forceps and bone fixation set

专利摘要:
BONE FIXATION SYSTEM INCLUDING K-WIRE COMPRESSION. A bone fixation system includes a bone plate, bone anchors, temporary fixation members and forceps. The temporary fixation members are configured to be inserted through openings in the bone plates and the underlying bone segments that are separated by a bone gap. Forceps are configured to apply a force to the temporary fixation members that causes at least one of the underlying bone segments to convert in relation to another bone segment, thereby reducing or distracting the bone segments without interfering with the final fixation with the bone segment screws
公开号:BR112012026818B1
申请号:R112012026818-0
申请日:2011-04-27
公开日:2020-12-01
发明作者:Dana Pappalardo；Sherri Wykosky；Kenneth Kobayashi；Dipan Patel；William Kolb；Colleen Flesher
申请人:Synthes Gmbh；
IPC主号:

专利说明:

CROSS REFERENCE WITH RELATED REQUESTS
This application claims the benefit of US Provisional Application Serial No. 61 / 372,212 filed on August 10, 2010, and US Provisional Application Serial No. 61 / 328,278 filed on April 27, 2010, the contents of which are incorporated here for reference in its entirety. BACKGROUND
Conventional bone fixation systems include a bone plate having screw holes that receive fixation members, such as screws that are configured to attach to an underlying bone that includes at least a pair of bone segments separated by a bone failure. Bone failure can be a fracture created by a traumatic event, an osteotomy, or it can be the result of a debridement of a joint of two distinct bones to be joined in an arthrodesis. In this way, the bone plate can be attached to a bone on opposite sides of the bone gap using bone screws to promote the union of bone segments (eg, fracture healing or joint ossofication). Bone fixation systems may also include temporary Kirschner wires (K wires) that are temporarily inserted into the openings of the bone fixation plate and the underlying bone segments to determine the length, rotation and proper alignment of the bone segments before fixing the permanent plate. Once the bone fixation plate has been properly positioned, the permanent bone screws can be inserted into one or more bone screw holes on opposite sides of the bone gap and attached to the underlying bone. In a conventional system, the K wire is screwed or otherwise directed through the screw holes of the plate on the opposite sides of the bone gap. The K-wire is smaller in diameter than the screw holes, and is thus positioned to support itself against the opposite edges of the respective screw holes in order to prevent the plate from moving during the examination. The process of precisely positioning the K wire in order to prevent bone plate movement has proved to be difficult and tedious, as any space between the K wire and the outer edge of the screw hole can allow the bone plate to move. SUMMARY
According to one embodiment, a method is provided for attaching a bone plate to the first and second segments that are separated by a bone defect. The method includes the step of aligning the bone plate with the first and the second bone segment so that the first plurality of openings extending through the bone plate through the bone plate are aligned with the first bone segment and the second plurality of openings extending through the bone plate are aligned with the second bone segment. One selected from a plurality of openings is a K wire groove and one selected from a second plurality of openings is a K wire hole. The method further includes the steps of inserting a distal portion of a first K wire through the wire groove. K and inside the first bone segment, inserting a distal part of the second wire K through the hole of wire K and into the second segment of wire K, and driving the forceps to polarize at least one of the wire K to convert relative to the other wire K .
According to another embodiment, a forceps is provided which is configured to apply a polarizing force to a pair of temporary fixation members. Each temporary fixation member has a distal part and a locking member arranged close to the distal part. The locking member can define a dimension larger than the distal part, and the locking member can have an external surface. The forceps can comprise a pair of arms that are pivotally connected to a joint. Each arm can have a proximal end and an opposite distal end. Each arm may also have a locking member defining a pocket that extends at the distal end. The pocket can define a locking surface having a shape corresponding to that of the locking member of the temporary fixing members. The relative movements of the arms cause the movement to correspond to the distal ends, so that each pocket receives at least partially one of the respective temporary fixing members and the locking surface applies a polarizing force against the locking member of the temporary fixing member. temporary fixing member received.
According to another embodiment, a bone fixation set is provided that includes at least one bone fixation plate, at least a pair of temporary fixation members, and a forceps. The plate can include a plurality of openings, at least some of which are configured to receive the respective bone fixing members. Each temporary fixation member can have a proximal part, a distal part, and a locking member disposed between the proximal part and the distal part. The engaging member can define a transverse dimension greater than that of the distal part, where at least one of the temporary fixing members is configured to extend through a respective plurality of openings and within the underlying bone segment of a pair of underlying bone segments that are separated by a bone gap. The forceps can include a pair of arms, each arm having a proximal end and an opposite distal end. The distal end may include a locking member that defines a corresponding locking surface that is configured to move along the direction to abut a locking member of one of the respective temporary fixing members, where another movement of the locking surface fitting along the direction causes at least one of the temporary fixing members to convert relative to the other temporary fixing member.
According to another embodiment, a method is provided for positioning the first and second bone segments which are arranged in a first position relative to each other and are separated by a bone defect during the surgical procedure. The method includes the step of inserting a distal part of a temporary fixation member into the first bone segment, and inserting a distal part of the second temporary fixation member into the second bone segment. The method also includes the step of driving a forceps to polarize at least one of the temporary bone fixation members relative to another temporary bone fixation member, thus adjusting the relative positions of the bone segments in relation to each other from the first relative position to second different relative position. Before completing the surgical procedure, the first and second temporary bone fixation members can be removed from the first and second bone segments, respectively.
According to another embodiment, a method is provided for positioning a bone plate to a first and second segment that are arranged in a relative position with respect to each other and are separated by a bone defect. The method may include the steps of aligning the bone plate with the first and second bone segment, the bone plate including the plate body and a plurality of openings extending through the plate body, where a first plurality opening of openings comprises a bone anchor hole which is aligned with the first bone segment, and a second opening of the plurality of openings comprises a coupler. The method also includes inserting a bone anchor through the bone anchor hole and inside the first bone segment, inserting a distal part of a support within the second opening, the distal part of the support defining a coupler that fits the coupler of the second opening to attach the support therein to the bone plate, and insert a distal part of a K wire into the second bone segment. A forceps can then be actuated to polarize at least one K wire and the support to convert one relative to the other, thereby adjusting the relative positions of the bone segments in relation to each other.
According to another embodiment, a bone fixation set is provided. The set may include at least a pair of temporary bone fixation members, and a forceps. Each temporary bone fixation member may have a proximal part, a distal part, and a locking member disposed between the proximal and the distal part, the locking member defining a transverse dimension greater than that of the distal part, where the temporary bone fixation members are configured to extend through the respective members of the plurality of openings and within the respective underlying bone segments that are separated by a bone gap. The forceps can include a pair of arms, each arm having a proximal end and an opposite distal end, the distal end includes a locking member that defines a corresponding locking surface that is configured to move along in a direction to lean against one of the respective temporary bone fixation members. Another movement of the engaging surface along one direction causes at least one of the temporary bone fixation members to become relative to the other temporary bone fixation member. BRIEF DESCRIPTION OF THE DRAWINGS
The above mentioned summary, as well as the following detailed description of an exemplary application modality, will be better understood when read in conjunction with the attached drawings, in which an exemplary modality has been shown in the drawings for the purpose of illustration. It must be understood, however, that the application is not limited to the precise arrangements and instruments shown. In the drawings:
Figure 1A is a perspective view of a bone fixation system constructed according to a modality operatively coupled to a pair of bone segments illustrated schematically separated by a bone failure, the bone fixation system including a bone fixation plate bone, a pair of K wires and forceps;
Figure 1B is a perspective view similar to figure 1A, but showing bone failure reduced by the bone fixation system;
Figure 2A is a plan view of the bone fixation plate shown in Figure 1 A;
Figure 2B is a top plan view of a variable angle closure hole of the bone fixation plate shown in Figure 2A;
Figure 2C is a perspective view showing a bone anchor shown in the variable angle closure hole shown in figure 2B;
Figure 2D is a top plan view of a combination hole in the bone fixation plate shown in Figure 2A;
Figure 2E is a sectional side elevation view of the bone fixation plate shown in Figure 2D taken along line 2E-2E in order to illustrate a screw hole;
Figure 2F is a sectional side elevation view of the bone fixation plate similar to figure 2E, but showing the screw hole constructed according to an alternative embodiment;
Figure 2G is a sectional side elevation view of a bone fixation plate similar to Figure 2F, but showing the screw hole constructed according to an alternative embodiment;
Figure 2H is an enlarged top plan view of the bone fixation plate shown in Figure 2A, showing a dedicated K-wire groove;
Figure 2I is a top plan view of a bone fixation plate similar to Figure 2A, but constructed according to an alternative embodiment;
Figure 3A is a perspective view of a bone fixation plate constructed in accordance with another embodiment;
Figure 3B is a top plan view of the bone fixation plate shown in Figure 3A;
Figure 3C is a sectional side elevation view of a bone fixation plate shown in Figure 3A;
Figure 3D is a top plan view of a bone fixation plate constructed similar to the bone plate illustrated in Figure 3A, but according to another embodiment;
Figure 3E is a top plan view of a bone fixation plate constructed similar to the bone plate illustrated in figure 3A, but according to another embodiment;
Figure 4A is a top plan view of a bone fixation plate constructed according to another embodiment;
Figure 4B is a side elevation view of the bone fixation plate shown in Figure 4A;
Figure 4C is a top plan view of the bone fixation plate constructed according to another embodiment;
Figure 4D is a top plan view of the bone fixation plate constructed similar to Figure 4C, but according to another embodiment;
Figure 4E is a top plan view of the bone fixation plate constructed according to another embodiment;
The figure is a top plan view of the bone fixation plate constructed according to another embodiment;
Figure 4G is a top plan view of the bone fixation plate constructed according to another embodiment;
Figure 5A is a side elevation view of a non-closing bone anchor constructed according to an embodiment;
Figure 5B is a side elevation view of a closing bone anchor constructed according to one embodiment;
Figure 5C is a side elevation view of a bone anchor head portion shown in Figure 5B;
Figure 5D is a sectional elevation view of a bone anchor constructed according to an alternative embodiment;
Figure 6A is a side elevation view of the K wire shown in Figure 1A;
Figure 6B is a side elevation view of a K wire constructed in accordance with an alternative embodiment;
Figure 7A is a perspective view of a forceps illustrated in Figure 1A;
Figure 7B is a perspective view of a forceps illustrated in Figure 7A shown in an open configuration;
Figure 7C is a perspective view of the forceps illustrated in Figure 7B shown in a closed configuration;
Figure 7D is a perspective view of a part of the forceps illustrated in Figure 7A, showing a rack mechanism;
Figure 7E is an enlarged perspective view of a distal end of the forceps illustrated in Figure 7A, showing a compression fitting member;
Figure 8A is an enlarged perspective view of a distal end of the forceps illustrated in Figure 7A, but constructed according to an alternative embodiment, including distraction and compression fitting members;
Figure 8B is a perspective view of a distal end illustrated in Figure 8A, showing schematically the distraction and compression fitting members operatively coupled to the respective K wires.
Figure 8C is an enlarged perspective view of a distal end of a forceps arm shown in Figure 7A, but constructed according to an alternative embodiment, including distraction and compression fitting members;
Figure 8D is a perspective view of a distal end illustrated in Figure 8C, showing schematically the distraction and compression fitting members operatively coupled to the respective K wires.
Figure 8E is an enlarged view of a distal end of a forceps arm shown in Figure 7A, but constructed according to an alternative embodiment, including distraction and compression fitting members;
Figure 8F is a perspective view of the distal end illustrated in Figure 8E, showing schematically the distraction and compression fitting members operatively coupled to the respective K wires;
Figure 9 is a schematic perspective view of a bone clamp secured to the bone segments using a bone fixation system illustrated in Figure 1A;
Figure 10 is a perspective view of a bone fixation system constructed according to an alternative embodiment operatively coupled to a pair of bone segments illustrated schematically separated by a bone failure, the bone fixation system including a fixation plate bone, a K wire, a support and a forceps;
Figure 11A is a perspective view of a bone fixation plate constructed in accordance with an alternative embodiment, and shown in Figure 10;
Figure 11B is a top plan view of the bone fixation plate shown in Figure 11A;
Figure 12A is a partial perspective view of a K wire constructed according to an alternative embodiment, and shown in Figure 10;
Figure 12B is a side elevation view of the wire K shown in figure 12A;
Figure 13A is a front perspective view of a support constructed in accordance with an embodiment and shown in Figure 10;
Figure 14A is a front perspective view of a forceps constructed according to an alternative embodiment, the forceps having compression fitting members;
Figure 14B is a front perspective view of the forceps illustrated in Figure 14A, but constructed according to an alternative embodiment, including distracting fitting members;
Figure 15A is a front perspective view of the bone fixation system illustrated in figure 10 reducing the bone gap defined between the first and the second bone segment, the bone fixation plate affixed to the first bone segment with an anchor of bone, the support fixedly coupled to the bone fixation plate adjacent to the first bone segment, and the K wire extending through the bone Ipaca and into the second bone segment;
Figure 15B is a front perspective view of the bone fixation system illustrated in figure 15A distracting the bone gap between the first and the second bone segment with the forceps illustrated in figure 14B;
Figure 16A is a front perspective view of the bone fixation system illustrated in Figure 10 compressing the bone gap defined between the first and the second segment, the bone fixation plate affixed to the first bone segment with a bone anchor, the K wire extending through the bone plate and into the second bone segment, and the support fixedly coupled to the bone plate adjacent to the second bone segment so that the distraction of the forceps causes compression of the bone failure;
Figure 16B is a front perspective view of the bone fixation system illustrated in figure 16A distracting the bone gap defined between the first and the second bone segment with the forceps illustrated in figure 14A;
Figure 17A is a front perspective view of the bone fixation system illustrated in Figure 10 compressing the bone gap defined between the first and the second segment, the bone fixation plate affixed to the first bone segment with a bone anchor, the K wire extending directly into the second bone segment, and a support fixedly attached to the bone plate adjacent to the second bone segment so that the compression of the forceps causes the compression of the bone defect; and
Figure 17B is a front perspective view of the bone fixation system illustrated in figure 17A distracting the bone defect defined between the first and the second bone segment with the forceps illustrated in figure 14B; DETAILED DESCRIPTION
Referring initially to Figure 1A, a bone fixation system 20 includes a bone fixation plate 22, at least one guide wire or a temporary fixation member illustrated as a K wire 24, such as a pair of opposite K wires 24a and 24b, and a forceps 26 configured to fit the wires K 24a and 24b. the bone fixation plate 22 can be operatively coupled to an underlying bone 27 having bone segments 27a and 27b separated by a bone failure 28. The bone failure can be a fracture created by a traumatic event, an osteotomy, or it can be a result of a debridement of a joint of different bones to be joined in an arthrodesis. The bone fixation plate 22 is placed against or in proximity to the underlying bone 27, the K 24a and 24b wires are inserted through the plate 22 and into the respective bone segments 27a and 27b, and the forceps 26 can apply a force in the K threads in order to convert at least one or both of the bone segments 27a and 27b, thereby adjusting the relative positions of the bone segments 27a and 27b with respect to each other. For example, forceps 26 can apply a compressive force that brings at least one or both bone segments 27a and 27b towards each other, thus reducing bone failure 28 to promote the union of bone segments 27a and 27b, as illustrated in figure 1B. According to certain modalities, forceps 26 can apply a distracting force to the K wires in order to urge one or both bone segments 27a and 27b away from each other, thereby distracting the bone gap 28, for example, from the position shown in figure 1B to the position shown in figure 1A. The bone fixation plate can be geometrically configured for fixation to bone 27, which can be the forefoot, midfoot, hindfoot, distal tibia, or any bone in the human body as desired, both in vivo and ex vivo. The bone fixation plate 22 may alternatively be attached in the manner described above to any bone in the body of a compatible non-human animal, in vivo or ex vivo.
The bone fixation system 20 may further include a plurality (example, at least two) bone anchors 30 (see figure 2C) that secure the bone fixation plate 22 to the underlying bone 27 on opposite sides of the bone gap 28. The bone fixation system 20 and the components of the bone fixation system 20 can be made from any compatible biocompatible material, such as titanium, including titanium alloys, stainless steel, ceramics, or polymers such as polyetheretherketone (PEEK), cobalt chromium molybdenum (CoCrMo) with a powdered plasma titanium coating, or any compatible alternative material as described.
Referring now to Figure 2A, the bone fixation plate 22 can be made in different shapes and sizes for use in a wide variety of clinical applications. The bone fixation plate 22 is elongated along a longitudinal direction L, defines a width along a lateral direction A that is perpendicular or substantially perpendicular to the longitudinal direction L, and the thickness along the transverse direction T that is perpendicular or substantially perpendicular to both longitudinal direction L and lateral direction A. In this regard, it should be appreciated that the various directions can extend along directions that are 90 ° angularly offset from each other, or anywhere within an average of approximately 45 ° and approximately 90 ° angularly offset from each other.
The bone fixation plate 22 includes a plate body 32 that extends substantially along a central longitudinal axis 31, and defines a proximal end 34 and a distal end 36 opposite the proximal end 34 along the longitudinal axis 31. The The body of the plate 32 further includes a bone facing an inner surface 38 and an opposite outer surface 40 spaced from the inner surface 38 along the transverse direction T. The body of the plate 32 includes a head portion 46 at the distal end 36 that can be configured and sized to fit the contour of the cortex closest to the underlying bone 27, and a shaft part 48 connected to the head part 46 and longitudinally proximal to the head part 46. The shaft part 48 can be configured and sized to fit adapt to the contour of the cortex closest to the underlying bone 27. According to the illustrated modality, the part of the head 46 resembles the shape of the clover, although it should be appreciated that and the head portion 46 can take any geometric shape as desired. The clover-shaped plate can be used in a variety of bone applications, especially where a small segment of bone is present. The designed cloverleaf beam allows a surgeon to place three screws for three fixation points on a small surface area that can provide greater stability than two fixation points on the same surface area.
The surface facing bone 38 of the head part 46 can generally be coplanar with or offset from the surface facing bone 38 of the shaft part 48. For example, the surface facing bone 38 of the head part 46 and the part of axis 48 can be curved to adapt to the contours of the underlying bone 27. The body of plate 32 may further include a neck portion 50 connected between the head portion 46 and the axis portion 48. The neck portion 50 may be straight, curved, and can define a lateral thickness that is greater than, or less than, or substantially equal to that of the head part and the axis part 48. According to the illustrated embodiment, the neck part 50 it has a lateral thickness less than that of the head part 46 and the axle part 48.
In continuous reference to Figure 2A, the bone plate 22 includes a plurality of openings 39 that extend transversely through the body of the plate 32, from the inner surface facing the bone 38 through the outer surface 40. The openings 39 can include at least one such a plurality of bone anchor holes 41, at least such a plurality of K thread holes 23 that can be dedicated K thread holes 43, and at least such a plurality of longitudinally elongated K thread grooves 25 that can be dedicated K wire 45. As will be appreciated from the description below, the hole of the K 43 wire and the K 45 wire groove can be dedicated to receive the respective K wires, or each can also be configured as an anchor hole of bone that are configured to receive both a bone anchor and a K wire.
As will now be described with reference to Figures 2A-2G, one or more of the bone anchor holes 41 to all bone anchor holes 41 can be configured as a variable angle hole 52, a fixed axis hole 54, a combination hole 57 including a variable angle hole part and a fixed angle hole part, and can further be configured as a compression hole, a threaded locking hole, or a combination of both. It should be appreciated that at least one of all the bone anchor holes 41, the wire hole K 43, and the wire groove K 45 can extend through head part 46, shaft part 48, and / or the neck part 50 as desired. According to an illustrated embodiment, the bone plate 22 includes a plurality of holes of varying angles 52 that extend through the head portion 46. For example, the bone plate 22 includes a pair of variable holes 52 extending through the head part 46 which are laterally spaced from one another and aligned along side direction A, and a third variable angle hole 52 extending through head part 46 to a position distal to and laterally between holes 52.
Referring now to Figure 2B, each variable angle hole 52 is defined by an inner surface 55 of the bone plate body 32. The inner surface 55 includes a plurality of columns extending vertically and transversely 56. According to an embodiment illustrated, four columns 56 are spaced equidistant circumferentially over hole 52, although the plate body 32 may alternatively include any number of columns as desired, circumferentially spaced as illustrated, or at varying circumferential distances as desired. Each column 56 has internal threads 58 that meet the hole 52 so that, if the columns 56 are expanded to join one another (that is, if fully extended around the inner surface 55), the columns 56 would form a continuous helical thread extending over the central transverse axis 49. In this way, it can be said that such threads 58 of the adjacent columns 56 are operatively aligned with each other.
It should be appreciated that while the columns 56 have internal helical threads 58 as shown, the columns 56 may alternatively define threads that are provided as teeth formed there. The columns of teeth, if expanded to join together (that is, if fully extended around the inner surface 55), will not form a helical thread, but a series of concentric grooves and grooves perpendicular to the central axis 49 of the plate hole bone 52. Thus, it can be said that such teeth can be operatively aligned with each other. The columns 56 are circumferentially spaced from one another in order to define the corresponding axes that are angled with respect to the transverse central axis 49, so that a screw can extend through hole 52 in any of the angled axes while screwed into the threads. 58.
The inner surface 55 that defines the hole 52 further includes a plurality of arcuate pockets 50 that project into the body of the plate 32 in a circumferential location between adjacent columns 56. The pockets 60 each have an arcuate surface 62 that is concave in with respect to a direction radially outward from the central axis 49 of bore 52. As illustrated in Figure 2C, and as described in more detail below, bone anchor 30 can be provided as a variable closing bone anchor 61 that can engage thread the threads 58 at variable angular positions. Alternatively, the bone anchor 30 can be provided as a fixed angle lock screw that are purchased with threaded columns 56 and extend along the transverse axis 49. The variable angle holes 52 can be configured to allow the bone anchor fit the threads 58 in any angular orientation as desired, up to +/- 15 ° (example, within the 30 ° fixed) in relation to the central axis 49, which extends along the transverse direction T. the hole variable angle 52 is further described in US Patent Application Publication No. 2008/0140130, published on June 12, 2008, which disclosure is hereby incorporated by reference as set forth herein in its entirety.
Referring now also to figures 2D-E, the fixed shaft hole 54 can generally be cylindrical, so that the body of the bone plate 32 defines a substantially cylindrical inner surface 64 that is substantially cylindrical and at least partially defines the hole 54. Hole 54, and thus, the inner surface 64 can extend fully through the body of the plate 32, from the surface facing the bone 38 through the outer surface 40 along the central transverse axis 51. The inner surface 64 can be closed, or the body of the plate 32 may define a circumferential gap 65 that extends longitudinally through the part of the inner surface 64, so as to extend between the fixed shaft hole 54 and the variable angle hole 52 of the combination hole 57 Failure 65 can extend transversely entirely through the plate body 32, from the outer surface 40 through the inner surface 38. The inner surface 64 of the combination hole 57 illus shown in figure 2D can be unscrewed so that the screw head of a screw inserted into hole 54 of the combination hole 57 can compress the bone plate 22 to the underlying bone 27, and / or compress the bone fragments 27a and 27b together. For example, the screw can be inserted into the underlying bone 27 on one side of hole 54 at a location offset from the center axis of the hole, so that as the screw is compressed against plate 22, hole 54 aligns with the screw, which causes the bone plate 22 to convert in a direction that compresses the bone fragments 27a and 27b.
Accordingly, it should be appreciated that plate 22 can define at least one or more distinct variable angle holes 52 and fixed axis holes 54, or plate 22 can define at least one or more combination holes 57 that include a bore hole. variable angle 52 and a fixed shaft hole 54 connected by a fault 65 that extends transversely through the plate body 32. According to the illustrated modalities, the variable angle hole 52 of a given combination hole 57 is spaced longitudinally distal with respect to, and longitudinally aligned with, the respective variable angle hole 52 of a given combination hole 57. Combination hole 57 is further described in US Patent Application Publication No. 2008/0140130, published on June 12, 2008 , which disclosure is hereby incorporated by reference as set forth herein in its entirety.
The inner surface 54 can extend in a transverse direction, so that the hole 54 has a constant diameter along its length through the body of the plate 32. As illustrated in figure 2E, the inner surface 64 can have internal threads 58 that are configured to fit the complementary threads of the head of a closing bone anchor, as described in more detail below. It should be appreciated that a screw having a fixed angle head (also referred to as a fixed angle screw) can be inserted into a fixed axis hole 54 along the transverse axis of hole 54. For example, the transverse annulus screw can include a cone-shaped screw head. Alternatively, a screw having a variable angle head, (also referred to as a variable angle screw) can be inserted into a fixed shaft hole 54 at an angle to the transverse central axis 51. For example, the angle screw variable can be provided as a cortical screw, or a screw whose screw head defines an external cancellous thread.
Alternatively, as shown in Figure 2F, the inner surface 64 can be tapered radially inward along the transverse direction from the outer surface 40 to the face facing the inner bone 38. The inner surface 64 can be threaded and configured to fit a non-head. threaded from a compression bone anchor that provides a compressive force against the plate 22 in an outward direction from the underlying bone, as will be described in more detail below. Alternatively, the inner surface 64 can be threaded, as described in U.S. Patent 6,206,881, which disclosure is hereby incorporated in its entirety, in order to join with the complementary threads of the closing bone anchor heads. Alternatively, yet another outer region of the inner surface 64 can be unscrewed to fit a compression bone anchor head, and an inner region of the inner surface 64 can be threaded to join with the complementary threads of an anchor head of closing bone.
Alternatively, as illustrated in figure 2G, a portion of the inner surface 64 can be tapered radially inward along the transverse direction from the outer surface 40 towards the surface facing the inner bone 38. Thus, the fixed shaft hole 54 can define a diameter that decreases along a direction from the outer surface 40 to the inner surface 38. Some or all of the inner surface 64 can be substantially linear (example, frustoconical or generally tapered), so that the diameter of the hole 54 decreases linearly, or part or all of the inner surface 64 can be curved, so that the diameter of the hole 54 decreases variably along the transverse direction of the outer surface 40 towards the inner surface 38.
For example, the inner surface 64 can define a first outer transverse region 64a that extends transversely from the outer surface 40 towards the inner surface 38, and a second inner transverse region 64b extending from the outer transverse region 64a towards, and to, the surface facing the bone 38. The outer transverse region 64a can be tapered along the transverse direction of the outer surface 40 towards the inner surface 38, and can be unscrewed and configured to fit a unscrewed thread from a compression bone anchor or non-closing that provides a compressive force against the plate 22 in one direction to the underlying bone. The internal transverse region 64b may extend in a transverse direction, in order to define a substantially constant diameter along its transverse length. The internal transverse region 64b may have internal threads 58 which are configured to fit the complementary threads of the head of a closing bone anchor.
It should be appreciated that while the bone plate 22 is illustrated as including variable angle holes 52 extending through the head portion 46 and combination holes 57 extending through the shaft portion 48, the bone plate 22 may alternatively include any bone anchor hole 41 of the embodiment described above that extends through the head part 46 and the shaft part 48. In addition, the multiple modalities of the bone anchor hole 41 can extend through the head part 46, while that the multiple bone anchor hole modalities 41 can extend through the shaft part 48. The anchor holes 41 extending through the head portion 46 can be the same or different from the anchor holes 41 that extend through the shaft part 48.
Referring again to Figures 1A-2A, the wire hole K 43 and the wire groove K 45 are separated by an intermediate part 35 configured to extend over the bone gap 28 of the underlying bone 27, so that the proximal end 34 can be clamped to a bone segment 27a or 27b and the distal end 36 can be clamped to another bone segment 27a or 27b. In this regard, it can be said that the K 43 thread hole extends through the first part 29 of the bone plate body 32, and the K 45 thread groove extends through the second part 33 of the bone plate body 32 which is spaced proximally longitudinally from the first part 29. Alternatively or additionally, a K wire groove can extend through the first part 29 and a K 43 wire hole can extend through the second part 33. The K 45 wire groove can extend be aligned longitudinally with, the wire hole K 43, and the intermediate part 35 is disposed between the first and the second part 31 and 33. At least one bone anchor hole 41 can extend through a bone plate body 32 at a location close to the K 43 thread hole (for example, in the first part 29), and at least one bone anchor hole 41 can extend through the bone body 32 at a location near the K 45 thread groove (for example, the second part 33).
The intermediate part 35 can include one or more to the entire proximal end of the head part 46 and a distal end of the axis part 48, a neck part that can extend between the head part 46, and the axis part 48 Alternatively, it should be appreciated that certain bone plates may not define a shaft part, a neck part, and / or a distinct head part. Therefore, the K 43 thread hole is operatively aligned with a bone segment 27a or 27b and the K 45 thread groove is operatively aligned with another bone segment 27a or 27b. according to the illustrated embodiment, the wire hole K 43 extends transversely through the part of the head 46, the outer surface 40 through the inner surface 38 in a lateral location proximal to the holes of variable angle 52.
The dedicated K-wire hole 43 is defined by an inner surface 66 of the bone plate 22 that extends transversely across the body of the plate 32, from the outer surface 40 through the inner surface 38. Hole 43 can be located centrally in the longitudinal axis 31 as illustrated, or laterally offset from the longitudinal axis 31. The inner surface 66 can be circular in a cross section as illustrated, so that hole 43 is cylindrical, or the inner surface 66 and hole 43 can define any format as desired. Hole 43 defines a cross-sectional diameter or dimension smaller than that of bone anchor holes 41 and substantially equal to the diameter of wire K 24 that is inserted through hole 43 and the underlying bone 27. Thus, the hole 43 defines a lateral dimension substantially equal to that of the K 24 yarn, and the longitudinal dimension substantially the same as that of the K 24 yarn. As a result, the K 24 yarn can be configured to abut the inner surface 66 as the bone gap 28 is reduced and distracted. In this regard, it should be appreciated that hole 43 may alternatively be larger in size than wire K 24, and wire K may be positioned in hole 43 so that it abuts the inner surface 66 at the location that is closest to the K 45 wire groove when the underlying bone gap is to be reduced, and at the location that is furthest from the K 45 wire groove when the underlying bone gap is to be canceled. According to the illustrated embodiment, the hole 43 is longitudinally aligned with the groove 45, so that the underlying bone gap 28 can be reduced and offset in the longitudinal direction L as desired.
Referring also to figure 2H, the wire groove K 45 is defined by an inner surface 68 of the bone plate 22 that extends transversely through the body of the plate 32, from the outer surface 40 through the inner surface 38. A the groove 45 can be located centrally on the longitudinal axis 68 including a pair of end pieces opposed longitudinally between the end parts 70. In this way, the groove 45 is elongated longitudinally, and is longitudinally aligned with the wire hole K 43.
The groove 45 defines a lateral width substantially equal to the diameter of the K 43 yarn hole. Both the lateral width of the groove 45 and the diameter of the K 43 yarn hole can be substantially the same as that of the respective K 24 yarns, so that a yarn K 24 can be inserted through hole 43 and fixed in relation to the longitudinal and lateral movement relative to the bone plate 22, while the wire K is inserted through the groove 45 and into the underlying bone 27 and fixed in relation to the lateral movement of the plate bone 22, but longitudinally convertible into the groove 45 relative to the bone plate 22. The end parts 70 of the inner surface 68, and thus the groove 45, can be curved as shown, and can be defined by a radius R that is substantially equal to half the lateral width of the groove 45, so that the corresponding K wire is fixed in relation to the lateral movement relative to the plate 22 when the K 24 wire is disposed at the end part 70. The end parts Ade 70 can be configured in any alternative size and format as desired. The end parts 70 define a tip 71 and a posterior edge 73. Tip 71 is arranged close to the hole of wire K, and limits the compression of the underlying bone segments 27a-b (and reduction of bone failure 28). The posterior edge 73 is evenly spaced from the K 43 wire hole, and limits the distraction of the underlying bone segments 27a-b.
With a continuous reference to figure 2A, the wire hole K 43 is illustrated as extending through the head part 46, and the wire groove K 45 is illustrated as extending through the shaft part 48. However, it should be appreciated whereas the K 43 thread hole may alternatively extend through the head portion 46, the shaft portion 48, or the neck portion 50. Alternatively, the bone plate 22 may include a plurality of K 43 thread holes, each extending through the head portion 46, the shaft portion 48, the neck portion 50. Also, it should be appreciated that the wire groove K 45 may alternatively extend through the head portion 46, the shaft portion 48, or the neck part 50. Alternatively, the bone plate 22 may include a plurality of K wire grooves, each through the head part 46, the shaft part 48, the neck part 50, or a combination of one or more of all head parts 46, shaft part 48, neck length 50, alone or in combination with one or more holes of K 43 thread.
In addition, as illustrated in Figure 2A, the K 43 thread hole is arranged proximal to the bone anchor holes 41 extending through the head portion 46. It should be appreciated, however, that the K 43 thread hole can be alternatively disposed distally from the bone anchor holes 41 extending through the head portion 46. In this way, one or more bone anchor holes 41 extending through the head portion 46 can be arranged proximal to or distal to the K 43 thread. Similarly, or more bone anchor holes 41 extending through shaft portion 48 may be arranged close to or distal to the K 45 thread groove. For example, as shown in Figure 2I, the groove 45 is arranged between a pair of bone anchor holes 41 that are configured as variable angle holes 52.
It should be appreciated that the bone plate 22 has been described according to one embodiment, and that the bone fixation system 20 may include bone plates of different geometric configurations compatible for attachment to various bones throughout the body. For example, referring to figures 3A-C, a bone plate 74 is provided as a metatarsal tarsal joint fusion plate that is configured to join the tarsal (cuneiform) bone to both the second and third metatarsals. According to the illustrated embodiment, the bone plate 74 includes a T-shaped bone plate 76 substantially that extends to the congo of a central longitudinal axis 77, and defines a proximal end 78 and a distal end 80 opposite the proximal end 78 along the longitudinal axis 77.
The plate body 76 further includes an internal surface facing bone 82 and an opposite external surface 84 spaced from the internal surface 82 along the transverse direction T. The plate body 76 further defines surfaces on opposite sides 79 and 81 that are spaced one the other along a lateral direction A. The body of plate 76 includes a head portion 83 at a distal end 80 that can be configured and dimensioned to fit the contour of the near cortex, and a shaft portion 85 connected to the head 83 and disposed longitudinally proximal from the head part 83. The shaft part 85 can be configured and dimensioned to adapt to the contour of the nearby cortex. The head portion extends laterally outwardly relative to the axis on both sides of the longitudinal axis 77. The body of the plate 76 still includes a neck portion 86 connected between the head portion 83 and the axis portion 85. The portion neck 86 defines a lateral width smaller than that of the shaft part 85 and the head part 83. According to an illustrated embodiment, the head part 83 and the neck part 86 are curved, and extend transversely inward with respect to axis part 85 along the longitudinal distal direction of axis part 85.
The bone plate 74 may include a plurality of openings 39 extending through the body of the bone plate 76 in the manner described above. The openings 39 may include at least one bone anchor hole 41, at least one dedicated K-wire hole 43, and at least one longitudinally elongated dedicated K-45 groove. The bone anchor holes 41, the wire hole K 43, and the wire groove K 45 can be constructed as described above in relation to the bone plate 22. According to an illustrated embodiment, the body of plate 76 includes a pair of longitudinally spaced combination holes 57 extending between the shaft part 85, and a longitudinally extending K-thread groove 45 arranged between the combination holes 57. The combination holes 57 and the wire groove K are illustrated as extending along the longitudinal axis 77. The plate body 77 includes a pair of laterally spaced variable angle holes 52 that extend through the head portion 83 on opposite sides of the longitudinal axis 77, and the wire hole K 43 that extends extends through the head part 83 at a location coincident with the longitudinal axis 77 and close to the variable angle holes 52.
Referring to the 3D figure, the head portion 83 can be of a size to accommodate any number of openings 39 as desired. For example, according to the illustrated embodiment, the head part 83 can include three openings 39, which are configured as variable angle holes 52. One of the variable angle holes 52 of the head part 83 can be located centrally on the longitudinal axis. 77, while a pair of variable angle holes 52 of the head portion 83 can be arranged laterally outwardly relative to the central variable angle hole 52. In addition, the axis portion 85 may include a plurality of openings 39, illustrated as combination holes 57, which are spaced longitudinally proximal to the K 45 wire groove.
Referring to figure 3E, the head part 83 can be configured to transmit an "L" shape to the body of the plate 76. In particular, one side of the surface 79 of the head part 83 can be substantially in line with the side surface 79 of the shaft part 85, while the other side surface 81 of the head portion 83 can be projected laterally outwardly relative to the side surface 81 of the shaft part 85. According to an illustrated embodiment, the head portion 83 is not of size to accommodate an opening 39 contained between the side surface 79 and the longitudinal axis 77. Preferably, the head portion 83 defines a first opening 39 on the longitudinal axis 77, and a second opening 39 arranged between the longitudinal axis 77 and lateral surface 81.
Referring to Figure 4A, and as described above, certain bone plates can be constructed without a distinct shaft part, neck part, and / or head part. An example of such a bone plate 88 includes a bone plate body 90 that extends substantially along a central longitudinal axis 92, and defines a proximal end 94 and a distal end 96 opposite the proximal end 94 along the longitudinal axis 92. The body of the plate 90 further defines an internal surface facing the bone 93 and an opposite external surface 95 spaced from the internal surface 93 along the transverse direction T. The body of the plate 90 still defines opposite side surfaces 97 and 99 that are spaced one from the other along the lateral direction A. the body of the plate 90 includes an axis portion 100 that extends between the proximal and distal ends 94 and 96, respectively, and a pair of longitudinally spaced wings 102 and 104 that project laterally out of both side surfaces 97 and 99 of the shaft part 100. Wing 102 is arranged distally from wing 104, and extends laterally outward by a greater distance than wings. to 104, although it should be appreciated that wing 104 can extend laterally outward a greater distance than that of wing 102.
The bone plate 88 includes a plurality of openings 40 that extend through the body of the plate 90 in the manner described above. For example, a K 45 thread groove is arranged distally from a K 43 thread hole. Bone plate 88 further includes a plurality of bone anchor holes 41 that extend through body 90. For example, a variable angle hole 58 extends through both side sides of wings 102 and 104. The first variable angle hole 52 still extends through shaft part 100 at a proximal location of the K 45 wire groove, and the second variable angle 52 extends through the shaft part 100 at a location proximal to the K 43 wire hole. A combination hole 57 extends through the shaft part 100 at a location proximal to the K 43 wire hole, and proximal to the second variable angle hole 52. As shown in figure 4B, the body of the plate 90 defines the intermediate part 91 arranged between the wire hole K 43 and the wire groove K 45.
The intermediate part 91 can be co-flat with the remainder of the plate body 90, or it can be angularly displaced from the remainder of the plate body 90 with respect to the longitudinal direction of travel along the inner surface facing the bone 93. In particular , the inner surface 93 is concave in the intermediate part 91 according to an illustrated embodiment. The body of the plate 90 can also be curved in relation to the lateral direction along the internal surface facing
Bone 93, for example, wings 102 and 104 alone or in combination with shaft part 100.
Referring to figure 4C, it should be appreciated that the hole of wire K 43 can be longitudinally displaced in relation to the groove of wire K 45. In particular, bone plate 88 is constructed substantially as described above in relation to figure 4A, however, the wings 102 and 104 define the respective first lateral extensions 102a and 104a that extend laterally outward from the first lateral surface 97, and the respective second lateral extension 102b and 104b that extend laterally outward from the second lateral surface 99 in a distal location in relation to the first extension 102 and 104a. In addition, the proximal end 94 and the distal end 96 are laterally displaced from each other. Therefore, the K 45 yarn groove extends longitudinally, and the K 43 yarn hole is not longitudinally aligned. Alternatively, as illustrated in figure 4D, the wire groove K 45 and the wire bore K 43 can both be angularly displaced with respect to the central longitudinal axis 92, and longitudinally aligned with each other.
Referring now to Figure 4E, an alternatively constructed bone plate 106 includes a bone plate body 108 having an axis portion 110 that extends substantially along a central longitudinal axis 112, and defines a proximal end 114 and a distal end 116 opposite the proximal end 114 along the longitudinal axis 112. The part of the axis 110 still includes an intermediate part 111 that extends between the proximal end 114 and the distal end 116. The body of the plate 108 still defines an inner surface facing bone 118 and an opposite outer surface 120 spaced from the inner surface 118 along a transverse direction T. The plate body 108 further defines surfaces on opposite sides 121 and 132 that are spaced from each other along one direction lateral A. The body of plate 108 further includes a first pair of laterally opposed widened regions 124a that extend distally and laterally towards the distal end tai 116 of the shaft part 110, and a second pair of laterally opposed widened regions 124b extending proximally and laterally towards the proximal end 114 of the shaft part 110. The shaft part 110 and the extended regions 124a-b transmit a substantially X-shaped for the body of the bone plate 108.
Bone plate 106 includes a hole of wire K 43 that extends through the first part 113 of the body of plate 108, and the groove of wire K 45 that extends through second part 115 of the body of plate 108 which is arranged proximally in relation to the first part 113, although as described above it should be appreciated that
The hole of the K 43 wire can extend through the second part 115 and the K 45 wire groove can extend through the first part 115. The intermediate part 111 extends between the first and the second part 113 and 115 of the plate body 118 It should still be appreciated that the first part 113 can include both the K 43 yarn hole and the K 45 yarn groove, and the second part 115 can also include both the K 43 yarn hole and the K 45 yarn groove in order to increase the positional flexibility of the plate 106, and allow both the underlying bone segment 27a or 27b to be converted relative to the other bone segment 27a or 27b. bone plate 106 further includes a bone anchor hole 41 illustrated as a variable angle hole 52 that extends transversely through each enlarged region 124a-b. in this way, one or both of the K 43 thread holes and the K 45 thread groove can be displaced laterally with respect to one or more bone anchor holes 41, to all bone anchor holes 41.
Referring now to Figure 4F, a substantially linear bone plate 130 further constructed according to an alternative embodiment includes a bone plate body 132 having an axis portion 134 that extends substantially along a central longitudinal axis 136, and defines a proximal end 138 and a distal end 140 opposite the proximal end 138 along the longitudinal axis 136. The axis part 134 further includes an intermediate part 135 that extends between the proximal end 138 and the distal end 140. The body of plate 132 further defines an inner surface facing bone 142 and an opposite outer surface 144 spaced from inner surface 142 along the transverse direction T. The body of plate 132 further defines surfaces on opposite sides 145 and 147 that are separate from each other along a direction A.
The bone plate 130 further includes a K 43 wire hole and a K 45 wire groove that extends through the first and second respective parts 131 and 133 of the plate body 132. The first part 131 can be arranged proximal to or away from the second part 133, so that the intermediate part 135 is arranged between the first and the second part. According to the illustrated embodiment, the bone plate 130 includes a plurality of bone anchor holes 41 illustrated as variable angle holes 52 arranged longitudinally outwardly with respect to the wire hole K 43 and the wire groove K 45, of so that the intermediate part 135 is devoid of openings 40. As illustrated in figure 4G, the proximal and distal ends 138 and 140 can extend laterally outwardly relative to the intermediate part 135 as desired.
Referring now to Figure 5A-D, it should be appreciated that bone anchors 30 can be provided as non-closing bone screws, a closing bone screw, a nail, a pin, or any fastener constructed alternatively to hold the bone plate 22 to the underlying bone 27. In addition, one or more of up to all bone anchors 30 can be provided as differently constructed bone anchors. For example, one or more of up to all bone anchors 30 can be provided as non-closing screws configured to be inserted through the bone plate (for example, in the head part or in the axis part) as one or more all bone anchors 30 can be provided as closing bone screws configured to be inserted through the bone plate (for example, in the head part or in the shaft part).
Referring to Figure 5A in particular, bone anchor 30 is illustrated as a non-closing screw 150, also known as a cortex screw. The non-closing screw 150 includes an axis 152 that extends distally from the screw head 153. The axis 152 can be at least partially threaded or serrated, and thus configured to be held in the underlying bone 27. As illustrated, axis 152 defines helical threads 154 on the surface thereof. The length of shaft 152 and the configuration of threads 154 (example, pitch, profile, etc.) may vary depending on the application. Axis 152 defines a tip end 156 which can be self-tapping and / or self-drilling to facilitate implantation of bone screw 150 in the underlying bone 27. Bone screw 150 may further include a cannula 158 that extends through the head 153 and axis 152, and is configured to receive a guide wire that assists in the proper placement of bone screw 150.
Head 153 defines a unscrewed engaging surface 155 configured to contact bone plate 22, and an opposite external driving surface 157 which includes a engaging member configured to mate with the complementary engaging member of a driving instrument that transmits a rotational movement in the bone screw 150 in order to drive the axis 152 into the underlying bone 27. During operation, the bone screw 150 is aligned with a bone anchor hole 41 of the type described above, and the axis 152 is driven through the aligned hole 41 and into the underlying bone 27. The axis 152 can be driven into the underlying bone 27 until the inner locking surface 155 abuts the bone plate 22, applying a compressive force there against the plate. bone 22 towards the underlying bone 27, and fixing the bone plate 22 to the underlying bone 27. The non-closing bone screw 150 may further be referred to as a compression bone screw. Generally the screw head 153 defines a smooth surface substantially on the internal locking surface 155, and has any compatible size and geometry corresponding to a selected anchor hole 41. The shape of the head 102 can be, for example, tapered, with straight faces , spherical, hemispherical, and the like. In certain cases it may be desirable for the unscrewed engaging surface 155 if it leans against the unscrewed inner surface of the bone plate 22 which at least partially defines a bone anchor hole 41.
Referring now to Figures 5B-C, a bone anchor 30 is illustrated as a closing bone screw 160 having a head 162 and an axis 164 extending distally from head 162 along central axis 165. The axis 164 can be at least partially threaded or serrated, and thus configured to be held in the underlying bone 27. As illustrated, axis 164 defines helical threads 166 on the outer surface thereof. Shaft length 164 and thread configuration 166 (example, pitch, profile, etc.) may vary depending on the application. Axis 164 defines a pointed end 168 which can be self-tapping and / or self-drilling to facilitate implantation of bone screw 160 in the underlying bone 27. Bone screw 160 may further include a cannula in the manner described above.
Head 162 defines a leading surface 170 configured to join with the complementary engaging member of a driving instrument as described above, and the threaded engaging surface 172 configured to join with the corresponding threads of the bone plate 22. A interlocking surface 172 defines helical threads 174 which define thread ridges 176 and rails 178 connected to each other by flanks 180, two adjacent flanks 180 defining a thread angle. Head 162, which is tapered in shape as is usual with known closing screws, is typically oriented so that the ridges of threads 176 lie in a straight line, such as lines 182 or 184, and the thread rails 178 lie on another straight line, such as lines 186 or 188, where the pairs of lines (182, 186) and (184, 188) are substantially parallel to each other, and can be parallel or not parallel to the central axis 165 of screw 160. For example, the outside diameter of threads 174 may decrease in a direction from head 162 towards tip 168. Lock screw 160 can also have a constant thread pitch (the distance between a ridge and the other, or from gutter to gutter) as measured along the central axis (example, 165).
During operation, the bone anchor 30 which can be provided as a non-closing screw 150 or a closing screw 160, can be inserted into one or more, up to all, bone anchor holes 41. The screws closing screws 160 and non-closing screws can be used alone or in combination with each other, on the head part and / or on the axis part of the bone plate 22. It should be appreciated that the non-closing screw 150 is configured to compress the bone plate 22 against the underlying bone 27 as it is pressed against the bone plate 22 in the bone anchor hole 41. The locking screw 160 is configured to threadably join with the threaded bone anchor hole 41 , in order to close the screw 160 on the bone plate 22, and affix the bone plate 22 to the underlying bone 27 without causing the compression of the bone plate 22 against the bone 27, or otherwise limit the compression of the bone plate 22 against the bone 27.
Referring now to Figure 5D, the bone anchor 30 is illustrated as a variable angle closing screw 190 having a head 192 and an axis 194 extending distally from the head 192 along the central axis 195. The axis 194 can be at least partially threaded or serrated, and thereby configured to be held in the underlying bone 27. As illustrated, axis 194 defines helical threads 196 on the outer surface thereof. The length of shaft 194 and the configuration of threads 196 (example, pitch, profile, etc.) may vary depending on the application. Axis 194 defines a pointed end 198 which can be self-tapping and / or self-drilling to facilitate implantation of bone screw 190 into the underlying bone 27. Bone screw 190 may further include a cannula in the manner described above.
The head of the screw 192 is shown to be at least partially spherical, and defines threads 200 on the outer surface thereof. Threads 200 can be double conducting threads, and define an arc-shaped profile 202 (example, non-linear or curved) along the radius of curvature. Threads 200 thus define a rail profile line 204a-f that intersects a center 206 of the radius of curvature, which is a distance 208 (measured perpendicularly) from the central axis 195 of screw 190. If, for example, the radius is 624 is 10 mm, the distance 208 can be about 8.2 mm for a 2.4 mm screw (the 2.4 mm refers to the larger diameter of the shaft 194). It should be appreciated, however, that at the same time that the radius of curvature increases, the 192 thread becomes less and less spherical in shape, causing the profile of the thread to become soft and more aligned with the straight line as described above in with respect to the closing screw 160.
The pitch of the thread can be constantly measured along the radius of curvature, but it can vary from narrow to wide to narrow when measured along the central axis 195 in a distal direction from the head 192 towards the tip 198. This thread profile allows that the variable angle lock screw fits into the variable angle hole 52 at a selectable angle within the mean of the angles while maintaining the same degree of contact with the bone plate regardless of the chosen angle. That is, the angle of the screw 190 with respect to the central axis of the bone plate hole 52 within the allowable mean of angles does not affect the fit of the screw head thread 200 with respect to the inner surface 55 of the plate hole 52. A tight closure is then obtained between the screw 190 and the bone plate 22 regardless of the angle (within the mean of angles) in which the screw 190 is inserted into the variable angle hole 52, because of the threads 200 that fit into the columns 56 of the thread segments 58 in exactly the same way, ensuring a good fit.
The non-closing bone screw 150, the closing bone screw 160, and the variable-angle closing bone screw 190 are further described in more detail in US Patent Application Publication No. 200/0140130, published on June 12 2008, disclosure of which is hereby incorporated by reference as set forth herein in its entirety.
Referring now to Figure 6A, the wire K 24 provides a temporary fixing member having a wire body 212 that is longitudinally elongated along a central axis 213. The wire body 212 defines a proximal part 214 and a part opposite distal 216 which is spaced from the proximal part 214 along the central axis 213. The wire K 24 includes a locking member 218 which is attached to the body of the wire 212 and separates the distal part 216 from the proximal part 214. The proximal and distal 214 and 216 can be cylindrical in shape or can define a compatible alternative shape as desired. The locking member 218 defines an external locking surface 220 which can be peripheral as illustrated, or can define any compatible alternative shape. For example, the outer surface 220 may be circular (for example, cylindrical or otherwise curved), polygonal, or the like, and thus compatible to be fitted by forceps 26.
The proximal part 214 of the K-wire is configured to be fitted by an insertion tool in order to be rotated. The distal part 216 of the K 24 wire is configured to be inserted through an opening 39 of the bone plate 22, and temporarily led in and thereby fixed to the underlying bone 27. In particular, the K 24 wire includes helical threads 222 in the distal part 216 and a conical or pointed conduction end or tip 224 which can have one or more cutting grooves as desired so that the thread K 24 can be self-threaded. The tip 224 is thus configured to be driven into the underlying bone to a depth so that the rotation of the wire K 24 causes the threads 222 to be driven into the bone 27. The threads 222 extend along the entire or a region of the distal part 216, for example, from a location for the tip 224 to a location close to the locking member 218. The threads 222 can extend to the locking member 218, or it can end at a location spaced distally from the member plug 218. Therefore, the wire K 24 can be guided into the underlying bone to a depth that causes the thrust member 28 to apply compression against the bone plate 22, or to a depth that causes the limb backrest 28 is spaced from the bone plate.
The wire body 212 can be of size and shape as desired, and according to an illustrated embodiment it is dimensioned so that the diameter of the proximal part 214 and the diameter of the external part of the threads 222 are both approximately 1.25 mm, although it should be appreciated that the diameter of the proximal end 24 and the outside diameter threads can be as desired in size, for example, approximately 1.6 mm, any distance between approximately 1.25 mm and approximately 1.6 mm, or any distance less than approximately 1.25 mm or greater than approximately 1.6 mm. In this regard, it should be appreciated that the outside diameter or cross-sectional dimension of threads 222 can be substantially equal to, greater than, or less than the diameter or cross-sectional dimension of the proximal part 214. As illustrated in 6A, the distal part 216 can have a first length, and as illustrated in Figure 6B, the distal part 216 'of the other wire K 24 can have a second length less than the first length of the distal part 216. The distal parts K 24 wires can be any length as desired, such as between approximately 1 mm and approximately 40 mm, or any alternative length compatible to extend across the bone plate and being attached to the underlying bone 27.
With continuous reference to figure 6A, the engaging member 218 may include an outer surface 220 that is spherical as shown, but may have any shape compatible to receive the force that polarizes the wire K 24 and the underlying bone in a desired position as defined through a bone plate opening 40 through which the distal part 216 extends. For example, the outer surface 220 can be cylindrical in shape on the central axis 213, or on any axis coinciding with or crossing the central axis 213. In this regard, the outer surface 220 can define a circular cross section, and a cross section oval, or any alternative polygonal or curved shape, regular or irregular, in cross section. Therefore, the outer surface 220 can define a curved surface in any direction as desired, or it can be polygonal, regular or irregular, angled, or it can define any alternative shape as desired. The spherical outer surface 220 allows the forceps 42 to engage the engaging member 218 at varying angles of approach, as described in more detail below. The locking member 218 can be integrally or distinctly attached (example, welded) to the body of the wire 212.
The outer surface 220 of the engaging member 218 defines an end facing a distal bone plate 226, an opposite proximal end 228, and an intermediate engaging surface 230 disposed between distal end 226 and proximal end 228. As described above with respect to the outer surface 220, the interlocking surface 230 can define a circular cross-section, and an oval cross-section, or any alternate polygonal or curved shape, regular or irregular, in cross-section. Therefore, the outer surface 220 can define a curved surface in any direction as desired, or it can be polygonal, regular or irregular, angled, or it can define any alternative shape as desired. The outer surface 220 can define a diameter or a cross-sectional dimension larger than that of the distal part 216 of the body of the wire 212, and in particular a lateral dimension that is larger than the distal part 216, and larger than the opening. 45 through which distal part 216 of wire K is inserted. Therefore, the engaging member 218 can provide a break that is configured to abut the bone plate 22 in a way that limits the deep insertion of the wire K 24 into the underlying bone 27.
The K 24 wires of the bone fixing system 20 can be similarly constructed and configured to be inserted into both the K 43 wire hole and the K 45 wire groove as described above. Alternatively, if the hole 34 and the groove 45 define different lateral dimensions, the K 24 wires can be provided with different diameter or lateral dimensions, one of which is equal to the diameter of the hole 34 and the other of which is equal to the lateral width of the groove 45. Wires 24 can be referred to temporary fixation members, temporary bone anchors or temporary bone fixation members, as they are guided into the underlying bone 27 and subsequently removed before completing the surgery or procedure fastening. Bone anchors 30, on the other hand, can be referred to as permanent bone anchors or permanent bone fixation members, as they remain implanted in the underlying bone 27 after the surgical procedure is complete, despite the bone anchors 30 can be removed in a second subsequent surgical procedure.
Referring now to Figures 7A-C, forceps 26 include a pair of articulated arms 250 connected to a joint 252, which divides arms 250 between a proximal part 254 and an opposite distal part 256. The proximal part 254 of each arm 250 defines a lever 258 which can have an external clamping surface 260, while the distal part 256 of each arm 250 defines a locking member 262 which is configured to lock the outer surface 220 of locking member 218 of the respective K 24 wire. The proximal part 254 of each arm 250 is generally flat, while the distal part 256 of each arm 250 extends in and out of the plane with respect to the proximal part 254. In particular, the distal end 256 is curved so that locking members 262 extend towards locking member 218 when lever 258 is spaced above (or outwardly) locking member 218.
The arms 250 are pivotally connected, so that when the levers 258 are brought together, the locking members 262 are also brought together, and when the levers 258 are separated, the locking members are also separated. Referring also to figure 7D, forceps 26 include a rack 264 which causes arms 250 to move together gradually. For example, one of the arms 250 carries a rack 266 which carries a plurality of teeth 268 extending outside the body of the rack 269. According to an illustrated embodiment, the rack 266 extends proximal 254 of the corresponding arm 250, and is articulated connected to arm 250 at a joint 270. Arm 250 can load rack 266 and also carry a guide 272 that defines a guide channel 273 that receives rack 266.
Opposite arm 250 carries a pair of opposite walls 274 that define a channel 276 between them. Channel 276 receives rack 266 which is directed into channel 276 by a guide 272, so that rack 266 is convertible into channel 276. The walls of channel 274 still carry at least one tooth 278 which can be a spring polarized within the socket with the teeth 268 of the rack 266. The tooth 278 and the teeth 268 can be configured so that the tooth 278 moves over the teeth 268 while the levers 258 are brought together. The force of the spring provides resistance while tooth 278 walks along each tooth 268, and polarizes tooth 278 within the depression between adjacent teeth 268 in order to provide tactile feedback like levers 258, and thus, the limbs of slot 262 gradually close. Teeth 268 and 278 can further be configured so that interference prevents tooth 268 from walking through teeth 278 when the separating force is applied to levers 258, if desired. Tooth 278 may include a locking surface 279 that can be compressed by a user against the force of the spring to bring tooth 278 out of the socket with teeth 268 to allow separation of levers 258, and thereby separation of the locking members 262. Alternatively, the teeth 268 and 278 can be configured so that the tooth 268 gradually travels along the teeth 278 in the manner described above both when the levers 268, and thus the locking members 262 are separated, and when levers 268, and thereby engaging members 262 are brought together.
Referring now also to Figure 7E, each locking member 262 defines an inner locking surface 280 that faces the corresponding inner locking surface 280 of each arm 250, and an opposite outer surface 282. When locking members 262 each a complementary locking member 218 of a corresponding K wire 24 engages, the inner surfaces 280 can convert the respective outer surfaces 220 of the locking members 218.
According to the illustrated modalities, each locking member 262 has a pocket 284 that protrudes into the outer surface 280. Pocket 284 can be any size and shape as desired, and thus has a corresponding inner locking surface 286 that can have any desired size and shape, so that the engaging surface 286 is configured to apply compressive force to a respective engaging member 218 of a K wire 24 that converts the corresponding K wire 24 inwardly to the opposite K wire 24. Pocket 284 has an open end 285 configured to at least partially receive the locking member 218 of the wire K 24 along a direction to the inner locking surface 286.
According to an illustrated embodiment, the engaging surface 286 extends along two radii of curvature which are directed substantially perpendicular to each other. One radius of curvature may be greater than the other, so that the locking surface 286 defines a vertical curvature substantially equal to that of the outer surface 220 of the locking members 218 of the K 24 wire. The locking surface 286 can define a radius horizontal curvature that is greater than the vertical radius of curvature, so that the engaging surface 286 has an average curvature that is greater in the vertical direction than in the horizontal direction. It should be appreciated that the vertical curvature can be circular and of a size and shape substantially identical to that of the outer surface 220 of the respective engaging member 218. The average horizontal curvature can be defined by a continuously curved surface, one or more angled surfaces, or a straight surface (thus defining an infinite radius of curvature). The curved surface 286 allows pocket 284 to reliably receive the respective locking member 218 at varying angles of approach. Alternatively, the horizontal curvature can be substantially identical to the vertical curvature, and thereby substantially identical to the spherical outer surface 220 of the locking member 218 of the K 24 yarn.
Referring again to figures 1A-B and 2H, during the operation, the bone plates 22 are aligned with a placement on or in an underlying bone 27 so that the intermediate part 35 extends over the bone gap 28, at least at least one bone anchor hole 41 is aligned with a bone segment 27a, and at least one bone anchor hole 41 is aligned with bone segment 27b. One of the K 24 wires is conducted through the K 43 wire hole and into the underlying bone segments 27a and 27b, and the other K 24 wire is conducted through the K 45 wire groove and into the other 27b or 27a bone segment. . The K 24 wire is guided through a location of the K 45 wire groove in a location separate from the tip 71. The bone gap site can be immediately photographed to ensure that the bone plate 22 is properly aligned with the underlying bone 27. Then, the levers 258 are separated until the locking members 262 are also further apart than the locking members 218 of the K 24 wires, so that the locking surfaces 286 fit over the locking members 218 .
Then, the forceps 26 are activated in order to drive the distal parts 256 of the arms 250 together so that the interlocking surfaces 286 move along the first direction C1 (see figure 7B) until they are brought into the initial interlock with and abuts or contacts the respective external locking surfaces 220 of the locking members 218. The first direction is angularly offset with respect to the central axis 213 of the wire body 212, and can, for example, be substantially perpendicular to the central axis 213 The pocket 284 at least partially receives the engaging member 218 at an open end 285, and thus does not circulate the engaging member 218.
A constant actuation of the forceps 26 in order to guide the locking members 262 along the first direction causes the locking surfaces 286 to apply a compressive force to the outer locking surface 220 of the wire K 24 disposed in the groove 45, thus polarizing the K wire out and causing the K wire 24 to convert into the groove towards the end 71 towards the opposite K wire 24. The opposite k wire 24 can be fixed in one position in the k 43 wire hole so that the movement of the wire K 24 disposed in the groove 45 towards the opposite wire K causes the corresponding underlying bone segment 27a and 27b to convert towards the other bone segment, thus reducing the bone gap 28 as illustrated in figure 1B. In this regard, it should be appreciated that the insert 262 of the forceps 26 can be referred to as a reducing insert. In this way, it can be said that at least one of the K 24 wires is convertible relative to the other K 24 yarn that can be fixed in one position. Referring also to Figure 9, once the bone gap 28 has achieved a desired reduction, at least one bone anchor 30 can be driven into a bone anchor hole 41 within a bone segment 27a, and at least one bone anchor 30 can be driven into a bone anchor hole 41 within a bone segment 27b, thereby fixing the bone segments 27a-b in their reduced configuration. The K 24 wires can then be removed once the bone anchors 30 have attached the bone plate 22 to the underlying bone 27. The locking members 218 of the K 24 wires can be brought along a minimum depicted distance of X1 (see figure 8B), which is achieved when the locking members 218 are received in the pockets 284 and touch each other.
It should be appreciated according to an alternative embodiment that the K 23 yarn hole can be replaced with a dedicated K yarn groove 45, or that the K 45 yarn groove can be added on the side of the intermediate part 35 which includes a bore hole. K wire 43. Thus, the bone plate 22 can include a pair of K 45 wire grooves disposed on opposite sides of the intermediate part 35 of the bone plate 22. Both K 24 wires can be inserted through the respective K wire grooves 45 in a separate location from the respective tips 71, so that both K 24 wires are converted into their respective grooves 45 towards each other. In this way, it can be said that both K 24 wires are removable in relation to each other. According to yet another embodiment, one of the K 24 wires can be disposed adjacent to the tip 71, or one of the K wires can be conducted into the bone 27 to a depth that causes the distal facing end 226 to compress against the bone plate 22, thereby securing the K wire in one position. In this way, the fit between the K 24 thread and the bone plate 22 can prevent the K thread from converting within the bone plate 22 while the other K 24 thread is free to convert relative to the other k 24 thread in the manner described above.
It should be appreciated that the K 43 thread groove and the hole 45 define respectively compatible cross sections for receiving the K 24 threads, but less than the bone anchor cross sections 30, so that the K 43 thread hole and the groove 45 are dedicated to receive only K 24 wires. However, it should still be appreciated that the K 23 wire hole and the K 25 wire groove can be multi-purpose, and configured to also receive a bone anchor 30. For For example, both one and both the K 23 wire holes and the K 25 wire groove can be provided as a bone anchor hole 41 each of size to receive a bone anchor 30 in the manner described above.
In particular, one or both of the K 24 wires can be inserted through a bone anchor hole 41 and opposite sides of the intermediate parts and conducted within the underlying bone. K 24 wires have a smaller cross-sectional diameter or dimension than bone anchor holes 41 in either one or both longitudinal directions. Therefore, one or both of the K 24 wires can initially be conducted to the underlying bone 21 at a location separate from the tip of the hole 41 (part of the inner surface that is closest to the opposite K wire hole), so that one or both the K 24 wires are converted into the respective hole 41 towards the other K 24 wire, thereby reducing bone failure 28 in the manner described above. It should be appreciated that one of the K 24 wires can initially be driven into the underlying bone 21 at a location adjacent to the tip of the hole 41 so that the tip prevents the K 24 wire from converting towards the opposite K 24 wire. Alternatively , one of the K 24 wires can be guided into the bone 27 to a depth that causes the end facing the distal bone plate 226 to press against the outer surface 40 of the bone plate 22, thus fixing the K 24 wire in the position, while the opposite K wire 24 can convert within the bone anchor hole 41 as desired.
Accordingly, it should be appreciated that the bone plate 22 can include at least one K 25 thread groove that can be formed from a bone anchor hole 41, a dedicated K thread groove 45, or any alternatively constructed opening 40 if extending across the bone plate 22 and having a dimension greater than the cross-sectional dimension of the distal part 216 of the K 24 wire, thus allowing the K 24 wire to convert into the groove 25. The bone plate may further include at least minus a hole of K 23 thread that can be formed from a bone anchor hole 41, a dedicated K thread hole 43, a dedicated K thread groove 45, or any alternatively constructed opening 40, at least partially defined by the surface ( which can be an inner surface such as the inner surface 55 shown in figure 2A or a bone plate surface 40) which is configured to prevent the hole of wire K 43 from converting towards the opposite wire K 24.
It should also be appreciated that the methods described here can include the steps of inserting K wire 24 into the underlying bone segments 27a-b without first placing the bone fixation plate over the bone segments, so that forceps 26 can trigger a or both K 24 wires in the manner described here to fit the K 24 wires, and thereby the underlying bone segments 27a-b, from a first relative position to a different second relative position in order to adjust accordingly to the size of the gap bone 28.
Referring now to Figure 8A, it should be appreciated that forceps 26 provide an instrument that can be configured to reduce bone failure 28 in the manner described above, and can be configured to distract bone segments 27a-b. therefore, if bone failure 28 is reduced, or bone segments 27a-b are distracted, it should be appreciated that at least one or both bone segments 27a-b are removed from the first position in relation to each other for a second position in relation to each other. Forceps 26 are configured to polarize at least one of the K threads 24 towards the other K thread in order to change the size of the bone gap 28. In particular, the engaging member 262 defines an inner pocket 284 in the manner described above. Each locking member 262 further defines a second outer pocket 300 that is configured to apply a force to the respective K24 thread that polarizes the K24 thread in a direction away from the opposite K thread 24. The outer pockets 300 are still spaced apart from each other. another, and are moved (example, recesses) from pockets 284 in relation to the first direction of travel and a second direction of travel D2 (see figure 8A) opposite the first direction D1. The pockets 300 can be any size and shape as desired, and thus have a corresponding outer engaging surface 302 that can be any size and shape as desired, so that the seating surface 302 is configured to apply a distracting force to a respective locking member 218 of a K 24 yarn which polarizes the K 24 yarn out of the opposite K yarn 24. According to an illustrated embodiment, the outer pocket 300 is substantially identical in shape to the inner pocket 284. Thus, the outer pocket 300 has an open outer end 301 configured to at least partially receive the locking member 218 of a K wire 24 along a direction to the outer locking surface 302.
According to an illustrated embodiment, the outer engaging surface 302 extends along two radii of curvature which are directed substantially perpendicular to each other. One radius of curvature may be greater than the other, so that the interlocking surface 302 defines a vertical curvature substantially equal to that of the outer surface 220 of the interlocking members 218 of the K 24 thread. The interlocking surface 302 can define a radius horizontal curvature that is greater than the vertical radius of curvature, so that the engaging surface 302 has an average curvature that is greater in the vertical than in the horizontal direction. It should be appreciated that the vertical curvature can be circular and of a size and shape substantially identical to that of the outer surface 220 of the respective engaging member 218. The average horizontal curvature can be defined by a continuously curved surface, one or more angled surfaces, or a straight surface (thus defining an infinite radius of curvature). The curved surface 302 allows pocket 300 to reliably receive the respective locking member 218 at varying angles of approach. Alternatively, the horizontal curvature can be substantially identical to the vertical curvature, and thereby substantially identical to the spherical outer surface 220 of the locking member 218 of the K 24 yarn.
Referring also again to figures 1A-B, 2H and 8B, during the operation the bone plate 22 is placed on the underlying bone 27 so that an intermediate part 35 extends over the bone gap 28, at least one hole of bone anchor 41 is aligned with a bone segment 27a, and at least one bone anchor hole 41 is aligned with a bone segment 27b. One of the K 24 wires is conducted through the K 43 wire hole and into one of the underlying bone segments 27a or 27b, and the other K 24 wire is conducted through the K 45 and even wire groove within another bone segment. 27b or 27a. The K wire is guided through a location of a K 45 thread groove in a separate location from the rear edge 73 so that the K thread 24 is convertible into the groove 45 towards the rear edge 73. Then, the levers 258 are brought close together so that pockets 300 are separated by a distance equal to or greater than Y1, which is the minimum achievable distance between pockets 300 when pockets 284 receive the respective locking members 218. It should be appreciated that the minimum distance Y1 is reduced when the pockets 284 are free of locking members 218. The distance Y1 is less than the distance between the locking members 218 of the K 24 wires so that the locking surfaces 302 fit between the locking members 218. Then, the distal parts 256 of the arms 250 are brought away from each other along a second direction until the interlocking surfaces 302 are brought into the initial interlock with a backrest or contact with the re respective external locking surfaces 220 of the locking members 218. The second direction is angularly offset with respect to the central axis 231 of the wire body 212, and can, for example, be substantially perpendicular to the central axis 213. Pocket 300 receives the locking member 218 at its open end 301, and thereby does not circulate the locking member and lock 218.
Another actuation of the distal parts 256 away from each other in a second direction causes the interlocking surfaces 302 to polarize on the external interlocking surface 220 of the K wire 24 arranged in a groove 45 outwardly, thus causing the conversion of the K wire 24 in the groove 45 towards the rear edge 73 away from the opposite K wire 24. The opposite K wire 24 can be fixed in one position in the hole of the K wire 43, so that the movement of the K wire 24 arranged in the groove 45 away from the opposite K wire causes the corresponding underlying bone segment 27a or 27b to convert away from the external bone segment, thereby distracting the bone gap 28 from a position, for example, shown in figure 1B to a position shown in figure 1A. In this regard, it should be appreciated that the insert 262 of the forceps 26 can also be referred to a distracting insert. Once bone failure 28 has achieved a desired distraction, at least one bone anchor 30 can be driven into a bone anchor hole 41 in bone segment 27b, thereby securing bone segments 27a-b in their configuration reduced.
It should be appreciated according to an alternative embodiment that the K 23 yarn hole can be replaced by a dedicated K yarn groove 45, or that the K 45 yarn groove can be added on the side of the intermediate part 35 which includes a bore hole. K wire 43. Thus, the bone plate 22 can include a pair of K 45 wire grooves disposed on opposite sides of the intermediate part 35 of the bone plate 22. Both K 24 wires can be inserted through the respective K wire grooves 45 in a location separate from the respective rear edges 73, so that both K 24 wires are convertible within their respective grooves 45 away from each other. In this way, it can be said that both K 24 wires are movable relative to each other. According to yet another embodiment, one of the K 24 wires can be disposed adjacent to the rear edge 73, or one of the K wires can be guided into the bone 27 to a depth that causes the end facing the distal bone plate 226 press against the bone plate 22, thus securing the K wire in one position. In this way, the fit between the K 24 thread and the bone plate 22 can prevent the K thread from being converted into the bone plate 22 while the other K 24 thread is free to convert relative to the other K 24 thread in the manner described above.
It should be appreciated that the K 43 thread groove and the hole 45 define respective cross sections compatible to receive the K 24 threads, but less than the bone anchor cross sections 30, so that the K 43 thread hole and the groove 45 are dedicated to receive only K 24 yarns. However, it should still be appreciated that the K 23 yarn hole and the K 25 yarn groove can be for a multiple purpose, and also configured to receive a bone anchor 30 from described above.
Thus, it should be appreciated that the bone plate 22 may include at least one K 25 thread groove which may be in the form of a bone anchor hole 41, a dedicated K thread groove 45, or any alternatively constructed opening 40 extending through the bone plate 22 and having a diameter greater than the cross-sectional dimension of the distal part 216 of the wire k 24, thus allowing the wire K 24 to convert into the groove 25. The bone plate 22 can also include at least one K 23 thread hole which may be in the form of a bone anchor hole 41, a dedicated K thread hole 43, a dedicated K thread groove 45, or any alternatively constructed opening 40, at least partially defined by the surface (which may be an inner surface such as the inner surface 55 shown in figure 2A or an outer bone plate surface 40) that is configured to prevent the bore of wire K from converting away from the opposite wire K 24.
It should be appreciated that the reduction pocket 284 and the distraction pocket 300 have been illustrated according to various modalities, and that the forceps 26 may include a reduction pocket 284 alone or in combination with a distraction pocket 300, or alternatively include a distraction pocket 300 without the reduction pocket 284. In addition, it should be appreciated that the engaging member 262 can be constructed according to any desired embodiment including any compatible reducing fitting surface and / or a distraction.
Referring now to Figures 8C-D, the outer pocket 300 can be substantially aligned with the inner pocket 284 with respect to the first and second travel directions. In this way, the locking members 218 of the K 24 yarns can be brought together at a minimum pictured distance of X1, which is achieved when the locking members 218 are received in the pockets 284 and abut each other. Levers 258 can be brought together so that pockets 300 are separated at a distance equal to or greater than Y2, which is the minimum distance reached between pockets 300 when locking members 218 are arranged in inner pockets 284, has been appreciated that the minimum distance Y2 can be reduced even further when the locking members 218 are arranged in the pockets 284. Due to the pockets 300 and substantially aligned with the pockets 284, the distance Y2 is greater than the distance Y1, which is reached when the pockets 300 and pockets 284 are offset in relation to the first and second travel directions.
Referring now to Figures 8E-F, locking member 262 is illustrated according to an alternative embodiment as a bifurcated locking member defining opposing inner and outer arms 350 and 352, respectively, which define a stake 354 between them. The space 354 is sized to receive the engaging member 282. The inner arm 350 defines a first surface 356 that faces the space 354, and an opposite outer surface 358 that faces the inner arm 352 of the other arm of forceps 26. The other arm 352 also defines a first surface 360 facing space 354, and an opposite outer surface 362. The engaging member 262 includes the reduction pocket 284 formed on the first surface 360 at a distal part of the outer arm 352, and the pocket of distraction 300 formed on the first surface 356 on the distal part of the inner arm 350. In this way, the reduction pocket 284 and the distraction pocket 300 face each other. Pockets 300 are shown to be at least partially aligned with pockets 284 along the first and second travel directions.
During operation, the locking members 218 and the wires 24 are received in the respective spaces 354, and the locking members 262 can be brought together, causing the locking members 218 to be received in the reduction pockets 284. As the members plug-in 262 are brought together, at least one of the plug-in members 218 converts towards the other in order to reduce bone failure 28 in the manner described above to a minimum distance of X3, which may be greater than, less than , or equal to X1 and X2, depending on the thickness of the arms 350 of the locking member 218. The locking members 262 can also be brought away from each other at a minimum separation distance from Y3, which can be greater than, equal to, or less than Y1 and Y2, depending on the dimensions of the locking members 262 and the locking member 218.
Referring now to figure 10, the bone fixation system 20 can also include a bone fixation plate 422, a temporary fixation member illustrated as a K wire 424, a second temporary fixation member illustrated as a support 425, and a forceps 426 configured to fit the K wire 424 and the support 425. The bone fixation plate 422 is placed against or in proximity to the underlying bone 27 and is affixed to the first bone segment 27a with a bone anchor. The K 424 wire is inserted through the plate 422 and into the second bone segment 27b, the support 425 is fixedly coupled to the bone plate 422 adjacent to the first bone segment, and the forceps 426 can apply a force to the K 424 wire and on support 425 in a way that converts at least one or both bone segments 27a and 27b, thereby adjusting the relative positions of the bone segments 27a and 27b with respect to each other.
Referring to figures 11A and 11B, an alternatively constructed bone fixation plate 422 includes a plate body 432 that extends substantially along a central longitudinal axis 431, and defines a proximal end 434 and a distal end 436 opposite proximal end 434 along a longitudinal axis 431. The body of plate 432 still includes an internal surface facing bone 438 and an opposite external surface 440 separated from the internal surface 438 along a transverse direction T. The body of plate 432 is still defines surfaces on opposite sides 442 and 444 that are separated from each other along a lateral direction A. The body of plate 432 includes a head portion 446 and a distal end 436 that can be configured and sized to adapt to the contour of the cortex close to the underlying bone 27, and an axis part 448 connected apart from the head 446 and longitudinally proximal to the head part 446. The axis part 448 can be r configured and sized to adapt to the contour of the cortex close to the underlying bone 27.
With continuous reference to figures 11A and 11B, bone plate 422 includes a plurality of openings 439 that extend transversely across the body of plate 432, from the inner surface facing bone 438 through the outer surface 440. As shown, openings 439 include a plurality of bone anchor holes 441, and a support receiving a hole 443. In particular, the head portion 446 includes a plurality of variable angle holes 452, and the shaft portion 448 includes a plurality of combined holes 457 which include a variable angle hole part combined with a fixed angle hole part.
As shown, at least one of the combined holes 457 includes a fixed angle hole portion 458 that is configured to receive the K wire 424. It should be understood, however, that the bone plate 422 can include openings 439 having another configuration. For example, at least one of the openings 439 can be configured as a compression hole, a threaded closure hole, or a combination of both or any other configuration as desired. In addition, the head portion 446 and the shaft portion 448 can include any of the openings as desired.
As shown in figure 11B, the support receiving the hole 443 extends through the head portion 446 of the bone plate 422. The support receiving the hole 443 includes a coupler 460, so that the threads 461 that are configured to fit the threads defined by support 425 to thus firmly couple support 425 to bone plate 422. It should be appreciated, however, that coupler 460 may include configurations other than threads 461, provided that support 425 can be fixedly coupled to bone plate 422. For example, coupler 460 can define a tapered inner surface that is configured as a slot in the mount. In addition, the support receiving hole 443 can be located anywhere along the bone plate 422. In particular, a hole receiving a dedicated support 443 can be positioned at other locations on plate 422 as desired. Alternatively, one of the bone anchor holes 441 or combination holes 457 can be configured to receive a support 425 there to define a hole receiving a support 443.
As shown in figure 11B, the combination hole 457 that includes an elongated fixed angle hole part 458 is configured to receive the K 424 wire so that the K 424 wire can be converted into the elongated fixed angle hole part 458 In this way, the elongated fixed angle hole portion 58 can be considered a K 564 yarn groove. As shown, the K 564 yarn groove includes a side dimension, and a longitudinal dimension that is larger than the side dimension for allow the K 424 yarn to be converted in a longitudinal direction. While the elongated fixed angle hole part 58 is illustrated as being combined with a variable angle hole, it should be understood that the elongated fixed angle hole part 58 may be a fixed angle hole alone that is not combined with a hole variable angle.
Now referring to Figures 12A and 12B, in an alternative embodiment, the yarn 424 provides a temporary fixing member having a yarn body 512 that is elongated longitudinally along a central axis 513. The yarn 424 can be referred to as a temporary fixation member, a temporary bone anchor, or a temporary bone fixation member, as it is guided into the underlying bone 27 and subsequently removed before completing the surgery or bone fixation procedure. The wire body 512 defines a proximal part 514 and an opposing distal part 516 which is separated from the proximal part 514 along the central axis 513. K wire 424 includes a first locking member 518 and a second locking member 519 which is attached to the body of wire 512 and separates distal part 516 from proximal part 514. The proximal part and distal part 514 and 516 can be cylindrical in shape or can define any compatible alternative shape as desired. The locking members 518 and 519 each define an outer locking surface 520 which can be spherical as shown, or can define any compatible alternative shape. For example, the outer surfaces 520 may be round (for example, cylindrical or otherwise curved), polygonal, or the like, and thus compatible to be fitted by the forceps.
The proximal part 514 of the K wire is configured to be fitted by an insertion tool in order to be guided in a rotating manner. The distal part 516 of the K 424 wire is configured to be inserted through an opening 439 of the bone plate 422, and temporarily led in and thus fixed to the underlying bone 27. In particular, the K 424 wire includes helical threads 522 in the part distal 516 and a conical or pointed conductive end or tip 524 which can have one or more cutting grooves as desired so that the K 424 thread can be self-threaded. The tip 524 is thus configured to be driven into the underlying bone to a depth so that rotation of the K 424 thread causes threads 522 to be driven into bone 27. Threads 522 extend across an entire region from the distal part 516, for example, from a location close to the tip 524 to a location close to the second socket segment 519. The threads 522 can extend to the second socket member 519, or it can end in a separate location distally from the second plug member 519.
In continuous reference to Figure 12B, the first locking member 518 may include an outer surface 520 that is spherical as shown, but may have any compatible shape to receive a force that polarizes the K 424 wire and the underlying bone in a desired direction as defined by the bone plate opening 458 through which the distal part 516 extends. For example, the outer surface 520 may be cylindrical in shape on the central axis 513, or on any axis coinciding with or crossing the central axis 513. In this regard, the outer surface 520 may define a circular cross section, an oval cross section , or any alternative polygonal or curved shape, regular or irregular, in cross section. Therefore, the outer surface 520 can define a curved surface in any direction as desired, or it can be polygonal, regular or irregular, angled, or it can define any alternative shape as desired. The spherical outer surface 520 allows the forceps to engage the engaging member 518 at varying angles of approach. The locking member 518 can be integrally or distinctly attached (example, welded) to the wire body 512.
Similarly, the second locking member 519 is positioned distally to the first locking member 518 and can include an outer surface 520b that is spherical as shown, but can have any shape compatible for at least one of the force receivers that polarize the wire K 242 and it provides a resting surface within the elongated fixed angle part 458 through which the K 424 wire extends. For example, the outer surface 520b can be cylindrical in shape on the central axis 513, or on any axis coinciding with or crossing the central axis 513. In this regard, the outer surface 520b can define a circular cross section, an oval cross section , or any alternative polygonal or curved shape, regular or irregular, in cross section. Therefore, outer surface 520b can define a curved surface in any direction as desired, or it can be polygonal, regular or irregular, angled, or it can define any alternative shape as desired. The second locking member 519 can be integrally or distinctly attached (example, welded) to the wire body 512.
When the K 424 thread is to be inserted into the elongated fixed shaft hole 458 of the combination hole 457, the outer surface 520b of the second locking member 519 will abut the bone plate 422 in order to allow the deep insertion of the K thread 424 within the underlying bone 27. Because the elongated fixed axis part 458 is a recess, the second locking member 519 will be a recess within the elongated fixed axis part 458 positioning the first locking member 518 there to be engaged by the forceps. As shown, the second locking member 519 is distal to and close to the locking member 518. In the illustrated embodiment the second locking member 519 abuts the first locking member 518, although it should be understood that the first and second locking member 518 and 519 can be separated along the body of the K 512 wire. In addition, if the K 424 wire is inserted through a hole so that the groove 45 of the bone plate 22 shown in figure 2A, the outer surface 520b of the second fitting member 519 does not lean against the bone plate 22, but will also be fitted by the forceps.
Referring to figures 13A and 13B, support 425 provides a temporary fixing member having a body support 612 that is longitudinally elongated along the central axis 613. Support 425 can be referred to as a temporary fixing member, or a temporary plate fixation member, as it is fixedly attached to plate 422 and subsequently removed before completing the surgery or bone fixation procedure. The support body 612 defines a proximal part 614 and an opposite distal part 616 which is separated from the proximal part 614 along the central axis 613. The support 425 includes a locking member 618 which is attached to the body of the support 612 and separates the distal part 616 of proximal part 614. The proximal and distal part 614 and 616 can be cylindrical in shape or can define any compatible alternative shape as desired. The locking member 618 can define an external locking surface 620 which can be spherical as shown, or can define a compatible alternative shape. For example, the outer surface 620 may be round (for example, cylindrical or otherwise curved), polygonal, or the like, and thus compatible to be fitted by the forceps.
The proximal part 614 of the support 425 is configured to be fitted by an insertion tool in order to be guided in a rotational manner. The distal part 616 of the support 425 is configured to be inserted into the support receiving a hole 443 of the bone plate 422, and temporarily fixedly attached to the bone plate 422. In particular, the support 425 includes a coupler such as the helical threads 622 in the distal part 616 which are configured to fit the internal threads 461 defined by a hole receiving the support 443 of the bone plate 422. In the illustrated embodiment the distal part 616 screw, although it should be understood that the distal part 616 can include other configurations such as wanted.
In continuous reference to Figure 13B, the engaging member 618 may include an outer surface 620 that is spherical as shown, but may have any shape compatible to receive a force that polarizes the support 425. For example, the outer surface 620 may be cylindrical in shape on the central axis 613, or on any conscious axis with or crossing the central axis 613. In this regard, the outer surface 620 may define a circular cross section, an oval cross section, or any alternative polygonal or curved shape, regular or irregular, in cross section. Therefore, the outer surface 620 can define a curved surface in any direction as desired, or it can be polygonal, regular or irregular, angled, or it can define any alternative shape as desired. The spherical outer surface 620 allows the forceps to engage the engaging member 618 at varying angles of approach. The locking member 618 can be integrally or distinctly attached (example, welded) to the body of the support 612.
When the support 425 is to be inserted into the hole receiving a support 443 of the bone plate 422, the outer surface 620 of the engaging member 618 will abut with the bone plate 422. At this time the support 425 will be fixedly attached to the bone plate 422, and the outer surface 620 of locking member 618 will be positioned to be engaged by the forceps along with the first locking member 518 of the K424 wire.
Referring to figures 14A and 14B, forceps 426 can be configured as a compression forceps 426a as shown in figure 14A or a distraction forceps 426b as shown in figure 14B. As shown in figures 14A and 14B, forceps 426 include a pair of arms 650 hingedly connected together in a joint 652, which divides arms 650 between a proximal part 654 and an opposite distal part 656. The proximal part 654 is similar to the proximal 254 of forceps 26 shown in figure 7C. Distal parts 656 of forceps 426 extend substantially perpendicular to the bone plate when forceps 426 is in use. Such a configuration allows an approximation above bone plate 422 with forceps 426. Like forceps 26, the distal part 656 of each arm 650 of forceps 426 defines a locking member 662 that is configured to fit the outer surfaces 520 and 620 of the K wire 424 and support 425 respectively.
Referring to figure 14A, forceps 426a are configured for compression. Therefore, as the proximal parts 654 of the arms 650 are brought together, the locking members 662 are also brought together, and when the proximal parts 654 are separated, the locking members 662 are also separated. As shown in Figure 14A, each locking member 662 defines a locking surface 680 that faces the corresponding inner locking surface 680 of the other arm 650, and an opposite outer surface 682. When locking members 662 each fit a locking member complementary fitting 518 or 618 of the K 424 yarn and support 425, the inner surfaces 680 can abut the respective outer surfaces 520 and 620 of the interlocking members 518 and 618 respectively.
According to an illustrated embodiment, each locking member 662 includes a pocket 684 projecting onto the inner surface 680. Pockets 684 are configured to receive the locking members 518 and 618 of the K 424 yarn and the support 425 respectively.
Now referring to figure 14B, forceps 426b are configured for distraction. Therefore, proximal parts 654 of arms 650 are brought together, locking members 662 are reciprocally separated from each other, and when proximal parts 654 are separated, locking members 662 are reciprocally brought together. As shown in figure 14B, each locking member 662 defines an outer surface 780 that faces away from the corresponding locking surface 780 of the other arm 650, and an opposite inner surface 782. When the locking members 662 each fits a locking member complementary plug 518 or 618 of the K 424 wire and the support 425, the inner surfaces 780 can abut the respective outer surfaces 520 and 620 of the plug members 518 and 618 respectively.
According to an illustrated embodiment, each locking member 662 of forceps 426b includes a pocket 784 that protrudes into the outer surface 780. Pockets 784 are configured to receive the locking members 518 and 618 of the K 424 wire and the support 425 respectively.
It should be understood that forceps 426, bone plate 422, wire K 424, and support 425 can alternatively be configured to include any of the characteristics of forceps described above, bone plates and K wires. For example, forceps 426 may include arms defining internal and external interlocking surfaces as shown in figure 8B or 8C, or arms with front loaded pockets as shown in figure 8E. Similarly, the bone plate 422 can include alternative shapes, openings, and configurations as desired, the K 424 yarn and the support 425 can include features described in conjunction with the K 24 yarns shown in figures 6A and 6B.
Now referring to figures 15A-17B, the bone fixation system 20 shown in figure 10 can be configured in a variety of ways to move the bone segments relative to each other. For example, system 20 can be configured to compress bone segments using forceps 426a, distract bone segments using forceps 426a, compress bone segments using forceps 426b, and / or distract bone segments using forceps 426b depending on the positions of the K 424 wire and the support.
As shown in figure 15A, in a configuration of the bone plate 422 can be affixed to the first bone segment 27a with a bone anchor 30, the support 425 is fixedly coupled to the bone plate 422 adjacent to the first bone segment 27a, and the K wire 424 extends through the bone plate 422 and into the second bone segment 27b. In particular the support 425 is fixedly coupled to the support receiving a hole 443 and the wire K 424 extending through the elongated fixed angle hole 458. The forceps 426a can then be positioned so that the locking members 520 and 620 of the K wire 424 and the support 425 are received by the pockets 684 defined by the support members 662. By compression or otherwise activating the forceps 426a the engaging members 662 are polarized towards each other and at least one of the first bone segment 27a and the second bone segment 27b moves towards the other, thereby reducing the bone gap defined between the bone segments. In this configuration and with forceps 426a, the first and second bone segments are pulled towards each other by polarizing forces against the K 424 wire and the support 425.
Alternatively, bone segments 27a and 27b can be moved away from each other or otherwise distracted if forceps 426b are used. As shown in figure 15B, forceps 426b can be positioned so that locking members 520 and 620 of wire K 424 and support 425 are received by pockets 784 defined by locking members 662 of forceps 426b. Distracting or otherwise activating forceps 426b, locking members 662 are polarized away from each other and at least one of the first bone segment 27a and the second bone segment 27b moves away from each other to distract the failure there bone defined between bone segments. In this configuration with forceps 426b, a first and a second bone segment are pushed away from each other by polarizing forces against the K 424 wire and the support 425.
In another configuration and with reference to figure 16A, the bone plate 422 can be fixed to the first bone segment 27a with a bone anchor 30, the support 425 is fixedly coupled to the bone plate 422 adjacent to the second segment 27b, and the K wire 424 extends through bone plate 422 and into the second bone segment 27b at a location closer to the bone gap than support 425. In particular support 425 is fixedly coupled to a variable angle hole that defines a support receiving a hole 443, and the K wire 424 extending through the elongated fixed angle hole 458. The forceps 426b can then be positioned so that the locking members 520 and 620 of the K wire 424 and the support 425 are received through pockets 784 defined by support members 662. Distracting or otherwise activating forceps 426b, engaging members 662 are polarized away from each other and at least one of the first bone segment 27a and the second bone segment 27 b move towards each other to reduce the bone gap defined between the bone segments there. In this configuration and with forceps 424b, the first bone segment 27a is pulled by the polarizing force against the support 425, and the second segment 27b is pushed by the polarizing force against the K 424 wire.
Alternatively, bone segments 27a and 27b can be moved away from each other or otherwise distracted if forceps 426a are used. As shown in figure 16B, the forceps 426a can be positioned so that the locking members 520 and 620 of the K wire 424 and the support are received by the pockets 684 defined by the locking members 662 of the forceps 426a. By compressing or otherwise activating forceps 426a, locking members 662 are polarized towards each other and at least one of the first bone segment 27a and the second bone segment 27b move away from each other to distract the bone failure defined between bone segments. In this configuration and with forceps 424a, the first bone segment 27a is pushed by the polarizing force against the support 425, and the second segment 27b is pulled by the polarizing force against the K wire 424.
In another configuration and with reference to figure 17A, the bone plate 422 can be affixed to the first bone segment 27a with a bone anchor 60, the support 425 is fixedly coupled to the bone plate 422 adjacent to the second bone segment 27b, and the K 424 wire extends directly into the second bone segment 27b at a different location of the bone gap than in the support 425. In particular the support 425 is fixedly coupled to a variable angle hole that defines a support receiving a hole 443 , and the K 424 wire extending into the second bone segment 27b without stopping through the bone plate 422. The forceps 426a can then be positioned so that the locking members 520 and 620 of the K 424 wire and the support 425 are received by the pockets 684 defined by the socket members 662. By compressing or otherwise activating the forceps 426a, the socket members 662 are polarized towards each other and at least one of the first bone segment 27a and the second bone segment 27b move towards each other to reduce the bone gap defined between the bone segments there. In this configuration and with forceps 424a, the first bone segment 27a is pulled by the polarizing force against the support 425, and the second segment 27b is pushed by the polarizing force against the K wire 424.
Alternatively, bone segments 27a and 27b can be moved away from each other or otherwise distracted if forceps 426b are used. As shown in figure 17B, the forceps 426b can be positioned so that the locking members 520 and 620 of the K wire 424 and the support 425 are received by the pockets 784 defined by the locking members 662 of the forceps 426b. Distracting or otherwise activating forceps 426b, locking members 662 are polarized away from each other and at least one of the first bone segment 27a and the second bone segment 27b s move towards each other to distract the failure there bone defined between bone segments. In this configuration and with forceps 424b, the first bone configuration 27a is pushed by the polarizing force against the support 425, and the second segment 27b is pulled by the polarizing force against the K wire 424.
It should be appreciated that the bone fixation set can be provided in a way that includes at least one or more, up to all, components of the bone fixation system 20, including, but not limited to one or more bone fixation plates which may be of the same or different shape and size, a plurality of guide wires which may be of the same or different size and shape, a plurality of the same or different configured bone anchors, and one or more same or different configured forceps. It should be appreciated that the components of the bone assembly can be provided as described above in relation to the various alternative modalities and modalities. In addition, the components of the set can be sold at the same time in a common package, or at different times in different packages.
It should be appreciated that the methods described here can include the steps of inserting the K wires into the underlying bone segments 27a-b without first placing the bone fixation plate over the bone segments, so that the forceps can drive the K wires in the manner described here to fit the underlying bone segments 27a-b from a first relative position to a different second relative position. In this regard, the bone fixation set described above can include one or more bone fixation plates as desired, or it can be devoid of bone fixation plates.
The modalities described in connection with the illustrated modalities have been presented by way of illustration, and the present invention, therefore, is not intended to be limited to the disclosed modalities. In addition, the structure and characteristics of each of the modalities described above can be applied to other modalities described here, unless otherwise indicated. Therefore, those skilled in the art will realize that the invention is intended to involve all modifications and alternative arrangements included within the spirit and scope of the invention, for example, as set out in the appended claims.

权利要求:
Claims (38)
[0001]
1. Forceps (26; 426) configured to apply a polarizing force to a pair of temporary fixation members (24; 424; 425), each temporary fixation member (24; 424; 425) having a distal part (216; 516; 616) and a locking member (218; 518; 618) disposed close to the distal part (216; 516; 616), the locking member (218; 518; 618) defining a dimension greater than that of the distal part ( 216; 516; 616), the forceps (26; 426) comprising: a pair of arms (250), each arm (250) having: a proximal end (254) and an opposite distal end (256); a locking member (262) defining a pocket (284) extending at the distal end (256), the pocket (284) defining a locking surface (286) having a shape corresponding to that of the locking member (218; 518; 618) of the temporary fixing member (24; 424; 425), the interlocking surface (286) extending along a first radius of curvature that defines a first profile of circular or oval cross section, having the pocket (284) an open end (285) configured to receive at least partially the locking member (218; 518; 618) along a direction towards the locking surface (286) and, therefore, not to surround the locking member (218; 518; 618); wherein the relative movement of the arms (250) causes the distal ends (256) to move correspondingly, so that each pocket (284) receives at least partially a respective temporary fixation member (24; 424; 425) and the interlocking surface (286) applies a pressure force against the work member (218; 518; 618) of the received temporary fixation member (24; 424; 425); and characterized by the fact that the interlocking surface (286) extends along a second radius of curvature that is directed perpendicular to the first radius of curvature and defines a second profile of circular or oval cross section, so that the shape of the fitting surface (286) corresponds to a spherical or ovoid shape of the fitting member (218; 518; 618).
[0002]
2. Forceps according to claim 1, characterized by the fact that the pockets of each arm face each other, so that the interlocking surfaces are configured to apply a compressive force to the interlocking members of the respective temporary fixing members. when the distal ends are joined.
[0003]
3. Forceps according to claim 2, characterized by the fact that the pockets are the first pockets, and each arm comprises a second pocket at the distal end, so that the first and second pockets of each arm are spaced apart from each other , each second pocket defining a locking surface having a shape corresponding to the locking member of the temporary fixing member, so that the locking surfaces are configured to apply a distracting force to the locking members of the respective temporary fixing members when the distal ends are separated.
[0004]
4. Forceps according to claim 3, characterized by the fact that the second pocket of each arm is aligned with the first pocket along a direction that is perpendicular to a vertical direction.
[0005]
5. Forceps, according to claim 3, characterized by the fact that the second pocket of each arm is displaced in relation to the first pocket.
[0006]
6. Forceps according to claim 3, characterized in that the second pockets define a second interlocking surface having a horizontal radius of curvature and a vertical radius of curvature
[0007]
7. Forceps according to claim 1, characterized by the fact that each fitting member of the forceps is bifurcated and comprises the first and second arms that define a space between them, the space dimensioned to receive the fitting member of the member temporary fixing.
[0008]
8. Forceps according to claim 1, characterized by the fact that the pockets face each other, so that the interlocking surfaces are configured to apply a compressive force to the interlocking members of the respective temporary fixing members when the ends distal are joined.
[0009]
9. Forceps, according to claim 1, characterized by the fact that the handles are coupled in an articulated manner.
[0010]
10. Forceps according to claim 9, characterized by the fact that the distal ends are moved closer, as the handles are moved closer.
[0011]
11. Forceps according to claim 9, characterized by the fact that the distal ends are moved further apart, as the handles are moved apart.
[0012]
12. Forceps according to claim 1, characterized by the fact that it comprises a rack connected between the arms and configured to gradually move the arms when a force is applied to the arms.
[0013]
13. Forceps according to claim 1, characterized in that the locking surface is in accordance with the locking member of the temporary fixing member along at least one direction.
[0014]
14. Forceps according to claim 13, characterized by the fact that the engaging surface is circular in the direction.
[0015]
15. Forceps, according to claim 1, characterized by the fact that each temporary fixation member is a K wire configured to fit bone segments.
[0016]
16. Forceps according to claim 1, characterized by the fact that one of the temporary fixation members is a K wire configured to fit bone segments, and the other among the temporary fixation members is a support configured to engage a bone plate .
[0017]
17. Forceps according to claim 1, characterized in that the interlocking surface defines a horizontal radius of curvature that is greater than a vertical radius of curvature.
[0018]
18. Bone fixation set (20), characterized by the fact that it comprises: at least one bone fitting plate (22; 74; 88; 106; 130; 422) including a plurality of openings (39; 41; 43; 45 ; 52; 57; 43; 439; 441; 443; 445; 452; 457), at least some of which are configured to receive the respective bone fitting members (30); a forceps according to any one of claims 1 to 17.
[0019]
19. Bone fixation set according to claim 18, characterized in that the opening that receives the temporary fixation member that extends to the underlying bone segment comprises a groove.
[0020]
20. Bone fixation set according to claim 19, characterized in that the groove defines a lateral dimension and a longitudinal dimension greater than the longitudinal dimension, so that the temporary fixation element received in the groove is convertible longitudinally within of the groove and fixed laterally inside the groove.
[0021]
21. Bone fixation set according to claim 18, characterized in that another of the openings comprises a hole that receives the other of the temporary fixation members.
[0022]
22. Bone fixation set according to claim 21, characterized by the fact that the hole has a size substantially equal to that of the distal part of the respective temporary fixation member, so that the respective temporary fixation member is fixed in a way convertible into the bore in relation to the movement in relation to the other temporary fixing member.
[0023]
23. Bone fixation set according to claim 21, characterized by the fact that the temporary fixation member that is received by the hole defines a support.
[0024]
24. Bone fixation set according to claim 23, characterized by the fact that the hole is a pole receiving hole that includes a coupler, and the bracket defines a coupler that is configured to fit the hole coupler so couple the bone fixation plate support.
[0025]
25. Bone fixation set according to claim 24, characterized by the fact that the couplers are helical threads.
[0026]
26. Bone fixation set according to claim 18, characterized by the fact that the hole is a K wire hole and the temporary fixation member that is received by the K wire hole defines a K wire that is configured to extend through the K wire hole and into the other underlying bone segment of the underlying bone segment pair.
[0027]
27. Bone fixation set according to claim 18, characterized by the fact that the openings include at least one of a closure hole, a compression hole and a combination hole that includes a compression part and a part of closure.
[0028]
28. Bone fixation assembly according to claim 18, characterized in that the openings include at least one of a variable angle hole, a fixed angle hole and a combination hole that includes an angle hole part variable and a fixed angle hole part.
[0029]
29. Bone fixation set according to claim 18, characterized by the fact that it comprises a plurality of permanent bone fitting members configured to extend through some of the openings, in order to fix the bone fixation plate in the bone segments underlying.
[0030]
30. Bone fixation assembly according to claim 29, characterized in that the permanent bone fitting members include at least one of a locking screw, a non-locking screw and a variable angle screw.
[0031]
31. Bone fixation set according to claim 18, characterized by the fact that the bone fitting plate is configured to fit one of a forefoot, a midfoot bone, a hindfoot bone and a distal tibia.
[0032]
32. Bone fixation set according to claim 18, characterized in that the temporary fixation members comprise a K wire.
[0033]
33. Bone fixation set according to claim 32, characterized in that the distal part of the K wires is threaded.
[0034]
34. Bone fixation set according to claim 18, characterized by the fact that at least one of the temporary fixation members includes a second fitting member that defines a cross-sectional dimension greater than that of the distal part.
[0035]
35. Bone fixation set according to claim 34, characterized in that the engaging members of at least one temporary fixing member abut one another and are aligned along a central axis of at least one member of temporary fixation.
[0036]
36. Bone fixation assembly according to claim 34, characterized in that the opening receiving the temporary fixation member extending to the underlying bone segment comprises a combination hole with an elongated fixed angle part.
[0037]
37. Bone fixation set (20), characterized by the fact that it comprises: at least one pair of temporary bone fitting members (24; 424; 425), each temporary bone fixation member (24; 424; 425) having a proximal part (214; 514; 614), a distal part (216; 516; 616) and a locking member (218; 518; 618) disposed between the proximal part (214; 514; 614) and the distal part (216 ; 516; 616), the locking member (218; 518; 618) defining a cross-sectional dimension greater than that of the distal part (216; 516; 616), so that an external surface of the locking member (218; 518; 618) define a distal end facing the bone plate (226) and an opposite proximal end (228), in which the temporary bone fixation members (24; 424; 425) are configured to extend to the respective underlying bone segments that are separated by a bone crack; and the forceps according to any one of claims 1 to 17.
[0038]
38. Bone fixation set according to claim 37, characterized by the fact that the external surface is spherical.

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法律状态:
2017-10-24| B15I| Others concerning applications: loss of priority|

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2017-12-12| B12F| Appeal: other appeals|

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2019-10-29| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|

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2020-08-25| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|

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2020-12-01| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 27/04/2011, OBSERVADAS AS CONDICOES LEGAIS. |

优先权:

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申请号 | 申请日 | 专利标题

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US32827810P| true| 2010-04-27|2010-04-27|

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US61/328.278|2010-04-27|

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US37221210P| true| 2010-08-10|2010-08-10|

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US61/372.212|2010-08-10|

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PCT/US2011/034113|WO2011137163A1|2010-04-27|2011-04-27|Bone fixation system including k-wire compression|

---