Resection template, resection set, and method for reconstructing an osseous structure using such a resection template

Abstract

The invention relates to a resection template (1) for reconstructing an osseous structure from a graft (2), the resection template comprising at least one segment (10) and at least one insert (12), and each insert having at least one drill sleeve (13) or opening for defining a drilling position in the graft (2). The at least one segment (10) comprises a main part (HK), at least two holes (14) located in the main part (HK), and first and second recesses (15) formed in the main part (HK), the recesses (15) being designed to receive the at least one insert (12) at a predefined position in the segment (10). The invention also relates to a resection set and to a method for reconstructing an osseous structure using such a resection template (1).

Description

[0001] Karl Leibinger Asset Management KLS0042P-WÖ GmbH & Co. KG 2025-08-13

[0002] - 1 -

[0003] Resection template, resection set and method for reconstructing bony anatomy with such a resection template

[0004] The present invention relates to a resection template, a resection set and a method for reconstructing bony anatomy, such as a mandible or an upper jaw.

[0005] Particularly in the reconstruction of a mandible using bone grafts, which are harvested, for example, from the patient's fibula, several graft segments are arranged three-dimensionally according to the desired shape of the reconstructed mandible and screwed together using plates. Templates are used to cut the graft segments into the required shape and to position the holes for the plates.

[0006] For example, US patent 2021137537 A1 discloses a surgical template comprising a cutting guide that defines a plurality of cutting slots and includes at least one removable insert positioned between the plurality of cutting slots. The removable insert has an opening for receiving a surgical fixation device. The template also includes a template guide that defines a feature. The removable insert is designed such that it fits, at least partially, into the template guide by means of this feature.

[0007] Furthermore, WO 2022167943 A1 describes a template consisting of several sections that can be arranged in a predetermined spatial orientation relative to each other. The sections can be fastened and aligned using fasteners.

[0008] According to the invention, a resection template for reconstructing bony anatomy from a graft according to claim 1 is provided. Claim 19 further relates to a resection set with a resection template. A method for reconstructing bony anatomy from a graft using a resection template according to the invention as described in claim 21 is also specified. Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13

[0009] - 2 -

[0010] The present invention facilitates the reconstruction of bony anatomy from at least one bone segment, which is taken, for example, from the patient's fibula. The at least one bone segment taken is hereinafter referred to as the "graft". Depending on the extent of the reconstruction required, for example, one, two, three, or more segments can be used.

[0011] A resection template according to the invention for reconstructing bony anatomy from a graft comprises at least one, preferably two or three segments. The resection template can also have more than three segments. Generally, a separate segment of the resection template is provided for each bone segment required for the reconstruction. Thus, the segments allow for easy allocation and assembly of the bone segments at the target site.

[0012] The at least one segment serves to hold the at least one bone segment and as a template for cutting the at least one bone segment from the donor bone. For this purpose, the at least one segment has a predefined shape. This shape can be determined in advance, for example, using a 3D simulation. Preferably, the at least one segment can then be manufactured from a suitable material using an appropriate manufacturing process, such as 3D printing.

[0013] The resection template comprises at least one insert, which has at least one drill sleeve or opening for predefining the position of a drill hole in the graft. The at least one insert can be easily inserted into and removed from the at least one segment of the resection template. Using the at least one insert, drill sleeves can be positioned flexibly and easily, which can facilitate the execution of appropriate drill holes in the graft. Alternatively, the insert can have suitable openings between the bone-facing side and the bone-away side to correctly position and execute the drill holes in the graft. The opening of the respective hole can protrude from the bone-away side of the insert to provide better drill guidance. Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13

[0014] - 3 -

[0015] The at least one segment comprises a main body, which essentially serves as a mechanical support and shaping element. The main body can preferably be made of a suitable surgical metal alloy or a polymer.

[0016] The main body of at least one segment has at least two holes for receiving fasteners such as screws. This allows the surgeon to attach the segment to the graft with screws, ensuring that the segment cannot slip or fall off.

[0017] Furthermore, the main body features first and second recesses for inserting at least one insert at a predetermined position within the segment. These recesses are designed to allow the insert to be easily inserted into the segment attached to the graft. This can be achieved, for example, by creating a press fit between the insert and the segment. If multiple segments are planned, the recesses can also be used to position the plates for screwing the bone segments together during subsequent assembly.

[0018] If several segments are provided, for example, two, three, or more segments, preferably at least one connecting element is provided which, in a state connected to the segments, holds the segments relative to each other in a corresponding relative position. Preferably, at least one first connecting element is present which holds the several segments in a first predetermined relative position. It is conceivable that the resection template according to the invention provides exactly one connecting element, which is specifically connected to the segments in order to hold them in their corresponding first relative position relative to each other. This first relative position is preferably used when harvesting the graft. In the first relative position, the segments are arranged relative to each other as determined by the shape of the donor bone, for example, linearly.The order and orientation of the segments on the connecting element need not correspond to the order or orientation of the bone segments in the reconstructed state. Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13.

[0019] - 4 -

[0020] In a further development of the invention, several connecting elements can be provided, each of which can be connected to the segments and, in their connected states, holds the segments in differing relative positions. In this case, the resection template thus has several connecting elements, the use of which, by connecting the respective connecting element to the segments, establishes a corresponding relative position of the segments relative to each other. Advantageously, this allows, in addition to positioning the segments in a first relative position, which is used when harvesting the graft, a further, second relative position of the segments to be established. This second relative position preferably defines a target position in which the segments are to be positioned relative to each other for the reconstruction of the bony anatomy.

[0021] One conceivable embodiment of the invention is that the at least one connecting element is designed as a bracket. This has the advantage that the relative positioning of the segments to one another can be easily achieved. Preferably, the segments are provided with receptacles into which the bracket can be inserted with its ends for connection to the segments. This allows the connection of the bracket to the segments to be formed in a simple manner. It is conceivable that press connections between the bracket and the segments are created when the ends of the bracket are inserted into the receptacles of the segments.

[0022] In the case of multiple connecting elements configured as brackets, it is conceivable within the scope of the invention that the brackets can be positioned with their ends in the segment receptacles to adjust the different relative positions. However, the resection template according to the invention can also be designed such that one of the brackets is initially formed integrally with the multiple segments and thus holds them in the first relative position. This one bracket is then detached from the segments to position them in a different, second relative position, after which the other bracket is placed in the segment receptacles to arrange them in the second relative position.

[0023] Preferably, each segment can be assigned exactly one insertion. If the resection template has exactly one segment, then only a single insertion is provided. If the resection template has exactly two segments, then a total of two insertions are provided. Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13

[0024] - 5 - provided, with each of the inserts being assigned to one of the segments. If the resection template has exactly three segments, a total of three inserts are provided, with each of the three inserts being assigned to one of the three segments. This keeps the number of individual parts of the resection template low, thereby simplifying assembly and reducing, preferably eliminating, the probability of incorrect assembly.

[0025] In general, the resection template according to the invention can be provided with exactly one insert or several inserts, regardless of the number of segments. Using exactly one insert simplifies the handling of the resection template, and this single insert can also be used when the resection template is equipped with multiple segments.

[0026] With regard to the design of the at least one connecting element, it is also conceivable that this at least one connecting element is formed by the at least one insert which, in its inserted state, sets the respective associated relative position. In particular, if the resection template according to the invention is equipped with exactly one insert, this insert can also be used for the relative positioning of the segments to one another.

[0027] According to a preferred embodiment, the at least one connecting element can have at least one marking with a serial number and / or a directional indication. This can facilitate the surgeon's work when performing the reconstruction. The application of a serial number and / or a directional indication can be implemented when the at least one connecting element is designed as a bar.

[0028] Preferably, two sections of the at least one insert can be connected by a bridge element that extends over a web of the main body separating the first and second recesses. This allows for a simple geometry of the at least one segment that enables unambiguous positioning of the at least one insert or the plates without increasing the number of individual parts. Karl Leibinger Asset Management KLS0042P-WO GmbH & Co. KG 2025-08-13

[0029] - 6 -

[0030] Preferably, the recesses extend along the longitudinal direction of at least one segment. This longitudinal direction essentially corresponds to the longitudinal direction of the donor bone, e.g., the fibula. Because the recesses are longitudinal, they can later be advantageously used to position plates for screwing the bone segments together during the reconstruction of the bony anatomy, provided the resection template has at least two segments.

[0031] Preferably, the main body has a semi-shell shape, the inner surface of which is adapted to a surface of the graft. This allows at least one segment to be easily placed onto an exposed donor bone. The appropriate surface shape of the inner surface can be designed in advance, for example, using three-dimensional tomography data or similar methods. The adapted shape of the inner surface ensures a secure hold when the resection template is placed on the graft. This can facilitate the surgeon's work and contribute to a better reconstruction outcome.

[0032] Advantageously, the at least one insert and the recesses each have shapes that correspond to each other, enabling unambiguous positioning and orientation of the at least one insert in the corresponding recesses. This prevents, for example, the surgeon from inserting the at least one insert into the wrong recess.

[0033] The recesses in the at least one segment can each have lateral notches. Accordingly, the at least one insert can each have corresponding projections that engage in the corresponding notches when the at least one insert is inserted into the recesses. This can improve the alignment of the at least one insert in the recesses and improve its retention. Alternatively or additionally, the notches in the at least one insert and the projections in the recesses can be configured in this way.

[0034] Particularly preferred are matching notches and projections, each featuring individually designed geometries as counterparts. This has the advantage that, especially in a multi-part version of the resection template, Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13

[0035] - 7 - with multiple segments and multiple inserts, a clear assignment of the inserts to the segments is possible, since only certain notches and certain projections fit together due to the individual geometries.

[0036] If at least two segments are provided, the segments and their respective inserts can have a label so that the surgeon is provided with a visible marking to assign the inserts to the segments.

[0037] Preferably, the at least one segment comprises a flange at at least one end in the longitudinal direction, and preferably at both ends in the longitudinal direction. The flange is essentially a collar at the edge of the segment. The at least one flange preferably has a lateral surface. If the resection template has several segments, the surfaces of the flanges serve to align the segments in a second predetermined relative position during the reconstruction of the bony anatomy. For this purpose, the at least one connecting element may first need to be separated from the segments. The second predetermined relative position is, in particular, a target position of the segments after removal of the connecting element.

[0038] For example, if three segments are used, the middle segment has two interfaces with the two outer segments. When the three segments are assembled, the two outer lateral surfaces of the flanges of the middle segment lie on the respective lateral surfaces of one flange each of the two outer segments at the interfaces. The shape and orientation of the surfaces also determine the orientation of the respective segments.

[0039] Preferably, a surface of the flange or flanges is configured as a template for guiding a saw, this surface being formed either by an outer surface of the flange or by a slot arranged in the flange. Thus, the at least one flange can define the desired shape and orientation of the respective cut.

[0040] If the resection template has at least two segments, the flanges may preferably have notches for aligning the segments in a second predetermined relative position. These notches are formed in particular on the flanges. Karl Leibinger Asset Management KLS0042P-WÖ GmbH & Co. KG 2025-08-13

[0041] - 8 - which form an interface to an adjacent segment during reconstruction. The notches can, for example, have a rectangular shape. By overlapping the notches, the adjacent segments can be aligned, particularly in rotation about the longitudinal axis.

[0042] If the resection template has at least two segments, the cutouts preferably extend longitudinally through the flanges to form a continuous opening. This allows the resection template to be easily removed from the graft after the individual bone segments have been assembled and screwed together, without any interaction with the plates used to secure the bone segments.

[0043] According to one embodiment of the invention, the at least one insert forms at least one guide area as a template for guiding a saw. This guide area is formed either by an outer surface of the insert or by a slot. Advantageously, in this case, the desired shape and orientation of each cut during the resection can be defined via the at least one insert.

[0044] In a further development of the invention, the at least one insert has at least one grip area. This simplifies handling for the surgeon when inserting and removing the at least one insert from the segment(s). This is particularly the case when the at least one insert is held by the segment(s) with an interference fit.

[0045] The invention further relates to a resection set which, in addition to several plates, comprises a resection template according to one or more of the variants described above. In particular, the plates and the recesses of the at least one segment are coordinated such that the recesses of the at least one segment are designed to fit at least a part of the plates.

[0046] In a further development of the aforementioned embodiment and when using a resection template in which notches or projections of the recesses are designed with individual geometries, the plates and the recesses of Karl Leibinger Asset Management KLS0042P-WO GmbH & Co. KG 2025-08-13

[0047] - 9 - at least one segment is uniquely assigned to each other by providing the plates with notches or projections designed as counterparts to the notches or projections of the recesses. This simplifies the unambiguous assignment of the plates for a surgeon performing the resection.

[0048] A method for reconstructing bony anatomy from a graft using a resection template according to the invention, comprising at least two segments, includes the steps described below. Prior to this, suitable methods known in the prior art for designing and manufacturing the resection template are carried out.

[0049] The resection template is placed on the graft, and the segments are screwed to the graft using the pre-drilled holes. It is preferable to first drill holes into the graft to facilitate screwing.

[0050] Once the segments are screwed to the transplant, the inserts are placed into the respective recesses of the segments. Markings and / or labels can indicate to the surgeon which insert should be placed where.

[0051] The surgeon can then drill holes into the graft, using the drill sleeves or openings in the inserts as guides. These holes will later be used to screw the plates in place. Once the drilling is complete, the surgeon can remove the inserts.

[0052] Osteotomies are then performed along a surface of the segment flanges. In other words, the bone segments are cut out of the donor bone according to the shape and orientation defined by the segments.

[0053] Next, at least one connecting element can be separated from the segments. In the case of a bar firmly attached to the segments, this can be done, for example, using a suitable saw or pliers. The individual bone segments are now held by the segments of the resection template and can be easily handled by the surgeon. Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13

[0054] - 10 -

[0055] To reconstruct the bony anatomy, the segments are arranged in the desired position using the second predetermined relative position. The lateral surfaces of the flanges can be used to align the segments. Additionally, the flanges can have notches for adjusting the angular alignment of the segments relative to each other. Clamps, preferably attached to the flanges, can be used to fix the segments relative to each other, securing adjacent segments. Alternatively, the segments can also be aligned relative to each other using at least one connecting element, such as another clamp.

[0056] To fix the bone segments in the second predetermined relative position, plates are placed in the recesses of the segments and screwed into the previously drilled holes in the graft. Thus, the recesses serve both for inserting the plates and for positioning them.

[0057] Finally, the segments can be removed from the graft. The pre-cut recesses make this process simple.

[0058] The present invention will be explained in more detail below with reference to the embodiment shown in the schematic figures. These figures show:

[0059] Fig. 1 shows a schematic view of the bones of a human calf with a resection template applied according to an embodiment of the invention;

[0060] Fig. 2a), b) perspective views of the resection template according to the embodiment shown in Fig. 1 with transplantation segments taken from the fibula;

[0061] Fig. 3a), b) Side views of the outer cut edges of the resection template according to the embodiment shown in Fig. 1 with graft segments taken from the fibula; Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13

[0062] - 11 -

[0063] Fig. 4 shows an enlarged view of the resection template from Fig. 1;

[0064] Fig. 5 shows another view of the resection template from Fig. 4 without

[0065] Graft;

[0066] Fig. 6 shows another view of the resection template from Fig. 4 without inserts;

[0067] Fig. 7 shows a representation of the resection template from Fig. 4 in a reconstruction

[0068] Position;

[0069] Fig. 8 shows another representation of the resection template from Fig. 7 with plates for screwing the graft segments together;

[0070] Fig. 9 shows a representation of a reconstructed mandible with plates for screwing the graft segments in place;

[0071] Fig. 10 shows a schematic view of a bone with a resection template applied according to a further embodiment of the invention;

[0072] Fig. 11 shows another view of the resection template from Fig. 10 with graft segments harvested from the bone, after removal of an insert and before insertion of plates; and

[0073] Fig. 12 shows another representation of the resection template from Fig. 10 with inserted plates for screwing the removed transplantation segments.

[0074] In the figures, identical, functionally equivalent, and equally effective elements, features, and components are each provided with the same reference symbols, unless otherwise stated.

[0075] Fig. 1 shows a first schematic overview view of the bones (tibia and fibula) of a human calf with a resection template 1 applied according to a Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13

[0076] - 12 -

[0077] Exemplary embodiment of the invention. This illustration serves as an overview to understand the harvesting of bone segments from a patient's graft 2. An enlarged view of the resection template 1 placed on the fibula is shown in Fig. 4.

[0078] Figs. 2a) and 2b) show further perspective views of the resection template 1 with graft segments taken from the fibula.

[0079] Bone segments. The view in Fig. 2b) is rotated relative to Fig. 2a) about the longitudinal axis of the fibula, so that bone segments 2 are visible in segments 10 of the resection template 1. Further details of the resection template 1 shown in Figs. 2a) and 2b) are described in more detail below with reference to Fig. 4.

[0080] Figures 3a) and 3b) each show a lateral view of segments 10 of the resection template 1 from Figures 1 and 2a), b), where Figure 3a) corresponds to a view from the right of the right outer segment 10 of Figure 2a). Figure 3b) corresponds to a view from the left of the left outer segment 10 of Figure 2a. In Figures 3a) and 3b), the excised bone segments 2 in the respective segments 10 of the resection template 1 can be seen.

[0081] The cross-section of the bone segments 2 is shown in each case, with the cutting edge running obliquely to the longitudinal axis of the bone, as can be seen in particular in Fig. 2a).

[0082] The orientation and alignment of the cutting edges of the bone segments 2 are predetermined. The lateral flanges 16 of the individual segments 10, described later, preferably serve as guide edges for aligning a saw when cutting out the bone segments.

[0083] Fig. 4 shows an enlarged view of the resection template 1 from Fig. 1. After the donor bone 2 has been exposed, the resection template 1 can be placed on the donor bone 2. Due to the three-dimensional shape of the inner surface of the segments 10, which is adapted to the surface of the donor bone 2 (see views in Fig. 3a) and 3b)), the resection template 1 finds a suitable hold on the donor bone 2.

[0084] The resection template 1 comprises three connected by a connecting element in the form of a

[0085] Bügels 11 interconnected segments 10. Each segment 10 comprises a Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13

[0086] - 13 -

[0087] The main body HK essentially serves as a mechanical support and shaping element. The main body HK is made, for example, of a suitable surgical metal alloy or a polymer. The three-segment version 10 is well-suited for reconstructing a mandibular geometry. For reconstructing a different bony anatomy, the resection template 1 can have only two or even just a single segment. For the sake of clarity, such variants are not explicitly shown in the figures.

[0088] The main body HK of each segment 10 has at least two holes 14 for receiving fasteners such as screws. This allows the surgeon to attach the respective segment 10 to the graft 2, particularly with screws, so that the segment 10 cannot slip or fall off.

[0089] Furthermore, the main body HK has first and second recesses 15 for inserting at least one insert 12 at a predetermined position in segment 10. In the illustrated embodiment, one insert 12 is provided for each segment 10. Each insert 12 has two sections connected by a bridge element 122. The two sections of one of the inserts 12 and the bridge element 122 can be formed in one piece or in multiple parts. The inserts 12 have drill sleeves 13 for guiding boreholes in the graft 2. Alternatively, instead of the drill sleeves 13, the inserts 12 can have openings suitable for positioning and guiding boreholes in the graft 2.

[0090] The bridge elements 122 each extend over a web 123 between the two recesses 15 of a segment 10. At the webs 123, the main body HK of the segments 10 can have a greater thickness, as shown in Fig. 6, so that a bridge element 122 can rest on a surface of a web 123, thereby achieving a stable fit.

[0091] The perspective view without the graft in Fig. 5 shows a view rotated relative to the view in Fig. 4 about the longitudinal axis of the fibula, with a rotation by an angle between the views in Fig. 2a) and Fig. 2b). Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13

[0092] - 14 -

[0093] As can be seen particularly in Fig. 6, the web 123 between two recesses 15 of a segment 10 in the longitudinal direction of the graft 2 can have a different width. To still provide sufficient strength, the thickness of the main body HK at the web 123 can be increased.

[0094] Before inserting the inserts 12, the surgeon can screw the segments 10 to the graft 2 using the holes 14. For this purpose, he can first drill the necessary holes in the graft 2. The holes 14 can be used as a drilling guide.

[0095] Segments 10 and inserts 12 may be labeled to simplify the assignment of inserts 12 to the respective recesses 15 of segments 10. This prevents confusion of segments 10 and ensures that bone segments 2 are assembled in the correct order to achieve the desired result.

[0096] In the state shown in Figs. 4 and 5, the segments 10 are held by the bracket 11 and aligned with each other. Figs. 4 and 6 also illustrate lateral notches 151 in the recesses 15 and the corresponding projections 121 in the inserts 12, which engage in the notches 151.

[0097] Fig. 6 shows another view of the resection template 1, similar to Fig. 4, but without inserts 12 or after removal of the inserts 12. In this illustration, the lateral notches 151 in the recesses 15 are clearly visible. Alternatively or additionally, such notches can be provided in the inserts 12, with corresponding projections in the recesses 15.

[0098] Not shown in the figures are the boreholes in the graft 2, which were made using the drill sleeves 13 or openings in the inserts 12. The screws for attaching the segments 10 to the graft 2 are also not shown.

[0099] Fig. 7 shows a representation of the resection template 1 in a reconstruction position.

[0100] After separating the bracket 11 from the segments 10, these can be arranged in the desired three-dimensional orientation using the flanges 16, to Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13

[0101] - 15 - to reconstruct the mandible. An angular alignment of the segments 10 can be achieved using notches 161 formed in the flanges 16.

[0102] In Fig. 7, the adjacent and abutting flanges 16 each have notches 161, which are each formed as a rectangular cutout in the flange 16. By aligning the notches 161, a desired angular alignment of the segments 10 relative to each other can be easily set. In addition, the recesses 15, which extend through the flanges 16, can be aligned relative to each other.

[0103] Fig. 8 shows a further representation of the resection template 1 from Fig. 7 with a total of four plates 20 arranged for screwing the bone segments 2 at the target site. The plates 20, together with the resection template 1, form a resection set for reconstructing the bony anatomy. The outer plates 20 connect the bone segments 2 to the surrounding bone. The plates 20 are fastened with screws, which are not shown in Fig. 8. The bone segments 2 are still held in place by the segments 10 of the resection template 1. The plates 20 can advantageously be arranged in the free recesses 15. Because the recesses 15 extend through the flanges 16, the plates 20 can be easily mounted without interfering with the segments 10. After the plates 20 are screwed in place, the segments 10 can be removed.

[0104] Fig. 9 shows a representation of the reconstructed mandible with the previously attached plates 20 after the segments 10 of the resection template 1 have been removed. The screws for fixing the plates 20 in the bone segments 2 are not shown in Fig. 9.

[0105] The resection template 1 thus facilitates the reconstruction of a mandible using bone segments obtained from a donor bone of the patient.

[0106] Figure 10 shows a view of a resection template 1 according to a further embodiment of the invention, wherein the resection template 1 is shown in a state in which it is placed on a bone. From this bone, Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13

[0107] - 16 - are to obtain a graft 2 in the form of bone segments using the resection template 1 as part of a resection.

[0108] The resection template 1 has two segments 10, on which the resection template 1 is placed on the bone in the area of ​​the bone segments to be formed. The segments 10 each have a main body HK in which holes 14 are formed and which can be made of a suitable surgical metal alloy or of a polymer.

[0109] The two segments 10 of the resection template 1 are connected to each other via a connecting element in the form of a bracket 11a, which is integrally formed with the main bodies HK of the two segments 10 and holds the two segments 10 of the resection template 1 in the relative position to each other shown in Fig. 10. In this relative position, the segments 10 of the resection template 1 are to be positioned and fastened on the bone. Fastening is achieved using fastening screws, which pass through the holes 14 of the main bodies HK.

[0110] The resection template 1 also has an insert 12, which is detachably received in recesses 15 of the two segments 10 of the resection template 1. These recesses 15 are particularly visible in Fig. 11, which shows the resection template 1 with the insert 12 removed. As can be seen there, each segment 10 has a first and second recess 15. Furthermore, the recesses 15 are each equipped with notches 151, to which projections 121 are assigned on the insert 12. Matching notches 151 and projections 121 are formed by having complementary, individually designed geometries. This, through the interaction of the notches 151 with the projections 121, defines a clear position and orientation of the insert 12 to the segments 10.Insert 12 preferably consists of a suitable surgical metal alloy, for example titanium or a titanium alloy, produced using a 3D printing process.

[0111] The insert 12 is equipped with several drill sleeves 13, which define the positions of boreholes in the graft 2 to be harvested. In this case, the drill sleeves 13 are connected to each other in pairs via bridge elements 122, as described in Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13

[0112] - 17 - in the inserted state of the insert 12, a bridge 123 is bridged between the first and second recesses 15 of the respective segment 10. Alternatively to the drill sleeves 13, the insert 12 can have openings between the bone-facing side and the bone-away side to guide the drilling in the graft 2 accordingly. The openings can protrude from the bone-away side of the insert 12 to better guide the drilling in the graft 2.

[0113] Furthermore, the insert 12 is equipped with several guide areas 17, one located centrally between the drill sleeves 13 and the other at each end of the insert 12. Each guide area 17 is formed as a slot, which serves to guide a saw and thus defines a cutting surface. The centrally located guide areas 17 are designed to intersect each other and thus also define intersecting cutting surfaces.

[0114] Furthermore, the insert 12 has several gripping areas 18, each located near the guide areas 17. These gripping areas 18 simplify the insertion of the insert 12 into the recesses 15, particularly when a press fit is formed between the insert 12 and the recesses 15.

[0115] Apart from the holes 14 and the recesses 15, the main bodies HK of the segments 10 are also equipped with receptacles 19, on which connections of the segments 10 can be made with a further connecting element in the form of an additional bracket 11b. This additional bracket 11b is shown in Fig. 11 and Fig. 12, wherein the additional bracket 11b is provided after the removal of the bracket 11a and in place of the bracket 11a, and each of its ends is inserted into the receptacles 19.

[0116] This positions the segments 10 of the resection template 1 in a further, second relative position in the form of a reconstruction position to each other, in which the bone segments forming the graft 2 are to be positioned to each other for the reconstruction of the bony anatomy.

[0117] During the resection, the resection template 1 is first attached to the area intended for the

[0118] The graft was removed and placed at the designated location on the bone, as described in Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13

[0119] - 18 -

[0120] Fig. 10 is shown. As already described above, the bracket 11a ensures that the segments 10 are positioned relative to each other in the first relative position.

[0121] The resection template 1 is then attached to the bone via the screws passed through the holes 14, before the drilling in the graft 2 is carried out using the inserted insert 12 on the drill sleeves 13 and the necessary cuts to form the bone segments are made on the guide areas 17.

[0122] The bone segments are then removed together with the resection template 1, and the bracket 11a is removed. By connecting the bracket 11b to the receptacles 19, the segments 10, and thus also the bone segments connected to them, are positioned relative to each other in the second relative position before the plates 20 shown in Fig. 11 are attached to the bone segments. The plates 20 are attached to the bone segments with screws (not shown in the figures), which are screwed into the bores previously prepared using the drill sleeves 13. The plates 20, together with the resection template 1, form a resection set.

[0123] As can be seen in Fig. 11 and also in Fig. 12, the plates 20 are also provided with projections 221, each designed as a counterpart to the individual geometries of the notches 151. This enables a clear assignment of the plates 20 to the recesses 15 of the segments 10 and thus also to the bone segments, as shown in Fig. 12. Following the screws securing the plates 20 to the bone segments, the resection template 1 is then removed.

[0124] In the present invention, several features are designated as "first" and "second". These designations serve only to clearly distinguish the individual features. In particular, no spatial or functional arrangement or prioritization should be derived from them.

[0125] Where a list of alternatives in this application is marked with the term "or", it should be understood that the listed alternatives can be considered individually, or, where appropriate, as a combination of several or all of the listed alternatives. Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13

[0126] - 19 -

[0127] Reference symbol list

[0128] 1 resection template

[0129] 2 transplants

[0130] 10 segments

[0131] 11 irons

[0132] 11a Iron

[0133] 11b Iron

[0134] 12 deployment

[0135] 13 Drill sleeve

[0136] 14 holes

[0137] 15 recess

[0138] 16 flange

[0139] 17 Management area

[0140] 18 Grip area

[0141] 19 recordings

[0142] 20 plates

[0143] 121 Cantilever

[0144] 122 bridge elements

[0145] 123 Bridge

[0146] 151 notch

[0147] 161 notch

[0148] 221 Cantilever HK main body

Claims

Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13 - 20 - Patent claims 1. Resection template (1) for reconstructing a bony anatomy from a graft (2), comprising at least one segment (10) and at least one insert (12), each of which has at least one drill sleeve (13) or opening for specifying a position of a bore in the graft (2), wherein the at least one segment (10) has a main body (HB) and at least two holes (14) arranged in the main body (HB) for receiving fastening means, wherein first and second recesses (15) for inserting the at least one insert (12) at a specified position in the segment (10) are formed in the main body (HB).

2. Resection template (1) according to claim 1, characterized in that the resection template (1) has several segments (10) and at least one connecting element, wherein the connecting element is configured to hold the segments (10) in a state connected to the segments (10) in each of an assigned relative position.

3. Resection template (1) according to claim 2, characterized in that several connecting elements are provided, each of which can be connected to the segments (10) and are designed to hold the segments (10) in differing relative positions to each other in their connected states.

4. Resection template (1) according to claim 2 or 3, characterized in that the at least one connecting element is designed as a stirrup (11 , 11a, 11b).

5. Resection template (1) according to claim 4, characterized in that receptacles (19) are provided on the segments (10) into which the bracket (11b) can be inserted for connection with the segments (10).

6. Resection template (1) according to at least one of claims 2 to 5, characterized in that the at least one connecting element is formed by the at least one insert which, in its state inserted into the recesses (15), sets the respective associated relative position. Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13 - 21 - 7. Resection template (1) according to at least one of claims 2 to 6, characterized in that the at least one connecting element has at least one inscription with a serial number and / or a direction indication.

8. Resection template (1) according to at least one of the preceding claims, characterized in that two sections of the at least one insert (12) are connected to each other by a bridge element (122) which extends over a web (123) of the main body (HK) separating the first and second recess (15).

9. Resection template (1) according to at least one of the preceding claims, characterized in that the at least one insert (12) and the recesses (15) have a shape that enables unambiguous positioning and orientation of the at least one insert (12) in the associated recesses (15).

10. Resection template (1) according to at least one of the preceding claims, characterized in that the recesses (15) have notches (151) and the at least one insert (12) have projections (121) matching the notches (151) or that the recesses (15) have projections and the at least one insert (12) have notches matching the projections.

11. Resection template (1) according to claim 10, characterized in that matching notches (151) and projections (121) are each provided with individual geometries designed as counterparts to each other.

12. Resection template (1) according to at least one of the preceding claims, characterized in that the at least one segment (10) has a flange (16) at at least one end in the longitudinal direction.

13. Resection template (1) according to claim 12, characterized in that a surface of the flange (16) is provided as a template for guiding a saw, wherein the surface of the flange (16) is formed either by an outer surface or by a slot. Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13 - 22 - 14. Resection template (1) according to claim 12 or 13 with reference to claim 2, characterized in that the flanges (16) of the segments (10) each have a notch (161) for aligning adjacent segments (10) in a further predetermined relative position.

15. Resection template (1) according to claim 14, characterized in that the further predetermined relative position is a target position of the segments (10) after removal of the at least one connecting element.

16. Resection template (1) according to one of claims 12 to 15 with reference to claim 2, characterized in that the recesses (15) continue through the respective flange (16).

17. Resection template (1) according to at least one of the preceding claims, characterized in that the at least one insert (12) forms at least one guide area (17) as a template for guiding a saw, wherein the at least one guide area (17) is formed either by an outer surface of the insert (12) or by a slot.

18. Resection template (1) according to at least one of the preceding claims, characterized in that the at least one insert (12) has at least one grip area (18).

19. Resection set comprising several plates (20) and a resection template (1) according to at least one of the preceding claims.

20. Resection set according to claim 19 with a resection template (1) according to claim 11, characterized in that the plates (20) and the recesses (15) of the at least one segment (10) are each uniquely assigned to one another by providing the plates (20) with notches or projections (221) designed as counterparts to the notches (151) or the projections of the recesses (15).

21. Method for reconstructing a bony anatomy from a graft (2) using a resection template (1) according to any one of claims 2 to 18 comprising the steps: Karl Leibinger Asset Management KLS0042P-WG GmbH & Co. KG 2025-08-13 - 23 - - Applying the resection template (1) to the graft (2) and screwing the segments (10) to the graft using the holes (14); - Inserting the inserts (12) into the respective recesses (15) in the segments (10); - Performing drilling into the graft (2) using the drill sleeves (13) or openings; - Performing osteotomies along one surface of the segments (10); - Removal of the inserts (12); - Separating the at least one connecting element from the segments (10); - Assembling the segments (10) at the desired position to reconstruct the bony anatomy; - Positioning plates (20) in the recesses (15) and screwing the plates (20) in place using the holes in the graft (2); and - Removal of segments (10) from the graft (2).

22. Method according to claim 21, characterized in that when assembling the segments (10) to reconstruct the bony anatomy, a relative alignment of the segments (10) to each other is carried out by means of the notches (161) and / or by means of the at least one connecting element.

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