WO2009095451A1 - Dispositif et procédé chirurgical pour réduire une fracture entre la tête épiphysaire et la diaphyse d'un os long, en particulier une fracture de l'humérus proximal - Google Patents

Dispositif et procédé chirurgical pour réduire une fracture entre la tête épiphysaire et la diaphyse d'un os long, en particulier une fracture de l'humérus proximal Download PDF

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Publication number
WO2009095451A1
WO2009095451A1 PCT/EP2009/051030 EP2009051030W WO2009095451A1 WO 2009095451 A1 WO2009095451 A1 WO 2009095451A1 EP 2009051030 W EP2009051030 W EP 2009051030W WO 2009095451 A1 WO2009095451 A1 WO 2009095451A1
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WO
WIPO (PCT)
Prior art keywords
plate
head
bone
jacking rod
fracture
Prior art date
Application number
PCT/EP2009/051030
Other languages
English (en)
Inventor
Edwin Spencer
Emmanuel Lizee
Original Assignee
Tornier
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 Tornier filed Critical Tornier
Priority to EP09705411A priority Critical patent/EP2244645A1/fr
Publication of WO2009095451A1 publication Critical patent/WO2009095451A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—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
    • A61B17/8061—Cortical 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • 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
    • A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
    • A61B17/8047—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers wherein the additional element surrounds the screw head in the plate hole
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/025—Joint distractors
    • 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
    • A61B17/8052—Cortical 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
    • A61B17/8057—Cortical 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

Definitions

  • proximal humeral fractures in shoulder surgery is aided with a stable construct that sustains early mobilization with high healing rates and low complication rates.
  • a plate bridging the fracture between the head and the diaphysis of the humerus aids in fixation, but the head must be reduced before fixation.
  • the invention also relates to a surgical method for reducing a fracture between the epiphyseal head and the diaphysis of a long bone, as defined in claim 17.
  • the surgeon can thus control the jacking rod and the pulling means in order to correct especially the varus position of the humeral head by tilting it slightly outwardly, largely about a horizontal anteroposterior geometrical axis passing through said head.
  • the point of the head, at which the jacking rod exerts its pushing force is located at the end frontal aspect of the head, just close to the fracture.
  • the corresponding device and method according to the invention are defined in dependent claims 6 and 20.
  • a jacking device pushes an inferior aspect of the head.
  • sutures pull the superior aspect of the head.
  • locking screws fix the head to a locking plate and the jacking device is removed.
  • FIG. 6 is a side view of a second embodiment of a device according to the invention, at an initial stage of fixation
  • Fig. 7 is a plan view of one embodiment of a locking plate for the second embodiment
  • - Fig. 12 is a side view of one embodiment of a radiolucent deltoid retractor; - Fig. 13 is a front view of the radiolucent retractor of Fig. 12;
  • FIG. 14 is a perspective view of another embodiment of a radiolucent retractor.
  • FIG. 15 is a block diagram of one embodiment of the steps for the method of reduction and fixation.
  • Various apparatuses and methods for the reduction and fixation of a fracture are disclosed. These apparatuses and methods are described with respect to treating a proximal humeral fracture, although they are suitable for treating other types of fractures. Treating a proximal humeral fracture during shoulder surgery includes reduction of the head out of varus or other malalignment and fixation of the diaphysis and head of the humerus.
  • Figs. 2 and 4 also schematically show the scapula S connected to the humerus H as well as some soft parts M formed substantially of muscles and ligaments which surround and interconnect the humeral head H1 and the scapula S.
  • the humeral head H1 , the scapula S and the soft parts M thus form the shoulder of a patient, in which on its outer side, the scapula S delimits a substantially hemi-spherical glenoid face G, inside which a largely complementary face H1A delimited by the upper side of the head H1 is articulated, the relative articulated movements between said faces G and H1A normally being controlled by the soft parts M which are engaged accordingly.
  • a device 1 comprising a humeral osteosynthesis plate 10 which, in the embodiment shown in the figures, consists substantially of a main elongated body, shaped so as to extend lengthwise along the outer face of the humerus H, covering the fracture F.
  • Said plate 10 thus comprises along its length an epiphyseal portion 11 and a diaphyseal portion 12 which extend over the humeral head H1 and the humeral diaphysis H 2 respectively.
  • the plate portion 11 is completely penetrated by a hole 11 i which, when the plate 10 is arranged on the humerus H, opens onto the humeral head H1.
  • the hole 12 1 opens onto the humeral diaphysis H 2 in such a way that a bone-anchoring screw, similar to the aforementioned screw 20, may be screwed into the diaphysis through the hole 12 1 ; as shown in Figs. 2 to 4 with a screw denoted by the reference numeral 22.
  • the presence of said screw 22 in the hole 12 1 thus fixes the position of the plate 10 relative to the humerus H over the width of the hole 12i, that is to say in an anteroposterior direction, whilst the position of the plate in the longitudinal direction thereof can be adjusted within the limits of the length of the hole 12i, as long as the head of the screw 22 is not engaged with the wall delimiting the opening of the hole * ⁇ 2- ⁇ on the side opposite the humerus.
  • Each of these holes 12 2 is thus able to receive a bone-anchoring screw, as shown in Fig. 4 with screws denoted by the reference numeral 23.
  • the plate portion 12 is completely penetrated by a threaded hole 12 3 which is centered on an axis X-X.
  • Said axis X-X is not perpendicular to the longitudinal direction of the plate 10 but is tilted towards the top of the side of the plate 10 which is to face the humerus H, forming with the longitudinal direction of the plate an angle denoted by ⁇ in Fig. 2, measuring approximately 45° in the embodiment sh own in the figures.
  • H is shaped as a manual guiding grip 32, in this case in the form of a knob for guiding the rod 30 in rotation about the central longitudinal axis thereof.
  • the distal end of the rod 30 is shaped into a rounded tip 33, as can be seen clearly in Figs. 2 to 4.
  • the device 1 is used as follows: Firstly, the surgeon cuts the biological tissue at the fracture F, preferably from a delto-pectoral approach. In a first step, the surgeon attempts to arrange the plate 10 along the humerus H in such a way that it covers the fracture F, whilst connecting the epiphyseal portion 11 of the plate to soft parts M.
  • the surgeon first passes, by means of the incision which he made previously, suture threads 21 through some soft parts M and threads these suture threads through the holes 11 2 so as to thus connect, by means of suturing, the plate 10 to said soft parts M.
  • the surgeon then inserts the plate 10 into the incision and slides it along the outer face of the humerus H until it is in the position shown in Fig. 2, in which said plate is held in a resilient manner by the loops formed by the suture threads 21.
  • the surgeon "parachutes" the plate 10 along the humerus using suture threads 21 , which makes it easier to fit the plate in place and improves the initial positioning of said plate without excessively enlarging the incision in the patient's shoulder.
  • the surgeon may form a tunnel which is largely centered on the axis X-X, for example by inserting a pin or drill fairly deeply into the diaphysis H2 from the outer face of said diaphysis.
  • the rod 30 is screwed into the threaded hole 12 3 until the rounded tip 33 of the rod reaches the fracture F. By screwing in the rod, this tip 33 thus abuts the lower face H1 B of the humeral head H1 , as shown in Fig. 2. Whilst still screwing in the screw 30, the rounded tip 33 firmly abuts the bone face H1 B and exerts a pushing force upwardly on the humeral head H1 in the direction of the axis X-X, as indicated by the arrow 41 in Fig. 3.
  • Tilting the entire humeral head H1 thus corrects the varus position of said head and also displaces it outwardly until it is in its normal anatomical position.
  • the fracture F is thus reduced by drawing the humeral head towards the diaphysis H2. Closing the fracture F in this manner may slightly modify the vertical position, either upwardly or downwardly, of the plate 10 along the diaphysis H2. This slight change to the altitude of the diaphyseal portion 12 of the plate is enabled by means of a corresponding relative translatory movement of the screw 22 in the oblong hole 12i, as shown in Fig. 3.
  • the plate 10 is thus completely immobilized along the humerus H on both sides of the reduced fracture F, as shown in Fig. 4.
  • the rod 30 may then be removed from the plate 10 by means of unscrewing, as indicated by the arrow 43 in Fig. 4.
  • the threaded hole 12 3 as well as any other through-holes in the plate 10 which have not been used to receive bone-anchoring screws or the like, are advantageously sealed using a bone filling material.
  • the sutures 21 are advantageously tied firmly to the epiphyseal portion 11 of the plate, by cutting and removing any unnecessary excess threads, as shown in Fig. 4.
  • the use of the variation of the reduction device 1 comprising the platelet 50 and the olive 53 is similar to that of the reduction device shown in Figs. 1 to 4, the difference being that, before the surgeon inserts and screws the rod 30 into the threaded hole 54, he has the option of adjusting the position of the axis Y-Y of said threaded hole relative to the platelet 50 and thus relative to the plate 10. Being able to adjust the position of said axis Y-Y allows the surgeon to modify the region of the lower face H1 B of the humeral head H1 , against which the rounded tip 33 of the rod 30 will press once the rod 30 has been screwed in.
  • the jacking device 104 applies an inward directed force 122 to the most inferior aspect of the head 108.
  • the two forces 120, 122 impart a rotary motion 124 to the head 108 that moves the head 108 out of varus.
  • Varus is the inward angulation of the humerus 110.
  • the jacking device 104 is positioned to move the head 108 in alignment when the head 108 is malaligned other than being in varus, for example, when the head 108 is in valgus.
  • FIG. 7 illustrates a plan view of one embodiment of the plate 102.
  • the plate 102 provides fixation of the fracture.
  • the plate 102 includes an assortment of holes and openings 202, 204, 206.
  • the plate 102 has a contoured shape that allows the plate 102 to mate to the humerus 110. Further, the superior end of the plate 102 is wider than the inferior end. The wider superior end accommodates the head 108, which is typically wider than the shaft 112.
  • the jacking screw 306 is an elongated threaded member.
  • the proximal end of the jacking screw 306 includes a driver tip 310 that is configured to engage a driver.
  • the driver rotates the jacking screw 306.
  • the driver is a manual or a powered rotary device that allows the jacking screw 306 to be precisely located by screwing the jacking screw 306 relative to the collar 302.
  • the distal end of the jacking screw 306 includes a spherical end 308 for engaging an inferior aspect of the head 108.
  • the proximal end of the jacking screw 306 has other shapes for engaging the head 108, for example, a spiked or cupped end.
  • the spherical end 308 of the jacking screw 306 is sized to pass through the jacking screw hole 202 in the plate 102.
  • the plate 102 is then provisionally secured to the shaft 112 of the humerus 110 by a screw 106 inserted through an elongated hole 208 that allows for superior and inferior translation of the plate 102.
  • a screw 106 inserted through an elongated hole 208 that allows for superior and inferior translation of the plate 102.
  • Using a non-locking screw 106 allows the shaft 112 to be drawn tight against the plate 102.
  • the most superior elongated hole 208 is configured to allow the greatest superior and inferior translation.
  • the other holes 208 are available for provisionally securing the shaft 112.
  • the jacking device hole 202A is a single threaded opening as illustrated, one of several threaded openings grouped together, or a multiple threaded opening, such as illustrated for the elongated holes 208 at the inferior end of the locking plate 102.
  • the additional options for the jacking device hole 202A allows for variations in the angle of the jacking screw 306.
  • FIG. 14 illustrates a perspective view of another embodiment of a radiolucent retractor 702B.
  • the retractor 702B includes a rounded handle 704B attached to a curved extension 708B that terminates in a curved blade 706B.
  • the curved handle 704B and the transition to the curved extension 708B have a thickness that results in sufficient strength for the radiolucent material to withstand the pulling and levering forces applied to the retractor 702B.
  • the thickness and configuration of the curved blade 706B is such that the radiolucent material withstands the forces applied to the curved blade 706B.
  • FIG. 15 illustrates a block diagram of one embodiment of the steps for the method of reduction and fixation.
  • the illustrated method results in shorter surgery time for the patient and eliminates the need for provisionally reducing the fracture with multiple pins.
  • the illustrated method also minimizes soft tissue stripping, thereby improving healing rates.
  • the following steps are described with respect to the reduction and fixation of a proximal humeral fracture, the method is applicable to reducing and fixing other fractures.
  • the first step 1002 is to position the plate 10 or 102 adjacent the humerus H or 110 with the superior end of the plate proximate the head H1 or 108.
  • suture material 21 or 114 is stitched to the tissue adjacent the superior aspect of the head H1 or 108.
  • the suture material is then passed through the appropriate suture holes 112 or 206 in the plate 10 or 102.
  • the plate is then parachuted down onto the humerus.
  • inverted mattress stitches of a non-absorbable braided suture material, such as #2 Fiber- wire are placed in the supraspinatus, infraspinatus, subscapulars, and/or teres minor.
  • the positioning step 1006 is performed under fluoroscopic guidance.
  • the radiolucent retractor 702 aids in positioning the head H1 or 108, along with pulling the suture material 22 or 114 and advancing the jacking rod 30 or screw 306.
  • the next step 1008 is to secure the plate 10 or 102 to the humerus H or 110. With the head H1 or 106 positioned, locking screws 20 or 106 are inserted through the locking holes 1 I 1 or 204 and into the head H1 or 108. The jacking rod 30 or device 104 is removed after the head is secured to the plate. The suture material 21 or 114 is tied. In the embodiment with the channels 210, the suture material 114 is tied and positioned in the appropriate channel 210.
  • the securing step 1008 also includes securing the diaphysis 112 to the locking plate 102 with locking screws 106.
  • Various developments and variations of the reduction devices and the associated surgical methods may also be envisaged. For example:
  • - resilient suture elements other than the threads 21 and the material 114 may be used to connect the epiphyseal portion of the plate 10 or 102 to some soft parts M and 116, as long as said suture elements can withstand the pulling force exerted thereupon by the surgeon so as to displace the humeral head from its incorrect position when reducing the fracture F;
  • the surgeon may, either alternatively or in addition, use suture systems comprising a bone anchor which is mechanically independent of the plate, that is to say an anchor which the surgeon engages in the bone matter of the humeral diaphysis H2 or 110 independently of fitting the plate in place; this type of anchor is generally screwed into or impacted in the bone matter; the surgeon then connects said bone anchor to some soft parts by means of suture elements, in particular threads, in such a way as to be able to pull on said suture elements and thus guide the humeral head, largely with the same movement, by tilting it and by using the suture elements described above; - another possibility, which may be used alternatively or in addition, for pulling the humeral head involves engaging an anchor of the type described above in the bone matter of said humeral head and in pulling a tie which is attached to said anchor so as to
  • the plate 10 or 102 constitutes an isolated osteosynthesis element; the invention may be integrated with more elaborate osteosynthesis assemblies as well as with prosthetic assemblies which are simultaneously arranged so as to reduce a bone fracture of the same type as the fracture;
  • the reduction device 1 may be used on other long bones which are fractured between an epiphyseal head thereof and the diaphysis thereof; and/or - instead of guiding the jacking rod 30 or screw 306 relative to the plate 10 or 102 by means of screwing/unscrewing, other mechanical means which can be used by the surgeon may be used to exert a force for guiding said jacking rod so as push against a bone head, such as the humeral head.

Abstract

L'invention concerne un dispositif améliorant la réduction d'une fracture entre la tête épiphysaire et la diaphyse d'un os long, limitant le détachement d'un tissu biologique à proximité, et comprenant ainsi : - une plaque allongée qui comprend, de part et d'autre de la fracture couverte par la plaque, une portion épiphysaire qui peut être fixée de manière rigide à la tête et une portion diaphysaire qui peut être fixée à la diaphyse à la fois de manière rigide et de façon à pouvoir être déplacée dans la direction longitudinale de la plaque, - une tige de levage destinée à pousser la tête, laquelle tige de levage pénètre la plaque et s'étend ainsi dans le sens de la longueur depuis la plaque jusqu'à atteindre une portion dure de la tête, de manière à pousser la tête vers une première voie, - un moyen de guidage mécanique pour guider de manière réversible la tige de levage par rapport à la plaque et dans la direction longitudinale de ladite tige, et - un moyen de traction pour tirer la tête, lequel moyen de traction tire la tête vers une voie opposée à la première voie, dans une direction en grande partie parallèle à la direction longitudinale de la tige de levage.
PCT/EP2009/051030 2008-01-29 2009-01-29 Dispositif et procédé chirurgical pour réduire une fracture entre la tête épiphysaire et la diaphyse d'un os long, en particulier une fracture de l'humérus proximal WO2009095451A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP09705411A EP2244645A1 (fr) 2008-01-29 2009-01-29 Dispositif et procédé chirurgical pour réduire une fracture entre la tête épiphysaire et la diaphyse d'un os long, en particulier une fracture de l'humérus proximal

Applications Claiming Priority (8)

Application Number Priority Date Filing Date Title
US2432708P 2008-01-29 2008-01-29
US61/024,327 2008-01-29
FR0852803A FR2930424A1 (fr) 2008-04-25 2008-04-25 Dispositif de reduction d'une fracture entre la tete epiphysaire et la diaphyse d'un os long, notamment d'une fracture humerale proximale.
FR0852803 2008-04-25
US5247508P 2008-05-12 2008-05-12
US5228308P 2008-05-12 2008-05-12
US61/052,475 2008-05-12
US61/052,283 2008-05-12

Publications (1)

Publication Number Publication Date
WO2009095451A1 true WO2009095451A1 (fr) 2009-08-06

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PCT/EP2009/051030 WO2009095451A1 (fr) 2008-01-29 2009-01-29 Dispositif et procédé chirurgical pour réduire une fracture entre la tête épiphysaire et la diaphyse d'un os long, en particulier une fracture de l'humérus proximal

Country Status (3)

Country Link
EP (1) EP2244645A1 (fr)
FR (1) FR2930424A1 (fr)
WO (1) WO2009095451A1 (fr)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8545539B2 (en) 2008-05-12 2013-10-01 Edwin E. Spencer Proximal humeral fracture reduction and fixation device
US20140005729A1 (en) * 2012-06-29 2014-01-02 Depuy Mitek, Inc. Tissue Repair Suture Plates and Methods of Use
CN108113740A (zh) * 2018-01-09 2018-06-05 江苏荷普医疗科技股份有限公司 新型桡骨远端内侧接骨装置
EP3192451A4 (fr) * 2014-09-13 2018-09-12 Yusuke Shimizu Crochet médical

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2294685A1 (fr) 1974-12-16 1976-07-16 Tornier Rene Perfectionnements aux dispositifs de prothese du femur
FR2483214A1 (fr) * 1980-05-30 1981-12-04 Tornier Sa Ets Dispositif perfectionne pour l'osteosynthese du col femoral

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2294685A1 (fr) 1974-12-16 1976-07-16 Tornier Rene Perfectionnements aux dispositifs de prothese du femur
FR2483214A1 (fr) * 1980-05-30 1981-12-04 Tornier Sa Ets Dispositif perfectionne pour l'osteosynthese du col femoral

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8545539B2 (en) 2008-05-12 2013-10-01 Edwin E. Spencer Proximal humeral fracture reduction and fixation device
US9113973B2 (en) 2008-05-12 2015-08-25 Edwin E. Spencer Method of reduction of proximal humeral fracture
US20140005729A1 (en) * 2012-06-29 2014-01-02 Depuy Mitek, Inc. Tissue Repair Suture Plates and Methods of Use
US8979909B2 (en) * 2012-06-29 2015-03-17 Depuy Mitek, Llc Tissue repair suture plates and methods of use
US9700298B2 (en) 2012-06-29 2017-07-11 Depuy Mitek, Llc Tissue repair suture plates and methods of use
EP3192451A4 (fr) * 2014-09-13 2018-09-12 Yusuke Shimizu Crochet médical
US10166016B2 (en) 2014-09-13 2019-01-01 Yusuke Shimizu Medical retractor
EP3679864A1 (fr) * 2014-09-13 2020-07-15 Yusuke Shimizu Rétracteur médical
US10765417B2 (en) 2014-09-13 2020-09-08 Yusuke Shimizu Medical retractor
CN108113740A (zh) * 2018-01-09 2018-06-05 江苏荷普医疗科技股份有限公司 新型桡骨远端内侧接骨装置

Also Published As

Publication number Publication date
FR2930424A1 (fr) 2009-10-30
EP2244645A1 (fr) 2010-11-03

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