WO2011121512A2 - Systeme externe de stabilisation et de distraction de surfaces osseuses courbes - Google Patents

Systeme externe de stabilisation et de distraction de surfaces osseuses courbes Download PDF

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Publication number
WO2011121512A2
WO2011121512A2 PCT/IB2011/051287 IB2011051287W WO2011121512A2 WO 2011121512 A2 WO2011121512 A2 WO 2011121512A2 IB 2011051287 W IB2011051287 W IB 2011051287W WO 2011121512 A2 WO2011121512 A2 WO 2011121512A2
Authority
WO
WIPO (PCT)
Prior art keywords
distraction
bone
rod
clamp
allows
Prior art date
Application number
PCT/IB2011/051287
Other languages
English (en)
Other versions
WO2011121512A3 (fr
Inventor
Rajiv Agarwal
Sanjeev Agarwal
Original Assignee
Rajiv Agarwal
Sanjeev Agarwal
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 Rajiv Agarwal, Sanjeev Agarwal filed Critical Rajiv Agarwal
Publication of WO2011121512A2 publication Critical patent/WO2011121512A2/fr
Publication of WO2011121512A3 publication Critical patent/WO2011121512A3/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
    • A61B17/56—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
    • A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
    • A61B17/64—Devices extending alongside the bones to be positioned
    • A61B17/6466—Devices extending alongside the bones to be positioned with pin-clamps movable along a solid connecting rod
    • A61B17/6475—Devices extending alongside the bones to be positioned with pin-clamps movable along a solid connecting rod the connecting rod being threaded
    • 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
    • A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
    • A61B17/64—Devices extending alongside the bones to be positioned
    • A61B17/6466—Devices extending alongside the bones to be positioned with pin-clamps movable along a solid connecting rod
    • A61B17/6483—Devices extending alongside the bones to be positioned with pin-clamps movable along a solid connecting rod the connecting rod having a non-circular section
    • 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
    • A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
    • A61B17/66—Alignment, compression or distraction mechanisms
    • 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
    • A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
    • A61B17/66—Alignment, compression or distraction mechanisms
    • A61B17/663—Alignment, compression or distraction mechanisms for jaw bones, e.g. subcutaneous distractors with external access

Definitions

  • the present invention relates generally to bone distraction, and more specifically, to system and methods for performing distraction of bones with curved surfaces in a cost effective, secure and versatile manner.
  • Distraction is a technique by which two segments of a bone after cutting are gradually separated from each other to allow new bone to be formed between the two segments.
  • the devices of distraction are also being modified and developed to suit the ever challenging demands of difficult bone anatomy.
  • Many designs of distractors are currently available which allow distraction osteogenesis of bony defects in the desired location. These devices however perform distraction based upon a straight threaded rod hence the regeneration of new bone occurs in a straight line. This is of optimum use in situations where the bone to be regenerated has to be in one axis.
  • This invention creates an external system for stabilization, distraction and compression osteogenesis for curved bone surfaces of the body in craniofacial skeleton, thoracic cage, pelvis and other similar bony surfaces.
  • the system allows anatomical stabilization along with simultaneous predictable and controlled distraction osteogenesis for bone losses in these regions where curvilinear regenerate is required to match the functional, occlusal and aesthetic requirements of reconstruction.
  • This system has a semicircular, threaded, curved rod which conforms to the shape of the curved bones of the human skeleton including mandible, maxilla, zygoma, calvarium, ribs, pelvis and other curved bones.
  • This rod can also be split into two equal pieces for use over a smaller area or over one side of the body.
  • This rod serves as the main component of this system. Bone stabilization and transport distraction are accomplished with the help of different assemblies that are attached on to this rod.
  • the present invention embodies three different assemblies having different functions but achieving the same goals of bone stabilization and bone transport for distraction and compression osteogenesis.
  • the first assembly is the stabilization assembly which helps in the rigid fixation of the frame to the bone thereby stabilizing the bony fragments securely.
  • the second assembly is the bone transport assembly which consists of one or two moveable clamp assemblies fixed at one end to the bone while the base unit of this assembly glides and engages on the threads of the semicircular distraction rod. This allows bone regeneration and laying down of new bone in a natural position in a curvilinear manner along the original anatomical topography of the bone.
  • the third assembly is the multivector distraction assembly which is also mobile at one end on the distraction rod while the other end is anchored to the bone through incorporation of distraction rod and 360° swivel joint. This arrangement allows bone distraction in the vertical and transverse axes in addition to the horizontal distraction performed by the bone transport assembly.
  • the system of three assemblies allows bone stabilization along with transport distraction in all the x,y and z axes and henceforth paves the way for repair and regeneration of challenging and difficult defects or deficiencies of the bone arising since birth, after trauma, infection, neoplastic resection or surgical remouldings.
  • Another great advantage of this system is the virtual avoidance of the use of autogenous bone grafts or expensive bone substitutes for reconstruction of the bone. All bone grafts involve the risk of failure, infection and donor site morbidity. This system obviates the use of any type of bone grafts. In addition the technique of transport distraction also distracts the soft tissues hence soft tissue covers for bone defect also become redundant with this invention.
  • the system is external hence it is especially useful for treating segmental bone losses in presence of contamination and allows for stable and secure fixation and reconstruction of the skeleton.
  • a millimeter scale is given on the distraction rod which helps in ready measurement of the amount of distraction done as calculated by increasing distance between the clamps.
  • the process of distraction is simple and can be performed by the patient himself after a session of patient education.
  • the patient activation spanner and screwdriver are ergonomical and user friendly for effortless and convenient distraction experience.
  • the present invention can be used for treating bony deformities, deficiencies and defects in all age groups ranging from congenital deficiency, hypoplasia, traumatic loss or neoplastic resection for the craniofacial skeleton, thoracic cage, pelvis and other curved bony surfaces of the body.
  • Figure 1 is the front view of a system for bone distraction, according to an exemplary embodiment of the present invention
  • Figure 1A is the side view of a system for bone distraction, according to an exemplary embodiment of the present invention.
  • Figure IB is the curved, semicircular, threaded distraction rod, according to an exemplary embodiment of the present invention.
  • Figure 1C is the curved, hemi-semicircular, threaded distraction rod, according to an exemplary embodiment of the present invention
  • Figure 2A is the pin holding clamp of the stabilization assembly, according to an exemplary embodiment of the present invention.
  • Figure 2B is the clamp mount of the stabilization assembly, according to an exemplary embodiment of the present invention.
  • Figure 2C is the clamp mount of the bone transport assembly, according to an exemplary embodiment of the present invention.
  • Figure 2D is the clamp mount of the multivector distraction assembly, according to an exemplary embodiment of the present invention.
  • Figure 2E is the distraction rod of the multivector distraction assembly, according to an exemplary embodiment of the present invention.
  • Figure 2F is the pin holding clamp of the multivector distraction assembly, according to an exemplary embodiment of the present invention
  • Figure 3A is the view of the patient activation distraction spanner, according to an exemplary embodiment of the present invention
  • Figure 3B is the view of the device activation screwdriver, according to an exemplary embodiment of the present invention.
  • Figure 3C is the multivector distraction screwdriver, according to an exemplary embodiment of the present invention.
  • Figure 4 is a view of the invention being used to treat mandible defect, according to an exemplary embodiment of the present invention
  • Figure 5 is a view of the invention being used on the calvarium, according to an exemplary embodiment of the present invention.
  • Figure 6 is a view of the invention being used on the maxilla, zygoma according to an exemplary embodiment of the present invention
  • Figure 7 is a view of the invention being used on the rib, according to an exemplary embodiment of the present invention.
  • Figure 8 is a view of the invention being used on the pelvis, according to an exemplary embodiment of the present invention.
  • Fig. 1 is a front view of the invention.
  • the system is comprised of a semicircular threaded rod 1A conforming to the shape of the curved bony surface.
  • This rod houses assemblies of various types of pin holding clamps meant for functions of stabilization of the mandible, multivector distraction, transport distraction and compression osteogenesis.
  • Each assembly engages on the threads of the central rod and move in a controlled directional manner.
  • Each assembly is composed of two rectangular blocks which are connected to each other by a controlled ball and socket type of attachment.
  • the pin / screw holding clamp 2A is the part which engages the bone and the clamp mount 2B, 2C is the part which engages on to the threaded curved rod.
  • the ball and socket joint type of connecting arrangement allows complete mobility of the blocks relative to each other in all angles along with provision for fixing these blocks in any particular position by a screw.
  • the bone stabilisation is done with the help of stabilisation assembly 2A, 2B minimum two in number, which are fixed towards both ends of the central rod for anchorage in the bone.
  • the bone transport assembly 2A, 2C consists of similar two interconnected rectangular blocks of which the lower one, 2C moves along the threads of the central rod and the upper one, 2A has three holes arranged in triangular orientation to each other for fixing to the bone / transport disc.
  • a half ellipse threaded rod may also be used in place of the full central elliptical rod and all these assemblies may be used on this rod.
  • the multivector distraction assembly, 2D has a clamp mount which engages on the threaded rod and a multivector distraction assembly with a threaded distraction rod and pin clamp, 2F.
  • Figure 1A is the side view of the system for bone distraction, according to an exemplary embodiment of the present invention.
  • FIG. IB is a semicircular curved threaded central rod which forms the basic component of this invention.
  • the curvature of this rod conforms to the shape of the curved surface of the bones.
  • This rod on cross-section has a shape conforming to the letter 'D' so that one end is flat while the other end is curved 1.
  • the flat end is towards the outer convex side away from the body so that it allows easy visibility and allows flat surface for tightening of the clamp mounts of the different assemblies.
  • a scale for measurement of the distraction distance 2 on the flat surface allows precise measurement of the movement of the clamps.
  • the other end 3 is curved with threads for passage of the bone distraction clamps 2C and 2D.
  • FIG. 1C which is a half semicircular curved threaded central rod and is half length of the semicircular rod IB. It has the same features as IB. It is useful when stabilization or distraction is required on any one side or half of the body for bone defects restricted to one particular half of the body. The curvature of this rod too conforms to the shape of the curved surface of the bones.
  • FIG. 2A which shows the pin holding clamp 2A.
  • This pin / screw holding clamp is similar and common for both the stabilization and bone transport assemblies.
  • This clamp in front view 4 has three holes 8, 9, and 10 arranged in a triangular orientation to each other. This allows the use of the best bone anchorage depending upon the particular situation in a given case. Each hole is traversed by a headless screw which helps in tightening the pins/ screws to the clamp.
  • the side view 5 shows a slot for the headless screw which helps in fixing this clamp with the clamp mount 2B.
  • 6 shows the top view of this clamp showing the slots for the headless screws which help in individually tightening the pins on this clamp.
  • 7 shows the headless screw which is used for tightening the pins.
  • An alternative embodiment of the design of the clamps 2A may consist of a central midline square cut with a central square shaped projection in the midline at the lower end of the clamp which is away from the clamp end harbouring the distraction rod.
  • the same design of three holes is made in this clamp with two holes at the lower part and a single midline hole in the square projection.
  • This alternative design also carries the same versatility and functionality as the clamp design. All these holes are also controlled independently by headless screws.
  • FIG. 2B which is the clamp mount of the stabilization assembly.
  • This clamp on front view 12 has a 'D' shaped slot 14 for accommodating the rod 1C.
  • On the top it has a knob 13 which helps in fixing this to the screw holding clamp 2A.
  • Clamp 2A and 2B together make up the stabilization assembly for this invention.
  • FIG. 2C which is the clamp mount of the bone transport assembly.
  • Components 2A and 2C together make up the bone transport assembly of this invention.
  • 17 shows the front view of the clamp mount of the bone transport assembly. It has a 'D' shaped slot for housing the rod 1A and the side view is shown in 18. It has no tightening screw unlike the component 2B. On one side it has a slot 19 for sliding and engaging the nut 20.
  • This nut engages on side to the clamp and is in turn engaged to the threads of rod 1A.
  • the nut can be easily moved along the threads in either direction in a controlled manner and it takes with itself the bone transport assembly.
  • the wider part of the nut 20 with threads on the inner aspect engages with the rod 1A while the flange slides onto a matching slot onto the Clamp 2C.
  • Components 2A and 2C together make the bone transport assembly of this invention.
  • FIG. 2D which shows the components of the multivector distraction assembly.
  • the clamp mount 2D engages on the semicircular rod IB with the help of nut 20.21 shows the side view of this clamp with slots for the distraction rod and 22 shows the front view with the upper end having slot for the straight distraction rod.
  • FIG. 2F which shows the pin holding clamp of the multivector distraction assembly.21 shows the side view and 22 shows the view facing the bone. It has slots 25, 26 and 27 for anchorage to the bone. Slot 28 is for the distraction rod 2E which is a threaded distraction rod with a measuring scale. The end of the distraction rod 2E is fixed to this clamp 2F.
  • FIG. 3A is the view of the patient activation distraction spanner. It has a spanner at one end which engages in the nut 20 and helps in rotation of the nut which in turn moves the bone transport and multivector distraction assemblies.
  • the end has a line marking 29 to help identify the completeness of one turn.
  • One full turn of 360° moves the assemblies by one mm.
  • FIG. 3B which is the device activation screwdriver. It has a solid shaft 30 which engages in the internal headless screws of the clamps, 7 to help in tightening and assembly of the device.
  • the endon view of this shaft 31 is shown in the inset.
  • FIG. 3C which is the multivector distraction screwdriver. It has a hollow shaft which accommodates and slides over the distraction rod 2E and the end of this shaft 33 engages with the nut 20. This end has a marking line 32 which denotes the amount of rotation of the screwdriver.
  • the arrow 35 denotes the direction of movement of the screwdriver to the patient or caregiver which leads to separation between the clamps and thus causing distraction.
  • One full turn of 360° as confirmed by the mark 35 moves the rod to a distance of 0.5 mm.
  • the end on view of the hollow shaft 35 is shown in the inset which shows the hexagonal configuration of the internal surface.
  • the surface of the handle of this screwdriver is made ergonomical 36 so as to allow a comfortable grip between the fingers and thumb.
  • FIG 4 is a depiction of the view of the invention being used to stabilize and perform transport distraction osteogenesis for defects of the mandible.
  • the skin and muscles are not shown to better illustrate the procedure.
  • the stabilization, bone transport and multivector distraction assemblies 2A- 2F are shown.
  • FIG. 5 is a depiction of the view of the invention being used to stabilize and perform transport distraction osteogenesis for defects of the calvarium.
  • the skin and muscles are not shown to better illustrate the procedure.
  • the stabilization, bone transport and multivector distraction assemblies 2A- 2F are shown.
  • FIG. 6 is a depiction of the view of the invention being used to stabilize and perform transport distraction osteogenesis for defects of the maxilla and zygoma.
  • the skin and muscles are not shown to better illustrate the procedure.
  • the stabilization, bone transport and multivector distraction assemblies 2A- 2F are shown.
  • FIG. 7 is a depiction of the view of the invention being used to stabilize and perform transport distraction osteogenesis for defects of the ribs.
  • the half semicircular rod is useful in this situation.
  • the skin and muscles are not shown to better illustrate the procedure.
  • the stabilization, bone transport and multivector distraction assemblies 2A- 2F are shown.
  • FIG 8 is a depiction of the view of the invention being used to stabilize and perform transport distraction osteogenesis for defects of the pelvis.
  • the half semicircular rod is useful in this situation.
  • the skin and muscles are not shown to better illustrate the procedure.
  • the stabilization, bone transport and multivector distraction assemblies 2A- 2F are shown.
  • a complete osteotomy is necessary in the bone for transport distraction.
  • the completeness of the osteotomy is confirmed before proceeding with fixation of the distractor.
  • the distractor is then fixed onto the bone with the help of Schanz screws.
  • First the line of osteotomy is marked as per the operative plan and screw locations (3) on both the sides of osteotomy are predetermined and marked.
  • the screws (3 on each side) are drilled bicortically into the bone on both the sides of the marked osteotomy site keeping adequate distance from the line of osteotomy. After drilling of each screw the fit of the distractor is checked. Once all the screws are drilled, the osteotomy is completed and the distractor is fixed with these screws on clamps with the help of internal headless screws.
  • Rotation- activation of the nut 20 causes the clamps to move apart thus causing distraction of the bone. This stimulates new growth at the site of the osteotomy and thus regenerates the bone in the desired natural curved contour without the need of callomodulation as seen the conventional and current devices which incorporate linear activation rods in their design.
  • the distractor is activated so it permits elongation at a rate of 1 mm a day. This elongation is continued till the desired end point after which a period of consolidation is allowed.
  • the invention is made of stainless steel; but those of ordinary skill in the art readily recognize that this distractor can be manufactured from hardened silicone, hardened plastic, titanium or any number of other materials.
  • the present invention creates a stable yet effective and easy system for bone stabilization and transport distraction for bone regeneration in all the three axes for curved bone surfaces of the body.

Abstract

L'invention concerne la création d'un système externe d'ostéogenèse par stabilisation, distraction et compression pour les surfaces osseuses courbes du corps dans le squelette craniofacial, la cage thoracique, le pelvis et autres surfaces osseuses analogues. Le système de l'invention permet une stabilisation anatomique en même temps qu'une ostéogenèse en distraction prévisible et contrôlable pour les pertes osseuses dans les régions où il est nécessaire d'obtenir un régénérat curviligne pour satisfaire aux exigences fonctionnelles, occlusales et esthétiques de la reconstruction. Le système utilisé est constitué d'une tige semi-circulaire filetée épousant la forme des surfaces osseuses courbes à réparer. La tige est pourvue d'un assemblage de divers types de pinces de support de broches destinées à assurer des fonctions de stabilisation de mandibule, de distraction multivecteur, de distraction de transport et d'ostéogenèse en compression. Selon l'invention, tous ces assemblages viennent en contact avec les filets de la tige centrale et se déplacent d'une manière directionnelle contrôlée. Chaque assemblage est constitué de deux blocs rectangulaires reliés l'un à l'autre par un type de fixation à rotule contrôlé.
PCT/IB2011/051287 2010-03-27 2011-03-26 Systeme externe de stabilisation et de distraction de surfaces osseuses courbes WO2011121512A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IN732DE2010 2010-03-27
IN732/DEL/2010 2010-03-27

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WO2011121512A2 true WO2011121512A2 (fr) 2011-10-06
WO2011121512A3 WO2011121512A3 (fr) 2011-12-15

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Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
ITRM20120574A1 (it) * 2012-11-19 2014-05-20 Univ Roma Fissatore esterno mandibolare
CN104644252A (zh) * 2015-02-02 2015-05-27 中国人民解放军第306医院 一种分段式弧形牵张成骨器
CN106264857A (zh) * 2016-08-31 2017-01-04 复旦大学附属华山医院 可调节弧形导轨式眼眶牵引器
WO2016209947A3 (fr) * 2015-06-22 2017-05-04 Smith & Nephew, Inc. Fixateur pelvien interne
RU2655086C1 (ru) * 2017-07-17 2018-05-23 Федеральное государственное бюджетное образовательное учреждение высшего образования "Волгоградский государственный медицинский университет" Министерства здравоохранения Российской Федерации ФГБОУ ВО ВолгГМУ МЗ РФ Экзоскелет нижней челюсти
RU2680025C1 (ru) * 2017-10-23 2019-02-14 Александр Анатольевич Слетов Устройство для оптимизации биомеханики нижней челюсти с субтотальным дефектом
EP3581130A1 (fr) * 2017-08-01 2019-12-18 Medizinische Hochschule Hannover Dispositif de transport de segment osseux modulaire universel
RU2764501C1 (ru) * 2021-04-13 2022-01-17 Государственное автономное учреждение здравоохранения "Республиканская клиническая больница Министерства здравоохранения Республики Татарстан" Устройство для репозиции нестабильных повреждений тазового кольца со смещением
EP4061261A4 (fr) * 2020-02-18 2023-12-13 Wright Medical Technology, Inc. Dispositif de fixation d'os
RU2816063C1 (ru) * 2023-06-23 2024-03-26 Государственное автономное учреждение здравоохранения "Республиканская клиническая больница Министерства здравоохранения Республики Татарстан" Способ репозиции нестабильных повреждений тазового кольца с вертикальным смещением

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Cited By (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2014076681A1 (fr) * 2012-11-19 2014-05-22 Universita' Degli Studi Di Roma "La Sapienza" Fixateur mandibuaire externe
ITRM20120574A1 (it) * 2012-11-19 2014-05-20 Univ Roma Fissatore esterno mandibolare
CN104644252A (zh) * 2015-02-02 2015-05-27 中国人民解放军第306医院 一种分段式弧形牵张成骨器
US10575874B2 (en) 2015-06-22 2020-03-03 Smith & Nephew, Inc. Internal pelvic fixator
WO2016209947A3 (fr) * 2015-06-22 2017-05-04 Smith & Nephew, Inc. Fixateur pelvien interne
CN107920845A (zh) * 2015-06-22 2018-04-17 史密夫和内修有限公司 骨盆内固定器
US11490930B2 (en) 2015-06-22 2022-11-08 Smith & Nephew, Inc. Internal pelvic fixator
CN107920845B (zh) * 2015-06-22 2021-04-27 史密夫和内修有限公司 骨盆内固定器
CN106264857A (zh) * 2016-08-31 2017-01-04 复旦大学附属华山医院 可调节弧形导轨式眼眶牵引器
RU2655086C1 (ru) * 2017-07-17 2018-05-23 Федеральное государственное бюджетное образовательное учреждение высшего образования "Волгоградский государственный медицинский университет" Министерства здравоохранения Российской Федерации ФГБОУ ВО ВолгГМУ МЗ РФ Экзоскелет нижней челюсти
EP3581130A1 (fr) * 2017-08-01 2019-12-18 Medizinische Hochschule Hannover Dispositif de transport de segment osseux modulaire universel
RU2680025C1 (ru) * 2017-10-23 2019-02-14 Александр Анатольевич Слетов Устройство для оптимизации биомеханики нижней челюсти с субтотальным дефектом
EP4061261A4 (fr) * 2020-02-18 2023-12-13 Wright Medical Technology, Inc. Dispositif de fixation d'os
RU2764501C1 (ru) * 2021-04-13 2022-01-17 Государственное автономное учреждение здравоохранения "Республиканская клиническая больница Министерства здравоохранения Республики Татарстан" Устройство для репозиции нестабильных повреждений тазового кольца со смещением
RU2816063C1 (ru) * 2023-06-23 2024-03-26 Государственное автономное учреждение здравоохранения "Республиканская клиническая больница Министерства здравоохранения Республики Татарстан" Способ репозиции нестабильных повреждений тазового кольца с вертикальным смещением

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