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    • 专利摘要:
    The invention relates to a shoe (1) for assisting the positioning and fixation of a surgical implant intended to be attached to bone bodies of a patient, for example of his forearm, said shoe (1) comprising a main body (24) and characterized in that said main body (24) comprises: -a least one radiopaque area (25) and at least one radiopaque area (26), and -positioning means (27) said shoe (1) relative to the surgical implant in a predetermined relative position, - so as to allow the control of the positioning of said implant relative to said bone body of the patient. Devices for assisting the placement of surgical implants for osteosynthesis
    公开号:FR3040132A1
    申请号:FR1557811
    申请日:2015-08-19
    公开日:2017-02-24
    发明作者:Bertrand Xavier Francois Gauneau；Eric Stephane Fourcault；Jean Christophe Alain Giet
    申请人:In2Bones SAS；
    IPC主号:
    专利说明:

    ASSEMBLY ASSEMBLY AND ATTACHMENT SHOE
    SURGICAL
    The present invention generally relates to the field of devices for assisting the placement of surgical implants osteosynthesis, in particular designed for the treatment of fractures or cracks of bone bodies located in particular in the forearm.
    The present invention more particularly relates to a support shoe for positioning and fixing a surgical implant intended to be attached to bone bodies of a patient, for example his forearm, said shoe comprising a main body.
    The present invention also relates to a surgical kit including such a shoe.
    To improve the reconstruction of the bones, for example bones of the forearm of a patient following certain types of fractures or cracks of the distal radius, it is known to use an implant. surgical, generally referred to in the case of the treatment of a radius, by the term "radial plate". This type of surgical implant is most often, if not exclusively, formed by a curved plate made of metal (T6A4V, CrCo, etc.) so that the anterior surface of the plate is convex to fit the shape of the extremal portion. of the radius to be repaired. The radial plate is intended to be fixed by screwing on at least two parts of the radius separated by fracture so that said plate straddles the fracture line (s) and immobilizes said at least two parts of the radius relative to one another for to promote their merger.
    When performing, during a surgical operation, the positioning of the implant next to the bony bodies to be fused, the surgeon must pay attention that said implant is perfectly positioned opposite the fracture line or lines.
    In addition, he must particularly ensure that the screws, once implanted, are not trans-articular, that is to say, they do not come out of the opposite face of the bone body in which they are fixed at the risk that said screws disrupt the proper functioning of the bone joint relative to the surrounding bones.
    Because of the great variety of morphologies of the radius of patients, the latter are likely, in some cases, to suffer pain during the process of osteosynthesis. Sometimes, tissue friction on the implant and especially on the edges of the latter, can also be a source of pain, despite the small thickness of the latter.
    In particular, in the example of the treatment of fractures or cracks of the distal radius, the surgeon must also be particularly vigilant about the positioning of the osteosynthesis plate facing a very specific anatomical area of the radius known in the art as the "watershed" line.
    This line "watershed" can, in essence, be considered as the crest line of the palmar part of the radius, on both sides of which the bone is more low, and on which the tendons come to rub in tension.
    It has been observed that when the osteosynthesis plate inadvertently comes to be positioned so that it projects beyond said "watershed" line, this causes problematic irritation of the surrounding flexor tendons. Surgeons are therefore strongly advised to ensure that the placement of the osteosynthesis plate is accurate so that it does not overflow from this "watershed" line.
    Conventionally, the surgeon in charge of the installation of such a plate, positions in first manually, with or without a particular tool, the latter relative to the line or the fracture zone.
    Then, to ensure the correct orientation of the fixing screws of said plate through the bone bodies, the surgeon usually makes use of a device, called shoe, which comes into contact with the free surface of the plate.
    A te! shoe has indeed oblong holes, intended to be placed in a predetermined position with respect to the holes for fixing the plate. These oblong holes are configured so as to allow, at first, an angular limitation of the positioning of a bone piercing guide, then in a second step, once the bone thus pierced in a desired orientation, to allow to guide the establishment of the plate fixing screws on the bone bodies to allow a setting easy and accurate position of these fixing screws according to said desired orientation.
    The surgeon then checks by radiography, and if necessary iteratively adjusts the position of said plate relative to the line "watershed".
    Once the plate is positioned and secured to the bone bodies by the fixing screws set up by the hoof, the surgeon also controls the correct configuration of said screws by taking X-rays.
    Finally, the surgeon disassembles the hoof of the plate and the extract out of body of the patient, said hoof not being intended to remain implanted.
    The metallic composition of the known radial plates, and also that of the fastening screws conventionally used, makes them radiopaque in effect, that is to say, visible on X-rays in contrast to the biological environment in which they are located. implanted. Therefore, the control of the positioning of the implanted plate relative to the "watershed" line and the control of the orientation of the fastening screws is thus facilitated.
    If the known solutions implementing metal osteosynthesis plates are generally satisfactory, it should be noted that the radio-opacity of the latter, however, not only prevents the visualization of fracture lines once the plate implanted in the patient, and not furthermore allows visualization of fixation screws to bone bodies considered only through profile X-rays.
    Consequently, it has been found that these so-called osteosynthesis plates could be improved, which is why the inventors of the present invention have themselves, moreover, recently proposed a new osteosynthesis implant which has, among other advantages, a radio-transparency characteristic making it possible to respond effectively to the aforementioned limitations.
    However, it has been observed that such an osteosynthesis implant, as advantageous as it is with regard to the problems previously enumerated, does not offer the surgeon the possibility of precise control, other than visual, of the positioning of said implant of a given anatomical area, for example the "watershed" line of a radius.
    In particular, the surgeon can not control this relative positioning with the aid of a conventional X-ray image since the osteosynthesis implant is not visible on X-ray. The aim of the invention is therefore to remedy this technical disadvantage and to propose a new support shoe for positioning and fixing a surgical implant that can be easily attached to said implant so as to allow the practical application of the implant. precise control of the position of said implant relative to said bone body of the patient even though said implant is not itself directly visible by radiography.
    Another object of the invention is to propose a new shoe and a new associated surgical kit making it easier to position and fix the implant in the patient's body, thanks to a better appreciation of the position of the patient. surgical implant.
    Another object of the invention is to propose a new shoe and a new associated surgical kit allowing better monitoring of the evolution of the fracture of a bone of a patient.
    Another object of the invention is to provide a new shoe and a new associated surgical kit fast and convenient to implement in the context of a surgical operation.
    Another object of the invention is to propose a new shoe and a new surgical kit! partner whose design and manufacture are relatively easy and inexpensive.
    Another object of the invention is to provide a new shoe and a new associated surgical kit to limit post-operative complications and pain suffered by the patient.
    The objects assigned to the invention are attained by means of a shoe for assisting the positioning and fixation of a surgical implant intended to be attached to bone bodies of a patient, for example of his / her forehead. arm, said shoe comprising a main body and characterized in that said main body comprises: - at least one radiopaque area and at least one radiopaque area, and - means for positioning said shoe relative to the surgical implant in a predetermined relative position, so as to allow control of the positioning of said implant relative to said bone body of the patient.
    The objects assigned to the invention are also achieved by means of a surgical kit including a surgical implant intended to be attached to the bone of a patient, for example his forearm, and a shoe compliant to the description above. Other objects and advantages of the invention will appear in more detail on reading the description which follows, and with the aid of the accompanying drawings provided for purely explanatory and non-limiting purposes, in which: FIG. , according to a general perspective view, a support shoe for positioning and fixing a surgical implant! according to the invention; - Figure 2 illustrates, in a longitudinal perspective view, a preferred embodiment of an osteosynthesis implant adapted to cooperate with the shoe of the invention; FIG. 3 illustrates, in a general perspective view, the shoe of FIG. 1, attached and fixed on an osteosynthesis implant, and associated with a piercing guide in order to prepare the fixation of said osteosynthesis implant on bony body of a patient; FIG. 4 illustrates, in a side view, the general assembly of a shoe according to the invention, shown very schematically, on an osteosynthesis implant, itself attached and held fixed on bone bodies at the a fracture zone using fastening screws; - Figure 5 illustrates, in a front view, the shoe of Figure 1, reported and fixed on an osteosynthesis implant, the assembly being positioned on a distal radius opposite the line "watershed" of the latter; - Figure 6 shows, in a view from above, the shoe of Figure 1 associated with an osteosynthesis implant, to form a surgical kit according to the invention. The invention relates as such to a shoe 1 for assisting the positioning and fixation of a surgical implant 2 intended to be attached to bone 3, 4 of a patient, shoe 1, an example of which is not shown. limiting and non-exhaustive is illustrated in Figure 1.
    Said surgical implant 2 is, for example, intended to be attached to bone bodies of a forearm and / or the wrist of a patient. In this example, said surgical implant 2 thus forms a forearm implant, in this case a distal radial plate for the treatment of a fracture of the distal end of the radius of the forearm of a patient. . The invention is however not limited to a shoe 1 for assisting the positioning and fixation of a forearm implant, and may for example relate to a tibial implant or a palmar implant.
    In any event, the surgical implant 2, the shoe 1 according to the invention is aiding positioning and fixation, is intended to be implanted in the body, the patient during a surgical operation performed for example under anesthesia, particularly following an injury to a bone of the patient type fracture or bone fracture, to treat or help to treat said lesion during an osteosynthesis process. The patient designated by the invention is preferably a human being, it being understood that nothing prevents the introduction and fixation of said implant 2 by means of the shoe 1 of the invention in the body of a patient. animal to treat similar veterinary pathologies corresponding to the human pathologies presently described. The surgical implant 2, to the positioning and fixation of which the shoe 1 of the invention helps, is intended to be attached to the bone 3, 4 of a patient, for example his forearm and / or of his wrist, by means of fixing means 5, 6, 7, 8 in order to maintain in position said bone bodies 3, 4 with respect to each other, as illustrated for example in FIG. in particular to allow, or at least to promote, the osteosynthesis of these. The surgical implant 2 is thus designed to be introduced into the body of a patient, and to be fixed temporarily or permanently to the injured bone bodies 3, 4. "Fixation means" means elements that may or may not belong to the surgical implant 2, and which make it possible to secure the latter to the bone bodies 3, 4.
    In this case, and as illustrated in FIG. 2, a surgical implant 2 capable of cooperating with the shoe 1 of the invention, so that the latter assists positioning and fixation, comprises a main body 9, which is intended to be attached to the bone bodies 3, 4. The fixing means 5, 6, 7, 8 are preferably formed by screwing openings 5, 6, 7, 8, in which are intended to be inserted screws fixation 10, 11 (visible in Figure 4) for securing said surgical implant 2, in particular its main body 9, with the bone bodies 3, 4 by screwing said fixing screws therein.
    Bones, cartilages, fragments of bone or cartilage, or even tendons, or a combination thereof, preferably intended to be fused by osteosynthesis with the aid of the surgical implant 2, the shoe 1 of the invention aids positioning and fixation, for example two fragments of the same fractured bone separated by a fracture line 3A, 4A.
    As illustrated in Figure 2, the main body 9 of the surgical implant 2 advantageously has an anterior surface 12 intended to rest at least partially on said bone bodies 3, 4, and a free surface 13 opposite to the anterior surface 12 forming a preferentially free dorsal surface when the surgical implant 2 is in place on said bone bodies 3, 4.
    In the following, the description and the drawings preferably refer to a surgical implant of the distal radial plate type intended for the treatment of a fracture of the distal end of the radius of the forearm of a patient, and therefore to a positioning and fixing aid shoe adapted to this type of implant.
    However, the shoe 1 of the invention may be intended for other types of osteosynthesis implants and may therefore have a different design to that described below.
    The main body 9 of a surgical implant 2 of distal radial plate type is preferably formed by a distal plate 14 which is extended by a proximal tab 15.
    Said distal plate 14 forms a portion of the main body 9 preferably located at a first end thereof, the proximal tab 15 forming the other end in the continuity of said distal plate 14. The main body 9 preferably extends longitudinally between: a distal edge 16, from which the distal plate 14 extends, and a proximal edge 17, from which the proximal leg 15 extends, and transversely between two lateral edges 18.
    The distal plate 14 is preferably designed and shaped to be related to a bone body extrema], preferably distal, that is to say located at the front or the front of the bone bodies 3, 4, preferably at a distance of distal part of the radius bone, that is closer to the patient's wrist.
    According to the embodiment illustrated in the figures, this distal plate 14 has a substantially trapezoidal shape, while the proximal tab 15 has a substantially elongated shape, so that the implant 2 has a generally spatula shape.
    The distal edge 16 of the surgical implant 2, to the positioning and fixation of which the shoe 1 of the invention comes into use, advantageously has a medial portion 19 and a lateral portion 20, the latter being recessed relative to said medial portion 19 so as to marry the anatomical line of the bone bodies 3, 4, in particular a bone of the patient's radius.
    Preferably, the distal edge 16 extends transversely and is composed of two successive portions, the medial portion 19 being advanced relative to the lateral portion 20. The distal edge 16 thus advantageously has an "S" shape to limit the pain suffered by the patient.
    Marrying the anatomical line of the bone bodies 3,4, this "S" shape corresponds advantageously to the outline of the crest line of the palmar part of the radius, or "watershed" line 21, visible in FIG. 5 in the form of a discontinuous line.
    The term "medial portion" the portion of the distal edge 16 intended to be preferably disposed on the medial side of the radius. The lateral portion 20 is preferably intended to be disposed on the radial side of the forearm, opposite the medial side.
    Thus, the surgical implant 2 on which the shoe 1 of the invention is intended to be positioned, can be in the form of two main variants formed by a left forearm implant (not shown in the figures) and an implant. for right forearm (shown in the figures).
    Preferably, the main body 9 of the implant 2 is provided with distal screwing openings 5, of at least one proximal screwing opening 7, which are formed respectively in the distal plate 14 and in the proximal tab 15, and which form or contribute to forming fastening means 5, 6, 7, 8 through which the implant 2 holds said bone bodies 3, 4 in position relative to one another. The screwing openings 5, 7 are preferably intended to each accommodate a fixing screw 10, 11 of the surgical implant 2 on the bone bodies 3, 4, as is particularly visible in FIG. 4.
    Preferably, the main body 9 of the surgical implant 2 is also provided with a through orifice 22, not intended to receive a fixing screw, formed through said main body 9 at the level of the zone which connects them. distal plate 14 and proximal tab 15.
    As illustrated in particular in Figure 2, preferably, the surgical implant 2 further comprises guide holes 23 formed in the main body 9, the surgical implant 2 being intended to be threaded through said guide holes 23 on guide pins (not shown) when it is placed in the body of the patient.
    The shoe 1 is intended to be temporarily deposited, during the placement of the surgical implant 2 in the body of the patient, on the free surface 13 of said implant 2, this free surface 13 corresponding to a surface opposite to the anterior surface 12 of the implant 2, the latter being intended to rest at least partially on said bone bodies 3, 4,
    According to an important characteristic of the invention, the shoe 1 comprises a main body 24 which itself comprises at least one radiopaque zone 25 and at least one radiopaque zone 26, and positioning means 27 of said shoe 1 relatively to the surgical implant 2 in a predetermined relative position, so as to allow control of the positioning of said implant 2 relative to said bone 3, 4 of the patient.
    The general principle of the invention indeed covers a shoe 1 intended to be attached to an implant 2 in a known and perfectly controlled position, by means of said positioning means 27 (which will be explained later), said shoe 1 having the at least one radiopaque zone 26 which acts, during an X-ray inspection, as a visible mark of the positioning of said implant 2 relative to said bone bodies 3,4, said mark being thus advantageously offset and removable from the implant 1.
    The shoe 1 of the invention finds its most interesting application when the implant 2 to which it is attached is completely radio-transparent. In this preferred embodiment, the radio-opaque zone 26 of the shoe 1 thus advantageously constitutes the only means of locating the positioning of said implant 2.
    However, the association of the shoe 1 of the invention is not excluded with an implant 2 which is not radiolucent, but which, for example, has no radiofrequency other than the zone of the implant 2 on which is positioned the shoe 1, or with an implant 2 which would be totally radio-opaque. In such an extreme configuration, the radiopaque area 26 of the shoe 1 would then not be the only, but at least one, means of locating the positioning of said implant 2.
    Preferably, the main body 24 of the shoe 1 comprises a base 28 intended to bear on said surgical implant 2.
    The base 28 advantageously has a lower surface 29 intended to rest at least partially on the free surface 13 of the implant 2 and an upper surface 30, opposite and substantially parallel to the lower surface 29, forming a dorsal surface preferably free when the shoe 1 is in place on said surgical implant 2.
    This base 28 has lateral edges 31, a distal edge 32 and a proximal edge 33. Said base 28 thus extends longitudinally between the distal edge 32 and the proximal edge 33, and transversely between two lateral edges 31.
    The lateral edges 31, the distal edge 32 and the proximal edge 33 advantageously delimit a contour substantially corresponding to at least a portion of the contour of said implant 2 on which the shoe 1 is intended to be positioned.
    In particular, according to the preferred embodiment illustrated in the figures, the shoe 1 is intended to be positioned solely on the distal plate 14 of the implant 2.
    Thus, as illustrated in FIG. 1, the distal edge 32 of the shoe 1 advantageously has a first portion 34 and a second portion 35, the latter being set back relative to said first portion 34. Preferably, the distal edge 32 is extends transversely and is composed of two successive portions, the first portion 34 advanced relative to the second portion 35. The distal edge 32 thus advantageously has an "S" shape. The shape of the distal edge 28 therefore corresponds advantageously to the "S" shape of the distal edge 16 of the implant 2.
    In addition, the lateral edges 31 are preferably substantially straight and said lateral edges 31, the distal edge 32 and the proximal edge 33 are configured such that the base 28 has a substantially trapezoidal contour, thus corresponding to the contour of the distal plate 14 of the implant 2.
    According to the preferred embodiment illustrated in the figures, and in particular in FIG. 1, the base 28 has at its distal edge 32 an area whose thickness preferably decreases slightly from the median portion of the base 28 towards said distal edge 32. In addition, still according to this preferred embodiment, the proximal edge 33 forms a stall projecting from the generally trapezoidal shape of said base 28.
    However, it is alternatively possible for the shoe 1 to cover the entire surface of the main body 9 of said implant 2, in which case the base 28 may, in the same way, have a contour corresponding to the spatular contour of said implant 2.
    The base 28 of the shoe 1 advantageously has oblong piercing openings 5A, 6A. When the shoe 1 is placed in position on the implant 2, these oblong drilling openings 5A, 6A are intended on the one hand and in a first step, to receive a drill guide 36 (visible in Figure 3) of the bone constituting the bone bodies 3,4, while angularly limiting the positioning of said piercing guide 36.
    Indeed, said oblong drilling openings 5A, 6A are configured in their respective orientation so as to finally allow drilling of the bone by means of the piercing guide 36 only in a given precise direction. On the other hand, and secondly, once the bone thus pierced in a desired orientation and the piercing guide 36 removed, the shoe 1 being maintained positioned on the implant 2, said oblong drilling openings 5A, 6A advantageously allow to guide the establishment and screwing by the surgeon of the fixation screws 10,11 of the implant 2 on the bone bodies 3, 4.
    The establishment of said fixing screws 10,11 is therefore particularly easy and accurate.
    As illustrated in FIG. 1, some oblong piercing openings 5A and 6A may be intersecting, in order to further facilitate the implementation of the piercing guide 36 and the fixing screws 10, 11 in a potentially complex field of operation and narrow.
    In the same way, the base 28 of the shoe 1 is advantageously provided with guide holes (not shown) intended to be threaded onto guide pins (not shown).
    The main body 24 of the shoe 1 comprises, according to the invention, and as previously introduced, at least one radiopaque area 25, that is to say invisible in the radiography, and at least one radiopaque area 26, that is to say, on the contrary visible on X-ray.
    According to a first preferred variant of the invention, represented in the figures and in particular in FIG. 1, the base 28 consists of a single-piece piece made of a substantially radiolucent material, capable of forming at least in part said at least one zone radio-transparent 25 of the main body 24.
    In other words, the base 28 is therefore a one-piece piece made of a material substantially invisible to radiography, for example polyether-ether-ketone (PEEK) or other biocompatible plastic material. Such a base 28 can easily be manufactured, for example, by machining or injection.
    Said at least one radio-opaque zone 26 of the shoe 1 according to this first variant is advantageously constituted by a substantially radiopaque element 37, distinct from said base 28 and fixed to the main body 24.
    Such an element 37 is preferentially single and monobloc, as retained in the preferred embodiment illustrated in FIG. 1. Said element 37 is produced, for example by machining or by forming, in a material that is substantially visible on radiography, for example a metal material based on stainless steel, titanium or other biocompatible metal or metal alloy.
    Alternatively, it is quite possible without departing from the scope of the invention for said radio-opaque zone 26 to consist of a plurality of elements 37 made of a material that is substantially visible on the radiography.
    Said radiopaque element 37 is advantageously fixed firmly and permanently to the base 28 of the shoe 1, for example by embedding said element 37 in the base 28 or by bonding said element 37 to the base 28 with the aid of a Adequate adhesive.
    This preferred variant of the invention has the advantage of being very simple to implement, since it makes use of a relatively simple mechanical combination of materials that are currently available and whose use is secured in the context of an intracorporeal therapeutic use. is largely tested.
    In a second variant of the invention, not shown in the figures, said base 28 is predominantly made of a substantially radiolucent material capable of forming at least in part said at least one radiopaque area 25 of the main body 24 of the shoe 1 , said material having locally in its mass one or more radio-opaque zones able to locally form at least in part said at least one radio-opaque zone 26 of the main body 24.
    In this case, the base 28 is therefore a single, one-piece piece made of a material or a mixture of materials that is generally radiolucent but exhibits a notable local variation in its radioprefficiency properties so as to locally generate one or more zones. identifiable on radiography.
    Such a composite material may, for example, be produced by implantation of radio-opaque particles in a radiolucent matrix or by local modulation of the density of a substantially radiolucent material, the zone or zones of greater density exhibiting then a relative radio-opacity contrasting with the areas of lower density. The substantially radio-opaque element 37 of the preferred embodiment of the invention is preferably positioned at the distal edge 32 of the base 25 of the shoe 1. In this preferred case, the radiopaque element 37 is therefore positioned in contact with the distal edge 32, and is thus for example positioned on, against or in the distal edge 32 of the base 28.
    However, and without departing from the scope of the invention, it is conceivable that said radiopaque area 26 is not positioned at the distal edge distal edge 32 of the base 25 of the shoe 1, but for example at the level of another part of the shoe 1.
    Even more preferably, the substantially radio-opaque element 37 is positioned so as to conform to the contour of the distal edge 32 of said base 28, that is to say that the element 37 fits perfectly into the contour of the distal edge 32 and, in particular, does not extend beyond one part of the lower surface 29 and on the other hand of the upper surface 30 of the base 28.
    Even more preferably, said substantially radio-opaque element 37 has a profile identical to that of the distal edge 32 of said base 28, and thus very faithfully reproduces the variations in the profile of the distal edge 32.
    Therefore, the radiopaque element 37 allows, on radiography, the clear and very precise identification of the distal edge 32 of the base 28 of the shoe 1 even though said base 28 remains invisible on the radiography.
    Still without departing from the scope of the invention, it is of course equally conceivable that said substantially radio-opaque element 37 is positioned and configured in a manner different from that, preferential, described above. Said substantially radio-opaque element 37 may, for example, have a profile different from that of the distal edge 32 of said base 28 or may be positioned slightly forward or recessed, of said distal edge 32.
    In the particularly advantageous embodiment shown in the figures, the radiopaque element 37 is in the form of a plate, or a ribbon, embedded in the distal edge 32 of the base 28 of the shoe 1 so as to flush the surface of said distal edge 32 reproducing very faithfully the variations of its profile. Said radiopaque element 37 could, alternatively, be in the form of a wire recessed in the same way. At the X-ray examination, when taking a snapshot of above, that is to say a snapshot taken in a direction perpendicular to the surface of the implant 2 on which is positioned the shoe 1, the element According to this preferred embodiment, radio-opaque material 37 appears by projection in the plane of the radiography, in the form of a line contrasting with the rest of the elements visible on the radiography.
    This feature is even more visible and recognizable when the implant 2 is made of a radiolucent material. It appears as a black line, or at least darker, on the X-ray. However, it remains perfectly identifiable when the implant 2 is instead made of a radiopaque material, if the radiopaque material forming the implant 2 is not strictly identical to the material forming the radiopaque element. 37.
    In the hypothesis of an implant 2 made of a substantially radio-opaque material, it would be advisable to retain, for the realization of the radiopaque zone 26, a material of significantly lower or greater density, or a method of realization. making it possible to confer on the material used a significantly lower or greater density than that of the material forming the implant 2, so as to show, in contrast, the line corresponding to the radio-opaque zone 26.
    The main body 24 of the shoe 1 also comprises, according to the invention, and as previously introduced, positioning means 27 of said shoe 1 relative to the surgical implant 2 in a predetermined relative position.
    Within the meaning of the invention, said predetermined relative position advantageously corresponds to a position in which the shoe 1 is placed on the free surface 13 of the surgical implant 2 so that the distal edge 32 and the lateral edges 31 of the base 28 of said shoe 1 are respectively positioned substantially at right distal edge 16 and side edges 18 of distal plate 14 of surgical implant 2.
    In this predetermined relative position, the piercing openings 5A, 6A, of the shoe 1 are superimposed and advantageously correspond to the screwing openings 5, 6 of the surgical implant 2 when the shoe 1 is attached to the latter.
    In the same way, in said predetermined relative position, the guide holes (not shown) of the shoe 1 advantageously correspond to the guide holes 23 of the surgical implant 2, so that the guide holes of the shoe 1 can be threaded onto the guide pins (not shown) in overlapping with the guide holes 23 of the surgical implant 2 when said shoe 1 is positioned on said implant 2.
    In this way, when the shoe 1 is attached to the surgical implant 2, and the latter is positioned with the aid of the guide pins (not shown) on the bone bodies 3, 4 of the patient, it is possible to performing a drilling or pre-drilling of the bone bodies 3, 4, for example using the drill guide 36, for the insertion of the fixing screws 10, 11. The pre-drilling or drilling being performed through the drilling openings 5A, 6A of the shoe 1, the integrity of the screwing openings 5, 6 is preserved, and the operation of setting up the surgical implant 2 facilitated.
    In order to facilitate the placement of the shoe 1 on the implant 2 in said predetermined relative position, the lower surface 29 of the base 28 of the shoe 1, intended to come into contact with the implant 2, is preferably provided with minus two pins 38 protruding from the lower surface 29 of said base 28.
    These pins 38 thus form or contribute advantageously to forming said positioning means 27.
    As illustrated in FIG. 1, these pins 38 are preferably arranged at the proximal edge 33 of the base 28, symmetrically on either side of the longitudinal axis of said base 28.
    Said pins 38 are preferably made of material with the base 28 so as to form a piece in one piece.
    They are advantageously intended to cooperate with at least two longitudinal guide members 39, 40 preferably formed in the free surface 13 of the implant 2 to allow the positioning of said shoe 1 relative to said implant 2 in said predetermined relative position.
    According to the preferred embodiment presented in particular in Figure 2, said longitudinal guide members 39,40 consist of two longitudinal grooves 39, 40 formed at the region of the main body 9 which connects the distal plate 14 to the proximal leg 15 of the implant 2. The longitudinal grooves 39, 40 are preferably arranged in "V" parallel to the lateral edges 18 of the implant 2, the opening of the "/" being oriented towards the distal edge 16 of the implant. the implant 2.
    The presence of these two pins 38 and their cooperation with the longitudinal guide members 39,40 of the implant 2, advantageously allow to facilitate the precise positioning of the shoe 1 on the implant 2, for example by sliding said pins 38 in said longitudinal guide members 39, 40, while preventing any rotational movement of said shoe 1 on said implant 2.
    Preferably, said minus two pins 38 protrude on either side of the lower 29 and upper surfaces 30 of said base 28 so that the shoe 1 can be reversibly positioned on the implant 2 and, according to two variants, thus constitute a shoe 1 for right implant or for left implant.
    In the preferred embodiment, shown in the figures, according to which the implant 2 constitutes a distal radial plate, the shoe 1 can therefore constitute a shoe 1 for a right forearm implant, as shown in the figures, or a shoe for left forearm implant, by simply reversing the shoe 1 relative to the free surface 13 of the implant 2.
    The lower surface 29 of the base 28 of the shoe 1 is furthermore, according to the preferred embodiment shown in the figures, provided with at least a third pin 41. Also projecting from the lower surface 29 of the base 28, this third pin 41 is positioned near the distal edge 32 of said base 28, so as to bear on the distal edge 16 of the implant 2 when the shoe 1 is in place on said implant 2.
    Thus, and particularly in the case where the distal plate 14 of the implant 2 has a chamfer at its distal edge 16, this third pin 41 advantageously allows the implant 2 to take over the force exerted by the surgeon. on the shoe 1, thus contributing to the precision of the gesture of placement and fixation of the implant 2 and the good mechanical strength of the shoe 1 avoiding the phenomena of cantilever.
    In a similar way to the configuration of the two pins 38, this third pin 41 also advantageously projects, according to the preferred embodiment shown in the figures, on either side of the lower 29 and upper surfaces 30 of said base 28 so as to that the shoe 1 can be reversibly positioned on the implant 2.
    Preferably, the shoe 1 is designed so that said at least one radio-opaque zone 26 of the main body 24 has a configuration which resumes that of an anatomical zone, for example the "watershed" line 21 given with respect to which said zone radiopaque 26 is intended to be positioned.
    In other words, the shoe 1 is advantageously designed so that the profile of the radiopaque zone 26 of its base 28 faithfully follows the profile of an anatomical zone of particular interest of the bone bodies 3, 4, so that the surgeon can accurately control the positioning of the implant 2 facing this anatomical area by superposition, radiography, the line formed by the projection of the radiopaque area 26 on the anatomical area profile concerned.
    Even more preferably, according to the embodiment illustrated in the figures, said anatomical zone is the "watershed" line 21 of a radius.
    Indeed, in the particularly advantageous embodiment illustrated in particular in Figure 4, when the shoe 1 is attached to said surgical implant 2 and positioned in said predestined position with the positioning means 27, the base 24 of the shoe 1 is preferably positioned on the distal plate 14 of said implant 2 so, in particular, that the distal edge 28 of the shoe 1 comes to be positioned precisely to the right of the distal edge 16 of the implant 2.
    Since said at least one radio-opaque zone 26 of the main body 24 of the shoe 1 advantageously allows the clear and very precise identification of the distal edge 32 of the base 28 of the shoe 1 to the radiography, then, in fact, said at least one radiopaque area 26 is, by the assembly of the shoe 1 on the implant 2, shaped and configured so as to indirectly control the positioning of said implant 2, and more particularly its distal edge 16, relative to a zone anatomical image of the body of the patient at which said implant is fixed 2.
    According to this particularly advantageous embodiment, the distal edge 16 of the implant 2 preferably has, as previously described, an "S" shape which, following the anatomical line of the bone bodies 3, 4, corresponds advantageously to the the crest line of the palmar part of the radius, or "watershed" line. Therefore, by assembling the shoe 1 on the implant 2 according to the predetermined relative position, the radiopaque area 26 of the shoe 1 advantageously takes up the configuration of this anatomically preferential zone that constitutes the "watershed" line 21, as is illustrated in Figure 5.
    Said at least one radio-opaque zone 26, preferably materialized by this radiopaque element 37, then makes it possible to control the position of the implant 2 relative to the "watershed" line 21 of the radius on which the implant 2 is intended to be fixed, as shown in Figure 5.
    By simultaneously viewing on the X-ray, on the one hand, this line "watershed" 21 and, on the other hand, the projection in the plane of the radiography of the position of the radiopaque element 37 which reflects that of the distal edge 16 of the implant 2, the surgeon can very precisely position the implant 2 on the bone bodies 3, 4, while monitoring that said distal edge 16 does not overflow from said line "watershed" 21.
    Alternatively, it is of course perfectly conceivable that, without departing from the scope of the invention, the radio-opaque zone 26 of the base 28 of the shoe 1 is shaped and configured in a different manner in order to resume the configuration of another anatomical area of interest and allow, using the shoe 1, the precise positioning of the implant 2 relative to this other anatomical area.
    Preferably, the main body 24 of the shoe 1 further comprises a securing means 42, in said predetermined relative position, of said shoe 1 relative to said surgical implant 2.
    This securing means 42 advantageously enables the shoe 1 to be held firmly, but removably, in position on a surgical implant 2, so as to allow precise guidance of the piercing guide 36, without the risk that the force applied by the surgeon to said drilling guide 36 inadvertently causes the separation of the shoe 1 and the implant 2.
    Preferably, this securing means 42 consists of a fastening orifice 43 passing through the base 28 of the main body 24, said fastening orifice 43 being intended to receive a securing screw 44 of the shoe 1 on the surgical implant 2 .
    According to the preferred embodiment illustrated in the figures, and in particular in FIG. 1, this fastening orifice 43 is formed in the base 28 of the shoe 1 so as to be closer to the proximal edge 33 than to the distal edge 32.
    Thus, when the shoe 1 is positioned on the implant 2 in the predetermined relative position defined above, said fastening orifice 43 advantageously coincides with the through orifice 22 of said implant 2, said through orifice 22 thus advantageously constituting an element of receiving 45 intended to cooperate with said securing means 42 of said shoe 1 by means of the securing screw 44, so as to allow the shoe 1 to be secured to the implant 2.
    Even more preferably, said securing screw 44 is a screw which allows the locking of the shoe 1 on the surgical implant (2) by a rotation of only a quarter turn of said screw 44.
    The surgeon can thus lock the shoe 1 in position on the surgical implant 2 in a particularly practical, fast and secure manner.
    Alternatively, and without departing from the scope of the invention, the securing means 42 may consist of a fastening screw 44 secured to said main body 24, that is to say being able to slide or turn in said fastening hole 43 , while remaining in mechanical connection with the main body 24.
    This variant, not shown in the figures, has the advantage of substantially limiting the risk of loss of the securing screw 44, in particular in the body of the patient, during the removal of the shoe 1 from the implant 2. However, in a In such a configuration, the shoe 1 no longer has the reversible nature described above which allows it to be associated, by simple reversal, to an implant 2 for right forearm or to an implant 2 for left forearm.
    It is also perfectly conceivable, without departing from the scope of the invention, that the securing screw 44 is replaced by another quarter-turn fastening system, or by a fastening system which is not of the quarter-turn type. tower. The invention also relates to a surgical kit 46, as illustrated in particular in FIG. 6, which includes a surgical implant 2 intended to be attached to bone bodies 3, 4 of a patient, for example of his forearm, and on the other hand, a shoe 1 as described above.
    Preferably, and in accordance with the example taken previously and illustrated in the figures, the implant 2 included in the surgical kit 46 is an osteosynthesis implant and, more particularly, a distal radial plate, that is to say intended for treatment of a fracture of the distal end of the radius of the forearm of a patient. Consequently, correlatively, the shoe 2 of the surgical kit 46 constitutes a positioning and fixing aid shoe adapted to an osteosynthesis implant of the type of a distal radial plate. However, the invention is not limited to a shoe 1 for assisting the positioning and fixation of a forearm implant, the surgical kit 46 may include, for example, a tibial implant or a palmar implant, and their hoof. corresponding.
    Said surgical implant 2 of the surgical kit 46 preferably comprises a receiving element 45 intended to cooperate with said securing means 42 of said shoe 1 and at least one radiolucent part 47, so as to allow on the one hand the fixation in said predetermined relative position, said shoe 1 on said surgical implant 2, and, secondly, the control of the positioning of said implant 1 relative to said bone 3, 4 of the patient.
    Indeed, as previously introduced, the shoe 1 of the invention finds its most interesting application when the implant 2 to which it is reported is completely radio-transparent, or at least partly radiolucent. For this reason, even more preferably, the main body 9 of the surgical implant 2, and more generally the surgical implant 2, can advantageously form a single piece of monobioc and unit made of a radiolucent material, preferably polyether-ether-ketone (PEEK).
    Preferably, the surgical kit 46 includes a shoe 1 whose bottom surface 29 of the base 28 intended to come into contact with the implant 2, is provided with at least two pins 38 projecting from the surface lower 29 of said base 28, and intended to cooperate with at least two longitudinal guide members 39, 40, preferably formed by the longitudinal grooves 39, 40, formed on the surface of said implant 2 to allow the positioning of said shoe 1 relatively implant 2 in said predetermined relative position.
    The surgical kit 46 includes, even more preferably, the shoe 1 previously described, in its variant according to which the base 28 of said shoe 1 comprises at least two pins 38 which protrude on either side of the lower surfaces 29 and upper 30 of said base 28, so that the shoe 1 can be reversibly positioned and thus constitute a left implant shoe or a right implant shoe.
    In the same way, the implant 1 included in the surgical kit 46 is advantageously according to its preferred variant in which its base 28 comprises the third pin 4, the latter also advantageously projecting, according to the preferred embodiment shown in FIGS. , on either side of the lower 29 and upper surfaces 30 of said base 28.
    This advantageously makes it possible to simplify inventory management and the preparation of surgical kits to be commercialized, since there is therefore only one hoof reference 1 to be taken into account for each of the right or left variants of an implant. 2.
    When the shoe 1 of the invention is attached to the surgical implant 2 of the surgical kit 46 in said predetermined relative position, said at least one radiopaque zone 25 of the main body 24 of the shoe 1 is advantageously intended to face at least one radiolucent portion 47 of said implant 2.
    Even more preferably, in said predetermined relative position of the shoe 1 on the implant 2, the distal edge 32 of the base 28 of the shoe 1 is intended to come substantially opposite a distal end of said surgical implant 2.
    In the preferred embodiment, illustrated in the figures, according to which the implant 2 is a distal radial plate, the distal edge 32 of the base 28 of the shoe 1 thus comes to be positioned facing the distal plate 14 of said implant 2, preferably at the distal edge 16 of the implant 2.
    Thus, said shoe 1 and implant 2 of the surgical kit 46 are preferably configured relative to each other so that the shoe 1 finds its most advantageous application, namely that it constitutes thanks to its area radiopaque 26 a particularly useful remote reference mark of the precise position of the implant 2 and, more precisely of the distal edge 16 of the implant 2, relative to the bone bodies 3, 4 of the patient.
    According to the previously preferred description of said shoe 1 and implant 2, when said shoe 1 of the kit 46 is attached to a surgical implant 2 of said kit 46, said at least one radiopaque area 26 of the main body 24 of the shoe 1 is advantageously shaped and configured to allow control of the positioning of said implant 2 relative to a given anatomical area, and more particularly, with respect to the "watershed" line 21 of a radius, the configuration of said "watershed" line 21 being advantageously repeated by the radio-opaque zone 34, for the reasons explained above.
    In addition, preferably, said receiving element 45 of said implant 2 consists of an orifice 48 intended to cooperate with said securing screw 41 of said shoe 1 to allow the locking of said shoe 1 relative to said implant 2 in said relative position. predetermined, said orifice 48 not otherwise intended for fixing said implant on said bone bodies 3, 4.
    In a preferred embodiment of the invention, this receiving element 45 consists of the through orifice 22 of the implant 2 according to the preferential description which has been made previously.
    Accordingly, the combination of the shoe 1 of the invention with a surgical implant 2 according to the preferred description which is made above, and which is illustrated in the figures, constitutes a surgical kit 46 particularly convenient for use by the surgeon and which enables it to respond fully to the problem of controlling the precise positioning of the distal edge 16 of the implant 2 relative to the "watershed" line 21 of the treated radius in the particular case where the implant 2 is radiopaque or when at least its distal plate 14 is radiopaque.
    Particularly advantageously, the surgical kit 46 may also include the fixing screws 9, 10 of the shoe 1 on the implant 2, guide pins, and the screw 44 for securing the shoe 1 in position on said implant 2, ie all being preferentially packaged in sterile packaging.
    In addition, in order to facilitate the surgeon's intervention and in particular to reduce the duration of the operation of placing and fixing the implant 2 in the body of the patient, the surgical kit 46 may even more advantageously include the shoe 1 of the invention already positioned and secured to said implant 2 according to said predetermined relative position. The invention may finally concern as such a method of placing a surgical implant 2 using the shoe 1 of the surgical kit 46 described above. The foregoing description concerning the shoe 1, the surgical implant 2 and the surgical kit 46 is also valid for the implementation method explained hereinafter.
    The method of placing the surgical implant 2 with the aid of the shoe 1 of the invention advantageously comprises at least the following successive steps: the body of the patient is incised in order to be able to introduce the surgical implant 2 to the inside, at the level of the bone bodies 3, 4 to be treated, - guide pins are implanted in the bone bodies 3, 4, for example by impaction, and optionally with the aid of the surgical implant 2 or the shoe 1 , the guide pins (not shown) being able to be impacted in the bone bodies 3, 4 through the guide holes 22 thereof, - the surgical implant 2 is positioned on the bone bodies 3, 4, using guide pins, so that the anterior surface 12 of the implant 2 rests at least partially on the bone bodies 3, 4, the distal plate 14 of the implant 2 being in contact with an end portion of the bone to be treated forming the bone body 3 and the paw With the roximal 15 in contact with an intermediate or median part of the bone to be treated forming the bone body 4, the shoe 1 is attached to the free surface 13 of the surgical implant 2, preferably by sliding the pins 38 into the longitudinal guide members 39, 40 formed in said free surface 13 of the surgical implant 2, so as to bring the distal edge 32 of the base 28 of the shoe 1 into confrontation with the distal edge 16 of the distal plate 14 of the implant 2 and the distal screwing openings 5, 6 of said distal plate 14 with the piercing apertures 5A, 6A of the shoe 1, the shoe 1 is secured in position on the surgical implant 2 by means of the screw 44, - an X-ray is taken to verify, by visualization of the radiopaque area 26 of the shoe 1, the correct positioning of the surgical implant 2 on the bone bodies 3,4, relative to the fracture zone 3A, 4A to treat and its surroundings anatomically, the bone bodies 3, 4 are pre-pierced through all or part of the piercing apertures 5A, 6A of the shoe 1 and through the openings 7, 8 of the proximal lug 15 of the implant 2 a first clamping screw 11 is inserted into one of the distal screwing openings 5 of the distal plate 14 of the implant 2, and a second clamping screw 10 into the screwing opening 8 of the proximal lug 15, - before tightening said first and second clamping fixing screws 11, the proximity and the orientation of the bone bodies 3, 4 are adjusted by sliding the second fixing screw 11 along the opening of the screwing 8, - the first and second clamping fastening screws 10 are tightened, the fastening screws 9 are then inserted into all or part of the remaining screwing openings 5, 6, 7 in order to ensure a durable fixing of the surgical implant 2 in the patient's body, - as and when in the operations of insertion and tightening of the fixation screws 9, 10, the guide pins of the bone bodies 3, 4 are removed; an X-ray is taken to check the orientation of the screws 10, 11 through the bone bodies 3, 4, - the boot 1 of the surgical implant 2 is unlocked and removed, - the incision of the patient's body is closed again
    Of course, certain steps may be reversed without departing from the scope of the invention. In particular, the step of assembling the shoe 1 on the implant 2 can be performed prior to the insertion of said implant 2 in the body of the patient, so as to facilitate the work of the surgeon.
    Ultimately, the shoe 1 allows an easy, precise and rapid implementation of the surgical implant 2, thereby helping to allow particularly rapid osteosynthesis of bone bodies 3, 4, and good quality, while limiting postoperative complications and the pain suffered by the patient.
    权利要求:
    Claims (21)
    [1" id="c-fr-0001]
    1- A sabot (1) for the positioning and fixation of a surgical implant (2) intended to be attached to bone bodies (3, 4) of a patient, for example of his forearm, said shoe (1) having a main body · (24) and being characterized in that said main body (24) comprises: - at least one radiopaque area (25) and at least one radiopaque area (26), and positioning means (27) for positioning said shoe (1) relative to the surgical implant (2) in a predetermined relative position, so as to allow control of the positioning of said implant (2) relative to said bone bodies (3, 4) of the patient.
    [2" id="c-fr-0002]
    2- shoe (1) according to the preceding claim, characterized in that the main body (24) comprises a base (28) intended to bear on said surgical implant (2), and having side edges (31), a distal edge (32) and a proximal edge (33) delimiting a contour substantially corresponding to at least a portion of the contour of said implant (2).
    [3" id="c-fr-0003]
    3 - Shoe (1) according to claim 2, characterized in that said base (28) consists of a one-piece piece made of a substantially radiolucent material, capable of forming at least in part said at least one radiolucent zone ( 25) of the main body (24), said at least one radio-opaque zone (26) consisting of a substantially radiopaque element (37), distinct from said base (28), and fixed to the main body (24) .
    [4" id="c-fr-0004]
    4- shoe (1) according to claim 3, characterized in that said element (37) substantially radiopaque is disposed at the distal edge (32) of said base (28).
    [5" id="c-fr-0005]
    5- shoe (1) according to the preceding claim, characterized in that said element (37) substantially radiopaque wife the contour of the distal edge (32) of said base (28).
    [6" id="c-fr-0006]
    6- Shoe (1) according to the preceding claim, characterized in that said element (37) substantially radiopaque has a profile identical to that of the distal edge (32) of said base (28).
    [7" id="c-fr-0007]
    7- Shoe (1) according to claim 2, characterized in that said base (28) is predominantly made of a substantially radiolucent material capable of forming at least in part said at least one radiopaque area (25) of the body primary (24), said material having locally in its mass one or more radio-opaque areas capable of locally forming at least in part said at least one radiopaque area (26) of the main body (24).
    [8" id="c-fr-0008]
    8- Shoe (1) according to any one of the preceding claims, characterized in that said at least one radio-opaque zone (26) of the main body (24) has a configuration that resembles that of a given anatomical area of which said radio-opaque zone (26) is intended to be positioned.
    [9" id="c-fr-0009]
    9 - Shoe (1) according to the preceding claim, characterized in that said at least one radio-opaque zone (26) of the main body (24) has a configuration that resembles that of the line "watershed" (21) of a radius.
    [10" id="c-fr-0010]
    10-shoe (1) according to any one of the preceding claims, characterized in that the main body (24) further comprises a securing means (42), in said predetermined relative position, said shoe (1) relatively surgical implant audit (2).
    [11" id="c-fr-0011]
    11 -Sabot (1) according to the preceding claim, characterized in that said securing means (42) consists of a fastening orifice (43) passing through the base (28) of the main body (24), said fastening orifice (43) being intended to accommodate a screw (44) for securing the shoe (1) on the surgical implant (2).
    [12" id="c-fr-0012]
    12 - Shoe (1) according to the preceding claim, characterized in that said screw (44) for securing is a screw (44) which allows the locking of the shoe (1) on the surgical implant (2) by a rotation of only a quarter turn of said screw (44).
    [13" id="c-fr-0013]
    13 - Surgical kit (46) including a surgical implant (2) intended to be attached to bone bodies (3,4) of a patient, for example of his forearm, and a shoe (1) according to the invention. one of the preceding claims,
    [14" id="c-fr-0014]
    14- Surgical kit (46) according to the preceding claim, characterized in that the surgical implant (2) comprises a receiving member (45) for cooperating with said securing means (42) of said shoe (1) and at least a radiolucent part (47), so as to allow on the one hand the fixation, in said predetermined relative position, of said shoe (1) on said surgical implant (2), and, on the other hand, the control of the positioning said implant (2) relative to said bone bodies (3, 4) of the patient.
    [15" id="c-fr-0015]
    15- Surgical kit (46) according to the preceding claim, characterized in that, said shoe (1) being attached to said surgical implant (2) in said predetermined relative position, said at least one radiopaque area (25) of the body main (24) faces at least one radiopaque portion (47) of said implant (2).
    [16" id="c-fr-0016]
    16 - Surgical kit (46) according to the preceding claim, characterized in that the distal edge (32) of the base (28) of the shoe (1) substantially faces a distal end (14) of said surgical implant (2). ).
    [17" id="c-fr-0017]
    17 - surgical kit (46) according to one of the preceding claims, characterized in that the lower surface (29) of the base (28) of the shoe (1) intended to come into contact with the implant (2), is provided with at least two pins (38), projecting from the lower surface (29) of said base (28), and intended to cooperate with at least two longitudinal guiding members (39, 40) formed in the surface (13) of said implant (2) to allow the positioning of said shoe (1) relative to said implant (2) in said predetermined relative position.
    [18" id="c-fr-0018]
    18 - Surgical kit (46) according to the preceding claim, characterized in that said at least two pins (38) project from either side of the lower (29) and upper (30) surfaces of said base (28), so that the shoe (1) can be reversibly positioned and thus constitute a left implant shoe or a right implant shoe.
    [19" id="c-fr-0019]
    19-surgical kit (46) according to one of the preceding claims, characterized in that said receiving element (45) of said implant (2) consists of an orifice (48) intended to cooperate with said screw (44) of securing said shoe (1) in order to allow the locking of said shoe (1) relative to said implant (2) in said predetermined relative position, said orifice (48) not being moreover intended for fixing said implant (2) on said shoe bone body (3, 4).
    [20" id="c-fr-0020]
    20 - Surgical kit (46) according to one of the preceding claims, characterized in that said surgical implant (2) is a distal radial plate.
    [21" id="c-fr-0021]
    21-surgical kit (46) according to the preceding claim, characterized in that, said shoe (1) being attached to a surgical implant (2), said at least one radio-opaque zone (26) of the main body (24) is shaped and configured to allow control of the positioning of said implant (2) relative to the line "watershed" (21) of a radius, whose configuration is taken up by the radiopaque area (26).
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    同族专利:
    公开号 | 公开日
    EP3132758A1|2017-02-22|
    US20170049493A1|2017-02-23|
    FR3040132B1|2021-11-12|
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    法律状态:
    2016-08-24| PLFP| Fee payment|Year of fee payment: 2 |
    2017-02-24| PLSC| Publication of the preliminary search report|Effective date: 20170224 |
    2017-08-28| PLFP| Fee payment|Year of fee payment: 3 |
    2018-08-23| PLFP| Fee payment|Year of fee payment: 4 |
    2019-08-12| PLFP| Fee payment|Year of fee payment: 5 |
    2020-08-21| PLFP| Fee payment|Year of fee payment: 6 |
    2021-08-25| PLFP| Fee payment|Year of fee payment: 7 |
    优先权:
    申请号 | 申请日 | 专利标题
    FR1557811A|FR3040132B1|2015-08-19|2015-08-19|BOOT TO ASSIST THE POSITIONING AND FIXATION OF A SURGICAL IMPLANT|FR1557811A| FR3040132B1|2015-08-19|2015-08-19|BOOT TO ASSIST THE POSITIONING AND FIXATION OF A SURGICAL IMPLANT|
    EP16183028.6A| EP3132758A1|2015-08-19|2016-08-05|Shoe to assist with the positioning and securing of a surgical implant|
    US15/240,551| US20170049493A1|2015-08-19|2016-08-18|Shoe for helping to position and fix a surgical implant|
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