U.S. patent application number 16/110824 was filed with the patent office on 2018-12-20 for calcaneum translation plate.
This patent application is currently assigned to BIOTECH ORTHO. The applicant listed for this patent is BIOTECH ORTHO. Invention is credited to Jean-Luc BESSE, Bernhard DEVOS, Thibaut LEEMRIJSE, Michel MAESTRO, Marc RELAVE.
Application Number | 20180360508 16/110824 |
Document ID | / |
Family ID | 47714237 |
Filed Date | 2018-12-20 |
United States Patent
Application |
20180360508 |
Kind Code |
A1 |
LEEMRIJSE; Thibaut ; et
al. |
December 20, 2018 |
CALCANEUM TRANSLATION PLATE
Abstract
A calcaneum translation plate (1) characterised in that it
comprises two end portions, i.e. a proximal anchoring portion (2)
and a distal fixing portion (3), oriented in opposing directions
and arranged in spaced parallel planes (P-P, P'-P'), said proximal
and distal portions connecting to an intermediate portion (4)
having a square general profile and comprising two perpendicular
bearing surfaces, the proximal anchoring portion extending from one
(5) of said surfaces and perpendicular thereto, whereas the distal
fixing portion extends in the extension of the other bearing
surface (6).
Inventors: |
LEEMRIJSE; Thibaut;
(Bruxelles, BE) ; MAESTRO; Michel; (Nice, FR)
; DEVOS; Bernhard; (Deurle, BE) ; RELAVE;
Marc; (Andrezieu Boutheon, FR) ; BESSE; Jean-Luc;
(Chaponnay, FR) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
BIOTECH ORTHO |
Salon De Provence |
|
FR |
|
|
Assignee: |
BIOTECH ORTHO
Salon De Provence
FR
|
Family ID: |
47714237 |
Appl. No.: |
16/110824 |
Filed: |
August 23, 2018 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
15697632 |
Sep 7, 2017 |
10064667 |
|
|
16110824 |
|
|
|
|
14438494 |
Apr 24, 2015 |
9814505 |
|
|
PCT/FR2013/052214 |
Sep 23, 2013 |
|
|
|
15697632 |
|
|
|
|
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 17/809 20130101;
A61B 17/8061 20130101 |
International
Class: |
A61B 17/80 20060101
A61B017/80 |
Foreign Application Data
Date |
Code |
Application Number |
Oct 29, 2012 |
FR |
12/60297 |
Claims
1-12. (canceled)
13. A calcaneum translation plate, comprising: an intermediate
portion having a first bearing surface and a second bearing
surface, the first and second bearing surfaces being transverse; a
proximal anchoring portion extending from the first bearing surface
such that a portion of the first bearing surface extends away from
the second bearing surface and past a connection of the proximal
anchoring portion to the first bearing surface to form a shoulder;
and a distal fixing portion extending as a prolongation of the
second bearing surface.
14. The calcaneum translation plate of claim 13, wherein the
proximal anchoring portion is arranged in a proximal plane and the
distal fixing portion is arranged in a distal plane, the proximal
plane and the distal plane being spaced apart and parallel.
15. The calcaneum translation plate of claim 13, wherein the distal
fixing portion includes at least one hole for passage of at least
one fastening screw.
16. The calcaneum translation plate of claim 15, wherein said at
least one hole has a conical shape.
17. The calcaneum translation plate of claim 13, wherein the
intermediate portion includes a concavity having at least one hole
for passage of at least one fastening screw.
18. The calcaneum translation plate of claim 13, wherein the distal
fixing portion and the intermediate portion are both provided with
holes for passage of screws, an axis of a hole of the intermediate
portion being inclined relative to an axis of a hole of the distal
fixing portion.
19. The calcaneum translation plate of claim 13, wherein the
intermediate portion includes, on its lateral edges, reinforcing
gussets.
20. The calcaneum translation plate of claim 13, wherein the
proximal anchoring portion includes anti-backoff teeth positioned
on lateral edges of the proximal anchoring portion.
21. The calcaneum translation plate of claim 13, wherein the
proximal anchoring portion comprises a blade presenting a narrowing
profile in a direction of its free end.
22. A calcaneum translation plate, comprising: an intermediate
portion having a first bearing surface and a second bearing
surface, the first and second bearing surfaces being transverse; a
proximal anchoring portion extending from the first bearing
surface, wherein the proximal anchoring portion comprises a blade
presenting a narrowing profile in a direction of its free end; and
a distal fixing portion extending as a prolongation of the second
bearing surface.
23. The calcaneum translation plate of claim 22, wherein the
proximal anchoring portion is arranged in a proximal plane and the
distal fixing portion is arranged in a distal plane, the proximal
plane and the distal plane being spaced apart and parallel.
24. The calcaneum translation plate of claim 22, wherein the distal
fixing portion includes at least one hole for passage of at least
one fastening screw.
25. The calcaneum translation plate of claim 24, wherein said at
least one hole has a conical shape.
26. The calcaneum translation plate of claim 22, wherein the
intermediate portion includes a concavity having at least one hole
for passage of at least one fastening screw.
27. The calcaneum translation plate of claim 22, wherein the distal
fixing portion and the intermediate portion are both provided with
holes for passage of screws, an axis of a hole of the intermediate
portion being inclined relative to an axis of a hole of the distal
fixing portion.
28. The calcaneum translation plate of claim 22, wherein the
intermediate portion includes, on its lateral edges, reinforcing
gussets.
29. The calcaneum translation plate of claim 22, wherein the
proximal anchoring portion includes anti-backoff teeth positioned
on lateral edges of the proximal anchoring portion.
30. A calcaneum translation plate, comprising: an intermediate
portion having a first bearing surface and a second bearing
surface, the first and second bearing surfaces being transverse,
the intermediate portion including a concavity having at least one
hole for passage of at least one fastening screw; a proximal
anchoring portion extending from the first bearing surface; and a
distal fixing portion extending as a prolongation of the second
bearing surface, the distal fixing portion having at least one hole
for passage of at least one fastening screw; wherein an axis of the
at least one hole of the intermediate portion is inclined relative
to an axis of the at least one hole of the distal fixing
portion.
31. The calcaneum translation plate of claim 30, wherein the
proximal anchoring portion is arranged in a proximal plane and the
distal fixing portion is arranged in a distal plane, the proximal
plane and the distal plane being spaced apart and parallel.
32. The calcaneum translation plate of claim 30, wherein the
proximal anchoring portion includes anti-backoff teeth positioned
on lateral edges of the proximal anchoring portion.
Description
CROSS-REFERENCE TO RELATED U.S. APPLICATIONS
[0001] Not applicable.
STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT
[0002] Not applicable.
NAMES OF PARTIES TO A JOINT RESEARCH AGREEMENT
[0003] Not applicable.
REFERENCE TO AN APPENDIX SUBMITTED ON COMPACT DISC
[0004] Not applicable.
BACKGROUND OF THE INVENTION
[0005] 1. Field of the Invention
[0006] The present invention relates to the field of corrective
orthopedic surgery.
[0007] It concerns an implant intended for osteotomy operations.
More precisely, the invention is relative to a calcanean
translation plate.
[0008] 2. Description of Related Art Including Information
Disclosed Under 37 CFR 1.97 and 37 CFR 1.98.
[0009] The skeletal bones of human beings and vertebrates generally
consist of at least two areas: a rigid cortical area and an
internal spongy area of more tender consistency which may itself,
for certain bones, be traversed by a marrowy canal enclosing soft
tissues.
[0010] The human hindfoot is essentially comprised of two bones:
the ankle-bone (or astragalus) above which is placed on the
calcaneum below. The calcaneum is a short bone, even and
asymmetric, of elongated shape from the rear end forward and
flattened across. The association of the calcaneum and the
ankle-bone forms the heel on which rests most of the body's weight.
This part of the foot is therefore subject to heavy pressures which
makes it prone to various malformations, sources of pain and
difficulty and/or incapability of walking for the patients.
[0011] It is sometimes indispensable to correct the shape of the
calcaneum. The intervention consists of an osteotomy of said bone
with medialization of the large tuberosity, i.e. the section of the
calcaneum into two parts and the displacement of one in relation to
the other. This will allow a better support of the hindfoot and
above all reducing the internal constraints on the muscles and
ligaments.
[0012] Osteotomy designates the surgical section of a long bone in
order to modify its axis, size or shape for therapeutic or plastic
purposes; it is directed at restituting better axes to long bones
in order to better distribute the pressures on the corresponding
articulations. Then, the principle is either to cut out a slice
over the width of the bone, and to refasten the remaining pieces
after having removed it, or to simply cut across and to open the
space of one side, by filling the void created with a bone graft,
depending on whether one wants to close an angle or open it.
Osteotomy may also be followed by a translation, i.e. the shifting
of one of the parts of the bone resulting from this section.
[0013] This operation requires the installation of support systems
for the calcaneum in order to keep the translation in place. As far
as the calcaneum is concerned, this part of the foot being
subjected to very strong pressures due to the weight of the body
and its role in walking, the major difficulty is to produce
orthopedic systems that are sufficiently stable and rigid to remain
in place and maintain the translation of the calcaneum.
[0014] One knows of calcanean implants of diverse and varied
shapes, but the perpetuation of the system, i.e. its lasting
stability and rigidity, is often uncertain because the implant
rests generally in the spongy part of the calcaneum, in spite of
the locally harder thalamic crossings, which leads to a rotation of
the system as well as a slipping of the latter under the effect of
the forces of the body's weight and the porosity of the spongy part
of the bone.
[0015] For example, the document US-2011/009.866 describes a system
for osteotomy composed of a plate which includes two ends aligned
along a longitudinal axis fitting together through a median portion
and screws. The first end includes a cutting edge and a hole which
receives a non-interlocking screw and presents a chamfer which
narrows from a lesser thickness at the edge in the direction of the
hole, the second end has a locking hole which receives a safety
screw, and the first and the second hole are aligned along the
longitudinal axis.
[0016] The drawback of this device is primarily the lack of
stability: as a matter of fact, the configuration of this implant
does not allow it to be supported by the cortical of the proximal
end of the calcaneum. Its only support therefore is the spongy bone
which is porous. In view of the extremely strong forces being
applied to this bone, in particular during walks, this system is
liable to enter into rotation or slide in the spongy part of the
proximal portion of the calcaneum which makes it very unstable and
presents major risks for the patient.
[0017] Also known are calcanean implants which have no compressive
effects on the orthopedic screws allowing their fixing, or for
which the locking of said screws is done with a metal-metal
coupling which leads, over time, to a cold solder of the galvanic
couple leading to toxic corrosion for the patient and making the
later removal of the screws impossible.
[0018] Furthermore, these implants present the drawback of
requiring particularly invasive surgery for their installation,
forcing the practitioner to make significant opening incisions over
the entire lateral portion of the calcaneum.
BRIEF SUMMARY OF THE INVENTION
[0019] One aim of the present invention is to remedy the drawbacks
cited above by providing an implant capable of perennating, i.e.
stabilizing and stiffening, the system created by the translation
of the calcaneum.
[0020] According to the invention, this aim has been achieved by a
calcaneum translation plate or implant, comprised of two end
portions, i.e. a proximal anchoring portion and a distal fixing
portion oriented in opposing directions and arranged in spaced
parallel planes, said proximal and distal portions connecting to
the third intermediate portion presenting a general square profile
and featuring two perpendicular bearing surfaces, the proximal
anchoring portion extending from one of these surfaces and
perpendicular thereto, whereas the distal fixing portion extends in
the prolongation of the other bearing surface.
[0021] According to another characteristic arrangement, the
proximal anchoring portion is constituted by a blade with a
narrowing profile in the direction of its free end.
[0022] An advantageous implementation consists of providing said
blade with anti-backoff teeth preventing the rotation of the
implant after its installation. Preferably these anti-backoff teeth
are present on the lateral edges of the proximal anchoring
portion.
[0023] According to a preferred implementation, the intermediate
portion presents a shoulder at its bearing surface at the proximal
portion of the implant. After the installation of the plate, said
shoulder abuts against the thin cortical of the proximal end of the
calcaneum and thus prevents the plate from sliding into the spongy
part of the bone.
[0024] According to a characteristic implementation of the
invention, the distal portion of the plate features at least one
hole for the passage of at least one fastening screw.
[0025] The intermediate portion of the plate may present a
concavity which can accommodate one or several holes for the
passage of one or several fastening screws. Advantageously, the
distal and intermediate portions each have two screw holes, the
axis of the holes in the intermediate portion being inclined
relative to the axis of the screw holes of the distal face.
Preferably, said holes have a conical shape.
[0026] According to a preferred implementation, the distal portion
of the plate presents some embossing on its face in contact with
the bone.
[0027] Remarkably, the intermediate portion of said plate presents
reinforcement gussets on its lateral edges.
BRIEF DESCRIPTION OF THE DRAWINGS
[0028] The aims, characteristics and advantages mentioned above and
still more, will become clearer in the detailed description below
and the attached drawings in which:
[0029] FIG. 1 is a front view of the calcanean translation plate
according to the invention.
[0030] FIG. 2 is a rear view of FIG. 1.
[0031] FIG. 3 is a perspective view of the plate according to the
invention.
[0032] FIG. 4 is a side view of the calcanean translation plate
according to the invention.
[0033] FIGS. 5 and 6 illustrate, as examples, different
implementations of the plate according to the invention,
constituting a part of a set of implants that may be presented to
the practitioner.
[0034] FIG. 7 is a longitudinal section, at a larger scale, along
the line 7-7 of FIG. 1.
[0035] FIG. 8 is a perspective view of the hindfoot showing the
calcaneum translation plate according to the invention in the
position of use, the distal and proximal portions of the calcaneum
being shown in transparency.
[0036] FIG. 9 is a detailed front view and at a larger scale,
showing the bearing surface of the shoulder of the intermediate
portion of the plate against the cortical of the proximal portion
of the calcaneum.
[0037] Reference to said drawings is made to describe an
interesting, although by no means limiting, example of
implementation of the calcaneum translation plate according to the
invention.
DETAILED DESCRIPTION OF THE INVENTION
[0038] The term "distal" designates the portion or end of a bone
which is the farthest away from the root of this bone. The term
"proximal" designates the portion or end of a bone which is the
closest to its fixing point. Here, the proximal end of the
calcaneum is the one that is attached to the ankle-bone and to the
rest of the bones of the foot, the distal portion or end of the
calcaneum designating the end of the bone which osteotomy separates
from the rest of the body. Likewise, the proximal and distal
portions of the implant are defined depending on whether their
bearing surface is the proximal or distal end of the calcaneum.
[0039] According to the invention, the objective has been achieved
by an implant consisting of a plate 1 which is comprised of three
parts: a proximal anchoring portion 2, a distal fixing portion 3
and an intermediate portion 4 which connects them. The distal and
proximal portions 2 and 3 are oriented in opposing directions and
positioned in spaced parallel planes P-P, P'-P', and present a
generally rectangular shape. The ergonomic design of the plates
reduces friction with the skin as well as detection of the implant
once it is installed.
[0040] The first proximal anchoring portion 2 is meant to insert
itself in the spongy bone of the proximal end of the calcaneum, the
second portion is a fixing face 3 and meant to place itself on the
cortical surface of the distal end of the calcaneum as its bearing
surface, thus stabilizing the portion of the bone that has been
separated from the rest of the skeleton by the osteotomy. Said
distal and proximal portions 3 and 2 are attached to an
intermediate portion 4 presenting a generally square profile and
featuring two perpendicular bearing surfaces 5 and 6, the proximal
anchoring portion extending from one of these surfaces 5 and
perpendicularly to it, whereas the distal fixing portion extends in
the prolongation of the other bearing surface 6.
[0041] The proximal and distal portions 2 and 3 are thus not
aligned but set off by said intermediate zone 4 which separates
them.
[0042] Advantageously, the proximal anchoring portion of the plate
according to the invention may be constituted by a blade 7
presenting a narrowing profile in the direction of its free end so
as to form a cutting edge.
[0043] According to a characteristic arrangement of the invention
the proximal anchoring portion 2 of the implant, i.e. the one meant
to be inserted in the spongy layer of the proximal end of the
calcaneum, presents anti-backoff teeth 8 which prevent the implant
from dislodging itself and stop it from rotating once it is
inserted in the bone. These anti-backoff teeth are, for example,
placed on the lateral edges of said proximal portion 2.
[0044] According to a characteristic arrangement of the invention,
the intermediate portion 4 of the plate has a concavity 9 on its
bearing surface 6 from which extends the distal fixing portion 3 of
the place and a shoulder 10 at its bearing surface 5 meant for the
proximal anchoring portion 2 of the plate. In the position of use,
the anchoring portion 2 being inserted in the spongy layer of the
bone, said shoulder 10 bears against the cortical layer of the
proximal portion of the calcaneum in order to stabilize the system
and to prevent it from slipping into this spongy part of the bone
under the effect of the forces generated by the weight of the
body.
[0045] According to a preferred implementation, the distal fixing
portion 3 of the plate 1 presents an embossed area 11 to prevent
the crushing and damaging of the periosteum. The periosteum is the
vascularized membrane which covers the entire surface of the bones
(with the exception of the articular cartilage) and contains the
blood vessels which carry the nutrients that are indispensable for
their repair. Any damage to the periosteum leads to the bone
becoming incapable of regenerating itself, and even to its
necrosis. This embossing 11 allows safeguarding the periosteum by
offering punctual bearing surfaces to the plate 1, and not a
surface-wide load which compresses the periosteum and damages it,
as is usually the case with calcanean implants.
[0046] According to one implementation of the invention, the distal
fixing portion 3 of the plate features at least one hole 12 for the
passage of at least one fastening screw.
[0047] According to one example of implementation, the intermediate
portion presents a concavity 9 which may typically feature one or
several holes 13 for the passage of one or several fastening screws
(15). Preferably, the distal portion 3 of the implant as well as
the intermediate portion 4 are both provided with holes 12 and 13
for the passage of the screws, the axis of the holes 13 of the
intermediate portion being inclined relative to the axis of the
holes 12 of the distal portion.
[0048] On the other hand, the translation plate of the calcaneum 1
according to the invention does not have any holes in the end of
the proximal anchoring portion 2.
[0049] According to the example illustrated in FIGS. 1 to 3, the
distal 3 and intermediate 4 portions each present two holes for the
passage of the screws, said holes may present a conical shape. The
large opening of the holes accessible from the inside of the plate
constitutes the entrance of these, whereas the small opening of
said holes opens on the outside of the plate meant to be applied
against the cortical of the distal end of the calcaneum as far as
the distal face of the plate is concerned, and against the spongy
portion of the proximal end of the calcaneum for the concavity of
the intermediate portion.
[0050] The calcanean translation plate 1 according to the invention
consists of a biocompatible, rigid but expansible material, to
allow locking of the screw heads while ensuring sufficient rigidity
to fasten together the two portions of the bone created by the
osteotomy.
[0051] For example, plate 1 is made of polyetheretherketone (PEEK),
for example of the type commercialized under the registered brand
name "PEEK-OPTIA".
[0052] According to an advantageous implementation, the lateral
walls of the hole passages 12 and 13 meant to receive the heads of
orthopedic screws 14 and 15 are expansible in the radial direction
so as to permit the compression of said screw heads which are
inserted there, thereby ensuring the locking or blocking of the
screws in the calcanean translation plate and preventing any
possibility of backward movement after having been screwed into the
bone material, which makes the translation resulting from the
osteotomy operation permanent.
[0053] The screws 15 locking themselves in the holes 13 of the
intermediate portion 4 do already have an angle of divergence which
increases the holding force of the device and the maintenance in
several planes. The locking action enables the screws 14 and 15 to
become integral with the plate.
[0054] According to one implementation, the screws 15 which are
seated in the proximal end of the calcaneum are already angled
between 10.degree. and 50.degree.. According to an advantageous
implementation, at least one of the screws used with the plate
according to the invention has a threaded head.
[0055] Advantageously, the biocompatible material constituting the
implant contains 30% carbon fibers which permits its future
retrieval if need be, while ensuring the necessary rigidity.
[0056] According to one implementation, the locking of the screw
heads in PEEK (compression) is inspired by the patented system
(FR-2.845.588 "Selfblocking Device of osteosynthesis" in the name
of Biotech International) and designated by the registered brand
name "EASYLOCK".
[0057] According to a characteristic example, the intermediate
portion 4 of plate 1 according to the invention presents
reinforcing gussets 16 on its lateral edges.
[0058] According to an advantageous implementation of the
invention, the portions of the plate that are not in contact with
the bone, i.e. the intermediate portion 4 which has a square-shaped
profile, the face of the distal portion of the plate which is not
bearing against the bone as well as the possibly present gussets
16, present rounded edges so as to increase the contact surface and
to reduce the angle of contact in order to avoid any lesions caused
by the friction coefficient between the skin and the translation
plate.
[0059] In order to enable adaptation to the specific needs of the
patient, each case being different, the implants according to the
invention will be made available to surgeons in the form of sets
each consisting of a plurality of calcanean translation plates of
different dimensions (for example FIGS. 4, 5, and 6).
[0060] The calcanean translation plate according to the invention
offers several interesting advantages and in particular: [0061]
Very great stability; [0062] No space requirement for screw heads
outside of the plate; [0063] Anatomical conformance of the plate
which adapts to the shape of the bone; [0064] Very good resistance
to the weight of walking.
* * * * *