WO2015076019A1

WO2015076019A1 - Anchor-fastening tool

Info

Publication number: WO2015076019A1
Application number: PCT/JP2014/075961
Authority: WO
Inventors: 靖治横山; 宏一黒田; 光也浦田
Original assignee: オリンパステルモバイオマテリアル株式会社
Priority date: 2013-11-22
Filing date: 2014-09-29
Publication date: 2015-05-28
Also published as: JP2015100473A; JP6296332B2

Abstract

The anchor-fastening tool (1) is provided with: a shaft section (3) having a recessed part for detachably interlocking in the axial direction and engaging in the circumferential direction with the head portion of an anchor (2), which has a screw portion (5) and a head portion provided on the base end of the screw portion (5) and formed in a pillar shape with a non-circular transverse cross-sectional shape, and an abutting part (12), which, when the head portion is interlocked with the recessed part, is disposed at a position that protrudes to the outside of the maximum diameter of the screw portion (5) on the base end side of the tip of the screw portion (5); and a grip section (4) that is connected to the base end of the shaft section (3) and is for supplying torque to rotate the shaft section (3) around the longitudinal axis.

Description

Anchor fastener

The present invention relates to an anchor fastener.

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

Special table 2012-502737 gazette

The suture anchor inserter of Patent Document 1 has a disadvantage that it is difficult to recognize the screwing amount of the anchor attached to the tip of the shaft into the bone. For this reason, it is difficult to adjust the fastening depth appropriately because the anchor is fastened to the bone deeply or the fastening is shallow and the fixation to the bone becomes unstable.

The present invention has been made in view of the above-described circumstances, and an object of the present invention is to provide an anchor fastener capable of appropriately adjusting the fastening depth of an anchor to a fastened object.

One aspect of the present invention is such that the head portion of an anchor having a screw portion and a head portion formed on a base end side of the screw portion and formed in a columnar shape having a non-circular cross section is detachable in an axial direction. A recessed portion that is fitted and circumferentially engaged, and in a state in which the head portion is fitted to the recessed portion, at a position closer to the base end side than the distal end of the screw portion, outside the maximum diameter of the screw portion. An anchor comprising a shaft portion having a projecting portion disposed at a projecting position, and a grip portion connected to a proximal end side of the shaft portion for supplying torque for rotating the shaft portion around a longitudinal axis It is a fastener.

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

When the anchor advances in the depth direction, the abutting portion arranged on the base end side with respect to the tip of the screw portion abuts against the surface of the object to be fastened, and the progression of the shaft portion stops. When the shaft portion continues to rotate with the abutting portion hitting the surface of the object to be fastened, the anchor to which torque is supplied by the fitting of the head and the recess advances in the depth direction of the object to be fastened. Therefore, when the head is extracted from the concave portion in the longitudinal direction and moved relatively by the fitting length, the fitting between the head and the concave portion is released.

Therefore, even if the user continues to rotate the grip portion, no torque is supplied to the head portion, so that further fastening of the anchor is prevented.
That is, it is possible to appropriately adjust the fastening depth of the anchor to the fastening target object by simply setting the position of the abutting portion without the user being aware of the fastening depth during fastening. .

In the above aspect, the anchor includes a flat protrusion extending in the longitudinal direction on the base end side of the head, and the abutting portion is formed in a cylindrical shape surrounding the periphery of the recess, and the abutting portion A slit having a width slightly larger than the thickness of the protrusion may be provided along the longitudinal direction from the tip.

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

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

In the said aspect, the said abutting part may have a shape which protrudes over the perimeter to radial direction outward at the front-end | tip of the said shaft part.
Thereby, the front end surface of the abutting portion can be widened, the surface area of contact with the surface of the object to be fastened can be increased, and the contact pressure applied to the surface of the object to be fastened can be reduced.

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

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

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

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

The effect that the fastening depth to the to-be-fastened object of an anchor can be adjusted appropriately is produced.

1 is an overall view of an anchor fastener according to an embodiment of the present invention. It is a longitudinal cross-sectional view of the A section of FIG. 1 in a state where the anchor is fitted to the anchor fastener of FIG. It is a longitudinal cross-sectional view of the A section of FIG. 1 in the state where the abutting part of the anchor fastener of FIG. 1 is in contact with the bone. FIG. 2 is a longitudinal sectional view of a portion A of FIG. 1 in a state where only the anchor of the anchor fastener of FIG. 1 is progressing in the depth direction of the bone. It is a longitudinal cross-sectional view of the A section of FIG. 1 of the state by which the fitting with the anchor fastener of FIG. 1 and the anchor was cancelled | released. It is the detailed view which looked at the anchor used for the anchor fastener of FIG. 1 from the base end side. It is the detailed view which looked at the anchor used for the anchor fastener of FIG. 1 from the direction substantially orthogonal to a longitudinal axis. FIG. 2 is an overall view showing a state in which a suture is exposed and held on an outer peripheral portion of a shaft portion through a through hole of the anchor fastener of FIG. 1. FIG. 2 is an overall view showing a state in which a suture thread is held through the shaft portion of the anchor fastener of FIG. 1. It is a figure which shows the cross section of the abutting part which has the slit penetrated to the radial direction of the anchor fastener which concerns on the 1st modification of one Embodiment of this invention. It is a figure which shows the cross section of the abutting part which has a slit which does not penetrate to the radial direction of the anchor fastener which concerns on the 1st modification of one Embodiment of this invention. It is a longitudinal cross-sectional view of the A section of FIG. 1 in the state which made the projection part of the anchor fit the slit of the anchor fastener of FIG. 9A. It is a longitudinal cross-sectional view of the A section of FIG. 1 which shows the relationship between the through-hole of the state which made the anchor fit to the anchor fastener which concerns on the 2nd modification of one Embodiment of this invention, and a hole part. It is a longitudinal cross-sectional view of the A section of FIG. 1 of the state which provided the notch in the abutting part of the anchor fastener which concerns on the 3rd modification of one Embodiment of this invention. It is a longitudinal cross-sectional view of the A section of FIG. 1 of the state which provided the cut-out in the abutting part of the anchor fastener which concerns on the 4th modification of one Embodiment of this invention. It is a longitudinal cross-sectional view of the A section of FIG. 1 of the anchor fastener which concerns on the 5th modification of one Embodiment of this invention. It is a longitudinal cross-sectional view of the A section of FIG. 1 of the anchor fastener which concerns on the 6th modification of one Embodiment of this invention. FIG. 16 is a longitudinal sectional view of a portion A in FIG. 1 in a state where the coupling between the anchor fastener and the anchor in FIG. 15 is released (when H <L1). It is a longitudinal cross-sectional view of the A section of FIG. 1 in the state (when H = L1) in which the anchor fastener and the anchor of FIG. 15 are released. FIG. 16 is a longitudinal sectional view of a portion A in FIG. 1 in a state where the coupling between the anchor fastener and the anchor in FIG. 15 is released (in the case of L1 <H <L1 + L2).

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

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

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

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

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

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

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

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

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

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

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

In the above-described embodiment, as shown in FIG. 9A, the abutting portion 12 penetrates in the radial direction along the longitudinal direction from the tip with a width dimension slightly larger than the plate thickness of the projecting portion 7. A slit 14 or a groove-like slit 14 extending in the longitudinal direction may be provided on the outer surface of the projection 7 without penetrating in the radial direction as shown in FIG. 9B.

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

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

A plurality of through holes 15 may be provided, or a single through hole 15 may be provided.
In the above-described embodiment, as illustrated in FIG. 8, the suture 9 is illustrated as being inserted through the inside of the shaft portion 3, but is not limited thereto. For example, as shown in FIG. 7, the shaft portion 3 may include a through hole 15. At this time, as shown in FIG. 7, the suture thread 9 is passed through the hole 8, exposed to the outer peripheral portion of the shaft portion 3, extended to the grip portion 4 side, and held by the stopper portion 19.

In the embodiment described above, the anchor fastener 1 has a shape in which the abutting portion 16 protrudes from the tip of the shaft portion 3 over the entire circumference in the radial direction, as shown in FIGS. 12 and 13. You may have.
Thereby, the front end surface 16a of the abutting portion 16 can be widened, the surface area of contact with the surface of the bone P can be increased, and the contact pressure applied to the surface of the bone P can be reduced.

In the embodiment described above, the abutting

portions

12 and 16 may be made of a transparent resin material.
In this case, as shown in FIGS. 3 to 5 and 11, the abutting

portions

12 and 16 abut against the surface of the bone P and cover the outer periphery of the anchor 2. The state of the anchor 2 and the bone P can be visually recognized through the abutting

portions

12 and 16 to be performed.

In the above-described embodiment, as shown in FIGS. 12 and 13, the abutting portion 16 includes at least a notch 17 and / or a portion that is connected to the proximal end surface of the abutting portion 16 and intersects the distal end surface 16 a. Alternatively, the cutout 18 may be provided.
Thereby, the state of the anchor 2 and the bone P can be visually recognized through the position where the notch 17 and / or the cutout 18 is formed in the abutting portion 16.

In the embodiment described above, the abutting

portions

12 and 16 may be configured such that the front end surfaces 12a and 16a are formed by curved surfaces that are convex in the front end direction, as shown in FIGS. 2 to 5 and 10 to 13. Good.
By doing in this way, the

contact parts

12 and 16 which contact the surface of the bone P can contact the surface of the bone P by the curved surface which does not have an edge, and can reduce a contact pressure.

In the embodiment described above, the head 6 of the anchor 2 made of a hexagonal column is illustrated, but instead of this, it can be removably fitted in the recess 10 of the shaft portion 3 in the axial direction, and the anchor 2 Any columnar structure having a non-circular cross section that can transmit torque with the head 6 fitted may be adopted.

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

In the embodiment described above, the abutting

portions

12 and 16 may be made of a material having both flexibility and biocompatibility such as silicone rubber.
By doing so, as shown in FIG. 3 to FIG. 5 and FIG. 11, when the distal end surface 12a of the abutment portion 12 abuts against the surface of the bone P, the contact pressure is reduced and applied to the bone P. Impact can be mitigated.

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

As shown in FIG. 15, the portion of the screw portion 5 that abuts against the shoulder portion 5a has an outer diameter that is smaller than the maximum diameter of the screw portion 5, and is closer to the proximal end than the distal end surface 12a than the maximum diameter of the screw portion 5. Alternatively, the abutting portion 12 including the step portion 20 having a larger outer diameter may be provided. By doing in this way, when the head 6 and the recessed part 10 of the anchor 2 are fitted, the shoulder part 5a of the screw part 5 and the front end surface 12a of the shaft part 3 are in contact with each other.

When the fastening of the anchor 2 proceeds and the anchor 2 is advanced in the depth direction of the bone P in a state where the head 6 is fitted in the recess 10, as shown in FIGS. 16 to 18, the shaft portion 3. At the position where the distal end portion partially enters the bone P, the stepped portion 20 comes into contact with the surface of the bone P, the advancement of the shaft portion 3 is stopped, and the anchor 2 is fitted to the head portion 6 and the recessed portion 10. It can be inserted into the bone P until it is released.
Here, depending on the relationship between the length L1 of the protrusion 7 in the longitudinal direction of the anchor 2, the length L2 of the head 6, and the length H from the stepped portion 20 to the distal end surface 12a in the longitudinal direction of the shaft 3, The position of the anchor 2 when the fitting between the portion 6 and the recess 10 is released differs in the depth direction.

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

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

DESCRIPTION OF SYMBOLS 1 Anchor fastener 2 Anchor 3 Shaft part 4 Grip part 5 Screw part 6 Head part 7 Projection part 8 Hole part 9 Suture thread (thread member)
DESCRIPTION OF SYMBOLS 10 Recessed part 11

Storage part

12,16 Abutting part 14 Slit 15 Through-hole 17 Notch 18

Claims

The head portion of the anchor having a screw portion and a head portion provided on the proximal end side of the screw portion and formed in a columnar shape having a non-circular cross section is detachably fitted in the axial direction and is circumferentially fitted. An engaging recess, and in a state where the head is fitted in the recess, is disposed at a position protruding outward from the maximum diameter of the screw portion at a position proximal to the distal end of the screw portion. A shaft portion having an abutting portion;
An anchor fastener comprising: a grip portion connected to a proximal end side of the shaft portion for supplying torque for rotating the shaft portion around a longitudinal axis.
The anchor includes a flat protrusion extending in the longitudinal direction on the base end side of the head,
The abutting portion is formed in a cylindrical shape surrounding the periphery of the concave portion, and a slit having a width slightly larger than the thickness of the projecting portion is provided in the abutting portion along the longitudinal direction from the tip thereof. The anchor fastener according to 1.
The protrusion is provided with a hole that penetrates in the thickness direction, and a thread member is attached through the hole, and the head is fitted to the recess on the base end side of the recess. The anchor fastener according to claim 2, wherein a housing portion in which the protruding portion is housed and a through hole that penetrates from the outer surface of the shaft portion to the housing portion are provided.
The anchor fastener according to any one of claims 1 to 3, wherein the abutting portion has a shape protruding from the tip of the shaft portion over the entire circumference in a radially outward direction.
The anchor fastener according to any one of claims 1 to 4, wherein the abutting portion is made of a transparent resin.
5. The anchor fastener according to claim 4, wherein the abutting portion has a cutout and / or a cutout that is at least partially connected to the proximal end surface of the abutting portion and intersects the distal end surface.
The anchor fitting according to any one of claims 1 to 6, wherein the abutting portion is formed of silicone rubber.
The anchor fastener according to any one of claims 1 to 7, wherein a distal end surface of the abutting portion is configured by a curved surface convex in the distal end direction.