EP3681417A1 - Dispositif de positionnement pour fixer une plaque polyaxiale à un os tubulaire au moyen d'une partie perforée - Google Patents

Dispositif de positionnement pour fixer une plaque polyaxiale à un os tubulaire au moyen d'une partie perforée

Info

Publication number
EP3681417A1
EP3681417A1 EP18779569.5A EP18779569A EP3681417A1 EP 3681417 A1 EP3681417 A1 EP 3681417A1 EP 18779569 A EP18779569 A EP 18779569A EP 3681417 A1 EP3681417 A1 EP 3681417A1
Authority
EP
European Patent Office
Prior art keywords
holes
plate
positioning device
hole
positioning
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.)
Pending
Application number
EP18779569.5A
Other languages
German (de)
English (en)
Inventor
Ulrich Schreiber
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
OT Medizintechnik GmbH
Original Assignee
OT Medizintechnik GmbH
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by OT Medizintechnik GmbH filed Critical OT Medizintechnik GmbH
Publication of EP3681417A1 publication Critical patent/EP3681417A1/fr
Pending legal-status Critical Current

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
    • A61B17/808—Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
    • 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
    • A61B17/56—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
    • A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
    • 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
    • A61B17/846—Nails or pins, i.e. anchors without movable parts, holding by friction only, with or without structured surface
    • A61B17/848—Kirschner wires, i.e. thin, long nails

Definitions

  • the invention relates to a positioning device for plate osteosynthesis according to the preamble of claim 1.
  • Plates are known tools for the treatment of fractures such as long bones, but also other bones. They are connected to the bone by means of screws.
  • the object of the present invention is to propose a positioning device for fixing a bone by means of a plate.
  • the object of the invention is achieved with a positioning device having the features of claim 1.
  • the positioning device serves to position and / or fix a plate to a bone. It has a plate holder. This includes a first attachment means for releasable attachment to the plate. He has a second one
  • the positioning device according to the invention also has a receptacle for a
  • the adjusting device has at least one aiming device.
  • the aiming device is designed to be a locking device, such as a
  • Bone screw and / or an instrument (eg tissue sleeve, drill sleeve, drill, screwdriver, depth gauge), at least in sections, to record;
  • an instrument eg tissue sleeve, drill sleeve, drill, screwdriver, depth gauge
  • the receptacle has at least or exactly a third fastening device or is connected herewith.
  • An element (or a fixing device) of the group consisting of the second fastening device and the third fastening device is as a
  • Holes section configured with a plurality of holes or has such a hole portion.
  • the other element of the group is designed as a plug-in section.
  • Insertion portion and the holes are for releasably connecting the second
  • Fastening device designed with the third fastening device.
  • the disc holder has the hole portion, whereas the receptacle has the insertion portion.
  • the plate holder has the insertion portion, whereas the receptacle has the hole portion.
  • the present invention further includes any combination of herein
  • the plate holder preferably at one of its two ends, a handle portion for the surgeon.
  • the holes each have a longitudinal axis. Not all longitudinal axes of the holes are parallel to each other. In some embodiments, five or more longitudinal axes are not parallel to each other.
  • the holes are arranged in a row or on a straight line or a curved or tortuous curve. In some embodiments, the holes are not in multiple rows (with more than one hole) side by side
  • the holes are arranged in - preferably only - one row or along - preferably only - a straight line or curve.
  • the longitudinal extent of the holes arranged in a row or along a straight line or curve is at least 5 cm, 10 cm, 15 cm, 20 cm, 25 cm or has a different dimension. The first and the last hole to the
  • Insertion of the insertion portion are thus at least 5 cm, 10 cm, 15 cm, 20 cm, 25 cm or another measure apart.
  • a first number of holes are arranged in-preferably only-one row or along-preferably only-a straight line or curve.
  • a second number of holes are offset from the aforesaid series arrangement or to the aforementioned arrangement along a straight line or a short.
  • at least one, two or more holes are arranged in rows one behind the other at an angle relative to the longitudinal orientation of the first holes.
  • the angle of the rows of holes may be, for example, 30 degrees, 60 degrees, 90 degrees, 120 degrees, or any other number of degrees.
  • the longitudinal extent of the first number of holes of the Hole portion of the holes arranged in a row or along a straight line or curve is at least 5 cm, 10 cm, 15 cm, 20 cm, 25 cm or has another dimension in some embodiments.
  • the first number of holes may, purely by way of example, comprise three, five, eight, ten or a different number.
  • the second number of holes may, purely by way of example, comprise two, four, five or a different number.
  • the arrangement of the second number of holes may correlate with an array of holes in a plate for fixation to a long bone.
  • At least one of the holes of the hole portion has a twist protection. This serves to turn a one inserted into a hole
  • the anti-rotation may consist of an asymmetrical cross-sectional shape or have such.
  • the inserted into a hole insertion a
  • the first fastener of the plate holder includes or is connected to a cannulated screw and / or screw having a longitudinal opening throughout the length of the screw.
  • the first attachment means of the plate holder includes a screw and / or a portion which is positively connected or connected to the plate.
  • the cannulated screw, and / or the screw with a longitudinal opening, at least partially funnel-shaped, with a
  • Funnel assembly or funnel-shaped extension connected or adjacent to this arranged.
  • the hole portion (second attachment means) is connected to the plate via the cannulated screw (here also: bone plate), in other embodiments, the hole portion (second attachment means) is directly connected to the plate Bone or another implant connected, in particular releasably fixed, optionally blocking all degrees of freedom.
  • the hole portion is permanently connected to the receptacle or to the plate holder.
  • the hole portion is detachably connected to the receptacle or to the plate holder, wherein the receptacle, with respect to its longitudinal axis, is preferably arranged against rotation with respect to or with respect to the hole portion.
  • Screw connection or has no screw connection.
  • the positive connection or fixation may be a plug connection, for example by a shoulder of the receptacle is inserted into an opening of the hole portion.
  • at least one of the holes of the hole portion includes or is connected to a display device.
  • the display device which
  • the display device is a visual display
  • a color mark for example, designed as a viewing window with underlying color position; when reaching an end position of the insertion within a hole, for example, a color mark can be visible as visual feedback.
  • the display device is configured to indicate that the correct position of the adjustment for the adjustment device relative to the hole section has been reached, allowing the surgeon to safely insert and aim and set the instrument or screw in the hole of the plate or corresponding bone allows.
  • the indicator is configured to indicate an already set screw / hole in the associated hole of the plate.
  • the display device serves the surgeons in particular intraoperatively, in particular for indicating that one, for example the third, fastening device in the form of a
  • the display device includes, in particular
  • longitudinally displaceable, section such as a ring, which is displaceable from the first position to the second position.
  • the display device has at least two or three different colors. Red and green can facilitate the orientation of the surgeons in a particularly simple or intuitive way.
  • the display device in particular the color, may be such that a
  • Mark such as a color marker (eg in green) is visible to the surgeon, as long as no insertion section has been inserted into the hole in question, and that the
  • Marking is no longer visible if this has changed.
  • a first marking such as a color marking, eg a green one
  • a second mark such as another color mark, for example, a red
  • the indicator could also be configured to be actuated in one operation by the instrument or by hand, such as by insertion, flipping, countersinking, twisting, etc., of pins, pins, tags, cones, etc. Such elements may be included.
  • a membrane that is pierced also counts as a display in some embodiments. If it is pierced, it indicates that in the corresponding hole Insertion section was introduced, otherwise not.
  • Such a membrane or a plurality of such membranes may be part of the positioning device.
  • the disc holder has at least one through opening for passing a surgical wire and / or a Kirschner wire.
  • the positioning device further comprises a support device. This can preferably be connected by means of the hole portion releasably connected to other portions of the positioning device, for. B. by using their own
  • Plug-in device of the support device is inserted into one of the holes of the hole portion.
  • the support device can serve to support a positive and / or non-positive support of the positioning device, by means of and / or over the plate.
  • a precise function of the positioning device and in particular a precise alignment of the holes with respect to the associated passage openings of the plate is ensured or is favored.
  • the support device may also be provided to rest on the body surface or skin of the patient.
  • a plurality of support devices which may be the same or different, are provided.
  • the support device has a through opening to
  • the supporting device may have a fixing device for fixing the rod or another element or the tissue protective cover.
  • the fixing device may for example be a screw, an eccentric or the like.
  • the plurality of holes are differentially distinguished, in particular for their optical discrimination during the operation.
  • the first attachment means comprises a clamping portion or terminal portion and / or a pin.
  • the first attachment means comprises a wire section.
  • the positioning device further comprises one or more locking means or latching means. They are each assigned to one or more of the holes. They engage the male portion or an end portion thereof releasably in the respective hole.
  • a latching nose and a latching step or latching opening may be provided.
  • the catch can on the second or on the third
  • Fastening device may be provided, the latching step or latching opening may be provided on the respective other of the two fastening devices.
  • the positioning device comprises at least one device which is self-locking, e.g. B. by means of eccentric force application, work.
  • Snap-in devices prevent unintentional slipping out of the second fastening device from the third fastening device (or vice versa). Nevertheless, the locking connection can be easily solved by the surgeon. For this purpose, an operating element can be provided. However, the locking connection can also be made detachable by means of a train.
  • the plate holder terminates at both ends with the first fastener and with the second fastener, respectively, or lie in the end portions thereof.
  • the adjustment device is a component of the positioning device which is movable relative to the receptacle.
  • the adjusting device can be rotated for example by a Gleitreibterrorism in a ring of recording.
  • the adjusting device can optionally be moved continuously or by means of (one) latching movements relative to the receptacle.
  • the adjusting device can be determined or
  • the aiming device may be moved by means of the adjusting device in the receptacle.
  • the aiming device can be hollow (inside) (cylindrical) and continuous, so that, for example, a tissue protection sleeve and / or a
  • Instrument in particular a drill, can be inserted or inserted into the target device.
  • an instrument can be aligned with an intramedullary nail, a plate or another (bone) implant.
  • the aiming device may be a receptacle for an instrument.
  • the receptacle is integral with or integral with the
  • the second fastener of the plate holder has a cross section that is rectangular, non-round, non-circular, angular, triangular, etc.
  • the cross section may be configured as a combination of a round shape and a square shape and z.
  • the cross-sectional shape may preferably advantageously allow for unambiguous alignment between the second and third attachment means, be easy to insert, and / or ensure high rigidity and registration accuracy
  • Fastening device at least one step or a stop, which further or deeper insertion of the provided with the step or the stop
  • Fastening device in the other fastening device ie in the third or the second
  • the hole portion is configured and / or arranged such that a male portion "from below" and / or from the side of the hole portion facing the plate in use is inserted into the holes of the hole portion or has no screw connection.
  • the top edges and / or the bottom edges of all or some (preferably at least five) holes of the hole portion terminate with the top edge or the lower edge of the hole section.
  • these holes do not project beyond the upper and / or lower contacting or surrounding surface of the hole portion.
  • the holes can advantageously be made easily and the hole section advantageously easy to clean.
  • the holes of the hole portion are through holes. In others, they are blind holes, positioning aids, notches, fits, or the like.
  • the holes are receptacles, in particular for at least one insertion section, these receptacles are preferably designed according to one of the aforementioned embodiments. The hole section must therefore have no holes. He has in certain embodiments blind holes, positioning aids, notches, fits, or the like.
  • the hole portion is a receiving portion for receiving at least one insertion portion.
  • the male portion is a fixable slide or slide.
  • the hole portion is a rail or, preferably slotted, profile.
  • Adjustment means a structure with a closed circumference. This structure can rewrite a through hole. In this way, the rigidity of the
  • Positioning device and in particular of the hole portion to be increased advantageously.
  • the fastening portions mentioned herein may be connecting or joining portions. These two terms (attachment section on the one hand and connecting or joining section on the other hand) can thus be used interchangeably.
  • the first attachment portion and / or a screw used in or with it has means for preventing rotation between the disc and disc holder.
  • This device can be one or more parts. She can do one
  • the hole portion has marks of holes disposed on the upper side or the side of the hole portion facing away from the plate in use.
  • the receptacle a web connected thereto and in turn connected thereto, designed as a third fastening device,
  • the plate holder has one or more undercuts into which one or more portions of the plate are received in use.
  • the undercuts can be arranged in the region of the first fastening device or part thereof.
  • the hole portion and / or several or all of its holes have no sleeves.
  • the positioning device does not include and / or is not connected to a receptacle assembly.
  • the positioning device does not have a plug-in portion with which a guide arc would be connected to a receptacle assembly and / or sleeves. In some embodiments, the positioning device has no guide arc.
  • the plate holder is not bolted to the hole portion.
  • the plate holder is rather integral or integral with the hole portion.
  • the holes may for example be made in a simple manner, such as by being pushed into the material of the plate holder, lasered, etc.
  • the plate holder and / or the hole portion is multi-part, e.g. B. executed as a modular system.
  • different plate systems e.g for tibia, femur, humerus or other bones
  • plate lengths e.g. with seven holes, with nine holes or more
  • designs eg a left and a right variant
  • the positioning device is connected to a plate for osteosynthesis, the plate having a plurality of through holes for receiving one or more locking devices.
  • the depth of the passage openings corresponds in each case to a thickness of the plate, wherein a plurality of the holes are each assigned to one of the passage openings, thus, for example, exactly one hole (or more) to exactly one passage opening (or more).
  • the adjusting device is, in some embodiments, configured such that the aiming device received in the adjusting device is aligned and movable such that a locking device received in the aiming device or in the
  • Target device recorded instrument is movable, in particular under rewriting or within a cone sheath.
  • the apex comes within the depth of the through hole of that hole, in which the insertion portion is inserted, for lying.
  • the positioning device may be exemplary in some of the invention
  • Embodiments are referred to as monoaxial, when the positioning device is configured or set, the locking device, for.
  • the positioning device is configured or set, the locking device, for.
  • the plate may be polyaxial or monoaxial, or a combination thereof. The same may apply to the positioning device according to the invention.
  • the positioning device associated with the plate is configured or set to introduce the locking device, eg, a bone screw, at a plurality of angles, also called multidirectional, into a concrete through opening of the plate.
  • the locking device eg, a bone screw
  • the positioning device associated with the plate is configured or adjusted, the locking device, eg a bone screw, at only one angle into a concrete through-opening of the plate contribute.
  • the plate may be referred to as polyaxial in some exemplary embodiments of the invention when the positioning device is configured or adjusted, the locking means, e.g. B. bone screws, at more than one angle in the plate.
  • the locking means e.g. B. bone screws
  • the cross-sectional shape of some or the holes is oval, rectangular, non-round, non-circular, angular, triangular, etc. You can as a combination of a round shape and a square shape
  • the tip of the virtual or computationally determinable cone comes to rest on a longitudinal axis of the corresponding passage opening , so for example in the center of the hole in top view of the passage opening.
  • conical tip can also be understood to mean the intersection of two or more directions of insertion which can be achieved by moving the locking device by means of the adjusting device, and an actual conical shape is not essential here.
  • the cone may also be limited to a cutout / section in one or more directions, so z. B. have a non-continuous circumference. To this
  • the cone tip can optionally slidable / pivotable to the plate, z. B. along a slot on the bone plate, be.
  • One or more of the holes of the plate may be a slot, and / or a hole which does not have a round cross section.
  • the positioning device according to the invention can be used for minimally invasive introduction of the plate to a bone.
  • At least the plate and plate holder can be made of radiolucent materials, optionally also other or all other elements of the positioning device.
  • Individual elements or sections of individual elements can carry X-ray markers to make them visible by X-ray.
  • their positions and / or angles and / or orientation relative to one another or to the plate or to an anatomical structure eg bone, nerve, vessel, etc.
  • an anatomical structure eg bone, nerve, vessel, etc.
  • the target device can be configured pivotally relative to the hole portion.
  • An optional grid arrangement could facilitate or enable this.
  • An advantage that can be achieved hereby consists in requiring only one hole in the hole section for equipping or machining a plurality of through-holes.
  • the hole section can be made smaller, lighter and clearer.
  • some (preferably at least five) or all holes of the hole portion do not have a slotted edge.
  • the hole portion is not intended to be plugged and / or bolted to both the disc holder and the
  • the hole portion is not connected by insertion and / or screwing to both the disc holder and the receptacle (directly or indirectly).
  • the hole portion is not with the disk holder
  • the hole portion is integral with or integral with the Plate holder screwed. This can advantageously prevent unwanted relative movement, for example in a screw connection (not present here).
  • the hole portion not only has holes in, or in
  • the staggered holes of the hole portion form a series of holes arranged one behind the other.
  • the angle of the straight line on which this row lies, based on the longitudinal orientation of the hole section, in this embodiment purely by way of example has a value between 45 and 135 degrees, more preferably between 50 and 90 degrees, most preferably 60 degrees.
  • At least one hole, several arbitrary holes or all holes of the hole portion are designed rotationally secure.
  • a rotationally secure configuration does not allow rotation of, for example, a plug-in section, a pin or a third fastening device about its longitudinal axis.
  • Embodiment may have, for example, a hole cross-sectional shape with an asymmetrical, non-circular, oval, U-shaped, polygonal (eg., mecanicendreikantform, inner square shape, hexagon shape) and / or a hexalobular shape.
  • the contemplatsteckende element may have a corresponding cross-sectional shape.
  • at least one hole, any multiple holes or all holes of the hole portion are optionally not provided and configured to receive a target device or a protective sleeve.
  • Tissue protection sleeve on the other hand may differ from each other.
  • the longitudinal axes of the holes of the hole portion are arranged at least at least two holes parallel or non-parallel to each other.
  • the upper abutment surface or the upper edge lie at least one first hole of the hole portion at a different height on the
  • Hole portion and / or related to the hole portion as the upper stop surface or the upper edge of at least a second and / or a third hole of the hole portion.
  • Such different heights can ensure an identical spacing between holes of the hole section and associated holes of the plate.
  • different heights may help to feed holes of the plate by different instrumentation through different holes in the hole section, even if the different instruments require different spacing between the hole section hole and the hole in the plate.
  • Some or all embodiments according to the invention may have one, several or all of the advantages mentioned above and / or below.
  • the location and angle of holes for the locking screws and their location can advantageously be adjusted intraoperatively by means of the positioning device according to the invention to an individual, anatomical and / or arising from an injury situations.
  • the angle of the plate penetrating locking device herein: locking screws, Kirschner wire, etc.
  • instruments herein also: drill, trocar, dipstick, etc.
  • the positioning device can be reliably and easily releasably connected to the plate to be fixed.
  • the positioning device can be decoupled from the fixed plate and removed.
  • the positioning device according to the invention can advantageously ensure that the positioning device during screwing, or during the release of the screw, between the bone and plate, advantageously not rotate relative to the plate.
  • the positioning device can offer the possibility of minimally invasive implantation of polyaxial osteosynthesis plates.
  • the surgeon can by means of
  • the positioning device can be handled intuitively. To implement the instrument within the positioning advantageously only one step, namely the Umsteckens the plug-in section from one hole to another.
  • a display device optionally in combination with a marker, can advantageously assist the surgeon, especially during the minimally invasive implantation, in the orientation for addressing the desired through-openings for the locking screws.
  • the positioning device can advantageously allow a secure limitation of the angle when inserting the locking screws in the through holes and thus can prevent collisions of locking screws or locking screws and instrument, in particular drill.
  • the positioning device can allow a safe limitation of the angle when inserting the locking screws in the through hole and thus can ensure a fixed angle stable locking of the locking screws in the plate.
  • fragment movement may be favored.
  • Another advantage may be the visual feedback on the orientation of the target device.
  • the present invention allows a simple, angularly stable blocking the
  • Fig. 1 shows a positioning device according to the invention in a first exemplary
  • FIG. 2a-c show a disc holder of the positioning device according to the invention
  • FIG. 1 in different, perspective views
  • FIG. 3a-c show a receptacle with a fastening device, an adjusting device and a target device of the positioning device according to the invention Fig. 1;
  • Fig. 4a, b show the disc holder, the plate, the receptacle of Fig. 1 and in addition a
  • 5a-e show a positioning device according to the invention in a second
  • Fig. 6 shows a positioning device according to the invention in a third exemplary
  • Fig. 7 shows the disc holder with a display device in an exemplary
  • Fig. 8 shows the hole portion with a display device in another
  • Fig. 9a, b show a cannulated screw as an optional embodiment of the first
  • Fig. 10 shows a wire connection as an optional embodiment of the first
  • Figures 11a, b show a stapler with a locking pin as an example of a first attachment means of the disc holder with the plate;
  • Fig. 12a shows schematically simplified another plate holder with another
  • Fig. 12b shows a further arrangement of the holes in the hole portion opposite to
  • the positioning device 100 has a disc holder 200, which the Positioning device 100 with a plate 300 and / or a bone 400 connects.
  • the connection is optionally effected by means of an optionally cannulated screw 1 as a first fastening device (see FIGS. 9a and 9b).
  • the bone 400 is purely exemplary of a tibial bone.
  • plate 300 is bolted to bone 400 to stabilize a previous bone fracture and aid in the healing process.
  • the positioning device 100 serves to the
  • the disc holder 200 in this embodiment optionally has a second one
  • the hole section 3 can be made with the connecting web or other sections of the plate holder 200 to the (here: cannulated) screw 1, for example by means of a clamping connection, a solder joint, an adhesive connection, a screw connection, a plug connection or other connection or integrally.
  • the hole section 3 has a plurality of holes 3a, 3b, 3c (as well as further holes which are not individually numbered for clarity) for connection to a receptacle 5 for an adjustment device 7 with a sighting device 9.
  • the receptacle 5 comprises a web and designed as a third fastening device
  • Plug-in portion 1 which can be referred to as a pin (see Fig. 3a and 3b).
  • Insertion section 1 1 is inserted in one or more successively more of the holes 3a, 3b, 3c of the hole portion 3.
  • the disc holder 200 has a handle portion 13, with which the positioning device 100 can be manually guided, aligned and held.
  • tissue protection sleeve 37 In the target device 9 are purely exemplary a tissue protection sleeve 37 and a
  • Instrument 15 may be, for example, a drill for drilling in the bone 400 can. Subsequently, the plate 300 can be connected to and fixed to the bone 400 with screws which are screwed into the bores produced.
  • small foldable shoulders 17 can be arranged purely by way of example, which as a display device can indicate a processing state of the bores or screw connections in the bone 400.
  • a display device can indicate a processing state of the bores or screw connections in the bone 400.
  • the holes 3a, 3b, 3c have an asymmetrical cross-sectional shape (with reference to FIG. 1, it optionally has a flat, rear-side bore wall), so that the
  • Insert sections 1 1 in the holes 3a, 3b, 3c can not rotate.
  • the plate holder 200 has an optional above the cannulated screw 1
  • Kirschner wire can be introduced.
  • Positioning device 100 shown in various perspective views.
  • Fig. 2b optionally rectangular recesses 21 are shown, the optional for
  • Locking the user can be given an optical, tactile and / or acoustic feedback on the achievement of the correct and final position of the insertion portion 1 1 of the receptacle 5 in one of the holes 3a, 3b, 3c, etc. of the hole portion 3.
  • Fig. 2c is by means of the angle 23 and the lateral offset 25, and the
  • Fig. 3a shows a side view of a receptacle 5 with a sectional view of
  • an optional coil spring 27 Concentric about the aiming device 9, an optional coil spring 27 is arranged.
  • the coil spring 27 is inserted into an optional sleeve 29, which may be referred to as a nut.
  • the sleeve 29 is also a protection against unintentional jamming of possible components in or on the coil spring 27 as well as protection against contamination or injury.
  • Spiral spring 27 can by a with respect to the longitudinal axis of the coil spring 27 axial
  • Compression can be set and / or biased.
  • the coil spring 27 can be compressed while the pressure on an optional intermediate ring between the actuating pins 31 and the receptacle 5 are relieved.
  • the adjusting device 7 can be converted into a slightly or freely within the receptacle 5 movable state and the target device 9 on the
  • Hole section 3 an asymmetrical cross-sectional shape. Accordingly, the insertion portion 1 1 optionally also has such an asymmetrical cross-sectional shape. This can advantageously be a clear alignment, a simple introduction and a high rigidity and accuracy of fit of the recording 5 can be achieved.
  • the arrangement has a lock, which can be referred to as latch 33 on.
  • the latching device 33 can be embodied, for example, by an elastic plastic hook, which can be designated as a snap hook.
  • a corresponding unlocking device by means of a slide or the like may additionally be arranged on the receptacle 5.
  • this latching device 33 can be advantageously prevented accidental slipping out of the receptacle 5 during use of the positioning device.
  • by means of the latching device 33 is a unique and defined position of the target device 9 in the receptacle 5 or based on this possible.
  • FIG. 3b shows the receptacle 5 with the insertion portion 1 1 in a perspective view.
  • FIG. 3c shows the half-section view of the adjusting device 7, the aiming device 9 with further components shown in FIG. 3a, in a side view.
  • Fig. 4a shows the disc holder 200, the plate 300, the receptacle 5 and an optional
  • a tissue protection sleeve 37 (see Fig. 4b) and in this tissue protection sleeve 37, a rod (not shown in Fig. 4a and 4b) are inserted against the plate 300 for supporting.
  • a tissue protection sleeve 37 see Fig. 4b
  • a rod (not shown in Fig. 4a and 4b) are inserted against the plate 300 for supporting.
  • This may be necessary and advantageous if the embodiment of the hole portion 3 has numerous holes 3a, 3b, 3c, as shown here, resulting in a relatively long hole portion 3. If then a hole at a distant hole, based on the distance between the
  • Supporting device 35 and a rod inserted therein a support of the plate holder 200 is achieved and a precise bore can be made possible.
  • the support device 35 can be used as a receptacle 5.
  • the supporting device 35 may, for example, a target device 9 (instead of a
  • Tissue protection sleeve 37 Tissue protection sleeve 37.
  • Fig. 4b shows a similar arrangement as shown in Fig. 4a, in another
  • FIGS. 5a to 5e show a further, second embodiment of the positioning device 100 according to the invention compared to the first embodiment from FIGS. 1 to 4.
  • Fig. 5a shows the positioning device 1 00, connected to the plate 300 and the bone 400. The connection is implemented by means of the cannulated screw 1 as a fastening device.
  • the receptacle 5 additionally in an integral
  • Fastening device here as a plug pin 41, plugged or connected to this.
  • the depressions 39 are concealed in the view in FIG. 5a and are not visible and can be clearly seen only in FIG. 5c.
  • the pin 41 is also not visible in Fig. 5a and shown clearly visible in Fig. 5e.
  • the recesses 39 are marked on the visible in Fig. 5a top with marks S1 to S10 and K1 to K3 to a clear assignment to the holes to be drilled in the bone 400 and
  • Fig. 5b shows the arrangement of Fig. 5a, supplemented by the adjusting device 7, the
  • Fig. 5c shows the receptacle 5, relative to the view of Fig. 5a rotated by 180 degrees, so that the recesses 39 are visible for connecting or plugging onto the socket pin 41.
  • FIG. 5d shows the receptacle 5 in the view from FIG. 5a.
  • Fig. 5e shows the disc holder 200 with the locking pin 41st
  • the plate holder 200 can be connected to the plate 300 by means of the cannulated screw 1 (see Figs. 9a and 9b).
  • FIG. 6 shows a positioning device 100 according to the invention in a third exemplary embodiment. Not shown is the plate holder 200.
  • the hole portion 3 comprises, similar to the first embodiment shown in Fig. 1 holes for inserting the receptacle 5.
  • the receptacle 5 is compared to the first and the second embodiment strong has been simplified.
  • the receptacle 5 and the adjusting device 7 have been functionally integrated in one component.
  • the aiming device 9 can be moved in the adjusting device 7.
  • the receptacle 5 or the adjusting device 7 can in the holes of the
  • Hole section 3 are rotated.
  • Instrument 15 in the tissue protection sleeve 37 aligned with the corresponding holes in the plate 300 and drilled into the bone 400.
  • FIG. 7 shows the plate holder 200 (as shown, for example, in FIG. 2) with a display device in the form of optional rings 45.
  • the rings 45 are axially (in the longitudinal direction of the holes) displaceable elements, which may optionally be configured as sleeves or rings.
  • the ring 45 shifts from top to bottom (relative to the view in Fig. 7). This ring position is maintained, even if the receptacle 5 is pulled out after drilling into the bone 400 again.
  • a ring 45 which is now arranged in the second position, ie below, indicates that a hole or screwing into the bone 400 has already taken place through this hole in the hole section 3.
  • the rings 45 may be marked multi-colored for better visibility, such as red for "already used” and green for "not used yet”.
  • FIG. 8 shows the hole section 3 with another pin 47
  • the display is made whether z. B. a hole through this hole has already been made, not by a sliding ring 45 as in the
  • FIG. 9a shows a cannulated screw 1 as the first fastening device (or counterpart thereto) of the plate holder 200 with the plate 300.
  • FIG. 9b shows an instrument 15 introduced into the cannulated screw 1, in particular a drill.
  • the cannulated screw 1 is designed funnel-shaped inside. This may be advantageous for drilling at a desired angle to fix the corresponding screw through the plate 300 into the bone 400 in exactly that position. Such a position may be necessary, for example, by the bone anatomy.
  • the first attachment device of plate holder 200 with plate 300 is a wire connection in this embodiment.
  • the wire connection comprises a wire 49 which is wound around the plate 300 and around the plate holder 200 and thus the
  • Plate holder 200 fixed to the plate 300.
  • Fig. 11a shows another alternative embodiment of fixing the plate holder 200 to the plate 300.
  • the first attachment means of the plate holder 200 with the plate 300 in this embodiment is a stapling device with a bracket 51 and a pin 53.
  • the pin 53 can act as a locking pin or be designated as a safety pin.
  • the clamp 51 is pushed onto the plate 300 (from the narrow to the wider cross section) and fixed by means of the pin 53 to the plate 300. Then the holes can be drilled.
  • FIG. 11b shows the clamp 51 pushed onto the plate 300 from below, ie rotated by 180 degrees relative to the view in FIG. 11a.
  • Fig. 12a shows schematically simplified another plate holder 200 according to the invention with a further hole section 3 with holes 3a, 3b, 3c. 3d, 3e, 3f.
  • receptacle 5 and an optional support device 35 are not shown, as shown for example in Fig. 4a.
  • the disc holder 200 includes a first attachment means 1 for releasably securing the disc holder 200 to the disc 300.
  • the hole section 3 in FIG. 12 not only has holes, approximately 3 a, 3 b, 3 c, in, or substantially in, the longitudinal direction of the hole section 3, but also holes 3d, 3e, 3f, which are transversely offset with respect to the longitudinal direction of the hole portion 3.
  • Fixed and screwed plates 300 which also have with respect to the longitudinal direction of the plate 300 transversely offset holes 302, 304, 306 of the plate 300.
  • the staggered holes 3d, 3e, 3f form a series of holes 3d, 3e, 3f arranged one behind the other.
  • the angle of the straight line on which this row lies, based on the longitudinal orientation of the hole section 3, in this embodiment, purely by way of example, has a value of approximately 60 degrees.
  • a rotationally secure configuration does not allow rotation of, for example, a plug-in section, a pin or a third fastening device 11, as shown by way of example in FIGS. 3a and 3b, about its longitudinal axis.
  • a rotationally secure configuration can be, for example, a hole cross-sectional shape with an asymmetrical, non-circular, oval, u-shaped,
  • the dormitory element can have polygonal (eg., formerlyendreikantform, inner square shape, hexagon shape) and / or a hexalobular shape.
  • the protagonist can a
  • the holes 3a, 3b, 3c, 3d, 3e, 3f, at least one hole, any multiple holes or all holes, are optionally not intended and designed to be a target device 9 or a protective sleeve 37, as shown in Figs Fig. 4b are shown to record.
  • the longitudinal axes of the holes 3a, 3b, 3c, 3d, 3e, 3f, at least of at least two arbitrary holes 3a, 3b, 3c, 3d, 3e, 3f, may be parallel or non-parallel to one another.
  • non-parallel axes from holes 3a, 3b, 3c, 3d, 3e, 3f to corresponding non-parallel axes of holes 301, 302, 303, 304, 305, 306 may be associated with a plate 300, around the plate 300 by screws to be able to fix. This assignment can be made, for example, by means of the receptacle 5 (see FIG. 1).
  • Particular embodiments of long bone plates 300 may include such non-parallel ones Have axes of holes 301, 302, 303, 304, 305, 306.
  • the holes 3a, 3b, 3c, 3d, 3e, 3f, at least at least two arbitrary holes 3a, 3b, 3c, 3d, 3e, 3f may be at different heights, for example at their upper abutment surface or at the upper edge of the respective hole 3a, 3b, 3c, 3d, 3e, 3f. Such different heights are shown by way of example in FIG. These different heights can correspond to different heights of corresponding holes 301, 302, 303, 304, 305, 306 of a plate 300.
  • a receptacle 5 can be inserted and / or fixed in a hole 3a, 3b, 3c, 3d, 3e, 3f by means of a pin 11, so that a screw can be inserted directly into a matching hole 301, 302, 303, 304, 305, 306 of the plate 300 or in the bone can be screwed. If the further holes 3a, 3b, 3c, 3d, 3e, 3f are already arranged and configured so that they also correspond directly to the corresponding holes of the 301, 302, 303, 304, 305, 306 of the plate 300, a fast Screwing the plate done. This advantageously allows a short duration of operation. A short duration of surgery can improve the patient's healing process and / or reduce the cost of the surgery.
  • FIG. 12b shows a further arrangement of the holes 3a, 3b, 3c, 3d, 3e, 3f in the hole section 3 compared to the embodiment in FIG. 12a.
  • the holes 3d, 3e, 3f are at a different position of the hole section 3 and in another Angle arranged.

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  • 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)
  • Neurology (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un dispositif de positionnement (100) comprenant un support de plaque (200), un premier moyen de fixation (1) destiné à fixer de manière amovible le support de plaque (200) à la plaque (300) et un deuxième moyen de fixation (3) ; un logement (5) destiné à un dispositif de réglage (7), le dispositif de réglage (7) comportant au moins un dispositif de visée (9), et le dispositif de visée (9) étant conçu pour recevoir, au moins par endroits, un dispositif de verrouillage et/ou un instrument (15) destiné à agir sur le dispositif de verrouillage ; le logement (5) comportant au moins un troisième dispositif de fixation (11) ou étant relié à celui-ci ; un élément du groupe, comprenant le deuxième moyen de fixation (3) et le troisième moyen de fixation (11), étant configuré comme une partie perforée (3) comportant une pluralité de trous (3a, 3b, 3c), et l'autre élément du groupe étant conçu comme une partie enfichable (11), la partie enfichable (11) et les trous (3a, 3b, 3c) étant conçus pour relier de manière amovible le deuxième moyen de fixation (3) au troisième moyen de fixation (11).
EP18779569.5A 2017-09-13 2018-09-12 Dispositif de positionnement pour fixer une plaque polyaxiale à un os tubulaire au moyen d'une partie perforée Pending EP3681417A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102017121242.6A DE102017121242A1 (de) 2017-09-13 2017-09-13 Positioniervorrichtung zum Fixieren einer polyaxialen Platte an einem Röhrenknochen mittels Löcherabschnitts
PCT/EP2018/074617 WO2019053065A1 (fr) 2017-09-13 2018-09-12 Dispositif de positionnement pour fixer une plaque polyaxiale à un os tubulaire au moyen d'une partie perforée

Publications (1)

Publication Number Publication Date
EP3681417A1 true EP3681417A1 (fr) 2020-07-22

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Application Number Title Priority Date Filing Date
EP18779569.5A Pending EP3681417A1 (fr) 2017-09-13 2018-09-12 Dispositif de positionnement pour fixer une plaque polyaxiale à un os tubulaire au moyen d'une partie perforée

Country Status (5)

Country Link
US (1) US11389218B2 (fr)
EP (1) EP3681417A1 (fr)
CN (1) CN111107797A (fr)
DE (1) DE102017121242A1 (fr)
WO (1) WO2019053065A1 (fr)

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US11517358B2 (en) * 2019-10-02 2022-12-06 Arthrex, Inc. Interfragmentary guide and plate system
CN112535524B (zh) * 2020-12-02 2022-03-08 中国科学院大学宁波华美医院 一种胫骨平台塌陷复位装置

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DE20013900U1 (de) 2000-08-11 2001-06-28 Schindler Christoph Zerlegbares Möbelstück
US20050049594A1 (en) 2001-04-20 2005-03-03 Wack Michael A. Dual locking plate and associated method
US8118810B2 (en) * 2006-01-17 2012-02-21 Stryker Trauma Gmbh Targeting device for bone implant
ES2344595T3 (es) 2006-01-17 2010-09-01 Stryker Trauma Gmbh Sistema medico y piezas del sistema para ajustar espacialmente un dispositivo de guiado respecto a un implante corporal.
DE102006016213B4 (de) 2006-04-03 2019-07-04 Aesculap Ag Chirurgische Verbindungsvorrichtung und chirurgische Vorrichtung
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EP3169254B1 (fr) * 2014-07-15 2020-11-18 OT Medizintechnik GmbH Dispositif de positionnement pour fixer un clou intramédullaire dans un os long
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DE102015117884B4 (de) * 2015-10-21 2019-05-23 Ryszard van Rhee Fixiervorrichtung zur unterstützten Handhabung und Befestigung operativ therapeutischer Platten zur weniger invasiven operativen Versorgung des Hallux valgus
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EP3422975B1 (fr) * 2016-03-01 2020-10-14 OT Medizintechnik GmbH Dispositif de positionnement pour fixer une plaque polyaxiale sur un os long
DE102016103681A1 (de) * 2016-03-01 2017-09-07 Ot Medizintechnik Gmbh Positioniervorrichtung zum Fixieren einer polyaxialen Platte an einem Röhrenknochen

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Publication number Publication date
DE102017121242A1 (de) 2019-03-14
US20200261129A1 (en) 2020-08-20
CN111107797A (zh) 2020-05-05
US11389218B2 (en) 2022-07-19
WO2019053065A1 (fr) 2019-03-21

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