WO2008149308A1 - Agrafe d'ostéosynthèse - Google Patents

Agrafe d'ostéosynthèse Download PDF

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Publication number
WO2008149308A1
WO2008149308A1 PCT/IB2008/052215 IB2008052215W WO2008149308A1 WO 2008149308 A1 WO2008149308 A1 WO 2008149308A1 IB 2008052215 W IB2008052215 W IB 2008052215W WO 2008149308 A1 WO2008149308 A1 WO 2008149308A1
Authority
WO
WIPO (PCT)
Prior art keywords
shape
staple
central branch
lateral branches
bone
Prior art date
Application number
PCT/IB2008/052215
Other languages
English (en)
Inventor
Jean-Jacques Martin
Original Assignee
Small Bone Innovation International
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Small Bone Innovation International filed Critical Small Bone Innovation International
Publication of WO2008149308A1 publication Critical patent/WO2008149308A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1728—Guides or aligning means for drills, mills, pins or wires for holes for bone plates or plate screws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B17/0642—Surgical staples, i.e. penetrating the tissue for bones, e.g. for osteosynthesis or connecting tendon to bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/809—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with bone-penetrating elements, e.g. blades or prongs
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00867—Material properties shape memory effect

Definitions

  • the present invention relates to an osteosynthesis staple made of a hyperelastic or shape memory material, in particular intended for corrective surgery of the hallux valgus. It may, however, be used for any other osteosynthesis technique for which it proves to be effective.
  • the invention also relates to an equipment including said osteosynthesis staple and a piercing guide usable for placement of this staple.
  • hyperelastic or shape memory staples In order to maintain two bone parts in position after an osteotomy, in particular upon corrective surgery of the hallux valgus, it is well known to use hyperelastic or shape memory staples.
  • This type of staple comprises two lateral branches and one central branch connecting these lateral branches, each lateral branch being intended to be inserted in one of the two bone parts.
  • a known staple comprises, at its central branch, a clevis going, by shape memory, from an elongated shape before implantation to a contracted shape after implantation, such that the two lateral branches of the staple are brought closer to each other. These lateral branches also rotate slightly after implantation, such that their free ends converge toward each other, achieving a certain compression of the interfaces of the two bone parts generated by the osteotomy.
  • This staple has the disadvantage of not being perfectly applied between the bone parts after implantation and therefore is in the way of the surrounding soft tissues. Moreover, the pressure exerted by the pivoting of the lateral branches on the cortices of the two bone parts results in a tendency for the staple to push itself out. Moreover and most importantly, this staple does not perfectly maintain the two bone parts, particularly with regard to pivoting of one bone part relative to the other in the longitudinal direction, and the bone interfaces are not perfectly maintained pressing against each other.
  • Another known staple comprises a central, S-shaped or broken line branch, the inflections of which become more marked after implantation, by shape memory, also bringing the two lateral branches of the staple closer together.
  • this piercing guide is very often poorly centered relative to the bone parts, which requires the practitioner and his assistant to resort to the use of either forceps or temporary fixation pins, thus creating additional steps and leading to cluttering of the operation site, and creating a risk of poor positioning of the two bone parts relative to each other.
  • the staple to which it relates comprises, in a known manner, a central branch and two lateral branches connected to the central branch, these two lateral branches each being intended to be inserted in one of the two bone parts to be connected; the central branch is modeled such that it can adopt a first shape, in which the two lateral branches are distanced from each other, and a second shape, in which the two lateral branches are brought closer to each other, and these lateral branches are substantially parallel to each other in the first shape and converge toward each other in the direction of their free ends in said second shape.
  • the central branch has, in said first shape, a substantially rectilinear shape, and, in said second shape, an arched or angular position, such that the central branch forms a concave curve on the side opposite that on which the lateral branches extend, or a "V" opening from the side opposite that on which these lateral branches extend, the curve or angle of the central branch in said second shape being such that this central branch extends, after implantation, close to the cortices of the bone parts in which this staple is implanted.
  • the staple according to the invention enables compression of the zones of the bone surfaces close to this central branch, all while having a weak tendency to push itself out.
  • the arched or angular shape of the central branch of the staple corresponds substantially to the angulation of the two bone parts to be brought together, such that this staple protrudes slightly beyond the cortex of the bone parts and never comes into any particular conflict with the surrounding soft tissues.
  • the central branch comprises two holes going through it, on either side of its median zone, each intended to receive a screw fixing the staple to the corresponding bone part.
  • the piercing guide which may be used to place this staple comprises, according to the invention, a first block comprising a first hole for guiding piercing and a second block comprising a second hole guiding piercing, these two blocks being able to slide in relation to each other in order to bring said holes closer together or further apart.
  • This piercing guide thus makes it possible to pierce holes in the bone before performing the osteotomy, therefore simply and easily, in stable bone parts.
  • the distance separating the hole for guiding piercing and the transverse surface of the corresponding interface is equal to the distance separating each lateral branch of the staple and the median zone of the central branch of this staple.
  • the piercing guide according to the invention thus makes it possible, using said transverse surfaces of the interface, to locate, on the proximal cortex, the size of the osteotomy to be carried out, and to develop, in the bone, the holes for receiving the lateral branches of the staple, at the appropriate distance relative to the bone interfaces which will result from the osteotomy. Perfect positioning of the holes for receiving the lateral branches of the staple is thus obtained regardless of the width of the osteotomy to be carried out on the proximal cortex.
  • the two blocks are separated from each other according to the proximal width of the osteotomy to be carried out and the piercing guide is applied against the proximal cortex; the width of the osteotomy to be carried out is them determined to the right of said transverse surfaces of the interface, then the holes for receiving the lateral branches of the staple are pierced.
  • the piercing guide is then withdrawn and the osteotomy is carried out.
  • the staple is placed by engagement of its lateral branches in the aforementioned reception holes, the median transverse zone of the central branch positioning itself precisely aligned with the osteotomy interfaces.
  • the staple then assumes the second shape, achieving compression of the proximal zones of the bone interfaces by the marked curvature or marked angulation of its central branch and by pivoting its lateral branches, and achieving compression of the distal zones of the bone interfaces.
  • the staple comprises fixing screws
  • these fixing screws are installed after implantation of the staple; the bearing of the lateral branches against the screws following pivoting of these lateral branches favors compression of the distal zones of the bone interfaces as well as maintaining the screws in the bone.
  • the surfaces of the piercing guide intended to come into contact with the bone have a concave shape allowing them to adapt to the convex shape of the bone, which facilitates positioning of this guide on this bone.
  • Figures 1 to 3 are views according to a first embodiment, from the side in a non-deformed state, in a perspective view in this non-deformed state, and from the side in a deformed state, respectively;
  • figures 4 to 6 are views according to a second embodiment, from the side in a non-deformed state, a perspective view in this non-deformed state, and from the side in a deformed state, respectively;
  • figures 7 and 8 are perspective views according to a third embodiment, in a first shape and second shape, respectively;
  • figure 9 is a perspective view of a cutting block making it possible to place the staple;
  • figure 10 is a view of this block and a metatarsal bone intended to undergo treatment of a hallux valgus;
  • figure 11 is a view of this bone after performing an osteotomy and during placement of the staple according to figures 7 and 8
  • figure 12 is a view similar to figure 11 , after permanent fixing of the bone staple.
  • Figures 1 to 8 illustrate an osteosynthesis staple 1 , in particular intended for corrective surgery of the hallux valgus.
  • FIG. 1 shows a staple 1 in a hyperelastic material, comprising a central branch 1 a and two lateral branches 1 b connected to the central branch 1 a, each lateral branch 1 b being intended to be inserted in one of the two bone parts 100a, 100b to be connected.
  • the staple 1 may be deformed between a normal state of non- deformation, shown in figures 1 an 2, and a state of elastic deformation, shown in figure 3.
  • the central branch 1 a of the staple 1 In its non-deformed state, the central branch 1 a of the staple 1 forms an open "V", opening from the side opposite that on which the lateral branches 1 b extend, and the lateral branches 1 b of the staple 1 converge toward each other in the direction of their free ends.
  • the staple 1 In its state of elastic deformation, the staple 1 is brought to a shape in which its central branch 1a is rectilinear or in the shape of a "V" clearly more open than in the normal, non-deformed state, such that the two lateral branches are farther away from each other than in the non-deformed state, following a direction parallel to the length of the central branch 1 a.
  • the lateral branches 1 b of the staple 1 In this same state of elastic deformation, the lateral branches 1 b of the staple 1 are substantially parallel to each other.
  • FIGS 4 to 6 show a staple 1 very similar to that shown in figures 1 to 3, except that the central branch 1 a, instead of forming a "V", has an arched shape with its concave curvature turned from the side opposite that on which the lateral branches 1 b extend.
  • FIGs 7 and 8 show a staple 1 in shape memory material, in particular in a nickel-titanium alloy known as "nitinol".
  • This staple 1 a upon its placement, has the shape shown in figure 7, in which its central branch 1 a is rectilinear or forms a very open "V” and in which its lateral branches 1 b are parallel; the staple 1 adopts, after implantation, by shape memory, the shape shown in figure 8, in which its central branch 1 a forms a closed “V", bringing the lateral branches 1 b together, and in which its lateral branches 1 b converge toward each other in the direction of their free ends.
  • the staple 1 also comprises two holes 2 placed through its central branch 1 a, for placement of the screw 5 for fixing the staple 1 to the bone 100, visible in figure 12.
  • Figure 9 shows a piercing guide 10 which may be used to place the staple 1.
  • This guide 1 is made up of two blocks 11 , 12, connected to each other, delimiting the transverse surfaces of the interface 13 and surfaces 14 to come into contact with the bone.
  • the block 11 comprises a hole 15 to guide piercing, this hole opening into the surface 14 of its block
  • the block 12 comprises a hole 16 for guiding piercing, this hole also opening into the surface 14 of this block.
  • each block 11 , 12 On each block 11 , 12, the distance separating the hole 15, 16 and the transverse surface of the corresponding interface 13 is equal to the distance separating each lateral branch 1 b of the staple 1 and the median zone of the central branch 1 a of this staple.
  • the two blocks 11 , 12 are connected to each other slidingly, such that the two blocks can slide relative to each other to bring the holes 15 and 16 closer together or farther apart.
  • This sliding may be done using any suitable sliding means, in particular in the form of pads integral with one of the blocks, slidingly engaged in sliding grooves provided in the other block. These sliding means are such that each of the two blocks 11 , 12 may come into contact with the other block at said transverse interface surfaces 13.
  • the surfaces 14 have a concave shape allowing them to adapt themselves to the convex shape of the bone 100.
  • the block 11 is integral with a grip shank 17, facilitating manipulation of the guide 10.
  • the two blocks 11 , 12 are distanced from each other according to the proximal width of the osteotomy 101 to be performed (a scale located on one of the blocks and mark found on the other block may be included to precisely measure the distance between the two blocks); the distance between the surfaces 13 then constitutes a mark of the width of the osteotomy 101 to be performed; the piercing guide 10 is then applied against the proximal cortex of the bone 100 and marks are made on this cortex to the right of the surfaces 13; the holes 102 for receiving the lateral branches 1 b of the staple 1 are then pierced, using the holes 15 and 16 as piercing guide (figure 10).
  • the guide 10 is then withdrawn and the osteotomy 101 is performed.
  • the staple 1 is placed on the bone 100 by engaging its lateral branches 1 b in the holes 102, the median transverse zone of the central branch 1a being positioned such that they are precisely aligned with the osteotomy interfaces 103 (figure 11 ).
  • the fixing screws 5 are then placed, after potential piercing of pre-holes intended to receive them.
  • the staple 1 then resumes, through shape memory, its second shape shown in figure 12, performing the compression of the proximal zones of the osteotomy interfaces 103 by marked angulation of the central branch 1 a of the staple, which brings the lateral branches 1 b closer to each other, and by pivoting these lateral branches 1 b such that they converge in the direction of their free end.
  • This pivoting allows these lateral branches 1 b to bear against the screws 5 in the direction bringing the free ends of these screws closer to each other, which makes it possible to achieve compression of the distal zones of the osteotomy interfaces 103.
  • the invention thus provides an osteosynthesis staple in hyperelastic or shape memory material, in particular intended for corrective surgery of the hallux valgus, and a piercing guide for the placement of this staple, which definitively resolves the disadvantages of similar materials of the prior art.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Neurology (AREA)
  • Rheumatology (AREA)
  • Dentistry (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne une agrafe (1) qui comprend une branche centrale (1a) et deux branches latérales (1b) destinées à être introduites dans les deux parties d'os (100a, 100b) devant être reliées ; la branche centrale (1a) peut adopter une première forme, dans laquelle les deux branches latérales (1b) sont espacées l'une de l'autre, et une seconde forme, dans laquelle les deux branches latérales (1b) sont rapprochées l'une de l'autre, et ces branches latérales (1b) sont sensiblement parallèles l'une à l'autre dans la première forme et convergent l'une vers l'autre dans la direction de leurs extrémités libres dans ladite seconde forme. Selon l'invention, la branche centrale (1a) a, dans ladite première forme, une forme sensiblement rectiligne, et, dans ladite seconde forme, une position arquée ou angulaire, de telle sorte que la branche centrale (1a) forme une courbe concave sur le côté opposé à celui sur lequel les branches latérales (1b) s'étendent, ou une ouverture en « V » à partir du côté opposé à celui sur lequel ces branches latérales (1b) s'étendent, la courbe ou l'angle de la branche centrale (1a) dans ladite seconde forme étant tel que cette branche centrale (1a) s'étend, après implantation, à proximité des sommets des parties d'os (100a, 100b) dans lesquelles cette agrafe (1) est implantée.
PCT/IB2008/052215 2007-06-05 2008-06-05 Agrafe d'ostéosynthèse WO2008149308A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FRFR0703990 2007-06-05
FR0703990A FR2916954B1 (fr) 2007-06-05 2007-06-05 Agrafe d'osteosynthese

Publications (1)

Publication Number Publication Date
WO2008149308A1 true WO2008149308A1 (fr) 2008-12-11

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PCT/IB2008/052215 WO2008149308A1 (fr) 2007-06-05 2008-06-05 Agrafe d'ostéosynthèse

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FR (2) FR2916954B1 (fr)
WO (1) WO2008149308A1 (fr)

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN105054983A (zh) * 2015-09-01 2015-11-18 天津天耀金属制品有限公司 一种包皮缝钉及采用其的包皮环切吻合器
US9907558B2 (en) 2011-07-08 2018-03-06 Smith & Nephew, Inc. Osteotomy guide and method
US9993246B1 (en) 2017-07-07 2018-06-12 Endure Enterprises, Pllc Medical device bending devices and methods of use
US10292743B2 (en) 2012-03-01 2019-05-21 Wright Medical Technology, Inc. Surgical staple
US10357260B2 (en) 2015-11-02 2019-07-23 First Ray, LLC Orthopedic fastener, retainer, and guide methods
US10376367B2 (en) 2015-07-02 2019-08-13 First Ray, LLC Orthopedic fasteners, instruments and methods
WO2020026174A1 (fr) * 2018-08-02 2020-02-06 DePuy Synthes Products, Inc. Procédé et appareil pour un implant à compression continue
WO2021183426A1 (fr) * 2020-03-09 2021-09-16 Crossroads Extremity Systems, Llc Systèmes et procédés de fixation de petits os

Families Citing this family (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8870876B2 (en) 2009-02-13 2014-10-28 Tarsus Medical Inc. Methods and devices for treating hallux valgus
US8277459B2 (en) 2009-09-25 2012-10-02 Tarsus Medical Inc. Methods and devices for treating a structural bone and joint deformity
US8652141B2 (en) 2010-01-21 2014-02-18 Tarsus Medical Inc. Methods and devices for treating hallux valgus
FR2956312B1 (fr) * 2010-02-15 2013-01-25 Implants Internat Ltd Materiel de fixation de deux parties d'un os l'une a l'autre
US8696719B2 (en) 2010-06-03 2014-04-15 Tarsus Medical Inc. Methods and devices for treating hallux valgus
FR3052047B1 (fr) * 2016-06-02 2021-12-17 Neosteo Dispositif medical implantable pour la solidarisation de parties osseuses separees en vue de leur fusion

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2642641A1 (fr) * 1989-02-09 1990-08-10 France Implant Agrafe chirurgicale
FR2725126A1 (fr) * 1994-10-04 1996-04-05 Mai Christian Implant ligamentaire a memoire de forme
US5662655A (en) * 1992-07-24 1997-09-02 Laboureau; Jacques Philippe Osteosynthesis plate-staple
FR2764183A1 (fr) * 1997-06-09 1998-12-11 Jacques Afriat Materiel permettant la correction de l'"hallux valgus"
EP0995403A1 (fr) * 1998-10-22 2000-04-26 Depuy Orthopaedics, Inc. Guide d'alignement d'un foret pour os
US20020019636A1 (en) * 1999-04-23 2002-02-14 James Ogilvie Shape memory alloy sample
US20030139746A1 (en) * 2002-01-22 2003-07-24 Groiso Jorge Abel Bone staple and methods for correcting bone deficiencies by controllably suppressing and/or inducing the growth of the epiphyseal plate
WO2006031692A2 (fr) * 2004-09-14 2006-03-23 Wright Medical Technology, Inc. Vis chirurgicale separable

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6007535A (en) * 1996-01-03 1999-12-28 John M. Rayhack Multi-plane bone distraction system

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2642641A1 (fr) * 1989-02-09 1990-08-10 France Implant Agrafe chirurgicale
US5662655A (en) * 1992-07-24 1997-09-02 Laboureau; Jacques Philippe Osteosynthesis plate-staple
FR2725126A1 (fr) * 1994-10-04 1996-04-05 Mai Christian Implant ligamentaire a memoire de forme
FR2764183A1 (fr) * 1997-06-09 1998-12-11 Jacques Afriat Materiel permettant la correction de l'"hallux valgus"
EP0995403A1 (fr) * 1998-10-22 2000-04-26 Depuy Orthopaedics, Inc. Guide d'alignement d'un foret pour os
US20020019636A1 (en) * 1999-04-23 2002-02-14 James Ogilvie Shape memory alloy sample
US20030139746A1 (en) * 2002-01-22 2003-07-24 Groiso Jorge Abel Bone staple and methods for correcting bone deficiencies by controllably suppressing and/or inducing the growth of the epiphyseal plate
WO2006031692A2 (fr) * 2004-09-14 2006-03-23 Wright Medical Technology, Inc. Vis chirurgicale separable

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9907558B2 (en) 2011-07-08 2018-03-06 Smith & Nephew, Inc. Osteotomy guide and method
US10736641B2 (en) 2011-07-08 2020-08-11 Smith & Nephew, Inc. Osteotomy guide and method
US10292743B2 (en) 2012-03-01 2019-05-21 Wright Medical Technology, Inc. Surgical staple
US11202666B2 (en) 2012-03-01 2021-12-21 Wright Medical Technology, Inc. Surgical staple
US10376367B2 (en) 2015-07-02 2019-08-13 First Ray, LLC Orthopedic fasteners, instruments and methods
CN105054983A (zh) * 2015-09-01 2015-11-18 天津天耀金属制品有限公司 一种包皮缝钉及采用其的包皮环切吻合器
US10357260B2 (en) 2015-11-02 2019-07-23 First Ray, LLC Orthopedic fastener, retainer, and guide methods
US10702290B2 (en) 2015-11-02 2020-07-07 First Ray, LLC Orthopedic fastener, retainer, and guide
US9993246B1 (en) 2017-07-07 2018-06-12 Endure Enterprises, Pllc Medical device bending devices and methods of use
WO2020026174A1 (fr) * 2018-08-02 2020-02-06 DePuy Synthes Products, Inc. Procédé et appareil pour un implant à compression continue
WO2021183426A1 (fr) * 2020-03-09 2021-09-16 Crossroads Extremity Systems, Llc Systèmes et procédés de fixation de petits os
US11937808B2 (en) 2020-03-09 2024-03-26 Crossroads Extremity Systems, Llc Small bone fixation systems and methods

Also Published As

Publication number Publication date
FR2916954B1 (fr) 2011-11-25
FR2916954A1 (fr) 2008-12-12
FR2962027A1 (fr) 2012-01-06

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