than the diameter of the inner hole or opening 722, and thus the radial wall or annular shoulder 727 is defined by the difference in diameter therebetween. As shown in FIGS. 77 and 79, the distal or front end 716 of the fastener 700 includes a set of radial through slots 728, 730, 732, and 734 that are substantially relative to each other. Arranged in a vertical relationship and extending radially inward from a first end or end 716 of fastener 700 for a predetermined distance. As shown, for the purposes described below, the diameter of the first portion 724 of the bore 722 is reduced or reduced in the region from slot 728 to 734 while the outer diameter of the fastener. Remains almost constant.

  As can be seen from an understanding of this embodiment, the axial length of the shank portion 710 of the fastener 700 is such that when the fastener is passed through the through hole 34 in the plate 32 of the guide member 20 and attached to the bone 18. The axially long portion of the shank 710 with the slots formed therein extends beyond the bone 18 by a distance approximately equal to the length of the slots 728-734. Of course, at the time of surgery, the surgeon may have a collection of various fasteners to choose from, such that each fastener can easily obtain the proper relationship to the bone thickness of the fastener. It has various lengths.

  As described above, this form of screw 28 further includes a driver 702 disposed in connection with fastener 700. A preferred form of driver 702 is shown in FIGS. As shown, the driver 702 preferably includes a one-piece member 750 formed from a material that is biocompatible with the bone tissue and bone quality of the human body. The driver member 750 includes a first portion 752 having a substantially constant diameter along the length and an axially aligned second portion having a substantially constant diameter along the length. The second portion 754 has a larger diameter than the first portion 752 and thus a radial wall or annular shoulder 757 is defined therebetween.

  In the illustrated embodiment, the annular shoulder or annular wall 757 of the driver 702 is generally coincident with the radial wall or annular shoulder 727 defined by the fastener 700. However, the axial length of the first portion 752 extending between the radial wall or annular shoulder 757 and the free end of the driver member 750 is such that the radial wall or annular shoulder extends from the distal end or free end 716 of the fastener 700. It is important to note that it is approximately equal to the distance separating 727. Further, the first portion 752 of the driver 702 is sized to establish a sliding fit in the first portion 724 of the inner bore 722 defined by the fastener 700. In the most preferred form of the invention, the second portion 754 of the driver 702 is sized to establish a sliding fit at the second portion of the bore 722 defined by the fastener 700.

  As can be seen from an understanding of the screw 28 and shown in FIG. 75, the first end or forward end 716 of the fastener 700 can be passed straight through the through bore 34 of the plate 32 of the guide member 20 and the shank portion 710. Is screwed into the bone 18 by turning the head portion 712. Finally, the head portion 712 contacts the plate 32 and pulls the guide member 620 into an attached relationship with the bone. In this regard, the free end of the fastener 700 in which the slot is provided extends beyond the bone 18 on the opposite side of the guide member 20 from the plate 32. In particular, when the fastener 700 is attached to the bone 18, the outer diameter of the shank portion 710 of the screw 700 is substantially constant as long as the driver 702 remains out of engagement with the fastener 700. Once proper attachment has been achieved between the guide member 620 and the fastener 700 being inserted, the driver 702 is driven into the bore 722 of the fastener 700 as shown in FIG. When the driver 702 is fully inserted into the fastener 700, the slotted end 716 of the fastener 700, for example, when the shoulder 757 of the driver member 750 engages the shoulder 727 of the fastener 700. Are spread radially outward to prevent inadvertent rotation of fastener 700, thereby maintaining the attached relationship between guide member 20 and bone 18 as shown in FIG.

  From the foregoing, it will be appreciated that numerous modifications and variations can be made without departing from the true spirit and scope of the novel concepts of the present invention. This disclosure is intended to illustrate examples of the invention, and the examples shown are not intended to limit the invention to the particular embodiments shown. This disclosure is intended to cover all modifications within the spirit and scope of the following claims.

FIG. 2 shows a surgical fastener assembly according to the present invention, wherein the surgical fastener assembly is operatively coupled to a condylar fracture and extends across the condylar fracture. FIG. 2 is an enlarged view, partially in section, of the device of the present invention shown in FIG. It is a perspective view of the present invention in an assembled state. It is a side view which shows the component components of one form of this invention of the state decomposed | disassembled. 1 is a longitudinal sectional view of a fastener forming part of the present invention. FIG. 6 is a cross-sectional view similar to FIG. 5 except that the pin or hook of the fastener shows a stretched state. It is a perspective view of the fastener shown by FIG.5 and FIG.6. FIG. 8 is an end view of the fastener as shown in FIG. 7. FIG. 9 is a cross-sectional view taken along line 9-9 of FIG. FIG. 4 is another end view of the present invention. 1 is an enlarged perspective view of a pin or bar forming part of a first embodiment of a surgical fastener assembly according to the present invention. FIG. It is a side view of the pin shown by FIG. FIG. 12 is a side view of the pin shown in FIG. 11 or the other side of the hook. FIG. 13 is an end view of the pin or barb shown in FIG. 12. FIG. 15 is a cross-sectional view taken along line 15-15 of FIG. 1 is a perspective view of one form of a compression screw that forms part of the present invention. FIG. FIG. 17 is a side view of the compression screw shown in FIG. 16. FIG. 18 is a left end view of the compression screw shown in FIG. 17. FIG. 18 is a right end view of the compression screw shown in FIG. 17. FIG. 20 is a cross-sectional view taken along line 20-20 of FIG. FIG. 3 is a perspective view of a retainer that forms part of the anchor assembly shown in FIG. 2. It is a side view of the holder shown by FIG. FIG. 23 is a left end view of the holder shown in FIG. 22. It is a right end view of the holder shown in FIG. FIG. 25 is a cross-sectional view taken along line 25-25 of FIG. FIG. 7 shows the assembly of a surgical anchor assembly according to one form of the present invention with a pin or barb unfolded and a tool arranged to engage the retainer shown in FIGS. Yes. Surgical anchor assembly according to one form of the present invention with the pin or barb extended and the retainer shown in FIGS. 21-25 to the insertion compression fastener shown in FIGS. FIG. 25B is a view similar to FIG. 25A, except that it shows yet another assembly with a tool for moving it into operative engagement. 2 is a perspective view of a driver that forms part of a first embodiment of this surgical fastener assembly according to the present invention; FIG. FIG. 27 is a partial side view of the driving body shown in FIG. 26. FIG. 28 is a left end view of the driving body shown in FIG. 27. FIG. 28 is a right end view of the driving body shown in FIG. 27. FIG. 30 is a longitudinal cross-sectional view taken along line 30-30 of FIG. 28. It is a perspective view of the limit stop member which forms a part of 1st embodiment of the present invention. FIG. 32 is an enlarged side view of a limit stop member shown in FIG. 31. FIG. 33 is a left end view of the limit stop member shown in FIG. 32. FIG. 33 is a right end view of the limit stop member shown in FIG. 32. FIG. 34 is a cross-sectional view taken along line 35-35 of FIG. FIG. 13 is a view similar to FIG. 12 except showing a pin or barb alternative according to the present invention. FIG. 37 is an enlarged right side end view of the pin or hook shown in FIG. 36. FIG. 6 is a view similar to FIG. 5 showing a pin or barb alternative located with the insertion member and in a retracted position relative to the insertion member. FIG. 39 is a view similar to FIG. 38 except showing an alternative form of the fastener in an extended position relative to the fastener. It is a figure similar to FIG. 5 except showing 2nd embodiment of this invention. FIG. 6 is a longitudinal cross-sectional view showing elements of a second embodiment of the present invention in a disassembled or removed relationship with respect to each other. FIG. 41 is a view similar to FIG. 40 schematically showing a pin or barb extension relative to the anchor. FIG. 43 is a view similar to FIG. 42 except showing an alternative form of compression screw assembly arranged to be operatively coupled to an anchor and a conventional side plate. FIG. 44 is a view similar to FIG. 43 except showing the drive of the compression screw assembly disposed in a locking relationship with the compression screw. FIG. 9 is a longitudinal cross-sectional view of a third embodiment of a surgical anchor assembly according to the present invention in an operatively coupled and contracted relationship with an alternate form pin. FIG. 6 is a longitudinal partial cross-sectional view showing components of a third embodiment of the present invention in an exploded or removed relationship with respect to each other. FIG. 6 is a partial longitudinal cross-sectional view of an anchor or insertion member that forms part of a third embodiment of the present invention. 48 is a left end view of the anchor shown in FIG. 47. FIG. 48 is a right end view of the anchor shown in FIG. 47. FIG. It is a side view of the pin which forms a part of 3rd embodiment of this invention. FIG. 52 is a cross-sectional view taken along line 51-51 of FIG. It is sectional drawing of the sliding member which forms the component of 3rd embodiment of this invention. FIG. 53 is a left end view of the sliding member shown in FIG. 52. FIG. 53 is a right side end view of the sliding member shown in FIG. 52. FIG. 55 is a cross-sectional view taken along line 55-55 of FIG. 54. It is sectional drawing of the end cap which forms a part of 3rd embodiment of this invention. FIG. 57 is a left end view of the end cap shown in FIG. 56. FIG. 57 is a right end view of the end cap shown in FIG. 56. FIG. 46 is a side view of a tool used to extend and retract a pin in the third embodiment of the anchor assembly shown in FIG. 45. FIG. 60 is a right end view of the tool shown in FIG. 59. 59 and FIG. 59 are arranged to be operatively coupled with a sliding assembly that forms part of a third embodiment of the present invention and the pin or barb is shown in a retracted position relative to the anchor. FIG. 60 is a cross-sectional view showing the tool shown in FIG. FIG. 64 is a cross-sectional view taken along line 61-61 of FIG. FIG. 62 is a view similar to FIG. 61 except showing the tool in operable relationship with the sliding member of the sliding assembly to force the pin or barb to extend radially outward from the anchor. FIG. 63 is a cross-sectional view taken along line 62A-62A of FIG. 62. FIG. 46 is a longitudinal cross-sectional view similar to FIG. 45 except showing the pins arranged in an extended relationship with respect to the anchor. Figure 5 is another form of surgical anchor assembly having an alternative form of compression screw assembly for holding the anchor and guide member in a compressive relationship with respect to each other. FIG. 65 is an enlarged cross-sectional view of the compression screw assembly surrounded by FIG. 64. FIG. 64B is a longitudinal cross-sectional view of the compression screw forming the component parts of the compression screw assembly shown in FIGS. 64 and 64A. FIG. 66 is a left end view of the compression screw shown in FIG. 65. FIG. 66 is a right end view of the compression screw shown in FIG. 65. FIG. 68 is an elevation view of a driver used with the compression screw assembly shown in FIGS. 65-67. FIG. 69 is a left end view of the driver shown in FIG. 68. FIG. 69 is a right end view of the drive body shown in FIG. 68. FIG. 69 is a schematic partial cross-sectional view of a compression screw (FIG. 65) and driver (FIG. 68) shown in a disassembled or removed relationship with respect to each other. 2 is a schematic view of a drive body shown in an imperfect relationship with a compression screw. 2 is a schematic representation of a driver shown in perfect relation with a compression screw. FIG. 3 is a reduced view similar to FIG. 2. FIG. 75 is an enlarged view of a region surrounded by FIG. 74. Fig. 3 shows components of an alternative form of screw assembly used to secure the guide member to the bone, these components being shown in a disassembled relationship with respect to each other. FIG. 77 is a longitudinal cross-sectional view of a compression screw that forms part of the screw assembly shown in FIGS. 75 and 76; FIG. 78 is a left end view of the compression screw shown in FIG. 77. FIG. 78 is a right end view of the compression screw shown in FIG. 77. FIG. 77 is a side view of a driver used with the screw assembly shown in FIGS. 75 and 76. It is a left end view of the drive body shown by FIG. FIG. 81 is a right end view of the driving body shown in FIG. 80. FIG. 6 shows a drive body partially arranged in operable relation with a compression screw.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Surgical fastener assembly 20 Guide member 30 Sleeve

Claims (83)

A surgical fastener assembly for joining a first bone portion and a second bone portion across a fracture therebetween,
An elongate anchor that is vertically insertable into the first bone portion such that one end portion is disposed on one side of the fracture and the second end portion is disposed on the opposite side of the fracture; ,
A guide member suitable for being fixedly fastened to the second bone part,
The protruding portion of the guide member is guided along the second end portion by the second end portion of the anchor,
An insertion fastener further comprising a head portion that is enlarged and a shank portion that is threaded outwardly, and an elongated inner bore extends through the head portion and the shank portion and opens at both ends thereof. Prepared,
The shank portion of the fastener extends until it threadably engages the anchor and the rotation of the fastener attracts the first bone and the second bone into a compressive relationship relative to each other. The head portion of the fastener is operatively engaged with the guide member, the fastener defining an axial bore that is open to both ends of the fastener;
Threadedly coupled with the second end of the anchor that is positionable relative to the fastener to releasably lock it, thereby preventing movement of the guide member away from the anchor. A surgical fastener assembly further comprising a retainer.   The surgical instrument of claim 1, wherein the retainer is engageable by a tool capable of extending through an inner bore of the fastener to position the retainer relative to the fastener. Fastener assembly.   The surgical fastener assembly of claim 1, wherein the anchor is formed from a material selected from a set consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy.   The surgical fastener assembly of claim 1, wherein the guide member is formed from a material selected from the group consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy.   The surgical of claim 1, wherein the retainer defines an axial bore formed to operatively engage a tool, thereby allowing rotational motion to be transmitted to the retainer. Fastener assembly.   The surgical fastener assembly of claim 1, wherein the anchor has an outer thread extending along an axial length over an axial length to secure the anchor to the first bone portion.   The second end of the anchor detachably accommodates a driving tool capable of transmitting rotational motion to the anchor such that an outer thread of the anchor engages the bone quality of the first bone. The surgical fastener assembly of claim 6, wherein the surgical fastener assembly is formed of   The guide member has a recess sized to accommodate a head portion of the fastener therein and not to have a portion of the fastener extending axially beyond the guide member when the guide member is fastened to the anchor. The surgical fastener assembly according to claim 1 defined by.   The surgical fastener assembly of claim 1, wherein the guide member and the anchor are releasably fastened to each other to prevent relative rotation therebetween. A surgical fastener assembly for joining a first bone portion and a second bone portion across a fracture therebetween,
An elongate anchor that is vertically insertable into the first bone such that one end region is disposed on one side of the fracture and the second end region is disposed on the opposite side of the fracture;
A set of pins operably coupled to one end of the anchor for movement between an extended position and a retracted position;
When the pin is in the retracted position, the pin does not have an effective anchoring effect between the anchor and the first bone portion, and when the pin is in the extended position, the pin operates with the anchor. Maintaining a possible connection and extending radially outward from the anchor, thereby fastening the anchor to the first bone portion;
A mechanism for actively moving the pin in both directions between the extended position and the retracted position;
And a guide member adapted to be fixedly secured to the second bone portion,
The protruding portion of the guide member is guided along the second end region by the second end region of the anchor,
And further comprising a fastener including a head portion that is enlarged and a shank portion that is threaded outwardly;
The shank portion of the fastener extends until it threadably engages the anchor, and rotation of the fastener attracts the first bone portion and the second bone portion relative to each other. A surgical fastener assembly wherein the head portion of the fastener is operatively engaged with the guide member.   The surgical fastener assembly according to claim 10, wherein the anchor is formed from a material selected from the group consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy.   The surgical fastener assembly of claim 10, wherein each pin of the set of pins is formed from a material selected from a set consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy. .   The surgical fastener assembly of claim 10, wherein each pin of the set of pins is moved by the anchor for longitudinal movement between the extended position and the retracted position.   The surgical fastener assembly according to claim 10, wherein the anchor includes an outer thread extending along a long portion for attachment of the anchor to the first bone portion.   The surgical fastener assembly according to claim 14, wherein the second end of the anchor is configured to removably receive a driving tool capable of transmitting rotational motion to the anchor.   The surgical fastener assembly according to claim 10, wherein the mechanism comprises a driver that is manually operated to effect active movement of the pin in each direction between an extended position and a retracted position.   The mechanism comprises a drive body mounted for free rotation in a cavity defined toward the first end of the anchor, the drive body having a saw tooth on each of the pins. 11. An outer thread for engagement, whereby each pin is actively moved longitudinally in either direction of movement as a function of rotational movement transmitted to the driver. A surgical fastener assembly according to claim 1.   The surgical device of claim 17, wherein the driver is configured to removably receive a driving tool suitable for transmitting rotational motion to the driver at a rear end of the driver. Fastener assembly.   19. The fastener is formed with an elongated axial bore to allow the drive tool to pass straight through and operably engage the drive. A surgical fastener assembly according to claim 1.   In order to releasably lock the fastener against inadvertent rotation, thereby preventing axial movement of the guide member away from the anchor, the same towards the second end of the anchor. A retainer that is moved by the second end and is positionable relative to the fastener, the retainer being in an axial direction that allows the drive tool to pass straight through the retainer; The surgical fastener assembly of claim 19, wherein the surgical fastener assembly defines a hole.   The axis of the guide member which is moved by the second end towards the second end of the anchor and detachably locks the fastener against inadvertent rotation, thereby moving away from the anchor The surgical fastener assembly according to claim 10, further comprising a retainer positionable relative to the fastener to prevent directional movement.   The surgical fastener assembly according to claim 10, wherein each pin of the set of pins has an arcuate shape between opposite ends.   The surgical fastener assembly of claim 10, wherein the pin is uniformly disposed about an axis of the anchor and relative to that axis.   The anchor defines a pair of axially elongated grooves for receiving pins so as to slide in the longitudinal direction within the anchor, and each groove is not visible to the front end and the periphery of the anchor. The surgical fastener assembly of claim 10, having an opposite end that is open.   25. The surgical fastener assembly of claim 24, wherein the grooves are provided about an elongate axis of the anchor in spaced relation relative to each other.   25. The surgical fastener assembly of claim 24, wherein each groove is curved between opposite ends.   The surgical fastener assembly according to claim 10, wherein the anchor and the guide member are formed with means for cooperating to prevent rotation relative to each other. A surgical fastener assembly for joining a first bone portion and a second bone portion across a fracture therebetween,
An axially elongated bone screw defining an elongated axis and having an outer thread;
The bone screw is disposed on the first bone portion such that a front end portion of the anchor is disposed on one side of the fracture portion and a rear end portion of the bone screw is disposed on the opposite side of the fracture portion. Vertically fastening the front end of the bone screw, and defining an elongated inner hole and a pair of axially elongated openings arranged around the axis, each opening between the two ends And one end is open to the outside of the bone screw,
A set of elongate pins configured to be received and moved in the set of openings defined by the bone screw;
In the retracted position, the pin is effective on the bone screw so that the long portion of each pin passes between the elongated axis of the bone screw and moves between the retracted and extended positions. In the extended position, the pin extends radially outward from the bone screw, greatly improving the ability of the bone screw to be fixed to the bone,
A manually operated mechanism to cause active movement of the pins in opposite directions relative to each other;
And a guide member adapted to be fixedly secured to the second bone portion,
The protruding portion of the guide member is guided along the second end portion by the second end portion of the bone screw,
And further comprising a fastener including a head portion that is enlarged and a shank portion that is threaded outwardly;
The shank portion of the fastener extends until it threadably engages the rear end portion of the bone screw, and rotation of the fastener causes the first bone portion and the second bone portion to move relative to each other. A surgical fastener assembly in which the head portion of the fastener is operatively engaged with the guide member so as to be drawn until engaged.   30. The surgical fastener assembly of claim 28, wherein the bone screw is formed from a material selected from the group consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy.   30. The surgical fastener assembly of claim 28, wherein each pin of the set of pins is formed from a material selected from a set consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy. .   29. The surgical fastener assembly of claim 28, wherein the rear end portion of the bone screw is configured to removably receive a driving tool capable of transmitting rotational motion to the bone screw. .   29. The surgical fastener assembly of claim 28, wherein the mechanism comprises a driver that is manually operated to cause active movement of the pin in each direction between an extended position and a retracted position. .   The mechanism comprises a drive body mounted for free rotation within the elongated bore toward the front end portion of the bone screw, the drive body engaging the serrated teeth of each pin 29. A surgical instrument according to claim 28, having an outer thread for making each pin actively moved longitudinally in either direction of movement as a function of the rotational motion transmitted to the driver. Fastener assembly.   34. The surgical fastener assembly of claim 33, wherein the driver is configured to removably receive a tool suitable for transmitting rotational motion to the driver at a rear end.   The surgical device of claim 34, wherein the fastener is formed with an elongated axial bore to allow the tool to operably engage the driver through a straight line. Fastener assembly.   In the rear end portion of the bone screw to releasably lock the fastener against inadvertent rotation, thereby preventing axial movement of the guide member away from the bone screw. Further comprising a retainer that is moved toward the fastener by the rear end portion thereof, the retainer allowing the drive tool to pass straight through the retainer. 35. The surgical fastener assembly of claim 34, wherein the surgical fastener assembly defines an axial bore.   In the rear end portion of the bone screw to releasably lock the fastener against inadvertent rotation, thereby preventing axial movement of the guide member away from the bone screw. 29. The surgical fastener assembly of claim 28, further comprising a retainer that is moved toward and by the rear end portion toward the fastener.   30. The surgical fastener assembly of claim 28, wherein each pin of the set of pins has an arcuate shape between the ends.   30. The surgical fastener assembly of claim 28, wherein the pin is uniformly disposed with respect to a coaxial line about the elongated axis of the bone screw.   The bone screw defines a set of grooves elongated in the axial direction for receiving pins so as to slide in the longitudinal direction within the bone screw. 29. The surgical fastener assembly of claim 28, having an opposite end that is open to the periphery.   41. The surgical fastener assembly of claim 40, wherein the grooves are provided about an elongate axis of the bone screw in an equally spaced relationship relative to each other.   41. The surgical fastener assembly according to claim 40, wherein each groove is curved between opposite ends.   29. The surgical fastener assembly of claim 28, wherein the bone screw and the guide member are formed with means that cooperate to prevent rotation relative to each other. A hip joint restraining device for compressing and joining the first fractured bone part and the second fractured bone part,
An elongate for vertically fixing the front end portion to the first bone portion such that the front end portion is disposed on one side of the fracture and the rear end portion is disposed on the opposite side of the fracture An axially elongated bone screw defining an axis and an outer thread extending axially along the axis;
The bone screw defines a set of elongated arcuate openings having an elongated axial bore and one end that intersects the bore between the ends and opens to the exterior of the bone screw. And
A set of elongated arcuate pins configured to be longitudinally received in the set of arcuate openings defined by the bone screw;
The pin is such that a long portion of each pin is movable between the retracted position and the extended position through the inner hole, and in the retracted position, the pin substantially provides an anchoring action. In the extended position, the pins extend radially from the bone screw, greatly improving the attachment of the bone screw to the bone,
And further comprising a drive body arranged for rotational movement in the bore of the bone screw and operatively coupled to each pin, whereby the rotational movement of the drive body is a function of the direction of rotation of the drive body. Actively causing a longitudinal movement of the pin in the radial direction with respect to the bone screw within each opening occurring substantially simultaneously in both directions,
And a guide member adapted to be fixedly secured to the second bone portion,
The protruding portion of the guide member is guided along the second end portion by the second end portion of the bone screw,
And further comprising a fastener including a head portion that is enlarged and a shank portion that is threaded outwardly;
The shank portion of the fastener extends until it threadably engages the rear end portion of the bone screw, and rotation of the fastener attracts the first bone portion and the second bone portion. A hip joint restraining device in which the head portions of the fasteners are operatively engaged with the guide member in a compressive relationship relative to each other.   45. The hip restraint device of claim 44, wherein the bone screw is configured to detachably accommodate a drive tool at a rear end portion.   45. The hip restraint device of claim 44, wherein the front end portion of the bone screw is generally sharpened to facilitate insertion of the first screw portion of the bone screw into the bone and self-tapping.   An inner bore defined by the bone screw is threaded inwardly disposed in an axially adjacent relationship with each other with an invisible cavity portion extending axially along the axis toward the front end portion of the bone screw. 45. The hip joint part restraining device according to claim 44, wherein the hip part restraining device according to claim 44, wherein the hip part restraining device is formed with an inscribed portion, and the inwardly threaded portion opens to a rear end portion of the bone screw.   48. The hip restraint device of claim 47, wherein the driver is arranged for free rotational movement within an invisible cavity defined by the bone screw.   45. The hip joint pressing device according to claim 44, wherein the driving body includes a member that is threaded on an outer side that is elongated in the axial direction and has a front end portion and a rear end portion.   50. A hip restraint according to claim 49, wherein a rear end portion of the axially elongated member is formed to removably receive a driving tool capable of transmitting rotational motion to the driver. apparatus.   51. The fastener of claim 50, wherein the fastener is formed with an elongated axial bore to allow the drive tool to operably engage the drive body straight through it. Hip joint restraining device.   Towards the second end of the anchor to releasably lock the fastener against inadvertent rotation, thereby preventing axial movement of the guide member away from the anchor Further comprising a retainer that is moved by the second end and is positionable relative to the fastener, the retainer being axially allowing the drive tool to pass straight through the retainer. 52. The hip joint restraining device according to claim 51, wherein an inner hole is defined.   In the rear end portion of the bone screw to releasably lock the fastener against inadvertent rotation, thereby preventing axial movement of the guide member away from the bone screw. 45. The hip restraint device of claim 44, further comprising a retainer that is moved toward and by the rear end portion toward the fastener. A surgical fastener assembly for joining a first bone portion and a second bone portion across a fracture therebetween,
It can be inserted vertically into the first bone portion such that one end portion is disposed in one end region of the fracture and the second end region is disposed on the opposite side of the fracture. An elongated anchor,
A guide member suitable for being fixedly attached to the second guide part,
The protruding portion of the guide member is guided in the axial direction along the second end portion by the second end region of the anchor,
A compression screw assembly for maintaining the anchor, the guide member and the bone portion to be fastened in a predetermined compressive relationship with respect to each other;
The compression screw assembly includes a compression screw having an outer threaded shank portion that is threadably engageable with the anchor and a head portion that is operably engageable with the guide member; After the compression screw has manipulated the anchor and the guide member into a predetermined compression relationship with respect to each other, the compression screw is passed straight through to extend a long portion of the shank portion of the compression screw in a radial direction. And further including a driver that is extendable, whereby extension of the long portion of the shank portion of the compression screw operably locks the compression screw to the anchor, thereby inadvertent rotation and Surgical fastener assembly that serves to prevent loosening of the compression screw relative to the anchor.   55. The surgical fastener assembly of claim 54, wherein the anchor is formed from a material selected from a set consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy.   55. The surgical fastener assembly of claim 54, wherein the guide member is formed from a material selected from a set consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy.   55. The surgical fastener set of claim 54, wherein the compression screw of the compression screw assembly is formed from a material selected from a set consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy. Solid.   55. The surgical fastener assembly of claim 54, wherein the driver of the compression screw assembly is formed from a material selected from the group consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy. Solid.   The head portion of the compression screw is increased relative to the diameter of the shank portion, the compression screw further defining an elongated opening extending therethrough, the elongated opening having a diameter that varies along the length. 55. The surgical fastener assembly according to claim 54.   55. The surgical fastener assembly of claim 54, wherein the driver includes an outwardly threaded shank portion and an enlarged head portion.   61. The surgical fastener assembly of claim 60, wherein the head portion of the compression screw defines a recess in the head portion for receiving the head portion of the driver.   The distal end of the shank portion of the compression screw includes a set of elongated slots that extend axially toward the head portion of the screw, the screw being open to the head portion of the screw. 55. The surgical fastener assembly of claim 54, further defining an elongated bore having a diameter that varies toward the distal end of the screw.   64. The surgical fastener assembly of claim 62, wherein the compression screw distal end defines four axially elongated slots.   63. The outer diameter of the shank portion of the compression screw remains substantially constant along the length as long as the driver remains disengaged from the compression screw. A surgical fastener assembly according to claim 1.   64. The surgical fastener assembly of claim 62, wherein the elongate bore defined by the compression screw has an inner thread extending along a major length portion. A hip joint restraining device for compressing and interconnecting a first fractured bone part and a second fractured bone part,
An elongate for vertically fixing the front end portion to the first bone portion such that the front end portion is disposed on one side of the fracture and the rear end portion is disposed on the opposite side of the fracture An axially elongated bone screw defining an axis and an outer thread extending axially along the axis;
Suitable for being fixedly fastened to the second bone part, having a protrusion extending from one end and being guided along the second end part by the second end part of the bone screw And a side plate that is prevented from rotating relative to the second end portion;
A compression screw assembly for maintaining the anchor and the side plate and the bone portion to be fastened in a predetermined compressive relationship with respect to each other;
The compression screw assembly includes an externally threaded shank portion that is threadably engageable with the anchor and a head portion that is operably engageable with the protrusion of the side plate. And the compression screw is configured to radially extend a long portion of the shank portion of the compression screw after operating the anchor and the guide member into a predetermined compression relationship relative to each other. Further including an insertion member capable of extending through straight, whereby extension of the long portion of the shank portion of the compression screw operably locks the compression screw to the anchor, thereby inadvertently A hip joint restraining device which functions to prevent rotation of the compression screw and thereby loosening of the compression screw with respect to the anchor.   The head portion of the compression screw is larger than the diameter of the shank portion, the compression screw further defining an elongated opening extending therein, the elongated opening having a diameter that varies along its length. 68. The hip joint unit pressing device according to claim 66.   67. The hip restraint device of claim 66, wherein the insertion member includes a shank portion threaded outward and a head portion that is enlarged.   67. The hip joint restraining device according to claim 66, wherein the head portion of the compression screw defines a recess for accommodating the head portion of the insertion member therein.   The distal end of the shank portion of the compression screw includes a set of elongated slots extending axially toward the head portion of the screw, the screw being open to the head portion of the screw. 68. The hip restraint device of claim 66, further defining an elongated bore having a diameter that varies toward the distal end of the screw.   71. The outer diameter of the shank portion of the compression screw remains substantially constant along the length as long as the insertion member remains detached from the compression screw. Hip joint restraining device.   71. The hip restraint device of claim 70, wherein the elongate bore defined by the compression screw has an inner thread extending along a major long portion. A surgical fastener assembly for joining a first bone portion and a second bone portion across a fracture therebetween,
An elongate anchor that is vertically insertable into the first bone portion such that one end region is disposed on one side of the fracture and the second end region is disposed on the opposite side of the fracture; ,
Having a projection guided by the second end region of the anchor and extending in an axial direction along the second end region, extending from and forming an angle from the projection A guide member further comprising a side plate defining a set of openings;
A plurality of screws for attaching the side plate of the guide member to the second bone portion;
Each screw includes an enlarged head portion that is integrally formed with an elongated shank portion that is externally threaded, wherein each screw is threaded after the screw is secured to the bone portion. Further including an insertion member capable of extending longitudinally from the head portion through the screw to radially extend a long portion of the shank portion of the shank portion of the shank portion of the screw. The extension of the long portion operatively locks the screw to the bone portion to prevent inadvertent rotation of the screw, thereby maintaining the side plate fastened to the bone portion. Fastener assembly.   74. The surgical fastener assembly of claim 73, further comprising a structure for preventing the guide member and the anchor from rotating relative to each other.   74. The surgical fastener assembly of claim 73, wherein the opening in the side plate is configured to receive the head portion of each screw in a recessed relationship with respect to a side surface of the side plate.   74. The surgical fastener assembly of claim 73, wherein the guide member is formed from a material selected from a set consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy.   74. The surgical fastener assembly of claim 73, wherein each screw is formed from a material selected from a set consisting of titanium, titanium alloy, stainless steel, or cobalt-chromium alloy.   74. The surgical fastener assembly of claim 73, wherein the outer thread of the shank portion of each screw has a relatively coarse pitch. A hip restraint device for maintaining a first bone portion and a second bone portion in a compressive relationship relative to each other across the fracture between them,
An elongate anchor that is vertically insertable into the first bone portion such that one end region is disposed on one side of the fracture and the second end region is disposed on the opposite side of the fracture; ,
A protrusion that is guided by the second end region of the anchor and extends in the axial direction along the second end region; A guide member further comprising a side plate that defines the opening of
A compression screw for holding the anchor, the guide member and the bone portion fastened to each in a compressive relationship with respect to each other;
A plurality of screws for fastening the side plate of the guide member to the second bone portion;
Each screw includes an enlarged head portion that is integrally formed with an elongated shank portion that is externally threaded, the shank portion having a distal end of the shank portion of the second bone portion. Each screw is sized to extend outward beyond the side plate opposite the side plate, and each screw radially extends the distal end of the shank portion of the screw after the screw is secured to the bone portion. Further including a driver that is capable of extending straight from the head portion through the screw so that extension of the shank portion of the screw can actuate the screw to the bone portion. A hip restraining device that locks to prevent inadvertent rotation of the screw, thereby keeping the side plate fastened to the bone portion.   80. The hip joint restraint device of claim 79, wherein the screw comprises an elongated inner bore that opens to the head portion of the screw to accommodate the driver within.   The inner bore of the screw has a stepped shape and the driver supplements the shape of the inner bore of the screw and provides a visual indication to the surgeon of the driver's longitudinal arrangement relative to the screw. 81. The hip joint restraining device of claim 80, comprising such a stepped long shape.   The distal end of the shank portion of each screw includes a set of elongated slots extending axially toward the head portion of the screw, the screw opening to the head portion of the screw. 80. The hip restraint device of claim 79, further defining an elongated bore having a diameter that varies toward the distal end of the screw.   80. The hip restraint device of claim 79, wherein the outer diameter of the shank portion of each screw remains substantially constant along its length as long as it remains detached from the compression screw. .

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