FR2860420A1 - Osteosynthesis device for repairing or compacting femur bone, has guiding unit mounted on osteosynthesis connection unit in removable manner and, after installation, guiding anchor unit in translation - Google Patents

Abstract

The device has a guiding unit (7) with a longitudinal passage through which an anchor unit (3) slides. The guiding unit (7) is independent of an osteosynthesis connection unit (4). The guiding unit is mounted on the connection unit in a removable manner for being integrated with the connection unit. The guiding unit, after its installation, guides the anchor unit in translation.

Description

OSTEOSYNTHESIS DEVICE

  The present invention relates to the technical field of osteosynthesis devices intended to be mounted on or against a bone support for the purpose of repairing or consolidating it.

  The present invention relates to an osteosynthesis device comprising: at least one anchoring element in a bone support, a substantially elongate osteosynthesis connecting piece, said connecting piece being intended to be mounted integrally on or against the support by means of said at least one anchoring element, a compression means capable of cooperating with said anchoring element so as to bring the bone support of the connecting piece, by translation of said anchoring element, an element a guideway provided with a passage, in which said anchoring element is slidable.

  The present invention also relates to a method of placing an osteosynthesis device according to the invention on or against a bone support.

  The invention is more particularly directed to a surgical device, of the implant type, intended to be assembled to a bone, in particular the femur bone.

  A particularly indicated use of the osteosynthesis device according to the invention is that relating to the reduction of fractures of the femoral head (upper end or neck of the femur). Such a device can also be used to reduce fractures of the lower end of the femur (condylar fractures).

  It is known from WO-97/25005 and US-4,612,920 to provide, for the repair of fractures of the femoral neck, screw-plate type surgical implants for which the osteosynthesis plate is formed by a rod secured to a guide member, specifically a guide barrel, which is integrally mounted at one end thereof by welding or molding.

  A major disadvantage of this type of device comes from the fact that it requires, because of the particular shape of the osteosynthesis plate and its large volume, heavy surgery. To set up this device, the surgeon is indeed obliged to make an incision over substantially the entire length of the osteosynthesis plate in order to fix the latter on the bone of the femur.

  In addition, such procedures can lead to post-operative complications as the tissues surrounding the bone are damaged by the operation, which can lead to poor bone irrigation and slow healing.

  In addition, the incisions required for the placement of the devices of the prior art are such that they give rise to unsightly scars once the device or implant is removed.

  Finally, the transplanted patient with the devices of the prior art can sometimes suffer severe pain following the surgical procedure, these pain being directly related to the large size of the incision performed by the surgeon.

  The object of the invention is therefore to remedy the various disadvantages listed above and to propose a new device that can be placed on a bone support using a technique that is not very intrusive, thus reducing the size of the bone. surgical incision and decrease the risk of postoperative complications.

  Another object of the invention is to propose a new osteosynthesis device that can be installed by means of an incision of reduced size relative to the size of the device, but which retains good bone support repair properties after its implementation.

  Another object of the invention is to propose a novel osteosynthesis device comprising few assembly parts, and which, once put in place, offers improved strength and safety.

  Another object of the invention is to propose a new osteosynthesis device whose design on the one hand avoids the crushing of the bone at the fracture and on the other hand allows the locking of the device, once the latter is put in place, so that the assembly parts forming said device can not move relative to each other.

  Another object of the invention is to propose a novel osteosynthesis device 20 shaped in such a way as to improve the stability of the bone support relative to the device.

  The objects assigned to the invention are achieved by means of an osteosynthesis device comprising: at least one anchoring element in a bone support, a substantially elongate osteosynthesis connecting piece, said connecting piece being intended to be mounted integrally on or against the bone support by means of said at least one anchoring element, a compression means, capable of cooperating with said anchoring element so as to bring the bone support of the part connecting, by translation of said anchoring element, a guide member provided with a passage, in which said anchoring element is slidable, characterized in that the guide member is independent of the connecting piece and intended to be removably mounted on the latter, so that after its introduction, it is integral with the connecting piece and provides the translational guide of said at least one el anchorage.

  Other advantages and objects of the invention will appear in more detail on reading the description which follows, and with the aid of the accompanying drawings provided for purely illustrative non-limiting purposes, among which: FIG. a view cut away from the side, the osteosynthesis device according to the invention mounted on a bone support, typically the femur bone.

  - Figure 2 illustrates, in a side view in longitudinal section, the device shown in Figure 1.

  - Figure 3 illustrates, in a longitudinal sectional side view, a detail of the device shown in Figure 2.

  - Figure 4 illustrates, in an exploded perspective view, the osteosynthesis device according to the invention before its implementation on the bone support.

  In what follows, reference will be made to an osteosynthesis device 1 intended to be mounted on or against a bone support 2, the bone support 2 advantageously representing the bone of the femur. In particular, the device 1 according to the invention will be intended to be mounted on the upper end of the femur, so as to repair the fractures of the femoral head (or neck of the femur).

  Within the meaning of the invention, the bone support 2 comprises an upper portion 2A and a lower portion 2B, said upper portions 2A and lower 2B optionally being separated at a fracture 2C.

  Nevertheless, within the meaning of the invention, the device 1 according to the invention may be mounted on other bone supports, and may in particular be used to reduce fractures of the lower end of the femur.

  The device 1 according to the invention comprises a connecting piece 4 of osteosynthesis, which is preferably formed by an osteosynthesis plate substantially elongated along a longitudinal axis YY '. The connecting piece 4 has an upper end 4A, a lower end 4B and an anterior face 4C and a rear face 4D. The connecting piece 4 is intended to be mounted integrally on or against the bone support 2, so as to extend longitudinally along the lower part 2B of the latter, said front face 4C coming into contact with the outer surface 2D of said lower part 2B (Figure 1).

  Advantageously, and as shown in FIG. 1, the connecting piece 4 is mounted on the lower part 2B by means of one or, preferably, several fastening screws 5 distributed substantially uniformly along the workpiece. 4. The connecting piece 4 is also mounted integrally on the upper part 2A of the bone support 2 by means of an anchoring element 3. Thus, if a fracture 2C is present at the neck of the femur , the anchoring element 3 will preferably be mounted on the bone support 2 so as to traverse the fracture 2C in an axial direction substantially perpendicular to said fracture 2C (Figure 1).

  As shown in FIGS. 1 to 4, the anchoring element 3 is preferably a screw having a threaded portion 3A and a smooth portion 3B, said threaded portion 3A being preferably intended to be screwed into the upper portion 2A. bone support 2 to be anchored. Even more preferably, the anchoring element 3 is a cephalic screw.

  According to the invention, and as shown in FIGS. 2 to 4, the osteosynthesis device 1 also comprises a compression means 6, which is capable of cooperating with the anchoring element 3 so as to bring the support closer together. Bone 2 of the connecting piece 4. Precisely, the compression means 6 will cause the anchoring element 3 in translation towards the connecting piece 4 so as to bring the upper part 2A of the bone support 2 of the workpiece 4, thus allowing the mutual contact of the upper 2A and lower 2B portions of the bone support 2 so as to reduce the fracture 2C.

  Preferably, the compression means 6 is a compression screw, formed by a head 6A and a threaded rod 6B.

  The osteosynthesis device 1 also comprises a guide member 7, which is provided with a passage 8, preferably longitudinal, in which the anchoring element 3 is slidable.

  According to the invention, the guide member 7 is independent of the connecting piece 4 and shaped so as to be removably mounted on said connecting piece 4 so that after its introduction, it is integral with said connecting piece 4 and forms with it a one-piece assembly. Once mounted, the guiding member 7 ensures the translational guidance of the anchoring element 3 relative to the connecting piece 4.

  Thus, according to the invention, there is obtained a device in two distinct parts, namely the guiding member 7 and the connecting piece 4, which are assembled functionally when they are put in place.

  According to a preferred embodiment of the invention, the guide member 7 is a substantially cylindrical and hollow tube, which can be likened to a guide gun independent of the connecting piece 4 (Figure 4). It comprises a distal end 7A and a proximal end 7B.

  Advantageously, the cooperation between the anchoring element 3 and the compression means 6 is achieved by means of the rod 6B, which is shaped so as to be screwed into a threaded hole 31 formed inside the element Thus, as the compression means 6 penetrates inside the tapped hole 31, the anchoring element 3 is progressively closer, by translation inside the guide member 7, of the connecting piece 4, thus bringing the upper and lower portions 2A and 2B closer to the bone support 2.

  According to an essential characteristic of the invention, the connecting piece 4 comprises an open housing 41 shaped to receive the guide member 7 for its introduction within the osteosynthesis device 1. The opening 41 opening is preferably formed towards the upper end 4A of the connecting piece 4.

  Preferably, the opening housing 41 is formed along an oblique axis XX 'relative to the longitudinal axis YY' of the connecting piece 4. This particular angular disposition is particularly adapted to the conformation of the femoral head relative to the stem of the femur. Such an arrangement is therefore variable according to the individuals so that the device 1 according to the invention should preferably be adapted to each individual or to each group of individuals.

  Advantageously, the oblique axis X-X 'is inclined at an angle α of between 90 and 150 relative to the longitudinal axis YY'.

  According to the invention, the angle α will preferably be of the order of 95 if the osteosynthesis device 1 is used to repair the fractures of the lower end of the femur (supra-condylar fractures). The angle a will preferably be between 130 and 150 if the device 1 according to the invention is intended to be used to reduce fractures of the upper end of the femur (femoral neck).

  Advantageously, the proximal end 7B of the guide member 7 comprises a flange 11 shaped so as to bear against a stop means 12 formed in the open housing 41.

  According to a preferred embodiment of the invention, the opening housing 41 comprises a threaded counterbore 42, which defines a tapped bore 43 and a bottom 44, said bottom 44 serving as a bearing surface for the proximal end 7B of the guiding member 7, thus forming the stop means 12. The guide member 7 can thus be introduced into the opening housing 41 by its distal portion 7A until the flange 11 abuts against the bottom 44.

  Preferably, an internal shoulder 13 is formed in the proximal end 7B of the guide member 7. Said internal shoulder 13 is intended to serve as a stop against the head 6A of the compression screw. Thus, the rod 6B of the compression means 6 can be screwed inside the threaded hole 31 until its head 6A bears against the internal shoulder 13. Said head 6A is preferably shaped so that when it bears against the internal shoulder 13, it does not protrude from the proximal end 7B of the guide member 7.

  Advantageously, the compression screw, through its head 6A, also serves as a locking means of the guide member 7 relative to the connecting piece 4. Thus, when the compression screw is completely screwed inside. of the tapped hole 31, its head 6A compresses the flange 11 against the bottom 44, thus immobilizing the guide member 7.

  According to a preferred embodiment of the invention, the osteosynthesis device 1 also comprises a counter-screw 20, which is intended to be inserted and screwed into the threaded counterbore 42, precisely in the threaded bore 43 so as to come resting against the proximal end 7B of the guiding member 7. Thus mounted, the counter-screw 20 makes it possible to secure the guiding member 7 with the connecting piece 4.

  Advantageously, the counter-screw 20 will preferably be formed by a solid cylinder comprising external walls, which define a threaded side wall 20C, an anterior wall 20A and a rear wall 20B. The anterior wall 20A is on the one hand intended to abut against the proximal ends 7B of the guide member 7, and on the other hand against the head 6A of the compression means 6 so as to prevent the movement of the latter relative to the connecting piece 4.

  In particular, counter-screw 20 makes it possible to avoid protrusion of the compression screw outside the opening housing 41 formed through the connecting piece 4.

  The compression means 6, in particular the compression screw, is thus interposed between the guiding member 7 and the counter-screw 20. Similarly, the guiding member 7 is interposed between the connecting piece on one side. 4 and the compression means 6 and on the other side the counter-screw 20. In this way, to separate the guide member 7 from the connecting piece 4, it is necessary to remove, by unscrewing, the against -vis 20. The latter thus offers additional guarantees of security of the device 1, after the establishment of the latter.

  Preferably, the thread located inside the threaded counterbore 42 will preferably be made in the same direction as the thread of the compression screw 6, but it can obviously also be made in the opposite direction.

  According to a preferred embodiment of the invention, the guide member 7 and the connecting piece 4 are provided with locking means 17, 18 in rotation to prevent rotation of one of these two parts relative to the 'other. Indeed, because of its preferentially cylindrical outer shape, the guide member 7 is rotatable inside the opening housing 41, such rotation being capable not only of generating undesirable friction at the interface between the 7 and the bone support 2, but also to introduce undesired stresses within the osteosynthesis device 1.

  By way of illustrative and nonlimiting example, the locking means 17, 18 in rotation are preferably made using at least one lug 17 formed on the guide member 7, said lug 17 being intended to cooperate with at least one corresponding groove 18 formed along the opening housing 41. Said lug 17 is formed outside the guide member 7 and preferably extends radially relative to the axis XX '(Figure 4). Said groove 18 extends substantially rectilinearly and longitudinally along the axis X-X ', on the inner face 45 of the opening housing 41.

  Of course, it is conceivable to make several lugs 17 and corresponding grooves 18, so as to strengthen, by multiplying, the rigidity of the locking means 17, 18 in rotation. It is also possible to produce a guide member 7 which locally has a non-circular section but for example square, capable of being introduced into a complementary space formed inside the opening housing 41. The square section and the complementary space then form the rotational locking means.

  Advantageously, the guide member 7 is provided with at least one flat part 19, which is intended to prevent the rotation of the bone support 2 around said guide member 7.

  Of course, several flats 19 may be made on the guide member 7, which may also have a non-cylindrical outer shape, for example substantially square or hexagonal.

  According to the invention, the anchoring element 3 is preferably provided with at least one cheek 21 intended to immobilize said anchoring element 3 within the bone support 2, so as to avoid the rotation of the bone support 2 relatively to said anchoring element 3.

  Particularly advantageously, the anchoring element 3 comprises a stop 60, which is intended to prevent excessive displacement of said anchoring element 3 within the guide member 7, in the direction of the connecting piece 4 Thus, since the abutment 60 bears against the distal end 7A of the guide member 7, the anchoring element 3 is substantially immobilized in translation. Such a stop 60 helps to prevent, during loading of the patient, the crushing of the bone at the fracture 2C and the projection of the compression screw 6 outside the opening housing 41. Such a stop 60 is particularly useful when the counter-screw 20 is not used. It constitutes an additional security in the opposite case.

  The establishment and operation of the invention will now be described based on the example of an osteosynthesis device 1 intended to be mounted on the upper end of the femur, namely on the upper parts 2A and lower 2B of the bone support 2.

  Of course, such an example is purely illustrative and can be transposed to another or another part of a bone support, in particular at the lower end of the femur.

  To set up the device 1 according to the invention, the surgeon must make an incision of sufficient length to allow the introduction of an osteosynthesis plate. In the following, the osteosynthesis plate bears the same reference as the connecting piece 4.

  According to the invention, it will not be necessary to make an incision of length greater than or equal to that of the length of the osteosynthesis plate 4. Thus, the incision made must simply be of sufficient length to allow the introduction of the osteosynthesis plate 4 at one of its ends. In particular, it will be necessary that the cross section of the osteosynthesis plate 4 can pass inside the incision.

  Once the incision is made, the surgeon pierces a cavity 50 inside the bone, precisely at the level of the femoral head, along an axis XX 'forming a determined angle relative to the longitudinal axis ZZ' femur (Figure 1). If the surgical act is intended to repair a fracture of the femoral neck, the cavity 50 will have to traverse the fracture 2C so as to extend from the lower part 2B to the upper part 2A of the femur.

  Once the cavity 50 has been made, the surgeon can introduce the osteosynthesis plate 4 through the incision, and position it against the femur. The osteosynthesis plate 4 can then be fixed to the bone support 2, specifically to the lower part 2B of the latter, with the aid of a plurality of fixing screws 5 distributed along the said osteosynthesis plate 4, preferentially in order to limit the stresses exerted on the bone support 2.

  The cephalic screw 3 can then be introduced on the one hand through the housing opening 41 of the osteosynthesis plate 4 and on the other hand through the cavity 50 formed in the bone support 2 to be screwed by its threaded portion 3A. at the top 2A.

  The surgeon can then introduce the guiding member (or barrel) 7 into the opening housing 41 of the osteosynthesis plate 4 so that it surrounds the smooth portion 3B of the cephalic screw 3. The guiding member 7 is introduced into the housing opening 41 through its distal end 7A, until it comes into abutment, through the flange 11, against the bottom 44 of the threaded counterbore 42 formed in said opening housing 41.

  The compression screw, hereinafter referenced 6, can then be introduced, through its rod 6B, respectively through the opening housing 41 and the passage 8 to be screwed into the threaded hole 31 formed inside the cephalic screw 3. The surgeon then screws the compression screw 6 until its head 6B abuts against the internal shoulder 13 formed inside the guiding member 7. Such screwing induces a translation of the element anchor 3 towards the connecting piece 4, so that the upper end 2A of the femur approaches the lower end 2B so as to reduce the fracture 2C.

  Finally, once the reduction of the fracture 2C is achieved by means of the compression screw 6, the surgeon can introduce the counter-screw 20 into the opening housing 41, precisely inside the threaded counterbore 42, so as to screw it on the one hand against the head 6A of the compression screw 6 and on the other hand against the proximal end 7B of the guide member 7, thus locking the osteosynthesis device 1.

  The design of the device according to the invention therefore allows the surgeon, to set up this device, to make a smaller incision than that required for the installation of the devices of the prior art for which the osteosynthesis plate and the organ guiding are integral.

  Another advantage of this device is that it avoids post-surgical complications due to the traumatization of the tissues surrounding the bone of the femur. In addition, a reduced surgical incision accelerates tissue healing and substantially reduces postoperative pain.

  Another advantage of this device, directly related to the size of the incisions made, is that it reduces the size of the scars thus giving a more aesthetic appearance to the wound compared to surgical procedures of the prior art.

  Another advantage of this device is that it allows the patient to be managed without risk of crushing the bone at the level of the fracture, which could lead to a longer period of consolidation.

  Another advantage of this device is that it makes it possible to prevent the compression screw from being pulled out of the opening housing formed inside the osteosynthesis plate, the protrusion of the compression screw being able to generate a space likely to to irritate the tissues surrounding the bone.

  The invention also relates to a method of fitting the osteosynthesis device 1 characterized in that it comprises, after a step of fixing an osteosynthesis plate 4 on or against a bone support 2, a step of mounting an independent guide member 7 on said osteosynthesis plate 4.

  Advantageously, the laying method according to the invention comprises, prior to the step of fixing the osteosynthesis plate 4 on or against the bone support 2, a step of making a small incision through which the surgeon will be able to conduct the operations necessary for the installation of the device 1 according to the invention.

  The laying method according to the invention also comprises, after the step of producing the incision, a step of drilling a cavity 50 through the lower portions 2B and 2A of the upper bone support 2, so as to allow the introduction of the cephalic screw 3 and the guide member 7. The angular position of the cavity 50 relative to the longitudinal axis ZZ 'of the femoral stem is determined by means of a specific ancillary well known to man of career.

  Once the cavity 50 has been formed, the osteosynthesis plate 4 can be introduced inside the incision, through its lower end 4B, then brought into contact with the bone support 2 so that the longitudinal axis YY 'is substantially parallel to the axis ZZ' of the femoral stem. The osteosynthesis plate 4 is then guided in translation along the bone support 2, along the axis ZZ 'and in the opposite direction of the upper part 2A, so that the opening 41 of the osteosynthesis plate 4 comes in substantially vis-à-vis the cavity 50.

  Once positioned, the osteosynthesis plate 4 can be secured to the bone support 2 by means of the fixing screws 5 distributed along the osteosynthesis plate 4.

  According to one possible variant, counter-screws (not shown in the figures) such as those described in patent EP-345 133 may be used to lock the fixing screws 5. According to this variant, threaded countersinks will preferably be arranged on the along the osteosynthesis plate 4 at the locations of the fixing screws 5, counterbores in which can be screwed against the screws.

  The cephalic screw 3 can then be introduced through the depressing housing 41 of the osteosynthesis plate 4 and then screwed inside the bone support 2, precisely at the upper part 2A of the latter.

  When the cephalic screw 3 is positioned within the cavity 50, the guiding member 7 is inserted inside the opening housing 41 so that the lug or lugs 17 are in facing relation to the grooves 18 to be guided in translation. The guiding member 7 is inserted until the flange 11 comes into abutment against the stop element 12, precisely against the bottom 44 of the threaded counterbore 42.

  After all these steps, the method of laying the osteosynthesis device 1 according to the invention also comprises a step of placing the compression screw 6, which is screwed inside the threaded hole 31 provided in the interior of the cephalic screw 3, so as to bring, in the particular case of a femoral neck fracture, the upper part 2A of the neck of the femur of the lower part 2B, thereby reducing the fracture 2C.

  In a final step, the surgeon screws the counter-screw 20 inside the threaded bore 43 until it comes into abutment against on the one hand the guide member 7, precisely the proximal end 7B of the latter, and secondly the head 6A of the compression screw 6 so as to lock the device 1.

  Of course, the surgeon will have full latitude, prior to all the aforementioned steps, to perform a radiograph of the area of the femur to repair. Such an X-ray will make it possible to measure the angle α formed between the longitudinal axis ZZ '(corresponding to the direction of extension of the femoral stem) and the axis XX' (corresponding to the main direction of extension of the femoral head ) and to choose the different assembly parts of the device 1 according to their dimensional characteristics.

  Such a laying method has the advantage of being less intrusive than the laying methods of the prior art, for which it was necessary to make a large incision, for example 12 to 20 cm, in order to introduce and positioning the osteosynthesis plate integral with the guide member on or against the bone support.

  The laying method according to the invention also has the advantage of not requiring the use of new ancillaries, the ancillaries of the prior art being capable of being used.

  Another advantage of the laying method according to the invention lies in its ease of implementation.

Claims (14)

  1 - Osteosynthesis device comprising: at least one anchoring element (3) in a bone support (2), a connecting piece (4) of substantially elongated osteosynthesis, said connecting piece (4) being intended to be mounted integrally on or against the bone support (2) via said at least one anchoring element (3), a compression means (6) capable of cooperating with said anchoring element (3) of in order to bring the bone support (2) closer to the connecting piece (4), by translation of said anchoring element (3), a guide member (7) provided with a passage (8), within which said element anchoring device (3) is slidable, characterized in that the guide member (7) is independent of the connecting piece (4) and intended to be removably mounted on the latter (4) so that after it has been put in place, it is secured to the connecting piece (4) and ensures the translational guidance of said at least one n anchor element (3).   2 - Device according to claim 1 characterized in that the connecting piece (4) comprises an opening housing (41) shaped to receive the guide member (7) for its introduction.   3 - Device according to claim 2 characterized in that the opening housing (41) is formed along an oblique axis (X-X ') with respect to the longitudinal axis (Y-Y') of the connecting piece (4) .   4 - Device according to claim 3 characterized in that the oblique axis (X-X ') is inclined at an angle of between 90 and 150.   - Device according to claim 2, 3 or 4 characterized in that the guide member (7) is a substantially cylindrical tube which has a distal end (7A) and a proximal end (7B), the latter being shaped so as to abut against a stop means (12) formed in the opening housing (41).   6 - Device according to claim 5 characterized in that the opening housing (41) comprises a threaded countersink (42), defining a threaded bore (43) and a bottom (44), said bottom (44) serving as a bearing surface and stop means for the proximal end (7B) of the guide member (7).   7 - Device according to claim 6 characterized in that it comprises a counter-screw (20) intended to be screwed into the threaded counterbore (42) and abut against the proximal end (7B) of the organ guide (7) so as to secure the latter with the connecting piece (4).   8 - Device according to one of claims 1 to 7 characterized in that the compression means (6) is a compression screw, formed by a head (6A) and a rod (6B), said rod (6B) being intended to be screwed into a threaded hole (31) formed inside the anchoring element (3).   9 Device according to claim 8 characterized in that the guide member (7) is provided, towards its proximal end (7B), an inner shoulder (13) forming a stop against the head (6A) of the compression screw.   - Device according to claim 7 and one of claims 8 or 9 characterized in that the counter-screw (20) abuts against the head (6A) of the compression screw.   11 - Device according to one of claims 1 to 10 characterized in that 5 the guide member (7) and the connecting piece (4) are provided with locking means (17, 18) in rotation one by report to the other.   12 - Device according to claim 2 and claim 11 characterized in that the locking means (17, 18) in rotation are formed by means of a lug (17) formed on the guide member (7) and intended to cooperate with a groove (18) corresponding formed along the opening housing (41).   13 -Dispositif according to one of claims 1 to 12 characterized in that the guide member (7) is provided with at least one flat (19) for preventing the rotation of the bone support (2) around said body guide.   14 -Dispositif according to one of claims 1 to 13 characterized in that the anchoring element (3) is provided with at least one cheek (21) for preventing rotation of the bone support (2) around the l anchoring element (3).   15 -Dispositif according to one of claims 1 to 14 characterized in that the connecting piece (4) is an osteosynthesis plate.   16 - Device according to one of claims 1 to 15 characterized in that the anchoring element (3) is a cephalic screw.   17 - Device according to one of claims 1 to 16 characterized in that it constitutes a device for osteosynthesis of the neck of the femur.