U.S. patent application number 10/047520 was filed with the patent office on 2002-05-23 for method and apparatus for mandibular osteosynthesis.
This patent application is currently assigned to W.L. Lorenz. Invention is credited to Duncan, Jeffrey A., Schumacher, Brian S., Stone, Kevin T..
Application Number | 20020062127 10/047520 |
Document ID | / |
Family ID | 26699345 |
Filed Date | 2002-05-23 |
United States Patent
Application |
20020062127 |
Kind Code |
A1 |
Schumacher, Brian S. ; et
al. |
May 23, 2002 |
Method and apparatus for mandibular osteosynthesis
Abstract
A system for mandibular reconstruction generally includes an
elongated locking plate having a plurality of internally threaded
apertures and a plurality of fasteners. Each fastener includes a
main body portion having an upper threaded shaft and a lower
threaded shaft. The lower threaded shaft is adapted to engage the
mandible. Each fastener further includes a removable head portion
internally threaded for engaging the upper shaft portion and
externally threaded for engaging a selected one of the internally
threaded apertures of the locking plate. In the preferred
embodiment, the thread leads of the head portion and lower shaft of
the main body portion are identical. A method of mandibular
osteosynthesis utilizes the system of osteosynthesis and generally
comprises the steps of temporarily securing the elongated locking
plate to the mandible with at least one fastener by engaging the
threads of the lower portion with the mandible and threadably
engaging the head with the locking plate, unthreading the head
portion from the main body of the fastener to thereby allow
displacement of the locking plate from the mandible without
removing the fasteners from the mandible, performing a surgical
procedure (e.g., removal of a cancerous growth), and re-securing
the elongated plate to the fastener with the removable head
portion.
Inventors: |
Schumacher, Brian S.;
(Jacksonville, FL) ; Stone, Kevin T.;
(Jacksonville, FL) ; Duncan, Jeffrey A.;
(Jacksonville, FL) |
Correspondence
Address: |
HARNESS, DICKEY & PIERCE, P.L.C.
P.O. BOX 828
BLOOMFIELD HILLS
MI
48303
US
|
Assignee: |
W.L. Lorenz
|
Family ID: |
26699345 |
Appl. No.: |
10/047520 |
Filed: |
October 29, 2001 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
10047520 |
Oct 29, 2001 |
|
|
|
09394287 |
Sep 10, 1999 |
|
|
|
09394287 |
Sep 10, 1999 |
|
|
|
09025140 |
Feb 18, 1998 |
|
|
|
Current U.S.
Class: |
606/70 ; 606/285;
606/300 |
Current CPC
Class: |
A61B 17/8071 20130101;
A61B 17/8047 20130101; Y10S 606/904 20130101; A61B 17/888 20130101;
A61B 17/8888 20130101; A61B 17/8615 20130101 |
Class at
Publication: |
606/70 ; 606/69;
606/73 |
International
Class: |
A61B 017/58 |
Claims
What is claimed is:
1. A method of surgically repairing a bone, the method comprising
the steps of: providing a mesh reinforcing member including a
plurality of holes; providing an elongated plate having a plurality
of apertures; placing the mesh reinforcing member adjacent the
bone; placing the elongated plate adjacent to the mesh reinforcing
member; and securing the elongated plate to the bone by passing a
fastener through one of the plurality of apertures in the elongated
plate and one of the plurality of holes in the mesh reinforcing
member.
Description
CROSS-REFERENCE TO RELATED APPLICATION
[0001] This is a continuation-in-part application of U.S. Ser. No.
09/025,140, filed Feb. 18, 1998.
BACKGROUND OF THE INVENTION
[0002] 1. Field of the Invention
[0003] The present invention relates to surgical applications for
the repair of bone fractures and deformities. More particularly,
the present invention relates to a method and apparatus for
mandibular osteosynthesis.
[0004] 2. Discussion of the Related Art
[0005] In various orthopedic surgical procedures, it is necessary
to align and secure two bone portions in a relatively fixed
relationship to each other. For example, the need for establishing
such a secured relationship is often a result of a fracture which
has occurred to the bone. To ensure that the bone can regenerate in
the proper orientation and fuse the fracture, it is important that
the bone portions be fixed in the desired position during bone
regeneration.
[0006] It is known in the art to provide metal plates for the
repair of bone fractures. These plates are generally secured to
bone portions with screws. Among other applications, such plates
and fasteners are used to provide rigid stabilization of orthopedic
and craniofacial fractures. The plates conventionally employed
for-cranial and facial osteosynthesis generally comprise small,
generally flat, elongated sections of metal. The sections contain
round and perhaps elongated screw holes at various points along
their lengths for fastening the sections to bone.
[0007] Because no surface of the human skeleton is completely flat,
existing plates must be extensively twisted, formed and bent during
surgery to conform to portions of the skeleton on which they are to
be affixed. Significant time is expended during surgery for shaping
and re-shaping metal plates adequately to conform to desire bone
surfaces. This additional time increases anesthesia requirements
and operating room time and also increases the potential for
infection.
[0008] In one commonly used technique for mandibular
reconstruction, a flat plate is drawn against the surface of the
mandible with a plurality of fasteners, thereby bending the plate
to a desired shape. Subsequently, the fasteners and plate are
removed to allow surgical access to the mandible (e.g. for removal
of a cancerous growth). Finally, the plate is again fastened to the
mandible by engaging the fasteners with existing holes in the
mandible.
[0009] While known systems utilizing plates and fasteners for
cranial and facial osteosynthesis have proven to be acceptable for
certain applications, such systems are nevertheless susceptible to
improvements that may enhance their performance. In this regard,
many known systems require time consuming surgical attachment.
Additionally, known systems which necessitate the insertion,
removal and subsequent reinsertion of fasteners into the bone
negatively affect fastener purchase. Furthermore, many known
techniques for cranial facial osteosynthesis disadvantageously
position a plate immediately adjacent to the bone which is
particularly susceptible to resorption.
SUMMARY OF THE PRESENT INVENTION
[0010] In one form, the present invention relates to a method for
mandibular osteosynthesis which includes the general step of
securing an elongated locking plate to a bone with a plurality of
fasteners each including a main body portion having an upper shaft
portion and a lower shaft portion. Each fastener further includes a
head member removably attached to the upper shaft portion. The
method of the present invention further includes the general step
of removing the locking plate from the bone by removing the
removable head member of each fastener from its main body
portion.
[0011] In another form, the present invention comprises a system
for osteosynthesis of a mandible including an elongated locking
plate and at least one fastener. The elongated locking plate has a
plurality of internally threaded apertures. Each of the at least
one fastener has a main body portion with an externally threaded
lower shaft portion and an upper shaft portion. The at least one
fastener further has a head member adapted to removably engage the
upper shaft portion. The head member is externally threaded for
engaging one of the plurality of internally threaded apertures. The
externally threaded shaft portion and the externally threaded head
member preferably have a common thread lead and an identical thread
pitch.
[0012] An advantage of the present invention is the provision of a
method and apparatus for mandibular osteosynthesis which quickly
and easily contours a plate to the mandible without sacrificing
fastener purchase with the bone.
[0013] A related advantage of the present invention is the
provision of a method and apparatus for mandibular osteosynthesis
which incorporates a threaded fastener having a removable head.
[0014] Another advantage of the present invention is the provision
of a method and apparatus for osteosynthesis which incorporates a
locking plate with an upwardly curved forward end that more
accurately cooperates with the geometry of the human mandible.
[0015] Another advantage of the present invention is the provision
of a method and apparatus for mandibular osteosynthesis which
incorporates an auxiliary reinforcement member adapted to be
removably attached to a locking plate.
[0016] Another advantage of the present invention is the provision
of a method and apparatus for mandible osteosynthesis which
incorporates a plate reinforcement member which may be selectively
secured to a locking plate for increased strength in areas of
significant loss of bone mass.
[0017] A related advantage of the present invention is the
provision of a method and apparatus for mandible osteosynthesis
which incorporates a mesh reinforcement member which may be
attached to a reconstruction plate for providing reinforcement
where a resection has been made or significant bone mass is
otherwise absent.
BRIEF DESCRIPTION OF THE DRAWINGS
[0018] FIG. 1 is a perspective view of a mandibular osteosynthesis
system constructed in accordance with the teachings of the
preferred embodiment of the present invention illustrated in
operative association with a human mandible.
[0019] FIG. 2 is an illustration the locking plate shown in FIG. 1
according to the teachings of the preferred embodiment of the
present invention.
[0020] FIG. 3 is a cross-sectional view taken along the line 3-3 of
FIG. 2.
[0021] FIG. 4 is an exploded view of one of the fasteners shown in
FIG. 1 according to the teachings of the preferred embodiment of
the present invention.
[0022] FIG. 5 is a cross-sectional view taken along the line 5-5 of
FIG. 4.
[0023] FIG. 6 illustrates an end view of the head of the fastener
shown in FIG. 4 according to the teachings of the preferred
embodiment of the present invention.
[0024] FIG. 7 is a view of the auxiliary reinforcement member of
FIG. 1.
[0025] FIG. 8 is an enlarged cross-sectional view taken along the
lines 8-8 of FIG. 7.
[0026] FIG. 9 is an illustration of a pair of links in accordance
with the teachings of the present invention.
[0027] FIG. 10 is a fragmentary exploded view of the pair of links
of FIG. 9 and a cooperating anchor member.
[0028] FIG. 11 is a perspective view similar to FIG. 1,
illustrating an alternative locking plate and an alternative
auxiliary reinforcement member of the mandibular osteosynthesis
system of the present invention operatively associated with a human
mandible.
[0029] FIG. 12 is a cross-sectional view taken along the line 12-12
of FIG. 11.
[0030] FIG. 13 is an illustration of a tool of the mandibular
osteosynthesis system of the present invention.
[0031] FIG. 14 is an enlarged view illustrating the detail shown in
circle 14 identified in FIG. 13.
[0032] FIG. 15 is an enlarged end view of the tool taken in the
direction of arrow 15 shown in FIG. 14.
[0033] FIG. 16 is a perspective view similar to FIG. 1, shown
incorporating a mesh reinforcing member of the mandibular
osteosynthesis system of the present invention.
[0034] FIG. 17 is an enlarged side view of the mesh reinforcing
member of FIG. 16.
[0035] FIG. 18 is a front view of an alternative mesh reinforcing
member.
DETAILED DESCRIPTION OF THE PRESENT INVENTION
[0036] The following description of the preferred embodiment of the
present invention is merely exemplary in nature and is in no way
intended to limit the invention or its application or uses.
[0037] Referring to FIG. 1, a system constructed in accordance with
a preferred embodiment of the present invention is generally
identified with reference numeral 10. The system 10 is shown
operatively associated with a human mandibular 12. However, it will
become apparent to those skilled in the art that certain aspects of
the present invention have applicability for other surgical
applications.
[0038] With continued reference to FIG. 1 and additional references
to FIGS. 2 and 3, the system 10 of the present invention is shown
to include an elongated reconstruction plate 14. The plate 14 is
formed to include a plurality of apertures 16, each adapted to
receive a fastener 18 for interconnecting the plate 14 with the
mandible 12. The apertures preferably include an oval countersink
20 and are internally threaded. For this reason, the plate 14 will
be interchangeably referred to herein as a locking plate 14.
[0039] The locking plate 14 is shown to generally include a central
portion 22, and first and second ends 24 and 26. The first end 24
is precontoured in an anterior-posterior direction to cooperate
with the shape of the mandible 12. The second end 24 is also curved
upwardly in the plane of the central portion 22, this curvature of
the second end 26 cooperates with the contour of the human mandible
12 when the locking plate 14 follows the shape of the mandible 12
in a medial-lateral direction.
[0040] In one application, the locking plate 14 is constructed of
titanium. More preferably, the locking plate 14 is constructed from
commercially pure, grade 2 or grade 4 titanium. However, it will be
appreciated by those skilled in the art that other materials having
suitable performance characteristics may be employed. Preferably,
the locking plate 14 is inelastically deformable so as to retain
its shape once contoured to cooperate with the shape of the
mandible 12.
[0041] With additional reference to FIGS. 4-6, the fastener 18 of
the present invention is shown to generally include a main body 30
and a head member 32. The main body 30 includes an upper shaft
portion 34 and a lower shaft portion 36. The lower shaft portion 36
is externally threaded and adapted to engage the mandible or bone
12 in a conventional manner. Insertion of the lower shaft portion
into the bone is limited by a flange 38 interdisposed between the
upper and lower shaft portions 34 and 36. The upper shaft portion
32 is also externally threaded and adapted to engage an internally
threaded aperture 40 of the head member 32. The head member 32 is
externally threaded for engaging one of the plurality of internally
threaded apertures 16 of the locking plate 14.
[0042] In one application, the thread pitches of the upper shaft
portion 34, lower shaft portion 36 and the thread pitch of the
external threads of the head member 32 are common. The external
threads of the head member 32 and the externally threaded lower
shaft portion 36 have a common thread lead. In the exemplary
embodiment illustrated, the externally threaded lower shaft portion
36 has a single lead configuration while the external threads of
the upper shaft portion 34 and head member 32 have a double lead
configuration.
[0043] In use, a malleable template (not shown) is position on the
mandible 12 and bent to the general shape of the cooperating bone
surface. Next, the locking plate 14 is bent to approximately the
shape of the template and positioned on the mandible 12 so that
certain apertures 16 may be selectively used as a guide for
drilling holes (not specifically shown) in the mandible 12 for
receiving the fasteners 18. A first of the fasteners 18 is passed
through a selected one of the apertures 16 and rotated so that the
externally threaded lower portion 36 is driven into the hole in the
mandible 12. For example, the first end 24 of the locking plate 14
may be first secured to the mandible 12 with a first fastener 18.
As the externally threaded lower portion 36 of the fastener 18 is
driven into the bone 12, the external threads of the head member 32
simultaneously engage the internally threaded aperture 16 of the
locking plate 14. This is possible as a result of the common thread
lead shared between the lower portion 36 and the head member
32.
[0044] Additional fasteners 18 are used to interconnect the locking
plate 14 with the bone 12 in a substantially identical manner. As
shown in FIG. 1, four (4) fasteners are used to interconnect the
locking plate 14 with the bone 12. However, it will be appreciated
by those skilled in the art that any number of fasteners 18 may be
employed depending on a particular application. In one application,
the order of the fastener insertion linearly progresses along the
locking plate 14 from one end (e.g. the first end 24) to the second
end (e.g. the second end 26). As additional fasteners are engaged
with the bone 12, the locking plate 14 is drawn into its operative
position adjacent to the bone 12.
[0045] At this point of the surgical procedure, the head members 32
of each of the threaded fasteners 18 are unthreaded from their
respective upper portions 34. This allows the surgeon to displace
the locking plate 14 from the fasteners 18 and provides access to
the bone 12 for accomplishing a desired surgical procedure (e.g.,
removal of a cancerous growth). When the locking plate 14 is
removed, it retains its shape due to the inelastic deformation.
When the surgical procedure is complete, the locking plate 14 is
replaced by inserting the upper portions 34 of the fasteners 18
through the selective apertures 14 and simultaneously threading the
internal threads of the aperture 16 with the external threads of
the upper portion 34 and the external threads of the head member 32
with the internal threads of the aperture 16. Since the fasteners
18 are not removed from the bone 12 after initial insertion,
fastener/bone purchase is not compromised.
[0046] With reference to FIGS. 13-15, one suitable tool for use in
connection with the system 10 of the present invention is shown and
generally identified with reference numeral 40. The tool includes a
handle 42 having an upper portion 44 and a lower portion 46. The
upper and lower portions 44 and 46 are rotatable relative to one
another about a longitudinal axis of the tool 40. The upper portion
44 is adapted to rotate with a first drive portion 48, while the
lower portion 46 of the handle 42 is adapted to rotate with a
second drive portion 50. The first drive portion 48 includes a
generally rectangular tip 52 adapted to engage a generally
rectangular aperture 54 provided in a top surface 56 of the upper
shaft portion 34 of each fastener 18. The second drive portion 50
is illustrated to include four (4) drive elements equally spaced
about the first drive member 48. The drive elements 58 are adapted
to engage a corresponding number of slots 60 equally spaced about
the head member 32 of each fastener 18.
[0047] After the holes are drilled into the mandible 12, the
surgeon selects a fastener with the head portion 32 threaded onto
the upper shaft portion 34 of the main body 30 and engages the
drive elements 58 of the tool 40 with the slots 60 of the head
member 32 simultaneously. Simultaneously, the tip 52 of the drive
member 48 engages the rectangular aperture 54 of the upper shaft
portion 34. The surgeon grasps the upper and lower portions 44 and
46 of the handle 42 and rotates the tool 40 in a conventional
manner. This action causes the head member 32 to threadably engage
an aperture 16 of locking plate 14 and simultaneously causes the
threads of the lower shaft portion 36 of the fastener 18 to engage
the hole provided in the bone 12.
[0048] Once all of the fasteners 18 are initially inserted into the
bone 12, the surgeon again engages the head 32 with the drive
elements 58. The thumb and forefinger are used to rotate the lower
portion 46 of the handle 42 and in turn the rotate the head portion
32 of the fastener 18 in a counterclockwise direction.
Simultaneously, the palm and remaining fingers grasp the upper
portion 44 of the handle 42 so that the lower portion 46 can be
rotated relative thereto. This action removes the head member 32
from its aperture 16. Since the main body portion 30 of the
fastener 18 is not simultaneously rotated, the head portion 32 is
simultaneously unthreaded therefrom. In a similar manner, the head
portion 32 is returned to threaded engagement with both the
aperture 16 of the plate 14 and the upper shaft portion 32 of the
main body portion 30 after the desired surgical procedure is
performed on the mandible 12.
[0049] When the locking plate 14 is operatively associated with the
mandible 12 as shown in FIG. 1, the locking plate 14 is adjacent to
but slightly displaced from the bone 12. In this regard, the flange
38 which is interdisposed between the upper and lower externally
threaded portions 34 and 36 of the fasteners 18 limits downward
translation of the removable head member 32. The thickness of the
head member 32 is greater than the thickness of the locking plate
14. As a result, when a head members 32 is completely threaded on
to the upper portion 34 of an associated fastener 18, the head
member 32 extends rearward beyond the locking plate 14 and the
locking plate 14 is displaced from the bone 12. Such spacing
reduces absorption of the bone which would otherwise be present if
the locking plate 14 were to directly contact the bone 12.
[0050] With continued reference to FIG. 1 and additional reference
to FIGS. 7 and 8, an auxiliary reinforcement member 64 is
illustrated. FIG. 1 shows the auxiliary reinforcement member 64
operatively interconnecting a portion of the mandible 12 and the
locking plate 14. The auxiliary reinforcement member 64 is intended
to reinforce fractured or otherwise weakened portions of the bone
12.
[0051] In the exemplary embodiment illustrated, the auxiliary
reinforcement member 64 is shown to generally include a bone
attachment portion 66 and a pair of plate attachment portions 68.
The plate attachment portions 68 are each interconnected to the
bone attachment portion 66 through a leg portion 70. In the
embodiment illustrated, the bone attachment portion 66 is generally
arcuate in shape and includes a plurality of apertures 72. Each of
the apertures 72 includes a countersunk portion 74. The apertures
72 are each adapted to receive a threaded fastener 76. The threaded
fastener 76 includes a head 78 adapted to seat in the countersunk
portion 74 of the aperture 72 and a threaded shaft (not shown) for
engaging a portion of the mandible 12. The head 78 of the threaded
fastener 76 further includes a generally rectangular aperture
substantially identical to the aperture 54 of the threaded fastener
18. As such, the threaded fastener 76 may be inserted and removed
with the first drive portion 48 of the tool 40. Alternatively, a
separate tool may be used to drive the fastener 76.
[0052] The plate engagement portions 68 of the auxiliary
reinforcement member 64 are generally circular in shape and include
an aperture 80 having a countersunk portion 82. As shown in FIG. 1,
each of the plate engaging portions 68 may be interconnected to the
plate 14 with a head portion 32 of the fastener 18. A tapered
flange portion 84 (shown in FIG. 4) of the removable head 32 seats
in the countersink 74 of the aperture 72 thereby securing the
auxiliary reinforcement member 64 to the plate 14 when the external
threads of the removable head 32 are engaged with the internal
threads of one of the plate apertures 16.
[0053] As shown more specifically in FIG. 8, each of the legs 70
are connected to its associated plate engagement portion 68 through
an intermediate portion 85. The intermediate portion 85 extends
perpendicular to the plane of the bone engagement portion 66 and
the plane of the plate engagement portion 68. As a result, the
plate engagement portion 66 is stepped down from bone engagement
portion 68.
[0054] With reference to FIGS. 9 and 10, a link system 88
constructed in accordance with the teachings of the present
invention is illustrated. The link system 88 is intended to
function as an alternative structure for the locking plate 14 and
generally includes first and second links 90 and 92 which are
preferably shown to be substantially linear in shape. Each of the
links 90 and 92 includes a plurality of apertures 16 substantially
identical to the apertures 16 of the locking plate 14. The
apertures 16 of the first and second links 90 and 92 are internally
threaded and function with one or more fasteners 18 as discussed
above. It will be understood by those skilled in the art that
either of the first and second links 90 and 92 may have a
non-linear shape.
[0055] The first and second links 90 and 92 are preferably shown to
include cooperating ends 94 and 96, respectively. To provide means
for positively locating the first and second links 90 and 92
angularly relative to one another, the cooperating ends 94 and 96
of the first and second links 90 and 92 are each provided with
serrations 98 which circumferentially surround an aperture 100. In
the embodiment illustrated, the apertures 100 surrounded by the
serrations 98 are not internally threaded. The first and second
links 90 and 92 are secured to one another and in turn to the bone
12 by a fastener 18'. The fastener 18' is largely identical to the
fastener 18 described in connection with FIGS. 4-6. As such,
identical reference numerals will be used to identify equivalent
elements. The fastener 18' differs from the fastener 18 in that the
external diameter of the head 32 is smooth, thereby permitting the
first and second link members 90 and 92 to rotate relative to the
fastener 18', effectively defining a pivot.
[0056] In the embodiment illustrated, the second link 92 of the
link system 88 is shown to include a longitudinally extending
groove 102. The groove 102 intersects the apertures 16 of the link
92 and functions to increase bending strength of the link 92. It
will be understood by those skilled in the art that a similar
groove may be added to the first link 90 and also incorporated into
the locking plate 14 of FIGS. 1 and 2.
[0057] In the preferred embodiment, the fasteners 18 and 18' are
constructed from 6AL4V titanium (ti64). However, it will be
appreciated by those skilled in the art that other materials of
having suitable strength and biocompatable characteristics may be
incorporated.
[0058] Turning to FIGS. 11 and 12, a link reinforcement member 104
of the system 10 of the present invention is illustrated. FIG. 11
illustrates the link reinforcement member 104 operatively
interconnected to a locking plate 14 which is substantially
identical to that described above with respect to FIGS. 1 and 2.
The locking plate 14 is in turn secured to the mandible 12. FIG. 12
is a cross-sectional view illustrating the cooperating relationship
between the locking plate reinforcement member 104 and the locking
plate 14. The link reinforcement member 104 is intended to
reinforce the locking plate 14 at areas where significant bone mass
may be absence.
[0059] The reinforcement member 104 is illustrated to include a
plurality of apertures 106 adapted to align with apertures 16 of
the locking plate 14. As shown most clearly in FIG. 12, the locking
plate reinforcement member 104 defines a groove 108 adapted to
receive the locking plate 14. In use, the plate reinforcement
member 104 is placed over the locking plate 14 such that the
locking plate 14 is positioned within the groove 108 and the
apertures 106 are aligned with the apertures 16. To secure the
reinforcement member 104 to the plate 14, a head portion 32 of the
fastener 18 is used in a manner substantially identical to the
interconnection of the auxiliary reinforcement plate 64 and the
locking plate 14. In this regard, the tapered portion 84 of the
removal head 32 seats in a countersink portion 108 of the aperture
106 and the removable head 32 threadably engages an aligning
aperture 16 of the locking plate 14. If desired, a main body
portion 30 of the fastener 18 may also be employed for purposes of
providing an additional point of attachment to the mandible 12.
[0060] Turning to FIGS. 16 and 17, a mesh reinforcement member 110
of the system 10 of the present invention is illustrated. FIG. 16
illustrates the mesh reinforcement member 110 operatively
interconnected to a reconstruction plate 14 which is substantially
identical to that described above with respect to FIGS. 1 and 2.
The plate 14 is in turn secured to the mandible 12. FIG. 17 is an
enlarged side view illustrating of the mesh reinforcement member
110. The mesh reinforcement member 110 provides another manner for
reinforcement at areas of the mandible 12 where a resection has
been made or significant bone mass is otherwise absent. In the
embodiment illustrated, the reconstruction plate is a locking plate
14. However, it will become apparent that the mesh reinforcement
member 110 may alternatively be used with a non-locking plate (not
specifically shown).
[0061] In one application, the mesh reinforcement member 110 is
constructed from a flexible, memory-retaining material such as
titanium. In other applications, it may be desirable to construct
the mesh reinforcement member 110 from a resorbable material. One
such material includes LactoSorb.RTM., which is commercially
available from W. Lorenz Surgical, Inc. of Jacksonville, Fla.
LactoSorb.RTM. is a registered trademark of Biomet, Inc. of Warsaw,
Ind. It will be readily appreciated that still other biocompatable
materials may be used within the scope of the present
invention.
[0062] The mesh reinforcement member 110 of the present invention
is illustrated to include a repeating pattern having larger holes
112 aligned in rows and columns. The repeating pattern additionally
includes smaller holes 114 similarly aligned in rows and columns.
The smaller holes 114 are arranged such that each smaller hole 114
is positioned equally between four larger holes 112 for the
repeating pattern. In other applications, the holes 112 and 114 may
be of smaller or larger size. Also, it may be desired to configure
the holes 112 or 114 in a shape other than a circle, including but
not limited to an oval or hexagonal shape. In the embodiment
illustrated, the smaller holes 114 are spaced so as to align with
apertures 16 of the plate 14.
[0063] In use, the mesh reinforcing member 110 is provided in a
generally U-shaped curved configuration. The mesh reinforcing
member 110 is adjusted to the general shape of the cooperating bone
surface. In the exemplary use shown in FIG. 16, a lower portion of
the mesh reinforcing member 110 wraps around a lower edge of the
mandible 12. The adjusted configuration of the mesh reinforcement
member 110 is shown in side view in FIG. 17. Typically, desired
surgical procedures are made to the bone 12 and the mesh
reinforcement member 110 is subsequently adjusted to the particular
desired configuration.
[0064] In one application, the mesh reinforcement member 110 may be
secured to the plate 14 and in turn secured to the mandible 12 by
the fasteners 18 which otherwise secure the plate 14 to the
mandible 12. Alternatively, the mesh reinforcement member 110 can
be secured to the plate 14 and the plate 14 can be independently
secured to the bone 12, or the mesh reinforcement member can be
independently secured to the bone 12 and subsequently secured to
the plate 14.
[0065] FIG. 16 illustrates a pair of fasteners 18 securing the mesh
reinforcing member 110 to the plate 14. The fasteners 18 are shown
to extend through one of the smaller holes 114 in the mesh
reinforcing member 110. It will be understood that additional
fasteners (not specifically shown) may be used to further secure
the mesh reinforcing member 110 to the mandible. Such additional
fasteners may pass through other of the apertures 16 in the plate
14, or directly through one of the smaller holes 114 or larger
holes 112 of the mesh reinforcing member 110. It will be further
understood that a variety of screws can be used to secure the plate
14, including but not limited to reconstruction screws, standard
fracture screws, or dedicated screws.
[0066] With final reference to FIG. 18 of the drawings, an
alternative mesh reinforcing member 120 is illustrated. The mesh
reinforcement member 120 is milled from titanium or other suitable
material. A substantially identical mesh material is commercially
available from W. Lorenz Surgical, Inc. of Jacksonville, Fla. for
cranial mesh applications. The alternative mesh reinforcement
member 120 has a repeating pattern including a plurality of smaller
holes 122 joined by a webbing 124. The alternative mesh
reinforcement member 120 may be more easily bent and configured to
a desired contour. In certain applications, it may be desirable to
incorporate larger holes into the alternative mesh reinforcement
member 120 to accommodate standard screws for attachment to the
bone.
[0067] The foregoing discussion discloses and describes merely
exemplary embodiments of the present invention. One skilled in the
art will recognize from such discussion and from the accompanying
drawings and claims, that various changes, modifications and
variations can be made therein without departing from the spirit
and scope of the invention. For example, the configuration of the
plate 14 shown in the drawings is one example of a plate suitable
for use with the teachings of the present invention. It will be
understood by those skilled in the art that various other shapes
may be employed. For example, the plate 14 may be straight, angled,
curved or any combination thereof. In certain applications, the
plate 14 may extend about the entire mandible 12.
* * * * *