Tendon Fixation Plate

Abstract

The invention relates to an implant IM for the flat connection of tissue to bone, the implant IM comprising a clamping face (1), wherein the clamping face (1) comprises an outer edge (3) and an inner edge (4), the outer edge (3) being connected at least partially to the inner edge (4) at least partially by means of at least one connecting bridge (5), and / or the clamping face (1) comprises an outer edge (3) and at least one opening (7', 7'') arranged inside the clamping face (1), the opening (7', 7'') being connected at least to a portion of the outer edge (4) of the clamping face (1) by means of at least one connecting bridge (5). The clamping face (1) has a circular or oval or polygonal circumference, in particular a rotationally symmetrical and / or mirror-symmetrical contour. The clamping face (1) has an opening (7', 7''), the opening (7', 7'') being designed to receive a fastener (2'), the fastener (2') comprising a pin (10), a head (8) and a neck (9).

Description

[0001] "tendon fixation plate"

[0002] The invention relates to an implant for the planar connection of tissue with bone according to the preamble of claim 1.

[0003] A medical procedure to fix and reconstruct severed tissue, such as tendon tissue, is a common procedure and can have various causes. Current techniques dictate that, for the reconstruction of a severed tendon, for example, the detached tendon tissue is fixed to the bone using an implant to allow it to heal. Among other things, sufficient blood supply to the tendon tissue must be ensured to prevent necrosis.

[0004] Such an implant is known, for example, from EP 3184 078 Bl. Here, the severed tendon tissue is permanently fixed to the bone by means of a perforated clamping surface and at least three fasteners attached to it. The implant is held in place for fixation using a special tool, and the fasteners are driven into the bone, for example, using a percussion tool. This results in the tissue being bonded to the bone over a large area and compressed.

[0005] A particular disadvantage here is that, for a secure hold, the implant and its fixings must be driven into the bone with extreme precision. Position,

[0006] The angle and orientation in which the implant is placed must be carefully chosen, which increases the time and associated costs of such a surgical procedure. Furthermore, incorrect insertion into the bone can affect the stability of the implant and promote tissue detachment from the bone. This necessitates a second procedure, placing an additional burden on the patient.

[0007] Moreover, minimally invasive implantation using surgical procedures is often not possible due to the considerable size of the implant.

[0008] The object of the invention is therefore to provide a method for attaching tissue to bone during a surgical procedure that is stable, minimizes necrotic processes, and is easier to perform with reduced time and cost expenditure.

[0009] This problem is solved according to the invention by the characterizing features of claim 1, in conjunction with the preamble of claim 1. Advantageous and expedient embodiments are specified in the dependent claims.

[0010] To solve this problem, an implant for the planar connection of tissue to bone is proposed, wherein the clamping surface comprises an outer edge and an inner edge, wherein the outer edge is at least partially connected to the inner edge by means of at least one connecting bridge and / or that the clamping surface comprises an outer edge and at least one opening arranged within the clamping surface, wherein the opening is connected to at least a partial area of ​​the outer edge of the clamping surface by means of at least one connecting bridge.According to the invention, the clamping surface has a circular, oval, or polygonal circumference, in particular a rotationally symmetric and / or mirror-symmetric contour, wherein the clamping surface has a further opening, wherein the further opening is designed to receive a fastening means, wherein the fastening means comprises a pin, a head, and a neck.

[0011] In this way, the largest possible contact area or clamping surface and symmetry of the implant can be provided for its fixation, without uneven pressure distribution, e.g., in pronounced corner areas. Furthermore, this implant shape offers

[0012] Potential applications include minimally invasive surgery, as it can be handled using minimally invasive tools and inserted and positioned through appropriate devices.

[0013] The fastener can be optimally adapted to the clamping surface and the bone. Furthermore, it is possible to drive the fastener into the bone using a special tool, such as a screwdriver or a striking adapter.

[0014] Furthermore, the implant can achieve continuous pressure that can be maintained throughout the entire healing process. This can therefore facilitate faster healing.

[0015] This can significantly reduce the time required for a surgical procedure and shorten the healing process. As a result, the duration of post-operative treatment and treatment costs can be reduced, since follow-up treatments can be considerably simplified. Any necessary treatments after implant placement or fusion of tissue and bone can therefore be minimized or even eliminated entirely.

[0016] Furthermore, it is intended that the additional opening is centered in the clamping surface.

[0017] This allows for optimal alignment and placement of the implant at the desired location, thus simplifying the procedure. For example, the implant can be attached to the bone in various orientations, resulting in less time and greater flexibility for the surgeon, as optimal alignment can be found more quickly during the procedure.

[0018] Furthermore, the wider opening is designed to have a recess for the form-fitting reception of the head.

[0019] This allows for a more uniform and faster attachment of the clamping surface to the bone. The head of the fastener can thus be positively connected to the implant, ensuring a defined hold and precise alignment between the fastener and the implant without the need for any further measures.

[0020] Furthermore, the neck and head are designed to form a joint with the opening, specifically a wobble-like joint. This allows the clamping surface to assume different angles relative to the fastening element. The clamping surface is thus flexibly connected to the fastening element, facilitating contact with the bone.

[0021] This is achieved by tilting the clamping surface relative to the bone, which allows for greater flexibility in the direction of implant insertion and tissue fixation.

[0022] Furthermore, irregularities and anatomical differences in the bone can be compensated for, ensuring optimal contact of the clamping surface. This allows for greater flexibility in choosing the best possible attachment point for the implant.

[0023] Furthermore, the joint is designed to allow the clamping surface to tilt to an axis defined by the longitudinal axis of the pin by between 0° and 65°, in particular between 0° and 55°, preferably between 0° and 45°, most preferably between 0° and 20°.

[0024] This limits the tilting of the clamping surface to the longitudinal axis of the pin and creates an angular range in which the clamping surface of the tendon provides optimal support on the one hand and on the other hand has the necessary flexibility for insertion and fastening.

[0025] Furthermore, the additional opening in the clamping surface is designed to be eccentric.

[0026] This gives the surgeon the opportunity to choose the position of the clamping surface relative to the fastening device and the tendon to be fixed, which can increase flexibility in the search for a suitable implantation site.

[0027] Furthermore, it is provided that the clamping surface comprises at least one extension, wherein the extension is cranked towards the clamping surface, wherein the extension has at least one opening, wherein the opening of the extension is designed to receive a fastening means and wherein a further opening of the extension is designed as a recess.

[0028] This provides an additional fixation option for the implant. Furthermore, the insertion of the implant during surgery can be simplified. For example, an additional fixation device can be used, positioned within the opening of the extension, to connect tissue and bone. It is also possible to secure the implant to both tissue and bone. Additionally, the recess can promote blood flow and oxygen supply to the tendon, thus supporting the healing process.

[0029] Furthermore, it is provided that the clamping surface comprises at least two opposing prongs, wherein the prongs are formed on the underside of the clamping surface and / or wherein the prongs preferably comprise barbs.

[0030] The prongs can provide an additional fastening option, for example, for pre-fixing the implant. Furthermore, they can be designed to prevent the fastener from being driven in too deeply and thus avoid excessive clamping pressure. The prongs therefore enable faster and more secure implant insertion.

[0031] Furthermore, the pin is designed to include a thread.

[0032] This allows for a secure and, if necessary, releasable hold of the fastener.

[0033] Furthermore, it is provided that the pin is designed in a sleeve shape, in particular in the manner of a drive-in sleeve, and / or that the pin includes barbs.

[0034] This allows the insertion of the fastener into the bone using a suitable tool, for example a hardened impact tool.

[0035] Furthermore, it is provided that the clamping surface comprises several fixing means, wherein the fixing means are formed on an underside of the clamping surface, in particular perpendicular to the clamping surface.

[0036] The fixation devices provide additional support for the tendon to the bone. The tendon is held between the clamping surface and the bone. Because the aforementioned circular, oval, or polygonal, and especially rotationally symmetrical, shape offers more possibilities for orienting the implant, the fixation devices must always be able to grip the tendon as effectively as possible.

[0037] The vertical design of the fixation elements ensures flexibility during implant insertion and stability when fixing the tendon. These elements prevent tissue, such as a tendon, from slipping and provide a secure and stable hold with minimal clamping pressure. This promotes faster healing and helps prevent necrotic processes.

[0038] Furthermore, it is provided that the fixing means are formed in one piece on the clamping surface and / or that the fixing means are conical and / or that the fixing means are surface-tight.

[0039] This ensures a stable connection between the fixation device and the clamping surface, which supports the secure attachment of the tendon to the bone. Furthermore, this simplifies the manufacturing of the implant, thus reducing the cost of production and, consequently, the surgical procedure.

[0040] It may be intended that at least the clamping surface and the fixing elements are made of a plastic, in particular a biocompatible plastic. On the one hand, such materials possess sufficient stability to connect tissue and bone. On the other hand, such materials are well tolerated by the human body.

[0041] The conical shape allows the fixation material to penetrate the tendon quickly. This makes it easier to hold the tendon in place with the implant and speeds up the implant insertion process. This reduces both the time and cost of the procedure.

[0042] Because the fixation elements are designed to be densely packed, the underside of the clamping surface is uniformly equipped with spaced-apart fixation elements to ensure optimal adhesion to the tendon. This increases the implant's contact area with the tissue being fixed, such as a tendon. A high number of fixation elements across the entire underside of the clamping surface enhances the implant's fixation effect and allows for a reduction in contact pressure. Furthermore, this prevents tissue, such as a tendon, from slipping through the fixation.

[0043] Furthermore, it is provided that the fixing means are designed with a length of more than 2 millimeters, preferably with a length between 2 and 6 millimeters, and / or that the length of the fixing means increases towards the outer edge of the clamping surface.

[0044] These lengths are particularly advantageous for tissue fixation, for example, tendons, especially tendons in the human shoulder region. A specific length of fixation device, by penetrating the tissue and subsequently supporting itself against the bone, prevents excessive pressure from the implant and simultaneously ensures a particularly secure and stable fixation of tissue to bone.

[0045] The longer fixing elements at the outer edge of the clamping surface compensate for differences in contact pressure due to the centering of the fastener. This ensures improved tendon fixation.

[0046] This also makes it possible to take individual anatomical conditions and bone irregularities into account. This simplifies and speeds up the insertion of the implant and the fusion of tissue and bone. Furthermore, it allows for increased stability in the connection between tissue and bone. It also enables more even compression of the tissue across the entire clamping surface.

[0047] Furthermore, it is provided that at least two fasteners are arranged approximately parallel to each other and / or have different lengths and / or that the clamping surface forms a plane, wherein at least one fastener is arranged approximately perpendicular to the plane and / or at least one fastener is arranged approximately parallel to the plane.

[0048] The different designs and arrangements of the fixing elements allow for the consideration of individual anatomical conditions. This can result in a reduced time required for a surgical procedure. Furthermore, it can lead to improved implant stability and, consequently, a firm bond between tissue and bone.

[0049] Furthermore, it is provided that the clamping surface includes a tool engagement surface and / or tool engagement opening, wherein the engagement surface is free of fixing means.

[0050] A stable grip on the implant for fixation to the bone can enable a time-saving and safe surgical procedure. The position and orientation can be precisely selected, particularly in the field of minimally invasive surgery, by means of a preferably form-fitting grip, for example, using a special tool such as a forceps holder with an internal tool guide.

[0051] The absence of fixatives at this point of contact is advantageous, as it allows for a simpler tool design and a more secure hold on the implant. This simplifies and speeds up the insertion of the implant during a surgical procedure.

[0052] Furthermore, it is provided that the at least one cantilever is arranged approximately along a transverse extension of the clamping surface and / or that the at least one cantilever and the clamping surface are designed as a single piece.

[0053] This provides an additional method for securing the implant, for example, to the bone. This allows the connection between tissue and bone to withstand increased stress after implant placement. Therefore, further treatments may be unnecessary after the tissue and bone have been connected using the implant.

[0054] Furthermore, it is stipulated that the clamping surface has a circumference that is rounded at least in sections and / or is curved at least in sections.

[0055] This allows for consideration of individual anatomical conditions. As a result, the insertion of the implant and the fusion of tissue and bone can be simplified and accelerated. Furthermore, a stable hold of tissue and bone can be achieved. This also results in more even compression of the tissue across the entire surface of the clamping area. A curved clamping surface is advantageous because it allows for easy shaping of the implant against the bone.

[0056] For the purposes of the invention, the fixing means can also be referred to as so-called spikes or teeth. Furthermore, for the purposes of the invention, the fastening means can also be referred to and understood as a screw, nail, or bone anchor. Such fastening means are inexpensive to produce and enable a stable connection between bone and implant.

[0057] Furthermore, for the purposes of the invention, a drive-in sleeve can be understood to be a sleeve with a conical tip that simplifies the penetration of the sleeve into a solid object, for example a bone.

[0058] Further details of the invention are described in the drawings with reference to schematically illustrated embodiments.

[0059] Here they show

[0060] Figure 1 shows a perspective view of an implant according to the invention with a screw as a fastening means;

[0061] Figure 2 shows a top view of an implant according to the invention with the head of a screw visible and

[0062] Figure 3 shows a perspective view of an implant according to the invention with a boom and two fastening means.

[0063] Figure 1 shows a perspective view of an implant IM according to the invention for the planar connection of tissue to bone. This includes a clamping surface 1 under which the tissue, for example tendon tissue, is fixed and held against the bone to promote healing. The clamping surface 1 comprises an outer edge 3 and an inner edge 4, the outer edge 3 being connected to the inner edge 4 by means of connecting webs 5. The clamping surface 1 further comprises openings 14 arranged within it, which are enclosed by the connecting webs 5 and the outer edge 3 of the clamping surface 1. The openings 14 enable sufficient blood supply to the tendon tissue for the healing process. At the same time, this helps prevent necrotic processes, since the clamping surface 1 rests over the entire area of ​​the tendon and peaks in contact pressure are avoided.

[0064] The clamping surface 1 forms a plane and, in the embodiment shown in Figure 1, has a circular circumference. In particular, according to the invention, the clamping surface 1 can also be formed with an oval, polygonal, rotationally symmetrical, and / or mirror-symmetrical contour. Such shapes enable the clamping surface 1 to contact the string over a large area, and the contact pressure is distributed evenly.

[0065] The clamping surface 1 has a centered opening 7'. This opening is designed to receive a fastening element 2'. The fastening element 2' allows the implant IM to be stably and securely attached to the bone.

[0066] In this embodiment, the fastening element 2' is designed as a screw 11, comprising a threaded pin 10, a head 8 (shown in Figure 2), and a neck 9. A screw 11 offers the advantage of allowing the penetration depth into the bone to be determined by rotation. This makes it possible to optimally adjust the contact pressure of the clamping surface on the tissue to be fixed, for example, a tendon. Furthermore, if the implant IM is fixed too deeply, which may lead to excessive contact pressure, it can be corrected by turning the screw back. Additionally, a screw 11 allows for subsequent loosening of the implant IM. A screw 11 can also be anchored in a bone using a dowel, thereby achieving improved stability within the bone.

[0067] The neck 9 and the head 8 (shown in Figure 2) form a wobble-like joint with the centered opening 7', which allows the position of the clamping surface 1 to tilt relative to the longitudinal axis of the pin 12 during the fixation of the implant IM. This enables optimal tissue contact and fixation, and the implant IM can adapt flexibly to anatomical conditions.

[0068] Also shown are fixation elements, exemplified by 6', 6'', 6''', 6'''', which enable the fixation of tissue, for example tendon tissue, and simplify or reinforce the connection between tissue and bone. The fixation elements 6', 6'', 6''', 6'''' are formed on the underside of the clamping surface 1. This allows the tissue to be held between the clamping surface 1 and the bone.

[0069] The fixation elements 6', 6'', 6''', 6'''' are designed perpendicular to the clamping surface 1, enabling the implant IM to provide stable and firm support to the tissue, e.g., a tendon. The fixation elements 1 are cone-shaped, allowing them to easily penetrate the tissue to be fixed and thus simplifying the application of the implant IM.

[0070] The fixing elements 6', 6'', 6''', 6'''' are formed in one piece on the clamping surface 1, so that a stable connection exists between fixing elements 6', 6'', 6'''', 6'''' and clamping surface 1 and the implant IM can be manufactured easily and quickly.

[0071] By forming the fixing elements 6', 6'', 6''', 6'''' flush with the underside of the clamping surface 1, they can provide improved, uniform support for the tissue. The length of the fixing elements 6', 6'', 6''', 6'''' is greater than 2 millimeters, preferably with a length of 2 to 6 millimeters, so that the tissue, for example a human shoulder tendon, can be optimally held.

[0072] Figure 2 shows a top view of the embodiment of the implant IM shown in Figure 1, with an outer rim 3 and an inner rim 4. The circular circumference of the clamping surface 1 enables its use in minimally invasive surgical procedures. In this top view of Figure 2, the head 8 of the fastening element covers the opening 7 (not visible) of the implant IM.

[0073] The fastening element 2', designed here as a screw 11, can be screwed into a bone using a suitable special tool. This enables quick and easy insertion of the implant. Simultaneously, the clamping pressure of the clamping surface 1 on the tissue to be fixed can be flexibly changed and adjusted by screwing in the screw 11. The clamping surface 1 is perforated by the connecting webs 5 and openings 14, also shown in Figure 1, which ensure sufficient blood supply to the tissue fixed underneath, for example, tendon tissue, and inhibit necrotic processes. A suitable holding or grasping tool can be attached to the connecting webs 5 to hold and optimally guide the implant IM during a surgical procedure. This allows it to be inserted and fixed at a precise location in the bone.

[0074] Figure 3 shows a perspective view of an embodiment of the implant IM with extension 15 from the underside of the implant. The implant IM for the planar connection of tissue to bone comprises the clamping surface 1, which includes the outer edge 3 and the inner edge.

[0075] 4 comprises. The outer edge 3 is connected by a connecting bridge.

[0076] 5 connected to the inner edge 4 and the clamping surface 1 includes openings 14, 7'' arranged within the clamping surface 1, wherein the opening 7'' is connected to a part of the outer edge 3 by means of a connecting web 5.

[0077] The clamping surface 1 has an oval contour, and the further opening 7'' is eccentrically formed in the clamping surface 1 to receive a fastening element 2'. This allows for optimal positioning of the implant IM relative to the tendon and the fastening element 2'. The fastening element 2' comprises a pin 10, a head 8 (not visible in this illustration), and a neck 9.

[0078] The clamping surface 1 comprises a bent extension 15, the extension 15 having openings 16 and 19, the opening 19 of the extension being designed to receive a fastening element 2'', and a further opening 16 of the extension being designed as a recess. The extension 15 is arranged along a transverse dimension of the clamping surface 1 and is formed in one piece. In conjunction with the eccentrically arranged opening 7'' of the clamping surface 1 and the fastening element 2'', simple and rapid fixation of the implant IM to the bone is enabled. The further opening 16 of the extension, designed as a recess, allows only a small contact area of ​​the extension 15 with the tissue it partially covers and can thus contribute positively to improving oxygen supply or blood flow.Because the boom 15 is designed with a cranked shape, excessive pressure of the clamping surface 1 on a tendon held beneath it, as well as resulting necrotic effects, can be prevented.

[0079] Figure 3 also shows that the clamping surface comprises two opposing prongs 17', 17'' formed on its underside, the prongs 17', 17'' themselves comprising barbs. The pin 10 of the fastening means 2', 2'' is sleeve-shaped, similar to a drive-in sleeve, and also comprises barbs.

[0080] Such a shape allows the fastening element 2'' to be easily driven into the bone and secures it against unintentional loosening.

[0081] Figure 3 further shows that the clamping surface comprises several fixing means 6', 6'', 6''', 6'''', which are formed on the underside of the clamping surface 1, perpendicular to it, integrally with it, and are conical and area-tight.

[0082] Furthermore, it can be seen that the fastening element of the clamping surface 1 and the fastening element 2'' of the boom are arranged parallel to each other and have different lengths, and that the clamping surface 1 forms a plane, with the fastening element 2' of the clamping surface being arranged perpendicular to this plane. Reference numeral list:

[0083] IM implant

[0084] 1 Clamping surface 2 ' Fastening device (clamping surface)

[0085] 2 Fastening devices (outriggers)

[0086] 3 Edge (outer)

[0087] 4 Edge (inner)

[0088] 5 Connecting bridge 6' to 6" " Fixing agent

[0089] 7' opening (central)

[0090] 7'' opening (eccentric)

[0091] 8 Head 9 Neck 10 Pen

[0092] 11 Screw 12 Longitudinal axis of the pin

[0093] 14 Opening

[0094] 15 outriggers 16 opening (further, outriggers)

[0095] 17 ', 17 ** Dorn

[0096] 18 Tool access opening

[0097] 19 Opening (Outrigger)

Claims

Claims:

1. Implant (IM) for the planar connection of tissue to bone, wherein the implant (IM) comprises a clamping surface (1), wherein the clamping surface (1) comprises an outer edge (3) and an inner edge (4), wherein the outer edge (3) is at least partially connected to the inner edge (4) by means of at least one connecting web (5), and / or wherein the clamping surface (1) comprises an outer edge (3) and at least one opening (14) arranged within the clamping surface (1), wherein the opening (14) is connected to at least a partial region of the outer edge (3) of the clamping surface (1) by means of at least one connecting web (5), characterized in that the clamping surface (1) has a circular, oval, or polygonal perimeter, in particular a rotationally symmetric and / or mirror-symmetric contour, wherein the clamping surface (1) has a further opening (7', 7"), wherein the further opening (7',7”) is designed to receive a fastening element (2'), the fastening element (2') comprising a pin, a head and a neck.

2. Implant (IM) according to claim 1 characterized in that the further opening (7') is centered in the clamping surface (1).

3. Implant (IM) according to at least one of the preceding claims characterized in that the further opening (7', 7") has a recess for the form-fitting reception of the head (8).

4. Implant (IM) according to at least one of the preceding claims characterized in that the neck (9) and the head (8) with the further opening (7', 7") form a joint, in particular a wobble joint-like joint.

5. Implant (IM) according to at least one of the preceding claims characterized in that the joint allows the clamping surface (1) to tilt to an axis defined by the longitudinal axis of the pin (12) by between 0° and 65°, in particular 0° and 55°, preferably 0° and 45°, particularly preferably between 0° and 20°.

6. Implant (IM) according to at least one of the preceding claims characterized in that the further opening (7 ) in the clamping surface (1) is eccentric.

7. Implant (IM) according to at least one of the preceding claims characterized in that the clamping surface (1) comprises at least one extension (15), wherein the extension (15) is formed with a crank relative to the clamping surface (1), wherein the extension (15) has at least one opening (16, 19), wherein the opening of the extension (19) is designed to receive a fastening means (2) and wherein a further opening of the extension (16) is formed as a recess.

8. Implant (IM) according to at least one of the preceding claims characterized in that the clamping surface (1) comprising at least two opposing prongs (17', 17''), wherein the prongs (17', 17'') are formed on the underside of the clamping surface (1) and / or wherein the prongs (17', 17'') preferably comprise barbs.

9. Implant (IM) according to at least one of the preceding claims characterized in that the pin (10) comprises a thread.

10. Implant (IM) according to at least one of the preceding claims characterized in that the pin (10) is sleeve-shaped, in particular in the manner of a drive-in sleeve and / or that the pin (10) comprises barbs.

11. Implant (IM) according to at least one of the preceding claims characterized in that the clamping surface (1) comprises several fixing means (6', 6'', 6'''', 6''''), wherein the fixing means (6', 6'', 6'''', 6'''') are formed on a bottom side of the clamping surface (1), in particular perpendicular to the clamping surface (1).

12. Implant (IM) according to at least one of the preceding claims characterized in that the fixing means (6', 6'', 6''', 6'''') are formed integrally with the clamping surface (1) and / or that the fixing means (6', 6'', 6'''', 6'''') are conical in shape and / or that the fixing means (6', 6'', 6''', 6'''') are surface-tight.

13. Implant (IM) according to at least one of the preceding claims characterized in that the fixation means (6', 6'', 6''', 6'''') have a length of more than 2 millimeters, preferably are designed with a length between 2 and 6 millimeters and / or that the length of the fixing means (6', 6", 6 , 6 ) increases towards the outer edge of the clamping surface (1).

14. Implant (IM) according to at least one of the preceding claims, characterized in that at least two fastening means (2', 2") are arranged approximately parallel to each other and / or have different lengths and / or that the clamping surface (1) forms a plane, wherein at least one fastening means (2', 2") is arranged approximately perpendicular to the plane and / or at least one fastening means (2 2") is arranged approximately parallel to the plane.

15. Implant (IM) according to at least one of the preceding claims, characterized in that the clamping surface (1) comprises a tool engagement surface and / or tool engagement opening (18), wherein the tool engagement surface is free of fixing means.

16. Implant (IM) according to at least one of the preceding claims, characterized in that the at least one extension (15) is arranged approximately along a transverse extent of the clamping surface (1) and / or that the at least one extension (15) and the clamping surface (1) are formed in one piece.

17. Implant (IM) according to at least one of the preceding claims, characterized in that the clamping surface (1) has a circumference that is rounded at least in sections and / or is curved at least in sections.

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