FR2626460A1 - OSTEOSYNTHESIS PLATES - Google Patents

Abstract

The osteosynthesis plate 10 includes a flexible, collapsible, elongated rod-shaped portion 12 with attachment portions 14, 16 located at opposite ends of the rod-shaped portion 12. The securing portions 14, 16 may be formed by punching or other suitable flattening operation. The fixing parts 14, 16 of different shape and orientation can be made in the osteosynthesis plate 10. Other embodiments of the invention include an alternating arrangement of a plurality of rod-shaped portions 12 and of a plurality of fixing portions. The osteosynthesis plate 10 is made of a material which can be bent, twisted or otherwise formed in three directions according to a predetermined contour and which can withstand a predetermined stress in the folded configuration. The osteosynthesis plate 10 can therefore provide stable attachment of bone sections at the site of a fracture.

Description

OSTEOSYNTRESE PLATES

  This invention relates to osteosynthesis plates and more particularly to an osteosynthesis plate which can be folded or twisted in one or more directions before being

fixed on a bone.

  A bone lesion that manifests as a fracture, fracture, breakage or crack often requires that the bone be supported or stabilized to

  promote healing or osteogenesis in the area of injury.

  The support and stabilization also allowing the alignment-

  of the two parts of bone during osteogenesis.

  In the sense given here, the term fracture includes fractures, osteotomies, cracks,

  shattered and broken bones.

  Occasionally, due to the nature of the lesion, the bone requires substantially permanent support in

  the area of the lesion. We often realize such direct support

  on the bone. In the case of osteotomy, it is often necessary, as part of the treatment plan, to maintain

  a bone segment at some distance during healing.

  There are also known means for fixing bone in place by means of surgical nails placed inside the bone, in particular in long bones, as shown,

  example, in US Patents 4,055,172; 4,169,470 and 4,483,335.

  The nails shown in the previous patents require the use of a centering tool and are generally attached to only one of their ends. The nails described are also difficult to bend or form because they must be

  elastic both longitudinally and laterally.

  Bone fractures which cannot be repaired with nails but which nevertheless require support for proper healing, can often be treated with plate fixation devices. According to a known type, the osteosynth plate is screwed directly into the bone through the fracture to stabilize the parts of the bone.

  on opposite sides of the fracture.

  Due to the irregularity of bone fractures, an osteosynthesis plate device which is suitable for a

  type of fracture may not be the same with another type of fracture.

  Since many fractures occur at irregular surfaces of the bone, it is a common practice to conform an osteosynthesis plate to the contour of the bone surface at the location of the fracture. As bone fractures and S bone shapes are rarely identical, it is desirable to make a device with osteosynthesis plates which can be folded or shaped according to a given contour just before fixation

on the bone.

  The tailor-made adjustment of the osteosynthesis plates on a bone surface allows the specific correction required to repair a particular lesion to be obtained in

each case whatever it is.

  US Patent 4,573,458 shows an osteo-plaque

  synthesis which can be folded or formed in suitable directions to meet the particular support needs of various bone lesions. The osteosynthesis plate described comprises an elongated rod perforated with several

  integral areas intended to hold transverse screws

  badly compared to the stem '. None of the areas that maintain-

  the screws do not intersect the axis of the rod. The osteo plate

  synthesis is therefore fixed on the bone at points which are offset

relative to the axis of the rod.

  The fact of providing parts intended to maintain the

  screw in these ears protruding on the rod requires operations

  relatively expensive production conditions. In addition,

  parts that hold the screw are at predeter distances-

  mined along the stem which can make it difficult to adjust

  Tailor-made osteosynthesis plate on an area of

bone lesion.

  It is therefore desirable to produce an osteo-plaque

  which is relatively easy to manufacture with fastening parts arranged along the axis of the osteosynthesis plate at any chosen distance. It is also desirable to make an osteosynthesis plate which can be folded or twisted in three directions to facilitate connection to an area of bone injury and prevent

  that the fixing parts are aligned with struc-

  vital tures where the fixing screw could scream a lesion.

  The object of the present invention is to produce a

  new bone plate, a new bone plate

  synthesis which can be folded or twisted in three directions to connect parts of bone separated by a fracture, a new g5 osteosynthesis plate having fixation parts aligned with the axis of the osteosynthesis plate, a new plate osteosynthesis which can have any desired length and have selected distances between the fixing parts. The invention also relates to a method

  2 new repair of a bone fracture.

  Other objects and features of the invention-appa-

  partially and will be indicated in part below.

  The osteosynthesis plate, according to one embodiment

  of the invention, comprises a flexible, elongated, foldable

  ble, rod-shaped to connect the elements of a broken bone

  tured. The osteosynthesis plate is formed from a material which can be folded or twisted in three directions and maintain this three-dimensional folding under a predetermined stress. The rod-shaped part has a generally circular cross-section and generally flat fixing parts arranged opposite one another at the ends of

the stem.

  Preferably, the fixing parts are stamped from a section of the rod-shaped part in utili-s

  a matrix tool which can be used manually -

  lement. The stamping operation can also be mechanized.

  - The fixing parts cut the longitudinal axis of the 4 'rod-shaped part and also have dimensions

  longitudinal and lateral 4ui exceed the diameter of the.

part in the form of a rod.

  In certain embodiments of the invention, the fixing parts have identical shapes and dimensions. In other embodiments of the invention, the

  fixing parts are of different dimensions and shapes

  annuities. In another embodiment of the invention, the osteosynthesis plate comprises several parts in the form

  rod alternating with fixing parts.

  In each embodiment of the invention, the attachment portions include attachment openings through which a screw or clip is used to

  fix the osteosynthesis plate on the bone.

  When using the osteosynthesis plate for

  assembling the elements of a fractured bone, the osteo plate

  Synthesis is properly folded to fit the bone contour at the fracture site. The fixation parts are fixed to the bone in areas distant from the fracture to fix the bone on the opposite sides of the fracture. Bends and twists in the osteosynthesis plate can withstand a predetermined stress to ensure stable fixation

  of bone at the location of a fracture.

  The invention therefore comprises structures and the method described below, the part of the invention being

indicated in the claims.

In the accompanying drawings,

  - Figure 1 is a plan view of an osteo plate

  synthesis according to an embodiment of the invention; - Figure 2 is a fragmentary view on a larger scale, partially shown in section, taken along line 2-2 of the

figure 1.

  - Figure 3 is a perspective view of the osteosynthesis plate with a folding tool and a holding device; - Figures 4, 5 and 6 are perspective views of other embodiments thereof with different folding configurations; - Figure 7 is a perspective view of a rod-like structure used to make the osteosynthesis plate; - Figure 8 is a perspective view of cellecl

  before insertion into a matrix tool

  cage; - Figure 9 is a perspective view thereof after insertion into a nmatrigage tool; - Figure 10 is a fragmentary sectional view to more

  large scale of it before matri-

  cage; - La- Figure 11 is a fragmentary sectional view on a larger scale thereof during the stamping ;, - Figure 12 is a perspective view thereof after the completion of the stamping; - Figure 13 is a fragmentary perspective view of a fastener and a fastening tool for the osteosynthesis plate; - Figure 14 is a view. simplified diagram of aortosynthesis plates on a fractured maxilla; - Figure 15 is a simplified schematic view thereof on an anterior mandibular osteotomy; - Figure 16 is a schematic view thereof on an oblique osteotomy of the maxilla; - Figure 17 is a simplified schematic view of the osteosynthesis plate for a sagittal mandibular osteotomy; and - Figures 18 and 24 show other modes of

realization of the invention.

  An osteosynthesis plate incorporating a mode of realization

  sation of the inventi.on is designated as a whole by the

  reference numeral-10 in Figure 1.

  The osteosynthesis plate 10 comprises a part 12 in the form of an elongated flexible rod with first and second

  fixing parts 14 and 16 formed on the opposite ends

of the rod part 12.

  Preferably, the osteosynthesis plate 10 is formed from a malleable, pliable, biocompatible material such as

  titanium which may be of the type designated by ASTM F-67 grade 2.

  The rod 12 is of a generally circular cross section and of any chosen length. The fixing part 14 comprises fixing holes 18 and 20 and the fixing part i6 likewise comprises fixing holes 22 and 24.

  The parts 14 and 16 of the fixing are formed by choosing

  weaving a rod such as rod 26 (Figure 7) and matri-

  glove these ends with a suitable stamping tool 28

  to form the fixing parts 14 and 16.

  The die-forging tool 28 is a similar structure & pliers comprising jaw members 30 and 32 which are pivotally mounted 34 and extend beyond the pivot 34

  in lever parts 36 and 38. Referring to the fig-

  res 8 and 10, the recesses 40 and 42 are formed in surfaces 44 and 46 of compression of the jaw members 30 and 32. The semicircular grooves 48 and 50 extend from the recesses 40 and 42 to respective end portions 52 and 54 of the jaw members 30 and 32. The

  burfaces of the semicircular grooves 48 and 50 and of the recesses

  40 and 42 are gradually connected.

  The formation of an osteosynthesis plate 10 is accom-

  bends by inserting one end 56 of the rod 26 between the jaw parts 30 and 32, as shown in FIGS. 8 and 9. The jaw members 30 and 32 are then pinched towards each other in the manner shown in figure I1l for

  stamp or flatten the extreme part 56 and give it the form

  me 57 fixing shown in Figure 12.

  The fixing holes 22 and 24 are formed in a way

  known any suitable and include contraindications

  bores 58 and 60, as shown most clearly in 4. figure 2. If desired, the fixing holes 22 and 24

  can be fully tapered.

  After stamping the end part 56 of the rod 26,

  the other extreme part 62 can be stamped in a similar manner.

  Any known device suitable (not shown) for simultaneously stamping the ends 56 and 62 of the rod 26

can also be used.

  Thus, a rod 26 of predetermined size produces a plate 10 for osteosynthesis with a part 12 in the form of

rod of predetermined length.

  Precise dimensions of the plate 10 dlostéosynth & s can vary depending on the location of use

  planned. However, to give an example of large orders

  deur in question, the part 12 of stem can present a di-

  meter from 1 to 1.5 mm, the thickness of the fixing parts 14 and 16 can be 1.0 mm, the side width can be about 5.0 mm, and the length of the fixing parts can

be about 10 mm.

  The fixing holes can have a diameter of

  2.8 mmn for the transverse hole and a 3.8 mm counterbore.

  The overall dimension, from one end to the other, of the plate

  osteosynthesis can reach between 2 mm and 12 mm.

  The osteosynthesis plate 10 is used for fractures and / or for osteotomies intended to fix bone fragments in a predetermined position. In the case of bone fractures, the predetermined attachment position

  suitable for bone is the pre-anatomical configuration

  traumatic. In the case of an osteotomy, the predefined position

  end of attachment is different from the position corresponding to the pre-surgical anatomy, the part in question being advanced, moved back, raised, lowered or moved laterally,

  and then fixed with the osteosynthesis plate 10.

  For example, referring to Figure 14, a maxilla-

  re 70 fractured is moved forward and immobilized with the

  osteosynthesis plates 10 folded and twisted in three dimensions

  sions. Fasteners 64 (Figure 13) are used to secure

  the parts 14 and 16 of attachment on the parts 66 and 67 of bone.

  A fluted key 68 drives the fasteners 64 in the holders

  66 and 67 of bone. The folding and twisting operation is accomplished using any suitable folding and / or twisting tool such as the folding tool 72 shown in FIG.

figure 3.

  The folding tool 72 is similar to pliers and

  takes a part 74 of jaw & two branches connected by the pivot 78 to a part 76 of jaw with a single branch. The jaw parts 74 and 76 extend beyond the pivot 1 by the arms 80, and 82. The folding is carried out by fixing one

  fixing parts, for example, 14, between the jaws

  res 30 and 32 of the stamping tool 28 and by pinching the part 12 in the form of a rod between the parts 74 and 76 of the jaw of the folding tool 72 in order to produce a folding as

  folding 84 shown in Figure 4. Another folding includes

  me 86 is shown towards the rod part 12a of the figure

  re 5. The part 12a of the rod is larger than the part 12.

  Other folds like 88, '90 and 92 are shown on the-

  part 12b of the rod in FIG. 6. The part 12b of the rod is larger than the part 12a. All folds can be

  made using the folding tool 72.

  The rod parts 12, 12a and 12b can also be twisted by a predetermined amount, in general, for the purpose of orienting the fixing parts 14 and 16 in planes

desired.

  In Figure 15, an anterior mandibular osteotomy

  or genioplasty, reprised in its simplified schematic form

  tick, is made using at least two osteosynthesis plates 10 which contain folds and twists composed to firmly fix the parts 94 and 96 of bone

at the site of a fracture 98.

  An oblique maxilla osteotomy, shown in its simplified schematic form in Figure-16, is facilitated with the osteosynthesis plates 10 which are fixed at preselected locations on the bones 91 and 93 across a

  fracture 95, as previously described.

  A sagittal mandibular osteotomy, shown in simplified schematic form in FIG. 17, is also facilitated with the osteosynthesis plates 10 fixed at preselected locations on the bones 97 and 99 across a fracture 101. The number of plates 10 of osteosynthesis used and their location is a matter of choice and the number of osteosynthesis plates 10 shown in Figures 14 to 17

has only an illustrative purpose.

  It is clear that two plates of osteosynthesis or forward

  Similar or different sizes can be used for a single osteotomy. Each of the osteosynthesis plates can be folded, twisted or otherwise formed to give a desired shape depending on the outline

  bone in the area of a. fracture.

  Another embodiment of an osteosyn- plate

  thesis is designated as a whole by the numerical reference

  than 100 in FIG. 18. The osteosynthesis plate 100 comprises rod-shaped parts 102, 104, 106, 108, 110 and 112, alternating with fixing parts 114, 116, 118, 120, 122, 124 and 126. The fixing parts 114 and 126 can be formed in a similar manner to that described above. However, the intermediate parts 116 to 124

  are formed with a modified mastering tool- (not shown-

  felt) in which the recesses 40 and 42 of the tool 28 of

  forging are oriented with their longitudinal axes respec-

  tifs parallel to the axis of the swivel of the stamping tool. The

  reorientation of the recesses allows the intermediate parts

  res 116, 124 of the osteosynthesis plate 100 to be formed with a stamping tool similar to pliers. The osteosynthesis plate 100 is used for a fracture which requires a -) support along an elongated and regular contour as in a maxillofacial trauma. The osteosynthesis plate 100 can

  be folded or twisted in three dimensions in a similar way

  to that described above.

  Another embodiment of the osteosynthesis plate

  -35 is designated as a whole by the reference numeral 130 to-

  Figure 19. The osteosynthesis plate 130 comprises parts 132, 134 and 136 of rod alternating with the fixing part 138, 140, 142 and 144. The parts 132, 134 and 136 of rod of the osteosynthesis plate 130 are longer than the stem parts 102 to 112 of the osteosynthesis plate 100

  and may be of larger diameter. Plate 130 of osteo-

  synthesis is also used for maxillo- trauma

  face and can be folded or twisted in three directions one

  similar to that described above.

  Another embodiment of the osteosynthesis plate is designated as a whole by the reference numeral 151 in FIG. 20. The osteosynthesis plate 150 comprises a part 152 of rods and opposite fixing parts 154 and 156 in V shape. Each of the fixing parts 154 and 156

  contains three fixing holes 158, 160 and 162. By the-

  ties.1S4 and 156 'of fixing can be formed using

  a modification (not shown) of the natrisage tool -28.

  The modified stamping tool comprises a recess whose shape is complementary to that of the fixing parts 154 and 156. The osteosynth plate 150 can be folded or twisted in three directions dtune. similar to that

has been described previously.

  Another embodiment of the osteosynthesis plate is designated as a whole by the reference numeral 170 to

  Figure 21. The osteosynthesis plate 170 includes a -

  rod part 172 and opposite fixing parts 174 and 176. The fixing parts 174 and 176 comprise fixing openings 175 and 177 and have a transverse dimension with respect to the axis of the rod part 172

  greater than the longitudinal dimension. Osteo- plate 170

  Synthesis is used in a similar manner to that previously described for the osteosynthesis plate 10 and can be twisted, folded or otherwise formed in three directions to conform to the contour of the bone place of

the divide.

  Another embodiment of the osteosynthesis plate is designated as a whole by the reference numeral 180 in FIG. 22. The osteosynthesis plate 180 comprises a part 182 of rod, a part 154 of V-shaped fixing has a extremitA 'and an I-shaped fixing part 16 at the other end. In this way the osteosynthesis plate 180 il - comprises fixing parts arranged in opposite manner which are of different shapes. The osteosynthesis plate 180 is produced and used in a manner similar to that which has

previously described.

  Other embodiments of the osteosynthesis plate are designated as a whole by the reference numerals 190 and 192 in FIGS. 23 and 24. The osteosynthesis plates 190 and 192 comprise fixing parts which are arranged in opposition from one another and which have 1 different shapes and orientations. The fixing parts of the osteosynthesis plates 190 and 192 are combinations of the fixing parts used for the embodiments described above and have been designated by references

  corresponding numbers. Plates 190 and 192 d! Osteosyn-

  thesis are likewise carried out and used in an analogous manner

to that described above.

  Some obvious advantages of the present invention are:

  parair of the previous description include a plate

  osteosynthesis that can be folded or twisted in three directions

  to conform to the bony contour at the location of the fracture. The osteosynthesis plate is easy to shape, fold or twist using a simple tool; ' it has enough elastic memory to withstand a

  predetermined stress, which allows the osteosyn-

  thesis to keep the fixation position of the bone pieces

the location of a fracture.

  In view of the above, it can be seen that the various aims of the invention are achieved and that other advantageous results

are obtained.

  As various modifications can be made to the above structures and methods without departing from the scope of the invention, it should be taken into account that all of the

  elements contained in the description above or represented

  in the accompanying drawings must be interpreted as given

  by way of example, and not in a limiting sense.

  Of course, the present invention is not limited to the embodiments described and shown, but it is susceptible of numerous accessible variants.

  art without moving away A. 7 - '. 4: A .: -

Claims (15)

CLAIMS 1. - Plate (10) Y of osteosynthesis comprising, (a) means (12) 'flexible, elongated, foldable in the form of rod to assemble the elements of a bone fracture, said means (12) in the form of rod having a generally circular cross-section with a first diameter and a longitudinal axis, said rod-shaped means (12) having a predetermined longitudinal dimension along said longitudinal axis and opposite end portions (56, 62), (b) first and second fixing parts (14, 16) to said respective opposite end parts such that said fixing parts (14, 16) intersect with said longitudinal axis, (c) said first and second parts (14, 16) fastener having a longitudinal and lateral dimension which exceeds the diameter of said circular cross section, and '(d) said rod-shaped means (12) being formed from a material which can be folded and retaining said folding tr idirectional under a predefined constraint.   2.- Plate (10) for osteosynthesis according to the claim   tion 1, wherein said first fixing part (14) has a longitudinal dimension smaller than the dimension   longitudinal of said second fixing part (16).   * 3X.3- Osteosynthesis plate (10) according to the claim-   tion 2, in which the first fixing part (14) has a lateral dimension greater than the dimension   lateral of said second fixing part (16).   4.- Plate (10) for osteosynthesis according to the claim   tion 1, wherein said first fixing part (14) has a lateral dimension smaller than the dimension   lateral of said second fixing part (16).   5.- Plate (10) for osteosynthesis according to the claim   tion 1, in which one of said first and second fixing parts (14, 16) has a shape different from   that of the other fixing part.   6.- Plate (10) for osteosynthesis according to the claim   tion 1, wherein said first and second fixing parts (14, 16) have a shape and orientation by   with respect to said substantially similar longitudinal axis.   7.- Plate (10) for osteosynthesis according to the claim   tion 1, wherein said first fixing part (14}   has a first orientation with respect to said lonqi- axis   tudinal and said second fixing part (16) has a   second orientation with respect to said longitudinal axis.   8.- Plate (10) for osteosynthesis according to la.ievendica-   tion 1, in which one of said fixing parts (14, 16) has an I shape.   9.- Plate (10) for osteosynthesis according to the claim   tion 1, in which one of said fixing patties (14, 16) has a V shape.   10.- Plate (10) for osteosynthesis according to the claim-   tion 1 ,. wherein the longitudinal dimension of each of said fixing parts (14, 16) exceeds the predetermined longitudinal dimension of said rod-shaped means (12).   11.- Plate (10) for osteosynthesis according to the claim-   tion 1, in which the predetermined longitudinal dimension of said rod-shaped means (12) exceeds the individual longitudinal dimension of each of said parts (14, 16) of fixing.   12.- Plate (10) for osteosynthesis according to the claim-   tion 1, in which each of said fixing parts (14, 16) has substantially parallel opposite mounting surfaces. located at a predetermined distance from each other, with at least one transverse opening in each of said parts (14, 16} of fastening that extends across   said opposite mounting surfaces.   13.- Plate (10) for osteosynthesis according to the claim-   tion 12, wherein said first predetermined distance   is less than said first diameter.   14.- Plate (10) for osteosynthesis according to the claim-   tion 1, wherein said first and second fixing parts (14, 16) are substantially flat relative to said circular cross section.   15.- Plate (10) for osteosynthesis according to the claim-   tion 1, wherein said first and second par-   fasteners (14, 16) are stamped from said circular cross section.   16.- Plate (10) for osteosynthesis according to the claim-   i10 tion 1, in which a predetermined number of said par-   fasteners (116, 118 ...) are formed on said mo-   rod-shaped yen (12) between said first and second fixing parts (14, 16) in such a way that said 'consecutive parts (16, 118 ...). fixing be to a   predetermined distance from each other.   17.- Plate (10) for osteosynthesis comprising, (a) means (12) flexible, elongated, foldable in the form of rods for assembling the elements of a bone fracture, said elements (12) in the form of   stem having a general cross section-   ment circular with a first diameter and a longitudinal axis, said means (12) in the form of   stem having a longitudinal dimension predefined   terminated along said longitudinal axis and opposite end portions (56, 62),   (b) first and second parts (14, 16) of fixing   tion to said respective opposite end portions such as said fixing portions (14, 16)   come into intersection with said longitudi-   nal, each of said fixing parts (14, 16)   having opposite mounting surfaces   clearly parallel to a predetermined distance   one from the other, have at least one opening very   dirty being provided in each of said par-   fastening parts (14, 16) extending through said opposite mounting surfaces, (c) said first and second fastening parts (14, 16) having a longitudinal and lateral dimension which exceeds the diameter of said section circular transverse and said first distance   predetermined being less than said first dia-   meter, and (d} said means (12} in the form of a tick being formed from a material which can be folded and hold said   three-way folding under a predefined stress finished.