US20010004694A1 - Apparatus for rigidly fixing craniomaxillofacial tissue grafts and bone plates - Google Patents

Apparatus for rigidly fixing craniomaxillofacial tissue grafts and bone plates Download PDF

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Publication number
US20010004694A1
US20010004694A1 US09/290,433 US29043399A US2001004694A1 US 20010004694 A1 US20010004694 A1 US 20010004694A1 US 29043399 A US29043399 A US 29043399A US 2001004694 A1 US2001004694 A1 US 2001004694A1
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United States
Prior art keywords
shaft
self
longitudinal axis
spline
central recess
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Granted
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US09/290,433
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US6398785B2 (en
Inventor
Joseph Edward Carchidi
Alan R. Balfour
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ACE Surgical Supply Co Inc
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Joseph Edward Carchidi
Alan R. Balfour
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Priority to US09/290,433 priority Critical patent/US6398785B2/en
Publication of US20010004694A1 publication Critical patent/US20010004694A1/en
Assigned to ACE SURGICAL SUPPLY COMPANY, INC. reassignment ACE SURGICAL SUPPLY COMPANY, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: BALFOUR, ALAN R., CARCHIDI, JOSEPH EDWARD
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8605—Heads, i.e. proximal ends projecting from bone
    • A61B17/861—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver
    • A61B17/8615—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver at the central region of the screw head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue
    • A61B17/8635—Tips of screws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8875—Screwdrivers, spanners or wrenches
    • A61B17/8877—Screwdrivers, spanners or wrenches characterised by the cross-section of the driver bit
    • A61B17/888—Screwdrivers, spanners or wrenches characterised by the cross-section of the driver bit the driver bit acting on the central region of the screw head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/28—Bones
    • A61F2/2846—Support means for bone substitute or for bone graft implants, e.g. membranes or plates for covering bone defects

Definitions

  • This invention relates generally to surgical apparatus and more particularly to bone screws for the retention of tissue grafts and bone plates.
  • the physician must perform multiple operations which involves first locating and drilling a pre-sized hole. Once the pilot hole is prepared, the physician must relocate the hole to insert the self-threading bone screw. Since most of the craniomaxillofacial procedures require small diameter bone screws, relocating the pilot hole prior to insertion of the bone screw can be difficult. However, the advantage to this procedure, if performed correctly, is that the pre-drilled pilot hole will act as a guide to insert the self-threading bone screw and minimize the risk of screw and/or bone fractures due to excessive applied seating torque.
  • An object of the present invention is the provision of apparatus to overcome the above noted prior art limitations. Another object is the provision of apparatus for rigidly fixing craniomaxillofacial tissue grafts and bone plates in a single surgical procedure.
  • a bone screw made in accordance with the present invention incorporates a sharp piercing twist drill point tip in series with a self-tapping threaded body.
  • a cylindrical dome shaped head is formed distal to the tip and body of the bone screw that drives the screw in or out of the surgical site using a unique spline driver tool.
  • the invention solves the problems of locating and self-starting a self-tapping bone screw into place while minimizing the surgical steps and maximizing the fixation.
  • This invention allows the physician to take advantage of a pre-drilled hole without compromising the surgical results common to the standard multiple step procedure.
  • the component provides the physician with a cost effective, easy to use, functional equivalent to rigidly fix craniomazillofacial tissue grafts and bone plates in a desired surgical site.
  • FIG. 1 is a front elevational view, partly in cross section, of a self-drilling and self-tapping bone screw made in accordance with the invention
  • FIG. 2 is left side elevational view of the FIG. 1 screw
  • FIG. 3 is a right side elevational view of the FIG. 1 screw
  • FIG. 4 is a front elevational view of a delivery and drive tool for use with the FIG. 1 screw
  • FIG. 5 is a view, similar to FIG. 4 but exploded to show the separate components of the tool
  • FIG. 6 is an enlarged view of an end portion of the FIGS. 4 and 5 tool.
  • FIG. 7 is a left side elevational view of FIG. 6.
  • self-drilling and self-tapping bone screw 10 comprises a self-drilling and self-tapping bone screw cylindrical body 12 and cylindrical dome shaped driving head 14 .
  • the self-drilling and self-tapping bone screw cylindrical body 12 locates, drills and threads the screw body into the graft site with minimal effort while achieving maximum fixation.
  • the self-drilling and self-tapping bone screw cylindrical body 12 incorporates a sharp twist drill point tip 12 a with a highly effective piercing and cutting tip 12 b at one end of a longitudinal axis 12 f to easily pierce and drill a pilot hole in preparation for the self-tapping thread 12 c.
  • the twist drill point tip 12 a is selected to exactly match the diameter size of the shaft having the self-tapping thread 12 c to further assist in the bone screw's insertion.
  • the helical flutes 20 of the twist drill point tip 12 a are extended along the drill shaft and into the first couple of threads of the larger diameter self-tapping screw threads 12 c forming radially projecting flat surfaces to provide cutting flutes 12 d for the bone screw's thread. These cutting flutes 12 d aid in driving the self-tapping screw thread 12 c down until the beveled seating neck 14 a , to be discussed below, is completely seated.
  • the coronal end of the self-drilling and self-tapping bone screw 10 incorporates a cylindrical dome shaped head 14 for retention of the craniomaxillofacial tissue grafts and bone plates to the surgical site.
  • a bevelled, or frusto-conical seating neck 14 a that matches the standard mating bevel angle on bone screw plates (not shown).
  • a smooth cylindrical dome shaped driving head 14 b having an outer periphery which extends radially outwardly of the shaft portion of body 12 .
  • a square recess 14 c and a cross-slot recess 14 d that, when combined, forms a unique female spline 14 e along with a circular bore 14 f formed inwardly of the square recess.
  • FIGS. 4 - 7 depict a press-fit, pick up and delivery spline driver tool 20 .
  • the body of the press-fit, pick-up and delivery spline driver tool 20 is made up of a detachable insert driver 24 and an oversized handle 22 .
  • the detachable insert driver 24 is connected and driven by the oversized handle 22 utilizing a coronal insert annular groove 24 a and central milled polygonal feature 24 b , such as hexagonal, at one end.
  • Bone screw spline driver head 24 c is formed at the opposite end from the connecting and driving features 24 a and 24 b of detachable insert driver 24 .
  • This male spline driver head is made up of a combined cylindrical shaft tip 24 f having a frictional locking taper that frictionally locks into bore 14 c having an appropriately sized diamter in bone screw 10 .
  • the friction lock allows bone screw 10 to be easily picked up and delivered by the physician to the surgical site to prevent any risk of contamination.

Abstract

A self-drilling and tapping multi-drive bone screw (10) for rigid fixation of craniomaxillofacial tissue grafts and bone plates has a tip (12a) which incorporates a defined twist drill shaft with a sharp cutting point tip (12b) to easily pierce and drill a pilot hole and prepare for the insertion of self-tapping screw threads (12c). A cylindrical dome shaped head (14) for rigid fixation of craniomaxillofacial tissue grafts and geometrically sized bone plates is formed on the screw distal to the drilling and tapping features. A spline feature (14e) is incorporated into the cylindrically dome shaped head for easy pickup, assembly and insertion of the bone screw with a corresponding spline driver tool (20). The spline driver feature also allows the bone screw (10) to be driven with either a standard square or cross blade driver tool.

Description

    FIELD OF THE INVENTION
  • This invention relates generally to surgical apparatus and more particularly to bone screws for the retention of tissue grafts and bone plates. [0001]
    • BACKGROUND OF THE INVENTION
  • Presently, a variety of bone screws and surgical procedures are used for the retention of craniomaxillofacial tissue grafts and bone plates with a primary objective being to minimize the surgical steps and to maximize fixation. These procedures generally fall into one of two categories: a self-threading screw that incorporates a self-cutting flute to minimize the need to surgically prepare a pilot hole or a self-threading screw without a self-starting cutting flute which always requires a surgically prepared pilot hole. [0002]
  • For the latter type, the physician must perform multiple operations which involves first locating and drilling a pre-sized hole. Once the pilot hole is prepared, the physician must relocate the hole to insert the self-threading bone screw. Since most of the craniomaxillofacial procedures require small diameter bone screws, relocating the pilot hole prior to insertion of the bone screw can be difficult. However, the advantage to this procedure, if performed correctly, is that the pre-drilled pilot hole will act as a guide to insert the self-threading bone screw and minimize the risk of screw and/or bone fractures due to excessive applied seating torque. [0003]
  • To overcome the surgical requirements of drilling a pilot hole into a surgical site prior to inserting a bone screw, a variety of bone screw systems have incorporated a self-starting cutting flute into the apex of the screw. This self-starting cutting flute is designed to initially penetrate and cut into the bone site and then to lead the self-threading features of the screw into place. Although, conceptually, these screws eliminate the pitfalls of a pre-drilled hole and maximize the bone screw fixation, locating and inserting these screws become difficult. Since a pilot hole is not drilled, these screws are difficult to locate and start in the denser cortical bone and effectively become challenging to insert. In addition, these screws require substantially higher seating torque which lead to greater risk of screw or bone fracturing during insertion. [0004]
    • SUMMARY OF THE INVENTION
  • An object of the present invention is the provision of apparatus to overcome the above noted prior art limitations. Another object is the provision of apparatus for rigidly fixing craniomaxillofacial tissue grafts and bone plates in a single surgical procedure. These and other objects and features of the invention will be apparent from the following description taken with reference to the accompanying drawings. [0005]
  • Briefly stated, a bone screw made in accordance with the present invention incorporates a sharp piercing twist drill point tip in series with a self-tapping threaded body. A cylindrical dome shaped head is formed distal to the tip and body of the bone screw that drives the screw in or out of the surgical site using a unique spline driver tool. The invention solves the problems of locating and self-starting a self-tapping bone screw into place while minimizing the surgical steps and maximizing the fixation. This invention allows the physician to take advantage of a pre-drilled hole without compromising the surgical results common to the standard multiple step procedure. Finally, the component provides the physician with a cost effective, easy to use, functional equivalent to rigidly fix craniomazillofacial tissue grafts and bone plates in a desired surgical site. [0006]
    • BRIEF DESCRIPTION OF THE DRAWINGS
  • FIG. 1 is a front elevational view, partly in cross section, of a self-drilling and self-tapping bone screw made in accordance with the invention, [0007]
  • FIG. 2 is left side elevational view of the FIG. 1 screw, [0008]
  • FIG. 3 is a right side elevational view of the FIG. 1 screw, [0009]
  • FIG. 4 is a front elevational view of a delivery and drive tool for use with the FIG. 1 screw, [0010]
  • FIG. 5 is a view, similar to FIG. 4 but exploded to show the separate components of the tool, [0011]
  • FIG. 6 is an enlarged view of an end portion of the FIGS. 4 and 5 tool, and [0012]
  • FIG. 7 is a left side elevational view of FIG. 6. [0013]
    • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
  • With reference to FIGS. [0014] 1-3, self-drilling and self-tapping bone screw 10 comprises a self-drilling and self-tapping bone screw cylindrical body 12 and cylindrical dome shaped driving head 14. The self-drilling and self-tapping bone screw cylindrical body 12 locates, drills and threads the screw body into the graft site with minimal effort while achieving maximum fixation. To achieve this, the self-drilling and self-tapping bone screw cylindrical body 12 incorporates a sharp twist drill point tip 12 a with a highly effective piercing and cutting tip 12 b at one end of a longitudinal axis 12 f to easily pierce and drill a pilot hole in preparation for the self-tapping thread 12 c. The twist drill point tip 12 a is selected to exactly match the diameter size of the shaft having the self-tapping thread 12 c to further assist in the bone screw's insertion. The helical flutes 20 of the twist drill point tip 12 a are extended along the drill shaft and into the first couple of threads of the larger diameter self-tapping screw threads 12 c forming radially projecting flat surfaces to provide cutting flutes 12 d for the bone screw's thread. These cutting flutes 12 d aid in driving the self-tapping screw thread 12 c down until the beveled seating neck 14 a, to be discussed below, is completely seated.
  • The coronal end of the self-drilling and self-tapping bone screw [0015] 10 incorporates a cylindrical dome shaped head 14 for retention of the craniomaxillofacial tissue grafts and bone plates to the surgical site. On the inner side of the bone screw head 14 is a bevelled, or frusto-conical seating neck 14 a that matches the standard mating bevel angle on bone screw plates (not shown). Opposite the beveled seating neck 14 a is a smooth cylindrical dome shaped driving head 14 b having an outer periphery which extends radially outwardly of the shaft portion of body 12. In the center of the driving head is a square recess 14 c and a cross-slot recess 14 d that, when combined, forms a unique female spline 14 e along with a circular bore 14 f formed inwardly of the square recess.
  • To deliver self-drilling and self-tapping screw [0016] 10 to the graft site, FIGS. 4-7 depict a press-fit, pick up and delivery spline driver tool 20. The body of the press-fit, pick-up and delivery spline driver tool 20 is made up of a detachable insert driver 24 and an oversized handle 22. The detachable insert driver 24 is connected and driven by the oversized handle 22 utilizing a coronal insert annular groove 24 a and central milled polygonal feature 24 b, such as hexagonal, at one end. Bone screw spline driver head 24 c is formed at the opposite end from the connecting and driving features 24 a and 24 b of detachable insert driver 24. This male spline driver head is made up of a combined cylindrical shaft tip 24 f having a frictional locking taper that frictionally locks into bore 14 c having an appropriately sized diamter in bone screw 10. The friction lock allows bone screw 10 to be easily picked up and delivered by the physician to the surgical site to prevent any risk of contamination.
  • Placing the twist drill tip in series with the self-tapping threads allows the physician to insert the bone screw in a single surgical procedure. As the bone screw is driven into the surgical site, bone chips will fill the space left by the helical cutting flutes that extend along the drill shaft and into the first couple of threads of the self-tapping screw. Once inserted in the bore formed by the drill shaft body, the self-tapping threads of the bone screw are engaged to rigidly fix and drive the screw into place. [0017]
  • It should be understood that this invention includes all modifications and equivalents of the described embodiment falling within the scope of the appended claims. [0018]

Claims (7)

What is claimed:
1. Apparatus for retention of tissue grafts and bone plates to a bone site comprising an elongated body member having a generally cylindrical shaft having a longitudinal axis and a selected diameter and first and second opposite end portions, a relatively sharp point formed at the first end portion aligned with the longitudinal axis, helical drill flutes formed on the shaft along a first axial length of the shaft having an outer diameter generally equal to the selected diameter, self-tapping screw threads formed on the shaft along a second axial length of the shaft, the self-tapping screw threads having a second outer diameter greater than the selected diameter, the helical drill flutes aligned with and forming a continuation of the self-tapping threads along a first portion of the second axial length forming cutting flutes and a driving head formed at the second end of the shaft, the driving head extending radially outwardly beyond the shaft forming an outer periphery and being formed with a frusto-conical surface extending from the outer periphery to the shaft and a female driving spline formed at the second end of the member aligned with the longitudinal axis of the body member.
2. Apparatus according to
claim 1
 in which the female driving spline comprises a polygonal central recess and a radially extending slot communicating with the central recess.
3. Apparatus according to
claim 2
 further comprising a circular bore extending along the longitudinal axis in communication with the central recess.
4. A driving tool for use with a threaded member having a female driving spline formed at an end thereof having a central recess having polygonal sides of a selected number and a radially extending slot communicating with the central recess and intersecting at least one of the sides comprising a polygonal shaped portion having the selected number of sides and having a size chosen to closely fit within the polygonal recess of the central recess and a blade portion extending from the polygonal shaped portion having a configuration chosen to be closely received in the at least one radially extending slot.
5. A driving tool according to
claim 4
 in which the female spline has a cylindrical bore extending along the longitudinal axis in communication with the central recess and further comprising a generally cylindrical male holding portion extending along the longitudinal axis beyond the polygonal shaped portion, the generally cylindrical male holding portion formed with a friction holding taper configured to closely fit within the cylindrical bore of the spline.
6. Apparatus for retention of tissue grafts and bone plates to a bone site comprising an elongated body member having a generally cylindrical shaft having a longitudinal axis and a selected diameter and first and second opposite end portions, a relatively sharp point formed at the first end portion aligned with the longitudinal axis, helical drill flutes formed on the shaft along a first axial length of the shaft having an outer diameter generally equal to the selected diameter, self-tapping screw threads formed on the shaft along a second axial length of the shaft, the self-tapping screw threads having a second outer diameter greater than the selected diameter, the helical drill flutes aligned with and forming a continuation of the self-tapping threads along a first portion of the second axial length forming cutting flutes and a driving head formed at the second end of the shaft, the driving head extending radially outwardly beyond the shaft forming an outer periphery and being formed with a frusto-conical surface extending from the outer periphery to the shaft and a female driving spline formed at the second end of the member aligned with the longitudinal axis of the body member, the female driving spline having side surfaces forming a polygonally shaped recess, at least one radially extending blade shaped slot communicating with the recess, an elongated tool member having a polygonal shaped portion having the selected number of sides and having a size chosen to closely fit within the polygonal recess of the central recess and a blade portion extending from the polygonal shaped portion having a configuration chosen to be closely received in the at least one radially extending slot.
7. Apparatus according to
claim 6
 in which the female spline has a cylindrical bore extending along the longitudinal axis in communication with the central recess and the elongated tool member has a generally cylindrical male holding portion extending along the longitudinal axis beyond the polygonal shaped portion, the generally cylindrical male holding portion formed with a friction holding taper configured to closely fit within the cylindrical bore of the spline.
US09/290,433 1998-04-14 1999-04-13 Apparatus for rigidly fixing craniomaxillofacial tissue grafts and bone plates Expired - Fee Related US6398785B2 (en)

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