EP1575434A1 - Plaque d osteosynthese pour l osteosynthese de petits os voisins les uns des autres - Google Patents
Plaque d osteosynthese pour l osteosynthese de petits os voisins les uns des autresInfo
- Publication number
- EP1575434A1 EP1575434A1 EP03778434A EP03778434A EP1575434A1 EP 1575434 A1 EP1575434 A1 EP 1575434A1 EP 03778434 A EP03778434 A EP 03778434A EP 03778434 A EP03778434 A EP 03778434A EP 1575434 A1 EP1575434 A1 EP 1575434A1
- Authority
- EP
- European Patent Office
- Prior art keywords
- plate
- bones
- osteosynthesis
- holes
- treated
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
Classifications
-
- 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
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1613—Component parts
- A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1728—Guides or aligning means for drills, mills, pins or wires for holes for bone plates or plate 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
- A61B17/1782—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hand or wrist
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B2017/1602—Mills
Definitions
- the present invention relates to an osteosynthesis plate for osteosynthesis of small bones adjacent to each other, in particular carp bone.
- the invention also relates to a set of instruments for installing this plate.
- osteosynthesis plates bearing on either side of the carpus, in particular on the radius on the one hand and on one or more metacarpals on the other. go. These plates have the major drawback of blocking the wrist joint.
- osteosynthesis plate sized to be able to be placed above the small bones to be assembled, therefore without taking support on larger neighboring bones, in particular the radius and one or more metacarpals in the case of carpal osteosynthesis.
- This plate has an annular shape, with a large central opening, has a conical shape seen transversely, which defines a lower rim for bearing against the bones to be treated, and has eight lateral holes for the placement of screws in these bones.
- This plate has the significant drawback of being relatively difficult to implant and of making it possible to place screws not in the bones to be treated but between two of these bones, which can have harmful consequences.
- the present invention aims to remedy these drawbacks.
- the plate to which it relates is of the type having dimensions such that it can be placed above the bones to be treated, without taking support on larger neighboring bones, and comprising lateral holes for the placement of screws for fixing to these bones.
- the plate has a face intended to come into contact with the bones to be treated which is planar, and comprises holes for receiving the screws having axes inclined with respect to said planar face, these holes being such as the screws, once engaged in these holes, diverge towards the outside of the plate.
- the plate according to the invention because of the flatness of its face intended to come into contact with the bones to be treated, only requires the fitting of a counterbore in the bones to be treated, which can be achieved by means of a the reamer of the "lamer” type, and has a perfect grip against the bones to be treated.
- This plate is much easier to install than the existing plate.
- the inclined holes make it possible to orient the screws in the direction of the bones in which these screws are to be implanted, notwithstanding the flat face of the plate.
- the plate can have a circular shape, and said reamer can then be cannula and able to be engaged in sliding, but of adjusted material, on a positioning pin.
- This pin thus makes it possible to guide the reamer in rotation and to arrange a recess precisely adapted to the shape of the plate.
- the face of the plate opposite to that coming into contact with the bones to be treated may have a recess making it possible to lower the heads of the screws relative to the plate in the position of implantation of this plate.
- This recess can in particular occupy the major part of said face of the plate opposite to that coming into contact with the bones to be treated, and be in the form of a hollow spherical cap.
- the recess thus shaped also makes it possible to delimit inclined zones with respect to the general plane of the plate, through which the screw holes can be arranged, perpendicular to these zones.
- at least one screw hole has a shape in the form of a hollow sphere portion
- the head of at least one screw has a side wall in the shape of a corresponding sphere portion, these respective shapes of the hole and of the screw head allowing multidirectional orientation of the screw relative to the plate.
- This multidirectional orientation makes it possible to adapt the direction of insertion of the screw, if necessary according to the relative positions of the plate and of a bone to be treated.
- the plate comprises a number of screw holes equal to or close to the number of bones to be treated, in particular four holes for carrying out, in the case of carpal bones, an osteosynthesis of the large bone, of semi-lunar bone, pyramidal bone and hooked bone.
- the plate will generally include three to five holes.
- This just enough number of screw holes helps reduce the risk of a screw being placed between two bones.
- the plate comprises a central hole of diameter adjusted to that of a positioning pin, allowing the engagement of the sliding plate on this pin, and a mark located at its periphery.
- the positioning pin is thus placed in one of the bones to be treated, or between the bones to be treated, then the plate is engaged on this pin and is oriented angularly so that the lateral screw holes that this plate includes are arranged opposite the bones to be treated, the appropriate angular position of the plate being identified by said marker.
- the screws for fixing the plate to the bones to be treated are then placed.
- the plate according to the invention thanks to its precise positioning made possible by said spindle and said mark, eliminates, or at least very greatly reduces, the risk of placing a screw between two bones.
- the set of instruments for laying the plate may comprise, in addition to said reamer, a phantom of the plate, that is to say a test piece of shape identical to that of the plate, provided with a mark. identical to that of the plate.
- This phantom is positioned on the location to be occupied later by the plate and is used to locate the appropriate angular position which it is necessary to give to this plate so that its screw holes are placed opposite the different bones to be treated.
- a mark is arranged on one of the bones to be treated, for example by means of an electrosurgical unit, facing the mark of the ghost, then the latter is removed.
- the appropriate position of the plate will later be easy to find, simply by placing the mark on the plate in coincidence with said mark.
- the phantom can advantageously be provided with a hole for receiving said positioning pin, identical to that of the plate.
- FIG 1 is a perspective view showing the osteosynthesis plate according to the invention while it performs an osteosynthesis of the large bone, semi-lunar bone, pyramidal bone and hooked bone; for the sake of simplification of the drawing, these bones have been shown very schematically, not in accordance with reality, except as regards their contours.
- Figure 2 is a top view illustrating this plate on an enlarged scale.
- FIG. 3 is a view in diametral section along the line III-III of FIG. 2.
- Figures 4 to 6 are top views of three plates similar to each other but having different diameters and a number of different screw holes.
- Figures 7 to 11 are views similar to Figure 1, showing four successive steps of positioning the plate.
- FIG. 1 An osteosynthesis plate 1 has been shown in FIG. 1 for the osteosynthesis of small bones close to each other, in particular carpal bones.
- this is the osteosynthesis of the large bone 2, the semi-lunar bone 3, the pyramidal bone 4 and the hooked bone 5.
- the fixation of this plate 1 with these bones is produced by means of screws 6 (only one is placed on the plate 1 represented by FIG. 1).
- This plate 1 and these screws 6 can be made of any suitable material, in particular of the titanium alloy known under the reference TA6V. As shown more particularly in FIGS. 2 and 3, the plate 1 has a cylindrical shape, with a flat face 10 intended to come into contact with the bones to be treated, a face 11 opposite to the face 10, having a recess 12, and a peripheral face 13, connected to face 11 by a rounded angle 14 not injurious.
- the recess 12 is in the form of a hollow spherical cap and occupies most of the face 11.
- the plate 1 comprises a central hole 15, holes 16 for receiving the screws 6, and an engraved diametral line 18, extending on the face 11 and extending on the peripheral face 13.
- the hole 15 is arranged along a perpendicular axis in the general plane of the plate 1. It has a diameter adjusted to that of a positioning pin 20, visible in FIG. 8, and allows the engagement of the plate 1 to slide on this pin 20.
- Each hole 16 is arranged substantially perpendicular to the area of the face 11 into which it opens, so that, taking into account the curvature of the recess 12, the axis of each of these holes 16 is inclined towards the outside of the plate 1 at an angle of the order of 10 ° relative to the axis of the hole 15.
- the zone of the plate 1 delimiting each hole 16 has a shape in the form of a hollow sphere.
- Each screw 6 is cannulated and self-drilling, and has a head having a side wall 6a in the form of a portion of a sphere.
- This side wall 6a has a shape corresponding to that of the zones of the plate 1 delimiting the holes 16, so that this wall 6a can take a surface support in each hole 16 but with a possibility of multidirectional orientation of the screw 6 in the hole 16.
- Each screw 6 also has a proximal cavity 21 allowing it to be maneuvered by means of an appropriate tool (not shown in the figures), this cavity 21 having, in the example shown, a hexagonal shape with rounded angles.
- the diametral line 18 forms, at the periphery of the plate 1, an angular positioning mark of this plate 1, as will be explained below.
- the plate 1 can include four holes 16 as shown in Figures 2, 3 and 5, or three or five holes 16 as shown respectively in Figures 4 and 6, depending on the different types of bone that can be treated by means of 'such a plate. As an indication, the following dimensions may be indicated:
- the plate shown in Figure 4 may have a diameter of 12.5 mm and a thickness of 3 mm outside of the recess 12, and the plate shown in Figure 6 may have a diameter of 16 mm and a thickness of 3 mm outside the recess 12.
- the material for laying the plate 1 comprises, in addition to the said positioning pin 20, a phantom 21 of the plate 1, that is to say a test piece of shape identical to that of the plate 1, having holes 15 and 16 and a reference 18 identical to those of this plate, a reamer to counter 22 cannula, visible in FIG. 9, and pins 23 for guiding the screws 6.
- the phantom 21 is positioned on the bones to be treated 2 to 5 and is angularly oriented so that the holes 16 which it comprises coincide as well as possible with each bone 2 to 5.
- a mark 25 is then arranged on one of the bones to be treated by means of an electric scalpel, opposite the reference 18 of the ghost 21.
- the phantom 21 is held in this position and then the pin 20 is put in place through the hole 15 of this phantom, as shown in FIG. 8.
- the phantom 21 is then removed by sliding along this pin 20.
- the reamer lamer 22 is then engaged on spindle 20 and is used to fit a counterbore 26 coaxial with this spindle 20, as shown in FIG. 9.
- the pins 23 are then in turn inserted into the bones to allow the guidance of each screw 6 in the corresponding hole 16, as shown in FIG. 11.
- the invention provides a plate for osteosynthesis of small bones close to each other, in particular carpal bones, having an implantation facilitated by the characteristics of this plate and by the set of instruments 20 to 23 which allow its pose.
- This plate also eliminates, or at least very greatly reduces, the risk of placing a screw between two bones, thanks to the precise positioning of this plate made possible by said pin 20 and said mark 18.
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Engineering & Computer Science (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Dentistry (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Neurology (AREA)
- Surgical Instruments (AREA)
Abstract
Description
Claims
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR0215614 | 2002-12-11 | ||
FR0215614A FR2848413B1 (fr) | 2002-12-11 | 2002-12-11 | Plaque d'osteosynthese pour l'osteosynthese de petits os voisins les uns des autres |
PCT/FR2003/003129 WO2004062515A1 (fr) | 2002-12-11 | 2003-10-22 | Plaque d'osteosynthese pour l'osteosynthese de petits os voisins les uns des autres |
Publications (1)
Publication Number | Publication Date |
---|---|
EP1575434A1 true EP1575434A1 (fr) | 2005-09-21 |
Family
ID=32338654
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
EP03778434A Withdrawn EP1575434A1 (fr) | 2002-12-11 | 2003-10-22 | Plaque d osteosynthese pour l osteosynthese de petits os voisins les uns des autres |
Country Status (8)
Country | Link |
---|---|
US (1) | US20060149249A1 (fr) |
EP (1) | EP1575434A1 (fr) |
JP (1) | JP2006509606A (fr) |
AU (1) | AU2003285433A1 (fr) |
CA (1) | CA2509415A1 (fr) |
FR (1) | FR2848413B1 (fr) |
NZ (1) | NZ540536A (fr) |
WO (1) | WO2004062515A1 (fr) |
Families Citing this family (27)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20060025772A1 (en) * | 2004-07-30 | 2006-02-02 | Leibel David A | Bone fusion plate |
US9615866B1 (en) | 2004-10-18 | 2017-04-11 | Nuvasive, Inc. | Surgical fixation system and related methods |
US7344538B2 (en) * | 2005-03-31 | 2008-03-18 | Depuy Products, Inc. | Mid-foot fixation plate |
US20080015590A1 (en) * | 2006-06-19 | 2008-01-17 | Depuy Products, Inc. | Implant device with placement indicia |
US8361130B2 (en) | 2006-10-06 | 2013-01-29 | Depuy Spine, Inc. | Bone screw fixation |
DE202006019220U1 (de) | 2006-12-19 | 2007-05-24 | Zrinski Ag | Orthopädisches Schraubenverschlusssystem |
US8702762B2 (en) * | 2007-03-27 | 2014-04-22 | Depuy Spine, Inc. | Passive screw locking mechanism |
US8282675B2 (en) * | 2008-01-25 | 2012-10-09 | Depuy Spine, Inc. | Anti-backout mechanism |
DE202008017034U1 (de) | 2008-12-30 | 2009-03-05 | Medartis Ag | Arthrodeseplatte |
DE202009001900U1 (de) * | 2009-02-23 | 2009-07-16 | Zrinski Ag | Implantat zur Fusion von Knochen oder Knochenteilen |
WO2010124205A1 (fr) * | 2009-04-24 | 2010-10-28 | Synthes Usa, Llc | Vis multiplexées |
USD754857S1 (en) | 2009-10-14 | 2016-04-26 | Nuvasive, Inc. | Bone plate |
EP3659535B1 (fr) * | 2010-06-02 | 2023-10-18 | Synthes GmbH | Lame osseuse |
US8911445B2 (en) * | 2011-01-28 | 2014-12-16 | DePuy Sysnthes Products, LLC | Reamer guide systems and methods of use |
BR112013018833B1 (pt) * | 2011-01-28 | 2020-08-04 | Synthes Gmbh | Sistema de guia de mandril |
US9480515B2 (en) | 2012-07-12 | 2016-11-01 | Exsomed International IP, LLC | Metacarpal bone stabilization device |
US11259849B2 (en) | 2013-10-02 | 2022-03-01 | ExsoMed Corporation | Full wrist fusion device |
DE102014117175A1 (de) * | 2014-11-24 | 2016-05-25 | Aesculap Ag | Pedikelschraubensystem und Wirbelsäulenstabilisierungssystem |
US10441330B2 (en) | 2015-05-19 | 2019-10-15 | Exsomed Holding Company, Llc | Distal radius plate |
US10245091B2 (en) | 2015-12-30 | 2019-04-02 | Exsomed Holding Company, Llc | Dip fusion spike screw |
US11147604B2 (en) | 2016-01-12 | 2021-10-19 | ExsoMed Corporation | Bone stabilization device |
US10194923B2 (en) | 2016-05-10 | 2019-02-05 | Exsomed International IP, LLC | Tool for percutaneous joint cartilage destruction and preparation for joint fusion |
US10653468B2 (en) * | 2016-08-29 | 2020-05-19 | Osteomed Llc | Four corner fusion device |
US11191645B2 (en) | 2017-09-05 | 2021-12-07 | ExsoMed Corporation | Small bone tapered compression screw |
WO2019050833A1 (fr) | 2017-09-05 | 2019-03-14 | ExsoMed Corporation | Clou fileté intramédullaire pour fixation corticale radiale |
US11147681B2 (en) | 2017-09-05 | 2021-10-19 | ExsoMed Corporation | Small bone angled compression screw |
US11141285B2 (en) * | 2018-08-06 | 2021-10-12 | Baylor University | Carpal bone fusion device and method |
Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5180381A (en) * | 1991-09-24 | 1993-01-19 | Aust Gilbert M | Anterior lumbar/cervical bicortical compression plate |
Family Cites Families (14)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3474537A (en) * | 1965-10-19 | 1969-10-28 | Robert W Christensen | Dental prosthetic appliance |
FR2561907B1 (fr) * | 1984-03-29 | 1987-12-11 | Scortecci Gerard | Implant dentaire pour la fixation de protheses dentaires fixes, son outil pour sa mise en place et son procede d'insertion |
US5374270A (en) * | 1991-12-13 | 1994-12-20 | David A. McGuire | Device and method for insertion of guide pin |
US5520690A (en) * | 1995-04-13 | 1996-05-28 | Errico; Joseph P. | Anterior spinal polyaxial locking screw plate assembly |
AU1997797A (en) * | 1996-05-31 | 1997-12-04 | Acromed Corporation | An apparatus comprising a plate and a fastener for connecting the plate to a bone portion |
US7094239B1 (en) * | 1999-05-05 | 2006-08-22 | Sdgi Holdings, Inc. | Screws of cortical bone and method of manufacture thereof |
US6179839B1 (en) * | 1999-09-20 | 2001-01-30 | Kinetikos Medical Incorporated | Bone fusion apparatus and method |
US6358250B1 (en) * | 2000-02-01 | 2002-03-19 | Hand Innovations, Inc. | Volar fixation system |
PL196903B1 (pl) * | 2000-09-22 | 2008-02-29 | Codman & Shurtleff | Narzędzie do zakładania spinacza chirurgicznego |
DE60140558D1 (de) * | 2000-10-25 | 2009-12-31 | Kyphon S A R L | Systeme zur reposition von gebrochenen knochen mittels einer kanüle zur reponierung von knochenfrakturen |
DE20019026U1 (de) * | 2000-11-08 | 2002-03-28 | Synthes AG Chur, Chur, Graubünden | Vorrichtung zur Fixierung eines Implantates |
GB2407510B (en) * | 2002-07-22 | 2006-06-28 | Acumed Llc | Bone fusion system |
US6827739B2 (en) * | 2002-08-26 | 2004-12-07 | Zimmer Technology, Inc. | Easily assembled provisional orthopaedic implant |
AU2003295749B2 (en) * | 2002-11-19 | 2007-12-06 | Acumed Llc | Adjustable bone plates |
-
2002
- 2002-12-11 FR FR0215614A patent/FR2848413B1/fr not_active Expired - Fee Related
-
2003
- 2003-10-22 AU AU2003285433A patent/AU2003285433A1/en not_active Abandoned
- 2003-10-22 NZ NZ540536A patent/NZ540536A/en unknown
- 2003-10-22 WO PCT/FR2003/003129 patent/WO2004062515A1/fr active Application Filing
- 2003-10-22 EP EP03778434A patent/EP1575434A1/fr not_active Withdrawn
- 2003-10-22 JP JP2004566077A patent/JP2006509606A/ja active Pending
- 2003-10-22 CA CA002509415A patent/CA2509415A1/fr not_active Abandoned
- 2003-10-22 US US10/538,809 patent/US20060149249A1/en not_active Abandoned
Patent Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5180381A (en) * | 1991-09-24 | 1993-01-19 | Aust Gilbert M | Anterior lumbar/cervical bicortical compression plate |
Non-Patent Citations (1)
Title |
---|
See also references of WO2004062515A1 * |
Also Published As
Publication number | Publication date |
---|---|
WO2004062515A1 (fr) | 2004-07-29 |
JP2006509606A (ja) | 2006-03-23 |
FR2848413B1 (fr) | 2005-07-29 |
NZ540536A (en) | 2007-06-29 |
US20060149249A1 (en) | 2006-07-06 |
AU2003285433A1 (en) | 2004-08-10 |
CA2509415A1 (fr) | 2004-07-29 |
FR2848413A1 (fr) | 2004-06-18 |
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Legal Events
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RIN1 | Information on inventor provided before grant (corrected) |
Inventor name: MATHOULIN, CHRISTOPHE Inventor name: MARTIN, JEAN-JACQUES |
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DAX | Request for extension of the european patent (deleted) | ||
RAP1 | Party data changed (applicant data changed or rights of an application transferred) |
Owner name: SMALL BONE INNOVATIONS INTERNATIONAL SAS |
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Effective date: 20070105 |
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