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    • 专利摘要:
    The invention relates to an implant (1) for arthrodesis of a first bone (2) with a second bone (3), said implant (1) being characterized in that it comprises: - an anchoring body (4) ) substantially rigid and non-deformable, designed to anchor the implant (1) in the first bone (2), the anchor body (4) extending between a penetration end (6) and an end base (7) opposite, and - a deformable portion (5) designed to anchor the implant (1) in the second bone (3), said deformable portion (5) comprising two anchoring arms (9). , 10, 11) projecting from the anchoring body (4) from the base end (7) thereof, the anchoring arms (9, 10, 11) being separated so as to be brought closer to each other by deformation of said anchoring arms under the action of the second bone (3). Surgical implants of osteosynthesis.
    公开号:FR3024835A1
    申请号:FR1457860
    申请日:2014-08-18
    公开日:2016-02-19
    发明作者:Daniel Edmond Boublil；Jean-Yves Paul Albert Coillard-Lavirotte
    申请人:In2Bones SAS；
    IPC主号:
    专利说明:

    [0001] The invention relates to the general field of surgical implants for osteosynthesis, and in particular to phalangeal implants intended to be placed in the body of a patient, at the hand or foot of the latter, to allow the fusion of two phalanges. The invention more specifically relates to an arthrodesis implant for promoting bone fusion of a first bone with a second bone. The invention also relates to an instrument for gripping an arthrodesis implant. In order to treat certain bone diseases, and in particular phalanges, such as inter-phalangeal deformities, toes in claws or hammers, or osteoarthritis, it is sometimes necessary to perform arthrodesis, that is to say ie to cause an interosseous fusion to fix one bone with respect to the other. In the case of phalanges for example, it is known to set up an intramedullary implant during a surgical procedure, which aims to secure two phalanges relative to one another, in order to train their bone fusion. In this case, this type of surgical implant has a distal portion intended to be anchored in the medullary canal of one of the two phalanges, and a proximal portion which can be anchored in the medullary canal of the second phalanx. Such known arthrodesis implants are most often made to form an integral piece, which makes it possible to improve their longevity in the body of the patient, so for example not to need to be removed. of said body. Such a design can sometimes also reduce the cost of manufacture. Nevertheless, the use of a single material is likely in some cases not to fully satisfy the patient's anatomy. Indeed, in most patients, within the same skeleton, certain bone bodies frequently have different hardnesses, so that the hardness or flexibility of a given implant can, while being particularly adapted to the hardness of one of the two phalanges, not be adapted to the hardness of the other phalanx. More generally, the implant may be unsuitable for its installation environment, because of the great variability of the latter.
    [0002] Too much maladjustment of the hardness of the material to the bone is likely to be a source of pain, insofar as the implant, when it is too rigid or too hard taking into account the mechanical properties of the bone, may damage said bone at the pose, or a posteriori, especially in the case of a patient with a weakened bone structure. This maladjustment may also be the cause of an extension of the duration of the therapy, insofar as the osteosynthesis, that is to say the bone reconstruction, may be hindered by the excessive hardness of the implant. to one of the bones. On the contrary, excessive flexibility can cause accidental removal of the implant of the medullary canal, or infections, especially in an elderly patient. Moreover, a bone of excessive rigidity relative to the implant, is likely to use the latter, so as to affect its longevity. Such an implant thus has the risk, in case of excessive wear, of having to be removed from the body of the patient during a second surgical removal of said implant. Of course, this involves a substantial additional cost, a waste of time, and a potential risk to the health of the patient, particularly in the case of an elderly patient. Furthermore, the installation of known implants can sometimes be difficult, especially in the case where the implant is particularly flexible. Indeed, if the surgeon can use a grasping tool to firmly hold the implant when it is introduced into the medullary canal of the bone, the flexible portion of the implant that is introduced may deform inappropriately to the moment of insertion, and make this operation difficult and imprecise. Thus, the known implants do not appear to have the characteristics sufficient to be both easy to implement, reliable, robust, and versatile to adapt to the morphology of each patient while allowing a relatively fast and painless arthrodesis.
    [0003] The objects assigned to the present invention therefore aim to remedy the various disadvantages listed above and to propose a new implant and a new instrument for gripping such an implant, particularly adapted to the physiology and morphology of the patient, and presenting a great versatility of use and adaptation to its installation environment. Another object of the invention is to propose a new implant and a new instrument for gripping such an implant, whose holding in the body of the patient is particularly reliable. Another object of the invention is to propose a new implant and a new instrument 10 for gripping such an implant, particularly robust and resistant. Another object of the invention is to propose a new implant and a new instrument for gripping such an implant, making it possible to limit the pain experienced by the patient. Another object of the invention is to propose a new implant and a new instrument for grasping such an implant, making it possible to treat a patient's bone pathology in a particularly efficient and rapid manner. Another object of the invention is to propose a new implant and a new instrument for grasping such an implant, which is easy to put into place in the body of the patient. Another object of the invention is to propose a new implant and a new instrument for gripping such an implant, the manufacture of which is relatively easy.
    [0004] Another object of the invention is to propose a new implant and a new instrument for grasping such an implant, making it possible to reduce the cost of the surgical procedure for placing the implant. Another object of the invention is to propose a new implant and a new instrument for gripping such an implant, making it possible to reduce the risk to the health of the patient related to implant placement and therapy.
    [0005] The objects assigned to the invention are attained by means of an arthrodesis implant making it possible to promote the bone fusion of a first bone with a second bone, said implant being characterized in that it comprises: a substantially rigid and non-deformable anchor body, adapted to anchor the implant in the first bone, the anchor body extending between a penetrating end in said first bone and an opposite base end, and a deformable portion adapted to anchor the implant in the second bone, said deformable portion comprising at least two anchor arms that protrude from the anchor body from the base end thereof , the anchoring arms being separated from each other by a free space so as to be brought closer to each other by deformation of said anchoring arms under the action of the second bone. The objects assigned to the invention are also achieved with the aid of an instrument for grasping an implant according to the invention, the grasping instrument comprising a detachable attachment end of the implant with the instrument of gripping, through the deformable portion of said implant. Other features and advantages of the invention will appear and will appear in more detail on reading the description given below, with reference to the accompanying drawings, given solely by way of illustrative and non-limiting example, in which: Figure 1 illustrates, in a general perspective view, a first variant of an implant according to the invention, which comprises an anchoring body and a coaxial deformable portion; - Figure 2 shows the implant of Figure 1 in a side view; Figures 3 and 4 each illustrate the implant of Figure 1 respectively in an axial view facing the anchoring body, and in an axial view facing the deformable portion; FIG. 5 illustrates a second variant of an implant according to the invention in a general perspective view, for which the anchoring body and the deformable portion are inclined with respect to each other. about 10 degrees; Figures 6 and 7 illustrate the implant of Figure 5 in side views; FIG. 8 represents, in a side view, a third variant of an implant according to the invention for which the anchoring body and the deformable portion are inclined relative to each other by about 17 degrees; FIGS. 9 and 10 each illustrate the implant of FIG. 8 respectively in an axial view facing the anchoring body, and in an axial view facing the deformable portion; - Figures 11 and 12 show, in perspective views, a gripping instrument according to the invention for grasping the implant of Figures 1 to 10; Figures 13 and 14 show, schematically in side views, the gripping instrument of Figures 11 and 12 associated with the implant of Figures 5 to 10; - Finally, Figures 15 and 16 illustrate instruments for opening a medullary canal of a bone prior to anchoring the implant of Figures 1 to 10 in said bone. The invention relates as such to an arthrodesis implant 1 (as illustrated for example in FIGS. 1-10), i.e., a surgical implant 1 intended to be implanted in the body of the body. a patient, human or animal, at the level of his bones, for example during a surgical operation performed under local or general anesthesia. The implant 1 of the invention makes it possible to perform an arthrodesis of a first bone 2 with a second bone 3, that is to say that it makes it possible to promote the bone fusion of said first bone 2 with said second bone. 3. After a successful arthrodesis and performed using the implant 1, the first bone 2 and the second bone 3 are advantageously fixed relative to each other in solidarity. The bone fusion is preferably performed at a joint connecting the first bone 2 to the second bone 3, so as to replace the latter.
    [0006] Such a surgical operation may for example allow, in the case where the patient suffers for example from interarticular osteoarthritis, to eliminate the pain suffered by the patient by fusing the affected joint. Alternatively, the operation can be used to treat, for example, inter-phalangeal deformity, or toes in claws or hammers. Thus, implant 1 of the invention can advantageously be inserted at the joint between two bones, for example a joint between two bones of the spine, knee, or elbow. Preferably, the implant 1 of the invention is a phalangeal implant 1, the first bone 2 forming a first phalanx and the second bone 3 forming a second phalanx of the same finger as the first phalanx, as illustrated in FIG. for example in Figures 13 and 14. The knuckles concerned are for example located in a foot of the patient, or in a hand of the latter. Once the arthrodesis is performed, the articulation between the two relevant phalanges of the same finger or toe is advantageously blocked, so that said finger or toe is no longer capable of being folded at this particular joint. The implant 1 is advantageously intended to be left in the body of the patient at the end of the operation, throughout the life of said patient, and not to require removal of said implant 1 once arthrodesis performed. Of course, the implant 1 may be designed on the contrary to be removed from the body of the patient at the end of the arthrodesis. As illustrated in FIGS. 1 to 10, the implant 1 of the invention comprises an anchoring body 4 designed to ensure the anchoring of the implant 1 in the first bone 2, and a deformable portion 5 designed to ensure the anchoring of the implant 1 in the second bone 3. The anchoring body 4 and the deformable portion 5 are integral with each other and preferably arranged in opposition to one another , for example on either side of an intermediate or median plane. The implant 1 of the invention can thus be anchored firstly in the first bone 2 via the anchoring body 4, and secondly in the second bone 3 via the deformable portion. 5, so that the first bone 3 and the second bone 4 are connected to each other by the implant 1. The anchoring body 4, and respectively the deformable portion 5, is advantageously designed to be planted in the bone concerned, or inserted in force, in the manner of a fixation pin. Once the implant 1 is anchored in the first bone 2 and in the second bone 3, the latter become integral with each other via the implant 1, in a flexible or rigid manner, so osteosynthesis occurs leading to bone fusion of said first and second bones 3. Preferably, the anchoring of the anchoring body 4 is effected by impaction, or by force wedging, of the latter in the first bone. 2, in the manner of an ankle. The anchoring body 4 is advantageously designed to be anchored thus, and is for example devoid of screwing means of said anchoring body 4 in the first bone 2. Similarly, the anchoring of the deformable portion 5 is preferably carried out by impaction, or by force jamming, of the latter in the second bone 3. The deformable portion 5 is thus advantageously devoid of means for screwing the latter into the second bone 3. Preferably, the anchoring body 4, as well as the deformable portion 5, are provided to be inserted into the medullary canal respectively of the first bone 2 and the second bone 3, so that the implant 1 of the invention preferentially forms an intramedullary implant 1. In this case, the anchoring body 4 is preferably intended to be anchored in a medullary canal of the first bone 2, the deformable portion 5 being intended to be anchored in the medullary canal of the second bone 3. The anchoring body 4 and the deformable portion 5 can in this case be implanted into the medullary ducts of the first and second bone 3, for example after the end of the bone concerned (formed for example by an extreme cartilaginous surface) has been pierced or removed from said bone to provide an access opening to said medullary canal. The internal bone stock of the medullary canal of the first bone 2, respectively of the second bone 3, must also preferably be arranged to allow the reception of the anchoring body 4. FIGS. 13 and 14 represent, in this respect, examples of instruments opening 26 of a medullary canal of a bone prior to the anchoring of the implant 1 of the invention in the first and second bone 3. These opening instruments 26 are preferably provided with a mouthpiece piercing the bone. Other instruments or tools may of course be used.
    [0007] Of course, without departing from the scope of the invention, the anchoring body 4 and / or the deformable portion 5 may be designed to be anchored in any other part of the bone, and for example to be anchored in an orifice arranged in the cortical part of the bone.
    [0008] In the preferred case where the implant 1 is intramedullary, the anchoring body 4, and respectively the deformable portion 5 are advantageously shaped to fit axially into the medullary canal of the first bone 2, respectively of the second bone. 3. The anchoring body 4 is thus preferably designed to be anchored in the first bone 2 coaxially with the latter, and the deformable portion 5 in the second bone 3 coaxially with the latter. In particular, the medullary canal of such bones being of generally tubular, substantially cylindrical shape, the anchoring body 4 and the deformable portion 5 will preferably have a generally elongate and axial shape, and preferably cylindrical, conical, prismatic or cruciform, such 10 to 10, and will be shaped to be inserted coaxially with the tubular form of the medullary canal concerned, so as to be wedged within the medullary canal. In the preferred case where the first bone 2 and the second bone 3 are phalanges, the medullary canal advantageously has a narrowing, forming for example the isthmus of the phalanx, which makes it possible to apply a centripetal pressure of jamming of the implant 1 within the medullary canal, and in particular the anchoring body 4 and / or the deformable portion 5, this centripetal pressure for adhesively retaining the implant 1 within the medullary canal. The implant 1, its anchoring body 4 and its deformable portion 5, will preferably be chosen, shaped and dimensioned to adapt to the morphology of the bones in which they are anchored, and possibly according to the morphology of the patient. . As illustrated in FIGS. 1 to 10, the anchoring body 4 of the invention extends between a penetration end 6 in said first bone 2 and an opposite base end 7, and thus has an elongated shape, preferably along an X-X 'axis. The penetrating end 6 forms a free end of the implant 1, and is advantageously tapered, conical, curved or chamfered to facilitate its penetration into the first bone 2. The opposite base end 7 forms a point of attachment of the anchoring body 4 with the rest of the implant 1, and in particular with the deformable portion 5. Preferably, the anchoring body 4 has an outer surface 8 connecting the base end 7 to the end 6, and forms for example a solid body delimited by said outer surface 8. Alternatively, as described below, the anchoring body 4 can be canulated. Preferably, the outer surface 8 is of generally convergent shape, for example conical, towards the penetration end 6, for example along the axis X-X ', which improves the jamming the anchoring body 4 in the first bone 2, the anchoring body 4 can thus for example adapt to several diameters of medullary channels. The anchoring body 4 thus preferably has a section of larger size for example in length, in width or in diameter in the vicinity of the base end 7 than near the penetration end 6. Alternatively, the anchoring body 4 may be of generally prismatic shape along the axis X-X ', and not be convergent, without departing from the scope of the invention. Within the meaning of the invention, the term "general shape" is understood to mean the external shape of the element concerned, that is to say not including in particular the various asperities, grooves, chamfers, fins, grooves, teeth , and other salient or re-entrant elements. The anchoring body 4 of the invention is substantially rigid and non-deformable, or at least the anchoring body 4 is less easily deformable than the deformable portion 5, and requires a greater effort to be deformed. Thus, the anchoring body 4 is advantageously designed to be anchored in the first bone 2, in particular in the case where the latter forms a bone that is stronger or of greater hardness than the second bone 3. According to such a design, the implant 1 is particularly adapted to the morphology of the patient's framework, in the case where the bones to be fused are of different strength, for example in the case where the first bone 2 forms a proximal phalanx, and the second bone 3 a distal phalanx, that is to say, extremal, the finger or the patient's toe. The deformable portion 5 being designed anchored in the second bone 3 and being more deformable than the anchoring body 4, its anchoring is not likely to damage the second bone 3, and allows a good bone reconstruction following the The insertion in the first bone 2 of the anchoring body 4 is in parallel particularly reliable and solid, and the implant 1 is particularly resistant. In particular, the structure and / or the material forming the anchoring body 4 are advantageously chosen and designed so that the anchoring body 4 does not deform, or minimally, under the action of the first bone 2, when the anchoring body 4 is anchored in said first bone 2. In particular, the anchoring body 4 is designed not to bend along the longitudinal axis X-X ', or to contract under the the effect of an axial or radial pressure, when introduced, and possibly anchored, in the first bone 2. Nevertheless, locally, the anchoring body 4 may undergo deformations to allow the maintenance of its anchoring in the first bone 2; in particular, the anchoring body 4 may comprise retention elements (described hereinafter) which can be deformed by the second bone 3, in particular at the level of the isthmus of the medullary canal, to allow good retention of the anchoring body 4 in said second bone 3. Preferably, the structure and the shape of the anchoring body 4 give it, or at least contribute to confer, its rigid character. For this, the anchoring body 4 preferentially forms a solid and solid body (as illustrated in FIGS. 5 to 10), or a tubular body (as illustrated in FIGS. 1 to 4). The anchoring body 4 preferably comprises longitudinal reinforcing ribs 12, which are for example distributed around the axis X-X ', protruding from the outer surface 8 in the direction of the length of the anchoring body 4 , for example from the penetrating end 6. The longitudinal reinforcement ribs 12 advantageously make it possible to stiffen the anchoring body 4, in particular in bending and torsion, without the latter being of any kind. too much thickness. According to the invention, the deformable portion 5 comprises at least two anchoring arms 9, 10, 11 which protrude from the anchoring body 4 from the base end 7 of the latter. As illustrated in FIGS. 1 to 10, the anchoring arms 9 of the invention 20 rise from the anchoring body 4, starting from the base end 7, and are oriented one and the other in a similar direction along a Y-Y 'axis, which is preferably opposite to the direction of the anchoring body 4. The YY' axis thus forms the general extension direction of the deformable portion 5, the latter being the result of the combination of the anchoring arms 9, 10, 11, which advantageously form an anchoring arm bundle 9, 10, 11. Each anchoring arm 9, 10, 11 advantageously extends between one end junction 16 with the anchoring body 4 and an opposite end end 17 of implantation of said anchoring arm 9 in the second bone 3, along a clean extension axis. Preferably, the anchoring arms 9, 10, 11 have a section orthogonal to their own axis of extension which is less important than the section orthogonal to the axis XX 'of the anchoring body 4. The arms of anchoring 9, 10, 11 are thus preferably more than the anchoring body 4, which gives them greater deformability than that of the latter. The anchoring arms 9, 10, 11 are therefore preferably flexible, elastically or elastically-plastic, so that the deformable portion 5 that they form is generally easier to deform than the anchoring body 4. The portion deformable 5 5 can thus advantageously be anchored in the second bone 3, in particular when the latter is softer, more fragile and / or thinner than the first bone 2. In addition, the deformable portion 5 adapts, by deformation, to the shape of the second bone 3, and in particular its medullary canal, so that it can be anchored reliably, safely, without pain for the patient. The implant 1 is thus particularly adapted to the mechanical and morphological characteristics of both the first bone 2 and the second bone 3, so that its connection with the latter is particularly reliable, the pain suffered by the relatively weak patient, and the duration of the reduced treatment. The deformability and flexibility of the anchoring arms 9, 10, 11 furthermore gives the connection between the first bone 2 and the second bone 3 formed by the implant 1 a certain flexibility 15 which is likely to stimulate the osteosynthesis natural, and accelerate bone fusion. The preferred embodiment of the invention shown in Figures 1 to 4 forms a right implant 1, that is to say in which, preferably, the anchoring body 4 extends along an axis X-X ', the deformable portion 5 extending in an opposite direction of the anchoring body 4 along an axis YY' coaxial with the axis X-X '. Such an implant 1 is particularly suitable in the case where the first bone 2 and the second bone 3 must be arranged coaxially, preferably so that their medullary channels are coaxial. Another preferred variant of the invention shown in FIGS. 5 to 10 forms an implant 1 bent, that is to say in which, preferably, the anchoring body 4 extends 25 along an axis XX 'and the deformable portion 5 extending in a direction opposite to the anchoring body 4 along an axis YY' intersecting the axis X-X ', so that the axis YY' is inclined relative to to the axis XX 'at an elevation angle α of between 8 and 12 degrees, preferably about 10 degrees (as illustrated in Figures 5 to 7), OR 30 - 15 and 19 degrees, preferably about 17 degrees (as illustrated in Figures 8 to 10).
    [0009] Such an implant 1 is particularly suitable in the case where the first bone 2 and the second bone 3 must be arranged in a secant manner, for example slightly secant, according to this same angle of elevation a, preferably so that their medullary ducts are intersecting according to this same angle of elevation a. Of course, the implant 1 could be designed with a different elevation angle value depending on the bone morphology and the desired orientation between the first bone 2 and the second bone 3. Preferably, the value of the angle α corresponds to an anatomical value of the natural orientation of the first bone 2 relative to the second bone 3. Preferably, the implant 1 forms a single piece in one piece, the deformable portion 5 coming from 4. In particular, the anchoring arms 9, 10, 11 preferably extend the anchoring body 4 and are made of material with the latter so that the implant 1 is formed of one piece, which gives a great structural strength to the implant 1, and facilitates its manufacture, which can be performed for example by molding and machining, without assembly step of inserts to each other. The implant 1 can be advantageously made using a single material, the deformability of the various elements that constitute it being obtained using the shape of the latter, and in particular with the aid of their section and / or their thickness. The implant 1 is preferably made of a polymer material, for example PEEK, which enables it, for example, to be both radio-transparent, biocompatible, light and inexpensive to manufacture. Of course, without departing from the scope of the invention, the implant 1 may be made of another material, for example a metallic material of stainless steel or titanium type. Also, the implant 1 may be the result of the assembly of several parts, and not be monobloc.
    [0010] According to the invention, the anchoring arms 9, 10, 11 are separated from one another by a free space E so that they can be brought closer to each other by deformation of said anchor arms. 9, 10, 11 under the action of the second bone 3. The anchoring arms 9, 10, 11 of the invention thus do not substantially touch, at least when they are not deformed, a space being advantageously provided between each of them, over at least a portion of their length, if not over their entire length. The anchoring arms 9, 10, 11 thus have between them a free central space, so that they can be deformed so as to invade this free space E. Such a design makes the compressible deformable portion 5 preferably centripetal with respect to the axis Y-Y ', and / or able to be twisted around said axis Y-Y', and / or able to be bent, the anchoring arms 9 being preferably free to occupy, at less in part, the free space E which separates them, under the action of the second bone 3 when anchored in the latter. The elasticity of the anchoring arms 9, 10, 11 preferably allows the deformable portion 5 to apply a centrifugal pressure to the medullary canal (or generally the anchoring housing), which is likely to contribute to retain the implant 1 in the second bone 3 for example by adhesion. Preferably, the anchoring arms 9, 10, 11 are designed to move between an undistorted configuration, which constitutes their initial position, and in which the free space E is effectively free, and a deformed position in which they are closer to each other, even touching each other, and invade the initial free space E. Preferably, the anchor arms 9, 10, 11 are resiliently deformable so as to return themselves substantially to their undeformed configuration when spaced apart therefrom. The deformable portion 5 thus forms a reliable, flexible and versatile connection, so that the implant 1 can be anchored to both a first bone 2 and a second bone 3 which are of different nature, strength and shape. Preferably, the deformable portion 5 is formed by three anchoring arms 9, 10, 11, as illustrated in the figures, so as to improve the stability of the implant 1 in the second bone 3 in three degrees of freedom . Of course, the deformable portion 5 may comprise two anchor arms, or four anchor arms, for example between two and eight anchor arms, or more, without departing from the scope of the invention. Preferably, the anchoring arms 9, 10, 11 are substantially parallel to each other, for example in undeformed configuration, so that their own extension axis is parallel to the Y-Y 'axis, so that may be deformed for example so as to converge towards each other, or at least their end ends 17 converge. Alternatively, the anchoring arms 9, 10, 11 may advantageously be convergent in undeformed configuration, for example slightly convergent, or conversely divergent. In the case where the anchoring arms 9, 10, 11 are convergent, the deformable portion 5 forms for example a beam of arms converging along the axis YY '. In the preferred case illustrated in the figures, the junction ends 16 of the three anchoring arms 9, 10, 11 are preferably arranged in Y (as shown in FIG. 4) or in T (as illustrated in FIG. 10) around the Y-Y 'axis, on the base end 7 of the anchoring body 4, so that the end ends 17 are also respectively arranged in Y or T. Preferably, in the In the case of the bent variant of the implant 1 shown in FIGS. 5 to 10, the junction ends 16 of the anchoring arms 9, 10, 11 are arranged in a T-shape. For the case of the rectilinear variant of the implant 1 shown in Figures 1 to 4, the junction ends 16 of the anchor arms are arranged in Y. The term "T-shaped" means that two of the anchor arms 10, 11 are arranged in opposition on both sides of the YY 'axis so as to extend along a common median plane carried by said Y-Y' axis, while the anchor arm 9 remaining is disposed in a median plane orthogonal to said common median plane and carried by the Y-axis Y '. In this case, the Y-Y 'axis forms the intersection of the common median plane and the orthogonal plane. By "arranged in Y" is meant that two of the anchoring arms 10, 11 are disposed on either side of the axis YY 'so as to extend along a common median plane parallel to the YY 'axis and spaced from the latter, while the remaining anchor arm 9 is disposed in a median plane orthogonal to said common median plane and carried by the Y-axis Y'. In this case, the Y-Y 'axis does not form the intersection of the common median plane and the orthogonal plane, the anchoring arms 9, 10, 11 are distributed around said axis YY'.
    [0011] In this configuration, two of the anchoring arms 10, 11 are preferably arranged symmetrically with respect to a plane carried by the axis YY ', the third anchoring arm 9 being carried by this same plane of symmetry, and being the third anchor arm 9 being itself, in its shape, symmetrical with respect to said symmetry plane. Preferably, the implant 1 has substantially a plane of symmetry carried by the axis YY 'and the own extension axis of the third anchoring arm 9. Two of the anchoring arms 10, 11 are preferably designed and shaped in order to be deformed in a preferred manner towards each other in a common plane, so as to form a clamp. In this preferred case, the last anchor arm 9 is advantageously designed and shaped so that it can be deformed centripetally at the Y-Y 'axis. Such a design makes it possible to improve the stability of the implant 1 within the second bone 3, and the reliability of its anchoring. Preferably, at least one of the anchoring arms 9, 10, 11 has a section whose overall shape is substantially trapezoidal. Thus, one of the anchoring arms 9, 10, 11, at least, preferably all the anchoring arms 9, 10, 11, has a generally prismatic shape trapezoidal bottom, which allows to promote its flexibility according to predetermined directions, for example in the direction of the Y-Y 'axis. Indeed, the distance between the opposite sides of the trapezium forming the section of the anchoring arms 9, 10, 11 may be chosen to be lower in the direction of deformation, and higher in the direction transverse to the deformation. . For example, the section of the anchoring arm 9 shown in the figures makes it possible to form an anchoring arm 9 comprising an inner side 18 forming a face oriented towards the axis YY 'and substantially ortho-radial to the latter, an opposite outer side 19, also substantially ortho-radial to the axis YY ', and two lateral sides 20 connecting the outer side 19 to the inner side 18, and being for example radial to the axis YY', or at least intersecting the inner side 18 and the outer side 19.
    [0012] Preferably, the inner side 18 is separated from the outer side 19 by a radial distance DR less than an ortho-radial distance C 0 separating the lateral sides 20, so that the radial flexion to the axis YY 'of the anchor arm 9 is facilitated with respect to an ortho-radial flexion to the Y-Y 'axis.
    [0013] 3024 835 16 This particular form that the anchoring arms 9, 10, 11 also have longitudinal edges to lock the implant 1 in rotation about the axis YY 'relative to the second bone 3. The term "form generally substantially trapezoidal "advantageously comprises the case where some sides of the trapezoid are curved, in particular the inner side 18 and / or the outer side 19. In particular, the outer side 19 of the anchoring arms 9, 10, 11 may advantageously be curve. Preferably, the outer side 19 of the generally trapezoidal shape of the anchoring arm 9, 10, 11 advantageously forms an arc of a circle whose center is for example formed by the axis Y-Y ', so that the outer contour 10 of the section orthogonal to the axis YY 'of the deformable portion 5 substantially forms a circle centered on said axis YY' (as illustrated in Figures 4 and 10). In undeformed configuration, the anchoring arms 9, 10, 11 are preferably substantially parallel to each other and to the Y-Y 'axis, so that the deformable portion 5 has an outer contour, which is formed, for example, joining the outer sides 19 of the anchoring arms 15 9, 10, 11, of generally cylindrical or prismatic general shape around the axis YY '. Preferably, in deformed configuration, the anchoring arms 9, 10, 11, which were initially parallel, converge, and see, for example, their end ends 17 tightened around the axis Y-Y ', so that the contour The outside of the deformable portion 5 converges, and is for example of generally frustoconical general shape. The inner side 18 may itself be preferably curved, so that the inner face of the anchoring arms 10, 11 forms a portion of a cylinder or concave cone of axis Y-Y ', so that portion of the free space E formed by the anchoring arms 10, 11 is substantially cylindrical or frustoconical, as can be seen in particular in FIG. 4 and in FIG. 10. The implant 1 preferably comprises a cannula 23 passing through the anchoring body 4 so as to extend said free space E to the penetrating end 6. Thus, preferably, the cannula 23 is extended by the free space E delimited by the inner sides 18 of the arms d 9, 10, 11, so that the implant 1 can be slidably threaded, via its cannula 23 and its free space E, onto a guide rod, or a guide pin, which facilitates the placement of the implant 1 in the patient's bones. The inner sides 18 of the anchoring arms 9, 10, 11 advantageously form an extension of the cannula 23 which is substantially cylindrical in shape with a diameter greater than the diameter of said cannula 23, so that the anchoring arms 9 , 10, 11 have a clearance formed by the residual free space E provided between the guide pin and the inner side 18, to be deformable in the direction of the axis YY 'despite the presence of said guide pin. Preferably, the implant 1 comprises a cannula 23 only if it forms a right implant 10 as illustrated for example in FIGS. 1 to 4, and not if it forms an angled implant as illustrated, for example 5 to 10. Thus, the guide rod, optionally rigid and rectilinear, can be inserted along the cannula 23, the free space E, and the axes XX 'and YY' which are coaxial and in the alignment of each other. Preferably, as shown in FIG. 4, the lateral sides 20 of two of the anchoring arms 10, 11 are parallel to one another, and two to two coplanar, so that the shape of the two anchor arms 10 , 11 concerned is delimited by two parallel planes common to said two anchoring arms 10, 11. Moreover, as shown for example in Figures 5 to 10, at least one of the anchoring arms 9, 10, 11 is preferably provided with a longitudinal fin 22 of reinforcement projecting from the anchoring arm 9, 10, 11 from a lateral side 20 of the latter, as is particularly visible in FIG. 10. Preferably, the implant 1 comprises two longitudinal fins 22, carried respectively by two anchoring arms 10, 11 whose lateral side 20 are for example substantially coplanar, the longitudinal fins 22 rising parallel to each other in the direction of the Y-Y 'axis. The longitudinal fins 22 advantageously make it possible at the same time to stiffen the anchor arm concerned, but also for example to contribute to allowing rotation locking around the axis YY 'of the implant 1 relative to the second bone 3 when it is anchored in it. At least one of the anchoring arms 9, 10, 11, preferably two or all of the anchoring arms 10, 11 has a zone of reduced section 21 so as to promote the deformation of said anchor arm 9, 10, 11 by bending said anchor arm 3024835 18 at the reduced section area 21, towards or away from another of the anchor arms 9, 10, 11. As illustrated in FIGS. 5 to 10, the zone of reduced section 21 preferably forms a notch formed in the anchoring arm 9, 10, 11, in the vicinity of the junction end 16, the notch being advantageously open on 5 free space E and turned towards another of the anchoring arms 9, 10, 11 or the Y-axis', for example so that the anchoring arm 9, 10, 11 concerned can be bent at its reduced section 21 so as to converge to another of the anchoring arms 9, 10, 11. Each anchoring arm 9, 10, 11, preferably two of them, can thus be c it is designed to be substantially rigid over most of its length, and not to deform for example at its reduced section 21 when it is stressed by the second bone 3. The anchoring body 4 extending along an axis XX 'from the base end 7 to the penetrating end 6, said anchoring body 4 comprises at least one peripheral longitudinal groove 24 for locking the implant 1 in rotation around 15 XX 'axis within the first bone 2, the longitudinal groove 24 extending substantially parallel to the axis XX' from the penetration end 6 over at least a portion of the length of the anchor body 4. The implant 1 advantageously comprises four peripheral longitudinal grooves 24, so that the anchoring body 4 has a substantially cruciform orthogonal section from the penetrating end 6 over at least a portion of its length. Preferably, the geometry of at least two peripheral grooves 24 is symmetrical with respect to the X-X 'axis, as is clearly visible in FIG. 3. The longitudinal grooves 24 are advantageously arranged in the extension of the spaces provided. between the anchoring arms 9, 10, 11, and in particular so as to extend the extension planes associated with the lateral sides 20 of the anchoring arms 9, 10, 11. Alternatively, the longitudinal grooves 24 may instead be arranged in the extension of the anchoring arms 9, 10, 11. The longitudinal grooves 24 may also be arranged so as not to be aligned with the anchor arms 9, 10, 11, or with the spaces between said anchoring arms 9, 10, 11.
    [0014] The longitudinal grooves 24 are preferably separated by the longitudinal reinforcing ribs 12, which are for example each aligned with one of the anchoring arms 9, 10, 11, in order to extend in particular along a common extension axis between the anchor arm and the associated longitudinal reinforcing rib. The orthogonal section of the anchoring body 4 is thus advantageously cross-shaped, each branch of which is formed by one of the longitudinal ribs 12. The implant 1 may comprise more or fewer longitudinal grooves 24 separated by the longitudinal ribs 12, for example as a function of the number of anchoring arms 9, 10, 11 envisaged, so that the anchoring body 4 has a star-shaped orthogonal section, each of whose branches is formed by one said longitudinal ribs 12. Preferably, the longitudinal grooves 24 and the associated longitudinal ribs 12 extend over only a portion of the anchoring body 4 from the penetration end 6, so that said longitudinal grooves 24 extend between said penetration end 6 and a stop end 27 of said longitudinal grooves 24 located between said penetration end 6 and the base end 7. According to this nfiguration preferential, the abutment end 27 of the longitudinal grooves 24 to stop the implant 1 in translation along the axis XX 'during its anchoring in the first bone 2, when the latter comes into contact with said end stop 27.
    [0015] The edge of the longitudinal grooves 24 preferably forms a projecting edge, as illustrated in FIGS. 1 to 10, so as to improve the locking in rotation around the axis XX of the implant 1 in the first bone 2. By elsewhere, the implant 1 is preferably provided with retention elements of said implant 1 in the bones.
    [0016] At least one of the anchoring arms 9, 10, 11, preferably each of the anchoring arms 9, 10, 11, is advantageously provided with a primary retention element 28 of said anchoring arm 9, 10 , 11 in the second bone 3.
    [0017] The primary retention element 28 is preferably formed by a line of primary retention teeth extending along the anchor arm 9, 10, 11, and projecting therefrom centrifugally relative to the Free space E. As illustrated in FIGS. 1 to 10, the primary retention teeth are disposed on the outer side 19 and rise radially with respect to the Y-Y 'axis. The primary retention element 28 is designed to oppose the removal of the implant 1 from the second bone 3 for example by hooking said primary teeth against the inner wall of the medullary canal, while not substantially opposing the insertion of the implant 1 into said second bone 3. For this, the primary teeth preferably have a gently sloping face, of low inclination with respect to the Y-Y 'axis, directed towards the terminal end 17 , and a steeply inclined face, with a large inclination with respect to the Y-Y 'axis, for example orthogonal to the axis XX' in the direction of the junction end 16. The anchoring body 4 advantageously comprises the minus one secondary retention element 29 of the anchoring body 4 in the first bone 2, which is preferably formed by a line of secondary retention teeth extending along the anchoring body 4. As illustrated in FIGS. 1 to 10, the secondary teeth of retention are di sposées at the top of the longitudinal ribs 12 and rise radially with respect to the axis X-X '. The secondary retention element 29 is designed to oppose the removal of the implant 1 from the first bone 2 for example by attachment of said secondary teeth against the inner wall of the medullary canal, while not substantially opposing the insertion of the implant 1 into said first bone 2. For this purpose, the secondary teeth preferably have a gently sloping face with a small inclination with respect to the axis X-X 'directed towards the penetration end 6 , and a steeply inclined face with a large inclination with respect to the axis X-X ', for example orthogonal to the axis XX' towards the base end 7. Thus, the anchoring of the implant 1 in the patient's bones is thus particularly reliable and durable, while being easy to perform. The invention also relates, as such, to an instrument 30 for gripping an implant 1 as described above, the gripping instrument 30 comprising a removable fastening tip 31 of the implant 1 with the instrument of FIG. 30, 302 4 83 5 21 through the deformable portion 5 of said implant 1. An embodiment of a gripping instrument 30 according to the invention is illustrated in Figures 11 to 14. This gripping instrument 30 is advantageously designed to allow the gripping of a right implant 1, as described above.
    [0018] The gripping instrument 30 preferably comprises a main body 32, of generally elongate shape, extending along an axis Z-Z ', and terminating in said fastening end 31. The latter advantageously makes it possible to removably grasping the implant 1 with the gripping instrument 30 via the deformable portion 5 of said implant 1. The attachment end 31 is preferably designed to accommodate the deformable portion 5 of said implant 1 so as to that the axis XX 'is coaxial with the axis ZZ' when the implant 1 is secured to the gripping instrument 30. When the implant 1 is secured to the attachment end 31, the anchor body 4 is preferably projecting from the latter so that the axis XX 'and the axis ZZ' are coaxial.
    [0019] The surgeon can thus advantageously grasp the implant 1 by means of the gripping instrument 30 in order to manipulate said implant 1 to anchor it to the first bone 2 and / or the second bone 3. The attachment end 31 is preferably of generally cylindrical outer shape of axis Z-Z '. As illustrated in FIG. 12, it preferably comprises a reception orifice 34 of the deformable portion 5 of the implant 1, said reception orifice preferably being cruciform or, for example, star-shaped, in order to block the implant 1 in rotation about the axis ZZ 'relative to the gripping tool 30. The cruciform or star shape advantageously corresponds to the outer contour of the deformable portion 5 of the implant 1, and in particular to the arrangement of the anchoring arms 9, 10, 11, which can be inserted into the four notches or branches of the cruciform shape so that they can be rotated about the axis ZZ 'by the surgeon, via of the gripping instrument 30. The gripping instrument 30 preferably comprises a removable handle 33 removably connectable and secured to the main body 32. The removable handle 3024 835 22 can advantageously constitute a privileged gripping zone connected to the grasping instrument 30 by the surgeon. Alternatively, the main body 32 may be connected to a machine to manipulate the implant through said machine.
    [0020] Finally, the invention relates, as such, to a gripping instrument 30 of an implant 1 as described above, and in particular of which the anchoring body 4 extends along an axis XX ' the deformable portion 5 extending in a direction opposite to the anchoring body 4 along an axis YY 'intersecting the axis X-X', so that the axis YY 'is inclined relative to the XX 'axis at an angle of elevation a between: 10 - 8 and 12 degrees, preferably about 10 degrees, or - 15 and 19 degrees, preferably about 17 degrees. Thus, this gripping instrument 30 may advantageously be used to perform the gripping of an elbow implant 1, as described above. The gripping instrument 30 of the invention comprises a main body 32 extending along an axis ZZ 'and ending with a fastening end 31 removably of the implant 1 with the gripping instrument 30, through the deformable portion 5 of said implant 1, the fastening end piece 31 being designed to receive the deformable portion 5 of said implant 1 so that the axis YY 'is intersecting with the axis ZZ' according to a compensation angle p equal to the elevation angle α, so as to compensate for the inclination of the axis YY 'with respect to the axis X-X', so that the axis XX 'is coaxial with the axis ZZ 'when the implant 1 is integral with the gripping instrument 30. The fastening end piece 31 is preferably of generally cylindrical outer shape of axis Z-Z'. As illustrated in FIG. 12, it preferably comprises a reception orifice 34 of the deformable portion 5 of the implant 1, said reception orifice preferably being cruciform, or for example star-shaped, in order to block the implant 1 in rotation about the axis YY 'and / or XX' and / or ZZ 'with respect to the gripping tool 30. The cruciform or star shape advantageously corresponds to the outer contour of the deformable portion 5 of 1, and in particular at the disposal of the anchoring arms 9, 10, 11, which can be inserted into the four notches or branches of the cruciform shape in order to be rotated around the axis YY 'and / or XX' and / or ZZ 'by the surgeon, through the gripping instrument 30. The characteristics of the gripping instrument 30 for a right implant 1, 5 of which axis XX 'and axis YY' are coaxial, preferably also apply mutatis mutandis to this gripping instrument 30 for implant 1 bent. Finally, an example of a surgical procedure for implantation of the implant 1 previously described in the body of a patient or an animal will be described below. The method comprises in particular the following steps, preferably carried out in the following order: An incision is made in the body of a patient in order to reach the first bone 2 and the second bone 3. - The joint connecting the first bone is divided bone 2 to the second bone 3 in order to disengage the extremal portions of said first bone 2 and second bone 3. 15 - The end of said first bone 2 and second bone 3 is removed, for example by piercing it, in order to update the channels medullaries of said first bone 2 and second bone 3, for example with the aid of an opening instrument 26 shown in FIGS. 15 and 16. The interior of the medullary ducts is partially or completely recessed in order to prepare a space free to allow the introduction of the deformable portion 5 and the anchoring body 4 of the implant 1 respectively in each of said medullary channels. The implant 1 is grasped with the aid of the gripping instrument 30, as illustrated for example in FIG. 13, so that the anchoring body 4 protrudes from the fastening end 31, and that the axes XX 'and ZZ' are coaxial. The implant 1, optionally in force, is anchored in the medullary canal of the first bone 2 (as shown in FIG. 14), via the anchoring body 4. - The gripping instrument 30 is detached. The second bone 3 is threaded onto the deformable portion 5 of the implant 1. The method may also include a step of adding an osteoinductive material into the medullary ducts, or around it. of implant 1 when anchored. Certain process steps described above may advantageously be omitted, or performed in a different order.
    权利要求:
    Claims (7)
    [0001]
    REVENDICATIONS1. An arthrodesis implant (1) for promoting the bone fusion of a first bone (2) with a second bone (3), said implant (1) being characterized in that it comprises: - an anchoring body ( 4) substantially rigid and non-deformable, designed to anchor the implant (1) in the first bone (2), the anchor body (4) extending between a penetration end (6) in said first bone (2) and an opposite base end (7), and - a deformable portion (5) adapted to anchor the implant (1) in the second bone (3), said deformable portion (5) comprising at least two anchoring arms (9, 10, 11) which protrude from the anchoring body (4) from the base end (7) thereof, the anchoring arms (9, 10) , 11) being separated from each other by a free space (E) so that they can be brought closer to each other by deformation of said anchoring arms under the action of the second bone (3).
    [0002]
    2- Implant (1) according to the preceding claim, characterized in that the deformable portion (5) is formed by three anchoring arms (9, 10, 11).
    [0003]
    3- Implant (1) according to any one of the preceding claims, characterized in that the anchoring arms (9, 10, 11) are substantially parallel to each other, so that the deformable portion (5) has an outer contour of generally cylindrical or prismatic general shape.
    [0004]
    4- Implant (1) according to any one of the preceding claims, characterized in that at least one of the anchoring arms (9, 10, 11) has a reduced section area (21) so as to favor deforming said anchor arm (9, 10, 11) by bending said anchor arm at the reduced section area (21), either towards or away from another of the anchor arms ( 9, 10, 11). 3024835 26
    [0005]
    5- Implant (1) according to any one of the preceding claims, characterized in that at least one of the anchoring arms (9, 10, 11) has a section whose general shape is substantially trapezoidal, one side outer portion (19) of the generally trapezoidal shape forming an arc of a circle so that the outer contour of the orthogonal section of the deformable portion (5) substantially forms a circle.
    [0006]
    6- Implant (1) according to any one of the preceding claims, characterized in that at least one of the anchoring arms (9, 10, 11), preferably each of the anchoring arms (9, 10). 11) is provided with a primary retention element (28) 10 of said anchor arm (9, 10, 11) in the second bone (3).
    [0007]
    7- Implant (1) according to the preceding claim, characterized in that the primary retention element (28) is formed by a line of primary retention teeth extending along the anchoring arm (9, 10, 11 ), and protruding from the latter centrifugally with respect to the free space (E). Implant (1) according to any one of the preceding claims, characterized in that at least one of the anchoring arms (9, 10, 11) is provided with a longitudinal fin (22) for reinforcing protruding from the anchor arm (9, 10, 11) from a lateral side (20) thereof. 9 Implant (1) according to any one of the preceding claims, characterized in that the anchoring body (4) extends along an axis (X-X '), the deformable portion (5) s extending in an opposite direction of the anchoring body (4) along an axis (Y-Y ') coaxial with the axis (X-X'). 10- Implant (1) according to the preceding claim, characterized in that each anchoring arm (9, 10, 11) extends between a junction end (16) with the anchoring body (4) and a opposite end end (17) of implantation of said anchoring arm (9) in the second bone (3), two of the anchoring arms (10, 11) being disposed on either side of the axis (Y -Y ') so as to extend along a common median plane parallel to the axis (Y-Y') and spaced from the latter. 11 - Implant (1) according to any one of claims 1 to 8, characterized in that the anchoring body (4) extends along an axis (X-X ') and the deformable portion (5) extending in a direction opposite to the anchoring body (4) along an axis (Y-Y ') secant to the axis (X-X'), so that the axis (Y Y ') is inclined with respect to the axis (X-X') according to an elevation angle (a) of between: - 8 and 12 degrees, preferably about 10 degrees, or - 15 and 19 degrees, preferably about 17 degrees. 12 - Implant (1) according to the preceding claim, characterized in that the anchoring body (4) has an outer surface (8) connecting the base end (7) to the penetration end (6), the outer surface (8) being of generally convergent shape, for example conical, in the direction of the penetration end (6). 13 - Implant (1) according to any one of the preceding claims, characterized in that it comprises a cannula (23) passing through the anchoring body (4) so as to extend said free space (E) to the penetration end (6). Implant (1) according to one of the preceding claims, characterized in that the anchoring body (4) extends along an axis (X-X ') from the base end (7). ) to the penetrating end (6), said anchoring body (4) comprises at least one peripheral longitudinal groove (24) for locking the implant (1) in rotation about the axis (X- X ') within the first bone (2), the longitudinal groove (24) extending substantially parallel to the axis (X-X') from the penetration end (6) on at least a portion of the length of the anchoring body (4). 15- Implant (1) according to the preceding claim, characterized in that it comprises four longitudinal grooves (24) peripheral, so that the anchoring body (4) 25 has a substantially perpendicular orthogonal section from the end penetration (6) over at least a portion of its length. 16- Implant (1) according to any one of the preceding claims, characterized in that the anchoring body (4) comprises at least one secondary retention element (29) of the anchoring body (4) in the first bone (2), which is preferably formed by a line of secondary retention teeth 5 extending along the anchoring body (4). 17- Implant (1) according to any one of the preceding claims, characterized in that it forms a one-piece integral piece, the deformable portion (5) coming from material with the anchoring body (4). 18- Implant (1) according to any one of the preceding claims, characterized in that it is made of a polymeric material, for example PEEK. 19- Implant (1) according to any one of the preceding claims, characterized in that it forms an implant (1) intra-medullary phalangeal, the first bone (2) forming a first phalanx and the second bone (3) forming a second phalanx of the same finger as the first phalanx, the anchoring body (4) being intended to be anchored in a medullary canal of the first bone (2), the deformable portion (5) being intended to be anchored in the channel medulla of the second bone (3). 20 - Instrument for gripping (30) an implant (1) according to any one of the preceding claims, the gripping instrument (30) comprising a removable attachment end (31) of the implant (1) with the gripping instrument (30), via the deformable portion (5) of said implant (1). 21 - Instrument for gripping (30) an implant (1) according to claim 11, the gripping instrument (30) comprising a main body (32) extending along an axis (Z-Z ') and ending with a detachable attachment end (31) of the implant (1) with the gripping instrument (30), via the deformable portion (5) of said implant (1), the endpiece securing means (31) being adapted to receive the deformable portion (5) of said implant (1) so that the axis (Y-Y ') intersects the axis (Z-Z') at an angle of compensation (i3) equal to the elevation angle (a), so as to compensate for the inclination of the axis (Y-Y ') relative to the axis (X-X'), so that raxe (X-X ') is coaxial with the axis (Z-Z') when the implant (1) is integral with the gripping instrument (30).
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    同族专利:
    公开号 | 公开日
    US20170239059A1|2017-08-24|
    FR3024835B1|2021-07-30|
    WO2016027025A3|2016-04-14|
    US10772734B2|2020-09-15|
    EP3182935B1|2019-08-07|
    ES2749011T3|2020-03-18|
    WO2016027025A2|2016-02-25|
    EP3182935A2|2017-06-28|
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    法律状态:
    2015-07-29| PLFP| Fee payment|Year of fee payment: 2 |
    2016-02-19| PLSC| Search report ready|Effective date: 20160219 |
    2016-08-24| PLFP| Fee payment|Year of fee payment: 3 |
    2017-08-28| PLFP| Fee payment|Year of fee payment: 4 |
    2018-08-23| PLFP| Fee payment|Year of fee payment: 5 |
    2019-08-12| PLFP| Fee payment|Year of fee payment: 6 |
    2020-08-21| PLFP| Fee payment|Year of fee payment: 7 |
    2021-08-25| PLFP| Fee payment|Year of fee payment: 8 |
    优先权:
    申请号 | 申请日 | 专利标题
    FR1457860A|FR3024835B1|2014-08-18|2014-08-18|ARTHRODESIS IMPLANT AND GRIPPING INSTRUMENT OF SUCH AN IMPLANT|FR1457860A| FR3024835B1|2014-08-18|2014-08-18|ARTHRODESIS IMPLANT AND GRIPPING INSTRUMENT OF SUCH AN IMPLANT|
    PCT/FR2015/052179| WO2016027025A2|2014-08-18|2015-08-07|Arthrodesis implant and instrument for gripping such an implant|
    ES15766899T| ES2749011T3|2014-08-18|2015-08-07|Arthrodesis implant and instrument for holding such an implant|
    EP15766899.7A| EP3182935B1|2014-08-18|2015-08-07|Arthrodesis implant and instrument for gripping such an implant|
    US15/504,488| US10772734B2|2014-08-18|2015-08-07|Arthrodesis implant and instrument for gripping such an implant|
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