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WO2018064779A1 - Ensemble implant d'ostéosynthèse modulaire - Google Patents

Ensemble implant d'ostéosynthèse modulaire Download PDF

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Publication number
WO2018064779A1
WO2018064779A1 PCT/CH2016/000128 CH2016000128W WO2018064779A1 WO 2018064779 A1 WO2018064779 A1 WO 2018064779A1 CH 2016000128 W CH2016000128 W CH 2016000128W WO 2018064779 A1 WO2018064779 A1 WO 2018064779A1
Authority
WO
WIPO (PCT)
Prior art keywords
bone
plate
modular
implant assembly
osteosynthesis implant
Prior art date
Legal status (The legal status 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 status listed.)
Ceased
Application number
PCT/CH2016/000128
Other languages
English (en)
Inventor
Pietro Regazzoni
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Suratec GmbH
Original Assignee
Suratec GmbH
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 Suratec GmbH filed Critical Suratec GmbH
Priority to PCT/CH2016/000128 priority Critical patent/WO2018064779A1/fr
Publication of WO2018064779A1 publication Critical patent/WO2018064779A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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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
    • 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 or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74—Devices for the head or neck or trochanter of the femur
    • A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • A61B17/746—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to a plate opposite the femoral head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • 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

Definitions

  • the invention relates to a modular osteosynthesis implant assembly according to the preamble of claim 1 , a method for open or minimally invasive stabilization to promote an osteosynthesis according to the preamble of claim 23, and a kit for assembling the modular osteosynthesis implant assembly according to the preamble of claim 24.
  • Hip fractures are a very common injury.
  • the number of annual hip fractures is increasing worldwide. Especially the elderly population suffers from hip fractures. Due to the increasing number of elderly people, the annual number of hip-fractures is increasing fast.
  • osteoporosis One reason for a hip fracturing is osteoporosis. With rising age, the bones become more brittle and fracture more easily after a fall.
  • hip-fractures There are many types of hip-fractures, which need an individual treatment.
  • a femoral neck fracture in a patient with degenerated joint cartilage is preferably treated with a hip implant, completely replacing the joint.
  • Fractures in younger patients with good quality cartilage are preferably treated with methods that reconstruct and maintain the joint.
  • Treatment methods vary from the insertion of two or more (cannulated) screws to the insertion of intramedullary nails to stabilize the bone fragments.
  • the sliding hip screws consist of a plate (with a barrel) which is fixed to the lateral cortex of the femoral bone, and one or more large screws extending through the barrel from the plate into the femoral head.
  • the screw can glide (telescope) within the plate barrel, therefore some types are called "dynamic".
  • This gliding capacity allows the femoral head-and-neck fragment - in case of a lack of medial buttress - to set itself laterally against the femoral shaft until a new buttress results.
  • Telescoping implants are therefore the preferred implants for femoral fractures in this region. They allow early mobilization and full weight bearing, as the elderly patients mostly are not capable to bear weight partially. Shortening due to telescoping as well as lateral protrusion of the screws might cause local irritation. These disadvantages are irrelevant compared to the risks of rigid implants (cut-out and implant fatigue)
  • the lateral cortex of the femoral bone has to be prepared for the insertion of the barrel of the plate and the plate-barrel-junction. This causes a certain soft tissue damage.
  • important efforts have been made in order to reduce the additional soft tissue damage caused by the operation. (Minimal invasive surgery) These efforts comprise both changes of the surgical access and the implants.
  • the invention solves the posed problem with a modular osteosynthesis implant assembly comprising the features of claim 1 , with a method for open or minimally invasive stabilization to promote an osteosynthesis according to claim 23, and a kit for assembling the modular osteosynthesis implant assembly according to claim 24.
  • the bone plate and the plate insert are separate element which can be assembled in situ and therefore allow a minimally invasive surgery avoiding a possible damage to soft tissues; and - Possibility to optionally use a trochanter fixation plate attachable to the modular osteosynthesis implant assembly according to the invention.
  • the inventive osteosynthesis implant assembly for fixation of fractures in the metaphysis area is a modular implant to facilitate minimal invasive implantation, which can be assembled "in situ" within the body of the patient at the site of the fractured target bone.
  • the individual parts require less soft tissue distraction or a smaller incision size, which benefits the recovery of the patient.
  • the elongated bone plate, the plate insert and the locking element form one integral bone plate unit.
  • This integral bone plate unit provides the same functionality as common monoblock or monolith implants, used for the treatment of the target indications.
  • the elongated bone plate has a first end and an opposite second end, defining a first central axis 'C along the length of the elongated bone plate.
  • an opening extends through the thickness of the elongated bone plate, and has length 'XV.
  • Length 'X1 ' may be substantially equal to the thickness of the elongate bone plate at its first end.
  • the opening is completely surrounded by the material of the bone plate, but alternatively can also comprise a gap extending to the outside of the elongated bone plate.
  • the elongate bone plate comprises at least one throughbore or elongated hole, configured to receive secondary bone fasteners. Said throughbore or elongated hole is located between said opening and said second end of the plate.
  • the elongate bone plate comprises at least one channel, sized and shaped to lockingly seat at least one locking element.
  • the channel that receives the locking element intersects with the opening that receives the plate insert.
  • the locking element is intended to rigidly fixate the plate insert into the elongated bone plate, and so form the integral plate unit, as described later.
  • the channel comprises an internal thread and is oriented under an acute angle 'a' to the first central axis 'C of the elongated bone plate.
  • the elongate bone plate comprises an attachment feature for the assembly of said bone plate to a targeting device.
  • a targeting device facilitates speed, accuracy and minimal invasiveness of insertion of the primary and secondary bone anchors.
  • the targeting device provides guidance in the bone bed preparation steps, and provides guidance in assembly steps to mount the individual components of the integral bone plate unit.
  • the attachment feature is configured as a second internal thread, combined with a pocket arranged at the first end of the elongate bone plate.
  • the attachment feature is configured as a second internal thread combined with at least one dent.
  • the opening at the first end of the elongate bone plate is configured to mate with and seat the plate insert.
  • the plate insert comprises a base with at least one hollow protrusion extending therefrom.
  • the hollow protrusion is shaped and sized to receive a primary bone anchor, and therefore extends completely through the plate insert.
  • the plate insert comprises two hollow protrusions; therefore the integral bone plate unit is intended to be used with two primary bone anchors. By usage of at least two anchors the target bone fragment is fixated in compressive direction, tensile direction, and furthermore against rotation.
  • the protrusion is shaped as at ieast one tubular protrusion.
  • the tubular protrusion is intended to be countersunk inside the target bone, and therefore for preparation of the bone bed in the target bone, one or more holes can be drilled or reamed.
  • the protrusions can have any shape, such as a quadratic, oblong, round or oval shape.
  • the bone bed preparation may be done by usage of a small reamer or a punching system. Alternatively oscillating saws can be used.
  • said two hollow protrusions are spaced from one another at a distance wherein the outer walls of the protrusions are spaced at a distance of less than 5 mm.
  • the protrusions almost or minimally intersect and are connected by a rib.
  • a rib provides a larger stability by connecting the individual tubular protrusions.
  • axis of the tubular protrusions need to be oriented under an anatomy matching angle in relation to the first central axis 'C of the elongated plate.
  • Exemplary angles for the application as a femur osteosynthesis device are angles between 90° and 150°.
  • the plate insert comprises a recess sized and shaped to mate with said locking element, and additionally coinciding with said hole of said elongated bone plate.
  • the osteosynthesis implant assembly comprises a locking element
  • the locking element is shaped to rigidly fixate the plate insert into the elongated bone plate, and so form the integral plate unit.
  • the locking element is shaped as a bolt with an externally threaded head including drive geometry.
  • the drive geometry is configured to engage with a screwdriver or similar.
  • the primary bone anchor is intended to fixate the fractured bone in the epiphysis area.
  • the primary bone anchor is a bone screw.
  • the primary bone anchor can be a pin shaped element, a bolt, a helical blade, and etcetera.
  • said primary bone anchor is an externally threaded screw comprising a smooth shaft portion with a diameter ⁇ , an externally threaded tip portion and a head portion comprising a second drive geometry.
  • the external thread partially extends from said tip toward said head portion and end is a first transition region. Said first transition region may have a smaller diameter than diameter 'D1 ' of said shaft portion.
  • the primary bone anchor may comprise a second transition region wherein the threaded tip merges into the smooth shaft portion. Furthermore the primary bone anchor comprises a circumferential rim and clearance groove in said smooth shaft portion. This rim is intended to form a stop or a seat to limit the telescoping distance of the primary bone anchor within the plate insert, by seating against said tubular protrusion.
  • the secondary bone anchor is intended to fixate the integral bone plate unit against the shaft of the target bone in the metaphysis and/or diaphysis area of the target bone.
  • the secondary bone anchor may be configured as a bone screw, dowel, bolt, pin, locking- screw or cerclage wire.
  • the osteosynthesis implant assembly is part of a kit comprising elongated bone plates of different lengths comprising different numbers of throughbores and elongated holes, furthermore comprising plate inserts having said different anatomical angles.
  • kit components are locking elements and primary and secondary bone anchors of different anatomical lengths.
  • a trochanter fixation plate can be attached to the integral bone plate unit.
  • the trochanter fixation plate 90 is configured as a frame with at least one arm extending thereof. Said arm comprises at least one screw receiving fixation unit, wherein screw receiving fixation units are linked by a thinner connectors to said frame.
  • the thinner connectors allow manual bending and shaping of the trochanter fixation plate for adaptation to the anatomic shape of the trochanteric bone, and furthermore to individual direct the trochanter fixation screws to most effectively fixate and stabilize the fractured trochanteric bone.
  • the individual components of the osteosynthesis implant assembly are made of biocompatible materials such as titanium, titanium alloys, cobalt chromium alloys, stainless steel, or combinations thereof, and may comprise coatings to prevent ongrowth or ingrowth, or provide better sliding or articulation properties.
  • the central axis 'C2' and * C3' of the first and second hollow protrusions of the osteosynthesis implant assembly are parallel. This embodiment allows optimal properties for the telescoping action of the bone anchors to be glideably received in the protrusions.
  • central axis 'C2' and 'C3' of the first and second hollow protrusions are divergent, preferably by an angle of ⁇ 3°.
  • first hollow protrusion has the shape of a hollow circular cylinder with an inner diameter di and the second hollow protrusion has the shape of a hollow circular cylinder with an inner diameter d 2 .
  • di d 2 .
  • the means at the first end of the elongate bone plate sized and shaped for engagement with the plate insert are designed in form of an opening extending completely through said bone plate for a length of "X1 " corresponding to the thickness of the bone plate in the region of the opening.
  • the plate insert has a length ⁇ 1 ', wherein length ⁇ is larger than said length 'XV and preferably in the range of 1 .1 ' ⁇ 1 ' ⁇ ⁇ 1 ' ⁇ 3.0 'XV.
  • said two hollow protrusions have a tubular shape with outer walls, wherein said outer walls are connected by a rib.
  • said locking mechanism comprises at least one locking element at said first end and at least one channel intersecting with said opening sized and shaped to lockingly seat said at least one locking element.
  • said locking element comprises at least partially an external thread for a threadedly engagement of said locking element in said elongate bone plate.
  • the plate insert comprises at least one recess sized and shaped for engagement with at least one locking element, to lockingly mate with said locking element, wherein when assembled inside said elongated bone plate, said first channel and said recess coincide and align.
  • said elongate bone plate comprises at least one through bore and/or elongated hole, configured to receive at least one secondary bone anchor, such as a bone screw, dowel, bolt, pin, locking-screw or cerclage wire.
  • the osteosynthesis implant assembly comprises primary bone anchors g!ideably received in said protrusions.
  • said primary bone anchor is an externally threaded screw with a smooth shaft portion with a diameter 1 ', a tip portion and a head portion, wherein said thread partially extends from said tip to said head portion, furthermore comprises a circumferential rim of third diameter 'D3' on said smooth shaft portion, wherein said rim forms a seat to limit the telescoping distance of said primary bone anchor.
  • said hollow protrusion of said plate insert has an inner second diameter 'D2' extending through said plate insert, wherein said diameter 2' > 1 " > 'D3' and upon loading of said tip portion of said primary bone anchor, said rim hangs over the hollow protrusion end.
  • the first end of said elongate bone plate comprises an attachment feature for assembly of said bone plate to a targeting device to facilitate the placement of said elongate bone plate onto said target bone and guide the insertion of said plate insert, and/or primary bone anchor and/or secondary bone anchor and/or said eventual locking elements.
  • the modular osteosynthesis implant assembly comprises a buttress element, preferably in the form of a trochanter fixation plate attachable to said first end for fixation and stabilization of additional fracture fragments.
  • the buttress element is not attached to said first end but rather an integral part of said elongate bone plate at said first end.
  • the buttress element comprises at least one arm with at least one screw receiving fixation unit, sized and shaped to be inter-operatively bend to seat flush against the target bone.
  • the modular osteosynthesis implant assembly is to be used for the treatment of proximal femur fractures in open surgery or minimal invasive surgery.
  • the modular osteosynthesis implant assembly is to be used for the treatment of split-off trochanter bone fragments.
  • said two tubular protrusions are spaced from one another at a distance 'K' smaller than 5 mm.
  • a method for open or minimally invasive stabilization to promote an osteosynthesis, by use of the modular osteosynthesis implant assembly according to the present invention comprises the following surgical steps,
  • a kit for assembling the modular osteosynthesis implant assembly according to the present invention comprises elongate bone plates of different lengths comprising different numbers of through bores and elongated holes, furthermore comprising plate inserts having different anatomical angles a, furthermore said kit comprising different primary bone anchors and secondary bone anchors of different lengths and potentially locking elements of different lengths.
  • Figure 1A depicts a perspective view each of an embodiment of the osteosynthesis implant assembly according to the invention in an assembled configuration
  • Figure 1 B illustrates an exploded view of the embodiment of the osteosynthesis implant assembly of fig. 1A without the trochanter fixation plate;
  • Figure 2A illustrates a perspective view of the elongate bone plate according to the embodiment of the osteosynthesis implant assembly of figs. 1A and 1 B;
  • Figure 2B illustrates a lateral view of the elongate bone plate according to the embodiment of the osteosynthesis implant assembly of figs. 1 A and 1 B;
  • Figure 2C illustrates a top view of the elongate bone plate according to the embodiment of the osteosynthesis implant assembly of figs. 1A and 1 B;
  • Figure 2D illustrates a front view of the elongate bone plate according to the embodiment of the osteosynthesis implant assembly of figs. 1A and 1 B;
  • Figure 2E illustrates a sectional view of the elongate bone plate along line A - A in fig. 2D;
  • Figure 3A depicts a perspective view of the plate insert according to the embodiment of the osteosynthesis implant assembly of figs. 1A and 1 B;
  • Figure 3B illustrates a lateral view of the plate insert according to the embodiment of the osteosynthesis implant assembly of figs. 1A and 1B;
  • Figure 3C illustrates a front view of the plate insert according to the embodiment of the osteosynthesis implant assembly of figs. 1A and 1B;
  • Figure 3D illustrates a sectional view of the plate insert along line B - B in fig. 3C;
  • Figure 3E depicts a cross sectional view illustrating the orientation of the primary bone anchor in relation the central axis of the elongated bone plate according to the embodiment of the osteosynthesis implant assembly of figs. 1A and 1 B;
  • Figure 4A depicts a perspective view of the locking element according to the embodiment of the osteosynthesis implant assembly of figs. 1 A and 1 B;
  • Figure 4B depicts a perspective view of the locking element in engagement inside the recess of the plate insert according to the embodiment of the osteosynthesis implant assembly of figs. 1A and 1B;
  • Figure 4C illustrates a lateral view of the elongate bone plate with the plate insert according to the embodiment of the osteosynthesis implant assembly of figs. 1A and 1 B;
  • Figure 4D depicts a cross sectional view along line C - C in fig. 4C;
  • Figure 5 depicts a side view of the primary bone anchor according to the embodiment of the osteosynthesis implant assembly of figs. 1A and 1B;
  • Figure 6A and 6B depict the iimited telescoping principle wherein the circumferential rim of the primary bone anchor seats against the plat insert according to the embodiment of the osteosynthesis implant assembly of figs. 1A and 1 B;
  • Figure 7 depicts an exploded view of the embodiment of the osteosynthesis implant assembly of fig. 1 A including the trochanter fixation plate;
  • Figure 8A depicts a perspective view of the elongate bone plate according to the embodiment of the osteosynthesis implant assembly of figs. 1A and 1 B attached to a targeting device;
  • Figure 8B illustrates a longitudinal section of the elongate bone plate according to the embodiment of the osteosynthesis implant assembly of figs. 1A and 1 B attached to the targeting device of fig. 8A;
  • Figure 9 depicts a perspective view of a secondary bone fixation element according to the embodiment of the osteosynthesis implant assembly of figs. 1A and 1B used for fixation of the plate against the shaft portion of the target bone.
  • an osteosynthesis implant assembly 1 is shown in an assembled configuration, comprising the elongate bone plate 10, the plate insert 30, two locking elements 50, one or two primary bone anchors 60, and an optional trochanter fixation plate 90.
  • the elongate bone plate 10, the plate insert 30, two locking elements 50 form said integral bone plate unit 2.
  • the elongate bone plate comprises an opening 13 at its first end 1 1 .
  • This opening is sized and shaped to receive plate insert 30 and has depth 'XV. Consequently depth 'XV equals the thickness of said elongate bone plate 10 in the opening area.
  • the opening 13 is shaped as a long hole.
  • the opening 13 can have any shape, such as a quadratic, oblong, round or oval shape. Said opening 13 Is completely surrounded by plate material.
  • the opening 13 might be open to the side or first end 1 1 of the elongated bone plate 10.
  • Attachment feature 14 is configured for engagement with a targeting device 100 (Figs. 8A and 8B).
  • a targeting device facilitates speed, accuracy and mirimal invasiveness of insertion of the primary and secondary bone anchors 80 (Fig. 9) and for preparation of their bone beds.
  • Said attachment feature 14 is configured as a second internal thread 15.
  • the elongate bone plate 10 comprises a pocket 22 adjoining the opening 13 at the first end 1 1 of the elongate bone plate 10 (Fig. 8B).
  • the second internal thread 15 allows for a rigid fixation of the targeting device 100 to the elongated bone plate 1 0, wherein the pocket 22 fixes the orientation of the targeting device 100 in relation to the sagittal plane 'P2' of the elongated bone plate 10.
  • the elongate bone plate 10 comprises at least one first channel 16, sized and shaped to lockingly seat at least one locking element 50.
  • the first channel 16 comprises a first internal thread 17 and is oriented under an acute angle , ⁇ ' (Fig. 2E) to the first central axis 'C of the elongated bone plate 10.
  • the first channel 16 is oriented substantially parallel to the first central axis 'C of the elongated bone plate 10.
  • Said first internal thread 17 is located at the first end 1 1 of the elongated bone plate 10.
  • the first internal thread 17 extends approximately 6mm inside said channel 16.
  • the whole channel 17 comprises a first internal thread 17.
  • said channel 16 extends into the sidewa!ls 21 of said opening 13 throughout the full length of said opening 13.
  • the locking elements 50 form a long interference fit with said plate insert 30 as described in greater detail later.
  • the number of throughbores 18 and/or elongated holes 19 relates to the overall length of the integral bone plate unit 2. This length is related to the bone fracture pattern and bone quality of the patient. For example, for an isolated femoral neck fracture often shorter bone plates can be used, only comprising two throughbores 18 for the fixation against the shaft portion of the bone.
  • the number and order of throughbores 18 and elongated holes 19 can vary per elongated bone plate 10.
  • the elongate bone plate 10 comprises three throughbores 18 and one elongated hole 19 at the second end 12 of the elongate bone plate 10. Between the throughbores 18 and elongated holes 19 one or more cerclage grooves 20 are positioned.
  • the cerclage grooves 20 can keep cerclage wires in place and prevent cerclage wires from slipping away over the elongate bone plate 10.
  • said plate insert comprises a hollow protrusion end 39.
  • said hollow protrusions 32, 33 are shaped as tubular protrusions 34 and 35.
  • the tubular protrusions 34, 35 are intended to be countersunk inside the target bone.
  • the preparation of the bone bed in the target bone is executed by drilling or reaming of one or more holes.
  • tubular protrusions 34, 35 are spaced from one another at a distance 'K' wherein the outer walls 36, 37 of the hollow protrusions 32, 33 are spaced at a distance of less than 5 mm. Most preferred the hollow protrusions 32, 33 almost or minimally intersect. Furthermore the tubular protrusions 34, 35 may be connected by a rib 38. By connection through a rib 38 the combined construct has a larger stability and stiffness in comparison to the individual tubular protrusions 34, 35.
  • a short spacing, when connected by a rib 38 or when intersecting facilitates easier surgical bone preparation steps.
  • the axis of the tubular protrusions 34, 35 need to be oriented under an anatomy matching inclination angle ' ⁇ ' in relation to the first central axis 'C1 ' of the elongated plate 10.
  • the tubular protrusions 34, 35 define the direction of the primary bone anchor 60 with fourth central axis 4'.
  • Exemplary inclination angles ' ⁇ ' for the application as a proximal femur osteosynthesis device are angles between 120° and 150°. Most common in monoblock bone plates angles are provided varying in 5° steps from 120° to 150° For the application as a distal femur osteosynthesis device for the fixation of condylar fractures, this angle may vary from 90° to 120°.
  • the locking element is a rivet, a pin with a press-fit, a dowel, a fully threaded bolt, a screw, a split pin, or similar.
  • the primary bone anchor 60 comprises a minimally enlarged rim 68 of third diameter 'D3 ⁇ followed by a circumferential clearance groove 66 in said smooth shaft portion 61.
  • the difference in diameter of the minimally enlarged rim 68 may be only 0.1 mm larger than the diameter of the smooth shaft portion 61.
  • the minimally enlarged rim 68 in combination with said clearance groove 66 is intended to form a stop or a seat 67 to limit the telescoping distance of the primary bone anchor 60 within the plate insert 30, by seating against said hollow protrusion end 39.
  • rim 68 is of substantially equal diameter as said smooth shaft portion 61. When substantially equal in diameter, said clearance groove 66 needs to be wide to allow said rim 68 to form said seat 67.
  • said trochanter fixation plate 90 comprises a base portion 93 located on the frame 94 at the end which contacts the first end 1 1 of the elongate bone plate 10 in the assembled state, wherein the base portion 93 has one or two holes 96 each suitable to pass a locking element 50 therethrough so that the trochanter fixation plate 90 can be affixed to the elongate bone plate 10 by means of the locking elements 50.
  • the thinner connectors allow manual bending and shaping of the trochanter fixation plate 90 for adaptation to the anatomic shape of the trochanteric bone, and furthermore to individual direct the trochanter fixation screws to most effectively fixate and stabilize the fractured trochanteric bone.
  • the targeting device comprises a sleeve 103 with at least one first targeting hole 101 and at least one second targeting hole 102.
  • an exemplary secondary bone anchor 80 is shown, configured as a shorter bone screw.
  • the secondary bone anchor is intended to fixate the integral bone plate unit 2 against the shaft of the target bone in the metaphysis and/or diaphysis area of the target bone.
  • the secondary bone anchor 80 may be configured as a bone screw, dowel, bolt, pin, locking-screw or cerclage wire.
  • the secondary bone anchor 80 is shaped and sized to engage into said throughbore 18 or elongated hole 19 of said elongate bone plate 10.

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Abstract

La présente invention concerne un ensemble implant d'ostéosynthèse modulaire (1) destiné à la stabilisation interne d'un os cible fracturé, comprenant : une plaque osseuse allongée (10) ; un insert de plaque (30) pouvant être fixé à la plaque osseuse allongée (10) ayant une partie de base (31), une première saillie creuse (34) avec un axe central ' C2 ' et une seconde saillie creuse (35) avec un axe central ' C3 ', lesdites saillies (34,35) sont dimensionnées et façonnées pour recevoir de manière coulissante chacune un élément d'ancrage osseux primaire (60) ; et un mécanisme de verrouillage pour le verrouillage dudit insert de plaque (30) à ladite plaque osseuse allongée (10) ; ladite plaque osseuse allongée (10) comprenant au niveau de ladite première extrémité (11) un moyen dimensionné et façonné pour venir en prise avec ledit insert de plaque (10), et dans lequel, lorsqu'elles sont en prise avec l'insert de plaque (10), les deux saillies (34, 35) sont agencées de telle sorte que leurs axes centraux ' C2 ' et ' C3 ' définissent un plan sagittal, " P2 " ; lesdits deux axes centraux ' C2 ' et ' C3 ' étant espacés l'un de l'autre d'une distance X supérieure à 9 mm et de préférence inférieure à 13 mm.
PCT/CH2016/000128 2016-10-04 2016-10-04 Ensemble implant d'ostéosynthèse modulaire Ceased WO2018064779A1 (fr)

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Application Number Priority Date Filing Date Title
PCT/CH2016/000128 WO2018064779A1 (fr) 2016-10-04 2016-10-04 Ensemble implant d'ostéosynthèse modulaire

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PCT/CH2016/000128 WO2018064779A1 (fr) 2016-10-04 2016-10-04 Ensemble implant d'ostéosynthèse modulaire

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2686788A1 (fr) * 1992-02-05 1993-08-06 Hardy Jean Marie Ensemble d'implants d'osteosynthese de l'extremite du femur notamment et son dispositif de pose.
US20060217722A1 (en) * 2003-09-08 2006-09-28 Christof Dutoit Bone-fixation device
US20070270845A1 (en) * 2003-09-08 2007-11-22 Kohsuke Watanabe Orthopaedic plate and screw assembly
US20160066968A1 (en) * 2014-09-08 2016-03-10 Pega Medical, Inc. Modular proximal femoral osteotomy blade-plate assembly and related fixation method

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2686788A1 (fr) * 1992-02-05 1993-08-06 Hardy Jean Marie Ensemble d'implants d'osteosynthese de l'extremite du femur notamment et son dispositif de pose.
US20060217722A1 (en) * 2003-09-08 2006-09-28 Christof Dutoit Bone-fixation device
US20070270845A1 (en) * 2003-09-08 2007-11-22 Kohsuke Watanabe Orthopaedic plate and screw assembly
US20160066968A1 (en) * 2014-09-08 2016-03-10 Pega Medical, Inc. Modular proximal femoral osteotomy blade-plate assembly and related fixation method

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