DE102021104306A1 - osteosynthesis plate - Google Patents

Abstract

The invention relates to an osteosynthesis plate (10) for connecting at least two bones or bone fragments (100, 102, 104), with a first plate part (12) and a separate second plate part (14), the first plate part (12) having at least one extension (16) and wherein the second plate part (14) has at least one recess (18) for receiving the extension (16), the extension (16) and the recess (18) being fitted into one another to connect the plate parts (12, 14). whereby the extension (16) and the recess (18) are designed in such a way that the plate parts (12, 14), starting from at least two different initial positions relative to one another, by fitting the extension (16) and the recess (18) into a defined End position are brought relative to each other.

Description

The present invention relates to an osteosynthesis plate for connecting at least two bones or bone fragments, having the features of the preamble of claim 1.

Osteosynthesis is the surgical connection of two or more bones or bone fragments so that the affected structures can grow back together. Osteosynthesis is often carried out with the help of so-called osteosynthesis plates. Such osteosynthesis plates are known from the prior art.

E.g. disclosed EP 3 485 829 A1 a one-piece pelvic bone plate which has a plurality of openings for attachment and whose shape is adapted to the shape of the human pelvic bone. Due to the one-piece design and the shape of the pelvic bone plate, extensive surgical access routes are required for implantation, which should be avoided if possible.

U.S. 6,325,803 B1 discloses a device for mandibular osteosynthesis, which can have a number of components, the components being positioned relative to one another and coupled to one another, for example by means of a screw. However, the problem here is that the positioning of the components relative to one another and the introduction of the screw are difficult to handle.

The object of the invention is to provide an osteosynthesis plate that requires only comparatively compact surgical access routes and is comparatively easy to handle.

The osteosynthesis plate is used for the (mechanical) connection of at least two bones or bone fragments. The osteosynthesis plate has a first plate part and a separate second plate part, the first plate part having at least one, preferably pin-shaped, extension and the second plate part having at least one recess for receiving the extension. The extension and the recess are designed or adapted to one another in such a way that they can be fitted into one another to connect the plate parts (first plate part and second plate part). The extension and the recess are designed in such a way that the plate parts, starting from at least two or more different initial positions and/or geometries relative to one another, are brought into a defined end position relative to one another by, in particular, axially fitting the extension and the recess into one another.

The extension and the recess thus represent form-bound connection elements which allow the plate parts (modular osteosynthesis plates) to be joined in mutually predefined positions. Due to the pre-defined geometry, the plate parts can achieve or assume the desired position, orientation, force direction and/or amount of force in relation to one another and to the bones or bone fragments of the patient to be fixed, and thus help to “fix the fracture”. . Since the setting and position are geometrically predetermined and the joining process is defined, no additional tool and possibly no measurement or testing is required. The division of the plates allows insertion into the body through a smaller skin incision (access route) than before, which among other things leads to a reduction in access-related complications. The proposed osteosynthesis plate can also be used for bone fractures that are difficult to access.

When the extension and the recess are joined together, preferably axially, the plate parts, starting from one or more initial positions, reach the defined end position via one or more intermediate positions. In the end position, in particular the position and/or the orientation of the plate parts relative to one another are predetermined.

The extension and the recess can be fitted into one another in particular by axial fitting into one another. Joining together axially does not mean that the central longitudinal direction of the extension and the axial direction of the recess must always be parallel or even congruent during joining. Rather, they can also be angled towards one another.

The extension can advantageously have an outer contour which tapers, in particular conically, along the central longitudinal direction of the extension towards the free end of the extension. A tapering extension makes it easier to insert the extension into the recess. The extension can have a (tapering) circular, annular or elliptical or polygonal (e.g. pyramidal) cross-section.

As an alternative to this, the extension can have a spherical or ellipsoidal outer contour which is partially or completely formed. A joint function can be achieved with this if necessary. The spherical outer contour can (in the case of a complete design) be, for example, a sphere act in shape, e.g. like a ball joint, or (in the case of a partial design) e.g. around a hemisphere. An ellipsoidal outer contour can also be formed completely (e.g. ellipsoid) or partially.

The recess can expediently have an inner contour which tapers, in particular conically, from a first side (top side) to a second side (bottom side) of the second plate part. This configuration leads to clamping between the extension and the recess. This favors positioning and attachment of the two plate parts to one another. The recess may have a (tapering) circular or elliptical cross-section.

As an alternative to this, the recess can have a spherical or ellipsoidal inner contour which is partially or completely formed. The spherical inner contour can (in the case of a complete design) be, for example, a spherical shape or (in the case of a partial design) be, for example, a hemisphere. An ellipsoidal inner contour can also be formed completely (e.g. ellipsoid) or partially. The inner contour of the recess is preferably adapted to the outer contour of the extension.

As part of a preferred embodiment, the outer contour of the extension and the inner contour of the recess can be adapted to one another in such a way that the extension in the end position rests with its outer contour at least in sections on the inner contour of the recess, for example with at least 50 percent of the contour surfaces. This allows a large contact area to be achieved between the extension and the recess. This promotes power transmission between the components and contributes to a secure fit.

Advantageously, the axial direction of the recess can be orthogonal to a first side (top side) of the second plate part or alternatively enclose an angle of less than 90° with the first side (top side), with the central longitudinal direction of the extension and the axial direction of the recess in the end position are parallel or congruent to each other. The recess can thus be formed upright or obliquely in the second plate part. Depending on the fit, the extension in the recess is oriented upright (central longitudinal axis orthogonal to the first side) or at an angle (central longitudinal axis encloses an angle of less than 90° to a first side) to the first side (top side). If the axial direction of the recess encloses an angle of less than 90° to the first side of the second plate part, the first plate part performs a pivoting movement about a pivot axis orthogonal to the central longitudinal axis of the extension when the extension is axially fitted into the recess.

Expediently, the extension can have at least one profile feature on its outer contour, which extends punctually, axially in sections or axially completely along the outer contour, e.g. helically, with at least one further profile feature being formed on the inner contour of the recess, which extends punctually, axially extends in sections or axially completely along the inner contour of the recess, e.g. helically, the profile feature and the further profile feature being at least partially, preferably completely, complementary to one another and engaging with one another when the extension and the recess are axially fitted into one another. In other words, the profile features run into one another when the extension and recess are joined together axially.

A profile feature that extends at certain points along the outer contour or the inner contour can be, for example, a (punctual), optionally spherical projection, for example a nub. In the case of an axially sectional configuration, the profile feature extends only along part of the outer contour or the inner contour. In the case of an axially complete configuration, the profile feature extends along the entire outer contour or inner contour.

In the case of a helical design, the profile features can have the same pitch and be designed with the same pitch (both right-hand or both left-hand). When the extension is axially fitted into one another in the recess, the first plate part then performs a rotational movement relative to the second plate part about the central longitudinal axis of the recess due to the profile features running into one another.

Specifically, one of the profile features, in particular the profile feature of the extension, can be designed as a projection, and the other profile feature, in particular the profile feature of the recess, can be designed as a depression for receiving the projection. These are structurally simple and stable profile features. The projection can extend without interruptions or with interruptions (helical) along the outer contour.

In the context of a preferred embodiment, the extension can have a passage that extends along its central longitudinal direction through the extension (and possibly through the first plate part), the recess being designed as a passage that extends along an axial direction direction extends through the second plate part, wherein in the end position of the passage of the extension and the recess designed as a passage form a (common and/or continuous) channel for inserting a fastening element, e.g. a screw. A fastening element can thus be introduced directly at the connection of the two plate parts. This favors alignment of the plate parts relative to one another and attachment of the plate parts to the bone or bone fragments.

Expediently, the first plate part can have a holding arm spaced apart from the extension, extending parallel or at an angle to the central longitudinal axis of the extension, which in the end position extends beyond the second plate part in order to hold a bone or a bone fragment (broken-out structure) relative to to hold another bone or bone fragment (preserved structure). This is particularly advantageous in the case of bone fractures that are difficult to access. Thus, when the extension and recess are axially joined together, the holding arm can reach behind the broken-out structure and position or move it in the direction of the structure obtained. In the end position, the holding arm can press the broken-out structure against the structure obtained. The second plate part can, for example, be fastened to the structure obtained.

• 1 eine Ausführungsform einer Osteosyntheseplatte in einer Draufsicht (1a) und in einer Schnittansicht gemäß Schnittachse A-A in 1a (1b);
• 2 eine weitere Ausführungsform einer Osteosyntheseplatte in einer schematischen Schnittansicht beim Ineinanderfügen des Fortsatzes und der Ausnehmung in einer Zwischenstellung ( 2a) und einer Endstellung (2b);
• 3 eine weitere Ausführungsform einer Osteosyntheseplatte in einer schematischen perspektivischen Ansicht;
• 4 die Ausführungsform aus 3 beim axialen Ineinanderfügen des Fortsatzes und der Ausnehmung in einer Anfangsstellung (4a), einer Zwischenstellung (4b) und einer Endstellung (4c);
• 5 eine weitere Ausführungsform einer Osteosyntheseplatte in einer schematischen perspektivischen Ansicht; und
• 6 die Ausführungsform aus 5 beim axialen Ineinanderfügen des Fortsatzes und der Ausnehmung in einer Anfangsstellung (6a), einer Zwischenstellung (6b) und einer Endstellung (6c).

The invention is explained in more detail below with reference to the figures, with identical or functionally identical elements being provided with identical reference symbols, but possibly only once. Show it:

• 1 an embodiment of an osteosynthesis plate in a plan view ( 1a) and in a sectional view along section axis AA in 1a ( 1b) ;
• 2 a further embodiment of an osteosynthesis plate in a schematic sectional view when the extension and the recess are joined together in an intermediate position ( 2a) and an end position ( 2 B) ;
• 3 a further embodiment of an osteosynthesis plate in a schematic perspective view;
• 4 the embodiment 3 during the axial fitting of the extension and the recess in an initial position ( 4a) , an intermediate position ( 4b) and an end position ( 4c );
• 5 a further embodiment of an osteosynthesis plate in a schematic perspective view; and
• 6 the embodiment 5 during the axial fitting of the extension and the recess in an initial position ( 6a) , an intermediate position ( 6b) and an end position ( 6c ).

the 1a and 1b show an embodiment of an osteosynthesis plate, which is denoted by the reference numeral 10 in its entirety. The osteosynthesis plate 10 has a first plate part 12 and a separate second plate part 14 . In the example, the first plate part 12 has two peg-shaped extensions 16 . The second plate part 14 has two recesses 18 for receiving one of the extensions 16 in each case.

The extensions 16 and the recesses 18 can be fitted into one another to connect the two plate parts 12, 14. The extensions 16 and the recesses 18 are designed in such a way that the plate parts 12, 14, starting from at least two different initial positions relative to one another, are brought into a defined end position relative to one another by fitting the extensions 16 and the recesses 18 into one another (end position in 1a and 1b shown).

The extensions 16 each have an outer contour 20 which tapers conically along the central longitudinal direction 22 of the extension 16 towards the free end of the extension 16 (cf. 1b) . The recesses 18 each have an inner contour 24 which tapers conically from a first side 26 (top side 26) to a second side 28 (bottom side 28) of the second plate part 14 . The outer contour 20 of the extension 16 and the inner contour 24 of the recess 18 are each adapted to one another in such a way that the extension 16 in the end position rests with its outer contour 20 at least in sections, in the example even completely on the inner contour 24 of the recess 18.

The axial direction 30 of the recesses 18 is orthogonal to the first side 26 (top side 26) of the second plate part 14, with the central longitudinal direction 22 of the extensions 16 and the axial direction 30 of the recesses 18 being congruent to one another in the end position (central longitudinal direction 22 and axial direction 30, respectively represented by a common line) .

The extensions 16 each have a passage 32 which extends along its central longitudinal direction 22 through the extension 16 and through the first plate part 12, with the recess 18 being designed as a passage which extends along the axial direction 30 through the second plate part 14 , Wherein in the end position of the passage 32 of the extension 16 and designed as a passage recess 18 in the example a Gemeinsa men and continuous channel for inserting a fastener, e.g. a screw (cf. 1b) .

The first plate part 12 and the second plate part 14 can have further passages, in the example a passage 34 and a passage 36.

the 2a and 2 B show another embodiment of an osteosynthesis plate 10 in schematic sectional views. The basic structure of the osteosynthesis plate 10 corresponds to that in connection with 1a and 1b described embodiment, so that to avoid repetition reference is made to the statements there.

The osteosynthesis plate 10 according to 2a and 2 B may have one or more projections 16 and one or more recesses 18, with only one projection 16 and only one recess 18 being shown.

The second plate part 14 is positioned on a bone 100 which is only shown schematically here and which has a preserved structure 102 and a broken-out structure 104 . The second plate part 14 can be attached to the resulting structure 102, for example by means of one or more screws (not shown).

The first plate part 12 has a retaining arm 40 which is spaced apart from the extension 16 and extends, in the example, parallel to the central longitudinal direction 22 of the extension 16, which at least in the intermediate position (cf. 2a) and in the final position (cf. 2 B) extends beyond the second plate portion 14 to hold the fractured structure 104 (bone or bone fragment) relative to the preserved structure 102 (further bone or bone fragment).

In the example, when the extension 16 and the recess 18 are joined together, the holding arm 40 engages behind the broken-out structure 104 in the intermediate position (cf. 2a) . As the process of joining continues, the extension 16 reaches the end position in the recess 18 (cf. 2 B) , wherein the support arm 40 displaces the broken-out structure 104 toward the preserved structure 102 and presses the broken-out structure 104 against the preserved structure 102 . Thus, the broken structure 104 and the structure 102 obtained can grow together.

3 and the 4a until 4c show a further embodiment of an osteosynthesis plate 10 in a simplified representation, wherein only the second plate part 14 with the recess 18 and the extension 16 are shown alone (without the second plate part 12). The basic structure of the osteosynthesis plate 10 corresponds to that in connection with 1a and 1b described embodiment, so that to avoid repetition reference is made to the statements there.

The axial direction 30 of the recess 18 encloses an angle of less than 90° with the first side 26 (top side 26). In the example, the angle of inclination of the axial direction 30 to the normal vector of the first side 26 is 10°, i.e. the axial direction 30 encloses an angle of 80° with the first side 26 (not shown). Other angles are also conceivable.

the 4a until 4c show the joining of the extension 16 and the recess 18 in an initial position (cf. 4a) , an intermediate position (cf. 4b) and an end position (cf. 4c ). Due to the angular position of the axial direction 30, the extension 16 and the first plate part 12 (not shown here) perform a pivoting movement about a direction orthogonal to the central longitudinal axis 22 of the extension 16 (from the plane of the drawing in Fig 4a until 4c orthogonally outstanding) pivot axis through (not shown).

In the final position (cf. 4c ) The central longitudinal direction 22 of the extension 16 and the axial direction 30 of the recess 18 are congruent to one another. Due to the angle of the axial direction 30 of 10° in the example, the extension 16 and the first plate part 12 are also oriented at an angle of 10° to the first side 26, i.e. the central longitudinal direction 22 of the extension 16 closes an angle with the first side 26 in the example from 80° (cf. 4c ).

The outer contour 20 of the extension 16 tapers conically along the central longitudinal direction 22 of the extension 16 towards the free end of the extension 16 . The inner contour 24 of the recess 18 also tapers conically from the first side 26 to the second side 28 of the second plate part 14 .

5 and the 6a until 6c show a further embodiment of an osteosynthesis plate 10 in a simplified representation, wherein only the second plate part 14 with the recess 18 and the extension 16 are shown alone (without the second plate part 12). The basic structure of the osteosynthesis plate 10 corresponds to that in connection with 1a and 1b described embodiment, so that to avoid Repetitions are referred to the statements there.

The extension 16 has at least one profile feature 50 on its outer contour 20, three profile features 50 being provided in the example. The profile features 50 each extend helically along the outer contour 20 of the extension 16, with the profile features 50 being arranged regularly around the outer contour 20 in the example, here, for example, with an angular offset of 120° each around the central longitudinal direction 22 of the extension 16 (cf. 5 ). Another angular offset is also conceivable.

At least one further profile feature 52 is formed on the inner contour 24 of the recess 18, with three further profile features 52 being provided in the example. The further profile features 52 each extend helically along the inner contour 24 of the recess 18, with the further profile features 52 being arranged regularly around the inner contour 24 in the example, e.g. with an angular offset of 120° each around the axial direction 30 of the recess 18 (in 5 only partially shown).

The profile features 50 and the further profile features 52 are complementary to one another and come into engagement with one another when the extension 16 and the recess 18 are fitted together. In the example, the profile features 50 of the extension 16 are each designed as a projection and the further profile feature 52 of the recess 18 is designed as a depression for receiving the projection 54 .

the 6a until 6c show the joining of the extension 16 and the recess 18 in an initial position (cf. 6a) , an intermediate position (cf. 6b) and in an end position (cf. 6c ). The profile features 52, 54 run into one another as a result of the fitting of the projection 16 and recess 18 into one another. Since the projections 52, 54 each extend helically, the extension 16 and thus also the first plate part 12 (not shown) rotates relative to the recess 18 and to the second plate part 14 about the axial direction 30 of the recess 18 (cf. 6a until 6c ).

The outer contour 20 of the extension 16 tapers conically along the central longitudinal direction 22 of the extension 16 towards the free end of the extension 16 . The inner contour 24 of the recess 18 also tapers conically from the first side 26 to the second side 28 of the second plate part 14 . In the end position, the outer contour 20 and the inner contour 24 come into contact with one another at least in sections, so that the extension 16 cannot be rotated any further into the recess 18 . However, the extension 16 can be released from the recess 18 again by rotating it in the opposite direction.

In the example, the recess 18 is oriented upright in the second plate part 14, i.e. the axial direction 30 of the recess 18 is oriented parallel to the normal direction of the first side 26 (axial direction 30 is oriented orthogonally with respect to the first side 26).

In the context of an embodiment that is not shown, it is conceivable that the axial direction 30 encloses an angle of less than 90° with the first side 26 (similar to that in FIGS 3 and 4a until 4c ). The extension 16 and the first plate part 12 would thus be oriented at an angle of, for example, 10° to the normal direction of the first side 26;

QUOTES INCLUDED IN DESCRIPTION

This list of the documents cited by the applicant was generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Patent Literature Cited

• EP 3485829 A1 [0003]
• US 6325803 B1 [0004]

Claims (9)

Osteosynthesis plate (10) for connecting at least two bones or bone fragments (100, 102, 104), with a first plate part (12) and a separate second plate part (14), characterized in that the first plate part (12) has at least one extension ( 16) and that the second plate part (14) has at least one recess (18) for receiving the extension (16), it being possible for the extension (16) and the recess (18) to be fitted into one another to connect the plate parts (12, 14). , wherein the extension (16) and the recess (18) are designed in such a way that the plate parts (12, 14), starting from at least two different initial positions relative to one another, are brought into a defined end position by fitting the extension (16) and the recess (18) into one another be brought relative to each other. Osteosynthesis plate (10) after claim 1 , characterized in that the extension (16) has an outer contour (20) which tapers along the central longitudinal direction (22) of the extension (16) towards the free end of the extension (16) or that the extension (16), partially or completely, has a spherical or ellipsoidal outer contour (20). Osteosynthesis plate (10) after claim 1 or 2 , characterized in that the recess (18) has an inner contour (24) which tapers from a first side (26) to a second side (28) of the second plate part (14) or that the recess (18), partially or completely, has a spherical or ellipsoidal inner contour (24). Osteosynthesis plate (10) after claim 2 or 3 , characterized in that the outer contour (20) of the extension (16) and the inner contour (24) of the recess (18) are adapted to one another in such a way that the extension (16) in the end position with its outer contour (20) at least partially on the Inner contour (24) of the recess (18). Osteosynthesis plate (10) according to one of the preceding claims, characterized in that the axial direction (30) of the recess (18) is orthogonal to a first side (26) of the second plate part (14) or at an angle of less than 90° with the first Side (26) includes, wherein in the end position the central longitudinal direction (22) of the extension (16) and the axial direction (30) of the recess (18) are parallel or congruent to each other. Osteosynthesis plate (10) according to one of the preceding claims, characterized in that the extension (16) has on its outer contour (20) at least one profile feature (50) which extends at points, axially in sections or axially completely along the outer contour (20), At least one further profile feature (52) is formed on the inner contour (24) of the recess (18) and extends at points, axially in sections or axially completely along the inner contour (24) of the recess (18), the profile feature (50 ) and the further profile feature (52) are at least partially complementary to one another and engage one another upon mating of the extension (16) and the recess (18). Osteosynthesis plate (10) after claim 6 , characterized in that one of the profile features (50, 52), in particular the profile feature (50) of the extension (16) as a projection, and the other profile feature (52, 50), in particular the profile feature (52) of the recess (18) , is designed as a recess for receiving the projection. Osteosynthesis plate (10) according to one of the preceding claims, characterized in that the extension (16) has a passage (32) which extends through the extension (16) along its central longitudinal direction (22), the recess (18) being passage is formed, which extends along an axial direction (30) through the second plate part (14), wherein in the end position the passage (32) of the extension (16) and the recess (18) formed as a passage form a channel for inserting a fastening element form. Osteosynthesis plate (10) according to one of the preceding claims, characterized in that the first plate part (12) has a holding arm (40) spaced apart from the extension (16) and extending parallel or at an angle to the central longitudinal direction (22) of the extension (16). , which, at least in the end position, extends beyond the second plate part (14) in order to hold a bone or a bone fragment (104) relative to a further bone or bone fragment (102).

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