FR2912895A1 - Arthrodesis equipment for e.g. metatarso-phalangeal joint of leg, has anchoring screw engaged in eyelet, and arthrodesis screw with thread adapted to support grip in metatarsal and phalanx, and another thread engaged with tapping of sleeve - Google Patents

Arthrodesis equipment for e.g. metatarso-phalangeal joint of leg, has anchoring screw engaged in eyelet, and arthrodesis screw with thread adapted to support grip in metatarsal and phalanx, and another thread engaged with tapping of sleeve Download PDF

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Publication number
FR2912895A1
FR2912895A1 FR0701424A FR0701424A FR2912895A1 FR 2912895 A1 FR2912895 A1 FR 2912895A1 FR 0701424 A FR0701424 A FR 0701424A FR 0701424 A FR0701424 A FR 0701424A FR 2912895 A1 FR2912895 A1 FR 2912895A1
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FR
France
Prior art keywords
screw
sleeve
arthrodesis
eyelet
thread
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.)
Granted
Application number
FR0701424A
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French (fr)
Other versions
FR2912895B1 (en
Inventor
Jean Jacques Martin
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.)
SMALL BONE INNOVATIONS INTERNATIONAL PAR ACTIONS SIMPLIFIEE Ste
SMALL BONE INNOVATIONS INTERNA
Original Assignee
SMALL BONE INNOVATIONS INTERNATIONAL SOCIETE PAR ACTIONS SIMPLIFIEE
SMALL BONE INNOVATIONS INTERNA
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Publication date
Application filed by SMALL BONE INNOVATIONS INTERNATIONAL SOCIETE PAR ACTIONS SIMPLIFIEE, SMALL BONE INNOVATIONS INTERNA filed Critical SMALL BONE INNOVATIONS INTERNATIONAL SOCIETE PAR ACTIONS SIMPLIFIEE
Priority to FR0701424A priority Critical patent/FR2912895B1/en
Publication of FR2912895A1 publication Critical patent/FR2912895A1/en
Application granted granted Critical
Publication of FR2912895B1 publication Critical patent/FR2912895B1/en
Application status is Expired - Fee Related legal-status Critical
Anticipated expiration legal-status Critical

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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
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8052Cortical 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
    • A61B17/8057Cortical 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 the interlocking form comprising a thread
    • 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
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
    • 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
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8085Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with pliable or malleable elements or having a mesh-like structure, e.g. small strips for craniofacial surgery
    • 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
    • A61B17/86Threaded wires, pins or screws; 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

The equipment (1) has a plate (2) comprising a tapped sleeve (5) and an eyelet (6) for receiving an arthrodesis screw (3) and a bone anchoring screw (4), respectively. A deformable portion connects the sleeve and eyelet. The portion is deformed for adapting the shape of the plate to the configuration of metatarsal (100) and phalanx (101) to be processed and adapting positions of the sleeve and eyelet. The screw (3) has a thread adapted to a support grip in the metatarsal and phalanx, and another thread cooperated with the tapping of the sleeve. The screw (4) is engaged in the eyelet.

Description

The present invention relates to an arthrodesis material, particularly for

  the arthrodesis of a foot joint such as a metatarsophalangeal joint. It is known to perform the arthrodesis of a joint, in particular of a foot joint, by performing a resection of the articular areas of the two bones concerned and then by keeping the resected faces of these bones against each other, with put in compression. This maintenance in compression can be achieved by: either a pin introduced from the end of the bone of the phalanx 10 into the metatarsal, along the axis of these bones; - Or two pins arranged obliquely through the resected interface, these pins crossing at this interface; - Or several screws set up through the resected interface; these screws can be of conventional type, that is to say include heads, or be without heads, can be cannulated or not, can be single thread or double thread; or by rigid plates held by screws fixed to the bones, these plates comprising oblong holes for receiving the screws. These different existing techniques do not give complete satisfaction. Indeed, the axial pin or the crossed pins are a risk of migration, are more or less inconvenient for the patient, and are often difficult to extract. The screws, given their plurality, must be placed at a slight angle with the axis of the diaphysis of the bones concerned, so as not to risk fracturing the bone cortices; these screws can therefore be relatively difficult to implement and may not ensure perfect compression of bones. Rigid plates can also be relatively difficult to set up, involving perforations and measurements for the precise setting of the screws for holding these plates, and may also not allow perfect compression of the bones. The present invention aims to solve all of these disadvantages, thereby providing a relatively easy material to put in place and allowing compression of the bones subject to arthrodesis, under the best conditions. For this purpose, the material according to the invention comprises: a plate including: at one end, a tapped sleeve, for receiving an arthrodesis screw; at least one eyelet for receiving a bone anchoring screw; a deformable portion connecting the sleeve and said eyelet, the deformation of which makes it possible to adapt the shape of the plate to the configuration of the bones to be treated and to adapt the relative positions of the sleeve and the eyelet; - said arthrodesis screw, comprising a thread adapted to a bearing in the bones concerned and, at one end, a thread adapted to cooperate with the tapping of the sleeve; - At least one bone anchoring screw adapted to be engaged in said eyelet. Said plate is intended to be fixed on the bones being arthrodesis, so that the sleeve extends on one side of the resected faces and that said one eyelet extends on the other side of said faces resected; said deformable portion makes it possible to adapt the shape of the plate to the configuration of the bones, to treat and to adapt the relative positions of the sleeve and the eyelet; the sleeve can thus be oriented obliquely with respect to the remainder of the plate so that the arthrodesis screw that it is intended to receive can be engaged obliquely simultaneously in the two bones, through the resected interface by which these two bones come into contact with each other; the eyelet can be oriented in the most appropriate manner for insertion into the bone of the bone anchoring screw which it is intended to receive, and in particular so that said anchor screw can be inserted perpendicular to the bone area in front of which this eyelet is placed. The sleeve therefore makes it possible to orient a single arthrodesis screw under the best conditions for carrying out the compression of the two bones; it also allows, thanks to its connection screwed with this screw, to ensure the perfect holding in position of the arthrodesis screw. The plate and the single arthrodesis screw that comprises the material according to the invention make it possible to greatly simplify the carrying out of an arthrodesis, particularly on small bones such as the bones of the foot. This material eliminates the problems associated with the placement of several screws, including the problems of bone fracture resulting, according to the prior art, from the placement of several screws, as well as the problems presented by the use of pins or rigid plates held by screws. Advantageously, the sleeve comprises a double tapping, one of which is not weaker than the other, and the arthrodesis screw comprises a double thread, namely a distal thread allowing this screw to bear in the bones concerned and a thread proximal of not less than that of the distal threading, to bind the screw to the sleeve. Thus, at the end of screwing, the proximal thread engages with the corresponding tapping of the sleeve and the continuation of the screwing allows, given that the pitch of this proximal thread is smaller than the pitch of the distal thread, a slight setting in compression of the bones concerned with respect to said plate. Another embodiment could be to provide the distal threading of the arthrodesis screw with a pitch greater than the length of the sleeve and to provide said sleeve with a single thread, equivalent to the proximal thread of the arthrodesis screw. Said eyelet mayl. have an inner face in the form of hollow sphere portion, and said anchoring screw may have a sphere portion head, intended to cooperate with this inner face to allow a multidirectional orientation of the anchor screw relative to the eyelet. A latitude of positioning of the anchor screw relative to the plate is thus obtained. Alternatively, at least one anchor screw could be secured to the plate, in particular by providing a thread on the head of the anchor screw and a tapped plate hole. The plate may comprise at least two eyelets as mentioned above, which may be connected to one another by one or more second deformable portions, similar to the deformable portion connecting one of the eyelets to the sleeve. 4 A solid anchorage can thus be implemented by means of at least two anchoring screws, under the best conditions. The invention will be better understood, and other features and advantages thereof will appear, with reference to the appended schematic drawing, showing, by way of non-limiting example, a preferred embodiment of the arthrodesis material that it concerned. Figure 1 is a top view of a plate that includes; Figure 2 is a view of this plate in median longitudinal section; FIG. 3 is a view of this side plate, partially in section, with insertion of an arthrodesis screw and with a bone anchoring screw, which it also comprises; Figure 4 is a top view of the bones of a metatarsophalangeal joint; Figure 5 is a view of these bones, side; Figure 6 is a view similar to Figure 4, after resection of the bones and placement of the arthrodesis material, and Figure 7 is a view similar to Figure 6, side. FIGS. 6 and 7 represent an arthrodesis material 1, in particular for arthrodesis of a foot joint such as a metatarsophalangeal joint, comprising a plate 2, an arthrodesis screw 3 and two screws 4 of bone anchorage (only one of these is shown). The entire equipment 1 is made of an implantable metal material, for example titanium or stainless steel. As shown more particularly in Figures 1 to 3, the plate 2 includes: - a threaded sleeve 5, at one end, for receiving the arthrodesis screw 3; two eyelets 6 for receiving the bone anchoring screws 4; - Two thinned portions 7, 8, namely a portion 7 connecting the sleeve 5 to an eyelet 6 and a portion 8 connecting the eyelet 6 to the other eyelet 6, the second eyelet 6 at the other end of the plate 2. The sleeve 5 protrudes from one side of the plate 2. In the example shown, it comprises uni double tapping, namely a tapping clean to cooperate with a mechanical thread 3a that includes the proximal portion of the screw arthrodesis 3 and a thread adapted to cooperate with a thread 3b for cancellous bone, which comprises the body of the screw 3. Each eyelet 6 has an inner face 6a in the form of a hollow sphere portion, and each anchoring screw 4 has a spherical head 4a intended to cooperate with this inner face 6a to allow a multidirectional orientation of the anchoring screw 4 relative to the eyelet 6. The thinned portions 7, 8 form a body with the sleeve 5 and the eyelets 6 to which they are have connected; they have a thickness such that they are rigid but they can be deformed, for example a thickness of the order of 1.5 mm. In practice, as shown in Figures 4 and 5, the first metatarsal 100 and the phalanx 101 are subject to resections of their joint surfaces, according to the respective section lines x-x 'and y-y'. Exostosectomy along the cut line c-c 'may also be performed, if necessary. The sections xx 'and yy' are arranged so as to impose, when the resected faces are placed in contact with one another, an angle α between the longitudinal axis of the first metatarsal 100 and the longitudinal axis of the phalanx. 101, this angle being determined according to the anatomical and functional needs of the patient.

  The first metatarsal 100 and the phalanx 101 are brought into contact by their resected faces and the phalanx 101 is pierced at the level of the metaphyseal-diaphyseal fossa 102, the outer diameter of the sleeve 5. This drilling is performed in a direction such that the screw 3, subsequently received in this sleeve 5, can be engaged through the resected interface of the bones 100 and 101 to ensure the maintenance of these in compression. The plate 2 is then shaped according to the anatomy of the implantation site, by deformation of the deformable portions 7 and 8; in the example shown, the portion 7 is folded close to the sleeve 5 and the portion 8 is folded between the eyelets 6. The plate 2 thus has a rectilinear median portion which extends along the bone face resulting from the cut cc 'when the sleeve 5 is engaged in the piercing of the phalanx 101 and that the eyelets 6 respectively come in the immediate vicinity of the first metatarsal 100. The arthrodesis screw 3, which is self-piercing and self-tapping, is then engaged through the sleeve 5, then, being guided by cooperation 6 of its thread 3b with the corresponding tapping of the sleeve 5, is screwed into the phalanx 101 and then into the first metatarsal 100, through the resected interface by which these bones are in contact with each other. At the approach of the end of the screwing, the mechanical thread 3a engages with the corresponding thread of the sleeve 5; the pitch of this thread 3a being smaller than the pitch of the thread 3b, the continuation of this screwing causes compression of the bones 100 and 101 with respect to the plate 2. A screw 4 is finally put in place through the eyelet 6 farthest from the sleeve 5, and, if necessary, through the intermediate eyelet 6.

  As appears from the foregoing, the plate 2 and the single arthrodesis screw 3 that comprises the material 1 according to the invention make it possible to greatly simplify: the realization of an arthrodesis, particularly on small bones such as the bones of the foot. This material eliminates the problems associated with the placement of several screws, including the problems of bone fracture resulting, according to the prior art, from the placement of several screws, as well as the problems presented by the use of pins or rigid plates held by screws. The invention thus provides a material to overcome the disadvantages of equipment of the same use according to the prior art.

  It goes without saying that the invention is not limited to the embodiment described above by way of example but that it extends to all embodiments covered by the appended claims.

Claims (4)

  1-Arthrodesis material (1), in particular for arthrodesis of a foot joint such as a metatarsophalangeal joint, characterized in that it comprises: a plate (2) including: at one end a threaded collar (5) for receiving an arthrodesis screw (3); at least one eyelet (6) for receiving a bone anchoring screw (4); a deformable portion (7) connecting the sleeve (5) and said eyelet (6), the deformation of which makes it possible to adapt the shape of the plate (2) to the configuration of the bones (100, 101) to be treated and to adapting the relative positions of the sleeve (5) and the eyelet (6); - said arthrodesis screw (3), comprising a thread (3b) adapted to a bearing in the bones (100, 101) concerned and, at one end, a thread (3a) adapted to cooperate with the tapping of the sleeve (5); - At least one bone anchoring screw (4) adapted to be engaged in said eyelet (6).
2 - Material according to claim 1, characterized in that the sleeve (5) comprises a double tapping, one of which is not smaller than the other, and in that the arthrodesis screw (3) comprises a double thread, namely a distal thread (3b) allowing this screw (3) to bear in the bones (100, 101) concerned and a proximal thread (3a) of not smaller than that of the distal thread (3b), to bind the screw (3) to the sleeve (5).
3 - Material according to claim 1, characterized in that the threading of the arthrodesis screw adapted to a support in the bones has a step greater than the length of the sleeve and in that the sleeve comprises a single thread, adapted to cooperate with the thread of the arthrodesis screw for cooperating with this tapping.
4 - Material according to one of claims 1 to 3, characterized in that said eyelet (6) has an inner face (6a) in the form of a hollow sphere portion, and in that said bone anchoring screw (4) has a head (4a) in sphere portion, intended to cooperate with this inner face (6a) to allow a multidirectional orientation of the screw (4) relative to the eyelet (6). 8 - Material according to one of claims 1 to 4, characterized in that the plate (2) comprises at least two eyelets (6) as mentioned above, connected to one another by one or more second deformable portions ( 8), similar to the deformable portion (7) connecting one of the eyelets (6) to the sleeve (5).
FR0701424A 2007-02-28 2007-02-28 Material of arthodesis Expired - Fee Related FR2912895B1 (en)

Priority Applications (1)

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FR0701424A FR2912895B1 (en) 2007-02-28 2007-02-28 Material of arthodesis

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Application Number Priority Date Filing Date Title
FR0701424A FR2912895B1 (en) 2007-02-28 2007-02-28 Material of arthodesis

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FR2912895A1 true FR2912895A1 (en) 2008-08-29
FR2912895B1 FR2912895B1 (en) 2009-05-01

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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2158865A1 (en) 2008-09-01 2010-03-03 Xavier Renard External fixing system for performing osteosynthesis between two portions of bone
WO2012033928A1 (en) * 2010-09-10 2012-03-15 Depuy Products, Inc. Joint fusion construct
JP2012525213A (en) * 2009-04-28 2012-10-22 オステオメド エルエルシー Bone plate with through-fixing screw holes
US8556946B2 (en) 2008-10-02 2013-10-15 Memometal Technologies Orthopedic implant in the form of a plate to be fixed between two bone parts

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0705572A2 (en) * 1994-10-03 1996-04-10 Synthes AG, Chur Locking plate and bone screw
US5674222A (en) * 1994-06-01 1997-10-07 Synthes (U.S.A.) Forked plate
EP0807420A1 (en) * 1996-05-13 1997-11-19 Stryker France S.A. Bone fixation device, particularly of the sacrum, for spinal osteosynthesis

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5674222A (en) * 1994-06-01 1997-10-07 Synthes (U.S.A.) Forked plate
EP0705572A2 (en) * 1994-10-03 1996-04-10 Synthes AG, Chur Locking plate and bone screw
EP0807420A1 (en) * 1996-05-13 1997-11-19 Stryker France S.A. Bone fixation device, particularly of the sacrum, for spinal osteosynthesis

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2158865A1 (en) 2008-09-01 2010-03-03 Xavier Renard External fixing system for performing osteosynthesis between two portions of bone
FR2935254A1 (en) * 2008-09-01 2010-03-05 Xavier Renard External fastening system for realizing osteosynthesis between two bone portions
US8556946B2 (en) 2008-10-02 2013-10-15 Memometal Technologies Orthopedic implant in the form of a plate to be fixed between two bone parts
US9078713B2 (en) 2008-10-02 2015-07-14 Memometal Technologies Orthopedic implant in the form of a plate to be fixed between two bone parts
US9333013B2 (en) 2008-10-02 2016-05-10 Stryker European Holdings I, Llc Orthopedic implant in the form of a plate to be fixed between two bone parts
US10349988B2 (en) 2008-10-02 2019-07-16 Stryker European Holdings I, Llc Orthopedic implant in the form of a plate to be fixed between two bone parts
JP2012525213A (en) * 2009-04-28 2012-10-22 オステオメド エルエルシー Bone plate with through-fixing screw holes
WO2012033928A1 (en) * 2010-09-10 2012-03-15 Depuy Products, Inc. Joint fusion construct

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Publication number Publication date
FR2912895B1 (en) 2009-05-01

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