Orthopaedic distraction device for distraction of a patient 's joint, advantageously the knee

Abstract

The present invention relates to an orthopaedic distraction device for distraction of a patient's joint (A), which comprises: - securing means (2), for securing said orthopaedic distraction device (1) to the bones (S) that make up said joint (A), - telescopic connecting means (3), connecting said securing means (2) and defining a degree of freedom in translational movement (T), - manoeuvring means (4), suitable for generating a manoeuvre of spacing said securing means (2) apart, and - locking means (5), suitable for locking said telescopic connecting means (3) in terms of translation after said distraction has been created.

Description

[0001] Orthopedic distraction device, for distracting a patient's joint, advantageously the knee

[0002] Technical field of the invention

[0003] The present invention relates to the technical field of orthopedic devices.

[0004] It particularly concerns orthopedic distraction devices which are suitable for distracting a patient's joint, advantageously the knee.

[0005] State of the art

[0006] Osteoarthritis of a joint, particularly the knee, is a degenerative joint disease characterized by persistent pain and can lead to loss of function.

[0007] Treatment options are currently limited, and standard treatments can only slow the disease.

[0008] In this context, this disease usually leads to surgery for prosthetic replacement of the joint (e.g. in bicompartmental joint degeneration).

[0009] There is therefore a definite interest in surgical treatments that can save joints, particularly in young patients with knee osteoarthritis.

[0010] In this context, joint distraction could be an interesting solution in that it improves joint homeostasis by temporary mechanical unloading of the joint.

[0011] However, current orthopedic distraction devices have various disadvantages for achieving this distraction, including significant bulk, significant discomfort for the patient, external arrangement (leading to a high infection rate due to percutaneous pins) and complexity of installation for the orthopedic surgeon.

[0012] Presentation of the invention

[0013] In order to overcome the aforementioned drawbacks of the state of the art, the present invention proposes an orthopedic distraction device, for the distraction of a patient's joint, advantageously the knee.

[0014] The orthopedic distraction device according to the invention, advantageously internal or external, comprises:

[0015] - securing means, for securing said orthopedic distraction device with the bones forming said joint, which securing means comprise first securing means for securing with at least one first bone of said joint, advantageously a tibia, and second securing means for securing with at least one second bone of said joint, advantageously a femur, - telescopic connecting means, connecting said securing means and defining a degree of freedom in translation between said securing means,

[0016] - maneuvering means, adapted to generate a separation maneuver between said securing means according to said degree of freedom in translation to create a distraction between the bones of said joint, and

[0017] - locking means, adapted to lock in translation said telescopic connecting means after the creation of said distraction.

[0018] Such an orthopedic distraction device according to the invention has various advantages, namely in particular reduced bulk, improved comfort for the patient, the possibility of versatile arrangement (possibly external and preferably internal, which eliminates the risks of infection linked to percutaneous pins) and ease of installation for the orthopedic surgeon.

[0019] Other non-limiting and advantageous characteristics of the product in accordance with the invention, taken individually or in all technically possible combinations, are as follows:

[0020] - the telescopic connecting means comprise at least two arms which together form a slide defining said degree of freedom in translation, which arms each comprise a proximal end which is connected to one of said securing means; preferably, said at least two arms comprise a first arm, comprising a tubular wall which defines an elongated housing opening out at an opening, and a second arm, attached to said elongated housing through said opening and guided in translation along said elongated housing;more preferably, the locking means comprise at least one stop screw which is guided in translation on one of said arms and which cooperates with the other of said arms to ensure said locking, advantageously among an axial stop screw, to maintain the distraction, preferably implanted parallel to the degree of freedom in translation, advantageously in a bottom of the elongated housing located opposite the opening, and a lateral stop screw, to lock the play in translation, preferably implanted perpendicular to the degree of freedom in translation, advantageously in the tubular wall of the first arm; the operating means advantageously comprise a cam, removable and free to rotate, to generate a relative movement of said arms by a rotational movement; preferably, the removable cam is assembled on a second arm and cooperates with a first arm;more preferably, the removable cam is assembled on the second arm, preferably at its proximal end, and cooperates with the tubular wall of the first arm, on the side of its opening; the maneuvering means advantageously comprise stop means, to define the end-of-rotation position of said cam, for example a pair of lugs including a first lug carried by said cam and a second lug carried by the tubular wall of the first arm; alternatively and / or complementary, the maneuvering means comprise an axial maneuvering screw which is guided in translation on one of said arms, parallel to the degree of freedom in translation (advantageously in a bottom of the elongated housing located opposite the opening), and which cooperates with the other of said arms to ensure the separation maneuver;

[0021] - the locking means comprise complementary securing means forming a spacer, which are structured to bridge the joint and to be fixed to an opposite bone of said joint.

[0022] - the securing means consist of two osteosynthesis plates, namely a first osteosynthesis plate, forming the first securing means intended to be secured to the first bone of said joint, and a second osteosynthesis plate, forming the second securing means intended to be secured to the second bone of said joint, which osteosynthesis plates advantageously comprise orifices suitable for the placement of fixing screws; preferably, the proximal end of an arm is in one piece with the associated osteosynthesis plate, or assembled with the osteosynthesis plate, for example by screwing;

[0023] - the orthopedic distraction device comprises angulation means for providing a degree of freedom in rotation between said securing means, perpendicular to said degree of freedom in translation, in order to allow distraction with the flexed joint; the angulation means advantageously comprise articulation means which are provided between one of the securing means and the telescopic connection means, and rotation locking means, adapted to lock said articulation means in rotation after adjustment of said angulation, for example in the form of complementary toothed crowns associated with a clamping member.

[0024] The present invention also relates to the method of orthopedic distraction, by implementing an orthopedic distraction device according to the invention, which method comprises:

[0025] - a prior surgical operation applied to at least one of the bones forming said joint,

[0026] - a step of positioning and securing said orthopedic distraction device with the bones forming said joint,

[0027] - possibly an angulation step between the means of securing,

[0028] - a step of creating the distraction by implementing the maneuvering means which causes a maneuver to separate the securing means,

[0029] - a step of maintaining the distraction, by implementing the locking means. Of course, the different characteristics, variants and embodiments of the invention can be associated with each other in various combinations to the extent that they are not incompatible or mutually exclusive.

[0030] Detailed description of the invention

[0031] In addition, various other characteristics of the invention emerge from the appended description given with reference to the drawings which illustrate non-limiting embodiments of the invention and where:

[0032] [Fig. 1] is a general view of a first orthopedic distraction device according to the invention;

[0033] [Fig. 2] is a general exploded view of the first orthopedic distraction device according to Figure 1;

[0034] [Fig. 3] is a general view of a first part of the orthopedic distraction device according to figure 1, namely a first arm (comprising an elongated housing) with its osteosynthesis plate intended to be secured here to the tibia;

[0035] [Fig. 4] is a general view of a second part of the orthopedic distraction device according to figure 1, namely a second arm (intended to be attached to the elongated housing) with its osteosynthesis plate intended to be secured here to the femur;

[0036] [Fig. 5] is a general view, in perspective, of the orthopedic distraction device according to figure 1, secured to the bones forming the joint and prior to the step of creating the distraction;

[0037] [Fig. 6] is a general front view of the orthopedic distraction device according to Figure 5;

[0038] [Fig. 7] is a general view of the orthopedic distraction device according to figure 1, secured to the bones forming the joint and following the step of creating the distraction;

[0039] [Fig. 8] is a general view of a second orthopedic distraction device according to the invention;

[0040] [Fig. 9] is a general exploded view of the second orthopedic distraction device according to Fig. 8;

[0041] [Fig. 10] is a general view of the orthopedic distraction device according to Figure 8, secured to the bones forming the joint;

[0042] [Fig. 11] is a general view of a third orthopedic distraction device according to the invention;

[0043] [Fig. 12] is a general exploded view of the third orthopedic distraction device according to Figure 11; [Fig. 13] is a general view of the orthopedic distraction device according to Figures 11 and 12, secured to the bones forming the joint, showing the implantation before distraction (part A.) and after distraction (part B.);

[0044] [Fig. 14] is a general view of a fourth orthopedic distraction device according to the invention, distinguished from the second orthopedic distraction device by additional securing means forming a spacer.

[0045] It should be noted that, in these figures, the structural and / or functional elements common to the different variants may have the same references.

[0046] As described below in connection with the figures, the present invention therefore relates to an orthopedic distraction device 1 which is designed for the distraction of a joint A of a patient, advantageously of the knee.

[0047] By "distraction" we mean a temporary mechanical unloading of joint A by creating a separation between the two bones S forming this joint A.

[0048] For example, as illustrated in Figures 5 to 7 or Figure 10 in the case of the knee, temporary distraction is implemented between the tibia S1 and the femur S2, advantageously with a separation dimension of the order of 5 mm and maintained for between 6 and 8 weeks.

[0049] In this case, the orthopedic distraction device 1 advantageously consists of a surgical or implantable orthopedic distraction device 1.

[0050] The orthopedic distraction device 1 is here internal, advantageously implanted under the skin and soft tissues of the patient, which eliminates the risk of infection linked to percutaneous pins.

[0051] Alternatively, the orthopedic distraction device 1 is external, advantageously positioned outside the patient's skin, with securing means intended to be implanted through the skin and soft tissues.

[0052] Generally speaking, according to the invention, the orthopedic distraction device 1 comprises:

[0053] - securing means 2, for securing the orthopedic distraction device 1 with the bones S forming the joint A,

[0054] - telescopic connecting means 3, connecting the securing means 2 and defining a degree of freedom in translation T between the securing means 2,

[0055] - maneuvering means 4, adapted to generate a maneuver in spacing between the securing means 2 according to the degree of freedom in translation T to create the distraction between the bones S of the joint A, and

[0056] - locking means 5, adapted to lock in translation the telescopic connection means 3 after the creation of the desired distraction. In particular, the degree of freedom in translation T advantageously extends perpendicularly to the folding axis of the joint A or to the joint space.

[0057] Means of solidarity

[0058] The means of solidarity 2 include:

[0059] - first securing means 21 for securing with at least one first bone S1 of the joint A (advantageously a tibia for the knee), and

[0060] - second securing means 22 for securing with at least one second bone S2 of the joint A (advantageously a femur for the knee).

[0061] Preferably, the securing means 2 consist of two osteosynthesis plates 2, namely:

[0062] - a first osteosynthesis plate 21, forming the first means of securing

[0063] 21 intended to be secured with at least a first bone S1 of the joint A, and

[0064] - a second osteosynthesis plate 22, forming the second securing means

[0065] 22 intended to be secured with at least a second bone S2 of the joint A.

[0066] Generally, for the knee, the first securing means 21 are adapted for securing with the tibia, forming tibial securing means 21; and the second securing means 22 are adapted for securing with the femur, forming femoral securing means 22.

[0067] Alternatively, as illustrated in figures 8 and following, the securing means 2 are adapted to an inverted assembly compared to figures 5 and following:

[0068] - the first securing means 21 are adapted for securing with a first bone S1 which is here the femur, forming femoral securing means 21, and

[0069] - the second securing means 22 are adapted for securing with a second bone S1 which is here the tibia, forming tibial securing means 22.

[0070] Generally speaking, the osteosynthesis plates 2 advantageously include orifices 23 adapted to the placement of fixing screws V in the bone S.

[0071] Preferably, the holes 23 are arranged so that the fixing screws V preserve the articular surfaces and the fixing screws V diverge to increase the anchoring force.

[0072] In a classic manner, such osteosynthesis plates 2 comprise:

[0073] - a rear face, advantageously anatomical and intended to come into contact with the bone, and

[0074] - a front, opposite face.

[0075] The thickness of such an osteosynthesis plate 2 is advantageously a few millimeters. Again in general, as illustrated in particular in Figures 5 to 7, the securing means 2 are advantageously shaped for fixing on the medial and / or lateral and / or anteromedial and / or anterior faces of the bones S of the joint A.

[0076] Telescopic connecting means

[0077] The telescopic connecting means 3 advantageously comprise at least two arms 31, 32 which together form a slide defining the degree of freedom in translation T.

[0078] The arms 31, 32 each have a proximal end 311, 321 which is connected (or coupled) with one of the securing means 2.

[0079] In this case, a first arm 31 cooperates with the first securing means 21 (figures 2 and 3, or figures 8 and following).

[0080] The first arm 31 (advantageously in the form of a sleeve or sheath) advantageously comprises a tubular wall 313 which defines an elongated housing 314, advantageously a blind housing, opening at an opening 315.

[0081] The elongated housing 314 advantageously consists of a blind housing, comprising a bottom 316 located opposite the opening 315.

[0082] The elongated housing 314 advantageously extends coaxially with respect to the translational degree of freedom T.

[0083] A second arm 32, cooperating with the second securing means 22, is visible in more detail in figures 2 and 4 or in figures 8 and following.

[0084] The second arm 32 is intended to be attached to the elongated housing 314 of the first arm 31, through its opening 315 and guided in translation along the elongated housing 314 (coaxially to the degree of freedom in translation T).

[0085] In particular, the cross-section of the second arm 32 corresponds, apart from the clearance, to the cross-section of the elongated housing 314 of the first arm 31 so as to ensure relative translational guidance between these two arms 31, 32 according to the degree of freedom in translation T.

[0086] Furthermore, the second arm 32 advantageously comprises a visual marking 325 which is useful for observing / measuring the movement of this second arm 32 relative to the opening 315 of the first arm 31, corresponding to the distraction applied to the joint A.

[0087] Generally, for the knee, the first arm 31 cooperates for example with first “tibial” securing means 21 and the second arm 32 cooperates with second “femoral” securing means 22 (figures 1 to 7 for example).

[0088] Alternatively, in the case of an assembly opposite to that illustrated in figures 5 and following (figures 8 and following), the first arm 31 cooperates with first “femoral” securing means 21 and the second arm 32 cooperates with second “tibial” securing means 22. In general, the telescopic connecting means 3 can be made in one piece (figures 9 to 11), or assembled (figures 1 to 8 or figures 11 and 12), with the securing means 2.

[0089] In practice, the proximal end 311, 321 of an arm 31, 32 is advantageously:

[0090] - monobloc with the associated osteosynthesis plate 21, 22 (figures 9 to 11), or

[0091] - assembled with the associated osteosynthesis plate 21, 22, for example by screwing (figures 1 to 8 or figures 11 and 12).

[0092] For example, according to figures 1 to 7 or 11 and 12, the proximal end 311 of the first arm 31 is in one piece with the first osteosynthesis plate 21. The proximal end 321 of the second arm 32 is assembled with the associated second osteosynthesis plate 22.

[0093] Generally, the assembly means 7, 9 (between the proximal end 321 of the second arm 32 and the associated second osteosynthesis plate 22) are advantageously chosen from:

[0094] - articulation means 7 forming part of angulation means 6 described below in connection with figures 1 to 7, conferring a degree of freedom in rotation between the proximal end 321 of the second arm 32 and the associated second osteosynthesis plate 22, or

[0095] - fixed assembly means 9, described below in connection with figures 11 to 13, defining a precise angular position between the second arm 32 and the second associated osteosynthesis plate 22.

[0096] For the “fixed assembly means 9” embodiment, the second osteosynthesis plate 22 advantageously comprises a location 225 intended to receive the proximal end 321 of the second arm 32 and to ensure the angular locking of this second arm 32.

[0097] Generally, to carry out the assembly, the proximal end 321 of the second arm 32 is advantageously:

[0098] - superimposed with a front face of the second osteosynthesis plate 22, then

[0099] - assembled by a clamping member 71, 91, for example a screw, which is attached through a pair of aligned orifices 72, 92 which are provided respectively in the arm 32 (at its proximal end 321) and in the associated osteosynthesis plate 22.

[0100] According to the embodiment illustrated in Figures 1 to 7 or Figures 11 and 12, the second osteosynthesis plate 22 preferably consists of an osteosynthesis plate adapted to be attached to a bone S1 after a surgical procedure applied to said bone S2 (for example a fracture osteosynthesis or a corrective osteotomy, as illustrated in Figure 13). Alternatively, according to Figures 8 to 10, the proximal end 311 of the first arm 31 is a single piece with the first osteosynthesis plate 21. The proximal end 321 of the second arm 32 is a single piece with the associated second osteosynthesis plate 22.

[0101] Means of maneuver

[0102] According to a first embodiment illustrated in Figures 1 to 7, the operating means 4 advantageously consist of a cam 41, here removable and free to rotate, to generate a relative movement of the arms 31, 32 by its rotational movement.

[0103] Preferably, the removable cam 41 is temporarily assembled on the second arm 32, preferably at its proximal end 321.

[0104] And this cam 41 cooperates with the tubular wall 313 of the first arm 31, on the side of its opening 315.

[0105] Such a removable cam 41 is of particular interest for limiting the size of the orthopedic distraction device 1, in particular when it is implanted internally.

[0106] This “removable” structure also makes it possible to choose the cam 41 from a range of cams 41 which have respective distraction values ​​and which make it possible to take into account a possible variation in initial length at the level of the telescopic connection means 3.

[0107] In this case, the cam 41 advantageously consists of a cam of the external profile type whose rotation around its axis of rotation 4 T generates a radial force (perpendicular to the axis of rotation 4T) between the arms 31, 32.

[0108] For this, the cam 41 has an external profile 411 which is curved and which gradually moves away from the axis of rotation 4T.

[0109] For its rotational guidance, the cam 41 advantageously comprises a cylindrical section 412 which is intended to cooperate with the second arm 32 to define the degree of freedom in rotation.

[0110] In this case, the cylindrical section 412 is intended to be housed within a housing located at the proximal end 321 of the second arm 32.

[0111] This housing is here formed by the female head 711 of the aforementioned clamping member 71.

[0112] For its rotational maneuver, the cam 41 advantageously comprises a gripping member 413, here centered on the rotation axis 41', adapted to cooperate with an maneuvering tool.

[0113] This gripping member 413 is presented here in the form of a hexagonal head.

[0114] More preferably, the maneuvering means 4 comprise stop means 42, to define the end of rotation position of the cam 41 during distraction.

[0115] For example, the stop means 42 comprise a pair of lugs 421, 422 intended to cooperate in the end-of-rotation position of the cam 41.

[0116] In this case, the pair of pins 421, 422 comprises:

[0117] - a first lug 421 carried by the cam 41, at the end of its external profile 411, and - a second lug 422, here protruding, carried by the tubular wall 313 of the first arm 31 (on the side of the opening 315).

[0118] The second lug 422 here sandwiches the cam 41 (at its outer profile 411) with the second arm 32 so as to participate in holding the cam 41 when it is rotated. In other words, the second lug 422 defines a groove with the second arm 32 which is intended to receive and guide the outer profile 411, to participate in holding the cam 41.

[0119] The second lug 422 can possibly serve as a reference point in relation to the visual marking 325, so as to check the distraction dimension applied to the joint A.

[0120] According to a second embodiment illustrated in particular in figures 8 and following, the maneuvering means 4 comprise an axial maneuvering screw 45 which is guided in translation on one of the arms 31, parallel to the degree of freedom in translation T.

[0121] Such an axial operating screw 45 has the advantage of eliminating additional instruments compared to a cam 41, thus simplifying the operating technique.

[0122] Preferably, this axial operating screw 45 is installed parallel to the degree of freedom in translation T, advantageously in the bottom 316 of the elongated housing 314 of the first arm 31.

[0123] Preferably, this axial operating screw 45 is intended to travel in translation along the degree of freedom in translation T.

[0124] This axial operating screw 45 advantageously comprises two ends (figure 9):

[0125] - a first end 451, located within the elongated housing 314 and intended to press on an end wall 323 of the second arm 32 for its translational maneuver, and

[0126] - a second end 452, located outside the elongated housing 314 and forming a rotating operating head.

[0127] Generally speaking, the rotational maneuver of the axial maneuver screw 45 (in screwing or unscrewing) generates a maneuver of the arms 21, 22 relative to each other, leading to a separation maneuver between the securing means 2 according to the degree of freedom in translation T to create a distraction between the bones S of the joint A.

[0128] Locking means

[0129] The locking means 5 advantageously comprise at least one stop screw 51, 52 which is guided in translation on one of the arms 31, 32 and which cooperates with the other of the arms 31, 32 to ensure this locking.

[0130] For example, the locking means 5 comprise at least one stop screw 51, 52 among:

[0131] - an axial stop screw 51, to maintain the distraction applied, and

[0132] - a lateral stop screw 52, ​​to lock the translational play. The axial stop screw 51 ensures an end-of-travel stop of the first arm 31 relative to the second arm 32.

[0133] Preferably, this stop screw 51 is installed parallel to the degree of freedom in translation T, advantageously in the bottom 316 of the elongated housing 314 of the first arm 31 to serve as a support stop with an end wall 323 of the second arm 32.

[0134] Generally, according to the first embodiment illustrated in Figures 1 to 7, the stop screw 51 is advantageously identical to the axial maneuvering screw 45 according to Figures 8 and following, to form maneuvering means 4 adapted to be maneuvered in addition to (or combination with) the cam 41 in order to adjust the distraction.

[0135] The lateral stop screw 52 is preferably located perpendicular to the degree of freedom in translation T.

[0136] This lateral stop screw 52 is for example installed:

[0137] - in the tubular wall 313 of the first arm 31, so as to exert compression on a side wall 324 of the second arm 32 (figures 1 to 7), or

[0138] - in the second arm 32, within a threaded through orifice 327 so as to exert friction pressure on the first arm 31 (figures 8 to 10).

[0139] For a lateral stop screw 52 carried by the second arm 32, said lateral stop screw 52 advantageously comprises:

[0140] - a support plate 521, intended to exert the friction force on the tubular wall 313 of the first arm 31, and

[0141] - an operating head 522, advantageously accessible through a window 317 provided in the tubular wall 313 of the first arm 31.

[0142] Alternatively or additionally, as illustrated in Figure 14, the locking means 5 advantageously comprise complementary securing means 55 forming a spacer, which are structured to bridge the joint A and to be fixed to a bone S1, S2 opposite this joint A.

[0143] In other words, the complementary securing means 55 advantageously consist of a spacer which has a fixed length and which is secured to the two bones S1, S2 forming the joint A.

[0144] As developed later, this complementary fixation is implemented after the distraction step (after translation).

[0145] Such complementary securing means 55 can be implemented in the different embodiments according to the invention.

[0146] In other words, the complementary securing means 55 advantageously comprise complementary securing means 55, equipping: - the first securing means 21 and / or the first arm 31 cooperating with a bone S, for securing with another bone S of the joint A (figure 14), and / or

[0147] - the second securing means 22 and / or the second arm 32 cooperating with a bone S, for securing with another bone S of the joint A (not shown).

[0148] For example, as illustrated in Figure 14, the complementary securing means 55 extend from the first arm 31 cooperating with a bone S2, in particular from its tubular wall 313. These complementary securing means 55 bridge the joint A and are fixed to a bone S1 opposite this joint A.

[0149] The complementary securing means 55 advantageously comprise at least one arm 551 (or a strut), which is intended to span or bridge the articulation A.

[0150] This arm 551 advantageously comprises at least one orifice 552 for the installation of a fixing screw 553 which is fixed to the opposite bone segment S1.

[0151] This arm 551 advantageously has a fixed length.

[0152] This arm 551 is preferably divergent with respect to the degree of freedom in translation T, from its upstream end 555 (here in one piece with the first arm 31).

[0153] Means of angulation

[0154] Still according to the invention, as illustrated in Figures 1 to 7, the orthopedic distraction device 1 advantageously comprises angulation means 6 to confer a degree of freedom in rotation between the securing means 2, along an axis of rotation R which extends perpendicular to the degree of freedom in translation T.

[0155] This technical characteristic then allows, if necessary, distraction with the flexed A joint.

[0156] According to a preferred embodiment, illustrated in Figure 2, the angulation means 6 comprise:

[0157] - articulation means 7 which are provided between one of the securing means 2 and the telescopic connecting means 3, to allow relative angulation around the axis of rotation R, and

[0158] - rotation locking means 8, adapted to lock the articulation means 7 in rotation after adjustment of the angulation around the rotation axis R.

[0159] In this case, the articulation means 7 define the aforementioned axis of rotation R.

[0160] The articulation means 7 comprise for example a clamping member 71, for example a screw, which is attached through a pair of orifices 72 which are provided respectively in an arm 32 (at its proximal end 321) and in its associated osteosynthesis plate 22. The rotation locking means 8 consist for example of a pair of complementary and frontal toothed crowns 81, forming a toothed wheel, which cooperates with the clamping member 71.

[0161] These toothed crowns 81 are arranged around the aforementioned orifices 72 and at the level of the facing surfaces to mesh with them when tightening the clamping member 71.

[0162] In other words, the tightening of the tightening member 71 allows a gearing of the toothed crowns 81 which causes a rotational lock between the arm 32 and its associated osteosynthesis plate 22.

[0163] Orthopedic distraction procedure

[0164] A method of orthopedic distraction, by implementing the orthopedic distraction device 1 according to the invention, is described below in connection with figures 5 to 7.

[0165] The orthopedic distraction procedure 1 includes:

[0166] - a step of positioning and securing the orthopedic distraction device 1 with the bones S forming the joint A (figures 5 and 6),

[0167] - possibly, and if necessary, an angulation step between the securing means 2,

[0168] - a step of creating the distraction, advantageously of the order of 5 mm, by the implementation of the maneuvering means 4 which causes a maneuver in separation of the securing means 2 (from figure 6 to figure 7), then

[0169] - a step of maintaining the distraction, by implementing the locking means 5.

[0170] The orthopedic distraction device 1 according to the invention has the advantage of allowing a positioning and securing step internally, advantageously under the skin and soft tissues.

[0171] In this case, the orthopedic distraction device 1 is positioned and locked on either side of the joint A by means of screws V attached to the two osteosynthesis plates 2.

[0172] According to the embodiment illustrated in Figures 1 to 7, an angulation step is authorized by the angulation means 6, by acting on the rotation locking means 8 (here tightening / loosening of the tightening member 71).

[0173] Still according to the first embodiment, the removable operating means 4 can here be temporarily attached for the implementation of the step of creating the distraction, then can be removed following the step of maintaining the distraction.

[0174] If necessary, the cam 41 is maneuvered in rotation, preferably to the end of rotation position, to generate the desired distraction.

[0175] The step of maintaining the distraction is here ensured by the two stop screws 51 which are operated successively: - the axial stop screw 51, to maintain the distraction applied, then

[0176] - the lateral stop screw 52, ​​to lock the translational play.

[0177] The cam 41 can in particular be removed after tightening the axial stop screw 51.

[0178] According to the second embodiment (figures 8 and following), the axial maneuvering screw 45 is maneuvered in rotation, preferably in the face, to generate the desired distraction.

[0179] The step of maintaining the distraction is here ensured by a combined action of the axial operating screw 45 and the lateral stop screw 52, ​​intervening in the locking of the translational play.

[0180] Where appropriate, according to the fourth embodiment described in connection with figure 14, the step of maintaining the distraction is still ensured by the implementation of the additional securing means 55.

[0181] These complementary securing means 55 are intended to bridge the joint A by being fixed to the opposite bone segment.

[0182] Once secured, these complementary securing means 55 provide a spacer (or strut) function between the two bones S1, S2 forming the joint A.

[0183] Furthermore, preferably, the method may comprise a prior surgical operation applied to at least one of the bones S1, S2 forming the joint A, for example a fracture osteosynthesis or a corrective osteotomy.

[0184] This preliminary surgical operation is in particular permitted by the orthopedic distraction device 1 according to figures 1 to 7, or figures 11 and 12.

[0185] In this sense, a preliminary surgical operation C (for example, fracture osteosynthesis or corrective osteotomy) is performed on the first bone S1 of the joint A (advantageously a tibia for the knee).

[0186] This preliminary surgical operation is stabilized by the implantation of the second securing means 22 on the first bone S1 (figure 13, part A).

[0187] The other components of the orthopedic distraction device 1 are then reported to carry out the step of positioning and securing the orthopedic distraction device 1 with the bones S forming the joint A (figure 13, part B).

[0188] In particular, the proximal end 321 of the second arm 32 is secured to the second securing means 22 secured to the first bone S1 by means of the assembly means 7, 9. And the first securing means 21 carrying the first arm 31 are secured to the second bone S2.

[0189] The practitioner can then continue the process:

[0190] - a step of creating the distraction, advantageously of the order of 5 mm, by implementing the maneuvering means 4 which causes a maneuver in separation of the securing means 2, then - a step of maintaining the distraction, by implementing the locking means 5.

[0191] Generally, at the end of the distraction period (usually after a few weeks), the orthopedic distraction device 1 is intended to be subjected to an ablation procedure.

[0192] Preferably, the ablation process is performed in the reverse order to the orthopedic distraction process 1:

[0193] - a step of unlocking the distraction, by unlocking the locking means 5, - a step of detaching the orthopedic distraction device 1 from the bones S forming the joint A.

[0194] Of course, various other modifications may be made to the invention within the scope of the appended claims.

Claims

Claims

1. Orthopedic distraction device, for the distraction of a joint (A) of a patient, advantageously of the knee, characterized in that said orthopedic distraction device (1) comprises: - securing means (2), for securing said orthopedic distraction device (1) with the bones (S) forming said joint (A), which securing means (2) comprise first securing means (21) for securing with at least one first bone (S1) of said joint (A), and second securing means (22) for securing with at least one second bone (S2) of said joint (A), which securing means (2) consist of two osteosynthesis plates (2), namely a first osteosynthesis plate (21), forming the first securing means (21) intended to be secured with the first bone (S1) of said joint (A), and a second osteosynthesis plate (22), forming the second securing means (22) intended to be secured with the second bone (S2) of said joint (A), - telescopic connecting means (3), connecting said securing means (2) and defining a degree of freedom in translation (T) between said securing means (2), - maneuvering means (4), adapted to generate a separation maneuver between said securing means (2) according to said degree of freedom in translation (T) to create a distraction between the bones (S) of said joint (A), and - locking means (5), adapted to lock in translation said telescopic connecting means (3) after the creation of said distraction.

2. Orthopedic distraction device, according to claim 1, characterized in that the telescopic connecting means (3) comprise at least two arms (31, 32) which together form a slide defining said degree of freedom in translation (T), which arms (31, 32) each comprise a proximal end (311, 321) which is connected with one of said securing means (2).

3. Orthopedic distraction device, according to claim 2, characterized in that said at least two arms (31, 32) comprise: - a first arm (31), comprising a tubular wall (313) which defines an elongated housing (314) opening at an opening (315), and - a second arm (32), attached to said elongated housing (314) through said opening (315) and guided in translation along said elongated housing (314).

4. Orthopedic distraction device, according to any one of claims 2 or 3, characterized in that the maneuvering means (4) comprise a cam (41), removable and free to rotate, to generate a relative displacement of said arms (31, 32) by a rotational movement.

5. Orthopedic distraction device, according to claim 4, characterized in that said removable cam (41) is assembled on a second arm (32) and cooperates with a first arm (31).

6. Orthopedic distraction device, according to any one of claims 2 to 5, characterized in that the maneuvering means (4) comprise an axial maneuvering screw (45) which is guided in translation on one of said arms (31), parallel to the degree of freedom in translation (T), and which cooperates with the other of said arms (32) to ensure the separation maneuver.

7. Orthopedic distraction device, according to claim 6 in combination with claim 3, characterized in that said axial maneuvering screw (45) is in a bottom (316) of the elongated housing (314) located opposite the opening (315).

8. Orthopedic distraction device, according to any one of claims 2 to 7, characterized in that the locking means (5) comprise at least one stop screw (51, 52) which is guided in translation on one of said arms (31) and which cooperates with the other of said arms (32) to ensure said locking.

9. Orthopedic distraction device, according to claim 8, characterized in that said at least one stop screw (51, 52) is chosen from: - an axial stop screw (51), to maintain the distraction, preferably implanted parallel to the degree of freedom in translation (T), where appropriate advantageously in a bottom (316) of the elongated housing (314) located opposite the opening (315) according to claim 3, and - a lateral stop screw (52), for locking the translational play, preferably installed perpendicular to the degree of freedom in translation (T), advantageously in the tubular wall (313) of the first arm (31).

10. Orthopedic distraction device, according to any one of claims 2 to 9, characterized in that the proximal end (311, 321) of an arm (31, 32) is: - monobloc with the associated osteosynthesis plate (2), or - assembled with the osteosynthesis plate (2).

11. Orthopedic distraction device, according to any one of claims 1 to 10, characterized in that the locking means (5) comprise complementary securing means (55) forming a spacer, which are structured to bridge the joint (A) and to be fixed on a bone (S1, S2) opposite said joint (A).

12. Orthopedic distraction device, according to any one of claims 1 to 11, characterized in that it comprises angulation means (6) for conferring a degree of freedom in rotation between said securing means (2), perpendicular to said degree of freedom in translation (T), in order to allow distraction with the articulation (A) flexed.

13. Orthopedic distraction device, according to claim 12, characterized in that the angulation means (6) comprise: - articulation means (7) which are provided between one of the securing means (2) and the telescopic connecting means (3), and - rotation locking means (8), adapted to lock said articulation means (7) in rotation after adjustment of said angulation.

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