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WO2013045713A1 - Dispositif d'arthrodèse partielle du carpe - Google Patents

Dispositif d'arthrodèse partielle du carpe Download PDF

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Publication number
WO2013045713A1
WO2013045713A1 PCT/ES2011/070668 ES2011070668W WO2013045713A1 WO 2013045713 A1 WO2013045713 A1 WO 2013045713A1 ES 2011070668 W ES2011070668 W ES 2011070668W WO 2013045713 A1 WO2013045713 A1 WO 2013045713A1
Authority
WO
WIPO (PCT)
Prior art keywords
section
sections
arthrodesis
partial
carpal
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/ES2011/070668
Other languages
English (en)
Spanish (es)
Inventor
Pedro HERNÁNDEZ CORTES
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Servicio Andaluz de Salud
Original Assignee
Servicio Andaluz de Salud
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Servicio Andaluz de Salud filed Critical Servicio Andaluz de Salud
Priority to PCT/ES2011/070668 priority Critical patent/WO2013045713A1/fr
Publication of WO2013045713A1 publication Critical patent/WO2013045713A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1728—Guides or aligning means for drills, mills, pins or wires for holes for bone plates or plate screws

Definitions

  • the present invention relates to the field of medical implantology, more specifically in those implants intended for immobilization of joints.
  • the object of the invention consists of a device that allows immobilization of the bone structure by anchoring said device to the bones that make up said structure.
  • the arthrodesis operation consists of a surgical intervention in which two bone pieces are fused, eliminating a joint.
  • This intervention is very common in the spine by fixing two or more vertebrae with each other, generating the initial fixation by means of more or less complex metal implants, which prey on the pedicles, plates or apophysis of the vertebrae, while the final fusion takes place biological process that results from the debridement of the joint segments to be sacrificed and contribution of graft or bone substitute.
  • Arthrodesis has been and is a very important therapeutic weapon in the treatment of advanced degenerative joint disease, since arthroplasty is not applicable to all joints or at least, it does not offer the best clinical-functional results for certain lesions and topographies These types of techniques were performed on the wrist as an alternative to joint resection or amputation in tuberculous conditions.
  • Other early indications of arthrodesis were the correction of polio deformities, spastic deformities, as Steindler described in 1918, and sequelae of Volkmann's ischemic contracture.
  • total wrist arthrodesis is a well-established surgical procedure that provides a reproducible reduction of pain in patients with multiple inflammatory, degenerative or post-traumatic conditions, although sacrificing all mobility.
  • Palmer and cois in 1985 described the degree of mobility necessary to perform most activities of daily living, the so-called functional mobility, which is 5 or flexion, 30 ° extension, 10 ° radial inclination and 15 ° of ulnar inclination.
  • the doll has 2 main joint lines: the joint radiocarpal (between the bones of the forearm and the first row of carpal bones) and the midcarpal (joint line between the two rows of the carpus).
  • the lesion or affects the radiocarpal and midcarpal joints total wrist arthrodesis is the only technique with which the disappearance of pain will be achieved.
  • the "partial" or focal arthrodesis (only of the affected area), has the advantage, at least theoretical of alleviating pain, preserving part of the mobility (that provided by the unaffected joint segments) and therefore improving the overall function of The wrist-hand unit.
  • radio-scapho-semilunar arthrodesis One type of partial wrist arthrodesis is radio-scapho-semilunar arthrodesis, which would be indicated in cases where there is joint degeneration limited to the radiocarpal joint, as occurs in the sequelae of fractures of the distal extremity of the radius, early stages of posttraumatic carpal osteoarthritis (SLAC doll) and in rheumatoid arthritis patients with wrist involvement.
  • the device object of the invention offers a series of advantages over known devices, since it allows performing partial wrist arthrodesis operations such as radio-scapho-semilunar arthrodesis.
  • the device object of the invention has a symmetric or asymmetric "Y" configuration and would be made of titanium, whose biological compatibility is demonstrated and allows magnetic resonance scanning after the intervention surgical
  • the second section coincides in its longitudinal axis with the first section and therefore appears as a continuation of said first section, while a third section starts from the junction point between said second section and the first section, although in this case the longitudinal axis of said third section defines a non-zero angle with respect to that of the first two sections, which is coincident between both first and second sections.
  • This setting looks like a lowercase "and”.
  • the second section is not a continuation of the first section and forms an angle with respect to the first section and the third section, which as in the previous configuration also defines a non-zero angle with the first section. This setting looks like a capital "Y".
  • the joints between the device and the bones of the joint are given by screws of 2.4 mm, in number of two, for each of the carpal bones in two different angles.
  • the anchor offered by the second oblique screw supports efforts in two senses, axial and tangential, providing greater mechanical resistance to the device, thus strengthening the immobilization of the joint.
  • the device has small guides (screw hole path) of the drill so that the screws are directed to predetermined points of the bones to be fixed and that have been checked with radiographic templates of normal and pathological carps.
  • the perpendicular screws to the scaphoid and semilunar would be placed and then the radius screws, which when introduced by oval holes (designed for this purpose in the main vertical branch of the plate) allow self-compression of the bones to be arthrodesed (improvement the bone union rate), to finally block this position with the oblique direction screws in scaphoid and semilunar.
  • osteoporotic bone screws fragment, not very dense
  • these are also threaded to the plate, which has been shown with other devices that significantly increases the stability of the system.
  • the device object of the invention also has a series of accessory holes to temporarily fix with needles and to be able to assess by radioscopy the proper placement thereof.
  • the implant has holes in its sections to house a centering device that allows the device to be placed and aligned with the bones to be joined and facilitates intraoperative manipulation. DESCRIPTION OF THE DRAWINGS
  • Figure 1. It shows an overhead view of the device object of the invention with the fork of the smaller sections configured in the form of "Y".
  • Figure 2. Shows an overhead view of the device object of the invention with one of the smaller sections coinciding with the greater section; showing a setting in "and".
  • Figure 3a Shows the device of the invention configured in "Y” on an x-ray of the wrist.
  • Figure 3b. Shows the device of the invention configured in "y” on a wrist x-ray.
  • Figure 4.- Shows the device of the invention configured in "y” with the center mounted.
  • the device (1) To perform a partial wrist arthrodesis, the device (1) is positioned on bones to be immobilized: radius, scaphoid and semilunar; For this purpose, a centering device (8) is used.
  • the device (1) has a series of accessory holes (5) in the main branch and in each of the sections (2,3,4) of the device (1) so that, by manipulating said centering (8) , the device (1) can be positioned and fixed, in holes intended to house said centering device (8), temporarily with Kirschner needles to assess a correct alignment by radioscopy.
  • the screws are 2.4 mm for the carpus and 3.5 mm for the radius, which are fixed perpendicularly to the bone passing through perpendicular through holes (7) while other screws, which form the anchoring pair, are fixed obliquely to the bone through oblique through holes (6) and always after fixing to the radius;
  • Each anchor pair is defined in each of the sections (2,3,4).

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne un dispositif et un procédé d'immobilisation des articulations radio-scapho-semi-lunaires par des techniques d'arthrodèse réalisée au moyen d'une plaque à trois éléments, chacun desdits éléments étant fixé sur un des os à solidariser au moyen de vis.
PCT/ES2011/070668 2011-09-26 2011-09-26 Dispositif d'arthrodèse partielle du carpe Ceased WO2013045713A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/ES2011/070668 WO2013045713A1 (fr) 2011-09-26 2011-09-26 Dispositif d'arthrodèse partielle du carpe

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/ES2011/070668 WO2013045713A1 (fr) 2011-09-26 2011-09-26 Dispositif d'arthrodèse partielle du carpe

Publications (1)

Publication Number Publication Date
WO2013045713A1 true WO2013045713A1 (fr) 2013-04-04

Family

ID=47994316

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/ES2011/070668 Ceased WO2013045713A1 (fr) 2011-09-26 2011-09-26 Dispositif d'arthrodèse partielle du carpe

Country Status (1)

Country Link
WO (1) WO2013045713A1 (fr)

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10231768B2 (en) 2003-05-30 2019-03-19 DePuy Synthes Products, Inc. Methods for implanting bone plates
US10342586B2 (en) 2003-08-26 2019-07-09 DePuy Synthes Products, Inc. Bone plate
US10624686B2 (en) 2016-09-08 2020-04-21 DePuy Synthes Products, Inc. Variable angel bone plate
US10772665B2 (en) 2018-03-29 2020-09-15 DePuy Synthes Products, Inc. Locking structures for affixing bone anchors to a bone plate, and related systems and methods
CN111757709A (zh) * 2018-02-23 2020-10-09 梅达提斯控股有限公司 腕关节固定板和腕关节固定板的使用方法
US10820930B2 (en) 2016-09-08 2020-11-03 DePuy Synthes Products, Inc. Variable angle bone plate
US10905476B2 (en) 2016-09-08 2021-02-02 DePuy Synthes Products, Inc. Variable angle bone plate
US10925651B2 (en) 2018-12-21 2021-02-23 DePuy Synthes Products, Inc. Implant having locking holes with collection cavity for shavings
US11013541B2 (en) 2018-04-30 2021-05-25 DePuy Synthes Products, Inc. Threaded locking structures for affixing bone anchors to a bone plate, and related systems and methods
US11026727B2 (en) 2018-03-20 2021-06-08 DePuy Synthes Products, Inc. Bone plate with form-fitting variable-angle locking hole
US11259851B2 (en) 2003-08-26 2022-03-01 DePuy Synthes Products, Inc. Bone plate
US11291484B2 (en) 2004-01-26 2022-04-05 DePuy Synthes Products, Inc. Highly-versatile variable-angle bone plate system

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5853413A (en) * 1997-04-18 1998-12-29 Bristol-Myers Squibb Company Wrist fusion plate
US6221073B1 (en) * 1999-08-20 2001-04-24 Kinetikos Medical, Inc. Wrist fusion apparatus and method
US20060173459A1 (en) * 2005-01-28 2006-08-03 Kay David B Orthopedic plate for use in small bone repair
US20090281543A1 (en) * 2008-05-09 2009-11-12 Skeletal Dynamics Llc Formable bone plate, clamping apparatus, osteotomy system and method for reconstructing a bone
EP2158864A2 (fr) * 2008-08-26 2010-03-03 NORMED Medizin-Technik Vertriebs-GmbH Plaque d'arthrodèse du poignet et assortiment
US20110224734A1 (en) * 2009-10-28 2011-09-15 Orthopro Llc Compression plate kit and methods for repairing bone discontinuities

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5853413A (en) * 1997-04-18 1998-12-29 Bristol-Myers Squibb Company Wrist fusion plate
US6221073B1 (en) * 1999-08-20 2001-04-24 Kinetikos Medical, Inc. Wrist fusion apparatus and method
US20060173459A1 (en) * 2005-01-28 2006-08-03 Kay David B Orthopedic plate for use in small bone repair
US20090281543A1 (en) * 2008-05-09 2009-11-12 Skeletal Dynamics Llc Formable bone plate, clamping apparatus, osteotomy system and method for reconstructing a bone
EP2158864A2 (fr) * 2008-08-26 2010-03-03 NORMED Medizin-Technik Vertriebs-GmbH Plaque d'arthrodèse du poignet et assortiment
US20110224734A1 (en) * 2009-10-28 2011-09-15 Orthopro Llc Compression plate kit and methods for repairing bone discontinuities

Cited By (16)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11419647B2 (en) 2003-05-30 2022-08-23 DePuy Synthes Products, Inc. Bone plate
US10653466B2 (en) 2003-05-30 2020-05-19 DePuy Synthes Products, Inc. Bone plate
US10231768B2 (en) 2003-05-30 2019-03-19 DePuy Synthes Products, Inc. Methods for implanting bone plates
US10342586B2 (en) 2003-08-26 2019-07-09 DePuy Synthes Products, Inc. Bone plate
US11259851B2 (en) 2003-08-26 2022-03-01 DePuy Synthes Products, Inc. Bone plate
US11291484B2 (en) 2004-01-26 2022-04-05 DePuy Synthes Products, Inc. Highly-versatile variable-angle bone plate system
US10820930B2 (en) 2016-09-08 2020-11-03 DePuy Synthes Products, Inc. Variable angle bone plate
US10905476B2 (en) 2016-09-08 2021-02-02 DePuy Synthes Products, Inc. Variable angle bone plate
US11529176B2 (en) 2016-09-08 2022-12-20 DePuy Synthes Products, Inc. Variable angle bone plate
US10624686B2 (en) 2016-09-08 2020-04-21 DePuy Synthes Products, Inc. Variable angel bone plate
CN111757709B (zh) * 2018-02-23 2023-03-10 梅达提斯控股有限公司 腕关节固定板和腕关节固定板的使用方法
CN111757709A (zh) * 2018-02-23 2020-10-09 梅达提斯控股有限公司 腕关节固定板和腕关节固定板的使用方法
US11026727B2 (en) 2018-03-20 2021-06-08 DePuy Synthes Products, Inc. Bone plate with form-fitting variable-angle locking hole
US10772665B2 (en) 2018-03-29 2020-09-15 DePuy Synthes Products, Inc. Locking structures for affixing bone anchors to a bone plate, and related systems and methods
US11013541B2 (en) 2018-04-30 2021-05-25 DePuy Synthes Products, Inc. Threaded locking structures for affixing bone anchors to a bone plate, and related systems and methods
US10925651B2 (en) 2018-12-21 2021-02-23 DePuy Synthes Products, Inc. Implant having locking holes with collection cavity for shavings

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