US20210145587A1 - Plug in struts for graft cage - Google Patents
Plug in struts for graft cage Download PDFInfo
- Publication number
- US20210145587A1 US20210145587A1 US17/248,549 US202117248549A US2021145587A1 US 20210145587 A1 US20210145587 A1 US 20210145587A1 US 202117248549 A US202117248549 A US 202117248549A US 2021145587 A1 US2021145587 A1 US 2021145587A1
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- Prior art keywords
- fixation
- containment device
- bone
- graft containment
- strut
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- 210000000988 bone and bone Anatomy 0.000 claims abstract description 82
- 230000008878 coupling Effects 0.000 claims abstract description 35
- 238000010168 coupling process Methods 0.000 claims abstract description 35
- 238000005859 coupling reaction Methods 0.000 claims abstract description 35
- 239000000463 material Substances 0.000 claims abstract description 12
- 239000011148 porous material Substances 0.000 claims description 20
- 210000004373 mandible Anatomy 0.000 description 10
- 238000000034 method Methods 0.000 description 5
- 238000011282 treatment Methods 0.000 description 3
- 238000005452 bending Methods 0.000 description 2
- 230000035876 healing Effects 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 238000012856 packing Methods 0.000 description 2
- 210000001909 alveolar process Anatomy 0.000 description 1
- 230000008468 bone growth Effects 0.000 description 1
- 238000004891 communication Methods 0.000 description 1
- 230000001054 cortical effect Effects 0.000 description 1
- 230000003247 decreasing effect Effects 0.000 description 1
- 230000007547 defect Effects 0.000 description 1
- 230000012010 growth Effects 0.000 description 1
- 239000007943 implant Substances 0.000 description 1
- 230000007794 irritation Effects 0.000 description 1
- 238000004904 shortening Methods 0.000 description 1
- 210000001519 tissue Anatomy 0.000 description 1
Images
Classifications
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Definitions
- a bone graft may, for example, be placed in a target area using any of a variety of methods. However, without a container for the bone graft, the graft material may fall away from a target site before it has been incorporated by the body into the healing bone.
- the present invention relates to a system for treating a bone, comprising a graft containment device extending longitudinally from a first end to a second end and including a channel extending therethrough for receiving a graft material therein, the graft containment device including a plurality of fixation openings extending therethrough, and a strut extending longitudinally from a first end to a second end and including an attaching portion configured to be attached to the graft containment device and an overhang portion configured to extend beyond one of the first and second ends, when the attaching portion is attached to the graft containment device, the attaching portion including a plurality of coupling elements for engaging the fixation openings of the graft containment device, the overhang portion including an overhang opening configured to receive a bone fixation element for fixing the strut to a bone.
- the present invention also relates to a device for fixing a graft container to a bone, comprising a longitudinally extending attaching portion configured to be attached to the graft container along a length thereof, the attaching portion including a plurality of coupling elements extending therefrom along the attaching portion, each of the coupling elements configured to engage a corresponding fixation opening of the graft container and an overhang portion extending longitudinally from the attaching and configured to extend beyond one of a first end and a second end of the graft container when the attaching portion is attached to the graft container, the overhang portion including an overhang opening extending therethrough, the overhang opening configured to receive a bone fixation element therein.
- the present invention also relates to a method for treating a bone, comprising packing a channel of the graft containment device with a graft material, attaching an attaching portion of a strut to a graft containment device so that an overhang portion extends beyond one of a first end and a second end of the graft containment device, coupling elements extending along the attaching portion engaging fixation openings of the graft containment device, positioning the graft containment device within a target space of a bone so that the overhang portion extends over a portion of bone to which the graft containment device is to be fixed, and inserting a bone fixation element through an overhang opening extending through the overhang portion to fix the strut and the attached graft containment device to the bone.
- FIG. 1 shows a longitudinal side view of a system according to an exemplary embodiment of the present invention
- FIG. 2 shows another side view of the system of FIG. 1 ;
- FIG. 3 shows a longitudinal side view of a strut of the system of FIG. 1 ;
- FIG. 4 shows a perspective view of the strut of the system of FIG. 1 ;
- FIG. 5 shows an enlarged longitudinal side view of a coupling element of the strut of the system of FIG. 1 .
- the present invention relates to the treatment of bone and, in particular, relates to treatments using bone grafts and bone graft substitutes.
- Exemplary embodiments of the present invention describe a strut attachable to a graft containment cage packed with graft material and positioned at a site within which it is desired to encourage and guide the growth of new bone.
- the strut fixes the graft containment cage at a desired position within the target site (e.g., a gap or space in a target bone such as the mandible).
- the strut includes an attachable portion configured to be attached along a portion of the length of the graft cage and an overhang portion which extends beyond one of a first and second end of the graft cage to extend over a portion of bone to which the graft containment device is to be fixed.
- the attachable portion includes fasteners configured to be plugged-in or otherwise engaged with pores or other openings of the graft containment device.
- the overhang portion includes one or more openings sized and shaped to receive bone fixation elements for fixing the strut, and thereby the attached graft containment device, to the bone.
- the graft containment device of the present invention may also be formed in different shapes and sized to permit use in treating other types of bone which would benefit from the use of a graft containment device.
- a system 100 for treating a bone includes a strut 102 for fixing a graft containment device 104 within a target gap or space of a bone (e.g., mandible).
- the strut 102 of this embodiment includes an attaching portion 106 configured to extend over a portion of the length of the graft containment device 104 in an operative position and an overhang portion 108 configured to extend beyond one of the first and second ends 110 , 112 , respectively, of the graft containment device 104 .
- the strut 102 may be particularly useful for fixing off-the-shelf graft containment devices which may need to be cut or trimmed to fit within a target space.
- shortening the device may entail the removal of a fixation tab for fixing the device to bone formed at an end of the graft containment device.
- a strut 102 may be attached to such a graft containment device to provide a mechanism for fixing the graft containment device to bone.
- the attaching portion 106 of the strut 102 includes a plurality of coupling elements 114 configured to engage fixation openings 144 of the graft containment device 104 .
- the overhang portion 108 includes one or more openings 118 configured to receive bone fixation elements for fixing the strut 102 , and thereby the attached graft containment device 104 , to the bone.
- the graft containment device 104 extends along a longitudinal axis from the first end 110 to the second end 112 and includes a channel 120 extending therethrough.
- the channel 120 may be packed with a graft material to encourage bone growth within the target space of the bone in which the graft containment device 104 is to be placed.
- the graft containment device 104 includes pores 116 extending laterally therethrough. The pores 116 are sized to promote vascularization while preventing graft material from falling out of the channel 120 . At least some of the pores 116 may also be sized to receive a bone fixation element therethrough.
- the graft containment device 104 may be formed of a mesh defined via, for example, a lattice of circumferential and longitudinal members 122 , 124 , respectively.
- the intersecting circumferential and longitudinal members 122 , 124 may define the pores 116 .
- a spacing between adjacent circumferential members 122 and adjacent longitudinal members 124 may be varied to vary a size of the pores 116 so that different portions of the graft containment device 104 may have different sized pores 116 , as desired.
- a cross-sectional area of the graft containment device 104 may be shaped to substantially correspond to a portion of the bone to be replaced by the graft containment device 104 .
- the graft containment device 104 is sized and shaped to be positioned between two separated portions of a target bone.
- a lateral cross-section of the graft containment device 104 may substantially match an outer profile of a target portion of bone which formerly occupied the space.
- the cross-section of the graft containment device 104 substantially corresponds to a cross-section of a portion of the mandible to be replaced.
- a length of the graft containment device 104 may be trimmed to fit within the target space of the bone.
- the graft containment device 104 includes a fixation portion 142 extending along a length of a surface 146 of the graft containment device 104 which, when the graft containment device 104 is positioned within the target space of, for example, a mandible, faces toward a buccal direction.
- the fixation portion 142 may extend substantially parallel to a longitudinal axis of the graft containment device 104 from the first end 110 to the second end 112 of the graft containment device 104 . In one embodiment, ends of the of fixation portion 142 are aligned with the first and second ends 110 , 112 of the graft containment device 104 .
- fixation portion 142 may extend beyond one of the first and second end 110 , 112 of the graft containment device 104 .
- the fixation portion 142 includes a plurality of fixation openings 144 extending therethrough, along a length thereof. As will be described in greater detail below, the fixation openings 144 are sized and shaped to receive and/or otherwise engage coupling elements 114 of the strut 102 .
- the fixation openings 144 may also be sized and shaped to receive bone fixation elements for additional fixation of the strut 102 to the graft containment device 104 and/or for fixing the graft containment device 104 to bone.
- one of the first and second ends 110 , 112 may be trimmed so that a portion of the fixation portion 142 including a fixation opening 144 remains extending beyond the trimmed end.
- the one of the first and second ends 110 , 112 that has been trimmed may be fixed to the bone via the remaining fixation opening 144 .
- a second strut 102 may be attached to the fixation portion 142 so that both the first and second ends 110 , 112 may be fixed to bone via struts 102 .
- the pores 116 may be sized and shaped to engage the coupling elements 114 so that the strut 102 may be coupled to another portion of the graft containment device 104 via the pores 116 .
- a first strut 102 may be coupled to the graft containment device 104 via the fixation portion 142 while a second strut 102 is coupled to another portion of the graft containment device 104 via the pores 116 .
- both first and second struts 102 may be coupled to the graft containment device 104 via the pores 116 . It will be understood by those of skill in the art that any number of struts 102 may be coupled to the graft containment device 104 to achieve a desired fixation of the graft containment device 104 to the bone.
- the graft containment device 104 further includes a plurality of laterally extending slots 130 extending thereinto, in communication with the channel 120 , to define cage segments 140 separated from one another by the slots 130 .
- the slots 130 may be formed as areas in which adjacent ones of the circumferential members 122 are not coupled to one another by longitudinal members 124 about a portion of a perimeter of the graft containment device 104 .
- the slots 130 are free of longitudinal members 124 so that the longitudinal members 124 extend only along the buccal surface 146 the graft containment device 104 in these areas.
- the slots 130 facilitate lateral (relative to the longitudinal axis) bending of the graft containment device 104 .
- adjacent cage segments 140 may be moved toward one another, decreasing a size of the slot 130 extending therebetween, so that a curved path of the graft containment device 104 substantially corresponds to a curve of a portion of the mandible to be replaced.
- the graft containment device 104 is not required to include slots 130 and may include other features facilitating such bending, increasing flexibility, facilitating fixation, etc.
- the graft containment device 104 may have any of a variety of configurations so long as the graft containment device 104 includes openings/pores configured to receive coupling elements 114 of the strut 102 .
- the strut 102 extends longitudinally from a first end 126 to a second end 128 and includes the attaching portion 106 and the overhang portion 108 .
- the attaching portion 106 includes coupling elements 114 and is configured to be attached to a surface of the graft containment device 104 so that the overhang portion 108 extends beyond one of the first and second ends 110 , 112 of the graft containment device 104 .
- the strut 102 may, for example, be attached to the buccal surface 146 of the graft containment device 104 .
- a length of the attaching portion 106 may vary to extend along a desired portion of a length of the graft containment device 104 .
- the strut 102 may also be attached to other surfaces of the graft containment device 104 such as, for example, surfaces of the graft containment device 104 corresponding to an alveolar ridge and/or a sub-mandibular region of the mandible.
- the coupling elements 114 are positioned along a length of the attaching portion 106 , each of the coupling elements 114 being spaced relative to one another to correspond to positions of the fixation openings 144 and/or the pores 116 along the graft containment device 104 .
- the coupling elements 114 of this embodiment include fasteners sized and shaped to be plugged-in to correspondingly sized fixation openings 144 .
- each of the coupling elements 114 may include a pair of clip arms 132 separated from one another via a slot 134 extending along a length of the clip arms 132 .
- the clip arms 132 are biased toward a separated configuration and include enlarged ends 136 .
- the enlarged ends 136 of each of the clip arms 132 form together a substantially ball shape. It will be understood by those of skill in the art that the coupling elements 114 are configured to engage the fixation openings 144 when the coupling elements 114 are pressed distally (i.e., in a direction away from a surgeon or other user) against the fixation openings 144 with a force exceeding a predetermine threshold level. In the embodiment in which the enlarged ends 136 are ball-shaped, a similar force would be required disengage the coupling elements 114 from the fixation openings 144 .
- each enlarged end 136 may be shaped so that, even when a proximal force (i.e., force in a direction toward the surgeon or other user) is exerted thereon, the enlarged ends 136 are prevented from moving toward one another to release the clip arms 132 from the corresponding one of the fixation openings 144 .
- each enlarged end 136 may include a planar proximal surface perpendicular to an axis of the element 114 which, when inserted into an opening 144 engages a portion of the graft containment device 104 surrounding the opening 144 to prevent the enlarged end 136 from passing therethrough to release the coupling element 114 from the graft containment device 104 .
- the attaching portion 106 may additionally include one or more attachment openings 138 , each of which is sized and shaped to receive a bone fixation element therethrough.
- bone fixation elements may be inserted through one or more attachment openings 138 to provide additional fixation of the strut 102 to the graft containment device 104 .
- a position of the one or more attachment openings 138 along the graft containment device 104 may also correspond to a position of a corresponding one of the fixation openings 144 of the graft containment device 104 so that, a bone fixation element inserted through the attachment opening 138 passes through the attachment opening 138 and into the fixation opening 144 .
- the overhang portion 108 extends from the attaching portion 106 so that, when the attaching portion 106 is coupled to the graft containment device 104 , the overhang portion 108 extends beyond one of the first and second ends 126 , 128 of the graft containment device 104 .
- the overhang portion 108 includes one or more overhang openings 118 for receiving bone fixation elements therethrough to fix the overhang portion 108 to the bone.
- the bone fixation element receiving overhang openings 118 may be configured to receive any of a variety of bone fixation elements such as, for example, cortical screws, locking screws and/or variable angle screws.
- the overhang portion 108 may be offset from the attaching portion 106 and connected thereto via a connecting portion 148 so that, when the strut 102 is attached to the graft containment device 104 and the graft containment device 104 is positioned in the target space, the graft containment device 104 may be recessed with respect to a surface of the bone to, for example, reduce tissue irritation.
- the overhang portion 108 extends along a plane different from a plane along which the attaching portion 106 extends.
- the plane along which the overhang portion 108 extends may be substantially parallel to the plane along which the attaching portion 106 extends. It will be understood by those of skill in the art, however, that this is not required and may be varied depending on a target space to be filled and a shape of the bone to which the overhang potion 108 is to be attached.
- the graft containment device 104 may be trimmed, as desired to fit the target space of the bone.
- the graft containment device 104 may be trimmed at one of the first and second ends 110 , 112 so that a length of the graft containment device 104 substantially corresponds to the target space.
- the one of the first and second ends 110 , 112 may be trimmed so that a portion of the fixation portion 142 including at least one fixation opening 144 remains to extend beyond one of the first and second ends 110 , 112 .
- one end of the graft containment device 104 may be fixed to the bone via the fixation portion 142 while the other end of the graft containment device 104 may be fixed to the bone via the strut 102 , as described below.
- the channel 120 may be packed with a graft material.
- the strut 102 may be attached to the graft containment device 104 by engaging the attaching portion 106 to the graft containment device 104 so that the overhang portion 108 extends beyond one of the first and second ends 110 , 112 .
- the attaching portion 106 may be pressed against the graft containment device 104 with a force exceeding a predetermined threshold value so that each of the coupling elements 114 are pressed into a corresponding one of the fixation openings 144 .
- enlarged ends 136 may be pressed distally against the fixation openings 144 so that the clip arms 132 are moved toward one another, thereby permitting the enlarged ends 136 to be inserted through the fixation opening 144 .
- the clip arms 132 revert to the biased, separated configuration so that enlarged ends 136 engage a distal surface of the fixation openings 144 .
- the attaching portion 106 may be attached to the surface 146 of the graft containment device 104 which, in the operative position, faces toward a buccal direction.
- a bone fixation element may be inserted through one or more of the attachment openings 138 , into a corresponding one of the fixation openings 144 .
- the graft containment device 104 may be positioned within the target space of the bone, between two separated portions of bone.
- the overhang portion 108 extends over a first portion of bone and the fixation portion 142 extends over a second portion of bone.
- At least one bone fixation element is inserted through one of the overhang openings 118 to fix the graft containment device 104 to the first portion of bone.
- At least one bone fixation element is inserted through a fixation opening 144 to fix the graft containment device 104 to the second portion of bone.
- the exemplary method describes fixation of the graft containment device 104 to the bone via both the strut 102 and the fixation portion 142
- the graft containment device 102 may be similarly fixed to the bone using more than one strut 102 so that fixation via the fixation portion 142 is not required.
- the one or more struts 102 may be attached to the graft containment device 104 via the openings 144 of the fixation portion 142 and/or the pores 116 .
- a bone fixation plate may be similarly attached to the graft containment device 104 .
- a fixation plate including a plurality of bone fixation element receiving openings may include coupling elements, similar to the coupling elements 114 , along a bone-facing surface thereof so that the fixation plate may be attached to the graft containment device 104 substantially similarly to the strut 102 .
- the graft containment device 104 may include coupling elements extending therefrom so that the coupling elements may be received within openings 138 of the strut 102 and/or bone fixation element receiving openings of a bone fixation plate.
Abstract
Description
- The present application is a Continuation application of U.S. patent application Ser. No. 16/124,313 filed on Sep. 7, 2018; which claims priority to U.S. Provisional Patent Application Ser. No. 62/556,786 filed on Sep. 11, 2017; the entire disclosure of the above application(s)/patent(s) is expressly incorporated herein by reference.
- Defects of the mandible and other bones are often treated with bone grafts and/or implants such as, bone plates, to assist with healing. Such a bone graft may, for example, be placed in a target area using any of a variety of methods. However, without a container for the bone graft, the graft material may fall away from a target site before it has been incorporated by the body into the healing bone.
- The present invention relates to a system for treating a bone, comprising a graft containment device extending longitudinally from a first end to a second end and including a channel extending therethrough for receiving a graft material therein, the graft containment device including a plurality of fixation openings extending therethrough, and a strut extending longitudinally from a first end to a second end and including an attaching portion configured to be attached to the graft containment device and an overhang portion configured to extend beyond one of the first and second ends, when the attaching portion is attached to the graft containment device, the attaching portion including a plurality of coupling elements for engaging the fixation openings of the graft containment device, the overhang portion including an overhang opening configured to receive a bone fixation element for fixing the strut to a bone.
- The present invention also relates to a device for fixing a graft container to a bone, comprising a longitudinally extending attaching portion configured to be attached to the graft container along a length thereof, the attaching portion including a plurality of coupling elements extending therefrom along the attaching portion, each of the coupling elements configured to engage a corresponding fixation opening of the graft container and an overhang portion extending longitudinally from the attaching and configured to extend beyond one of a first end and a second end of the graft container when the attaching portion is attached to the graft container, the overhang portion including an overhang opening extending therethrough, the overhang opening configured to receive a bone fixation element therein.
- The present invention also relates to a method for treating a bone, comprising packing a channel of the graft containment device with a graft material, attaching an attaching portion of a strut to a graft containment device so that an overhang portion extends beyond one of a first end and a second end of the graft containment device, coupling elements extending along the attaching portion engaging fixation openings of the graft containment device, positioning the graft containment device within a target space of a bone so that the overhang portion extends over a portion of bone to which the graft containment device is to be fixed, and inserting a bone fixation element through an overhang opening extending through the overhang portion to fix the strut and the attached graft containment device to the bone.
-
FIG. 1 shows a longitudinal side view of a system according to an exemplary embodiment of the present invention; -
FIG. 2 shows another side view of the system ofFIG. 1 ; -
FIG. 3 shows a longitudinal side view of a strut of the system ofFIG. 1 ; -
FIG. 4 shows a perspective view of the strut of the system ofFIG. 1 ; and -
FIG. 5 shows an enlarged longitudinal side view of a coupling element of the strut of the system ofFIG. 1 . - The present invention may be understood with reference to the following description and the appended drawings, wherein like elements are referred to with the same reference numerals. The present invention relates to the treatment of bone and, in particular, relates to treatments using bone grafts and bone graft substitutes. Exemplary embodiments of the present invention describe a strut attachable to a graft containment cage packed with graft material and positioned at a site within which it is desired to encourage and guide the growth of new bone. The strut fixes the graft containment cage at a desired position within the target site (e.g., a gap or space in a target bone such as the mandible). The strut includes an attachable portion configured to be attached along a portion of the length of the graft cage and an overhang portion which extends beyond one of a first and second end of the graft cage to extend over a portion of bone to which the graft containment device is to be fixed. The attachable portion includes fasteners configured to be plugged-in or otherwise engaged with pores or other openings of the graft containment device. The overhang portion includes one or more openings sized and shaped to receive bone fixation elements for fixing the strut, and thereby the attached graft containment device, to the bone. Although the exemplary embodiment is shown and described in regard to the treatment of a mandible, it will be understood by those of skill in the art that the graft containment device of the present invention may also be formed in different shapes and sized to permit use in treating other types of bone which would benefit from the use of a graft containment device.
- As shown in
FIGS. 1-5 , asystem 100 for treating a bone includes astrut 102 for fixing agraft containment device 104 within a target gap or space of a bone (e.g., mandible). Thestrut 102 of this embodiment includes an attachingportion 106 configured to extend over a portion of the length of thegraft containment device 104 in an operative position and anoverhang portion 108 configured to extend beyond one of the first andsecond ends graft containment device 104. As would be understood by those skilled in the art, thestrut 102 may be particularly useful for fixing off-the-shelf graft containment devices which may need to be cut or trimmed to fit within a target space. For example, when an off the shelf graft containment device must be cut or trimmed to fit a target space, shortening the device may entail the removal of a fixation tab for fixing the device to bone formed at an end of the graft containment device. Astrut 102 may be attached to such a graft containment device to provide a mechanism for fixing the graft containment device to bone. The attachingportion 106 of thestrut 102 includes a plurality ofcoupling elements 114 configured to engagefixation openings 144 of thegraft containment device 104. Theoverhang portion 108 includes one ormore openings 118 configured to receive bone fixation elements for fixing thestrut 102, and thereby the attachedgraft containment device 104, to the bone. - As shown in
FIGS. 1-2 , thegraft containment device 104 extends along a longitudinal axis from thefirst end 110 to thesecond end 112 and includes achannel 120 extending therethrough. Thechannel 120 may be packed with a graft material to encourage bone growth within the target space of the bone in which thegraft containment device 104 is to be placed. Thegraft containment device 104 includespores 116 extending laterally therethrough. Thepores 116 are sized to promote vascularization while preventing graft material from falling out of thechannel 120. At least some of thepores 116 may also be sized to receive a bone fixation element therethrough. In one embodiment, thegraft containment device 104 may be formed of a mesh defined via, for example, a lattice of circumferential andlongitudinal members longitudinal members pores 116. A spacing between adjacentcircumferential members 122 and adjacentlongitudinal members 124 may be varied to vary a size of thepores 116 so that different portions of thegraft containment device 104 may have different sizedpores 116, as desired. A cross-sectional area of thegraft containment device 104 may be shaped to substantially correspond to a portion of the bone to be replaced by thegraft containment device 104. In one exemplary embodiment, thegraft containment device 104 is sized and shaped to be positioned between two separated portions of a target bone. A lateral cross-section of thegraft containment device 104 may substantially match an outer profile of a target portion of bone which formerly occupied the space. Where the target bone is the mandible, the cross-section of thegraft containment device 104 substantially corresponds to a cross-section of a portion of the mandible to be replaced. A length of thegraft containment device 104 may be trimmed to fit within the target space of the bone. - The
graft containment device 104 includes afixation portion 142 extending along a length of asurface 146 of thegraft containment device 104 which, when thegraft containment device 104 is positioned within the target space of, for example, a mandible, faces toward a buccal direction. Thefixation portion 142 may extend substantially parallel to a longitudinal axis of thegraft containment device 104 from thefirst end 110 to thesecond end 112 of thegraft containment device 104. In one embodiment, ends of the offixation portion 142 are aligned with the first andsecond ends graft containment device 104. In another embodiment, at least one end of thefixation portion 142 may extend beyond one of the first andsecond end graft containment device 104. Thefixation portion 142 includes a plurality offixation openings 144 extending therethrough, along a length thereof. As will be described in greater detail below, thefixation openings 144 are sized and shaped to receive and/or otherwise engagecoupling elements 114 of thestrut 102. Thefixation openings 144 may also be sized and shaped to receive bone fixation elements for additional fixation of thestrut 102 to thegraft containment device 104 and/or for fixing thegraft containment device 104 to bone. For example, where thegraft containment device 104 requires a length thereof to be trimmed to fit thegraft containment device 104 to the target space of the bone, one of the first andsecond ends fixation portion 142 including afixation opening 144 remains extending beyond the trimmed end. Thus, when thegraft containment device 104 is positioned within the target space, the one of the first andsecond ends graft containment device 104 via a portion of thefixation portion 142 extending beyond one of theends graft containment device 104, as described above, asecond strut 102 may be attached to thefixation portion 142 so that both the first andsecond ends struts 102. - Although the exemplary embodiment shows and describes the
strut 102 as being coupled to thefixation portion 142, in another embodiment, thepores 116 may be sized and shaped to engage thecoupling elements 114 so that thestrut 102 may be coupled to another portion of thegraft containment device 104 via thepores 116. Alternatively, afirst strut 102 may be coupled to thegraft containment device 104 via thefixation portion 142 while asecond strut 102 is coupled to another portion of thegraft containment device 104 via thepores 116. In yet another embodiment, both first andsecond struts 102 may be coupled to thegraft containment device 104 via thepores 116. It will be understood by those of skill in the art that any number ofstruts 102 may be coupled to thegraft containment device 104 to achieve a desired fixation of thegraft containment device 104 to the bone. - In one embodiment, the
graft containment device 104 further includes a plurality of laterally extendingslots 130 extending thereinto, in communication with thechannel 120, to definecage segments 140 separated from one another by theslots 130. For example, theslots 130 may be formed as areas in which adjacent ones of thecircumferential members 122 are not coupled to one another bylongitudinal members 124 about a portion of a perimeter of thegraft containment device 104. Theslots 130 are free oflongitudinal members 124 so that thelongitudinal members 124 extend only along thebuccal surface 146 thegraft containment device 104 in these areas. Theslots 130 facilitate lateral (relative to the longitudinal axis) bending of thegraft containment device 104. In particular,adjacent cage segments 140 may be moved toward one another, decreasing a size of theslot 130 extending therebetween, so that a curved path of thegraft containment device 104 substantially corresponds to a curve of a portion of the mandible to be replaced. - It will be understood by those of skill in the art, however, that the
graft containment device 104 is not required to includeslots 130 and may include other features facilitating such bending, increasing flexibility, facilitating fixation, etc. Thegraft containment device 104 may have any of a variety of configurations so long as thegraft containment device 104 includes openings/pores configured to receivecoupling elements 114 of thestrut 102. - As shown in
FIGS. 3-4 , thestrut 102 extends longitudinally from afirst end 126 to asecond end 128 and includes the attachingportion 106 and theoverhang portion 108. The attachingportion 106 includescoupling elements 114 and is configured to be attached to a surface of thegraft containment device 104 so that theoverhang portion 108 extends beyond one of the first and second ends 110, 112 of thegraft containment device 104. Thestrut 102 may, for example, be attached to thebuccal surface 146 of thegraft containment device 104. A length of the attachingportion 106 may vary to extend along a desired portion of a length of thegraft containment device 104. Thestrut 102 may also be attached to other surfaces of thegraft containment device 104 such as, for example, surfaces of thegraft containment device 104 corresponding to an alveolar ridge and/or a sub-mandibular region of the mandible. - The
coupling elements 114 are positioned along a length of the attachingportion 106, each of thecoupling elements 114 being spaced relative to one another to correspond to positions of thefixation openings 144 and/or thepores 116 along thegraft containment device 104. Thecoupling elements 114 of this embodiment include fasteners sized and shaped to be plugged-in to correspondinglysized fixation openings 144. For example, as shown inFIG. 5 , each of thecoupling elements 114 may include a pair ofclip arms 132 separated from one another via aslot 134 extending along a length of theclip arms 132. Theclip arms 132 are biased toward a separated configuration and include enlarged ends 136. When the enlarged ends 136 are pressed against a corresponding one of thefixation openings 144, an edge of thefixation opening 144 forces the enlarged ends 136, and thereby theclip arms 132, toward one another, permitting the enlarged ends 136 to be moved through thefixation opening 144. Once the enlarged ends 136 have moved into thefixation opening 144, theclip arms 132 are free to revert to the biased separated configuration so that the enlarged ends 136 are prevented from moving out of thefixation openings 144. - In one embodiment, the enlarged ends 136 of each of the
clip arms 132 form together a substantially ball shape. It will be understood by those of skill in the art that thecoupling elements 114 are configured to engage thefixation openings 144 when thecoupling elements 114 are pressed distally (i.e., in a direction away from a surgeon or other user) against thefixation openings 144 with a force exceeding a predetermine threshold level. In the embodiment in which the enlarged ends 136 are ball-shaped, a similar force would be required disengage thecoupling elements 114 from thefixation openings 144. Alternatively, the enlarged ends 136 may be shaped so that, even when a proximal force (i.e., force in a direction toward the surgeon or other user) is exerted thereon, the enlarged ends 136 are prevented from moving toward one another to release theclip arms 132 from the corresponding one of thefixation openings 144. For example, eachenlarged end 136 may include a planar proximal surface perpendicular to an axis of theelement 114 which, when inserted into anopening 144 engages a portion of thegraft containment device 104 surrounding theopening 144 to prevent theenlarged end 136 from passing therethrough to release thecoupling element 114 from thegraft containment device 104. - Although the exemplary embodiment shows and describes the
coupling elements 114 as includingclip arms 132 withenlarged ends 136, it will be understood by those of skill in the art that thecoupling elements 114 may have any of a variety of configurations so long as each of thecoupling elements 114 is configured to engage a corresponding one of thefixation openings 144. The attachingportion 106 may additionally include one ormore attachment openings 138, each of which is sized and shaped to receive a bone fixation element therethrough. Thus, bone fixation elements may be inserted through one ormore attachment openings 138 to provide additional fixation of thestrut 102 to thegraft containment device 104. A position of the one ormore attachment openings 138 along thegraft containment device 104 may also correspond to a position of a corresponding one of thefixation openings 144 of thegraft containment device 104 so that, a bone fixation element inserted through the attachment opening 138 passes through theattachment opening 138 and into thefixation opening 144. - The
overhang portion 108 extends from the attachingportion 106 so that, when the attachingportion 106 is coupled to thegraft containment device 104, theoverhang portion 108 extends beyond one of the first and second ends 126, 128 of thegraft containment device 104. Thus, when thegraft containment device 104 is positioned in the target space of the bone, theoverhang portion 108 extends over a portion of bone to which thegraft containment device 104 is to be fixed. Theoverhang portion 108 includes one ormore overhang openings 118 for receiving bone fixation elements therethrough to fix theoverhang portion 108 to the bone. The bone fixation element receivingoverhang openings 118 may be configured to receive any of a variety of bone fixation elements such as, for example, cortical screws, locking screws and/or variable angle screws. - In one embodiment, the
overhang portion 108 may be offset from the attachingportion 106 and connected thereto via a connectingportion 148 so that, when thestrut 102 is attached to thegraft containment device 104 and thegraft containment device 104 is positioned in the target space, thegraft containment device 104 may be recessed with respect to a surface of the bone to, for example, reduce tissue irritation. In other words, theoverhang portion 108 extends along a plane different from a plane along which the attachingportion 106 extends. In one particular embodiment, the plane along which theoverhang portion 108 extends may be substantially parallel to the plane along which the attachingportion 106 extends. It will be understood by those of skill in the art, however, that this is not required and may be varied depending on a target space to be filled and a shape of the bone to which theoverhang potion 108 is to be attached. - According to an exemplary method, the
graft containment device 104 may be trimmed, as desired to fit the target space of the bone. In one exemplary embodiment, thegraft containment device 104 may be trimmed at one of the first and second ends 110, 112 so that a length of thegraft containment device 104 substantially corresponds to the target space. The one of the first and second ends 110, 112 may be trimmed so that a portion of thefixation portion 142 including at least onefixation opening 144 remains to extend beyond one of the first and second ends 110, 112. Thus, one end of thegraft containment device 104 may be fixed to the bone via thefixation portion 142 while the other end of thegraft containment device 104 may be fixed to the bone via thestrut 102, as described below. Once thegraft containment device 104 has been trimmed, as desired, thechannel 120 may be packed with a graft material. - Upon packing of the graft material, the
strut 102 may be attached to thegraft containment device 104 by engaging the attachingportion 106 to thegraft containment device 104 so that theoverhang portion 108 extends beyond one of the first and second ends 110, 112. In particular, the attachingportion 106 may be pressed against thegraft containment device 104 with a force exceeding a predetermined threshold value so that each of thecoupling elements 114 are pressed into a corresponding one of thefixation openings 144. In particular, enlarged ends 136 may be pressed distally against thefixation openings 144 so that theclip arms 132 are moved toward one another, thereby permitting the enlarged ends 136 to be inserted through thefixation opening 144. Once the enlarged ends 136 have been moved distally past thefixation openings 144, theclip arms 132 revert to the biased, separated configuration so that enlarged ends 136 engage a distal surface of thefixation openings 144. Where thegraft containment device 104 is to be inserted into a target space of a mandible, the attachingportion 106 may be attached to thesurface 146 of thegraft containment device 104 which, in the operative position, faces toward a buccal direction. Where additional fixation of thestrut 102 to thegraft containment device 104 is desired, a bone fixation element may be inserted through one or more of theattachment openings 138, into a corresponding one of thefixation openings 144. - Once the
strut 102 has been attached to thegraft containment device 104, thegraft containment device 104 may be positioned within the target space of the bone, between two separated portions of bone. Theoverhang portion 108 extends over a first portion of bone and thefixation portion 142 extends over a second portion of bone. At least one bone fixation element is inserted through one of theoverhang openings 118 to fix thegraft containment device 104 to the first portion of bone. At least one bone fixation element is inserted through afixation opening 144 to fix thegraft containment device 104 to the second portion of bone. - Although the exemplary method describes fixation of the
graft containment device 104 to the bone via both thestrut 102 and thefixation portion 142, thegraft containment device 102 may be similarly fixed to the bone using more than onestrut 102 so that fixation via thefixation portion 142 is not required. Additionally, as noted above, the one ormore struts 102 may be attached to thegraft containment device 104 via theopenings 144 of thefixation portion 142 and/or thepores 116. - In addition, although the exemplary embodiment describes a
strut 102 attached to agraft containment device 104 via thecoupling elements 114, in another embodiment, a bone fixation plate may be similarly attached to thegraft containment device 104. For example, a fixation plate including a plurality of bone fixation element receiving openings may include coupling elements, similar to thecoupling elements 114, along a bone-facing surface thereof so that the fixation plate may be attached to thegraft containment device 104 substantially similarly to thestrut 102. In another embodiment, thegraft containment device 104 may include coupling elements extending therefrom so that the coupling elements may be received withinopenings 138 of thestrut 102 and/or bone fixation element receiving openings of a bone fixation plate. - It will be understood by those of skill in the art that modifications and variations may be made in the structure and methodology of the present invention, without departing from the spirit or the scope of the invention. Thus, it is intended that the present invention cover the modifications and variations of this invention, provided that they come within the scope of the appended claims and their equivalents.
Claims (18)
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US17/248,549 US20210145587A1 (en) | 2017-09-11 | 2021-01-28 | Plug in struts for graft cage |
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CN108601658A (en) * | 2016-01-28 | 2018-09-28 | 德普伊新特斯产品公司 | Spiral bone graft containment retainer |
KR101996849B1 (en) * | 2018-12-26 | 2019-10-01 | (주)메디쎄이 | Patient-tailored mandibular implants and methods for manufacturing the same |
WO2021080689A1 (en) * | 2019-10-16 | 2021-04-29 | Ponce Brent Andrew | Glenoid bone graft retention plate |
TWI716156B (en) * | 2019-10-18 | 2021-01-11 | 財團法人工業技術研究院 | Mandibular reconstruction prosthesis |
US11504240B2 (en) | 2020-06-04 | 2022-11-22 | DePuy Synthes Products, Inc. | Modular bone graft cage |
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EP3407836B1 (en) | 2016-01-28 | 2021-05-05 | DePuy Synthes Products, Inc. | Splitting attachment for graft containment cage |
CN108601658A (en) | 2016-01-28 | 2018-09-28 | 德普伊新特斯产品公司 | Spiral bone graft containment retainer |
AU2017286289B2 (en) * | 2016-06-13 | 2021-06-24 | DePuy Synthes Products, Inc. | Bone graft cage |
US11369474B2 (en) * | 2017-07-17 | 2022-06-28 | Warsaw Orthopedic, Inc. | Bone implant having a mesh |
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