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WO2024159332A1 - Plaque de fixation de fracture pour application à l'humérus distal - Google Patents

Plaque de fixation de fracture pour application à l'humérus distal Download PDF

Info

Publication number
WO2024159332A1
WO2024159332A1 PCT/CH2023/050002 CH2023050002W WO2024159332A1 WO 2024159332 A1 WO2024159332 A1 WO 2024159332A1 CH 2023050002 W CH2023050002 W CH 2023050002W WO 2024159332 A1 WO2024159332 A1 WO 2024159332A1
Authority
WO
WIPO (PCT)
Prior art keywords
plate
fracture fixation
fixation plate
bores
segment
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/CH2023/050002
Other languages
German (de)
English (en)
Inventor
Emanuel BENNINGER
Patrick Burki
Jorrit BÜHLMANN
Beat Kaspar MOOR
Michael SCHÄR
Christian SPROSS
Matthias Zumstein
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.)
Bonebridge AG
Original Assignee
Bonebridge AG
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 Bonebridge AG filed Critical Bonebridge AG
Priority to PCT/CH2023/050002 priority Critical patent/WO2024159332A1/fr
Publication of WO2024159332A1 publication Critical patent/WO2024159332A1/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
    • A61B17/56—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
    • A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
    • A61B17/8057—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded the interlocking form comprising a thread
    • 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
    • A61B17/8004—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones
    • A61B17/8014—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones the extension or compression force being caused by interaction of the plate hole and the screws

Definitions

  • Fracture fixation plate for application to the distal humerus
  • the invention relates to a fracture fixation plate, in particular for posterolateral application to the distal humerus according to the preamble of patent claim 1.
  • EP-B 2 397 090 BIOMET discloses a humeral plate with a straight plate shaft and a single elongated hole in the proximal plate segment.
  • the plate also has a first and a second segment, which are connected distally to the rest of the plate via deformable bridge elements.
  • the main disadvantage of this known plate is the lack of a laterally widening plate segment with through-holes in the area of its lateral widening, so that no screws can be placed parallel to the axis of the elbow joint, which is important for complex intra-articular fractures. Therefore, only a suboptimal adaptation to the bone anatomy is possible, especially in complex fractures, and the surgeon's intraoperative options are limited.
  • the invention aims to remedy this situation.
  • the invention is based on the object of creating a fracture fixation plate, in particular for posterolateral application to the distal humerus, which allows optimal anatomical repositioning and refixation of the fracture fragments on the distal humerus.
  • the invention solves the problem with a fracture fixation plate having the features according to claim 1.
  • the advantages achieved by the invention are essentially the following:
  • the distal end portion of the distally extending plate segment can be spoon-shaped.
  • distal end portion of the distally extending plate segment can be laterally widened only on one side.
  • the distal end portion of the distally extending plate segment has three plate bores, preferably four plate bores.
  • the bore axes of the plate bores in the laterally widened area converge towards the underside of the fracture fixation plate.
  • the bore axes of the plate bores present in the laterally widened region are arranged such that they do not intersect.
  • the bore axes of the lateral plate bores located in the laterally widened area are aligned in such a way that they point towards the trochlea after posterolateral application of the fracture fixation plate to the distal humerus.
  • At least one of the plate bores of the distal end portion of the plate segment - preferably the laterally widening region - is a variable angle screw hole configured to receive a bone screw at an angle of ⁇ 15° with respect to a central axis of the variable angle screw hole.
  • At least one of the plate bores of the distal end section of the plate segment - preferably its laterally widening region - has an inner wall made of a material with a hardness HP, wherein a hollow cylindrical or hollow conical insert is mounted in the at least one plate bore in such a way that the insert is at least partially rests against the inner wall, wherein the insert is designed to receive a head of a bone screw, wherein the insert is arranged in the at least one plate bore such that it is secured against twisting, and wherein the insert consists of a material with a hardness HE ⁇ HP.
  • two guide holes for K-wires are arranged between the two plate holes in the laterally widened area.
  • the medial guide hole between the two plate holes is designed as a thread hole with rounded edges, which can be used to fix surrounding soft tissue.
  • a guide hole for K-wires is arranged proximal to the two plate holes in the laterally widened area. This guide hole enables improved repositioning of the fracture.
  • the two distally and proximally extending plate segments are angled against each other in the plate plane.
  • the central axis of the distally extending plate segment intersects the central axis of the proximally extending plate segment at an angle a.
  • the angle a can expediently be greater than 5°, preferably greater than 10°, and is expediently less than 25°, preferably less than 15°. With the angle ranges selected in this way, a more optimal, more distal placement of the fracture fixation plate on the humerus could be achieved.
  • the distally extending plate segment has at least two plate holes, between which a compression slot is arranged.
  • This distal slot simplifies the initial plate position.
  • the plate can be set for the time being, but is still can be moved if the screw is loosened slightly if the anatomical fit still needs to be adjusted.
  • the elongated hole also allows for interfragmentary compression during fracture reduction.
  • the proximally extending plate segment has a curvature in the plate plane and defines a tangential axis to the curvature at its free end.
  • This embodiment is particularly advantageous in the shorter versions of the fracture fixation plate, in which the proximally extending plate segment has a curvature.
  • the tangential axis of the proximal end section intersects the central axis of the distal end section preferably at an angle a.
  • the distally extending plate segment has a constant width.
  • the fracture fixation plate according to the invention is suitable for the treatment of bone fractures of the distal humerus and in particular for posterolateral application.
  • the fracture fixation plate according to the invention can also be combined with a standard bone plate to carry out a 180° screw connection, in which the standard bone plate is positioned medially to the fracture fixation plate according to the invention.
  • the fracture fixation plate according to the invention is located on the medial side of the humerus.
  • a "180° screw connection" defines how the screws of the two plates are positioned distally to each other.
  • the screws run parallel to each other, i.e. they are at an angle of 180° to each other.
  • the screws simply run posteriorly, so that these screws then run 90° to the laterally directed screws of the medial plate.
  • Fig. 1 is a plan view of the upper side of an embodiment (short version) of the fracture fixation plate according to the invention for the left humerus;
  • Fig. 2 is a side view of the embodiment shown in Fig. 1 (short version) of the fracture fixation plate according to the invention
  • Fig. 3 is a plan view of the upper side of another embodiment (long version) of the fracture fixation plate according to the invention for the left humerus;
  • Fig. 4 is a side view of the embodiment shown in Fig. 3 (long version) of the fracture fixation plate according to the invention.
  • Fig. 5 is a perspective view of the embodiment shown in Fig. 3 placed proximolaterally on the distal humerus (long version).
  • FIG. 1 and 2 represents a short version of the fracture fixation plate 1 according to the invention. It has a lower side 20 intended for bone contact and an upper side 21.
  • An elongated body section 2 comprises:
  • a laterally widened area 14 of length 22 mm is attached, which has two medial lying plate bores 12 and two laterally positioned plate bores 15,17 with two guide bores 16 for K-wires arranged therebetween.
  • the two distally and proximally extending plate segments 3,5 are angled against each other in the plate plane 22 at an angle of 8° (angle between the central axis 4 and the central axis 6).
  • the proximally extending plate segment 5 has a length of 52 mm (instead of 10 mm) with 4 (instead of 2) plate holes 12, as well as an elongated hole proximally located therefrom.
  • the two distally and proximally extending plate segments 3,5 are angled against each other in the plate plane 22 at an angle of 20° (angle between the central axis 4 and the central axis 6).
  • Figure 5 shows a plate applied proximolaterally to the distal humerus as shown in Figures 3 and 4.
  • FIGs. 1 to 5 Two embodiments for the left humerus are shown in Figs. 1 to 5.
  • Mirror-image embodiments are provided for the right humerus, whereby the embodiments for the right humerus only differ from the embodiments for the left humerus shown in Figs. 1 to 5 in that they are mirror-image.

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)
  • Surgical Instruments (AREA)

Abstract

La plaque de fixation de fracture (1) comprend les caractéristiques suivantes : a) une face inférieure (20) destinée à entrer en contact avec l'os ; b) un côté supérieur (21) ; c) une section de corps allongée avec (i) un segment de plaque s'étendant de manière distale (3) avec l'axe central (4) et une section d'extrémité distale (8), (ii) un segment de plaque s'étendant de manière proximale (5) avec l'axe central (6) et une section d'extrémité proximale (10) ainsi qu'au moins deux trous de forage de plaque continus (12), et (iii) un segment de plaque central (7) reliant les deux segments de plaque (3, 5) l'un à l'autre, qui définit un plan de plaque (22) entre la face inférieure (20) et le côté supérieur (21) ; d) la section d'extrémité distale (8) du segment de plaque s'étendant de manière distale (3) a une région d'élargissement latéral (14) avec au moins deux trous de forage de plaque continus (15, 17).
PCT/CH2023/050002 2023-02-02 2023-02-02 Plaque de fixation de fracture pour application à l'humérus distal Ceased WO2024159332A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/CH2023/050002 WO2024159332A1 (fr) 2023-02-02 2023-02-02 Plaque de fixation de fracture pour application à l'humérus distal

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/CH2023/050002 WO2024159332A1 (fr) 2023-02-02 2023-02-02 Plaque de fixation de fracture pour application à l'humérus distal

Publications (1)

Publication Number Publication Date
WO2024159332A1 true WO2024159332A1 (fr) 2024-08-08

Family

ID=85222089

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CH2023/050002 Ceased WO2024159332A1 (fr) 2023-02-02 2023-02-02 Plaque de fixation de fracture pour application à l'humérus distal

Country Status (1)

Country Link
WO (1) WO2024159332A1 (fr)

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19629011A1 (de) * 1996-07-18 1998-01-22 Wolter Dietmar Prof Dr Med Hilfsmittel für die Osteosynthese
US20100030277A1 (en) * 2008-07-31 2010-02-04 Haidukewych George J Periarticular bone plate with biplanar offset head member
EP2397090B1 (fr) 2007-11-02 2014-08-13 Biomet C.V. Système de fixation de fracture du coude
US20190076177A1 (en) * 2017-09-13 2019-03-14 Globus Medical, Inc. Bone stabilization systems
EP3533402A1 (fr) * 2018-03-02 2019-09-04 Globus Medical, Inc. Système de placage tibial distal

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19629011A1 (de) * 1996-07-18 1998-01-22 Wolter Dietmar Prof Dr Med Hilfsmittel für die Osteosynthese
EP2397090B1 (fr) 2007-11-02 2014-08-13 Biomet C.V. Système de fixation de fracture du coude
US20100030277A1 (en) * 2008-07-31 2010-02-04 Haidukewych George J Periarticular bone plate with biplanar offset head member
US20190076177A1 (en) * 2017-09-13 2019-03-14 Globus Medical, Inc. Bone stabilization systems
EP3533402A1 (fr) * 2018-03-02 2019-09-04 Globus Medical, Inc. Système de placage tibial distal

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