FR2809300A1 - Surgical fracture reduction screw has conical shank with variable pitch self tapping thread - Google Patents

Surgical fracture reduction screw has conical shank with variable pitch self tapping thread Download PDF

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Publication number
FR2809300A1
FR2809300A1 FR0006728A FR0006728A FR2809300A1 FR 2809300 A1 FR2809300 A1 FR 2809300A1 FR 0006728 A FR0006728 A FR 0006728A FR 0006728 A FR0006728 A FR 0006728A FR 2809300 A1 FR2809300 A1 FR 2809300A1
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FR
France
Prior art keywords
thread
screw
screw according
proximal end
axial support
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Granted
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FR0006728A
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French (fr)
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FR2809300B1 (en
Inventor
Robert Py
Jacques Teissier
Yves Jacob
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SARL BIO SUPPLY
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SARL BIO SUPPLY
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Priority to FR0006728A priority Critical patent/FR2809300B1/en
Publication of FR2809300A1 publication Critical patent/FR2809300A1/en
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/8625Shanks, i.e. parts contacting bone tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/8625Shanks, i.e. parts contacting bone tissue
    • A61B17/863Shanks, i.e. parts contacting bone tissue with thread interrupted or changing its form along shank, other than constant taper

Abstract

Screw has a conical shank (2) with self tapping thread (16) and a main thread (4) which has variable pitch. The surfaces of the main thread are concave with a radius of curvature having a value greater than the outer median outer diameter (DO) of the shank. The concave profile of alignment surfaces of the shank are exempted from variations in flexion to separate them from the upper thread surfaces (8) which axially retain the screw in the bone.

Description

<B>VIS A USAGE CHIRURGICAL POUR LA</B> REDUCTION <B>DES FRACTURES NON</B> DEPLACEES. L'invention est du domaine des implants chirurgicaux, et elle a pour objet une vis à usage chirurgicale plus particulièrement destinée à la réduction des fractures non déplacées de petits os, tels que calcanéum, scaphoïde ou phalange. <B> SURGICAL SCREWS FOR <B> REDUCTION <B> OF NON </ B> FRACTURES DISPLACED. The invention is in the field of surgical implants, and it relates to a screw for surgical use more particularly for the reduction of non-displaced fractures of small bones, such as calcaneus, scaphoid or phalanx.

On connaît des implants chirurgicaux organisés en vis, pour la réduction de fractures non déplacées. On pourra notamment se reporter aux brevets W089109030 (AESCULAP), W093!00518 (MATHYS) et W094116636 (HUEBNER) qui décrivent des vis du genre. Visible surgical implants are known for the reduction of non-displaced fractures. In particular, reference may be made to patents WO89109030 (AESCULAP), WO93 / 00518 (MATHYS) and WO94116636 (HUEBNER) which describe screws of the kind.

L'implantation de telles vis pose le problème des dommages causés à l'os qui les reçoit. Ces dommages sont d'autant plus important que pour obtenir une réduction satisfaisante de la fracture, il est nécessaire que les parties correspondantes de l'os soient maintenues durablement en appui l'une contre l'autre, et donc que le serrage opéré par la vis soit important et fiable. De surcroît, la vis implantée est amenée à être retirée après consolidation de l'os ou pour des interventions successives, ce qui tend à accroître la détérioration de l'os. Par ailleurs, la présence d'espaces éventuels entre le filet et !'évidemment de l'os qui reçoit la vis, induit la formation de zones de rétention favorables à une colonisation osseuse inopportune, qui tend à faire obstacle à un retrait ultérieur de la vis et de ce fait à provoquer des arrachements osseux. II en découle qu'un problème général à résoudre dans la conception des vis pour la réduction des fractures non déplacées, réside dans le choix intuitif d'un compromis entre une structure de la vis favorisant son efficacité et sa fiabilité d'une part, et la facilité de son implantation et de son extraction d'autre part, avec un minimum de dommages pour l'os. The implantation of such screws poses the problem of damage to the bone that receives them. This damage is all the more important that to obtain a satisfactory reduction of the fracture, it is necessary that the corresponding parts of the bone are held sustainably against each other, and therefore that the tightening effected by the screw is important and reliable. In addition, the implanted screw is caused to be removed after consolidation of the bone or for successive interventions, which tends to increase the deterioration of the bone. Furthermore, the presence of possible gaps between the net and the obvious bone receiving the screw, induces the formation of retention zones favorable to untimely bone colonization, which tends to hinder a subsequent withdrawal of the bone. screw and thereby cause bone pulling. It follows that a general problem to be solved in the design of the screws for the reduction of non-displaced fractures lies in the intuitive choice of a compromise between a structure of the screw favoring its efficiency and its reliability on the one hand, and the ease of implantation and extraction on the other hand, with minimal damage to the bone.

Le but de la présente invention est de proposer une vis pour la réduction des fractures non déplacées, dont la structure réponde au mieux à sa fonction avec une détérioration minimale de l'os. Un autre but de l'invention est de proposer une telle vis dont la structure lui confère en outre la faculté de participer à l'implantation percutanée de broches. La présente invention va être décrite en relation avec une forme préférée de réalisation illustrée sur les figures de la planche annexée, dans laquelle - les fig.1 et fig.2 sont des exemples d'applications d'une vis de l'invention, respectivement à la réparation d'une fracture de malléole et à la synthèse d'un scaphoïde, - la fig.3 est une illustration de profil en vue partiellement écorchée d'une vis selon une forme préférée de réalisation de l'invention, - la fig.4 est un détail de la vis représentée sur la fig.1, illustrant le profil de son filet. The object of the present invention is to provide a screw for the reduction of non-displaced fractures, whose structure best meets its function with minimal deterioration of the bone. Another object of the invention is to provide such a screw whose structure also gives it the faculty to participate in the percutaneous implantation of pins. The present invention will be described in connection with a preferred embodiment illustrated in the figures of the attached plate, in which - fig.1 and fig.2 are examples of applications of a screw of the invention, respectively the repair of an malleolus fracture and the synthesis of a scaphoid, - fig.3 is a profile illustration in partially cutaway view of a screw according to a preferred embodiment of the invention, - fig .4 is a detail of the screw shown in Fig.1, illustrating the profile of its net.

- la fig.5 est une vue du bout proximal de la vis illustrée sur la fig.1. FIG. 5 is a view of the proximal end of the screw illustrated in FIG.

On comprendra par extrémité distale 12 de la vis l'extrémité du corps 2 prévue pour être premièrement introduite à l'intérieur de l'os, par opposition à l'autre extrémité 14 du corps, dite corrélativement proximale. It will be understood by distal end 12 of the screw the end of the body 2 intended to be first introduced into the interior of the bone, as opposed to the other end 14 of the body, said correlatively proximal.

On rappelle qu'une vis est un corps de révolution 2 qui comporte à sa périphérie une partie saillante en hélice, ou filet 4, et qui est équipé d'un organe 6 d'entraînement en rotation autour de son axe A de révolution. Le filet 4 de la vis est enroulé en hélice à la surface extérieure du corps 2, et comporte des surfaces composées de surfaces 8 d'appui axial du corps 2 contre l'os, et de surfaces 10 de centrage du corps à l'intérieur de l'os. On notera que selon certaines variantes de réalisation, ces surfaces 8 et 10 comportent des zones communes. Le pas P du filet 4 est la distance axiale séparant deux de ses crêtes 22 voisines ; le profil du filet est défini par sa conformation entre deux de ses crêtes 22 voisines. It is recalled that a screw is a body of revolution 2 which comprises at its periphery a protruding part in a helix, or thread 4, and which is equipped with a member 6 driving in rotation about its axis A of revolution. The thread 4 of the screw is wound helically to the outer surface of the body 2, and comprises surfaces composed of surfaces 8 of axial support of the body 2 against the bone, and surfaces 10 of centering the body inside. of the bone. Note that according to some embodiments, these surfaces 8 and 10 comprise common areas. The pitch P of the thread 4 is the axial distance separating two of its neighboring ridges 22; the profile of the net is defined by its conformation between two of its neighboring ridges 22.

La démarche inventive de la présente invention a consisté à proposer une vis pour la réduction des fractures non déplacées qui comportent les caractéristiques suivantes, prises seules ou en combinaison 1) Le corps 2 a une conformation conique évasée vers son extrémité proximale, avec notamment une pente a de l'ordre comprise entre 3% et 6%. De plus, le corps 2 est de préférence pourvu à son extrémité distale d'un agencement autotaraudant 16. Ces dispositions visent à faciliter l'introduction de la vis dans l'os avec un minimum de dommage pour celui-ci. The inventive step of the present invention has been to provide a screw for the reduction of non-displaced fractures which have the following characteristics, taken alone or in combination 1) The body 2 has a conical conformation flared towards its proximal end, including a slope is in the range of 3% to 6%. In addition, the body 2 is preferably provided at its distal end with a self-tapping arrangement 16. These provisions are intended to facilitate the introduction of the screw into the bone with a minimum of damage to it.

2) Le pas P du filet 4 est variable avec une diminution progressive vers l'extrémité proximale 14 du corps 2 (21>P2), incrémentée entre deux pas P voisins d'une valeur préférentiellement comprise entre 0,5% et 1,5%. La variation du pas P du filet 4 offre l'avantage de favoriser la mise en compression l'une contre l'autre des parties de l'os à assembler, pour l'obtention d'un serrage important entre ces dernières. 2) The pitch P of the net 4 is variable with a gradual decrease towards the proximal end 14 of the body 2 (21> P2), incremented between two adjacent pitches P with a value preferably between 0.5% and 1.5 %. The variation of the pitch P of the thread 4 offers the advantage of favoring the compression of the parts of the bone to be joined together, in order to obtain a significant tightening between the latter.

3) Les surfaces 10 du filet 4, de centrage du corps 2, sont globalement concaves avec un rayon R1 de courbure d'une valeur supérieure au diamètre extérieur moyen DO du corps 2, de telle sorte que le profil concave des surfaces 10 de centrage du corps soit exempt d'un changement d'inflexion de ces dernières, pour les rendre distinctes des surfaces 8 d'appui axial du corps. On notera que la valeur du rayon R1 est préférentiellement comprise entre 2 à 4 fois la valeur du diamètre moyen DO du corps 2. 3) The surfaces 10 of the thread 4, centering the body 2, are generally concave with a radius R1 of curvature greater than the average outside diameter OD of the body 2, so that the concave profile of the centering surfaces 10 the body is free of a change of inflection of the latter, to make them distinct from the surfaces 8 of axial support of the body. It will be noted that the value of the radius R1 is preferably between 2 and 4 times the value of the average diameter OD of the body 2.

On comprendra par diamètre moyen DO du corps 2 le diamètre de ce dernier pris au voisinage de sa zone axialement médiane. It will be understood by the average diameter OD of the body 2 the diameter of the latter taken in the vicinity of its axially median zone.

4) Les surfaces 8 du filet 4, d'appui axial du corps 2, sont globalement inclinées par rapport à l'axe géométrique A de rotation de ce dernier, en étant orientées vers l'extrémité proximale 14 du corps 2, et sont éventuellement convexes avec notamment un rayon de courbure R2 d'une valeur comprise entre 1 à 4 fois la valeur du diamètre moyen DO du corps 2. Ces dispositions permettent d'éviter la formation d'une zone de colonisation osseuse en fond 20 de filet. 4) The surfaces 8 of the thread 4, axial support body 2, are generally inclined relative to the geometric axis A of rotation of the latter, being oriented towards the proximal end 14 of the body 2, and are optionally convexes including a radius of curvature R2 of a value between 1 to 4 times the value of the mean diameter OD of the body 2. These provisions prevent the formation of a bone colonization area in the bottom of net.

On comprendra que le cas échéant les rayons R1 et R2, bien que relevant d'une même plage de valeur par rapport au diamètre DO du corps 2 peuvent, selon diverses variantes, soit être d'une valeur différente avec de préférence R2 < R1, soit être d'une valeur identique. On relèvera la forme préférée de réalisation illustrée sur les figures, selon laquelle le profil du filet 4 comporte en combinaison une surface 10 de centrage et une surface 8 d'appui axial du corps 2 qui sont distinctes l'une de l'autre en étant séparées par des arrêtes vives 20 et 22 correspondantes respectivement au fond et au sommet du filet 4, les tangentes respectives T1 et T2 des surfaces de centrage 10 et d'appui axial 8 à leur zone de jonction en fond 20 de filet formant entre elles un angle ouvert B. It will be understood that, if appropriate, the radii R1 and R2, although falling within one and the same range of values with respect to the diameter OD of the body 2, may, in various variants, be of a different value, preferably with R2 <R1, be of identical value. It will be noted the preferred embodiment illustrated in the figures, according to which the profile of the thread 4 comprises in combination a centering surface 10 and an axial bearing surface 8 of the body 2 which are distinct from one another by being separated by sharp edges 20 and 22 respectively corresponding to the bottom and the top of the thread 4, the respective tangents T1 and T2 of the centering surfaces 10 and axial support 8 at their junction zone 20 net forming between them a open angle B.

Les caractéristiques susvisées du profil du filet 4, associées avec celles relatives à la conformation conique du corps, à l'agencement autotaraudant de son extrémité proximale et à la variation du pas du filet, permettent de limiter l'impact de la vis à l'intérieur de l'os, sans pour autant porter atteinte à la robustesse de la liaison entre eux. The aforementioned characteristics of the profile of the thread 4, associated with those relating to the conical conformation of the body, to the self-tapping arrangement of its proximal end and to the variation of the pitch of the thread, make it possible to limit the impact of the screw to the inside the bone, without compromising the strength of the connection between them.

En outre, ces caractéristiques évitent les effets d'arrachement d'os lors du retrait de la vis, grâce au marquage de l'os par la vis elle-même sans pour autant induire un risque de formation de zone de rétention. In addition, these features avoid the effects of bone tearing during removal of the screw, through the marking of the bone by the screw itself without inducing a risk of formation of retention zone.

5) L'organe 6 d'entraînement en rotation du corps 2 est constitué par un relief en creux de forme polygonale, hexagonale plus particulièrement, pour faciliter sa prise et sa manoeuvre par le praticien au moyen d'un outil de forme correspondante. 5) The body 6 for rotating the body 2 is constituted by a hollow recess of polygonal shape, hexagonal more particularly, to facilitate its grip and maneuver by the practitioner by means of a tool of corresponding shape.

6) Le corps 2 comporte un évidemment axial interne 24, pour recevoir en contact glissant une partie allongée correspondante de l'outil d'entraînement en rotation de la vis, afin de favoriser le guidage de cette dernière lors de sa pénétration dans l'os. Par ailleurs, cet évidemment axial 24 du corps 2, qui est débouchant à chacune de ses extrémités, constitue en outre et avantageusement un organe de guidage d'une broche en vue de l'implantation percutanée de cette dernière, conférant de ce fait une fonction supplémentaire à la vis de l'invention. 6) The body 2 comprises an internal axial recess 24, to receive in sliding contact a corresponding elongated portion of the screw driving tool in order to promote the guidance of the latter during its penetration into the bone . Furthermore, this axial recess 24 of the body 2, which is opening at each of its ends, is further and advantageously a guide member of a spindle for the percutaneous implantation of the latter, thereby conferring a function additional to the screw of the invention.

7) le bout proximal du corps 2 est à arrête 26 arrondie depuis la crête 22 située à l'extrémité proximale du filet 4, pour exempter la vis d'un débordement radial inopportun au-delà du filet 4.7) the proximal end of the body 2 is stopped 26 rounded from the crest 22 located at the proximal end of the thread 4, to exempt the screw from an undesirable radial overflow beyond the thread 4.

Claims (1)

<B><U>REVENDICATIONS</U></B> 1.- Vis à usage chirurgical plus particulièrement destinée à la réduction des fractures non déplacées, du genre de vis constituée d'un corps de révolution (2) qui comporte à sa périphérie une partie saillante en hélice, ou filet (4), et qui est équipé d'un organe (6) d'entraînement en rotation autour de son axe A de révolution, le filet (4) comportant des surfaces composées de surfaces (8) d'appui axial du corps (2) contre l'os et de surfaces (10) de centrage du corps (2) à l'intérieur de l'os, le pas P du filet (4) étant variable avec une diminution progressive vers l'extrémité proximale (14) du corps (2), ce dernier ayant une conformation conique évasée vers son extrémité proximale et étant pourvu à son extrémité distale d'un agencement autotaraudant (16), caractérisée en ce que les surfaces de centrage (10) du corps (2) sont globalement concaves avec un rayon R1 de courbure d'une valeur supérieure au diamètre extérieur moyen DO du corps (2), de telle sorte que le profil concave des surfaces (10) de centrage du corps (2) soit exempt d'un changement d'inflexion de ces dernières (10), pour les rendre distinctes des surfaces (8) d'appui axial du corps (2) ; 2.- Vis selon la revendication 1, caractérisée en ce que les surfaces (8) d'appui axial du corps (2) sont globalement inclinées par rapport à l'axe géométrique A de rotation de ce dernier, en étant orientées vers l'extrémité proximale du corps (2) ; 3.- Vis selon la revendication 2, caractérisée en ce que les surfaces (8) d'appui axial du corps (2) sont convexes ; 4.- Vis selon la revendication 1 et l'une quelconque des revendications 2 et 3, caractérisée en ce que les surfaces de centrage (10) et d'appui axial (8) du corps (2) sont séparées par des arrêtes vives (20,22) correspondantes respectivement au fond et au sommet du filet (4), les tangentes respectives T1 et T2 des surfaces de centrage (10) et d'appui axial (8) à leurs zones de jonction en fond (20) de filet formant entre elles un angle ouvert B ; 5.- Vis selon l'une quelconque des revendications précédentes, caractérisée en ce que l'organe (6) d'entraînement en rotation du corps (2) est constitué par un relief en creux de forme polygonale<B>;</B> 6.- Vis selon l'une quelconque des revendications précédentes, caractérisée en ce que le corps (2) comporte un évidemment axial interne (24); 7.- Vis selon la revendication 6, caractérisée en ce que le dit évidemment axial (24) est débouchant à chacune de ses extrémités pour constituer un organe de guidage d'une broche en vue de l'implantation percutanée de cette dernière ; 8.- Vis selon l'une quelconque des revendications précédentes, caractérisée en ce que le bout proximal du corps (2) est à arrête (26) arrondie depuis la crête (22) située à l'extrémité proximale du filet.1.-Screws for surgical use more particularly intended for the reduction of non-displaced fractures, of the kind of screw constituted by a body of revolution (2) which comprises at least its periphery a helically protruding part, or thread (4), and which is equipped with a member (6) driving in rotation about its axis A of revolution, the thread (4) having surfaces composed of surfaces ( 8) of axial support of the body (2) against the bone and of surfaces (10) for centering the body (2) inside the bone, the pitch P of the thread (4) being variable with a decrease progressive to the proximal end (14) of the body (2), the latter having a conical conformation flared towards its proximal end and being provided at its distal end with a self-tapping arrangement (16), characterized in that the centering surfaces (10) of the body (2) are generally concave with a radius R1 of curvature greater than the diameter external mean OD of the body (2), so that the concave profile of the centering surfaces (10) of the body (2) is free of a change in inflection of the latter (10), to make them distinct from the surfaces (8) axial support of the body (2); 2. Screw according to claim 1, characterized in that the surfaces (8) of axial support of the body (2) are generally inclined relative to the geometric axis A of rotation of the latter, being oriented towards the proximal end of the body (2); 3. Screw according to claim 2, characterized in that the surfaces (8) of axial support of the body (2) are convex; 4. Screw according to claim 1 and any one of claims 2 and 3, characterized in that the centering surfaces (10) and axial support (8) of the body (2) are separated by sharp edges ( 20,22) respectively corresponding to the bottom and the top of the thread (4), the respective tangents T1 and T2 of the centering surfaces (10) and axial support (8) to their junction areas bottom (20) net forming between them an open angle B; 5. Screw according to any one of the preceding claims, characterized in that the member (6) for driving the body (2) in rotation is constituted by a recessed relief of polygonal shape <B>; </ B 6. A screw according to any one of the preceding claims, characterized in that the body (2) comprises an internal axial recess (24); 7. Screw according to claim 6, characterized in that said obviously axial (24) is opening at each of its ends to form a guide member of a spindle for the percutaneous implantation of the latter; 8. Screw according to any one of the preceding claims, characterized in that the proximal end of the body (2) is stopped (26) rounded from the ridge (22) located at the proximal end of the net.
FR0006728A 2000-05-26 2000-05-26 SURGICAL SCREWS FOR REDUCING NON-DISPLACED FRACTURES Expired - Fee Related FR2809300B1 (en)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004089255A1 (en) * 2003-04-10 2004-10-21 Synthes Ag Chur Device for the temporary splinting of toes

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1989009030A1 (en) 1988-04-02 1989-10-05 Aesculap Ag Bone screw
WO1993000518A1 (en) 1991-06-25 1993-01-07 Synthes Ag, Chur Fastening element
WO1994016636A1 (en) 1993-01-21 1994-08-04 Huebner Randall J Tapered bone screw with continuously varying pitch
US5891146A (en) * 1997-10-15 1999-04-06 Applied Biological Concepts, Inc. Wedge orthopedic screw

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1989009030A1 (en) 1988-04-02 1989-10-05 Aesculap Ag Bone screw
WO1993000518A1 (en) 1991-06-25 1993-01-07 Synthes Ag, Chur Fastening element
WO1994016636A1 (en) 1993-01-21 1994-08-04 Huebner Randall J Tapered bone screw with continuously varying pitch
US5891146A (en) * 1997-10-15 1999-04-06 Applied Biological Concepts, Inc. Wedge orthopedic screw

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
BELLOLI D M ET AL: "A BIOMECHANICAL COMPARISON BETWEEN HERBERT AND 4.0 CANCELLOUS SCREWS", PROCEEDINGS OF THE ANNUAL INTERNATIONAL CONFERENCE OF THE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY,US,NEW YORK, IEEE, vol. CONF. 9, 13 November 1987 (1987-11-13), pages 1725 - 1726, XP000040854 *

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2004089255A1 (en) * 2003-04-10 2004-10-21 Synthes Ag Chur Device for the temporary splinting of toes
US8672986B2 (en) 2003-04-10 2014-03-18 DePuy Synthes Products, LLC Device for temporarily splinting toes

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