Bone screw

Abstract

A bone screw comprising a shaft having a first set of leading threads and a second set of trailing threads spaced apart from the first set of threads by an unthreaded central portion. The second set of threads are carried externally on a sleeve having a smooth inner cylindrical surface such that the sleeve is slidable about the unthreaded shaft portion. A raised lip is provided about the trailing end of the shaft to retain the sleeve on the shaft. The first and second set of screw threads are like-handed, but preferably of different pitch, with the pitch of the first set of screw threads exceeding that of the second set of screw threads to effectively hold portions of a fractured bone in compressive engagement. Provision of the second set of threads on a slidable sleeve enables the main shaft to slide through the sleeve and back out of the bone, when absorption occurs such as when the invention is used to repair a femoral neck fracture. The ability of the main shaft to back out in a direction opposite the femoral head is an advantage because if the second set of threads were fixed on the main shaft, the bone screw would tend to penetrate the femoral head and enter the joint capsule when absorption occurs, which would cause interference of the joint articulation and pain to the patient.

I claim: 
     
       1. A bone screw for connecting portions of bone across a fracture therebetween, comprising: (a) a shaft comprising a leading end portion including a first set of uniformly pitched screw threads and an elongated, smooth unthreaded portion including a central portion and a trailing end portion;   (b) a sleeve member having a smooth inner cylindrical surface surrounding the elongated unthreaded portion and being freely slidable thereabout.Iadd., the bone screw not having any resilient means between the sleeve member and the unthreaded portion.Iaddend., the sleeve member including a second set of uniformly pitched screw threads thereon, the sleeve member adapted to be positioned substantially about the trailing end portion spaced apart from the first set of threads by the central portion;   (c) a retaining means to prevent the sleeve member from sliding off the shaft; and   (d) a driving means on the trailing end portion to accommodate a tool for driving the screw.   
     
     
       2. The bone screw of claim 1 wherein the first and second sets of screw threads are like-handed but of different pitch. 
     
     
       3. The bone screw of claim 2 wherein the pitch of said first set of screw threads is greater than that of the second set of screw threads. 
     
     
       4. The bone screw of claim 1 wherein the retaining means includes a protruding lip about the trailing end of the shaft. 
     
     
       5. The bone screw of claim 1 wherein the shaft has a cannulation throughout its axial length. 
     
     
       6. The bone screw of claim 1 wherein the driving means includes a slot in the trailing end of the shaft for accepting a tool. 
     
     
       7. The bone screw of claim 6 wherein the driving means further includes a slot in the sleeve member. .Iadd.8. A bone screw for connecting portions of bone across a fracture therebetween, comprising: (a) a shaft comprising a leading end portion including a first set of uniformly pitched screw threads and an elongated, smooth unthreaded portion including a central portion and a trailing end portion;   (b) a sleeve member having a smooth inner cylindrical surface surrounding the elongated unthreaded portion and being freely slidable thereabout, the sleeve member including a second set of uniformly pitched screw threads thereon, the sleeve member adapted to be positioned substantially about the trailing end portion spaced apart from the first set of threads by the central portion;   (c) a retaining means to prevent the sleeve member from sliding off the shaft; and   (d) a driving means on the trailing end portion to accommodate a tool for driving the screw, and wherein the driving means includes a slot in the trailing end of the shaft for accepting a tool, and .Iaddend..[.The bone screw of claim 6.]. wherein the sleeve member includes a leading edge and a trailing edge and wherein the driving means further includes a slot in the sleeve member on both the leading and trailing edges and wherein the threads on the sleeve member are adapted to cut in both the forward and reverse directions, enabling the sleeve member to be assembled onto the   
     
     
        shaft with either end being the leading or trailing end. 9. The bone screw of claim 1 wherein the outside diameter of the second set of threads is 
     
     
        greater than the outside diameter of the first set of threads. 10. The bone screw of claim 1 wherein the inner cylindrical surface of the sleeve member has a uniform diameter throughout providing an uninterrupted surface to directly slide against the smooth unthreaded portion of the 
     
     
        shaft. .Iadd.11.  A bone screw for connecting portions of bone across a fracture therebetween, comprising: (a) a shaft comprising a leading end portion including a first set of threads and an elongated unthreaded portion extending therefrom;   (b) a sleeve member having an inner surface surrounding the elongated unthreaded portion and being freely slidable relative to the unthreaded portion of the shaft, the bone screw not having any resilient means between the sleeve member and the unthreaded portion, the sleeve member including a second set of threads thereon; and   (c) a means for driving the bone screw. .Iaddend. .Iadd.12. A bone screw for connecting portions of bone across a fracture therebetween, comprising:   (a) a shaft comprising a leading end portion including a first set of threads and an elongated unthreaded portion extending therefrom;   (b) a sleeve member having an inner surface surrounding the elongated unthreaded portion and being freely slidable relative to the unthreaded portion of the shaft, the bone screw not having any resilient means between the sleeve member and the unthreaded portion, the sleeve member including a second set of threads thereon;   (c) a retaining means to prevent the sleeve member from sliding off the shaft; and   
     
     
       (d) a means for driving the bone screw. .Iaddend. .Iadd.13.  A bone screw for connecting portions of bone across a fracture therebetween, comprising: (a) a shaft comprising a leading end portion including a first set of threads and an elongated unthreaded portion extending therefrom;   (b) a sleeve member having an inner surface surrounding the elongated unthreaded portion and being freely slidable in the longitudinal direction relative to the unthreaded portion of the shaft, the bone screw not having any resilient means between the sleeve member and the unthreaded portion, the sleeve member including a second set of threads thereon; and   
     
     
       (c) a means for driving the bone screw. .Iaddend. .Iadd.14.  A bone screw for connecting portions of bone across a fracture therebetween, comprising: (a) a shaft comprising a leading end portion including a first set of threads and an elongated unthreaded portion extending therefrom;   (b) a sleeve member having an inner surface surrounding the elongated unthreaded portion and being freely slidable relative to the unthreaded portion of the shaft, the sleeve member including a second set to threads thereon; and   (c) a means for driving the bone screw, and wherein the inner surface of the sleeve member has a uniform diameter throughout substantially the entire length of the sleeve member providing an uninterrupted surface to directly slide against the smooth unthreaded portion of the shaft.   
     
     
        .Iaddend. .Iadd.15.  The bone screw of claim 11 wherein the inner surface of the sleeve member surrounding the elongated unthreaded portion of the shaft extends at least one-third of the length of the sleeve member 
     
     
        providing a bearing surface to slide along the shaft. .Iaddend. .Iadd.16. A bone screw for connecting portions of bone across a fracture therebetween, comprising: (a) a shaft comprising a leading end portion including a first set of threads and an elongated unthreaded portion extending therefrom;   (b) a sleeve member having an inner surface surrounding the elongated unthreaded portion and being freely slidable relative to the unthreaded portion of the shaft, the sleeve member including a second set of threads thereon; and   (c) a means for driving the bone screw, and wherein the inner surface of the sleeve member surrounding the elongated unthreaded portion of the shaft extends substantially the entire length of the sleeve member providing a bearing surface to slide along the shaft. .Iaddend.