• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
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  • 优先权
    • 专利摘要:
    system for osteotomy of the ulna. it is a bone plate (100) that includes: a first three-part combination hole (110) that crosses a proximal region of the plate, a first part (112) of which is configured to engage the threaded head of a bone fixation element (122), a second part (114) of which being configured to receive a bone fixation element (126) along an axis substantially perpendicular to the longitudinal axis of the bone and a third part (116) of which defining a screw axis extending towards the distal end of the elongated body at a non-perpendicular angle to the longitudinal axis; and a first two-part hole (138) that crosses the proximal region, a first threaded part (140) of which is configured to engage the head of a bone fixation element (122) and a second part (142) of which defining an elongated slit that extends along the longitudinal axis of the plate to receive a bone fixation element so that the plate slides along its longitudinal axis in relation to the bone fixation element.
    公开号:BR112012021877B1
    申请号:R112012021877-8
    申请日:2011-01-26
    公开日:2020-05-26
    发明作者:Eva Lietz；Dirk Kerstan；Ladislav NAGY
    申请人:Synthes Gmbh；
    IPC主号:
    专利说明:

    Invention Patent Descriptive Report for “ULNA OSTEOTOMY SYSTEM”
    Priority claim
    This application claims priority to the United States provisional application for serial number 61 / 310,406, filed on March 4, 2010, entitled “Ulna Osteotomy System”, the disclosure of which is incorporated by reference in its entirety by reference.
    Field of invention
    The present invention relates to systems and methods for performing an osteotomy and, in particular, an osteotomy plate and other devices, such as a drill guide, to provide precise alignment of the cut parts of a bone.
    Background of the invention
    Osteotomy is a surgical procedure in which a bone is cut in order to decrease, enlarge and / or change its alignment. In particular, in the ulna shortening osteotomy, the ulna is cut to treat symptoms such as wrist pain, swelling, limited range of motion and reduced support force, which can result from conditions such as ulnar impingement syndrome. Ulnar impingement syndrome is a degenerative condition related to excessive load support due to the ulnar aspect of the wrist and the chronic shock of the ulna head against CCCT, the semilunar bone and the pyramidal bone. By shortening the ulna, the impact is reduced, thus avoiding wrist pain, swelling, etc., thus causing the function of the wrist joint to be regained. Current ulna osteotomy systems require complex surgical techniques with complex instruments, resulting in delayed joints or non-joints caused by inaccurate osteotomies and / or the difficulty of maintaining bone alignment. In addition, osteotomy systems often contain bulky instruments and implants, resulting in irritation by the hardware and, often, removal of the implant.
    Summary of the invention
    The present invention relates to a bone plate, which comprises an elongated body that extends from one end proximal to the other distal and includes a first surface, which, when in the operational position, faces away from the bone on which the plate is installed, and a second surface, which, when in the operational position, faces the bone, as well as a first three-part combining orifice that crosses the proximal region of the plate, the first part of the first combining orifice in three parts being threaded and configured
    2/15 to engage the threaded head of a bone fixation element, its second part being configured to receive a bone fixation element along an axis substantially perpendicular to the longitudinal axis of the bone when the plate is installed in the desired orientation and its third part defining a screw axis that extends from the second surface to the distal end of the elongated body at a non-perpendicular angle in relation to the longitudinal axis of the bone when the plate is installed in the desired orientation, and a first combination hole in two parts that cross the proximal region of the plate, a first threaded part of which is configured to receive and engage with the threaded head of a bone fixation element and a second part of which defining an elongated slit that extends along the longitudinal axis of the plate to receive a bone fixation element through it so that the plate can slide along its longitudinal axis in r connection to the bone fixation element received in it.
    Brief description of the drawings
    Figure 1 shows a top plan view of an osteotomy plate according to an exemplary embodiment of the present invention;
    figure 2 shows an enlarged top view of a three-part hole in the plate of figure 1;
    figure 3 shows an enlarged bottom view of the three-part hole in figure 2;
    figure 4 illustrates an enlarged cross-sectional view of the orifice in three parts of figure 2 along line A-A;
    figure 5A shows an enlarged top view of the three-part hole in figure 2 including a bone fixation element inserted therein in a first configuration;
    figure 5B shows an enlarged cross-sectional view of the three-part orifice and the bone fixation element of figure 5A;
    figure 6A shows an enlarged top view of the three-part hole in figure 2 including a bone fixation element inserted therein in a second configuration;
    Figure 6B shows an enlarged cross-sectional view of the three-part orifice and the bone fixation element of Figure 6A;
    figure 7A shows an enlarged top view of the three-part hole in figure 2 including a bone fixation element inserted therein in a third configuration;
    3/15, figure 7B shows an enlarged cross-sectional view of the three-part orifice and the bone fixation element of figure 7A;
    figure 8 shows a top plan view of another embodiment of the plate of figure 1;
    figure 9 illustrates a perspective view of an osteotomy plate according to an alternative embodiment of the present invention;
    figure 10 shows an enlarged perspective view of a three-part hole in the plate of figure 9;
    figure 11 illustrates a perspective view of a drill jig according to an exemplary embodiment of the present invention;
    figure 12 shows a side view of a guidewire according to an exemplary embodiment of the present invention;
    figure 13 illustrates a perspective view of a saw guide according to an exemplary embodiment of the present invention;
    figure 14 shows a perspective view of the saw guide in figure 13;
    figure 15 shows a side view of a saw guide according to an alternative embodiment of the present invention;
    figure 16 illustrates a perspective view of a saw with blades according to an exemplary embodiment of the present invention;
    figure 17 illustrates a perspective view of the drill template of figure 11 installed in a bone according to an exemplary embodiment of a surgical technique of the present invention;
    figure 18 illustrates a perspective view of the saw with blades of figure 16 aligned with cross marks formed on the drill template according to the exemplary embodiment of figure 17;
    figure 19 illustrates a perspective view of the saw guide of figure 14 installed in the drill template and aligned with oblique markings formed therein according to the exemplary embodiment of figure 17;
    figure 20 shows a side view of the plate of figure 1 positioned next to the bone according to the exemplary embodiment of figure 17;
    figure 21 shows a side view with a first bone fixation element inserted in the plate according to the exemplary embodiment of figure 17;
    figure 22 shows a side view with a second bone fixation element inserted in the plate according to the exemplary embodiment of
    4/15 figure 17;
    figure 23 shows a side view with a third bone fixation element inserted in the plate according to the exemplary embodiment of figure 17;
    figure 24 shows a perspective view of the plate of figure 1 as used to fix a cross-section of the bone according to the exemplary embodiment of figure 17;
    figure 25 illustrates a perspective view of the plate of figure 1 as used to fix an oblique section of the bone according to the exemplary embodiment of figure 17;
    figure 26 illustrates a top plan view of a bone plate according to another exemplary embodiment of the present invention;
    figure 27 illustrates a perspective view of a drill template installed on a bone according to the exemplary embodiment of figure 26;
    figure 28 illustrates a perspective view of a saw guide according to the exemplary embodiment of figure 26;
    figure 29 illustrates a perspective view of the bone plate positioned next to the bone according to the exemplary embodiment of figure 26;
    figure 30 illustrates a perspective view of compressing the bone according to the exemplary embodiment of figure 26;
    figure 31 shows a perspective view with a bone fixation element inserted in the bone plate of figure 26; and figure 32 shows a perspective view with additional bone fixation elements inserted in the bone plate of figure 26.
    Detailed Description
    The present invention will be better understood by reading the description below with reference to the accompanying drawings, in which like elements are indicated by like reference numbers. The present invention relates to systems and methods for performing an osteotomy. More specifically, exemplary embodiments describe an osteotomy plate and other devices, such as a drill guide, to provide precise alignment of the cut parts of a bone. Those skilled in the art will realize that, although exemplary embodiments specifically describe the ulna osteotomy, it is also possible to use the present invention for osteotomy of other bones.
    An osteotomy system according to a first
    5/15 exemplary embodiment comprises an osteotomy plate 100, as shown in figures 1 to 8, a drill jig 200, as shown in figure 11, and a parallel saw 250, as shown in figure 16. The system can further comprise a saw guide 222, as shown in figures 13 and 14, and a guide wire, as shown in figure 12. Plate 100 is used to fix parts of a bone (for example, the ulna) cut using the saw 250 and drill jig 200 and / or saw guide 222 as a guide. The drill jig 200 allows you to pre-drill the bone, before cutting it, as it has holes that correspond to the location of openings on the plate 100. The drill jig 200 includes markings that indicate predefined shortening lengths and has holes formed in it so that, when placed on a targeted part of the bone before cutting, the holes align with positions that will correspond to the location of the holes formed in the plate 100 after a part of the bone is cut out and during the compression of the remaining parts of the bone to that they come into contact with each other. That is, plate 100 includes two holes 138, which include elongated parts 142 which, when plate 100 is arranged on the bone in the desired orientation, extend substantially parallel to the compression axis (i.e., the axis along from which the cut parts of the bone will move towards each other). Initial bone screws are inserted into holes 138 and / or holes 110 and the corresponding holes previously drilled into the bone in order to retain the plate 100 over the parts of the bone to maintain the desired rotational alignment of the cut parts of the bone in relation to each other. The initial screw inserted at one end of the elongated part 142 will then be free to move longitudinally within the elongated parts 142 during compression of the cut parts of the bone towards each other in order to maintain the desired rotational alignment during compression. The saw 250 includes two parallel blades 252, 254 that allow the user to make two parallel and simultaneous cuts in order to remove the desired amount of bone with a single precise action.
    As shown in Figure 1, the bone plate 100 extends longitudinally from a proximal end 102 to a distal end 104 and includes a first surface 106, which, when in the operational position, faces away from the bone, and a second surface 108 , which, when in the operational position, turns to the bone. Plate 100 includes several holes, including at least one three-part combination orifice 110, at least one two-part combination orifice 138 and at least one locking orifice 148. Plate 100 may assume a discrete profile with the proximal ends 102 and distal 104 being tapered and / or
    6/15 rounded along rounded edges to prevent irritation of the surrounding tissue. The plate 100 is also previously folded at an angle of about 4 o in relation to its longitudinal axis to enable compression in an opposite cortex. Plate 100 can be made of any biocompatible material, including, for example, stainless steel, titanium etc.
    In a preferred embodiment, the plate 100 is symmetrical about an axis of symmetry 150 that substantially perpendicularly crosses a midpoint of the plate 100 along its length. Thus, plate 100 includes a portion 152 proximal to the axis of symmetry 150, which is substantially symmetrical, and / or a mirror image, of a part 154 distal to the axis of symmetry 150. Those skilled in the art will appreciate that a plate 100 symmetrical is preferred so that it can be positioned close to the bone in any orientation. Those skilled in the art will also realize that, since plate 100 can be positioned in any orientation next to the bone, the terms "proximal and" distal ", as used in this document, do not refer to specific ends of plate 100, but are used for refer to the extremities that, when in the operational position, are oriented towards the proximal and distal ends of the bone, respectively. In this preferred embodiment, plate 100 includes two holes in three parts 110, two holes in two parts 138 and two locking holes 148. More specifically, a first hole in three parts 110a, a first hole in two parts 138a and a first hole locking holes 148a are formed in the proximal part 152 of the plate 100, while a second hole in three parts 110b, a second hole in two parts 138b and a second locking hole 148b are formed, in a corresponding symmetrical position, in the distal part 154 of plate 100. In this embodiment, the holes in three parts first 110a and second 110b are positioned closer to the axis of symmetry 150, while locking holes 148a and 148b are arranged further away from the axis of symmetry 150 and closest to the proximal ends 102 and distal 104, respectively. However, those skilled in the art will realize that different numbers of any of these types of orifices can be adopted in order to meet the requirements of a given procedure without thereby diverging from the teachings of this invention.
    As figures 2 to 4 illustrate, the three-part orifice 110 includes a first part 112, a second part 114 and a third part 116. The first parts 112 and third 116 define opposite longitudinal ends of the three-part orifice 110, with one connected to the other by the second part 114. The first part 112 defines a partial circular opening, which tapers radially
    7/15 into the first surface 106 to the second surface 108 according to a substantially tapered shape. The first part 112 includes a thread 118 along its inner surface 120 and is adapted and configured to receive a first type of bone fixation element 122 (for example, a locking screw) through it along its central axis, as illustrate figures 5A and 5B. As those skilled in the art will appreciate, the thread 118 engages correspondingly to the threaded head 124 of the first bone fixation element 122 as it rotates within it about its central axis.
    Together, second parts 114 and third 116 define a substantially elongated region of the orifice in three parts 110, which is adapted and configured to receive a second type of bone fixation element 126 (for example, a cortex screw) through it any desired angle between 0 o and 45 ° relative to an axis substantially perpendicular to the bone surface on which the plate 100 is installed without the bolt head protrudes. The second part 114 extends between the first 112 and third 116 parts, including radially opposed curved walls 130 that taper from the first 106 to the second surface 108. The second type of bone fastener 126 can be inserted in the second part 114 at the along its central axis until its head 128, of corresponding shape (for example, spherical), is seated between the curved walls 130 of the second part 114, as shown in figures 6A and 6B. The curved walls 130 are formed in order to receive the head 128 and prevent it from projecting beyond the first surface 106. The third part 116 is contiguous with the second part 114, flowing fluidly from it so that the second type of element bone fixation 126 can be inserted between it at an angle of up to 45 ° in relation to its central axis. The third part 116 includes a first inner wall 132 that penetrates the plate 100 of the first surface 106 to a second inner wall 134, which extends from a bone-facing end of the first inner wall 132 to the second surface 108. The first wall inner 132 forms a surface contiguous with the curved walls 130 of the second part 114 to accommodate the head 128 at a desired angle to them. The second inner wall 134 extends radially outwardly from the first inner wall 132 to the second surface 108 in order to accommodate the rod 136 of the second type of bone fixation element 126 at any desired angle to a maximum angle. For example, in this embodiment, the second inner wall 134 extends outwardly from the first inner wall 132, along the longitudinal axis of the plate 100, at an angle of 45 °, as shown in figures 7A to 7B, allowing so the second type of
    8/15 bone fixation element is inserted through it at any angle in relation to the bone surface between perpendicular and 45 °. As we will describe in more detail below, when shortening the bone by means of slanted cuts in relation to the transverse direction, it is preferable to make cuts at an angle that is not greater than the maximum angulation of the second type of bone fixation element in the third part 116 of the hole 110. Thus, the user can insert the second type of bone fixation element through it along an axis perpendicular to the cut in the bone.
    The two-part orifice 138 includes a first part 140 and a second part 142. In this embodiment, the first part 140 is substantially similar to the first part 112 of the three-part orifice 110 and is adapted and configured to receive the first type of bone fixation 122 along its axis so as to engage its head 124 by means of a thread 144 formed thereon. The second part 142 defines a substantially elongated slot that includes a curved inner wall 146 that tapers from the first 106 to the second surface 108.
    Locking hole 148 includes a thread (not shown) along its inner surface to engage the threaded head of a bone fixation element, such as a locking screw. The locking screws 148 are arranged close to the proximal ends 102 and are distant 104 from the plate 100 to anchor the plate 100 in the bone, fixing it there. A first part of the locking hole 148, which penetrates the plate 100 from the first surface 106, tapers radially inwards towards the second surface 108 in order to match the shape of the locking screw head.
    Those skilled in the art will realize that it is possible to manufacture plate 100 in various lengths, including any combination of the holes 110, 138 and 148 described, preferably in a symmetrical pattern. For example, a smaller six-hole plate 100, as shown in Figure 1, may include two three-part combination holes 110a and 100b, two two-part combination holes 138a and 138b and two locking holes 148a and 148b formed along its length according to a symmetrical pattern. In the case of a plate 100 with eight holes, larger, as shown in figure 8, plate 100 would include two holes in two non-elongated parts 158a, 158b, the hole in two non-elongated parts 158a being formed in the proximal part 152 of the plate 100, while the two-part non-elongated orifice 158b would form in a corresponding symmetrical position in the distal part 154. Each of the two-part non-elongated orifices 158a, 158b may include a first part 160 and a second part 162
    9/15 substantially similar to the orifice in two parts 138. However, the second part 162 is not elongated. Those skilled in the art will realize that, depending on the intended use of a particular plate, the holes need not be symmetrically distributed along its length.
    According to an alternative embodiment, as figures 9 and 10 illustrate, a plate 100 'is substantially similar to plate 100, but includes a three-part combination orifice 110'. Like the plate 100, the combination hole 110 'includes parts first part 112', second 114 'and third 116'. However, unlike device 110 of plate 100, the second 114 'and third 116' parts are not provided with a fluid transition between them. Instead, the second 114 'and third 116' parts define separate and separate rounded openings so that it is only possible to insert a fastener in one of the two at the same time. Because of this, the bone fixation element can only be inserted into the hole along the central axis of the second part 114 'at an angle of 0 o or along a predefined insertion axis of the third part 116', which is adjusted at a certain angle (for example, 45 °) with respect to the central axis of the three-part hole 110 '. The orifice 110 'does not allow the introduction of a bone fixation element through it at a certain angle between the second 114' and third 116 'parts.
    As shown in figure 11, the drill jig 200 extends longitudinally from a proximal end 202 to a distal end 204 and includes a first surface 206, which, when in the operational position, faces away from the bone, and a second surface 208, which, when in the operational position, turns to the bone. As those skilled in the art will realize, the terms proximal and distal, with regard to drill jig 200, correspond only to the desired orientation of drill jig 200 in the example procedures. In other procedures, the orientation of the drill jig components can be reversed. The drill jig 200 includes several openings 210 that pass through it from the first 206 to the second surface 208. The drill jig 200 can be manufactured with several predefined shortening lengths (for example, 2.0 cm, 2.5 cm, 3 , 0 cm, 4.0 cm and 5.0 cm) that allow prior drilling, before cutting the bone. Therefore, each of the openings 210 is positioned in the drill jig 200 in a location corresponding to the position of one of the holes in three parts 110 and in two parts 138. In a preferred embodiment, the drill jig 200 includes three openings 210 Two of them are positioned towards the distal end 204 of the drill jig 200, while one of them is
    10/15 positioned towards the proximal end 202; that is, at a location corresponding to the part of the bone on the opposite side of the cut in relation to the part of the bone in which holes will be drilled from the first two openings 210. For example, a first 210a of the three openings 210 coincides with the position of the orifice in three parts 110 in the distal part 154 of the plate 100, while a second 210b of the openings 210 coincides with the position of the orifice in two parts 138b in the distal part. The third opening 210c coincides with the proximal end 146 of the two-part orifice 138a that passes through the proximal part 152.
    Preferably, the openings 210 are dimensioned and formed to receive a guide wire 240, as shown in figure 12, and / or a drill bit through them. The drill jig 200 also includes protrusions 212 on the first surface 206, which extend from there around each of the openings 210 in order to allow greater support around the length of the guide wires 240 inserted in the openings 210. Each guide wire 240 can include a drill tip 242 at its distal end, thus making it possible to drill holes in the bone by inserting guide wires 240 in the openings 210. The drill template 200 further comprises a recess 214 in the second surface 208 so that it is possible to cut completely through the bone while the drill jig 200 is on the bone without the saw 250 coming into contact with the drill jig 200. On the side side 216 of the recess 214, the drill jig 200 includes markings 218, 220 which indicate where the bone should be cut. For example, a first marking 218 indicates a substantially transversal cut (for example, substantially perpendicular to the longitudinal axis of the bone), while a second marking 220 indicates a cut at a desired angle (for example, 45 °) with respect to the longitudinal axis of the bone. Thus, the drill jig 200 can also serve as a guide for the saw 250, making it unnecessary to use a separate saw to make a cross-section through the bone, since it is possible to align the blade substantially with the 218 markings. the drill jig 200 together with a saw guide 222, as we will describe in more detail below, the drill jig 200 can include a groove 215 in the first surface 206 to receive part of the saw guide 222.
    When the drill jig 200 is used to make an oblique cut according to the second markings 220, the system can also comprise the saw guide 222, as shown in figures 13 and 14, which can be installed in the drill jig 200 a in order to guide the saw 250 along the markings at an oblique angle. The saw guide 222 can include at least one inclined surface
    11/15
    224, which, when saw guide 222 is installed in drill template 200, aligns with second markings 220 allowing, when sliding a saw 250 along said inclined surface, to cut the bone according to the angle predefined oblique (for example, 45 °). In a preferred embodiment, however, saw guide 222 can be symmetrical, including two inclined surfaces 224, thus allowing to install saw guide 222 in drill jig 200 so that the bone can be cut at an oblique angle according to the markings 220 formed on either side of the drill template 200, depending on the side on which the saw guide 222 was installed. The saw guide 222 includes a connecting element 228, which extends therefrom so that it is received in the groove 215 in order to prevent rotational movement of the saw guide 222 during cutting. The connecting element 228 can be installed in the groove 215 of the first surface 206 of the drill jig by means of a screw 226 inserted through an opening 230 formed in the connecting element 228 to mate with the first surface 206 of the drill jig 200. The saw guide 222 must connect to the drill jig 200 so that the inclined surface 224 aligns with the markings 220 on the drill jig 200. In an alternative embodiment, a saw guide 222 'can be installed on the side side 216 of the drill template 200 by means of a pin 226 ', as shown in figure 15, so that an inclined surface 224' aligns with the second markings 220.
    As shown in Figure 16, saw 250 comprises blades first 252 and second 254, each of which is substantially flat and fixed with respect to the other, so that blades first 252 and second 254 are substantially parallel to each other. The first 252 and second 254 blades include sharp, cutting and distal edges 256, 258, respectively. The distal sharp edges 256, 258 may include teeth 260, 262, respectively, or other features that facilitate the cutting of the bone, as those skilled in the art will understand. The saw 250 can be manufactured in any of several sizes for both transverse and oblique cuts, with the first 252 and second 254 blades separated from each other by a predefined distance corresponding to the predefined shortening length of drill template 200 given by markings 218 , 220. The parallel blades first 252 and second 254 enable precise and parallel cutting of the bone with a single cutting action that drives the saw 250 back and forth. The saw 250 can be reciprocated perpendicularly to its longitudinal axis, thus guiding the first 252 and second 254 blades through the bone.
    According to an exemplary surgical technique, as shown in figures 17 to 23, a bone is dimensioned so that it can be fixed
    12/15 using plate 100. As shown in figure 17, drill jig 200 is positioned close to the bone, preferably close to the inner edge of the half to a distal third of the bone (for example, the ulna), making with the distal end 204 of the drill template 200 facing the distal end of the bone and its proximal end 202 facing the proximal end of the bone. The drill template 200 is fixed to the bone by means of guide wires 240 inserted through two or more of the openings 210. The guide wires 240 are inserted so that they drill holes in corresponding positions in the bone by means of their tips. drill 242. Those skilled in the art will realize that this pre-drilling facilitates proper bone alignment when it is cut. When the user wants to make a cross-section through the bone, he aligns the first 252 and second 254 blades of the saw 250 to the first markings 218 indicated on the drill template 200, as shown in figure 18. When the user wants to make an oblique cut , it connects the saw guide 222 to the drill jig 200 and aligns the inclined surface 224 with the second markings 220, thus allowing the saw 250 to slide along them, as shown in figure 19.
    Saw 250 is pressed into the bone to make parallel transverse and / or oblique cuts in the bone. After cutting the bone and removing the cut part, drill template 200 is removed, while guidewires 240 inserted into the bone are maintained. After removing the drill template 200, the plate 100 is slid along the guide wires 240 towards the bone so that each of the guide wires 240 is received in a corresponding hole between the holes 110 and 138 of the plate, as shown in Figure 20. As shown in Figure 21, the guide wire 240 initially inserted in the opening 210a corresponding to the three-part hole 110b of the plate 100 is then removed in order to insert a first bone fixation element of the second type 126 through the hole. Then, as shown in figure 22, the guide wire 240 initially inserted in the opening 210b is removed in order to insert a second bone fastening element of the second type 126 into the hole in two corresponding parts 128b formed in the distal part 154 of the plate 100 .
    Finally, as shown in figure 23, the last wire 240 is removed and a third bone fastening element of the second type 126 is inserted in the proximal end 156 of the orifice in two parts 138a formed in the proximal part 152 of the plate 100 and through of the hole previously drilled in the bone. Then, the cut bone is compressed by bringing its proximal part closer to its distal part until both assume a desired spatial relationship in relation to each other (for example, making contact with each other according to a rotational alignment)
    Desired 13/15). The proximal part of the bone can be moved relative to the plate 100 by sliding the bone fixation element from the proximal end 156 through the second elongated part 142 of the orifice into two parts 138a formed on the proximal part 152 of the plate 100. Then, bone fixation is completed by inserting bone screws into the bone through the remaining holes in plate 100. For example, bone fasteners of the first type 122 (for example, locking screws) are inserted into the locking holes 148a, 148b and a fastener of the first 122 or of the second type 126 (for example, locking screws, cortex screws) is inserted into the hole in three parts 110a, as shown in figure 24. When making an oblique cut in the bone, an element of bone fixation of the second type 126 is inserted through the hole in three parts 110a at a certain angle in relation to the central axis, thus causing the rod 136 to extend across the surfaces of the cut bone obliquely, as shown in figure 25.
    According to a second exemplary embodiment of the present invention, as shown in figures 26 to 32, it is possible to use a plate 300, as shown in figure 26, to fix cut bone parts using a drill guide 400 and a saw blade 450. Plate 300, as shown in Figure 26, is substantially similar to plate 100, as described above, extending longitudinally from a proximal end 302 to a distal end 304. Like plate 100, in one embodiment The plate 300 includes a proximal part 352 and a distal part 354, which can be formed substantially symmetrically with respect to each other around an axis of symmetry 350. The plate 300, however, does not include combination holes in three or two parts. Instead, it includes several locking holes 310 that pass through it from a first 306 to a second surface 308 on both the proximal 352 and distal 354 parts. For example, the proximal 352 may include several locking holes 310a and the distal 354 may also include several locking holes 310b. As shown in Figure 26, however, the various locking holes 310a, 310b do not need to be mirrored in the proximal 352 and distal 354 parts. Furthermore, each of the proximal 352 and distal 354 parts can include an elongated orifice 338a, 338b, respectively.
    The locking holes 310 can be substantially similar to the locking holes 148, including a thread 318 that extends around its inner surface to engage the threaded head of a bone fastener. The elongated orifice 338 can be elongated in the longitudinal direction,
    14/15 including an inner surface 346 that tapers from the first 306 to the second surface 308. The inner surface 346 can be substantially spherical to receive a head of corresponding shape from a bone fixation element, such as, for example, a screw. cortex.
    As shown in figure 27, the drill jig 400 is substantially similar to the drill jig 200 described above, extending from a distal end 402 to a distal end 401 and including openings 410, which correspond to the position of the locking holes 310b, in the distal part 354, and the elongated hole 338a, in the proximal part 352. Like drill template 200, drill template 400 is positioned close to the bone to allow holes to be previously drilled in it using guide wires or drill tips 440 inserted through the openings 410 in positions corresponding to the positions in which the holes 310b, 338a that pass through the plate 300 will be disposed when the plate 300 assumes the desired position on the cut parts of the bone after cutting it. Then, saw 450, which is substantially similar to saw 250, is used to make a parallel transverse and / or oblique cut in the bone in the same manner as described above. As shown in figure 28, it is possible to position the saw guide 422 against the bone to make a substantially transversal cut through it. Alternatively, the saw guide 422 includes angled surfaces 424 so that it is possible to move the saw 450 against the inclined surface in order to cut the bone over a predefined oblique angle to the bone axis.
    The surgical technique for using the exemplary second accretion system is substantially similar to the technique described above. After cutting the bone, remove the drill template 400 and slide the plate 300 along the guide wires 440, positioning it next to the bone. As an alternative, it is possible to remove the guide wires and / or the drill bit 440 after previously drilling the holes in the bone. After removing the guide wires 440, bone fasteners 322 of the first type (for example, screws with locking head) are inserted into the locking holes 310b formed in the distal part 354, as shown in figure 29, and a fixing element bone 326 of the second type (for example, a cortex screw) is inserted in the proximal end 356 of the elongated orifice 338a formed in the proximal part 352. Then, the bone is compressed, approaching its proximal part to its distal part until both assume a desired spatial relationship in relation to each other, as shown in figure 30. During this movement, the bone fixation element 326, which was inserted through the proximal end 356 of the elongated bone 338a, slides distally into the elongated orifice 338a towards The
    15/15 distal end 358 of this. For additional compression, it is possible to insert a second bone fixation element 326 at the proximal end 356 of the elongated hole 338a, as shown in figure 31. To improve the fixation, other bone fixation elements 322 can be inserted into the locking holes 310a 5 remaining, as shown in figure 32.
    It will be evident to those skilled in the art the possibility of making several modifications and variations in the structure and methodology of the present invention without, therefore, diverging from its essence or scope. Therefore, it is intended that the present invention covers modifications and variations to it, provided that within the scope of the appended claims and their equivalents.
    权利要求:
    Claims (14)
    [1]
    1. Bone plate (100) characterized by the fact that it comprises:
    an elongated body extending from a proximal end (102) to a distal end (104) and includes a first surface (106) which, when in an operational position, faces away from a bone on which the plate (100) must be mounted, and a second surface (108) which, when in the operational position, faces the bone;
    a first three-part combination hole (110) extending through a proximal portion of the plate (100), the first three-part combination hole (110) including a first part (112), a second part (114) and a third part (116), the first and third parts (112,116) defining opposite longitudinal ends of the first three-part combination hole (110) with the first part (112) and the third part (116) connected via the second part (114), the first part (112) being threaded and configured to engage a threaded head portion (124) of a bone fixation element (122), the second part (114) being threadless and configured to receive an element of bone bone fixation (126) along an axis perpendicular to a longitudinal axis of the bone when the plate (100) is mounted on it in the desired orientation, and the third part (116) being without thread and including a first wall (132) if extending from the first surface (106) in d direction to the second surface (108) and a second wall (134) extending outwardly along the longitudinal axis of the bone plate (100) from one end of the first wall (132) to the second surface (108), so to define a screw axis extending from the second surface (108) towards the distal end (104) of the elongated body at an angle not perpendicular to the longitudinal axis of the bone when the plate (100) is mounted on the even in the desired orientation; and a first two-part combination orifice (138) that extends through the proximal portion of the plate (100), the first two-part combination orifice (138) including a first part (140) and a second part (142) ,
    Petition 870190106606, of 10/21/2019, p. 4/12
    [2]
    2/5 the first part (140) being threaded and configured to receive and engage a threaded head portion (124) of a bone fixation element (122) and the second part (142) that defines an elongated portion that extends to the along a longitudinal axis of the plate (100) to receive a bone fixation element through it, so that the plate (100) can slide along its longitudinal axis in relation to the bone fixation element received through it.
    2. Plate according to claim 1, characterized by the fact that it still comprises a first threaded locking hole (148) which extends through a distal portion of the elongated body, the first locking hole (148) including a thread along its internal surface to screw a bone fixation element to a head.
    [3]
    3. Plate according to claim 1 or 2, characterized by the fact that the proximal and distal portions of the elongated body are symmetrical to each other, the plate (100) still comprising:
    a second three-part combination orifice (110b) that extends through the distal portion of the plate (100), a first part of the second three-part combination orifice being threaded and configured to engage a threaded head portion of an bone fixation, the second part of it configured to receive a bone fixation element along an axis perpendicular to a longitudinal axis of the bone when the plate is mounted on it in a desired orientation and a third part defining a screw axis that extends from the second surface towards the distal end of the body elongated at an angle not perpendicular to the longitudinal axis of the bone when the plate is mounted on it in a desired orientation;
    a second two-part combination hole (138b) extending through the distal portion of the plate (100), a first threaded portion being configured to receive and engage a threaded head portion of a bone fixation element and a second portion of the even defining an elongated portion that extends along a longitudinal axis of the plate to receive a bone fixation element through it, so that the plate can slide along its longitudinal axis in relation to the bone fixation element received through it ;
    Petition 870190106606, of 10/21/2019, p. 5/12
    3/5 and a non-elongated two-part combination orifice (158) that extends through at least one between the proximal portion and the distal portion of the plate (100), a first threaded portion being configured to receive and engage a portion of the threaded head of a bone fixation element and a second portion thereof defining a non-elongated portion to receive a bone fixation element therethrough.
    [4]
    Plate according to any one of claims 1 to 3, characterized in that the second part (114) of the first three-part hole (110) includes curved walls (130) that taper from the first surface (106) ) towards the second surface (108).
    [5]
    5. Plate according to any one of claims 1 to 4, characterized in that the second and third parts (114,116) of the first three-part hole (110) overlap so that a bone fixation element is received between they at any angle selected by the user in relation to the longitudinal axis of the bone between 90 degrees and the non-perpendicular angle of 45 degrees.
    [6]
    6. Osteotomy system comprising:
    the bone plate (100) as defined in claim 1;
    characterized by the fact that it still comprises:
    a drill jig (200) including:
    a longitudinal member extending from a proximal end (202) to a distal end (204) and including a first surface (206) which, when in operation, faces away from a bone on which the plate (100) must be mounted and a second surface (208) which, when in an operational position, faces a bone on which the plate (100) is to be mounted, a length of the longitudinal element including markings (218,220) indicating a predefined shortening length of the bone; and a plurality of openings (210) extending through them at locations corresponding to the locations where the first three-part hole (110) and the first double hole (138) of the bone plate (100) will be located after a predetermined portion of the bone be removed.
    [7]
    7. Osteotomy system, according to claim
    Petition 870190106606, of 10/21/2019, p. 6/12
    4/5
    6, characterized by the fact that it still comprises a locking hole (148) which extends through the elongated body from the first surface (106) to the second surface (108), the locking hole (148) including thread along a internal surface of the same to engage a corresponding thread on the head of a bone screw to be inserted through it.
    [8]
    8. Osteotomy system according to claim 6 or 7, characterized by the fact that the proximal and distal portions of the elongated body are symmetrical to each other, the bone plate (100) still including:
    a second three-part combination orifice (110b) that extends through the distal portion of the plate (100), a first part of the second three-part combination orifice being threaded and configured to engage a threaded head portion of an bone fixation, the second part of it configured to receive a bone fixation element along an axis perpendicular to a longitudinal axis of the bone when the plate is mounted on it in a desired orientation, and a third part defining a screw axis that is extends from the second surface towards the distal end of the elongated body at an angle not perpendicular to the longitudinal axis of the bone when the plate is mounted on it in a desired orientation; and a second two-part combination hole (138b) extending through the distal portion of the plate (100), a first threaded portion being configured to receive and engage a threaded head portion of a bone fixation element and a second portion of the same defining an elongated portion that extends along a longitudinal axis of the plate to receive a bone fixation element through it, so that the plate can slide along its longitudinal axis in relation to the bone fixation element received through her.
    [9]
    9. Osteotomy system according to any one of claims 6 to 8, characterized in that the second and third part (114,116) of the first three-part orifice (110) overlap so that a bone fixation element is it received at any angle selected by the user between 90 degrees and the non-perpendicular angle.
    [10]
    10. Osteotomy system, according to any
    Petition 870190106606, of 10/21/2019, p. 7/12
    5/5 of claims 6 to 9, characterized by the fact that it still comprises:
    a saw (250) including the first and second blades (252, 254) parallel to each other and separated by a distance corresponding to a predefined length; and a saw guide (222) attachable to the drill jig (200), the saw guide (222) including an angled surface (224) to guide the saw blade, when the drill jig (200) is in the operational position , along a desired oblique angle to a longitudinal axis of a bone on which the plate (100) is to be mounted, on which the saw guide (222) is attachable to the first surface (206) of the drill template ( 200) using a fixing screw.
    [11]
    Osteotomy system according to any one of claims 6 to 10, characterized in that the longitudinal member of the drill template (200) includes a recess (214) along the second surface (208) in a location that , when the drill jig (200) is in the operational position, it overlaps a portion of bone to be removed.
    [12]
    Osteotomy system according to any one of claims 6 to 11, characterized by the fact that the longitudinal member of the drill jig (200) includes a marking (218,220) on its lateral surface, showing locations in which a bone must be cut to obtain a desired shortening, the mark (218,220) indicating one of a cross section and an oblique section.
    [13]
    13. Osteotomy system according to any one of claims 6 to 12, characterized by the fact that it still comprises a guide wire (240) including a drill bit (242) for insertion through the plurality of openings (210) of the model drill bit (200) for pre-drilling the bone at the locations and along the axes determined by the openings in the drill template (200).
    [14]
    14. Osteotomy system, according to claim 10, characterized by the fact that the drill jig (200) includes a notch (215) in a first surface (206) of the same dimension to receive the non-rotating guide saw (222).
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    同族专利:
    公开号 | 公开日
    CN102791211B|2015-08-12|
    KR101768706B1|2017-08-16|
    JP5770211B2|2015-08-26|
    US20150223852A1|2015-08-13|
    CN102791211A|2012-11-21|
    CA2789011C|2019-06-18|
    KR20130018646A|2013-02-25|
    CA2789011A1|2011-09-09|
    EP2542170A1|2013-01-09|
    BR112012021877A2|2018-06-05|
    WO2011109127A1|2011-09-09|
    EP2542170B1|2018-05-09|
    US20120123484A1|2012-05-17|
    JP2013521046A|2013-06-10|
    US9023052B2|2015-05-05|
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    法律状态:
    2019-01-08| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|
    2019-07-30| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|
    2020-03-24| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|
    2020-05-26| B16A| Patent or certificate of addition of invention granted [chapter 16.1 patent gazette]|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 26/01/2011, OBSERVADAS AS CONDICOES LEGAIS. |
    优先权:
    申请号 | 申请日 | 专利标题
    US31040610P| true| 2010-03-04|2010-03-04|
    US61/310.406|2010-03-04|
    PCT/US2011/022574|WO2011109127A1|2010-03-04|2011-01-26|Ulna osteotomy system|
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