Abstract:
In order to provide the surgeon with means which allow the surgeon to use screws in a gentle and time-efficient manner, particularly in the setting of craniotomy, a surgical screw magazine is proposed comprising a holding device and a plurality of surgical screws, the holding device of said surgical screw magazine comprising a screw-receiving body which comprises for each of the screws a receiving opening in which the screws are at least substantially received, wherein the receiving openings are formed in the screw-receiving body spaced apart a predetermined distance from one another.

Description:
[0001]    This application claims the benefit of German application number 10 2013 103 780.1 filed on Apr. 15, 2013 and German application number 10 2014 102 907.0 filed on Mar. 5, 2014, which are incorporated herein by reference in their entirety and for all purposes. 
       BACKGROUND OF THE INVENTION 
       [0002]    The invention relates to a novel surgical screw magazine comprising a holding device and a plurality of surgical screws. 
         [0003]    Screw magazines comprising a holding device and a plurality of screws arranged thereon are known per se in the general art of fastening and are disclosed for example in DE 101 62 635 A1. 
         [0004]    However, these screw magazines are not suited for use in the field of surgery because of the risk of injury to bones and tissue in the vicinity of the site of application, making their use in the field of surgery prohibitive. 
         [0005]    It is an object of the present invention to provide a means which allows the surgeon to use screws in a gentle and time-efficient manner, particularly in the setting of craniotomy. 
       SUMMARY OF THE INVENTION 
       [0006]    This object is achieved by the novel surgical screw magazine having the features of claim  1 . 
         [0007]    The surgical screw magazines constructed in accordance with the invention are particularly suited for craniotomy procedures in which a patient&#39;s skull cap is to be re-closed using a previously prepared skull fragment. In this regard, frequently used systems are those comprising what are known as bone plates, made of metal or plastics materials, as are described for example in DE 299 13 390 U1. 
         [0008]    The bone plates establish a connection between two bone parts, wherein the bone plates are joined to the bone parts of the skull cap by surgical screws. The screwing-in of these surgical bone screws very often places high manual demands on the surgeon. He or she must not only fixate the plates against slipping out of place but must also at the same time take a screw from a magazine, start it securely and, frequently by exertion of quite an amount of force, drive it into the bone part without angular misalignment. During an operation the patient&#39;s skull is rigidly fixated, and in many cases this makes the process of driving the screws even more difficult because the surgeon must for example screw sideways at an ergonomically awkward angle. 
         [0009]    The screw magazine constructed in accordance with the invention now provides a plurality of surgical screws, particularly for use as bone screws in craniotomy, said screws being both easy and safe to handle so that there is no danger to the tissue and bones in the immediate vicinity of the site of application. Moreover, the receiving openings for the screws can at the same time form a guide for the screws so that angular misalignment of the screws during the application thereof is prevented. 
         [0010]    Furthermore, the surgical screw magazine constructed in accordance with the invention prevents the screws from being lost, as the screws are substantially fully received by the screw-receiving body and the receiving openings thereof. The surgeon&#39;s task is thereby considerably simplified because the need for separating and picking up the screws with the screwdriver is obviated. 
         [0011]    Optionally, the surgical screw magazine constructed in accordance with the invention can be adapted for feed with a corresponding screwing machine which automatically positions the screws stored in a screw-receiving body. 
         [0012]    Preferably, in the surgical screw magazine constructed in accordance with the invention, the screw-receiving body is fabricated from an elastic material, for example a silicone material, which when the screw is being screwed in can yield and can recede in a radial direction of the screw and therefore does not hinder the screw-driving process. Nonetheless, the screws can still be guided by way of the receiving opening during the screwing-in process. 
         [0013]    The screw-receiving body can be pulled off the screw after same is fully driven in, typically with its screw head countersunk, unless such separation occurs substantially automatically. 
         [0014]    Finally, it is also conceivable for the receiving openings each to comprise a point of weakness by which the screw can be separated from the surrounding screw-receiving body at a point in time at which the screw is already held securely in the bone material and the screwing-in process may be completed separately from the screw-receiving body. 
         [0015]    The previously mentioned elastic materials are preferably light-transmissive, i.e., transparent or at least translucent, so that the screw-receiving body can be seen through to view at least the contours of the application site and optionally the body of the bone plate that is to be fastened by the screws. 
         [0016]    Preferably, the receiving openings of the screw-receiving bodies of the surgical screw magazines constructed in accordance with the invention are configured as through-openings. Alternatively, the receiving openings can also be configured as blind holes, with the tip of the respective screw being arranged at the closed end of the receiving opening, thereby ensuring that the tip of the screw cannot come into contact with the surrounding tissue or the bone before the surgeon intentionally starts the screwing process. 
         [0017]    As mentioned previously, the receiving openings are preferably configured as guides for the screws, i.e., in addition to holding the screws in a predetermined position while in the rest position, the mechanical properties of the screw-receiving body are selected such that, in spite of the elasticity of the screw-receiving body, unintentional angular misalignment of the screws during the application thereof is prevented. 
         [0018]    It is preferred for the screws to be held in the receiving openings of the screw-receiving body by way of a form-locking engagement and/or a force-locking engagement. 
         [0019]    In accordance with another alternative embodiment of the surgical screw magazines constructed in accordance with the invention, provision may be made for the screws to be arranged in the screw-receiving body such that the screws are held in the receiving openings with their tips projecting slightly from the screw-receiving body. This facilitates alignment of the surgical screw magazine with bone plates that are to be placed on and attached to the bone material and with the through-openings thereof. 
         [0020]    In accordance with a further variant, provision may be made for the screws to be arranged in the receiving openings with their screw head protruding at least partially from the screw-receiving body. This facilitates engagement of the screw driver with the screw, in particular where the screws are small. 
         [0021]    Typically, the screws are arranged in the screw-receiving body in substantially parallel alignment with one another and can thus be applied one by one without interfering with one another. 
         [0022]    One form of the surgical screw magazines includes configuring the screw-receiving body as a screw belt in which the receiving openings for the screws are formed in the screw belt in successive relation to one another in a single row or in a plurality of parallel rows. 
         [0023]    In accordance with an alternative scheme of the screw magazine constructed in accordance with the invention, the screw-receiving body is configured as a volumetric body having three major directions of extension. 
         [0024]    The outer contour of the volumetric body, when viewed in plan view of the receiving openings of the screw-receiving body, may be configured in a rectangular shape, a polygonal shape, a round shape or also in an oval shape. 
         [0025]    It is preferred for the screw receiving-body to be configured in the shape of a block, for example in the shape of a cuboid or polygon, the receiving openings for the screws being configured in the screw-receiving body in a predetermined application pattern. Said application pattern may for example correspond to the through-opening pattern of a bone plate for which the screws are held ready in the screw magazine. 
         [0026]    In accordance with a further variant of the surgical screw magazines, provision may be made for the screw magazine to comprise one or more bone plates arranged on the side of the screw-receiving body towards which the tips of the screws face. 
         [0027]    Thus, for example, a screw magazine of the present invention that is configured in a screw belt-like manner may have a plurality of bone plates of substantially linear configuration arranged thereon one behind the other. 
         [0028]    If the bone plates to be applied have a geometry that is more complex than the linear geometry, the screw-receiving body is preferably configured conforming to the geometry of the bone plate. 
         [0029]    More preferably, in such a case the bone plate is releasably connected to the holding device of the screw magazine, in particular to the screw-receiving body, so that the alignment of the screws with a given screw application pattern (for example the through-openings) of the bone plate is predetermined from the outset, i.e., before the surgeon starts applying the bone plate. This manner of applying the bone plate brings still further simplification to the surgeon and thus also makes using the bone plate safer for the patient. 
         [0030]    The releasable connection of the holding device, or screw-receiving body, to the bone plate may be a substance-to-substance bond, a form-locking engagement and/or a force-locking engagement, for example by way of a releasable adhesive bond or by snapping together the bone plate and the elastically yielding material of the screw-receiving body. 
         [0031]    These and further advantages of the invention are described in more detail below with reference to the drawings. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0032]      FIG. 1  is a first embodiment of a surgical screw magazine constructed in accordance with the invention; 
           [0033]      FIG. 2  is a second embodiment of a surgical screw magazine constructed in accordance with the invention, shown as having a bone plate held thereon; 
           [0034]      FIGS. 3 to 5  illustrate further variants of the second embodiment of the surgical screw magazine constructed in accordance with the invention. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0035]    Shown in  FIG. 1  is a surgical screw magazine  10  constructed in accordance with the invention, comprising a holding device which is configured as a screw belt  12  and in the present case is to be equated with the screw-receiving body of the surgical screw magazine  10 . 
         [0036]    Held in the screw belt  12 , in receiving openings  15  thereof, are a multiplicity of screws  14  arranged in linear relationship one behind the other in a single row. 
         [0037]    In the present exemplary embodiment, the receiving openings  15  are configured as through-openings which extend from the upper side  16  of the screw belt  12  to the underside  18  thereof. 
         [0038]    In the surgical screw magazine  10  constructed in accordance with the invention, the thickness of the holding device, or screw-receiving body  12 , and hence the distance between the upper side  16  and the underside  18  is selected such that the screws  14  are essentially fully received in the receiving openings  15 , with only the screw head  14   a  of the screws  14  projecting slightly from the surface  16  of the screw belt  12 . 
         [0039]    In particular, with this embodiment of the surgical screw magazine  10 , the arrangement of the screws  14  in the receiving openings  15  is selected such that the tips of the screws  14  do not protrude beyond the underside  18  of the screw belt  12 . Optionally, the receiving openings  15  may be configured as a blind hole, with the tips of the screws  14  then being placed at the closed end of the receiving openings  15 . 
         [0040]    This precludes injury to bones or tissue of a patient being treated in handling the screw magazine constructed in accordance with the invention. 
         [0041]    The material used to form the screw belt  12  is preferably a transparent or at least translucent silicone material so that the surgeon is able to view during the process of applying the screws  14  whether the particular screw  14  to be applied is properly located over the bone plate that is to be fixated and over the screw position thereof, which may for example be a through-opening provided therefor. 
         [0042]    The receiving openings  15  can receive the screws  14  in a close fit relationship therewith, thereby affording guidance to the screws  14  as these are screwed into place. In particular, this is possible without the need for further measures because the elastic silicone material of the screw belt  12  can yield laterally to the screws  14  as they are screwed into place and thus creates room for the passage of the screw heads  14   a . Owing to the elasticity of the silicone material, once the screw  14  is fully screwed into place, the screw belt can be separated from that fully applied screw with little physical effort and without fragments of the screw belt being torn off. The separation between the screw  14  and the screw belt  12  can be facilitated further by the receiving opening having its end adjacent the underside  18  slightly enlarged. 
         [0043]      FIG. 2  illustrates another embodiment of a surgical screw magazine  20  constructed in accordance with the invention, comprising a holding device  22  having a cuboid-shaped basic structure. 
         [0044]    The holding device  22 , which again is to be equated with the screw-receiving body, has arranged therein four receiving openings  23  which receive screws  24  in an arrangement corresponding to the arrangement of through-openings  32  in a bone plate  30 . 
         [0045]    Typically, the screw heads  24   a  of the screws  24  protrude slightly beyond the upper side  26  of the screw-receiving body  22 . 
         [0046]    The bone plate  30  is arranged at the underside  28  of the screw-receiving body  22  and is fixed to said underside  28  for example by a releasable adhesive bond. 
         [0047]    Alternatively, provision may be made for the holding device  22  to hold the bone plate  30  in a releasable form-locking and/or force-locking engagement in the predetermined position thereof in which the through-openings  32  of the bone plate  30  are aligned with the receiving openings  23  in the screw-receiving body  22 . 
         [0048]    Since the bone plate  30  is held beneath the screw-receiving body and surrounds the tips of the screws  24  with the through-openings  32  thereof, with this embodiment the screws  24  may be arranged in the screw-receiving body  22  such that the tips of the screws  24  protrude slightly beyond the underside  28  of the screw-receiving body  22 . 
         [0049]      FIG. 3  shows another embodiment of a surgical screw magazine  40  constructed in accordance with the invention, likewise comprising a cuboid-shaped basic body of a screw-receiving body  42  which in the present case serves as a holding device of the surgical screw magazine  40 . 
         [0050]    Arranged within the screw-receiving body  42  are receiving openings  43  which receive six screws  44  in an arrangement that corresponds to the geometry of a bone plate  50 . 
         [0051]    The screw heads  44   a  of the screws  44  protrude slightly from the upper side  46  of the screw-receiving body  42 , while the tips of the screws  44  project only slightly from the underside  48  of the screw-receiving body  42 . 
         [0052]    Again, the underside  48  of the screw-receiving body  42  has the above-mentioned bone plate  50  with its screw through-openings  52  arranged such that the latter are in alignment with the receiving openings  43  for the screws  44 . 
         [0053]    Again, the bone plate  50  and the screw-receiving body  42  may be releasably connected to each other, such as by an adhesive bond or a force-locking and/or form-locking engagement. 
         [0054]    A further alternative embodiment of a surgical screw magazine  60  is depicted in  FIG. 4 , in which a screw-receiving body  62  comprises receiving openings  63  for screws  64  which are arranged in the screw-receiving body  62  in an arrangement corresponding to the arrangement of through-openings  72  of a bone plate  70 . Again, the bone plate  70  is releasably held at the underside  68  of the screw-receiving body  62 . 
         [0055]      FIG. 5  shows a further embodiment of a surgical screw magazine  80  in which receiving openings  83  for receiving four screws  84  are formed in the screw-receiving body  82 , said receiving openings  83  being arranged in linear relationship one behind the other in a row and spaced apart at different distances from one another. 
         [0056]    Again, a bone plate  90  comprising through-openings  92  is releasably attached to the underside  88  of the screw-receiving body  82  such that the through-openings  92  are arranged in aligned relationship with the receiving openings  83  for the screws  84 . 
         [0057]    In the previously discussed embodiments of the surgical screw magazine of  FIGS. 2 to 5 , the screw-receiving bodies are shown to be cuboid-shaped. It is understood, however, that the screw-receiving bodies may have geometries different from that and may in particular have a geometry that is adapted to the geometry of the bone plate held on the screw-receiving body. 
         [0058]    Moreover, it is within the scope of the present invention for a single screw-receiving body to have a plurality of bone plates arranged at the underside thereof and, therefore, for a screw-receiving body to comprise receiving openings for screws that are associated with a plurality of bone plates. 
         [0059]    This arrangement may for example also be implemented in the screw belt of  FIG. 1 , for example in the context of using bone plates as are used for example for application in the exemplary embodiment of  FIG. 5 . The receiving openings in the screw belt are then no longer arranged one behind the other in a single row and spaced apart at equal distances as shown in  FIG. 1  but spaced apart at varying distances as correspond for example to the distances of the through-openings  92  in the bone plate  90 . 
         [0060]    Moreover, it is of course also conceivable for a screw belt to comprise a plurality of parallel rows of screw-receiving openings so that bone plates as are used for example in  FIGS. 2 to 4  can be releasably fixed one behind the other to the underside of the screw belt. 
         [0061]    With each of the embodiments as discussed previously, the invention significantly facilitates the surgeon&#39;s task in applying the screws, since these are securely received and positioned in the screw-receiving body for their use. At the same time, the screws can be given guidance and orientation by way of the receiving openings, wherein the use of the elastic, transparent material additionally greatly facilitates for the surgeon application of the screws at the predetermined site. 
         [0062]    The surgeon not only has the advantage of being able to handle the better graspable screw magazine in lieu of the individual bone screws, some of which are very small, but also, as shown in the example of  FIGS. 2 to 5 , has presented to him or her the bone plates in correct orientation with respect to the screws so that the surgeon can focus his or her entire attention on correctly aligning the bone plate on the patient.