Osteosynthesis plate and osteosynthesis set

Abstract

The invention relates to an osteosynthesis plate (P) designed for attachment to the proximal humerus (H) for fixing bone fragments and comprising an elongated base body (G) with a top surface (G1) and an opposing bottom surface (G2). The base body (G) has two fastening sections (BA1, BA2) arranged longitudinally at the respective ends (E1, E2) of the base body (G), each of which is equipped with at least one through-hole (A1, A2, A3, A4), wherein the through-holes (A1, A2, A3, A4) are each provided for receiving one screw (SK). The osteosynthesis plate (P) is designed for anterior fixation to the proximal humerus (H), wherein the base body (G) is provided on the underside (G2) in the longitudinal direction between the fixation sections (BA1, BA2) with a recess (AS) which completely penetrates the base body (G) transversely.The invention further relates to an osteosynthesis set (O) with such an osteosynthesis plate (P).

Description

[0001] The invention relates to an osteosynthesis plate designed for attachment to the proximal humerus for the fixation of bone fragments. The invention further relates to an osteosynthesis set comprising the aforementioned osteosynthesis plate.

[0002] In osteosynthesis, following a bone fracture, two or more bone fragments are surgically joined together to promote fusion. The goal of osteosynthesis is to achieve stable fixation of the bone fragments, ensuring they are correctly aligned and, if necessary, correcting any misalignments. In addition to fixation with wires or screws, osteosynthesis plates are also used, depending on the application. The plate is placed on the bone at the fracture site and attached to the bone fragments to be joined. This attachment is typically achieved with screws, for which the plate has multiple through-holes.Typically, the design of an osteosynthesis plate is adapted to the specific area of ​​the bone.

[0003] US Patent 2012 / 0191104 A1 describes an osteosynthesis plate designed for fixation to the proximal humerus. Specifically, the osteosynthesis plate of US 2012 / 0191104 A1 serves for the lateral fixation of bone fragments in a proximal humerus fracture. The osteosynthesis plate has an elongated base body, the underside of which is designed to rest on the bone fragments to be joined. The base body also features two attachment sections, arranged longitudinally one behind the other. One attachment section is the head section, and the other is the adjoining shaft section. The head section provides at least partial support to the humeral head and neck, while the shaft section provides at least partial support to the humeral shaft.Both the head and shaft sections have several through-holes, each running between the underside of the base body and an upper surface facing away from the underside. Each through-hole accommodates a screw, through which the osteosynthesis plate can be fixed to the corresponding area of ​​the humeral bone fragment.

[0004] Based on the prior art described above, the object of the present invention is to create an osteosynthesis plate which is suitable for anterior attachment to the proximal humerus and which causes as little irritation as possible to neuronal structures and blood vessels in the area of ​​application.

[0005] This problem is solved starting from the preamble of claim 1 in conjunction with its characterizing features. The subsequent dependent claims each describe advantageous embodiments of the invention. An osteosynthesis set comprising an osteosynthesis plate according to the invention is further the subject of claim 16. Advantageous embodiments also become apparent from the description and the figures.

[0006] According to the invention, an osteosynthesis plate, designed for attachment to the proximal humerus to fix bone fragments, has an elongated base body with a top surface and a bottom surface facing away from the top surface, on which the osteosynthesis plate is placed on the bone fragments. The base body has two fastening sections arranged longitudinally at each end, each equipped with at least one through-hole. These through-holes are designed to accommodate a screw and extend between the top and bottom surfaces of the base body. The two fastening sections are designed on the bottom surface to provide at least partial bone contact.

[0007] The osteosynthesis plate according to the invention is therefore intended for the fixation of bone fragments on the proximal humerus. For fixation, the osteosynthesis plate according to the invention is placed on the underside of its base body onto the bone fragments to be joined together, whereby, in particular, two bone fragments formed as part of a bone fracture can be joined together via the osteosynthesis plate. The base body of the osteosynthesis plate according to the invention is an elongated body whose greatest extent is in a longitudinal direction.The base body is particularly preferably in a plate-like shape, with extensions of the base body in a transverse direction orthogonal to the longitudinal direction and in a depth direction orthogonal to the longitudinal and transverse directions being significantly smaller compared to its longitudinal extension, which gives the base body and also the osteosynthesis plate an overall rib-like shape.

[0008] The base body is designed with two attachment sections arranged longitudinally at opposite ends of the base body, forming a proximal end and a distal end. When used on the proximal humerus, the osteosynthesis plate according to the invention is preferably oriented with its proximal end facing proximally and its distal end facing distally. In the transverse direction of the base body, the two attachment sections can, in particular, have the same length. According to the invention, the two attachment sections can be rotated relative to each other on the base body and / or each attachment section can be twisted in on itself.

[0009] The fastening sections are equipped with through-openings, each of which extends between the top and bottom surfaces of the base body. The path of each through-opening through the base body between the top and bottom surfaces follows a corresponding central axis. Furthermore, each through-opening serves to guide a screw through which the osteosynthesis plate according to the invention can be connected to the bone. Each fastening section is provided with at least one through-opening, preferably with several. Preferably, the at least one through-opening in each fastening section is arranged centrally in the transverse direction of the base body.

[0010] Within the scope of the invention, the respective through-opening can be designed to accommodate different screws, preferably different types of screws and / or different screw shank diameters. Locking screws and compression screws can preferably be passed through the respective through-opening. In a manner known to those skilled in the art, a locking screw is equipped, in particular, with a conical head thread and a shank thread adjoining the screw head. In contrast, a compression screw has a spherical screw head to which a shank with a shank thread is attached.Both a locking screw and a compression screw can, in principle, be designed as a cortical screw or as a cancellous screw with partial or full thread.

[0011] In particular, one or more of the through-holes allow the respective screw to pivot relative to its central axis, preferably in the area of ​​a conical surface, and especially preferably a conical surface with an opening angle of 30°. Specifically, the through-hole allowing pivoting is provided with an insert, this insert being made of a material with higher ductility than the rest of the base body, such as preferably pure titanium. The base body, on the other hand, is preferably made of a titanium alloy or steel. Alternatively or additionally, one or more through-holes can also be designed as elongated slots extending longitudinally along the base body.

[0012] When the osteosynthesis plate according to the invention is used on the proximal humerus, at least partial contact with the bone occurs at the two attachment sections.

[0013] According to the invention, the base body can be equipped in its peripheral region with suture anchors forming suture holes, each of which serves to guide sutures for attaching tissue to the osteosynthesis plate. In particular, these suture anchors each have an undercut on the underside of the base body.

[0014] Alternatively or additionally, further openings can be incorporated into the base body, each serving to guide a fixation wire or similar device. Furthermore, the base body of the osteosynthesis plate can be designed to accommodate a drill plate, which assists the surgeon in aligning the drill holes when drilling receiving holes in the bone. This attachment point can, for example, take the form of one or more blind holes in the base body.

[0015] The invention now comprises the technical teaching that the osteosynthesis plate is designed for anterior fixation to the proximal humerus. The base body is provided on its underside with a longitudinal recess between the fixation sections, which completely penetrates the base body transversely. In other words, the osteosynthesis plate according to the invention is thus designed to be fixed to the proximal humerus from the anterior side. The osteosynthesis plate is particularly preferably designed or configured specifically for this anterior fixation to the proximal humerus. Furthermore, a recess is provided on the base body, which is formed on its underside and extends longitudinally between the fixation sections.This recess penetrates the base body in its transverse direction, so that the recess, in the sense of a breakthrough, passes completely transversely through the base body from one longitudinal side to the other longitudinal side of the base body.

[0016] This design of the osteosynthesis plate offers the advantage that, when the plate is attached to the proximal humerus near the joint and from the anterior aspect, the risk of irritation or even compression of neural structures and blood vessels in this area can be reliably minimized or even completely eliminated. This is because the recess on the underside between the attachment sections creates a space between the osteosynthesis plate and the bony structure when it is attached to the proximal humerus. This space allows neural structures and blood vessels to be guided between the osteosynthesis plate and the bony structure, thus relieving pressure. This also relieves pressure on the periosteum and improves blood flow.

[0017] Preferably, exactly one recess is provided between the attachment sections. In other words, the recess forms a bridge between the attachment sections formed at each end of the osteosynthesis plate, thus creating a large open space for blood vessels and neural structures.

[0018] According to one embodiment of the invention, the recess in a longitudinal section of the base body has a trapezoidal shape. This recess design has proven advantageous. For the purposes of the invention, a "longitudinal section" is defined as a section plane formed by a longitudinal median plane of the base body. This longitudinal median plane is a plane that passes centrally through the base body in its longitudinal direction and penetrates both the top and bottom surfaces.

[0019] In a further development of the aforementioned embodiment, the trapezoidal shape is formed by a first base side, which is enclosed on the underside between the fastening sections in the longitudinal section of the base body, and a second base side, which, in the longitudinal section of the base body, limits the recess towards the top, as well as two flank sides, which connect the base sides to each other in the longitudinal section of the base body. Particularly preferably, the first base side has a length in the range of 15 to 25 mm, preferably 20 mm, and the second base side has a length in the range of 5 to 20 mm, particularly 10 mm, wherein one flank side extends at an angle of 20° to 60°, preferably 30°, towards the second base side, and the other flank side extends at an angle of 20° to 60°, preferably 30°, towards the first base side.

[0020] The sides of the trapezoidal shape are preferably rounded, at least in sections, which further reduces the risk of irritation to neural structures and blood vessels passing through the openings. Alternatively, the individual sides could also be linear.

[0021] Alternatively, but preferably in addition to the aforementioned variants, the base sides can run at least largely parallel to each other. "At least largely" parallelism of the base sides is understood to mean only a slight deviation from a perfectly parallel course. Preferably, the base sides enclose an angle between them which is at most a few degrees, preferably only a fraction of a degree.

[0022] According to one embodiment of the invention, the fastening sections taper on both sides from the longitudinal sides of the base body via entry surfaces into the recess. This minimizes the risk of irritation or pinching, even when neural structures and blood vessels run obliquely to the osteosynthesis plate. Preferably, the entry surfaces are designed as chamfers or rounded edges.

[0023] Another possible embodiment of the invention is that the fastening sections taper in a wedge shape towards their respective ends in the longitudinal section of the base body. This allows the osteosynthesis plate to conform tightly to the respective area of ​​the humerus when applied.

[0024] According to a further embodiment of the invention, the fastening sections in the longitudinal section of the base body are not parallel, but arranged at an angle to each other. Preferably, the angle between the fastening sections in the longitudinal section of the base body is in the range of 10° to 30°, with 25° being preferred. In other words, the osteosynthesis plate is not flat, but curved, bent, or angled. Such a shape has proven particularly advantageous for the arrangement of the osteosynthesis plate on the anterior side of the proximal humerus.

[0025] According to one embodiment of the invention, the fastening sections for the at least partial bone support are each equipped with a bearing surface on the underside. Preferably, each bearing surface is at least partially flat and / or at least partially spherical and / or at least partially ellipsoidal. This allows each bearing surface to be created with a suitable contour for contact with the bone. Alternatively or additionally, each bearing surface is formed in the longitudinal section of the base body along an associated guide curve, which is either completely straight or formed by at least two straight segments that run at an angle of 10° to 30°, preferably 20°, to each other, and / or has at least one curvature that causes a change in direction of the associated guide curve at an angle of 10° to 30°, preferably 20°.This also allows for a suitable design of the respective contact surface for the contact with the bone.

[0026] Within the scope of the invention, it is also conceivable that the respective fastening section in the longitudinal section of the base body follows its respective guide curve. This allows for a design, particularly with regard to the fastening section located at the proximal end, in which this fastening section can lie close to the humeral head and neck.

[0027] In a further development of the invention, the fastening sections each have at least two through-openings. Particularly preferably, the fastening sections are each equipped with exactly two through-openings, thereby enabling reliable fastening to the anterior side of the proximal humerus.

[0028] Preferably, the base body has through-openings from the top to the bottom only in the area of ​​the attachment sections. In other words, the base body has no through-opening in the area of ​​the recess between the attachment sections. This allows the base body to have a relatively thin wall thickness in the area of ​​the recess, as there is no structural weakening caused by a through-opening. Such a compact design is of greater importance for use on the anterior side of the proximal humerus than a geometry designed in the area of ​​the recess for the attachment of tissue or bone.

[0029] The invention further relates to an osteosynthesis set which, in addition to an osteosynthesis plate according to one or more of the variants described above, also comprises a further osteosynthesis plate designed for lateral fixation to the proximal humerus. This osteosynthesis set thus enables reliable fixation and stabilization of bone fragments formed on the proximal humerus as a result of a proximal humeral fracture.

[0030] An advantageous embodiment of the invention, which is explained below, is illustrated in the drawings. They show: Fig. 1 to 5 different views of an osteosynthesis plate according to a preferred embodiment; Fig. 6 and Fig. 7 views of a proximal humerus to which an osteosynthesis plate has been attached according to the Fig. 1 to 5 is attached; and Fig. 8 and Fig. 9 illustrations of a proximal humerus with an attached osteosynthesis set, comprising an osteosynthesis plate according to the Fig. 1 to 5.

[0031] From the Fig. Figures 1 to 5 show different views of an osteosynthesis plate P, which is designed according to a preferred embodiment of the invention. The osteosynthesis plate P has a base body G, which is provided with a top surface G1 and a bottom surface G2 facing away from the top surface G1. The base body G is elongated such that it has its greatest extent in a longitudinal direction, while it has a comparatively smaller extent in a transverse direction and its smallest extent in a depth direction running between the top surface G1 and the bottom surface G2. This gives the base body G a ridge-like shape.

[0032] The base body G has longitudinally arranged fastening sections BA1 and BA2, one behind the other. Fastening section BA1 is located longitudinally at a first end E1 of the base body G, and fastening section BA2 is located longitudinally at a second end E2 of the base body G, opposite to the first. Both fastening sections BA1 and BA2 are each equipped with two associated through-openings A1 and A2, and A3 and A4, respectively. These through-openings A1 to A4 are designed for the passage of one SK screw each, as shown in Fig. Figure 3 shows that each of the through-holes A1, A2, and A4 accommodates an annular insert R, which, compared to the base body G, is made of a material with higher ductility. Thus, the inserts R are preferably made of pure titanium, while the base body G of the osteosynthesis plate P is preferably made of a titanium alloy or steel. The receiving opening A3 is designed as an elongated slot LL. The through-holes A1 to A4 are suitable for accommodating both locking screws and compression screws.

[0033] The osteosynthesis plate P is designed for anterior fixation to the proximal humerus and serves to fix bone fragments resulting from a proximal humerus fracture. For this purpose, the osteosynthesis plate P is aligned with its first end E1 proximally and its second end E2 distally, and placed on the underside G2 of the base body G at the fixing sections BA1 and BA2 on the bone.

[0034] To improve the contact with the bone anatomy, the two attachment sections BA1 and BA2 are arranged at an angle α to each other, which is in Fig. 5 can be seen. The angle α lies in a range of 10° to 30° and is preferably 25°. The fastening section BA1 and the fastening section BA2 are each provided on the underside G2 of the base body G with a bearing surface AF1 and AF2 respectively, on which the respective fastening section BA1 or BA2 is at least partially placed on the bone.

[0035] As particularly in Fig. As can be seen in Figure 2, the contact surfaces AF1 and AF2 are concavely curved, with each individual contact surface AF1 or AF2 being at least partially spherical and / or at least partially ellipsoidal. The contact surface AF1 of the fastening section BA1 is shown in the longitudinal section of the base body G along a Fig. The guide curve LK is formed by two segments S1 and S2, as indicated in Figure 5. The two segments S1 and S2 of the guide curve LK run at an angle β to each other, which is in the range of 10° to 30° and preferably 20°.

[0036] The guide curve LK defines not only the shape of the bearing surface AF1 but also the shape of the fastening section BA1, whereby it is tilted at the end E1 with an end segment ES by the angle β.

[0037] As in Fig. As can be seen in Figure 5, the attachment sections BA1 and BA2 taper in a wedge shape in the longitudinal section of the base body G towards their respective ends E1 and E2. Furthermore, several suture anchors N are formed on the attachment section BA1 in the edge region of the base body G, each serving to guide a thread for attaching tissue to the osteosynthesis plate P and each featuring an undercut on the underside G2.

[0038] The base body G of the osteosynthesis plate P has a recess AS on its underside G2, which is designed to run longitudinally along the base body G between the two attachment sections BA1 and BA2 and completely penetrates the base body G transversely. This creates a passage between the attachment sections BA1 and BA2 via the recess AS on the underside G2 of the base body G.

[0039] In longitudinal section, the recess AS has a trapezoidal shape, as shown in Fig. Figure 5 shows that this trapezoidal shape is formed by a first base side BS1, a second base side BS2, and two flank sides FS1 and FS2. The first base side BS1 extends in the longitudinal section of the base body G between the bearing surfaces AF1 and AF2 of the fastening sections BA1 and BA2, while the second base side BS2 defines the recess AS in the longitudinal section of the base body G towards the top surface G1. The two flank sides FS1 and FS2 connect the base sides BS1 and BS2 on both sides, with flank side FS1 forming an angle γ between the first base side BS1 and the second base side BS2, and flank side FS2 forming an angle δ between the first base side BS1 and the second base side BS2.

[0040] In the present case, the first base side BS1 has a length in the range of 15 to 25 mm, preferably 20 mm, while the second base side BS2 has a length in the range of 5 to 20 mm, particularly 10 mm. Furthermore, the angle γ lies in the range of 20° to 60° and is preferably 30°, whereas the angle δ lies in the range of 20° to 60° and is particularly 30°.

[0041] As demonstrated by Fig. 2 and also from Fig. As can be seen in Figure 4, the fastening sections BA1 and BA2 taper on both sides from the longitudinal sides LS1 and LS2 of the base body G via inlet surfaces EF into the recess AS. These inlet surfaces EF are designed as chamfers.

[0042] In Fig. 6 and Fig. Figure 7 shows the osteosynthesis plate P according to the invention in its fixed state at the proximal end of a right humerus H. The osteosynthesis plate P rests on the underside G2 of its base body G with the fixing section BA1 in the region of the head and neck of the humerus H, while the fixing section BA2 rests in the region of the shaft of the humerus H. Through the through-openings A1 to A4, Fig. The 7 screws SK shown were passed through to connect both fastening sections BA1 and BA2 to the proximal humerus H, thereby aligning and stabilizing bone fragments relative to each other.

[0043] Furthermore, in the Fig. 8 and Fig.Nine further views of a right humerus H in the proximal region are shown, wherein a proximal humeral fracture has been treated using an osteosynthesis set O. This osteosynthesis set O comprises, in addition to the osteosynthesis plate P according to the invention, a further osteosynthesis plate P', which is attached laterally to the proximal humerus H. Reference symbol list P Osteosynthesis plate G Basic body G1 Top G2 underside BA1 fastening section BA2 fastening section E1 End E2 End A1 to A4 Through openings SK screws R deployments LL slotted hole AF1 contact surface AF2 contact surface LK guide curve S1 Segment S2 Segment ES end segment N Near tanker AS recess BS1 first basic page BS2 second base page FS1 side FS2 side LS1 Long side LS2 Long side EF inlet surfaces H Humerus O Osteosynthesis set P' further osteosynthesis plate α angle β angle γ angle δ angle QUOTES INCLUDED IN THE DESCRIPTION

[0000] This list of documents cited by the applicant was automatically generated and is included solely for the reader's convenience. The list is not part of the German patent or utility model application. The DPMA accepts no liability for any errors or omissions. Cited patent literature

[0000] US 2012 / 0191104 A1

[0003]

Claims

[1] Osteosynthesis plate (P) which is designed for attachment to the proximal humerus (H) for the fixation of bone fragments, - wherein the osteosynthesis plate (P) has an elongated base body (G) with a top (G1) and a bottom (G2) facing away from the top (G1), wherein the bottom (G2) is designed to support the osteosynthesis plate (P) on the bone fragments, - wherein the base body (G) has two fastening sections (BA1, BA2) arranged in a longitudinal direction at the respective end (E1, E2) of the base body (G), each of which is equipped with at least one through-hole (A1, A2, A3, A4), wherein the through-holes (A1, A2, A3, A4) are provided for receiving one screw (SK) each and run between the top (G1) and the bottom (G2) of the base body (G), - and wherein the two attachment sections (BA1, BA2) on the underside (G2) are designed for at least partial bone support, characterized by , - that the osteosynthesis plate (P) is designed for anterior fixation to the proximal humerus (H), - and that the base body (G) is provided on the underside (G2) in the longitudinal direction between the fastening sections (BA1, BA2) with a recess (AS) which completely penetrates the base body (G) transversely. [2] Osteosynthesis plate (P) according to claim 1, characterized by , that exactly one recess (AS) is provided between the fastening sections (BA1, BA2). [3] Osteosynthesis plate (P) according to claim 1 or claim 2, characterized by , that the recess (AS) in a longitudinal section of the base body (G) has a trapezoidal shape. [4] Osteosynthesis plate (P) according to claim 3, characterized by, that the trapezoidal shape is formed by a first base side (BS1), which in the longitudinal section of the base body (G) is enclosed on the underside (G2) between the fastening sections (BA1, BA2), and a second base side (BS2), which in the longitudinal section of the base body (G) limits the recess (AS) towards the top (G1), as well as two flank sides (FS1, FS2), which connect the base sides (BS1, BS2) to each other in the longitudinal section of the base body (G). [5] Osteosynthesis plate (P) according to claim 4, characterized by, that the first base side (BS1) has a length in the range of 15 to 25 mm, preferably 20 mm, and the second base side (BS2) has a length in the range of 5 to 20 mm, in particular 10 mm, wherein one flank side (FS1) extends to the first base side (BS1) at an angle (γ) in the range of 20° to 60°, preferably 30°, in the direction of the second base side (BS2), and the other flank side (FS2) extends to the first base side (BS1) at an angle (δ) in the range of 20° to 60°, preferably 30°, in the direction of the second base side (BS2). [6] Osteosynthesis plate (P) according to claim 4 or 5, characterized by that the flank sides (FS1, FS2) are at least partially rounded. [7] Osteosynthesis plate (P) according to any one of claims 3 to 6, characterized by that the base pages (BS1, BS2) run at least largely parallel to each other. [8] Osteosynthesis plate (P) according to any of the preceding claims, characterized by, that the fastening sections (BA1, BA2) taper from both sides of the longitudinal sides (LS1, LS2) of the base body (G) via inlet surfaces (EF) into the recess (AS). [9] Osteosynthesis plate (P) according to claim 8, characterized by that the inlet surfaces (EF) are designed as a chamfer or as a rounding. [10] Osteosynthesis plate (P) according to any of the preceding claims, characterized by , that the fastening sections (BA1, BA2) taper in a wedge shape in the longitudinal section of the base body (G) towards their respective ends (E1, E2). [11] Osteosynthesis plate (P) according to any of the preceding claims, characterized by that the fastening sections (BA1, BA2) are not arranged parallel to each other in the longitudinal section of the base body (G), but at an angle (α) to each other. [12] Osteosynthesis plate (P) according to claim 11, characterized by, that the angle (α) between the fastening sections (BA1, BA2) in the longitudinal section of the base body (G) is in the range of 10° to 30°, preferably 25°. [13] Osteosynthesis plate (P) according to any of the preceding claims, characterized by that the fastening sections (BA1, BA2) for at least partial bone support on the underside (G2) are each equipped with a support surface (AF1, AF2) which - is at least partially flat and / or at least partially spherical and / or at least partially ellipsoidal in shape, and / or - is formed in the longitudinal section of the base body (G) along each associated guide curve (LK), which is designed to be completely straight or is formed by at least two straight segments (S1, S2) which run at an angle (β) to each other in the range of 10° to 30°, preferably 20°, and / or - has at least one curvature which causes a change in direction of the respective guide curve with an angle in the range of 10° to 30°, preferably 20°. [14] Osteosynthesis plate (P) according to any of the preceding claims, characterized by that the fastening sections (BA1, BA2) each have at least two through openings (A1, A2, A3, A4), preferably exactly two through openings (A1, A2, A3, A4). [15] Osteosynthesis plate (P) according to any of the preceding claims, characterized by , that the base body (G) has through openings (A1, A2, A3, A4) exclusively in the area of ​​the fastening sections. [16] Osteosynthesis set (O) comprising an osteosynthesis plate (P) according to one or more of claims 1 to 15 and a further osteosynthesis plate (P') designed for lateral attachment to the proximal humerus (H).

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