U.S. patent application number 11/926294 was filed with the patent office on 2008-04-17 for plate for fixing the bones of a joint, in particular a metatarso-phalangeal joint.
This patent application is currently assigned to NEWDEAL S.A.. Invention is credited to Michael John Coughlin.
Application Number | 20080091197 11/926294 |
Document ID | / |
Family ID | 8867652 |
Filed Date | 2008-04-17 |
United States Patent
Application |
20080091197 |
Kind Code |
A1 |
Coughlin; Michael John |
April 17, 2008 |
PLATE FOR FIXING THE BONES OF A JOINT, IN PARTICULAR A
METATARSO-PHALANGEAL JOINT
Abstract
A plate for fixing the bones of a joint, in particular of a
metatarso-phalangeal joint, for the purpose of performing
arthodesis. The plate comprises two sections, respectively a
proximal section and a distal section, each section having a
respective longitudinal axis of symmetry S.sub.1, S.sub.2 such that
the projection onto a horizontal plane of the axis of symmetry
S.sub.2 of the distal section presents an angle of inclination
relative to the projection of the axis of symmetry S.sub.1 of the
proximal portion, the projections inserting at a point A. The
projection onto a vertical plane of the axis of symmetry S.sub.2
presents an angle of inclination relative to the projection of the
axis of symmetry S.sub.1, their intersection taking place at a
point A.sub.2 which is distinct from the point A.sub.1.
Inventors: |
Coughlin; Michael John;
(Boise, ID) |
Correspondence
Address: |
THOMAS, KAYDEN, HORSTEMEYER & RISLEY, LLP
600 GALLERIA PARKWAY, S.E.
STE 1500
ATLANTA
GA
30339-5994
US
|
Assignee: |
NEWDEAL S.A.
Parc d'activites Garigiano, 31 rue de la Conventio
Vienne
FR
38200
|
Family ID: |
8867652 |
Appl. No.: |
11/926294 |
Filed: |
October 29, 2007 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
10255204 |
Sep 26, 2002 |
|
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|
11926294 |
Oct 29, 2007 |
|
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Current U.S.
Class: |
606/60 |
Current CPC
Class: |
A61B 17/58 20130101;
A61B 17/8061 20130101 |
Class at
Publication: |
606/060 ;
606/073 |
International
Class: |
A61B 17/58 20060101
A61B017/58; A61B 17/56 20060101 A61B017/56 |
Foreign Application Data
Date |
Code |
Application Number |
Sep 26, 2001 |
FR |
01 12417 |
Claims
1. A surgical device comprising: a plate having a plurality of
holes for receiving respective screws to fix the plate to at least
one bone, wherein the plate further comprises: a first portion
comprising an elongate body extending along a first axis through a
first plane and comprising at least one of the plurality of holes;
and a second portion comprising an elongate body comprising at
least one of the plurality of holes, the second portion comprising
a first length and second length, the first length extending along
a second axis and through the first plane, the second axis of the
first length having a pre-established non-zero angle .alpha. with
respect to the first axis of the first portion, the second length
of the second portion extending along a third axis and through a
second plane different from the first plane, the second plane of
the second length having a pre-established non-zero angle .beta.
with respect to the first plane, wherein the first axis and the
second axis intersect at a point A.sub.1, and the projection of the
third axis onto the first plane intersects with point A.sub.1.
2. A plate for fixing the bones of a metatarso-phalangeal joint in
order to perform arthrodesis, said plate having a plurality of
holes for receiving respective screws to fix the plate to the bone
fragments to be fused together, wherein the plate further comprises
a first portion comprising an elongate body which comprises at
least one of the plurality of holes and a second portion comprising
an elongate body which comprises at least one of the plurality of
holes, the projection onto an horizontal plane of the second
portion having a pre-established non-zero angle .alpha. with
respect to the projection onto an horizontal plane of the first
portion, and the projection onto a vertical plane of the second
portion having a pre-established non-zero angle .beta. with respect
to the projection onto a vertical plane of the first portion.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This application is a Continuation application of pending
U.S. patent application Ser. No. 10/255,204, filed on Sep. 26, 2002
and entitled "PLATE FOR FIXING THE BONES OF A JOINT, IN PARTICULAR
A METATARSO-PHALANGEAL JOINT", incorporated herein by
reference.
FIELD OF THE INVENTION
[0002] The present invention relates to the general technical field
of surgical devices for fixing together and aligning the two bony
parts of a joint relative to each other, and in particular a joint
including the phalanges of a toe or a finger in order to perform
arthrodesis.
[0003] The present invention relates to a plate for fixing together
the bones of a joint, in particular a metatarso-phalangeal joint,
in order to perform arthrodesis.
[0004] In a preferred but non exclusive application of the
invention, the fixing plate is more particularly, but not
exclusively, intended and designed for setting an angular position
and then performing arthrodesis on a metatarso-phalangeal joint.
However, it should be understood that in the meaning of the
invention applications to other joints can be envisaged, whenever
the purpose is to bond the two bony parts of a joint together in a
fixed relative position.
BACKGROUND OF THE INVENTION
[0005] In the event of arthrosis in joints between bones, and in
particular in a metatarso-phalangeal joint, it is often necessary
to perform arthrodesis in order to fuse the two bones together. As
a general rule, arthrodesis constitutes an operation that is
difficult in that it sets a joint in a position that is defined and
it does so in a manner that is not reversible. Thus, it is very
important for arthrodesis of a metatarso-phalangeal joint to be
performed correctly insofar as the joint is involved as an
essential actor in the walking cycle of a human being. It will thus
be understood that it is essential for the two bones to be
positioned relative to each other prior to fusion with an
orientation that is implemented as accurately as possible in order
to avoid any subsequent difficulty.
[0006] It is therefore essential for the axes of the bones to be
fixed relative to each other so as to comply as well as possible
with the flexing and the axes of the patient, and this must be done
as a function of the patient's sex, gait, and morphology.
[0007] Until now, metatarso-phalangeal arthrodesis has been
performed using fixing plates of a variety of shapes and provided
with slots for receiving fixing screws in order to secure the plate
to each of the two bones to be fused together.
[0008] Thus, by way of example, fixing plates are known that
present a curved "quarter-tube" cross-section which the surgeon
places across the joint between the bones to be fused together.
That known plate is bent by the surgeon so as to take up an angle
in the dorsi-flexion plane having a value that has been determined
by the surgeon and that is specific to the patient. Once a joint
has been blocked, plates of that type thus make it possible to
confer a particular orientation in elevation on one of the two
bones on which arthrodesis is performed. This constitutes an
advantage to the patient since the joint is blocked under
conditions close to normal conditions of use for that joint,
thereby reducing difficulty for the patient while walking and
reducing possible future complications.
[0009] Nevertheless, fixing plates of that type turn out to suffer
from a variety of drawbacks, and in particular they are quite
difficult for the surgeon to bend. In addition, it turns out that
bending is rarely performed with sufficient accuracy and that
bending gives rise to deformed zones of the plate presenting edges
that can be quite sharp and likely to generate irritation or
inflammation on coming into contact with adjacent tissue such as
tendons, muscles, ligaments, skin, etc. Finally, plates of that
type are unsuitable for bending through a varus-valgus angle, which
means that they are not capable of implementing arthrodeses that
are sufficiently close to conditions of optimum geometrical
orientation between the two bones to be fused together for the
purpose of reducing to the greatest possible extent any risk of
subsequent difficulties and complications for the patient.
[0010] Fixing plates that are completely plane are also known, and
although they greatly reduce the risk of complications for the
patient following the operation of installing them, insofar as no
bending is performed, they nevertheless do not make it possible to
perform an arthrodesis in which the bones present specific dorsi
flexion and varus-valgus angles.
[0011] As a general rule, it also turns out that fixing plates for
bending by the surgeon require a special bending tool to be used
that is specific to each type of plate, thereby constituting a
further constraint. Finally, it turns out that a fixing plate that
has been bent suffers from weakening of its metal in the bend zone,
and that can constitute a drawback in terms of strength.
Furthermore, the need to provide openings through the plate for
passing fixing screws complicates the operation of bending the
plate, specifically because of the presence of said openings.
OBJECTS AND SUMMARY OF THE INVENTION
[0012] Consequently, the object of the invention is to remedy the
various drawbacks set out above and to propose a novel plate for
fixing the bones of a joint, in particular a metatarso-phalangeal
joint, for the purpose of performing arthrodesis between two bone
fragments under good conditions while ensuring that the relative
orientation of the two bones to be fused together is determined
with excellent accuracy.
[0013] Another object of the invention is to propose a novel plate
for fixing the bones of a joint that makes it easier to put the
plate into place and to seek a precise geometrical orientation.
[0014] Another object of the invention is to propose a novel plate
for fixing the bones of a joint with improved placing of the
plate.
[0015] Another object of the invention is to propose a novel plate
for fixing the bones of a joint that is particularly well adapted
to the anatomy of the bones to be fused together.
[0016] Another object of the invention is to propose a novel plate
for fixing the bones of a joint that is suitable for being adapted
to various possible anatomical configurations.
[0017] The objects given to the invention are achieved by means of
a plate for fixing the bones of a joint, in particular a
metatarso-phalangeal joint, for the purpose of performing
arthrodesis, wherein:
[0018] the plate comprises two sections, respectively a proximal
section and a distal section, each section presenting a respective
longitudinal axis of symmetry S.sub.1, S.sub.2 said plate being
designed to be placed across the joint, the axes S.sub.1 and
S.sub.2 being parallel and aligned with the longitudinal axes of
the two bone fragments to be fused together such that the
projection onto a horizontal plane of the axis of symmetry S.sub.2
of the distal section is inclined at an angle .alpha. relative to
the projection of the axis of symmetry S.sub.1 of the proximal
portion, the projections intersecting at a point A.sub.1; and
[0019] the projection onto a vertical plane of the axis of symmetry
S.sub.2 presents an angle of inclination .beta. relative to the
projection of the axis of symmetry S.sub.1, the projections
intersecting at a point A.sub.2 which is distinct from the point
A.sub.1, the distal section extending over a first length fraction
L.sub.1 away from the proximal section while remaining in the same
plane P.sub.1 as the proximal section.
BRIEF DESCRIPTION OF THE DRAWING
[0020] Other advantages and objects of the invention appear in
greater detail on reading the following description made with
reference to the accompanying drawing that is provided purely by
way of non-limiting explanation and in which:
[0021] FIG. 1 is a diagrammatic perspective view showing a plate
for fixing the bones of a joint in order to perform arthrodesis,
the plate being shown in position on a metatarso-phalangeal
joint;
[0022] FIG. 2 is a plan view corresponding to a horizontal plane
showing a plate of the invention for fixing together the bones of a
joint, the plate turning to the left; and
[0023] FIG. 3 is a fragmentary side view corresponding to a
vertical plane showing a plate of the invention for fixing together
the bones of a joint.
MORE DETAILED DESCRIPTION
[0024] FIGS. 1 to 3 show a fixing plate 1 in position and fixed to
a metatarso-phalangeal joint for the purpose of performing
arthrodesis between a metatarsal bone M and a phalangeal bone
P.
[0025] Nevertheless, in the meaning of the invention, the fixing
plate 1 of the invention could be used with appropriate anatomic
shape and size for performing arthrodesis of some other joint, in
particular for a joint in the hand when performing surgery of the
hand.
[0026] The fixing plate 1 of the invention is in the form of an
elongate body of plane cross section, for example, e.g. made of
metal and of sufficient stiffness to provide a junction between the
bones of the joint that are to be fused together and to provide
firm support.
[0027] In accordance with the invention, the fixing plate 1
comprises two sections 2 and 3, respectively a proximal section and
a distal section, each section presenting its own longitudinal axis
of symmetry, respectively referenced S.sub.1 and S.sub.2.
[0028] Each section 2, 3 can thus be considered in general terms as
a body having a thickness of a few millimeters and a length that is
longer than its width so as to form a geometrical shape that is
approximately that of a rectangular parallelepiped.
[0029] The proximal section 2 is for placing and fixing
substantially on the metatarsal bone M, while the distal section 3
is for placing and fixing substantially on the phalangeal bone P in
order to perform arthrodesis between these two bone fragments, the
plate 1 thus being placed across the joint, with the axes of
symmetry S.sub.1 and S.sub.2 being parallel and in alignment with
the longitudinal axes of symmetry of the bones.
[0030] In conventional manner, fixing is performed by means of
screws (not shown in the figures) which the surgeon screws into the
bones through a series of slots 4 formed in the fixing plate 1, and
in particular in each of its sections 2, 3 for the purpose of
passing the fixing screws.
[0031] As shown in the figures, the proximal section 2 is
advantageously longer than the distal section 3 while being of
equal thickness and of width that is likewise equal. Because the
proximal section 2 is longer, it advantageously has a larger number
of orifices 4, for example it has three orifices while the distal
section 3 has two orifices 4, and the orifices can be of any
suitable shape, for example circular or oblong.
[0032] Alternatively the distal and proximal sections 3 and 2 are
advantageously of identical length. In any event, the distal and
proximal sections 3 and 2 are adjacent and form a single part.
[0033] This dimensional characteristic enables the fixing plate to
be better adapted to the anatomy of the bones to be fused together
and it improves the supporting and holding ability of said
plate.
[0034] Advantageously, the two sections 2 and 3 are plane and
rectilinear, it being understood that in a variant the cross
sections of the proximal section 2 and of the distal section 3
could be curved to some extent, preferably equally, so as to
provide a better fit to certain particular anatomical
configurations.
[0035] According to an important feature of the invention, and as
shown in particular in FIG. 2, the axes of symmetry S.sub.1 and
S.sub.2 are not in alignment with each other, but on the contrary
present a certain angle of inclination so that the two sections
present respective inclinations in the horizontal plane. Thus, in
accordance with the invention, the projection of the axis of
symmetry S.sub.2 of the distal section 3 onto a horizontal plane
presents an angle of inclination .alpha. relative to the projection
of the axis of symmetry S.sub.1 of the proximal portion 2, these
projections intersecting at a point A.sub.1.
[0036] This feature makes it possible to impart an accurate and
pre-established varus-valgus angle on the phalangeal bone relative
to the metatarsal bone, the axes of symmetry S.sub.1 and S.sub.2 of
the plate 1 being intended for mounting by a surgeon so as to be
strictly parallel to the longitudinal axes of the two bone
fragments M and P that are to be fused together.
[0037] In accordance with the invention, this angle of inclination
.alpha. lies in the range 5.degree. to 20.degree. and is preferably
about 10. It is specified that the angle of inclination .alpha.
between the proximal and distal sections 2 and 3 is of a value that
is fixed and specific to the fixing plate 1 of the invention, thus
avoiding any need for the surgeon to bend the plate during the
operation as is the case in the known prior art. The distal section
3 can be inclined either to the left or to the right relative to
the proximal section 2.
[0038] According to another important characteristic of the
invention, the fixing plate 1 is such that the projection onto a
vertical plane (FIG. 3) of the axis of symmetry S.sub.2 presents an
angle of inclination .beta. relative to the projection of the axis
of symmetry S.sub.1, these projections intersecting at a point
A.sub.2which is distinct from the point A.sub.1.
[0039] According to this important characteristic of the invention,
and as shown in particular in FIGS. 1 and 3, the distal section 3
extends away from the proximal section 2 over a first length
fraction L.sub.1 while lying in the same plane P.sub.1 as the
proximal section 2, said first length fraction L.sub.1 being
extended by a second length fraction L.sub.2 which extends in a
plane P.sub.2 forming an angle with said plane P.sub.1, and
specifically the angle .beta.. The angle .beta. enables the
phalangeal bone P to be given a dorsi-flexion angle that is
accurate and pre-established.
[0040] According to this characteristic, the sum of the lengths
L.sub.1 and L.sub.2 corresponds to the total length of the distal
section 3 starting from the line of inclination A (FIG. 1) marking
the change in direction between the two sections 2 and 3. Thus, the
proximal and distal sections 2 and 3 are connected together
directly without a connection zone, and they are tangential to the
single radius of curvature forming their connection.
[0041] According to this characteristic, the fixing plate of the
invention has two distinct inclinations, one in the horizontal
plane corresponding to the line A and to the angle .alpha.
responsible for the varus-valgus angle, and the other corresponding
to the line B and to the angle .beta. responsible for the
dorsi-flexion angle, the two inclination zones of the plate not
coinciding, but on the contrary being offset from each other, with
the change of inclination B being situated in a position that is
distal relative to the line A.
[0042] Advantageously, the angle .beta. lies in the range 5.degree.
to 20.degree., and is preferably about 10.degree.. This angle
.beta. can be modified by the surgeon before or during surgery.
[0043] This disposition makes it possible to obtain a better match
between the fixing plate 1 and the various bony parts to be fused
together, since only the terminal fraction L.sub.2 of the distal
section 3 presents two angles of inclination, one in the horizontal
plane and the other in the vertical plane, while the other fraction
of the distal section presents only one angle of inclination, which
angle is in the horizontal plane.
[0044] According to a particularly advantageous characteristic of
the invention, the fixing plate 1 is provided with an intermediate
fixing orifice 5. Advantageously, the intermediate fixing orifice 5
is situated at the intersection of the axes of symmetry S.sub.1 and
S.sub.2. i.e. on the inclination line A, and it corresponds to the
point A.sub.1. This orifice enables the surgeon to fix the fixing
plate 1 temporarily in register with the center C of the head of
the metatarsal bone M by means of a pin prior to installing the
final fixing screws through the slots 4.
[0045] The fixing plate of the invention is put into place as
follows: after making an incision over the joint to be fused, the
surgeon mills or cuts the faces of the joint so as to remove the
arthrodesis present in the joint. Thereafter the surgeon puts the
two bones to be fused together into position relative to each other
and places the fixing plate 1 of the invention on the top faces of
the bones M and P.
[0046] This positioning must be done while taking care to ensure
that the fixing plate 1 is placed in such a manner that its axes of
symmetry S.sub.1 and S.sub.2 are strictly parallel and aligned with
the longitudinal axes of the two bone fragments M and P to be fused
together. The surgeon must also take care to position the proximal
section 2 in such a manner that the intermediate fixing orifice 5
is substantially in register with the center C of the head of the
metatarsal bone M so as to achieve the best possible match between
the plate and the bony parts. Fixing proper of the bones in the
required geometrical configuration is then performed naturally
because of the two natural angles of inclination of the fixing
plate of the invention, which angles are fixed and
pre-established.
[0047] The fixing plate of the invention thus makes it possible
simply, quickly, and accurately to perform arthrodesis of the bones
of a joint in a geometrical configuration that is accurate and pre
established.
* * * * *