CA3190560A1 - Method for generating digital models of osteosynthesis plates specific to the morphology of the patient - Google Patents
Method for generating digital models of osteosynthesis plates specific to the morphology of the patientInfo
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- CA3190560A1 CA3190560A1 CA3190560A CA3190560A CA3190560A1 CA 3190560 A1 CA3190560 A1 CA 3190560A1 CA 3190560 A CA3190560 A CA 3190560A CA 3190560 A CA3190560 A CA 3190560A CA 3190560 A1 CA3190560 A1 CA 3190560A1
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- osteosynthesis plate
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- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
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- Life Sciences & Earth Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
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- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Robotics (AREA)
- Neurology (AREA)
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- Apparatus For Radiation Diagnosis (AREA)
Abstract
Method for generating an osteosynthesis plate comprising obtaining a bone model representing a bone and generated from imaging data corresponding to the bone, determining a set of virtual input locations in the bone model, and constructing a virtual surface adjacent to the bone model on the basis of the bone model and of all of the virtual input locations.
Description
DESCRIPTION
TITLE: Method for generating digital models of osteosynthesis plates specific to the morphology of the patient Technical Field The present disclosure relates to a method for manufacturing an osteosynthesis plate as well as to osteosynthesis plates manufactured in this way.
Prior Art Users or patients receiving care from a surgeon or operator are often treated with a uniform approach, especially when it comes to common surgical operations. This approach extends to the implants or devices used for each patient, even though each patient is different. This is partly because it is impractical to produce customized materials for each patient due to cost, time, and technological limitations.
The description of the background provided here is intended to provide a general overview of the background to the disclosure. The works of the presently named inventors, to the extent they are described in this section, as well as those aspects of the description that cannot be considered to form part of the state of the art at the time of filing, are not expressly or implicitly admitted as part of the state of the art in the context of this disclosure.
Disclosure of the Invention According to a first aspect of the invention, proposed is a method for generating an osteosynthesis plate suitable for being fixed on a bone comprising the following steps: obtaining a bone model representing a bone generated from data imaging corresponding to the bone;
TITLE: Method for generating digital models of osteosynthesis plates specific to the morphology of the patient Technical Field The present disclosure relates to a method for manufacturing an osteosynthesis plate as well as to osteosynthesis plates manufactured in this way.
Prior Art Users or patients receiving care from a surgeon or operator are often treated with a uniform approach, especially when it comes to common surgical operations. This approach extends to the implants or devices used for each patient, even though each patient is different. This is partly because it is impractical to produce customized materials for each patient due to cost, time, and technological limitations.
The description of the background provided here is intended to provide a general overview of the background to the disclosure. The works of the presently named inventors, to the extent they are described in this section, as well as those aspects of the description that cannot be considered to form part of the state of the art at the time of filing, are not expressly or implicitly admitted as part of the state of the art in the context of this disclosure.
Disclosure of the Invention According to a first aspect of the invention, proposed is a method for generating an osteosynthesis plate suitable for being fixed on a bone comprising the following steps: obtaining a bone model representing a bone generated from data imaging corresponding to the bone;
2 determining a set of virtual entry points on the bone model; generating a virtual surface adjacent to the bone model based on the bone model and the set of virtual entry points; generating an osteosynthesis plate model based on the virtual surface; creating a virtual hole at each virtual entry point of the set of virtual entry points along the osteosynthesis plate model; and transmitting the osteosynthesis plate model to an osteosynthesis plate manufacturing machine.
In the present description, a bone model is aimed at achieving a realistic 2D or 3D representation of the bone, that is to say, which does not comprise any approximation of the mathematical modeling type.
Advantageously, the set of virtual entry points can indicate the places where a screw is inserted into the bone.
Preferably, the bone model is three-dimensional.
The method may further comprise a step of obtaining imaging data corresponding to the bone from an imaging device.
The virtual surface may comprise all of the virtual entry locations, a screw is one of multiple screws, and the virtual hole is one of multiple holes.
The osteosynthesis plate model may comprise a virtual face defined by the virtual surface and a thickness defined by an extrusion of the virtual face.
The method may further comprise generating a virtual scene comprising the bone model, in which the osteosynthesis plate model is pressed against the bone model and positioned such that a virtual face of the osteosynthesis plate model coincides with the virtual surface; and wherein the generation of an osteosynthesis plate model and subsequent fabrication of a custom osteosynthesis plate saves the surgeon from
In the present description, a bone model is aimed at achieving a realistic 2D or 3D representation of the bone, that is to say, which does not comprise any approximation of the mathematical modeling type.
Advantageously, the set of virtual entry points can indicate the places where a screw is inserted into the bone.
Preferably, the bone model is three-dimensional.
The method may further comprise a step of obtaining imaging data corresponding to the bone from an imaging device.
The virtual surface may comprise all of the virtual entry locations, a screw is one of multiple screws, and the virtual hole is one of multiple holes.
The osteosynthesis plate model may comprise a virtual face defined by the virtual surface and a thickness defined by an extrusion of the virtual face.
The method may further comprise generating a virtual scene comprising the bone model, in which the osteosynthesis plate model is pressed against the bone model and positioned such that a virtual face of the osteosynthesis plate model coincides with the virtual surface; and wherein the generation of an osteosynthesis plate model and subsequent fabrication of a custom osteosynthesis plate saves the surgeon from
3 having to modify the plate during the operation.
Advantageously, the virtual surface can be determined electronically from a virtual generatrix curve that successively passes through reference points, the reference points being determined as the centers of the set of virtual entry points and of at least two lateral virtual curves that are disposed on each side of the virtual generatrix curve.
According to one possibility, the reference points comprise longitudinal ends, the virtual generatrix curve successively passing through one of the longitudinal ends, the centers of all the virtual entry points, and another of the longitudinal ends.
The virtual generatrix curve can be a spline of the geodesic type passing through the reference points.
The lateral virtual curves can be geodesic-like splines that pass through images of the reference points, and the images can be obtained by translation of a distance that is a function of a width of a screw at a maximum diameter perpendicular to an axis of the osteosynthesis plate model and tangent to the virtual surface of the bone model.
The lateral virtual curves can be virtual curves spaced apart by a predetermined distance on either side of the virtual generatrix curve and projected onto the virtual surface of the bone.
The method may further comprise determining an intermediate osteosynthesis plate model by adding virtual fillets to the osteosynthesis plate model at the longitudinal ends of the osteosynthesis plate model, wherein the osteosynthesis plate model is determined by modifying the intermediate osteosynthesis plate model.
The osteosynthesis plate manufacturing machine can be an additive or subtractive manufacturing machine.
Advantageously, the virtual surface can be determined electronically from a virtual generatrix curve that successively passes through reference points, the reference points being determined as the centers of the set of virtual entry points and of at least two lateral virtual curves that are disposed on each side of the virtual generatrix curve.
According to one possibility, the reference points comprise longitudinal ends, the virtual generatrix curve successively passing through one of the longitudinal ends, the centers of all the virtual entry points, and another of the longitudinal ends.
The virtual generatrix curve can be a spline of the geodesic type passing through the reference points.
The lateral virtual curves can be geodesic-like splines that pass through images of the reference points, and the images can be obtained by translation of a distance that is a function of a width of a screw at a maximum diameter perpendicular to an axis of the osteosynthesis plate model and tangent to the virtual surface of the bone model.
The lateral virtual curves can be virtual curves spaced apart by a predetermined distance on either side of the virtual generatrix curve and projected onto the virtual surface of the bone.
The method may further comprise determining an intermediate osteosynthesis plate model by adding virtual fillets to the osteosynthesis plate model at the longitudinal ends of the osteosynthesis plate model, wherein the osteosynthesis plate model is determined by modifying the intermediate osteosynthesis plate model.
The osteosynthesis plate manufacturing machine can be an additive or subtractive manufacturing machine.
4 The osteosynthesis plate that is manufactured may be made of medical grade materials.
The osteosynthesis plate manufacturing machine can use laser sintering or three-dimensional printing and is located in a location remote from the modeling.
According to a second aspect of the invention, proposed is a computer program product comprising instructions that, when the program is executed by a computer, lead the latter to implement the steps of the method according to the first aspect of the invention, or one or more of its improvements.
According to a third aspect of the invention, proposed is a computer-readable recording medium comprising instructions that, when executed by a computer, lead the latter to implement the steps of the method according to the first aspect of the invention, or one or more of its improvements.
According to a fourth aspect of the invention, provided is a method for generating a surgical model, comprising the following steps: obtaining imaging data; generating a bone model based on the bone imaging data;
constructing a virtual surface on a face the bone model using the bone model; receiving a drilling position on the bone model; generating a surgical model based on the virtual surface and the position of the drill;
and sending the surgical model to a surgical model manufacturing machine.
The surgical model can for example be an osteosynthesis plate model, a surgical guide, or both an osteosynthesis plate model and a surgical guide.
The surgical model manufacturing machine may be an additive or
The osteosynthesis plate manufacturing machine can use laser sintering or three-dimensional printing and is located in a location remote from the modeling.
According to a second aspect of the invention, proposed is a computer program product comprising instructions that, when the program is executed by a computer, lead the latter to implement the steps of the method according to the first aspect of the invention, or one or more of its improvements.
According to a third aspect of the invention, proposed is a computer-readable recording medium comprising instructions that, when executed by a computer, lead the latter to implement the steps of the method according to the first aspect of the invention, or one or more of its improvements.
According to a fourth aspect of the invention, provided is a method for generating a surgical model, comprising the following steps: obtaining imaging data; generating a bone model based on the bone imaging data;
constructing a virtual surface on a face the bone model using the bone model; receiving a drilling position on the bone model; generating a surgical model based on the virtual surface and the position of the drill;
and sending the surgical model to a surgical model manufacturing machine.
The surgical model can for example be an osteosynthesis plate model, a surgical guide, or both an osteosynthesis plate model and a surgical guide.
The surgical model manufacturing machine may be an additive or
5 subtractive manufacturing machine.
The surgical model that is manufactured may be made of medical grade materials.
According to a fourth aspect of the invention, proposed is a system for generating a surgical model, comprising: a graphical user interface; at least one processor; and a memory coupled to at least one processor, wherein the memory stores instructions executed by the at least one processor.
The instructions comprise performing the following steps: retrieving a bone model from imaging data corresponding to a bone; displaying the bone model via a screen; receiving data, via the display, indicating a virtual entry location on the bone model; constructing a virtual surface adjacent to the bone model based on the bone model and the virtual entry location; creating an osteosynthesis plate model based on the virtual surface; drilling a virtual hole at the virtual entry location on the osteosynthesis plate model; and transmitting the osteosynthesis plate model to a plate model storage.
The osteosynthesis plate model may comprise a virtual face defined by the virtual surface and a thickness defined by an extrusion of the virtual face.
The instructions may comprise performing the following steps:
generating a virtual scene comprising the bone model, in which the osteosynthesis plate model is pressed against the bone model and positioned such that a virtual face of the osteosynthesis plate model coincides with the virtual surface, and wherein the generation of an osteosynthesis plate model and the subsequent fabrication of a custom osteosynthesis plate saves the surgeon from having to modify the plate during the operation.
The surgical model that is manufactured may be made of medical grade materials.
According to a fourth aspect of the invention, proposed is a system for generating a surgical model, comprising: a graphical user interface; at least one processor; and a memory coupled to at least one processor, wherein the memory stores instructions executed by the at least one processor.
The instructions comprise performing the following steps: retrieving a bone model from imaging data corresponding to a bone; displaying the bone model via a screen; receiving data, via the display, indicating a virtual entry location on the bone model; constructing a virtual surface adjacent to the bone model based on the bone model and the virtual entry location; creating an osteosynthesis plate model based on the virtual surface; drilling a virtual hole at the virtual entry location on the osteosynthesis plate model; and transmitting the osteosynthesis plate model to a plate model storage.
The osteosynthesis plate model may comprise a virtual face defined by the virtual surface and a thickness defined by an extrusion of the virtual face.
The instructions may comprise performing the following steps:
generating a virtual scene comprising the bone model, in which the osteosynthesis plate model is pressed against the bone model and positioned such that a virtual face of the osteosynthesis plate model coincides with the virtual surface, and wherein the generation of an osteosynthesis plate model and the subsequent fabrication of a custom osteosynthesis plate saves the surgeon from having to modify the plate during the operation.
6 The virtual surface can be determined electronically from a virtual generatrix curve that successively passes through reference points, the reference points being determined as the centers of the drilling position and of at least two lateral virtual curves that are disposed on each side of the virtual generatrix curve.
The reference points may comprise longitudinal ends, the virtual generatrix curve successively passing through one of the longitudinal ends, the centers of the drilling position and another of the longitudinal ends.
Brief Description of the Figures Further features and advantages of the present disclosure will become apparent from the following detailed description, which can be understood with reference to the accompanying drawings, in which:
Fig. 1 is a perspective view of a representation of a three-dimensional bone model in which virtual screws are positioned, Fig. 2 is a view similar to Fig. 1, the virtual screws being removed from the bone, leaving only a trace of virtual entries of the virtual screws on the surface of the bone.
Fig. 3 is a view similar to Fig. 2, further comprising longitudinal ends.
Fig. 4 is a view similar to Fig. 3, further comprising a generatrix curve that passes through reference points.
Fig. 5 is a view similar to Fig. 4, further comprising two lateral curves that frame the generatrix curve.
Fig. 6 is a view similar to Fig. 5, comprising a virtual surface that is determined by the two lateral curves of Fig. 4.
The reference points may comprise longitudinal ends, the virtual generatrix curve successively passing through one of the longitudinal ends, the centers of the drilling position and another of the longitudinal ends.
Brief Description of the Figures Further features and advantages of the present disclosure will become apparent from the following detailed description, which can be understood with reference to the accompanying drawings, in which:
Fig. 1 is a perspective view of a representation of a three-dimensional bone model in which virtual screws are positioned, Fig. 2 is a view similar to Fig. 1, the virtual screws being removed from the bone, leaving only a trace of virtual entries of the virtual screws on the surface of the bone.
Fig. 3 is a view similar to Fig. 2, further comprising longitudinal ends.
Fig. 4 is a view similar to Fig. 3, further comprising a generatrix curve that passes through reference points.
Fig. 5 is a view similar to Fig. 4, further comprising two lateral curves that frame the generatrix curve.
Fig. 6 is a view similar to Fig. 5, comprising a virtual surface that is determined by the two lateral curves of Fig. 4.
7 Fig. 7 comprises three sub-figures similar to Fig. 1, comprising a three-dimensional bone model and a model of an osteosynthesis plate.
Fig. 8 comprises two sub-figures similar to Fig. 1, comprising a three-dimensional bone model and a model of a perforated osteosynthesis plate.
Fig. 9 shows a three-dimensional model of a perforated plate.
Fig. 10 is a high-level block diagram of a plate generation system according to the present disclosure.
Fig. 11 is an example of an additive manufacturing machine creating a perforated osteosynthesis plate.
Fig. 12 is a flowchart describing the generation of a perforated osteosynthesis plate model.
Since these embodiments are not limiting in nature, it is possible in particular to consider variants of this disclosure that comprise only a selection of the features that are described or illustrated below in isolation from the other features that are described or illustrated (even if this selection is isolated within a sentence comprising these other features), provided that this selection of features is sufficient to confer a technical advantage or to differentiate this disclosure from the prior art. This selection comprises at least one preferably functional feature without structural detail, and/or with only a portion of the structural details if this part alone is sufficient to confer a technical advantage or to differentiate this disclosure from the prior art.
In the remainder of the description, elements having an identical structure or similar functions will be designated by the same references.
Fig. 8 comprises two sub-figures similar to Fig. 1, comprising a three-dimensional bone model and a model of a perforated osteosynthesis plate.
Fig. 9 shows a three-dimensional model of a perforated plate.
Fig. 10 is a high-level block diagram of a plate generation system according to the present disclosure.
Fig. 11 is an example of an additive manufacturing machine creating a perforated osteosynthesis plate.
Fig. 12 is a flowchart describing the generation of a perforated osteosynthesis plate model.
Since these embodiments are not limiting in nature, it is possible in particular to consider variants of this disclosure that comprise only a selection of the features that are described or illustrated below in isolation from the other features that are described or illustrated (even if this selection is isolated within a sentence comprising these other features), provided that this selection of features is sufficient to confer a technical advantage or to differentiate this disclosure from the prior art. This selection comprises at least one preferably functional feature without structural detail, and/or with only a portion of the structural details if this part alone is sufficient to confer a technical advantage or to differentiate this disclosure from the prior art.
In the remainder of the description, elements having an identical structure or similar functions will be designated by the same references.
8 Technical Issues Addressed by This Disclosure An osteosynthesis plate, sometimes also referred to as a "bone plate" in the literature, is generally used to keep different parts of a fractured or otherwise severed bone substantially stationary relative to one another during and/or after the consolidation process, during which the bone repairs itself. Fractures of a bone in the region of the head can be particularly troublesome due to movement and/or the presence of soft tissue in the osteoarticular region.
Typically, an orthopedic osteosynthesis plate can comprise an elongate portion that can be fixed to a body of bone using a plurality of bone-anchored screws, said elongate portion defining a longitudinal axis, a flared portion that is capable of being fixed to a head of the bone using at least one of the bone screws, and an intermediate portion that interconnects said elongate portion and said flared portion.
A plurality of sizes of plates can be provided having different widths and lengths. However, they are not fitted exactly to each anatomy. The surgeon will often use a straight plate and deform it. The plate can have a basic, roughly anatomical shape with a curvature, but this curvature is not adapted to each morphology.
After all, substantial anatomical variability exists in the inter- and intrapopulational skeleton, requiring wide dimensional intervals to be defined as well as dedicated designs for retention systems in order to address all of the situations that are encountered by practitioners. It is also proposed that the surgeon himself perform the anatomical deformation of the proposed plates in order to optimize contact with the bone. This practice is not very satisfactory, however, because it is often imprecise and time-consuming and thus constitutes a risk situation during a surgical intervention. This practice also requires the practitioner to use massive forceps to deform metallic material, which may be damaged when subjected to such stresses, portending a potential risk
Typically, an orthopedic osteosynthesis plate can comprise an elongate portion that can be fixed to a body of bone using a plurality of bone-anchored screws, said elongate portion defining a longitudinal axis, a flared portion that is capable of being fixed to a head of the bone using at least one of the bone screws, and an intermediate portion that interconnects said elongate portion and said flared portion.
A plurality of sizes of plates can be provided having different widths and lengths. However, they are not fitted exactly to each anatomy. The surgeon will often use a straight plate and deform it. The plate can have a basic, roughly anatomical shape with a curvature, but this curvature is not adapted to each morphology.
After all, substantial anatomical variability exists in the inter- and intrapopulational skeleton, requiring wide dimensional intervals to be defined as well as dedicated designs for retention systems in order to address all of the situations that are encountered by practitioners. It is also proposed that the surgeon himself perform the anatomical deformation of the proposed plates in order to optimize contact with the bone. This practice is not very satisfactory, however, because it is often imprecise and time-consuming and thus constitutes a risk situation during a surgical intervention. This practice also requires the practitioner to use massive forceps to deform metallic material, which may be damaged when subjected to such stresses, portending a potential risk
9 for the postoperative period.
The variability of designs must also include the great number of types of skeletal fracture identified (long bones, spinal bones, simple or compound fracture, extra-articular or intra-articular fracture, transverse fracture, multi-fragmentary fracture, etc.), in addition to osteotomies¨
which, by nature, occur intentionally. For long bone fractures alone, the classification carried out by Muller identifies more than 120 different fractures, at least 50 of which are conventionally treated by osteosynthesis.
The consequence of all of these requirements, increased by the variety of possible manufacturing materials, is that a plethora of osteosynthesis devices are being made available to orthopedic surgeons and human or veterinary traumatologists. It is therefore not uncommon for a practitioner to have to choose during the intervention from among several dozen plates and screws in order to carry out his intervention, these plates and screws being associated with several instruments that are specially designed for the placement of the associated implants. In addition to the time that the practitioner must take refining his preoperative analysis in order to determine the products that he will be requiring among the dozens offered, it is necessary to integrate the cumbersome management of this stock, both upstream and downstream, whether in terms of the financial and administrative impact or the management of the cleaning and sterilization of these devices. In view of the historical choice from among the overabundance of products aimed at meeting all of the needs of orthopedic and traumatological practitioners, the operational impact for healthcare establishments is inseparable from the analysis.
The manufacture of tailor-made osteosynthesis systems, and more particularly of plates, thus represents one solution for better meeting the expectations of practitioners on the surgical level, but¨by extension, and through an adapted and competitive manufacturing process and
The variability of designs must also include the great number of types of skeletal fracture identified (long bones, spinal bones, simple or compound fracture, extra-articular or intra-articular fracture, transverse fracture, multi-fragmentary fracture, etc.), in addition to osteotomies¨
which, by nature, occur intentionally. For long bone fractures alone, the classification carried out by Muller identifies more than 120 different fractures, at least 50 of which are conventionally treated by osteosynthesis.
The consequence of all of these requirements, increased by the variety of possible manufacturing materials, is that a plethora of osteosynthesis devices are being made available to orthopedic surgeons and human or veterinary traumatologists. It is therefore not uncommon for a practitioner to have to choose during the intervention from among several dozen plates and screws in order to carry out his intervention, these plates and screws being associated with several instruments that are specially designed for the placement of the associated implants. In addition to the time that the practitioner must take refining his preoperative analysis in order to determine the products that he will be requiring among the dozens offered, it is necessary to integrate the cumbersome management of this stock, both upstream and downstream, whether in terms of the financial and administrative impact or the management of the cleaning and sterilization of these devices. In view of the historical choice from among the overabundance of products aimed at meeting all of the needs of orthopedic and traumatological practitioners, the operational impact for healthcare establishments is inseparable from the analysis.
The manufacture of tailor-made osteosynthesis systems, and more particularly of plates, thus represents one solution for better meeting the expectations of practitioners on the surgical level, but¨by extension, and through an adapted and competitive manufacturing process and
10 simple and attractive surgical instruments¨it must allow for integration into a broader offering that will also have to optimize the operational impact within healthcare establishments and medical teams.
This disclosure provides a solution to these problems by providing a method for generating digital files for plates that are specific to the anatomy of the patient for the purpose of manufacturing them.
Today, it is possible to plan an intervention based on 3D representations of the bone to be treated. These 3D representations can be obtained, for example, from scanographic data obtained by tomodensitometry or even magnetic resonance imaging (MRI). This planning is generally accompanied by a simulation of the different stages of the intervention, particularly the position and angles of different cutting planes (in the case of osteotomy to correct deformed bones) or the repositioning of bone fragments relative to one another (in the case of fractures). In order to help the surgeon to adhere as closely as possible to the pre-established surgical plan in the case of a corrective osteotomy, for example, dedicated and personalized surgical guides are sometimes made available to practitioners. These cutting guides have bone attachment surfaces that match the shape of the latter, which makes it possible to position the cutting planes and the holes in a precise and unambiguous manner.
However, the prior art does not make it possible to offer bone retention (osteosynthesis) plates that are custom-designed prior to their manufacture.
Introduction Proposed according to a first aspect of the present disclosure is a method for generating an osteosynthesis plate suitable for being fixed on a bone comprising: a step of obtaining a three-dimensional bone model representing the bone, from an imaging device for imaging said
This disclosure provides a solution to these problems by providing a method for generating digital files for plates that are specific to the anatomy of the patient for the purpose of manufacturing them.
Today, it is possible to plan an intervention based on 3D representations of the bone to be treated. These 3D representations can be obtained, for example, from scanographic data obtained by tomodensitometry or even magnetic resonance imaging (MRI). This planning is generally accompanied by a simulation of the different stages of the intervention, particularly the position and angles of different cutting planes (in the case of osteotomy to correct deformed bones) or the repositioning of bone fragments relative to one another (in the case of fractures). In order to help the surgeon to adhere as closely as possible to the pre-established surgical plan in the case of a corrective osteotomy, for example, dedicated and personalized surgical guides are sometimes made available to practitioners. These cutting guides have bone attachment surfaces that match the shape of the latter, which makes it possible to position the cutting planes and the holes in a precise and unambiguous manner.
However, the prior art does not make it possible to offer bone retention (osteosynthesis) plates that are custom-designed prior to their manufacture.
Introduction Proposed according to a first aspect of the present disclosure is a method for generating an osteosynthesis plate suitable for being fixed on a bone comprising: a step of obtaining a three-dimensional bone model representing the bone, from an imaging device for imaging said
11 bone, three-dimensional data of the bone and, based on the obtained three-dimensional data, a step of receiving virtual entry locations of a plurality of virtual anchoring objects, from a three-dimensional representation comprising a representation of a virtual bone generated from the three-dimensional bone model to which a plurality of virtual anchoring objects are added, and a step of generating a virtual surface disposed on the virtual bone, the virtual surface being generated from the virtual entry locations of the plurality of virtual anchoring objects, said virtual surface comprising the virtual entry locations.
The method comprises a step of generating an osteosynthesis plate model, the osteosynthesis plate having a virtual face defined by the virtual surface and a thickness obtained by extrusion of the virtual face, a step of generating a virtual scene comprising the virtual bone, the virtual osteosynthesis plate model pressed on the virtual bone and positioned so that its virtual face coincides with the virtual surface, a step of determining a second osteosynthesis plate model by modifying the osteosynthesis plate model by virtual drilling of the osteosynthesis plate over its thickness to form holes for virtual anchoring objects arranged to receive the plurality of virtual anchoring objects, a step of sending the modified osteosynthesis plate model to a device making it possible to manufacture an osteosynthesis plate from the modified osteosynthesis plate model.
The imaging device can be a computed tomography scanner or an MRI, for example. The three-dimensional data of the bone can be reconstructed, for example, from files in DICOM format (Digital Imaging and Communications in Medicine), which is a standard for the IT
management of data from medical imaging. The virtual anchoring objects can be virtual screws, for example. Alternatively, or in addition, anchoring objects can be pins or any other type of implant that can be attached to the plate.
Virtual anchoring objects such as virtual screws are solid polygon-based
The method comprises a step of generating an osteosynthesis plate model, the osteosynthesis plate having a virtual face defined by the virtual surface and a thickness obtained by extrusion of the virtual face, a step of generating a virtual scene comprising the virtual bone, the virtual osteosynthesis plate model pressed on the virtual bone and positioned so that its virtual face coincides with the virtual surface, a step of determining a second osteosynthesis plate model by modifying the osteosynthesis plate model by virtual drilling of the osteosynthesis plate over its thickness to form holes for virtual anchoring objects arranged to receive the plurality of virtual anchoring objects, a step of sending the modified osteosynthesis plate model to a device making it possible to manufacture an osteosynthesis plate from the modified osteosynthesis plate model.
The imaging device can be a computed tomography scanner or an MRI, for example. The three-dimensional data of the bone can be reconstructed, for example, from files in DICOM format (Digital Imaging and Communications in Medicine), which is a standard for the IT
management of data from medical imaging. The virtual anchoring objects can be virtual screws, for example. Alternatively, or in addition, anchoring objects can be pins or any other type of implant that can be attached to the plate.
Virtual anchoring objects such as virtual screws are solid polygon-based
12 elements. Typically, such virtual anchoring objects are formed from a plurality of meshes. A mesh is a three-dimensional object made up of vertices, edges, and faces that are organized into polygons in the form of a wire-frame in a three-dimensional infographic. The faces are usually composed of triangles, quadrilaterals, or other simple convex polygons, as this simplifies rendering. The faces can be combined to form more complex concave polygons or polygons with holes. The virtual anchoring objects can be of different dimensions in terms of length or diameter.
The virtual anchoring screws can have different types of imprint, and possibly several levels of imprints that possibly have a plurality of types of imprint. The virtual screws can be cortical or spongy, and locked or not.
The virtual entry locations of the virtual anchoring objects can be determined by a user, for example. To this end, the user can specify these entry locations on a representation of the bone model. According to a first option, the virtual exit locations of the virtual anchoring objects can be determined by the user. To this end, the user can specify these exit locations on a representation of the bone model.
According to a second option, the orientation of the virtual anchoring objects can be determined in such a way that, once positioned at the virtual entry location according to said orientation, the virtual anchoring object is directed toward the center of the medullary canal of the bone.
In other words, the virtual anchoring object is directed toward the barycenter of the medullary canal of the bone perpendicular to the longitudinal axis that passes through the virtual entry location.
According to one variant, the virtual anchoring objects can be positioned based on processing carried out by a computing unit on the basis of the three-dimensional bone model. In addition, the positioning of the virtual anchoring objects positioned by the computing unit can be validated¨or modified¨by a surgeon who alone has the qualification to perform a movement that may affect the therapeutic choice. The virtual entry
The virtual anchoring screws can have different types of imprint, and possibly several levels of imprints that possibly have a plurality of types of imprint. The virtual screws can be cortical or spongy, and locked or not.
The virtual entry locations of the virtual anchoring objects can be determined by a user, for example. To this end, the user can specify these entry locations on a representation of the bone model. According to a first option, the virtual exit locations of the virtual anchoring objects can be determined by the user. To this end, the user can specify these exit locations on a representation of the bone model.
According to a second option, the orientation of the virtual anchoring objects can be determined in such a way that, once positioned at the virtual entry location according to said orientation, the virtual anchoring object is directed toward the center of the medullary canal of the bone.
In other words, the virtual anchoring object is directed toward the barycenter of the medullary canal of the bone perpendicular to the longitudinal axis that passes through the virtual entry location.
According to one variant, the virtual anchoring objects can be positioned based on processing carried out by a computing unit on the basis of the three-dimensional bone model. In addition, the positioning of the virtual anchoring objects positioned by the computing unit can be validated¨or modified¨by a surgeon who alone has the qualification to perform a movement that may affect the therapeutic choice. The virtual entry
13 locations of the plurality of virtual anchoring objects are preferably disposed within the topological interior of the virtual surface. The present description is aimed at the method for obtaining a three-dimensional object from a three-dimensional surface through extrusion of the virtual face. This is common terminology in the field of vector images, for example.
According to one option, the virtual surface is determined from a virtual generatrix curve that passes successively through reference points, the reference points being determined as the centers of the virtual entry locations and of at least two lateral virtual curves that are disposed on the bones on either side of the virtual curve.
The method according to this disclosure can also comprise positioning of longitudinal ends of a virtual plate model on the surface of the virtual three-dimensional bone model, said longitudinal ends being determined from the entry locations of the plurality of virtual anchoring objects and positioned on the surface of the three-dimensional bone model.
When the longitudinal ends are positioned on the surface of the three-dimensional bone model, the method according to this disclosure can further comprise a step of determining an intermediate osteosynthesis plate model by adding virtual fillets to the osteosynthesis plate model at the longitudinal ends, the determination of the second osteosynthesis plate model being performed by modifying said intermediate osteosynthesis plate model.
When longitudinal ends are positioned on the surface of the three-dimensional bone model, the reference points also comprise the longitudinal ends, with the virtual generatrix curve passing successively through one of the longitudinal ends, the centers of the virtual entry locations, and another of the longitudinal ends. The virtual curve can be a spline representing a geodesic that passes through the reference points on the surface of the virtual bone.
According to one option, the virtual surface is determined from a virtual generatrix curve that passes successively through reference points, the reference points being determined as the centers of the virtual entry locations and of at least two lateral virtual curves that are disposed on the bones on either side of the virtual curve.
The method according to this disclosure can also comprise positioning of longitudinal ends of a virtual plate model on the surface of the virtual three-dimensional bone model, said longitudinal ends being determined from the entry locations of the plurality of virtual anchoring objects and positioned on the surface of the three-dimensional bone model.
When the longitudinal ends are positioned on the surface of the three-dimensional bone model, the method according to this disclosure can further comprise a step of determining an intermediate osteosynthesis plate model by adding virtual fillets to the osteosynthesis plate model at the longitudinal ends, the determination of the second osteosynthesis plate model being performed by modifying said intermediate osteosynthesis plate model.
When longitudinal ends are positioned on the surface of the three-dimensional bone model, the reference points also comprise the longitudinal ends, with the virtual generatrix curve passing successively through one of the longitudinal ends, the centers of the virtual entry locations, and another of the longitudinal ends. The virtual curve can be a spline representing a geodesic that passes through the reference points on the surface of the virtual bone.
14 According to a first option, the lateral virtual curves can be splines that pass through images of the reference points, said images being obtained through translation of a distance that is a function of the width of the screw of greatest diameter, perpendicular to the axis of the plate and tangent to the surface of the bone. Thus, the image points are tangent to the surface of the bone and are offset by half a plate width perpendicular to the spline. According to another possibility, which may possibly be combined with the first, the lateral virtual curves are virtual curves spaced apart by a predetermined distance on either side of the virtual generatrix curve and projected onto the virtual surface of the bone. During the step of determining the second osteosynthesis plate model, the virtual drilling step can be carried out by subtracting models of holes, which advantageously depend on the type and size of the virtual anchoring object, of the osteosynthesis plate over its thickness to form holes in virtual anchoring objects that are designed to receive the plurality of virtual anchoring objects.
The device that makes it possible to manufacture an osteosynthesis plate from the modified osteosynthesis plate model can be of the additive manufacturing machine type, often referred to by the generic term "3D
printer." However, it is possible to use traditional manufacturing methods such as multi-axis machining or injection and rework molding for the production of the bores in the plate manufactured in this way. The manufactured osteosynthesis plate can be made of medical-grade metallic material. In particular, this type of material includes 316L
stainless steel, pure titanium, or even TA6V or TA6V-Eli titanium alloy.
According to a second aspect of the present disclosure, proposed is a device for generating an osteosynthesis plate suitable for being fixed to a bone comprising a computing unit configured to: obtain a three-dimensional bone model representing the bone in the three-dimensional database obtained from an imaging device for imaging said bone, obtaining virtual entry locations of a plurality of virtual anchoring objects
The device that makes it possible to manufacture an osteosynthesis plate from the modified osteosynthesis plate model can be of the additive manufacturing machine type, often referred to by the generic term "3D
printer." However, it is possible to use traditional manufacturing methods such as multi-axis machining or injection and rework molding for the production of the bores in the plate manufactured in this way. The manufactured osteosynthesis plate can be made of medical-grade metallic material. In particular, this type of material includes 316L
stainless steel, pure titanium, or even TA6V or TA6V-Eli titanium alloy.
According to a second aspect of the present disclosure, proposed is a device for generating an osteosynthesis plate suitable for being fixed to a bone comprising a computing unit configured to: obtain a three-dimensional bone model representing the bone in the three-dimensional database obtained from an imaging device for imaging said bone, obtaining virtual entry locations of a plurality of virtual anchoring objects
15 from a representation comprising a three-dimensional representation of a virtual bone generated from the three-dimensional bone model to which a plurality of positioned virtual anchoring objects are added, each of the virtual anchoring objects being positioned between a virtual entry location on the virtual bone and a virtual exit location on the virtual bone, generating a virtual surface disposed on the virtual bone, the virtual surface being generated from the virtual entry locations of the plurality of virtual anchoring objects, said virtual surface comprising the virtual entry locations.
The computing unit can be configured to generate an osteosynthesis plate model, the osteosynthesis plate model having a virtual face defined by the virtual surface and a thickness obtained by extrusion of the virtual face, to generate a virtual scene comprising the virtual bone, the virtual osteosynthesis plate model pressed on the virtual bone and positioned so that its virtual face coincides with the virtual surface, to determine a drilled osteosynthesis plate model by modifying the osteosynthesis plate model by virtual drilling of the osteosynthesis plate over its thickness to form holes for virtual anchoring objects arranged to receive the plurality of virtual anchoring objects, to send the drilled osteosynthesis plate model to a device making it possible to manufacture an osteosynthesis plate from the drilled osteosynthesis plate model.
According to a second aspect of the present disclosure, a system is provided for generating an osteosynthesis plate that is suitable for being fixed to a bone, comprising a device for generating an osteosynthesis plate according to the first aspect of this disclosure, or one or more improvements thereof, and a device that makes it possible to manufacture an osteosynthesis plate from the model of the perforated osteosynthesis plate received from said generation device.
Bone model Referring to Fig. 1, one sees a perspective view of a representation of a
The computing unit can be configured to generate an osteosynthesis plate model, the osteosynthesis plate model having a virtual face defined by the virtual surface and a thickness obtained by extrusion of the virtual face, to generate a virtual scene comprising the virtual bone, the virtual osteosynthesis plate model pressed on the virtual bone and positioned so that its virtual face coincides with the virtual surface, to determine a drilled osteosynthesis plate model by modifying the osteosynthesis plate model by virtual drilling of the osteosynthesis plate over its thickness to form holes for virtual anchoring objects arranged to receive the plurality of virtual anchoring objects, to send the drilled osteosynthesis plate model to a device making it possible to manufacture an osteosynthesis plate from the drilled osteosynthesis plate model.
According to a second aspect of the present disclosure, a system is provided for generating an osteosynthesis plate that is suitable for being fixed to a bone, comprising a device for generating an osteosynthesis plate according to the first aspect of this disclosure, or one or more improvements thereof, and a device that makes it possible to manufacture an osteosynthesis plate from the model of the perforated osteosynthesis plate received from said generation device.
Bone model Referring to Fig. 1, one sees a perspective view of a representation of a
16 bone model with positioned screws 1. In the following description, only one type of virtual anchor is given, namely that of the virtual screw. The bone model with positioned screws comprises a bone model 10 on the one hand and a screw 20 on the other hand. The screw 20 is positioned in the bone.
The three-dimensional bone model 10 is obtained from three-dimensional data relating to real bone that are obtained from an imaging device. The three-dimensional data can be in a DICOM format, for example. The three-dimensional data can be sent to the computing unit, which is configured to determine the three-dimensional bone model 10 from said three-dimensional data.
In order to obtain the bone model with positioned screw 1, a representation of the bone model 10 can be presented to a user¨for example on a display screen such as a computer screen, or even by means of a virtual reality or hologram generation device (augmented or mixed reality). The user can select one screw or a plurality of screws and position it or them on the representation, and hence in the bone model, thus generating the three-dimensional bone model with positioned screws 1.
To position the screw, the user may be given the option to indicate an entry location for a screw on the representation of the bone model. For example, the user can indicate the entry location by means of a pointing device, such as a mouse, and by pointing to the entry location of the screw on the representation of the bone model. The entry locations can be sent to the computing unit. According to one option, an orientation of the screw is then determined in such a way that, once positioned at the entry location according to said orientation, the virtual screw is directed toward the center of the medullary canal of the bone.
Alternatively, the orientation of the virtual screw is determined by the user. The user may be given the option to indicate an exit location for
The three-dimensional bone model 10 is obtained from three-dimensional data relating to real bone that are obtained from an imaging device. The three-dimensional data can be in a DICOM format, for example. The three-dimensional data can be sent to the computing unit, which is configured to determine the three-dimensional bone model 10 from said three-dimensional data.
In order to obtain the bone model with positioned screw 1, a representation of the bone model 10 can be presented to a user¨for example on a display screen such as a computer screen, or even by means of a virtual reality or hologram generation device (augmented or mixed reality). The user can select one screw or a plurality of screws and position it or them on the representation, and hence in the bone model, thus generating the three-dimensional bone model with positioned screws 1.
To position the screw, the user may be given the option to indicate an entry location for a screw on the representation of the bone model. For example, the user can indicate the entry location by means of a pointing device, such as a mouse, and by pointing to the entry location of the screw on the representation of the bone model. The entry locations can be sent to the computing unit. According to one option, an orientation of the screw is then determined in such a way that, once positioned at the entry location according to said orientation, the virtual screw is directed toward the center of the medullary canal of the bone.
Alternatively, the orientation of the virtual screw is determined by the user. The user may be given the option to indicate an exit location for
17 the screw on the representation of the bone model. For example, the user can indicate the exit location by means of a pointing device, such as a mouse, and by pointing to the exit location of the screw on the representation of the bone model. According to yet another option, the orientation of the virtual screw is determined by the user. The user may be given the option to indicate an exit location for the screw on the representation of the bone model. For example, the user can indicate the exit location by means of a pointing device, such as a mouse, and by moving the exit location on the model, for example by moving the tip of the screw on the representation of the bone model.
Fig. 2 is a perspective view of a representation of a bone model with positioned entry location points 2. The entry location bone model comprises the bone model 10 on the one hand and one or more entry locations 12 on the other hand. A plurality of entry locations are shown in Fig. 2. Thus, the central unit can receive: a three-dimensional model 10 and virtual entry locations of a plurality of virtual screws.
Fig. 3 is a perspective view of a representation of a bone model with entry locations and positioned ends 3 The bone model with entry location, for its part, comprises the bone model 10, an entry location 12, and a longitudinal end location 14. Two longitudinal end locations are shown in Fig. 3. In one variant of the present disclosure, the longitudinal end locations can be determined by the user.
Alternatively, the longitudinal end locations can be determined by the computing unit from the entry locations of the plurality of virtual screws and positioned on the surface of the bone model. The location of the distal longitudinal end is positioned on the surface of the bone in the extension of the two entry locations of the most distal virtual screws at a distance that depends on the size of the largest screw used. The same is true for the location of the proximal longitudinal end.
Fig. 4 is a perspective view of a representation of a bone model with
Fig. 2 is a perspective view of a representation of a bone model with positioned entry location points 2. The entry location bone model comprises the bone model 10 on the one hand and one or more entry locations 12 on the other hand. A plurality of entry locations are shown in Fig. 2. Thus, the central unit can receive: a three-dimensional model 10 and virtual entry locations of a plurality of virtual screws.
Fig. 3 is a perspective view of a representation of a bone model with entry locations and positioned ends 3 The bone model with entry location, for its part, comprises the bone model 10, an entry location 12, and a longitudinal end location 14. Two longitudinal end locations are shown in Fig. 3. In one variant of the present disclosure, the longitudinal end locations can be determined by the user.
Alternatively, the longitudinal end locations can be determined by the computing unit from the entry locations of the plurality of virtual screws and positioned on the surface of the bone model. The location of the distal longitudinal end is positioned on the surface of the bone in the extension of the two entry locations of the most distal virtual screws at a distance that depends on the size of the largest screw used. The same is true for the location of the proximal longitudinal end.
Fig. 4 is a perspective view of a representation of a bone model with
18 virtual generatrix curve 4. The bone model with virtual generatrix curve 4, for its part, comprises the bone model 10, the entry location 12, the longitudinal end location 14, and a virtual generatrix curve 32. The virtual generatrix curve 32 passes successively through reference points. The reference points comprise the centers of the virtual entry locations 12. In the example shown, the reference points also comprise the longitudinal ends 14. The virtual generatrix curve passes successively through one of the longitudinal ends 14, the centers of the virtual entry locations 12, and another of the longitudinal ends 14. The generatrix curve can be determined in the manner of a spline. In this case, the reference points are called intermediate points.
In this case, the degree of the spline is typically 3. As will readily be understood, other degrees can be chosen. This parameter is an input parameter for the device according to this disclosure. Of course, the spline is determined on the surface having the reference points. The spline passes through a finite number of points on the surface of the bone. It passes through anchor points and points defined on the bone surface so that it follows the shape of the bone, for example with points every 0.5 mm.
The spline is a geodesic-like curve that passes through intermediate points on the surface of the bone. The virtual generatrix curve is determined by the computing unit from the entry locations of the plurality of virtual screws and the longitudinal ends.
Fig. 5 is a perspective view of a representation of a bone model with virtual curves 5. The bone model with virtual generatrix curve 5, for its part, comprises the bone model 10, the virtual generatrix curve 32, and two lateral curves 34, 36, respectively. According to one possibility, the lateral curves 34, 36, respectively, are spaced apart by a predetermined distance on either side of the virtual generatrix curve and projected onto the virtual surface of the bone. Typically, a distance can be a multiple of the diameter of the screws, for example three screw diameters.
In this case, the degree of the spline is typically 3. As will readily be understood, other degrees can be chosen. This parameter is an input parameter for the device according to this disclosure. Of course, the spline is determined on the surface having the reference points. The spline passes through a finite number of points on the surface of the bone. It passes through anchor points and points defined on the bone surface so that it follows the shape of the bone, for example with points every 0.5 mm.
The spline is a geodesic-like curve that passes through intermediate points on the surface of the bone. The virtual generatrix curve is determined by the computing unit from the entry locations of the plurality of virtual screws and the longitudinal ends.
Fig. 5 is a perspective view of a representation of a bone model with virtual curves 5. The bone model with virtual generatrix curve 5, for its part, comprises the bone model 10, the virtual generatrix curve 32, and two lateral curves 34, 36, respectively. According to one possibility, the lateral curves 34, 36, respectively, are spaced apart by a predetermined distance on either side of the virtual generatrix curve and projected onto the virtual surface of the bone. Typically, a distance can be a multiple of the diameter of the screws, for example three screw diameters.
19 Fig. 6 is a perspective view of a representation of a bone model with virtual surface. The bone model with virtual generatrix curve 6, for its part, comprises the bone model 10 and a virtual surface 30. The virtual surface is determined by the computing unit from the three virtual curves 32, 34, and 36.
Fig. 7 illustrates a bone model with osteosynthesis plate 7. The bone model with osteosynthesis surface 7 comprises the bone model 10 on the one hand and a model 40 of the osteosynthesis plate on the other hand. The bone models 10 and the osteosynthesis plate model 40 are seen from the front in sub-figure A, from the left in sub-figure B, and from the right in sub-figure C. The model 40 of the osteosynthesis plate has a virtual face 42 that is defined by the virtual surface 30. When the model 40 is positioned on the bone model, the virtual face 42 and the virtual surface 30 coincide.
The model 40 is obtained by volumization of the virtual surface 42. For example, the model 40 is obtained by extruding the virtual face 42. The extrusion of a surface is aimed at achieving the method that enables a volume to be obtained by translation of the surface along a predetermined axis. For example, an axis passing through the center of the medullary canal of the bone. According to another option, the model 40 is obtained by filling between the virtual surface 42 and the surface parallel to 42 spaced apart by a predetermined distance corresponding to the thickness of the model 40. In addition, the computing unit can determine fillets at the longitudinal ends of the virtual surface 30.
Fig. 8 illustrates a bone model with perforated osteosynthesis plate and positioned screws 8. The bone model with virtual surface and positioned screws 8 comprises the bone model 10 on the one hand and a model 42 of a perforated osteosynthesis plate on the other hand. It also comprises screws positioned in the model 50 and in the bone model 10. The bone
Fig. 7 illustrates a bone model with osteosynthesis plate 7. The bone model with osteosynthesis surface 7 comprises the bone model 10 on the one hand and a model 40 of the osteosynthesis plate on the other hand. The bone models 10 and the osteosynthesis plate model 40 are seen from the front in sub-figure A, from the left in sub-figure B, and from the right in sub-figure C. The model 40 of the osteosynthesis plate has a virtual face 42 that is defined by the virtual surface 30. When the model 40 is positioned on the bone model, the virtual face 42 and the virtual surface 30 coincide.
The model 40 is obtained by volumization of the virtual surface 42. For example, the model 40 is obtained by extruding the virtual face 42. The extrusion of a surface is aimed at achieving the method that enables a volume to be obtained by translation of the surface along a predetermined axis. For example, an axis passing through the center of the medullary canal of the bone. According to another option, the model 40 is obtained by filling between the virtual surface 42 and the surface parallel to 42 spaced apart by a predetermined distance corresponding to the thickness of the model 40. In addition, the computing unit can determine fillets at the longitudinal ends of the virtual surface 30.
Fig. 8 illustrates a bone model with perforated osteosynthesis plate and positioned screws 8. The bone model with virtual surface and positioned screws 8 comprises the bone model 10 on the one hand and a model 42 of a perforated osteosynthesis plate on the other hand. It also comprises screws positioned in the model 50 and in the bone model 10. The bone
20 model with virtual surface and positioned screws 8 is seen from the front in sub-figure A and from three-quarters to the right in sub-figure B.
To generate the perforated osteosynthesis plate model, the computing unit is configured to generate a representation comprising the bone model and the virtual osteosynthesis plate model 40 pressed against the virtual bone and positioned such that its virtual face coincides with the virtual surface 30.
The model 42 of the perforated osteosynthesis plate is obtained by modifying the model 40 of the osteosynthesis plate by virtual drilling of the osteosynthesis plate over its thickness to form virtual screw holes designed to receive the plurality of virtual screws. The perforated osteosynthesis plate model 40 can be of the volumetric file model type, for example in STL or OBJ format.
Fig. 9 is a view of a representation of the model of a perforated osteosynthesis plate 50 obtained. The model of the perforated osteosynthesis plate 40 can be sent to a device that makes it possible to manufacture an osteosynthesis plate from the model of the perforated osteosynthesis plate. The osteosynthesis plate that is produced is made of medical grade material.
Fig. 10 is a schematic view of a system 100 according to this disclosure.
The system 100 according to this disclosure can comprise an imaging device 102 situated in an imaging unit S1, for example in a hospital, a clinic, or a private facility dedicated to medical imaging. The three-dimensional data of the real bone can be sent to a central unit 104 in a location S2 remote from the location S1, for example in a cloud-type network infrastructure.
The user, typically a surgeon, can be situated in a third location S3¨in his office, for example¨and have a representation of a model of the bone generated by the central unit 104 be displayed on a computer
To generate the perforated osteosynthesis plate model, the computing unit is configured to generate a representation comprising the bone model and the virtual osteosynthesis plate model 40 pressed against the virtual bone and positioned such that its virtual face coincides with the virtual surface 30.
The model 42 of the perforated osteosynthesis plate is obtained by modifying the model 40 of the osteosynthesis plate by virtual drilling of the osteosynthesis plate over its thickness to form virtual screw holes designed to receive the plurality of virtual screws. The perforated osteosynthesis plate model 40 can be of the volumetric file model type, for example in STL or OBJ format.
Fig. 9 is a view of a representation of the model of a perforated osteosynthesis plate 50 obtained. The model of the perforated osteosynthesis plate 40 can be sent to a device that makes it possible to manufacture an osteosynthesis plate from the model of the perforated osteosynthesis plate. The osteosynthesis plate that is produced is made of medical grade material.
Fig. 10 is a schematic view of a system 100 according to this disclosure.
The system 100 according to this disclosure can comprise an imaging device 102 situated in an imaging unit S1, for example in a hospital, a clinic, or a private facility dedicated to medical imaging. The three-dimensional data of the real bone can be sent to a central unit 104 in a location S2 remote from the location S1, for example in a cloud-type network infrastructure.
The user, typically a surgeon, can be situated in a third location S3¨in his office, for example¨and have a representation of a model of the bone generated by the central unit 104 be displayed on a computer
21 screen 106. The device 108 making it possible to manufacture the osteosynthesis plate can be a 3D printer, for example, and be located in a production plant S4, in a location that is separate from the two previous locations. The production plant may comprise software, for example, that is interfaced with that of a hospital or clinic for notifying the hospital planning software of the imminent availability of the osteosynthesis plate.
In various embodiments, an image storage database 112 may store medical image files for a plurality of patients/users. The image storage database 112 may be accessible to the operator device 106, the imaging device 102 (for downloading image files), the central unit 104, the production plant 108, etc. through the Internet. In various embodiments, the image storage database 112 may be located on a local access network of one of the sites, for example, the production plant 108 or a hospital. Additionally, the system 100 comprises a digital file storage database 116, which can store digital files generated for the production of a bone plate or surgical guide for a particular patient or user. The production plant 108 may obtain the digital files from digital file storage 116 via the Internet to produce the bone plate or surgical guide.
Of course, the various features, forms, variants, and embodiments of this disclosure can be combined with one another in various combinations as long as they are not incompatible or exclusive of one another. In particular, all of the variants and embodiments described above may be combined with one another.
Fig. 11 is an example of an additive manufacturing machine 200 creating a perforated osteosynthesis plate 204. In various embodiments, the additive manufacturing machine 200 receives a perforated osteosynthesis plate model from a separate device that generates an image-based model of the bone. The additive manufacturing machine 200 can construct the perforated osteosynthesis plate 204 using the perforated bone plate model by applying the methods described
In various embodiments, an image storage database 112 may store medical image files for a plurality of patients/users. The image storage database 112 may be accessible to the operator device 106, the imaging device 102 (for downloading image files), the central unit 104, the production plant 108, etc. through the Internet. In various embodiments, the image storage database 112 may be located on a local access network of one of the sites, for example, the production plant 108 or a hospital. Additionally, the system 100 comprises a digital file storage database 116, which can store digital files generated for the production of a bone plate or surgical guide for a particular patient or user. The production plant 108 may obtain the digital files from digital file storage 116 via the Internet to produce the bone plate or surgical guide.
Of course, the various features, forms, variants, and embodiments of this disclosure can be combined with one another in various combinations as long as they are not incompatible or exclusive of one another. In particular, all of the variants and embodiments described above may be combined with one another.
Fig. 11 is an example of an additive manufacturing machine 200 creating a perforated osteosynthesis plate 204. In various embodiments, the additive manufacturing machine 200 receives a perforated osteosynthesis plate model from a separate device that generates an image-based model of the bone. The additive manufacturing machine 200 can construct the perforated osteosynthesis plate 204 using the perforated bone plate model by applying the methods described
22 above.
Fig. 12 is a flowchart describing the generation of a perforated osteosynthesis plate model. The control can be performed by a set of instructions stored in the memory of a device and operated by a processor of the device. For example, the instructions can be executed by the central unit 104. The control begins in response to receiving a model request, for example, from an operator or a surgeon to send the model to be generated and to send the model for the generation of the perforated osteosynthesis plate. In step 404, the control obtains a 3D
bone model from, for example, a data store that stores imaging data for a plurality of users. In various embodiments, the model request identifies a user or patient and the control obtains the 3D bone model corresponding to the user. In various embodiments, the bone model is not 3D, for example the bone model may include 2D images of the bone.
The control continues to 408 to determine a set of virtual entry locations on the bone model. The control passes to 412 to generate a virtual surface disposed on the bone model based on the virtual entry points.
As previously described, the virtual surface can form a particular shape based on the virtual entry points. The control moves to position 416 to generate a virtual osteosynthesis plate model based on the virtual surface and virtual entry points, such as the virtual osteosynthesis plate model shown in Fig. 9.
The control goes to 420 to optionally generate a virtual scene comprising the bone model and the virtual osteosynthesis plate. In various embodiments, the control jumps to 420 and continues to 424. At 424, the control transmits the virtual osteosynthesis plate model to a manufacturing device. In various embodiments, at 424, the control may transmit the virtual bone model to a storage device, which may be accessed by the manufacturing device for production of an osteosynthesis plate.
Fig. 12 is a flowchart describing the generation of a perforated osteosynthesis plate model. The control can be performed by a set of instructions stored in the memory of a device and operated by a processor of the device. For example, the instructions can be executed by the central unit 104. The control begins in response to receiving a model request, for example, from an operator or a surgeon to send the model to be generated and to send the model for the generation of the perforated osteosynthesis plate. In step 404, the control obtains a 3D
bone model from, for example, a data store that stores imaging data for a plurality of users. In various embodiments, the model request identifies a user or patient and the control obtains the 3D bone model corresponding to the user. In various embodiments, the bone model is not 3D, for example the bone model may include 2D images of the bone.
The control continues to 408 to determine a set of virtual entry locations on the bone model. The control passes to 412 to generate a virtual surface disposed on the bone model based on the virtual entry points.
As previously described, the virtual surface can form a particular shape based on the virtual entry points. The control moves to position 416 to generate a virtual osteosynthesis plate model based on the virtual surface and virtual entry points, such as the virtual osteosynthesis plate model shown in Fig. 9.
The control goes to 420 to optionally generate a virtual scene comprising the bone model and the virtual osteosynthesis plate. In various embodiments, the control jumps to 420 and continues to 424. At 424, the control transmits the virtual osteosynthesis plate model to a manufacturing device. In various embodiments, at 424, the control may transmit the virtual bone model to a storage device, which may be accessed by the manufacturing device for production of an osteosynthesis plate.
23 Conclusion The foregoing description is for illustrative purposes only and is not intended to limit the disclosure, application or uses in any way. The general teachings of the disclosure can be implemented in various forms.
Accordingly, although this disclosure includes specific examples, its actual scope should not be so limited as other modifications will become apparent from a study of the following drawings, specification and claims.
It should be understood that one or more steps of a method can be performed in a different order (or simultaneously) without altering the principles of the present disclosure. Furthermore, although each of the embodiments is described above as having certain features, one or more of those features described with respect to any embodiment of the disclosure may be implemented in and/or combined with features of any other incorporation, even if this combination is not explicitly described.
In other words, the disclosed embodiments are not mutually exclusive and permutations of one or more embodiments therebetween remain within the scope of the disclosure.
The term "code," as used above, may include software, firmware and/or microcode, and may refer to programs, routines, functions, classes, data structures and/or objects. The term "shared processor circuit"
encompasses a single processor circuit that executes all or part of the code of several modules. The term "bundled processor circuit"
encompasses a processor circuit that, in combination with additional processor circuits, executes all or part of the code of one or more modules. References to multiple processor circuits encompass multiple processor circuits on different dies, multiple processor circuits on a single die, multiple cores of a single processor circuit, multiple wires of a single processor circuit, or a combination of these elements. The term "shared memory circuit" encompasses a single memory circuit that stores some or all of the code for multiple modules. The term "collective memory circuit" encompasses a memory circuit that, in combination with additional memories, stores all or part of the code of one or more
Accordingly, although this disclosure includes specific examples, its actual scope should not be so limited as other modifications will become apparent from a study of the following drawings, specification and claims.
It should be understood that one or more steps of a method can be performed in a different order (or simultaneously) without altering the principles of the present disclosure. Furthermore, although each of the embodiments is described above as having certain features, one or more of those features described with respect to any embodiment of the disclosure may be implemented in and/or combined with features of any other incorporation, even if this combination is not explicitly described.
In other words, the disclosed embodiments are not mutually exclusive and permutations of one or more embodiments therebetween remain within the scope of the disclosure.
The term "code," as used above, may include software, firmware and/or microcode, and may refer to programs, routines, functions, classes, data structures and/or objects. The term "shared processor circuit"
encompasses a single processor circuit that executes all or part of the code of several modules. The term "bundled processor circuit"
encompasses a processor circuit that, in combination with additional processor circuits, executes all or part of the code of one or more modules. References to multiple processor circuits encompass multiple processor circuits on different dies, multiple processor circuits on a single die, multiple cores of a single processor circuit, multiple wires of a single processor circuit, or a combination of these elements. The term "shared memory circuit" encompasses a single memory circuit that stores some or all of the code for multiple modules. The term "collective memory circuit" encompasses a memory circuit that, in combination with additional memories, stores all or part of the code of one or more
24 modules.
The devices and methods described in this application may be partially or fully implemented by a specialized computer created by configuring a general computer to perform one or more particular functions incorporated in computer programs. The function blocks and flowchart elements described above serve as software specifications, which can be translated into computer programs by the routine work of a skilled technician or programmer.
The computer programs comprise instructions executable by the processor that are stored on at least one non-transitory computer-readable medium. The computer programs may also include or rely on stored data. The computer programs may comprise a basic input/output system (BIOS) that interacts with specialized computer hardware, device drivers that interact with particular peripherals of the specialized computer, one or more operating systems, user applications, background services, background applications, etc.
The computer programs may include: (i) descriptive text to be parsed, such as HTML (hypertext markup language), XML (extensible markup language), or JSON (JavaScript Object Notation), (ii) assembly code, (iii) object code generated from source code by a compiler, (iv) source code for execution by an interpreter, (v) source code for compilation and execution by a just-in-time compiler, etc. By way of example only, the source code may be written using the syntax of languages such as C, C++, C#, Objective C, Swift, Haskell, Go, SQL, R, Lisp, Java , Fortran, Perl, Pascal, Curl, OCaml, JavaScript , HTML5 (Hypertext Markup Language 5th revision), Ada, ASP (Active Server Pages), PHP (PHP:
Hypertext Preprocessor), Scala, Eiffel, Smalltalk, Erlang, Ruby, Flash , Visual Basic , Lua, MATLAB, SIMULINK, and Python .
The devices and methods described in this application may be partially or fully implemented by a specialized computer created by configuring a general computer to perform one or more particular functions incorporated in computer programs. The function blocks and flowchart elements described above serve as software specifications, which can be translated into computer programs by the routine work of a skilled technician or programmer.
The computer programs comprise instructions executable by the processor that are stored on at least one non-transitory computer-readable medium. The computer programs may also include or rely on stored data. The computer programs may comprise a basic input/output system (BIOS) that interacts with specialized computer hardware, device drivers that interact with particular peripherals of the specialized computer, one or more operating systems, user applications, background services, background applications, etc.
The computer programs may include: (i) descriptive text to be parsed, such as HTML (hypertext markup language), XML (extensible markup language), or JSON (JavaScript Object Notation), (ii) assembly code, (iii) object code generated from source code by a compiler, (iv) source code for execution by an interpreter, (v) source code for compilation and execution by a just-in-time compiler, etc. By way of example only, the source code may be written using the syntax of languages such as C, C++, C#, Objective C, Swift, Haskell, Go, SQL, R, Lisp, Java , Fortran, Perl, Pascal, Curl, OCaml, JavaScript , HTML5 (Hypertext Markup Language 5th revision), Ada, ASP (Active Server Pages), PHP (PHP:
Hypertext Preprocessor), Scala, Eiffel, Smalltalk, Erlang, Ruby, Flash , Visual Basic , Lua, MATLAB, SIMULINK, and Python .
Claims (23)
1. Method for generating an osteosynthesis plate that is suitable for being fixed to a bone comprising a computing unit that is configured to implement the following steps:
= obtaining (404) a bone model (10) representing a bone generated from imaging data corresponding to the bone from an imaging device;
= determining (408) a set of virtual entry points (12, 14) on the bone model;
= generating (412) a virtual surface (30) adjacent to the bone model based on the bone model and the set of virtual entry points;
= generating (416) an osteosynthesis plate model (40) based on the virtual surface;
= creating a virtual hole at each virtual entry point of the set of virtual entry points along the osteosynthesis plate model; and = transmitting (420) the osteosynthesis plate model to an osteosynthesis plate manufacturing machine (108).
= obtaining (404) a bone model (10) representing a bone generated from imaging data corresponding to the bone from an imaging device;
= determining (408) a set of virtual entry points (12, 14) on the bone model;
= generating (412) a virtual surface (30) adjacent to the bone model based on the bone model and the set of virtual entry points;
= generating (416) an osteosynthesis plate model (40) based on the virtual surface;
= creating a virtual hole at each virtual entry point of the set of virtual entry points along the osteosynthesis plate model; and = transmitting (420) the osteosynthesis plate model to an osteosynthesis plate manufacturing machine (108).
2. Method according to claim 1, wherein the set of virtual entry points (12) indicates where a screw is inserted into the bone.
3. Method according to either claim 1 or claim 2, wherein the bone model (10) is three-dimensional.
4. Method according to one of the preceding claims, further comprising a step of obtaining imaging data corresponding to the bone from an imaging device (102).
5. Method according to one of the preceding claims, wherein the virtual surface comprises all of the virtual entry locations, a screw is one of multiple screws and the virtual hole is one of multiple holes.
6. Method according to one of the preceding claims, wherein the osteosynthesis plate model (40) comprises a virtual face defined by the virtual surface (30) and a thickness defined by an extrusion of the virtual face.
7. Method according to one of the preceding claims, further comprising:
= generating (420) a virtual scene comprising the bone model, in which the osteosynthesis plate model is pressed against the bone model and positioned such that a virtual face (42) of the osteosynthesis plate model (40) coincides with the virtual surface (30), wherein the generation of an osteosynthesis plate model and the subsequent fabrication of a custom osteosynthesis plate saves the surgeon from having to modify the plate during the operation.
= generating (420) a virtual scene comprising the bone model, in which the osteosynthesis plate model is pressed against the bone model and positioned such that a virtual face (42) of the osteosynthesis plate model (40) coincides with the virtual surface (30), wherein the generation of an osteosynthesis plate model and the subsequent fabrication of a custom osteosynthesis plate saves the surgeon from having to modify the plate during the operation.
8.
Method according to one of the preceding claims, wherein the virtual surface is determined electronically from a virtual generatrix curve (32) that successively passes through reference points, the reference points being determined as the centers of the set of virtual entry points and of at least two lateral virtual curves that are disposed on each side of the virtual generatrix curve.
Method according to one of the preceding claims, wherein the virtual surface is determined electronically from a virtual generatrix curve (32) that successively passes through reference points, the reference points being determined as the centers of the set of virtual entry points and of at least two lateral virtual curves that are disposed on each side of the virtual generatrix curve.
9.
Method according to the preceding claim, wherein the reference points comprise longitudinal ends (14), the virtual generatrix curve (32) successively passing through one of the longitudinal ends, the centers of all the virtual entry points, and another of the longitudinal ends.
Method according to the preceding claim, wherein the reference points comprise longitudinal ends (14), the virtual generatrix curve (32) successively passing through one of the longitudinal ends, the centers of all the virtual entry points, and another of the longitudinal ends.
10. Method according to claim 8, wherein the virtual generatrix curve (32) is a spline of the geodesic type passing through the reference points.
11. Method according to claim 8, wherein the lateral virtual curves (34, 36) are geodesic-like splines that pass through images of the reference points, and wherein the images are obtained by translation of a distance that is a function of a width of a screw at a maximum diameter perpendicular to an axis of the osteosynthesis plate model and tangent to the virtual surface of the bone model.
12. Method according to claim 8, wherein the lateral virtual curves (34, 36) are virtual curves spaced apart by a predetermined distance on either side of the virtual generatrix curve (32) and projected onto the virtual surface of the bone.
13. Method according to one of the preceding claims, further comprising:
= determining an intermediate osteosynthesis plate model by adding virtual fillets to the osteosynthesis plate model at the longitudinal ends of the osteosynthesis plate model, in which the osteosynthesis plate model is determined by modifying the intermediate osteosynthesis plate model.
= determining an intermediate osteosynthesis plate model by adding virtual fillets to the osteosynthesis plate model at the longitudinal ends of the osteosynthesis plate model, in which the osteosynthesis plate model is determined by modifying the intermediate osteosynthesis plate model.
14. Method according to one of the preceding claims, wherein the osteosynthesis plate manufacturing machine is an additive or subtractive manufacturing machine.
15.
Method according to one of the preceding claims, wherein the osteosynthesis plate that is manufactured is made of medical grade materials.
Method according to one of the preceding claims, wherein the osteosynthesis plate that is manufactured is made of medical grade materials.
16. Method according to one of the preceding claims, wherein the osteosynthesis plate manufacturing machine uses laser sintering or three-dimensional printing and is located in a location remote from the modeling.
17. Computer program product comprising instructions that, when the program is executed by a computer, lead the latter to implement the steps of the method according to one of the preceding claims.
18. Computer-readable recording medium comprising instructions that, when executed by a computer, cause the latter to perform the steps of the method according to one of the preceding method claims.
19. System for generating a surgical model, comprising:
= a graphical user interface;
= at least one processor; and = a memory coupled to at least one processor, wherein the memory stores instructions executed by the processor(s) and wherein the instructions comprise implementing the following steps:
= retrieving a bone model from imaging data corresponding to a bone;
= displaying the bone model via a screen;
= receiving data, via the display, indicating a virtual entry location on the bone model;
= constructing a virtual surface adjacent to the bone model based on the bone model and the virtual entry location;
= creating an osteosynthesis plate model based on the virtual surface;
= drilling a virtual hole at the virtual entry location on the osteosynthesis plate model; and = transmitting the osteosynthesis plate model to a plate model storage.
= a graphical user interface;
= at least one processor; and = a memory coupled to at least one processor, wherein the memory stores instructions executed by the processor(s) and wherein the instructions comprise implementing the following steps:
= retrieving a bone model from imaging data corresponding to a bone;
= displaying the bone model via a screen;
= receiving data, via the display, indicating a virtual entry location on the bone model;
= constructing a virtual surface adjacent to the bone model based on the bone model and the virtual entry location;
= creating an osteosynthesis plate model based on the virtual surface;
= drilling a virtual hole at the virtual entry location on the osteosynthesis plate model; and = transmitting the osteosynthesis plate model to a plate model storage.
20. Model generation system according to the preceding claim, wherein the osteosynthesis plate model comprises a virtual face defined by the virtual surface and a thickness defined by an extrusion of the virtual face.
21. Surgical model generation system according to the preceding claim, wherein the instructions comprise the implementation of the following steps:
= generating a virtual scene comprising the bone model, in which the osteosynthesis plate model is pressed against the bone model and positioned such that a virtual face of the osteosynthesis plate model coincides with the virtual surface, and wherein the generation of an osteosynthesis plate model and the subsequent fabrication of a custom osteosynthesis plate saves the surgeon from having to modify the plate during the operation.
= generating a virtual scene comprising the bone model, in which the osteosynthesis plate model is pressed against the bone model and positioned such that a virtual face of the osteosynthesis plate model coincides with the virtual surface, and wherein the generation of an osteosynthesis plate model and the subsequent fabrication of a custom osteosynthesis plate saves the surgeon from having to modify the plate during the operation.
22. Model generation system according to one of claims 19 to 21, wherein the virtual surface is determined electronically from a virtual generatrix curve that successively passes through reference points, the reference points being determined as the centers of the drilling position and of at least two lateral virtual curves that are disposed on each side of the virtual generatrix curve.
23. Model generation system according to the preceding claim, wherein the reference points comprise longitudinal ends, the virtual generatrix curve successively passing through one of the longitudinal ends, the centers of the drilling position and another of the longitudinal ends.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FRFR2008889 | 2020-09-02 | ||
| FR2008889A FR3113575B1 (en) | 2020-09-02 | 2020-09-02 | Method for generating digital models of osteosynthesis plates specific to the morphology of the patient |
| PCT/FR2021/051480 WO2022049333A2 (en) | 2020-09-02 | 2021-08-24 | Method for generating digital models of osteosynthesis plates specific to the morphology of the patient |
Publications (1)
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|---|---|
| CA3190560A1 true CA3190560A1 (en) | 2022-03-10 |
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| CA3190560A Pending CA3190560A1 (en) | 2020-09-02 | 2021-08-24 | Method for generating digital models of osteosynthesis plates specific to the morphology of the patient |
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| EP (1) | EP4208112A2 (en) |
| CN (1) | CN116261431A (en) |
| BR (1) | BR112023003448A2 (en) |
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| CN118587337B (en) * | 2024-06-21 | 2025-11-25 | 江苏意领数字科技有限公司 | A hierarchical virtual character skeleton volumetric simulation sampling method |
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|---|---|---|---|---|
| US8246663B2 (en) * | 2006-04-10 | 2012-08-21 | Scott Lovald | Osteosynthesis plate, method of customizing same, and method for installing same |
| EP1982652A1 (en) * | 2007-04-20 | 2008-10-22 | Medicim NV | Method for deriving shape information |
| CN103150442A (en) * | 2013-03-15 | 2013-06-12 | 常州华森医疗器械有限公司 | Manufacturing technique of digitally customizing orthopedic implants |
| CN113180805B (en) * | 2013-12-09 | 2024-12-20 | 穆罕默德·R·马赫福兹 | Bone reconstruction and orthopedic implants |
| US11033333B2 (en) * | 2017-04-06 | 2021-06-15 | Stryker European Holdings I, Llc | Plate selection user interface and design tool with database |
| CN106983556B (en) * | 2017-05-08 | 2020-05-19 | 莆田学院附属医院（莆田市第二医院） | Method for digitally pre-bending bone fracture plate through internal fixation, locking and reconstruction of acetabular fracture |
| CN108492359A (en) * | 2018-03-13 | 2018-09-04 | 广东工业大学 | The method for customizing and software of bone plate profile in the customization of Medical bone plate digital |
| WO2020139809A1 (en) * | 2018-12-23 | 2020-07-02 | Smith & Nephew, Inc. | Osteochondral defect treatment method and system |
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- 2020-09-02 FR FR2008889A patent/FR3113575B1/en active Active
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- 2021-08-24 WO PCT/FR2021/051480 patent/WO2022049333A2/en not_active Ceased
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| WO2022049333A3 (en) | 2022-05-05 |
| CN116261431A (en) | 2023-06-13 |
| FR3113575B1 (en) | 2023-08-04 |
| EP4208112A2 (en) | 2023-07-12 |
| WO2022049333A2 (en) | 2022-03-10 |
| BR112023003448A2 (en) | 2023-05-02 |
| FR3113575A1 (en) | 2022-03-04 |
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