CN210784536U

CN210784536U - Four-in-one osteotomy plate

Info

Publication number: CN210784536U
Application number: CN201921301488.6U
Authority: CN
Inventors: 王俊文
Original assignee: Beijing Jinchali Artificial Joint Technology Co ltd; Kuanyue Medical Equipment Suzhou Co ltd
Current assignee: Kuanyue Medical Technology (Shanghai) Co.,Ltd.
Priority date: 2019-08-12
Filing date: 2019-08-12
Publication date: 2020-06-19
Anticipated expiration: 2029-08-12

Abstract

The utility model discloses a four-in-one bone cutting plate, which comprises an upper part, a middle part and a lower part. The upper part and the middle part are connected through an upper vertical plate, and the middle part and the lower part are connected through a lower vertical plate. The upper part is provided with an anterior condyle osteotomy groove, the middle part is provided with an anterior inclined plane osteotomy groove and a posterior inclined plane osteotomy groove, and the lower part is provided with a posterior condyle osteotomy groove. The anterior condyle osteotomy groove, the anterior oblique osteotomy groove, the posterior oblique osteotomy groove and the posterior condyle osteotomy groove extend along the width direction of the four-in-one osteotomy plate and penetrate from the front surface of the four-in-one osteotomy plate to the rear surface of the four-in-one osteotomy plate, and the rear surface of the middle part is further provided with a positioning nail for positioning the relative position of the four-in-one osteotomy plate and the femur. The utility model discloses a cut the hone lamella and can adjust the bucking clearance at the osteotomy in-process to and reduce risks such as front side incision damage.

Description

Four-in-one osteotomy plate

Technical Field

The utility model relates to the field of medical equipment, concretely relates to four close a bone plate for in the knee joint replacement operation, specifically be used for the distal femur to cut the many unifications of face of bone and cut the bone.

Background

The knee joint is one of the most complex joints of the human body and is also an important weight bearing joint of the lower limbs of the human body. Due to accidents, bad exercise habits, diseases and the like, knee joints of many patients have injuries of different degrees, and the lives of the patients are extremely inconvenient. Wherein, the knee joint function of part of patients can be recovered by knee joint replacement surgery.

In knee replacement surgery, particularly total knee replacement surgery, it is necessary to perform multiple osteotomies of the distal femur so that the shape of the osteotomy matches the shape of the prosthesis to be implanted. Generally, the distal femur is firstly resected to expose the resected surface, then the corresponding resected plate is attached to the resected surface, and the anterior condyle, the posterior condyle and the anterior and posterior inclined surfaces of the femur are resected for multiple times, so as to finally obtain a resected surface similar to a piano to match the shape of the prosthesis.

At present, in the market, a plurality of osteotomy plates are needed to be adopted for the resection of the anterior condyle, the posterior condyle and the anterior and posterior inclined planes of the femur, so that the usage is inconvenient, the osteotomy plates are switched for a plurality of times, the osteotomy error is increased, and the accuracy of osteotomy positioning is reduced. In addition, the products currently on the market do not meet the needs of the surgeon well for the management of surgical risks, such as risk of anterior resection injury, risk of improper flexion and extension gaps during osteotomy.

SUMMERY OF THE UTILITY MODEL

The utility model aims at providing a can once only carry out many times excision on thighbone anterior condyle, posterior condyle and front and back inclined plane to thighbone distal end osteotomy face to reduce the osteotomy board of secondary damage risk in the operation.

In order to solve the problem, the utility model provides a four-in-one bone cutting plate, four-in-one bone cutting plate includes upper portion, middle part and lower part, upper portion and middle part are connected through last riser, middle part and lower part are connected through lower riser, upper portion is provided with anterior condyle bone cutting groove, the middle part is provided with anterior inclined plane bone cutting groove and back inclined plane bone cutting groove, and the lower part is provided with back condyle bone cutting groove, wherein, anterior condyle bone cutting groove, anterior inclined plane bone cutting groove, back inclined plane bone cutting groove and back condyle bone cutting groove follow the width direction of four-in-one bone cutting plate extends and follows the front surface of four-in-one bone cutting plate runs through the rear surface of four-in-one bone cutting plate, and the rear surface at middle part still is provided with the staple, in order to fix a position the relative position of four-in-one bone cutting plate and thighbone.

In one embodiment, the middle portion is further provided with an offset hole extending from the front surface of the middle portion through the rear surface of the middle portion and spaced a distance from the locating pin to secondarily locate the four in one piece bone plate.

In one embodiment, the four-in-one osteotomy plate is an anterior reference osteotomy plate or a posterior reference osteotomy plate, and the offset hole is disposed at a position 1.5mm from a distal femoral osteotomy surface location point of the anterior reference osteotomy plate or the posterior reference osteotomy plate.

In one embodiment, a first recess is formed between the upper portion and the middle portion, a second recess is formed between the middle portion and the lower portion, and the first recess and the second recess extend from the anterior surface of the four-in-one bone plate through the posterior surface of the four-in-one bone plate.

In one embodiment, the upper surface of the middle part is an inclined plane with a bottom front and a top rear, and the inclined plane is provided with a bulge to prevent an operator from cutting bones along the inclined plane.

In one embodiment, the four-in-one osteotomy plate comprises different size types of four-in-one osteotomy plates, and the different size types of four-in-one osteotomy plates are provided with size indicia to fit different size prostheses.

In one embodiment, the left side and the right side of the middle part form a wide side and a narrow side, the distance between the wide sides corresponds to the M/L direction width of the standard size prosthesis, and the distance between the narrow sides corresponds to the M/L direction width of the narrow size prosthesis.

In one embodiment, the left and right sides of the lower portion define broad sides and narrow sides, the distance between the broad sides corresponding to the M/L directional width of a standard size prosthesis and the distance between the narrow sides corresponding to the M/L directional width of a narrow size prosthesis.

In one embodiment, the four-in-one osteotomy plate is provided with oblique nail holes on the left and right sides of the middle portion to further secure the four-in-one osteotomy plate to the distal femoral osteotomy surface.

In one embodiment, adjacent ones of the different types of four in one osteotomy plates differ by 3 mm.

The utility model has the advantages that: the utility model discloses a four close a bone cutting plate is provided with anterior condyle bone cutting groove, anterior inclined plane bone cutting groove, posterior inclined plane bone cutting groove and posterior condyle bone cutting groove. The osteotomy plate of the utility model combines four osteotomy requirements in the total knee joint replacement operation into an osteotomy instrument, and has convenient operation and increased osteotomy accuracy. Furthermore, the osteotomy plate of the utility model is provided with an offset hole on the osteotomy plate for the secondary positioning osteotomy plate position. The buckling clearance can be adjusted by utilizing the device, and the surgical risks such as front side incisional injury and the like are reduced.

Wherein, a first groove is formed between the upper part and the middle part, a second groove is formed between the middle part and the lower part, and the first groove and the second groove penetrate through the front surface and the back surface of the osteotomy plate. This setting makes the operation field of vision better, and the user can observe the osteotomy face better. The setting can also reduce the weight of the osteotomy plate, so that the osteotomy plate is lighter.

Wherein, the front and back both sides in middle part form the inclined plane respectively, the inclined plane is followed the front of middle part is to both sides slope, be provided with the arch on the inclined plane, prevent that the operative person from with the inclined plane cuts the bone. The inclined plane of this setting is unanimous with the direction of osteotomy face slope, and supplementary the use for the user can obtain the osteotomy direction of each osteotomy groove directly perceivedly.

Wherein the osteotomy plate is provided with size indicia for differently sized prostheses, the arrangement being such that a user can assess a size parameter, particularly medial-lateral (M/L position) width, of the differently sized prostheses of the femoral component from the osteotomy plate.

The left side and the right side of the middle part form wide edges and narrow edges, the distance between the wide edges corresponds to the M/L direction width of the standard prosthesis, and the distance between the narrow edges corresponds to the M/L direction width of the narrow prosthesis. This arrangement allows the user to assess the medial-lateral (M/L position) width of the femoral component with respect to the osteotomy plate.

The left side and the right side of the lower portion form wide edges and narrow edges, the distance between the wide edges corresponds to the M/L direction width of the standard size prosthesis, and the distance between the narrow edges corresponds to the M/L direction width of the narrow size prosthesis. This arrangement allows the user to assess the medial-lateral (M/L position) width of the femoral component with respect to the osteotomy plate.

The left side and the right side of the osteotomy plate are provided with inclined nail holes, and the arrangement can further reinforce the connection between the osteotomy plate and the distal femur osteotomy surface on the basis of fixing the osteotomy plate by the osteotomy positioning holes. The inclined nail holes are obliquely arranged, so that the parts of the nail holes can be cut off in the process of subsequent intercondylar osteotomy.

Drawings

FIG. 1 is a perspective view of a bone plate of a reference four-in-one section according to an embodiment of the present application;

FIG. 2 is a front view of the bone plate of FIG. 1 with reference to a four-in-one cross-section;

FIG. 3 is a rear view of the bone plate of FIG. 1 with reference to a four-in-one section;

FIG. 4 is a right side view of the bone plate of FIG. 1 with reference to a four-in-one section;

fig. 5 is a front view of a bone plate of the present application with reference to a four-in-one cross-section.

Reference numerals:

11-middle part; 12-upper part; 13-lower part; 111-front bevel; 112-a first groove; 113-back slope; 114-a second groove; 21-anterior condylar osteotomy groove; 22-anterior chamfer osteotomy slot; 23-a posterior chamfer osteotomy slot; 24-posterior condylar osteotomy groove; 3-deviating the hole; 41-a first projection; 42-a second projection; 5-oblique nail holes; 6-positioning the nail; 7-taking out the hole; n-narrow side width; w-broadside width.

Detailed Description

The preferred embodiments of the present invention will be described in detail below with reference to the accompanying drawings so that the objects, features and advantages of the invention can be more clearly understood. It should be understood that the embodiments shown in the drawings are not intended as limitations on the scope of the invention, but are merely illustrative of the true spirit of the technical solution of the invention.

In the following description, for the purposes of illustrating various disclosed embodiments, certain specific details are set forth in order to provide a thorough understanding of the various disclosed embodiments. One skilled in the relevant art will recognize, however, that the embodiments may be practiced without one or more of the specific details. In other instances, well-known devices, structures and techniques associated with this application may not be shown or described in detail to avoid unnecessarily obscuring the description of the embodiments.

Throughout the specification and claims, the word "comprise" and variations thereof, such as "comprises" and "comprising," are to be understood as an open, inclusive meaning, i.e., as being interpreted to mean "including, but not limited to," unless the context requires otherwise.

Reference throughout this specification to "one embodiment" or "an embodiment" means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment. Thus, the appearances of the phrases "in one embodiment" or "in an embodiment" in various places throughout this specification are not necessarily all referring to the same embodiment. Furthermore, the particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments.

As used in this specification and the appended claims, the singular forms "a", "an", and "the" include plural referents unless the context clearly dictates otherwise. It should be noted that the term "or" is generally employed in its sense including "and/or" unless the context clearly dictates otherwise.

In the following description, for the sake of clarity, the structure and operation of the present invention will be described with the aid of directional terms, but the terms "front", "rear", "left", "right", "outer", "inner", "outer", "inward", "upper", "lower", etc. should be understood as words of convenience and not as words of limitation.

The four-in-one osteotomy plate of the present application is used for further osteotomy of the distal femoral osteotomy surface in knee replacement surgery, which incorporates a plurality of osteotomy modules in one osteotomy plate, specifically four osteotomy modules, and is therefore referred to as a four-in-one osteotomy plate. The four-in-one osteotomy plate of the present application is divided into an anterior reference osteotomy plate and a posterior reference osteotomy plate, corresponding to surgical procedures based on the anterior or posterior condyles of the femur, respectively. Wherein, the osteotomy amount of the anterior condyle is constant by selecting the anterior reference osteotomy plate, and the osteotomy amount change caused by selecting different types of osteotomy plates is reflected on the posterior condyle. Wherein, the back reference osteotomy plate is selected, the osteotomy amount of the back condyle is constant, and the osteotomy amount change caused by selecting different types of osteotomy plates is reflected on the front condyle.

Fig. 1-4 illustrate the structure of a posterior-reference four-in-one osteotomy plate of an embodiment of the present application. Fig. 1-4 are perspective, front, rear, and right side views, respectively, of a posterior reference four-in-one fragment plate. As shown in fig. 1-4, the four-in-one bone plate 100 has a "king" shape overall, including an upper portion 12, a middle portion 11, and a lower portion 13. The upper portion 12 is provided with an anterior condylar resection slot 21, the middle portion 11 is provided with an anterior chamfer resection slot 22 and a posterior chamfer resection slot 23, and the lower portion 13 is provided with a posterior condylar resection slot 24 for respectively resecting an anterior condyle, an anterior chamfer resection, a posterior chamfer resection and a posterior condylar resection of a distal femoral resection surface.

The upper part 12 and the middle part 11 are connected through an upper vertical plate 2A, and the middle part 11 and the lower part 13 are connected through a lower vertical plate 2B. Wherein, the upper standing plate 2A is integrally formed with the upper part 12 and the middle part 11 and is connected at the middle position of the upper part 12 and the middle part 11, and the lower standing plate 2B is integrally formed with the middle part 11 and the lower part 13 and is connected at the middle position of the middle part 11 and the lower part 13, so that the upper standing plate 2A and the lower standing plate 2B are basically positioned on the same vertical plane.

And a positioning nail 6 is arranged behind the osteotomy plate and is used for being inserted into the osteotomy positioning hole for positioning. Specifically, the positioning nail 6 is provided on the back surface (bone-contacting surface) of the middle portion 11, and the four-in-one cutting plate 100 can be accurately positioned to the femur by inserting the positioning nail 6 into a positioning hole previously drilled in the femur.

In the knee joint replacement operation, for natural bone osteotomy, the balance between the flexion gap and the extension gap needs to be kept, so that the knee joint of a patient can move freely after the prosthesis is implanted. Therefore, the utility model discloses be provided with inclined to one side hole 3 on osteotomy plate's middle part 11, inclined to one side hole 3 runs through to the rear surface of middle part 11 from the front surface of middle part 11 always, and respectively sets up an inclined to one side hole 3 in the both sides of middle part 11 by last riser 2A separation to be used for the secondary positioning to cut the bone plate position, make to cut the bone after the clearance of buckling and straightening the clearance balance.

Specifically, when the four-in-one osteotomy plate is fixed by matching the osteotomy positioning hole drilled on the distal end osteotomy surface of the femur to be osteotomy with the positioning nail 6 in advance to find that the flexion gap and the extension gap are not balanced, a new hole can be drilled on the femur again through the eccentric hole 13 to serve as a new osteotomy positioning hole, the osteotomy plate is taken out from the original osteotomy positioning hole, the positioning nail 6 is placed into the new osteotomy positioning hole, and the osteotomy position is determined again.

In one embodiment, for a posterior reference osteotomy plate, the offset hole 3 is disposed at a perpendicular distance of 1.5mm from the osteotomy plate location point (i.e., the location nail 6) such that the intraoperative posterior reference osteotomy plate is capable of adjusting 1.5mm downward, thereby adjusting the flexion gap. Preferably, as shown in fig. 1, the two offset holes 3 are symmetrically disposed about the central axis of the osteotomy plate. To match the position of the offset hole 3, the posterior reference osteotomy plate may comprise a plurality of different sizes, incremented by 3mm between adjacent different sizes. If the use of the money reference four-in-one osteotomy plate presents a serious risk of side-track injury, a hole is drilled in the 1.5mm offset hole, then the four-in-one bone plate is taken out, a larger one-size four-in-one osteotomy plate is selected and positioned in the newly drilled positioning hole.

Upper 12 lower 13

With continued reference to FIG. 1, a first recess 112 is formed between the upper portion 12 and the intermediate portion 11, a second recess 114 is formed between the intermediate portion 11 and the lower portion 13 of the lower portion 13, and the first and

second recesses

112, 114 extend through the front and back surfaces of the osteotomy plate. This setting can provide better operation field of vision for the user when reducing the osteotomy plate dead weight. In this embodiment, the first groove 112 is divided into two parts by the upper plate 2A connecting the upper part 12 of the upper part 12 and the middle part 11, the second groove 114 is also divided into two parts by the lower plate 2B connecting the lower part 13 of the middle part 11 and the lower part 13, and the two parts are symmetrically arranged with respect to the central axis of the osteotomy plate. It is to be understood that the arrangement of the first groove 112 and the second groove 114 is not limited to this arrangement, and may be divided into two asymmetric left and right portions, or three portions, for example. In addition, the several parts of it that are separated may be completely separated or partially connected. Preferably, the central recess or through-going opening 7 of the upper plate 2A, which is the part connecting the upper portion 12 and the middle portion 11 of the upper portion 12, serves as the point of force for removing the osteotomy plate.

With the above osteotomy plate, the front side of the middle portion 11 of the osteotomy plate forms a front bevel 111 towards the face of the first recess 112 and the rear side of the middle portion 11 forms a rear bevel 113 towards the face of the second recess 114. The two bevels are oriented so as to slope from the front of the middle portion 11 of the osteotomy plate to the two sides. In order to prevent the surgeon from performing osteotomy on the anterior slope 111, a first protrusion 41 is provided on the anterior slope 111. Also, to prevent the surgeon from resecting the posterior slope 113, a second protrusion 42 is provided on the posterior slope 113. In this embodiment, both the first protrusion 41 and the second protrusion 42 include left and right vertical bars that are symmetrical with the middle axis of the osteotomy plate. It will be appreciated that the first and

second projections

41, 42 may be arranged in other ways as long as the surgeon is prevented from cutting the bone with the bevel.

Lower portion fig. 5 is a front view of a bone plate of the present application with reference to a four-in-one cross-section. For the anterior reference osteotomy plate, the eccentric hole 3 is arranged at the position +1.5mm away from the front side of the positioning point of the osteotomy plate, so that the anterior reference osteotomy plate can be adjusted forwards by 1.5mm in the operation, thereby adjusting the flexion gap or reducing the operation risks such as injury of an anterior incision and the like. Generally, the offset holes 3 are arranged in two, as shown in fig. 1, symmetrically to the median axis of the osteotomy plate. Preferably, the anterior reference osteotomy plate includes a plurality of versions, increasing in size by 3mm posteriorly of adjacent versions.

The front reference four-in-one bone plate of fig. 5 also shows a preferred embodiment of the size indication for a different size prosthesis, specifically: the osteotomy plate has a central portion 11 with broad sides and narrow sides formed on its left and right sides, wherein the distance between the broad sides corresponds to the M/L directional width W of the standard size prosthesis and the distance between the narrow sides corresponds to the M/L directional width N of the narrow size prosthesis. In addition, the size indicator may be configured such that the lower portion 13 of the osteotomy plate defines broad sides and narrow sides on both the left and right sides thereof, wherein the distance between the broad sides corresponds to the M/L directional width W of the standard size prosthesis and the distance between the narrow sides corresponds to the M/L directional width N of the narrow size prosthesis. Wherein the middle part 11 and the lower part 13 of the osteotomy plate may be provided with size markings, or alternatively with size markings.

In one embodiment, oblique nail holes 5 are provided on the left and right sides of the osteotomy plate for further fixing the osteotomy plate on the distal osteotomy surface of the femur.

When the size measuring device is used, a size measuring device and the like are used for drilling an osteotomy positioning hole on the distal femur osteotomy surface in advance, then, a four-in-one osteotomy plate with a proper size is selected, a positioning nail 6 at the rear side of the four-in-one osteotomy plate is inserted into the osteotomy positioning hole drilled by the size measuring device, and the four-in-one osteotomy plate is placed and attached to the distal femur osteotomy surface.

Subsequently, the osteotomy face position and the osteotomy plate rotation angle are checked using the osteotomy gauge. The medial-lateral (M/L position) width W of the standard size femoral component prosthesis or the medial-lateral (M/L position) width N of the narrow size prosthesis can also be evaluated by the four-in-one osteotomy plate at this time.

If a serious risk of anterior resection occurs when using the anterior reference osteotomy plate, two holes are drilled in the +1.5mm offset hole 3, then the osteotomy plate is removed, and a larger one size of the osteotomy plate is selected and placed into the newly drilled osteotomy positioning hole.

If the risk of front side incisional lesion damage occurs when the rear reference four-in-one osteotomy plate is used, the original osteotomy plate is taken down, the rear reference four-in-one osteotomy plate with the size one larger is used, and the front side osteotomy is rechecked. A large-size posterior reference four-in-one bone plate is selected, and the anterior-posterior diameter size of the femoral condyle is increased by 3mm on the basis that the flexion gap is not influenced.

After confirming the osteotomy amount and the osteotomy plate position, fixing nails are respectively driven into the inclined nail holes 5 at the two sides, and the four-in-one osteotomy plate is fixed on the distal osteotomy surface of the femur. Referring to the posterior condylar resection slot 24, a saw blade is used to perform a posterior condylar resection.

Two fixing nails in the oblique nail holes 5 are taken out using a screw connector or the like. The extracting device is inserted into the extracting hole 7 on the four-in-one osteotomy plate, and the four-in-one osteotomy plate is extracted. And measuring the flexion gap, and if the flexion gap is balanced with the extension gap, fixing the four-in-one osteotomy plate on the distal femur osteotomy surface again to continue to complete femur osteotomy. If the flexion gap is not balanced with the extension gap, two holes can be drilled in the +1.5mm eccentric hole 3, and the four-in-one osteotomy plate is taken out and put into the two holes again to adjust the flexion gap.

When the total osteotomy is completed, the distal femoral osteotomy face presents a piano-like shaped osteotomy face. In the knee replacement surgery, a series of subsequent operations are continued on the piano-shaped osteotomy face to obtain a surface shape matching the prosthesis to be implanted. Preferably, the posterior condylar resection slots 24 are left and right sided open to aid in the completion of the resection.

While the preferred embodiments of the present invention have been described in detail above, it should be understood that aspects of the embodiments can be modified, if necessary, to employ aspects, features and concepts of the various patents, applications and publications to provide yet further embodiments.

These and other changes can be made to the embodiments in light of the above detailed description. In general, in the claims, the terms used should not be construed to be limited to the specific embodiments disclosed in the specification and the claims, but should be construed to include all possible embodiments along with the full scope of equivalents to which such claims are entitled.

Claims

1. A four-in-one bone cutting plate is characterized by comprising an upper portion, a middle portion and a lower portion, wherein the upper portion and the middle portion are connected through an upper vertical plate, the middle portion and the lower portion are connected through a lower vertical plate, an anterior condyle bone cutting groove is formed in the upper portion, an anterior oblique bone cutting groove and a posterior oblique bone cutting groove are formed in the middle portion, a posterior condyle bone cutting groove is formed in the lower portion, the anterior condyle bone cutting groove, the anterior oblique bone cutting groove, the posterior oblique bone cutting groove and the posterior condyle bone cutting groove extend in the width direction of the four-in-one bone cutting plate and penetrate from the front surface of the four-in-one bone cutting plate to the rear surface of the four-in-one bone cutting plate, and a positioning nail is further arranged on the rear surface of the middle portion so as to position the four-in-one bone cutting plate relative to a femur.

2. A four in one bone plate as in claim 1, wherein said middle portion is further provided with an offset hole extending from a front surface of said middle portion through a rear surface of said middle portion and spaced from said locating pin to secondarily locate said four in one bone plate.

3. A tetragon osteotomy plate as claimed in claim 2, wherein said tetragon osteotomy plate is an anterior reference osteotomy plate or a posterior reference osteotomy plate, said offset hole being provided at a location of 1.5mm from a distal femoral osteotomy surface location point of said anterior reference osteotomy plate or said posterior reference osteotomy plate.

4. A tetraploid slab as claimed in claim 1, wherein the upper part is lower part, the upper part is lower part

A first groove is formed between the upper portion and the middle portion, a second groove is formed between the middle portion and the lower portion, and the first groove and the second groove penetrate through the rear surface of the four-in-one bone plate from the front surface of the four-in-one bone plate.

5. A bone cutting plate according to claim 4, wherein the upper surface of the middle portion is an inclined surface with a bottom front and a top rear, and the inclined surface is provided with a protrusion to prevent the operator from cutting the bone along the inclined surface.

6. A four-in-one osteotomy plate as in claim 1, wherein said four-in-one osteotomy plate comprises different size types of four-in-one osteotomy plates, and said different size types of four-in-one osteotomy plates are provided with size indicia to fit different size prostheses.

7. A tetraploid plate as defined in claim 6, wherein said middle portion is formed at its left and right sides with wide sides and narrow sides, the distance between said wide sides corresponding to the M/L directional width of a standard size prosthesis and the distance between said narrow sides corresponding to the M/L directional width of a narrow size prosthesis.

8. A tetraploid plate as defined in claim 6, wherein said lower portion is formed with broad sides and narrow sides on both left and right sides, the distance between said broad sides corresponding to the M/L directional width of a standard size prosthesis, and the distance between said narrow sides corresponding to the M/L directional width of a narrow size prosthesis.

9. The four in one osteotomy plate of claim 1, wherein oblique nail holes are provided on left and right sides of a central portion of the four in one osteotomy plate to further secure the four in one osteotomy plate to a distal femoral osteotomy surface.

10. A tetraploid plate according to claim 6, wherein adjacent types of the different types of tetraploid plates differ by 3 mm.