Assemblies kit-of-parts and methods of prosthetic reconstruction of long bone defects

Abstract

A modular endoprosthetic system for reconstruction of long-bone defects is disclosed, including an intramedullary nail anchored within one or both natural epiphyseal bone fragments or connectable to corresponding proximal and / or distal epiphyseal reconstruction artificial implants, optionally with a plurality of segmental members each formed of two subpart moieties having semi-cylindrical interior faces engaging the nail and mutually interlockable faces fastenable together to enclose the nail, the system optionally incorporating self-locking fasteners, porous or osteogenic structures, and structural elements on the nail and the implants forming frictional or interlocking engagements, thereby enabling rapid intraoperative assembly, firm fixation, and modular reconstruction of partial or complete diaphyseal and epiphyseal portions of long bones.

Description

ASSEMBLIES KIT-OF-PARTS AND METHODS OF PROSTHETIC RECONSTRUCTION OF LONG BONE DEFECTSTECHNICAL FIELD

[0001] In general, the present invention pertains to medical prostheses, implementable in the art of orthopedics. In particular, the invention relates to assemblies, kit-of-parts and methods of prosthetic reconstruction of long bone defects, mounted onto intramedullary nail. Some preferred embodiments of the invention relate to implant assemblies, respective kit-of-parts and methods of constructing a segmental intercalary endoprosthetic placeholder, installable on intramedullary nail in situ.BACKGROUND ART

[0002] It is believed that the current state of the art is represented by the following patent literature: US10743997, US10568670, US10130485, US9636226, US9421045, US9730740, US9060820, US8974538, US8518122, US8496658, US8100982, US7785325, US6833007, US6443992, US3846846, US2020038547, US2020352735, US2020015973, US2016324551 , US2020129303, US2013330301 , US2011208315, US2008103602, US2005189043, DE102005018644 and WO2009135146.

[0003] US20200038547 discloses a bone implant comprising a porous body comprising particles of bioactive glass having a particle size of at least 500 micron, wherein the composition of the bioactive glass is 45-59 weight-% of SiO2, 18-25 weight-% of Na2O, 17-25 weight-% of CaO and 0.1-6 weight-% of P2O5, and a film having a thickness of 10 pm-200 micron, made of a biocompatible polymer.

[0004] US7125423 which is also believed to represent relevant prior art discloses an intercalary prosthesis that spans the space in the shaft of a long bone between native proximal and distal ends of the long bone. The intercalary prosthesis in US7125423 has first and second intercalary segments connected to proximal and distal stem components. The stem components in US7125423 are implanted in the proximal and distal ends of the long bone. One of the intercalary segments has a male dovetail and the other has a female dovetail. The male and female dovetails in US7125423 are positioned to allow the male dovetail to be moved into the female dovetail in a direction other than the proximal-distaldirection. The intercalary segments in US7125423 can thus be connected after the segments have been implanted without damaging the soft tissue at the native bone through distraction. The intercalary segments and stem components in US7125423 are provided as part of a kit. The method of implanting the intercalary prosthesis is also disclosed in US7125423.

[0005] US10130485 which is also believed to be relevant discloses a multi-walled placeholder including a tubular body, which along its jacket surface has a plurality of breakthroughs or openings for over-growth with adjacent tissue. The placeholder of US10130485 includes at least a second tubular body provided with a plurality of breakthroughs and openings at least partially inside the first tubular body. The first and second tubular bodies in US10130485 can have different cross-sectional shapes, can be arranged inside one another by press fit or force fit or can be connected to each other via connecting pins and arranged side by side to one another in the first body.

[0006] An intramedullary rod, also colloquially often referred as an intramedullary nail (IM nail) or inter-locking nail or Kuntscher nail (without proximal or distal fixation), is a metal rod forced into the medullary cavity of a bone. Intramedullary nails have long been used to treat fractures of long bones of the body.

[0007] An intercalary reconstruction is the replacement of the diaphyseal portion of a long bone after segmental skeletal resection, such as diaphysectomy. Intercalary reconstructions typically result in superior function compared to other limb-sparing procedures because the patient’s own joints above and below the reconstruction are left undisturbed. Various endoprosthetic intercalary implants and assemblies are available for specific types of intercalary reconstructions.SUMMARY OF THE INVENTION

[0008] The following summary of the invention is provided in order to provide a basic understanding of some aspects and features of the invention. This summary is not an extensive overview of the invention and as such it is not intended to particularly identify key or critical elements of the invention or to delineate the scope of the invention. Its sole purpose is to present some concepts of the invention in a simplified form as a prelude to the more detailed description that is presented below.

[0009] The invention was made in view of the deficiencies of the prior art and providessystems, methods and processes for overcoming these deficiencies. According to some embodiments and aspects of the present invention, there are provided assemblies, respective kit-of-parts and methods of constructing a segmental intercalary endoprosthetic placeholder on intramedullary nail, while the intramedullary nail is implanted in situ.

[0010] In accordance with some aspects and embodiments of the present invention, there is provided an assembly of modular intercalary endoprosthetic placeholder includes: an intramedullary nail, where flanking portions of the intramedullary nail are anchored within two respective epiphyseal fragments of a bone, where diaphyseal portion of the bone is at least partially absent and where respective portion of the intramedullary nail is exposed; a plurality of segmental members selected from the group consisting of: at least one segmental member for complete diaphyseal reconstruction and at least one segmental member for partial reconstruction; where each one of the segmental members configured to assume a longitudinal segment of a diaphyseal absent portion of the bone; where each one of the segmental members including: a first subpart moiety including: a semi- cylindrically shaped interior face, configured to engage to the intramedullary nail; an interlockable face, configured to engage to a respective interlockable face of a counterpart moiety; an exterior circumferential face, configured to approximately match an exterior profile of a respective epiphyseal bone fragment; a pair of essentially planar flanking faces, configured to adjoin flanking faces of the respective epiphyseal bone fragment and / or another segmental member; at least two structural elements operationally connectable to fasteners; a second subpart moiety including: a semi-cylindrically shaped interior face, configured to engage to the intramedullary nail; an interlockable face, configured to engage to a respective interlockable face of a counterpart moiety; an exterior circumferential face; a pair of essentially planar flanking faces; at least two structural elements operationally connectable to fasteners; at least two fasteners operationally connectable to the structural elements of the first and second subpart moieties; where each one of the plurality of segmental members is configured to assume a configuration selected from the group consisting of: an open configuration, where the first and second subpart moieties are spaced apart one from another; a closed configuration, where the first and second subpart moieties are fastened one to another by the fasteners, so that the interlockable faces of the first and second subpart moieties are engaged one to another and the semi-cylindrically shaped interior faces of the first and second subpart moieties are engaged to the intramedullary nail; where the plurality of segmental members are readily connectable onto the intramedullary nail.

[0011] In accordance with some aspects and embodiments of the present invention, there is provided an assembly of modular intercalary endoprosthetic placeholder in which the segmental members comprise a longitudinal locking trunnion.

[0012] In accordance with some aspects and embodiments of the present invention, there is provided an assembly of modular intercalary endoprosthetic placeholder in which the segmental members comprise a porous matrix.

[0013] In accordance with some aspects and embodiments of the present invention, there is provided an assembly of modular intercalary endoprosthetic placeholder in which the segmental members comprise an osteogenesis promoting substance.

[0014] In accordance with some aspects and embodiments of the present invention, there is provided an assembly of modular intercalary endoprosthetic placeholder in which the segmental members comprise a kit of single-packed presterilized units.

[0015] In accordance with some aspects and embodiments of the present invention, there is provided an assembly of modular intercalary endoprosthetic placeholder in which at least one of the fasteners is of a self-interlocking type.

[0016] In accordance with some aspects and embodiments of the present invention, there is provided an assembly of modular intercalary endoprosthetic placeholder in which at least one of the fasteners is integral to at least one of the first and second subpart moieties.

[0017] In accordance with some aspects and embodiments of the present invention, there is provided an assembly of modular intercalary endoprosthetic placeholder includes: an intramedullary nail, where flanking portions of the intramedullary nail are anchored within two respective epiphyseal fragments of a bone, where diaphyseal portion of the bone is at least partially absent and where respective portion of the intramedullary nail is exposed; a plurality of segmental members selected from the group consisting of: at least one segmental member for complete diaphyseal reconstruction and at least one segmental member for partial reconstruction; where each one of the segmental members configured to assume a longitudinal segment of a diaphyseal absent portion of the bone; where each one of the segmental members including: a first subpart moiety including: a semi- cylindrically shaped interior face, configured to engage to the intramedullary nail; an interlockable face, configured to engage to a respective interlockable face of a counterpart moiety; an exterior circumferential face, configured to approximately match an exterior profile of a respective epiphyseal bone fragment; a pair of essentially planar flanking faces, configured to adjoin flanking faces of the respective epiphyseal bone fragment and / oranother segmental member; at least one structural element connectable to a fastener; at least one hinge element configured to form operational connection with a respective hinge element a counterpart moiety; a second subpart moiety including: a semi-cylindrically shaped interior face, configured to engage to the intramedullary nail; an interlockable face, configured to engage to a respective interlockable face of a counterpart moiety; an exterior circumferential face; a pair of essentially planar flanking faces; at least one structural element connectable to a fastener; at least one hinge element configured to form operational connection with a respective hinge element a counterpart moiety; at least one fastener operationally connectable to the structural elements of the first and second subpart moieties; at least one hinge operationally connecting the first subpart moiety to the second subpart moiety; where each one of the plurality of segmental members is configured to assume a configuration selected from the group consisting of: an open configuration, where the first and second subpart moieties are displaced one relative to another; a closed configuration, where the first and second subpart moieties are fastened one to another by the fasteners, so that the interlockable faces of the first and second subpart moieties are engaged one to another and the semi-cylindrically shaped interior faces of the first and second subpart moieties are engaged to the intramedullary nail; where the plurality of segmental members are readily connectable onto the intramedullary nail; where the operational connection between the first and second subpart moieties is characterized by at least one degree of freedom in movement of the subpart moieties one relative to another, while the subpart moieties remain essentially connected one to another; whereby the first and second subpart moieties of the plurality of segmental members are readily appendable to and thereby conveniently mountable onto the intramedullary nail.

[0018] In accordance with some aspects and embodiments of the present invention, there is provided an assembly of modular intercalary endoprosthetic placeholder in which the degree of freedom in the movement includes freedom of rotationally displacing the subpart moieties one relative to another.

[0019] In accordance with some aspects and embodiments of the present invention, there is provided an assembly of modular intercalary endoprosthetic placeholder in which the degree of freedom in the movement includes freedom of angularly displacing the subpart moieties one relative to another.

[0020] In accordance with some aspects and embodiments of the present invention, there is provided an assembly of modular intercalary endoprosthetic placeholder in which the hinge elements of the first subpart moiety to the second subpart moiety are of a self-interlocking type.

[0021] In accordance with some aspects and embodiments of the present invention, there is provided an assembly of modular intercalary endoprosthetic placeholder in which the hinge further includes an interconnecting component, operationally connecting the hinge elements of the first subpart moiety to the second subpart moiety.

[0022] In accordance with some aspects and embodiments of the present invention, there is provided a method of assembling a modular intercalary endoprosthetic placeholder includes: providing an intramedullary nail; providing a kit-of-parts including: a plurality of segmental members selected from the group consisting of: at least one segmental member for complete diaphyseal reconstruction and at least one segmental member for partial reconstruction; where each one of the segmental members configured to assume a longitudinal segment of a diaphyseal absent portion of the bone; where each one of the segmental members including a first subpart moiety and a second subpart moiety, where each one of the subpart moieties including: a semi-cylindrically shaped interior face, configured to engage to the intramedullary nail; an interlockable face, configured to engage to a respective interlockable face of a counterpart moiety; an exterior circumferential face; a pair of essentially planar flanking faces; at least one structural element connectable to a fastener; at least one hinge element configured to form operational connection with a respective hinge element a counterpart moiety; at least one fastener operationally connectable to the structural elements of the first and second subpart moieties; at least one hinge operationally connecting the first subpart moiety to the second subpart moiety; forming an operational connection between the first and second subpart moieties by essentially connecting the subpart moieties one to another by the at least one hinge, with at least one degree of freedom in movement of the subpart moieties one relative to another; appending the plurality of segmental members to the intramedullary nail, in an open configuration, where the first subpart moiety is operationally connected to the second subpart moiety, thereby conveniently mounting the plurality of segmental members onto the intramedullary nail; altering a configuration of the plurality of segmental members from the open configuration to a closed configuration, where the first and second subpart moieties are fastened one to another by the fasteners; thereby readily connecting the plurality of segmental members onto the intramedullary nail and assembling the modular intercalary endoprosthetic placeholder.

[0023] In accordance with some aspects and embodiments of the present invention, there is provided a method of assembling a modular intercalary endoprosthetic placeholderincludes: providing an intramedullary nail; providing a kit-of-parts including: a plurality of segmental members selected from the group consisting of: at least one segmental member for complete diaphyseal reconstruction and at least one segmental member for partial reconstruction; where each one of the segmental members including: a first subpart moiety and a second subpart moiety, where each one of the subpart moieties including: a semi- cylindrically shaped interior face, configured to engage to the intramedullary nail; an interlockable face, configured to engage to a respective interlockable face of a counterpart moiety; an exterior circumferential face; a pair of essentially planar flanking faces; at least two structural elements connectable to fasteners; at least two fasteners operationally connectable to the structural elements of the first and second subpart moieties; forming an operational connection between the first and second subpart moieties by essentially connecting the subpart moieties one to another by the fasteners; altering a configuration of the plurality of segmental members from the open configuration, where the subpart moieties are spaced apart one from another, to a closed configuration, where the first and second subpart moieties are fastened one to another by the fasteners; thereby readily connecting said plurality of segmental members onto the intramedullary nail and assembling the modular intercalary endoprosthetic placeholder.

[0024] In accordance with some aspects and embodiments of the present invention there is provided a segmental member for assembling a modular intercalary endoprosthetic placeholder, configured to assume a shape of a longitudinal segment of a diaphyseal absent portion of a bone, including: a first subpart moiety including: a semi-cylindrically shaped interior face configured to engage an intramedullary nail; an interlockable face configured to engage a respective interlockable face of a counterpart moiety; an exterior circumferential face configured to approximately match an exterior profile of a respective epiphyseal bone fragment; a pair of essentially planar flanking faces configured to adjoin flanking faces of the respective epiphyseal bone fragment and / or another segmental member; and at least one structural element operationally connectable to a fastener; and a second subpart moiety including: a semi-cylindrically shaped interior face configured to engage the intramedullary nail; an interlockable face configured to engage a respective interlockable face of a counterpart moiety; at least one structural element operationally connectable to a fastener; and a pair of essentially planar flanking faces configured to adjoin flanking faces of the respective epiphyseal bone fragment and / or another segmental member; in which the segmental member is configured to assume a configuration selected from the group consisting of: an open configuration in which the first and second subpart moieties are spaced apart, and a closed configuration in which the first and second subpart moieties arefastened one to another by at least one fastener so that the interlockable faces are engaged, the segmental member being readily connectable onto an intramedullary nail, in which in the closed configuration the semi-cylindrically shaped interior faces of the subpart moieties are engaged to an exterior surface of the intramedullary nail, and in which the segmental member is selected from the group consisting of a segmental member for complete diaphyseal reconstruction and a segmental member for partial reconstruction.

[0025] In some embodiments an exterior surface of the intramedullary nail includes at least one structural element configured to form a firm connection with the semi- cylindrically shaped interior faces of the subpart moieties.

[0026] In some embodiments the semi-cylindrically shaped interior faces of the subpart moieties include at least one structural element configured to form a firm connection with an exterior surface of the intramedullary nail.

[0027] In some embodiments the semi-cylindrically shaped interior faces of the subpart moieties and an exterior surface of the intramedullary nail form an interlocking arrangement.

[0028] In some embodiments the semi-cylindrically shaped interior faces of the subpart moieties and an exterior surface of the intramedullary nail form a frictional engagement.

[0029] In accordance with some aspects and embodiments of the present invention there is provided an assembly for prosthetic reconstruction of long bone defects including: an intramedullary nail in which at least one of the following is held true: both flanking portions of the intramedullary nail are anchored within two respective epiphyseal fragments of a bone; a first flanking portion is anchored within a distal epiphyseal fragment of a bone whereas a second flanking portion is configured to connect to a proximal epiphyseal fragment reconstruction artificial implant; or a first flanking portion is anchored within a proximal epiphyseal fragment of a bone whereas a second flanking portion is configured to connect to a distal epiphyseal fragment reconstruction artificial implant; and at least one epiphyseal fragment reconstruction artificial implant selected from the group consisting of a proximal epiphyseal fragment reconstruction artificial implant and a distal epiphyseal fragment reconstruction artificial implant, in which the at least one epiphyseal fragment reconstruction artificial implant is readily connectable onto the intramedullary nail.

[0030] In some embodiments the assembly further includes segmental members selected from the group consisting of: at least one segmental member for completediaphyseal reconstruction and at least one segmental member for partial reconstruction, each configured to assume a longitudinal segment of a diaphyseal absent portion of the bone, each including: a first subpart moiety including: a semi-cylindrically shaped interior face configured to engage the intramedullary nail; an interlockable face configured to engage a respective interlockable face of a counterpart moiety; an exterior circumferential face configured to approximately match an exterior profile of a respective epiphyseal bone fragment; a pair of essentially planar flanking faces configured to adjoin flanking faces of the respective epiphyseal bone fragment and / or another segmental member; and at least one structural element operationally connectable to a fastener; and a second subpart moiety including: a semi-cylindrically shaped interior face configured to engage the intramedullary nail; an interlockable face configured to engage a respective interlockable face of a counterpart moiety; and at least one structural element operationally connectable to a fastener; in which each of the segmental members is configured to assume a configuration selected from the group consisting of: an open configuration in which the first and second subpart moieties are spaced apart, and a closed configuration in which the first and second subpart moieties are fastened one to another so that the interlockable faces are engaged and the semi-cylindrically shaped interior faces are engaged to the intramedullary nail, in which the segmental members are readily connectable onto the intramedullary nail.

[0031] In some embodiments an exterior surface of the intramedullary nail includes at least one structural element configured to form a firm connection with an interior face of the at least one epiphyseal fragment reconstruction artificial implant.

[0032] In some embodiments an interior face of the at least one epiphyseal fragment reconstruction artificial implant includes at least one structural element configured to form a firm connection with an exterior surface of the intramedullary nail.

[0033] In some embodiments an interior face of the subpart moieties and an exterior surface of the intramedullary nail form an interlocking arrangement.DEFINITIONS

[0034] The term intramedullary rod or nail as referred to herein is to be construed as including any metal rod forced into the medullary cavity of a bone, to treat fractures of bones of the body. In some embodiments an intramedullary nail is anchored within an epiphyseal and / or diaphyseal bone fragment / s, where epiphyseal and / or diaphyseal portion / s of thebone is / are partially present and viable. In some embodiments an intramedullary nail is readily connectable to an epiphyseal and / or diaphyseal artificial reconstruction implant, where epiphyseal and / or diaphyseal portion / s of the bone is / are partially absent. An intramedullary rod or nail as referred to herein is typically not anchored within an epiphyseal and / or diaphyseal bone fragment / s by a means of screw threading, as opposed to an intramedullary screw.

[0035] The term diaphysectomy as referred to herein is to be construed as including a partial or complete removal of the shaft of a bone of the body.

[0036] The term intercalary endoprosthesis as referred to herein is to be construed as including any artificial object used for reconstruction or replacement of the diaphyseal portion of a bone after segmental skeletal resection, such as diaphysectomy. The term intercalary endoprosthesis is to be construed as including any endoprosthetic implant used for any intercalary reconstruction.

[0037] The term in situ, as referred to herein, should be construed in place or namely after the intramedullary nail has been implanted or deployed.

[0038] The term placeholder as referred to herein is to be construed as including any artificial object configured for occupying the space of any missing diaphyseal portion of a bone, so as for placeholder to substantially match the proximal and / or distant epiphyseal portions of the bone. The term placeholder as referred to herein is further optionally to be construed as including any artificial object providing for ingrowth of osseous tissue and / or facilitating osteogenesis.

[0039] The term modular, as referred to herein, should be construed as a stand-alone unit. The term modular inter alia means a standardized unit that may be conveniently installed or deployed without significant impact to the environment. The term modular, however, doesn’t necessarily mean providing for ease of interchange or replacement. The term modular is optionally satisfied by providing for ease of at least onetime deployment or installation.

[0040] The term readily connectable, as referred to herein, should be construed as a standardized unit that may be conveniently connected to other components of the system. The term readily connectable, however, doesn’t necessarily mean readily disconnectable or removable. The term readily connectable is optionally satisfied by providing for ease of at least onetime connection or coupling.

[0041] The terms matching and / or matchable as referred to herein is to be construedas a cross-sectional area and / or shape of a component is equal or essentially similar to a cross-sectional area and / or shape of another component. It should be acknowledged that the component need only to be similar in the cross-sectional areas and / or shapes, to satisfy the term matching / matchable, so long as the cross-sectional areas can be mated or the combination will fit into and / or occupy essentially the same lateral space.

[0042] The term structured as referred to herein is to be construed as including any geometrical shape, exceeding in complexity a plain linear shape or a shape embodying simple cylindrical, elliptical or polygonal contour or profile. A more complex shape, a plain linear shape or a shape embodying simple cylindrical, elliptical or polygonal contour or profile, constitutes an example of structured geometry.

[0043] The terms firm rigid, or stiff, as referred to herein, are to be construed as having rigidity modulus value, otherwise referred to as the shear modulus, of 4800 MPa or more. Materials are considered to be firm rigid, or stiff but not tensile, when such materials are incapable of being efficiently elastically flexed or bent. Stiff materials, such as steel, are defined as having rigidity modulus value well exceeding 4800 MPa.

[0044] By "operationally connected" and "operably coupled", as used herein, is meant connected in a specific way (e.g., in a manner allowing water to move and / or electric power to be transmitted) that allows the disclosed system and its various components to operate effectively in the manner described herein.

[0045] In the specification or claims herein, any term signifying an action or operation, such as: a verb, whether in base form or any tense, gerund or present / past participle, is not to be construed as necessarily to be actually performed but rather in a constructive manner, namely as to be performed merely optionally or potentially.

[0046] The term “substantially” as used herein is a broad term and is to be given its ordinary and customary meaning to a person of ordinary skill in the art (and is not to be limited to a special or customized meaning) and refers without limitation to being largely but not necessarily wholly that which is specified.

[0047] As used herein, the term “substantially” changes a specific meaning, meaning an interval of plus or minus ten percent (± 10%). For any embodiments disclosed herein, any disclosure of a particular value, in some alternative embodiments, is to be understood as disclosing an interval approximately or about equal to that particular value (i.e., ± 10%).

[0048] As used herein, the term “essentially” changes a specific meaning, meaning an interval of plus or minus ten percent (± 20%). For any embodiments disclosed herein,any disclosure of a particular value, in some alternative embodiments, is to be understood as disclosing an interval approximately or about equal to that particular value (i.e., ± 20%).

[0049] The term "essentially" further means that the composition, method or structure may include additional ingredients, stages and or parts, but only if the additional ingredients, the stages and / or the parts do not materially alter the basic and new characteristics of the composition, method or structure claimed.

[0050] As used herein, the term “about” or “approximately” modifies a particular value, by referring to a range equal to the particular value, plus or minus twenty percent (+ / -35%). For any of the embodiments, disclosed herein, any disclosure of a particular value, can, in various alternate embodiments, also be understood as a disclosure of a range equal to about that particular value (i.e. + / -35%).

[0051] As used herein, the term “or” is an inclusive “or” operator, equivalent to the term “and / or,” unless the context clearly dictates otherwise; whereas the term “and” as used herein is also the alternative operator equivalent to the term “and / or,” unless the context clearly dictates otherwise.

[0052] It should be understood, however, that neither the briefly synopsized summary nor particular definitions hereinabove are not to limit interpretation of the invention to the specific forms and examples but rather on the contrary are to cover all modifications, equivalents and alternatives falling within the scope of the invention.DESCRIPTION OF THE DRAWINGS

[0053] The present invention will be understood and appreciated more comprehensively from the following detailed description taken in conjunction with the appended drawings in which:

[0054] FIG 1 A and 1 B schematically illustrate practical use of a prior art bone implant according to US20200038547;

[0055] FIG 2 is a perspective view of an exemplary intramedullary nail anchored into epiphyseal bone fragments of a bone, wherein diaphyseal portion of the bone is partially absent and wherein respective portion of the intramedullary nail is exposed;

[0056] FIG 3A and 3B are perspective views of an exemplary segmental member of intercalary endoprosthetic placeholder, configured for complete reconstruction of thediaphyseal portion of a bone after segmental skeletal resection of the diaphyseal portion of the bone, in a closed configuration;

[0057] FIG 3C is a top view of an exemplary segmental member of intercalary endoprosthetic placeholder, configured for complete reconstruction of the diaphyseal portion of a bone after segmental skeletal resection of the diaphyseal portion of the bone, in a closed configuration;

[0058] FIG 3D is a side view of an exemplary segmental member of intercalary endoprosthetic placeholder, configured for complete reconstruction of the diaphyseal portion of a bone after segmental skeletal resection of the diaphyseal portion of the bone, in a closed configuration;

[0059] FIG 4A is a perspective view of an exemplary segmental member of intercalary endoprosthetic placeholder, configured for partial reconstruction of the diaphyseal portion of a bone after partial segmental skeletal resection of the diaphyseal portion of the bone, in a closed configuration;

[0060] FIG 4B is a top view of an exemplary segmental member of intercalary endoprosthetic placeholder, configured for partial reconstruction of the diaphyseal portion of a bone after partial segmental skeletal resection of the diaphyseal portion of the bone, in a closed configuration;

[0061] FIG 4C is a side view of an exemplary segmental member of intercalary endoprosthetic placeholder, configured for partial reconstruction of the diaphyseal portion of a bone after partial segmental skeletal resection of the diaphyseal portion of the bone, in a closed configuration;

[0062] FIG 5A is a perspective view of an exemplary segmental member of intercalary endoprosthetic placeholder, configured for complete reconstruction of the diaphyseal portion of a bone after segmental skeletal resection of the diaphyseal portion of the bone, in an exploded open configuration;

[0063] FIG 5B is a top view of an exemplary segmental member of intercalary endoprosthetic placeholder, configured for complete reconstruction of the diaphyseal portion of a bone after segmental skeletal resection of the diaphyseal portion of the bone, in an exploded open configuration;

[0064] FIG 5C is a side view of an exemplary segmental member of intercalary endoprosthetic placeholder, configured for complete reconstruction of the diaphyseal portion of a bone after segmental skeletal resection of the diaphyseal portion of the bone, inan exploded open configuration;

[0065] FIG 6A is a perspective view of an exemplary segmental member of intercalary endoprosthetic placeholder, configured for complete reconstruction of the diaphyseal portion of a bone after segmental skeletal resection of the diaphyseal portion of the bone, in a rotatably open configuration;

[0066] FIG 6B is a side view of an exemplary segmental member of intercalary endoprosthetic placeholder, configured for complete reconstruction of the diaphyseal portion of a bone after segmental skeletal resection of the diaphyseal portion of the bone, in a rotatably open configuration;

[0067] FIG 7A is a perspective view of an exemplary segmental member of intercalary endoprosthetic placeholder, configured for complete reconstruction of the diaphyseal portion of a bone after segmental skeletal resection of the diaphyseal portion of the bone, in an angularly open configuration;

[0068] FIG 7B is a side view of an exemplary segmental member of intercalary endoprosthetic placeholder, configured for complete reconstruction of the diaphyseal portion of a bone after segmental skeletal resection of the diaphyseal portion of the bone, in an angularly open configuration;

[0069] FIG 8 is a perspective view of an assembly of exemplary intramedullary nail anchored into epiphyseal bone fragments of a bone and exemplary segmental member of intercalary endoprosthetic placeholder for partial reconstruction, in a closed configuration radially connected onto intramedullary nail;

[0070] FIG 9 is a perspective view of an assembly of exemplary intramedullary nail anchored into epiphyseal bone fragments of a bone and exemplary segmental members of intercalary endoprosthetic placeholder for complete reconstruction and exemplary segmental members of intercalary endoprosthetic placeholder for partial reconstruction, in a closed configuration connected onto intramedullary nail, as well as exemplary segmental member of intercalary endoprosthetic placeholder in an open configuration, radially appendable to the intramedullary nail;

[0071] FIG 10A is a photographic image of an exemplary intramedullary nail implanted into epiphyseal bone fragments, prior to the installation of the intercalary segmental endoprosthetic placeholder, in accordance with a working example of the present invention;

[0072] FIG 10B is a radiographic image of the diaphyseal portion of an exemplaryintramedullary nail implanted into epiphyseal bone fragments, prior to the installation of the intercalary segmental endoprosthetic placeholder, in accordance with a working example of the present invention;

[0073] FIG 10C is a radiographic image of the proximal portion of an exemplary intramedullary nail implanted into respective epiphyseal bone fragment, prior to the installation of the intercalary segmental endoprosthetic placeholder, in accordance with a working example of the present invention;

[0074] FIG 10D is a radiographic image of the distal portion of an exemplary intramedullary nail implanted into respective epiphyseal bone fragment, prior to the installation of the intercalary segmental endoprosthetic placeholder, in accordance with a working example of the present invention;

[0075] FIG 11 is a photographic image of an exemplary segmental member of intercalary endoprosthetic placeholder, prior to the installation thereof on an intramedullary nail, in accordance with another working example of the present invention;

[0076] FIG 12A is a photographic image of an exemplary intramedullary nail implanted into epiphyseal bone fragments, after the installation of the intercalary segmental endoprosthetic placeholder, in accordance with a working example of the present invention;

[0077] FIG 12B is a radiographic image of the diaphyseal portion of an exemplary intramedullary nail implanted into epiphyseal bone fragments, after the installation of the intercalary segmental endoprosthetic placeholder, in accordance with a working example of the present invention;

[0078] FIG 12C is a radiographic image of the proximal portion of an exemplary intramedullary nail implanted into respective epiphyseal bone fragment, after the installation of the intercalary segmental endoprosthetic placeholder, in accordance with a working example of the present invention;

[0079] FIG 12D is a radiographic image of the distal portion of an exemplary intramedullary nail implanted into respective epiphyseal bone fragment, after the installation of the intercalary segmental endoprosthetic placeholder, in accordance with a working example of the present invention;

[0080] FIG 13A is a perspective view of an assembly for prosthetic reconstruction of long bone defects comprising an intramedullary nail anchored within two respective epiphyseal fragments of a bone, in accordance with one embodiment of the present invention;

[0081] FIG 13B is a perspective view of an assembly for prosthetic reconstruction of long bone defects comprising an intramedullary nail with at least one segmental member, anchored in-between two respective epiphyseal fragments of a bone, in accordance with one embodiment of the present invention;

[0082] FIG 14A is a perspective view of an assembly for prosthetic reconstruction of long bone defects, in which a first flanking portion of an intramedullary nail is anchored within a distal epiphyseal fragment of a bone, in accordance with another embodiment of the present invention;

[0083] FIG 14B is a perspective view of an assembly for prosthetic reconstruction of long bone defects, in which the first flanking portion of an intramedullary nail is anchored within a distal epiphyseal fragment of a bone, whereas the second flanking portion is connected to a proximal epiphyseal fragment reconstruction artificial implant, in accordance with another embodiment of the present invention

[0084] FIG 15A is a perspective view of an assembly for prosthetic reconstruction of long bone defects, in which a second flanking portion of an intramedullary nail is anchored within a proximal epiphyseal fragment, in accordance with another embodiment of the present invention;

[0085] FIG 15B is a perspective view of an assembly for prosthetic reconstruction of long bone defects, in which the first flanking portion of an intramedullary nail is anchored within a proximal epiphyseal fragment of a bone, whereas the second flanking portion is connected to a distal epiphyseal fragment reconstruction artificial implant, in accordance with another embodiment of the present invention.

[0086] While the invention is susceptible to various modifications and alternative forms, specific embodiments thereof have been shown merely by way of example in the drawings. The drawings are not necessarily complete, and components are not essentially to scale; emphasis instead being placed upon clearly illustrating the principles underlying the present invention.DETAILED DISCLOSURE OF EMBODIMENTS

[0087] Prior to elaborating any embodiment of the present invention, in order to present the background for the inventive concept more clearly, reference is firstly made to FIG 1A and 1B, showing prior art bone implant 16, shown in Figures 4A-4B of US20200038547. Practical use of prior art bone implant 16, for intramedullary fixation, is shown in FIG 1A and 1B. Bone implant 16 comprises three discs 17 arranged on top of each other, each disc 17 comprising an aperture 18 through it, from top surface to bottom surface.

[0088] A film 19 is arranged to surround the discs, which are cut open at one point, in order to make their placement around the nail. In FIG 1B, bone implant 16 is shown between two bone parts 20, 21 and fixed with a nail system 22, wherein a part of the nail system passes through the bone implant via the apertures.

[0089] Illustrative embodiments of the invention are described below. In the interest of clarity, not all features of actual implementation are described in this specification. It should be appreciated that various features or elements described in the context of some embodiment may be interchangeable with features or elements of any other embodiment described in the specification. Moreover, it will be appreciated that for the development of any actual embodiment, numerous implementation-specific decisions must be made to achieve the developers' specific goals, such as compliance with technology- or business- related constraints, which may vary from one implementation to another, and the effort of such a development might be complex and time-consuming, but would nevertheless be a routine undertaking for those of ordinary skill in the art having the benefit of this disclosure.

[0090] Reference is now made to FIG 2, showing a perspective view of exemplary intramedullary nail 30 anchored into epiphyseal bone fragments 32 and 34. The diaphyseal portion of the bone is partially absent. Consequently, respective portion of intramedullary nail 30 is exposed. Epiphyseal bone fragment 32 terminates with flanking face 33.

[0091] In the example of intramedullary nail 30 shown on FIG 2, diaphyseal extension 36 is present on epiphyseal bone fragment 34. Diaphyseal extension 36 covers a portion of intramedullary nail 30. Longitudinal faces 37 of diaphyseal extension 36 are exposed. Epiphyseal recession 38 on epiphyseal bone fragment 34 exposes the respective complimentary portion of intramedullary nail 30 that is not covered by diaphyseal extension 36. Epiphyseal recession 38 terminates with proximal flanking face 39; whereas diaphyseal extension 36 terminates with a distal flanking face.

[0092] The respective portion of intramedullary nail 30 is covered by diaphyseal extension 36, rendering such portion of intramedullary nail 30 suitable for partial diaphyseal reconstruction; whereas the portion intramedullary nail 30 that is not covered by diaphyseal extension 36, rendering such portion suitable for complete diaphyseal reconstruction.

[0093] Intramedullary nail 30 is optionally a standard intramedullary rod known in the art. Examples of intramedullary nail 30 in a non-limiting manner include any metal rod forced into the medullary cavity of a bone. Examples of intramedullary nail 30 further in a nonlimiting manner include interlocking nails with a locking mechanism for fixing the nail to the bone, for instance by forming apertures in the nail, on the proximal and / or distal end of the nail for a stable fixation, solid nails, hollow nails, flexible nails, as well as universal tibial and femoral nails. In some examples, intramedullary nail 30 is made of stainless steel and / or titanium alloy.

[0094] In some examples, interlocking nails includes at least one aperture at either end. An aperture is drilled in the bone perpendicularly to the nail. A screw or bolt passes throughout the aperture in the nail and is affixed with apertures in the bone, thus locking nail and bone together. The apertures are typically round, as they are to accommodate a screw or bolt.

[0095] In accordance with some embodiments of the present invention, reference is now made to FIG 3A to 3D, respectively showing perspective, top and side views of segmental member 40 of intercalary endoprosthetic placeholder, configured for complete diaphyseal reconstruction of a bone after segmental skeletal resection of the diaphyseal portion of the bone, in a closed configuration. Segmental member 40 for complete diaphyseal reconstruction is readily connectable onto an intramedullary nail, such as standard intramedullary nail 30 shown in FIG 2. The particular segmental member 40 for complete diaphyseal reconstruction of the embodiment of FIG 3A to 3D illustrates various features and / or elements that may be interchangeable with features and / or elements of any other embodiment described in the specification.

[0096] In some preferred embodiments, segmental member 40 for complete diaphyseal reconstruction comprises a porous, intercalated or intertwined structure, embodying a plurality of cavities, pores and / or channels. In some preferred embodiments, segmental member 40 for complete diaphyseal reconstruction including a substance promoting osteogenesis. Segmental member 40 comprising a porous, intercalated or intertwined structure and / or including a substance promoting osteogenesis facilitate bone ingrowth and integration of segmental member 40 into the osseous tissue. Examples ofmaterials having porous structure as well as including a substance promoting osteogenesis facilitate bone ingrowth and integration of segmental member 40 into the osseous tissue are disclosed in US20200038547.

[0097] Segmental member 40 for complete diaphyseal reconstruction is optimally made of biocompatible materials including biocompatible polymers and / or metals, such as titanium, titanium alloys, niobium, nickel-titanium alloys. In some examples, segmental member 40 for complete diaphyseal reconstruction is manufactured by a means of 3D printing technology. Such technologies are known in several variations, sometimes referred to as additive manufacturing, rapid prototyping, solid free form technology, powder bed fusion, in which a bed of powdered metal is selectively fused, through sintering or melting, typically by a laser beam or electric arc. Alternatively or additionally electron beam melting of metal powder (EBM) may be used.

[0098] In some embodiments, segmental member 40 for complete diaphyseal reconstruction comprises first subpart moiety 42A. Fist subpart moiety 42A comprises semi- cylindrically shaped interior face 44A. Semi-cylindrically shaped interior face 44A is configured to engage to intramedullary nail 30.

[0099] In some embodiments, first subpart moiety 42A of segmental member 40 further comprises interlockable face 46A. Interlockable face 46A is configured to engage to a respective interlockable face 46B of counterpart subpart moiety. In some embodiments, first subpart moiety 42A of segmental member 40 further comprises exterior circumferential face 48A. Exterior circumferential face 48A is configured to approximately match an exterior profile of a respective epiphyseal bone fragment.

[0100] In some embodiments, first subpart moiety 42A of segmental member 40 further comprises a pair of essentially planar flanking faces 50A and 50B. Flanking faces 50A and 50B are configured to adjoin flanking faces of a respective epiphyseal bone fragment, such as flanking face 33 of epiphyseal bone fragment 32 shown in FIG 2, and / or a flanking face of another segmental member (not shown). In the example of diaphyseal extension 36 on epiphyseal bone fragment 34 shown in FIG 2, flanking faces 50A and 50B are configured to adjoin in combination, with a distal face of a diaphyseal extension, such as the distal face diaphyseal extension 36 of epiphyseal bone fragment 32 shown in FIG 2, as well as with a respective flanking face of another segmental member (not shown) for partial diaphyseal reconstruction.

[0101] In some embodiments, first subpart moiety 42A of segmental member 40further comprises at least two structural elements 52A. Structural elements 52A are operationally connectable by fasteners 54. In some examples, structural elements 52A are through apertures including any types of apertures penetrating through first subpart moiety 42A.

[0102] In some embodiments, segmental member 40 for complete diaphyseal reconstruction comprises second subpart moiety 42B. Second subpart moiety 42B of segmental member 40 comprises semi-cylindrically shaped interior face 44B. Semi- cylindrically shaped interior face 44B is configured to engage to intramedullary nail 30. Second subpart moiety 42B of segmental member 40 further comprises interlockable face 46B. Interlockable face 46B is configured to engage to a respective interlockable face 46A of first subpart moiety 42A. In some embodiments, second subpart moiety 42B of segmental member 40 further comprises exterior circumferential face 48B. Exterior circumferential face 48B is configured to approximately match an exterior profile of a respective epiphyseal bone fragment, such as the profile of epiphyseal bone fragment 32 shown in FIG 2, and / or the profile of another segmental member (not shown) for complete diaphyseal reconstruction, and / or the combination of the profile of a diaphyseal extension, such as the profile of diaphyseal extension 36 of epiphyseal bone fragment 32 shown in FIG 2, with the respective profile of another segmental member (not shown) for partial diaphyseal reconstruction.

[0103] Second subpart moiety 42B of segmental member 40 further comprises a pair of essentially planar flanking faces 50C and 50D. Flanking faces 50C and 50D are configured to adjoin flanking faces of a respective epiphyseal bone fragment, such as flanking face 33 of epiphyseal bone fragment 32 shown in FIG 2, and / or a flanking face of another segmental member (not shown) for complete diaphyseal reconstruction, and / or the combination of a distal face of a diaphyseal extension, such as the distal face diaphyseal extension 36 of epiphyseal bone fragment 32 shown in FIG 2, with a respective flanking face of another segmental member (not shown) for partial diaphyseal reconstruction.

[0104] In some embodiments, first subpart moiety 42B of segmental member 40 further comprises at least two structural elements 52B. Structural elements 52B are operationally connectable by fasteners 54. In some examples, structural elements 52B are through apertures including any types of apertures penetrating through first subpart moiety 42B.

[0105] In some embodiments, segmental member 40 for complete diaphyseal reconstruction comprises at least two fasteners 54. Fasteners 54 are operationally connectable to structural elements 52A and 52B of first and second subpart moieties 42Aand 42B.

[0106] In some preferred embodiments, at least one of fasteners 54 are selfinterlocking type, such as in a non-limiting manner: a locking screw readily securable in a lock nut, a conical screw threading facilitating rapid the insertion of the screw, threaded locking screws, bolt screws with thread-lock, head screw securable by a sleeve nut, a ratcheting mechanism with a pawl, etc.

[0107] In some embodiments, fasteners 54 comprise an assembly of parts, such as bolt and nut. In some embodiments, at least one of fasteners 54 is integral to first and / or second subpart moieties 42A and 42B. In some embodiments, at least one of fasteners 54 and / or parts or portions thereof is / are integral or monolithic with first and / or second subpart moieties 42A and 42B.

[0108] In some embodiments, flanking faces 50A and 50B of first subpart moiety 42A comprise a pair of respective longitudinal locking trunnions 56A and 56B and pair of respective apertures 58A and 58B. Longitudinal locking trunnion 56A on flanking face 50A of segmental member 40 is insertable into aperture 58B of planar flanking face 50B of another segmental member, adjoined to segmental member 40, whereas longitudinal locking trunnion 56B of planar face 50B of another segmental member, adjoined to segmental member 40, is insertable into aperture 58A of flanking face 50A of segmental member 40, thereby preventing rotation of segmental member 40, relative to another segmental member adjoined to segmental member 40.

[0109] In some embodiments, flanking faces 50C and 50D of second subpart moiety 42B comprise a pair of respective longitudinal locking trunnions 56C and 56D and pair of respective apertures 58C and 58D. Longitudinal locking trunnion 56C on flanking face 50C of segmental member 40 is insertable into aperture 58D of planar flanking face 50D of another segmental member, adjoined to segmental member 40, whereas longitudinal locking trunnion 56D of flanking face 50D of another segmental member, adjoined to segmental member 40, is insertable into aperture 58C of flanking face 50C of segmental member 40, thereby preventing rotation of segmental member 40, relative to another segmental member adjoined to segmental member 40.

[0110] In some embodiments, segmental member 40 is configured to assume a closed configuration, in which first and second subpart moieties 42A and 42B are fastened one to another by fasteners 54, so that respective interlockable faces 46A and 46B of first and second subpart moieties 42A and 42B are adjoined one to another, whereas semi-cylindrically shaped interior faces 44A and 44B of first and second subpart moieties 42A and 42B are engageable to intramedullary nail 30, thereby rendering segmental members 40 readily connectable onto intramedullary nail 30.

[0111] In accordance with some embodiments of the present invention, reference is now made to FIG 4A to 4C, respectively showing perspective, top and side views of segmental member 60 of intercalary endoprosthetic placeholder, configured for partial diaphyseal reconstruction of a bone after segmental skeletal resection of the diaphyseal portion of the bone, in a closed configuration. Segmental member 60 for partial diaphyseal reconstruction is readily connectable onto an intramedullary nail, such as standard intramedullary nail 30 shown in FIG 2. The particular segmental member 60 for partial diaphyseal reconstruction of the embodiment of FIG 4A to 4C illustrates various features and / or elements that may be interchangeable with features and / or elements of any other embodiment described in the specification.

[0112] In some embodiments, segmental member 60 for partial diaphyseal reconstruction comprises first subpart moiety 62A. First subpart moiety 82 is essentially smaller than that of first d subpart moiety 42A shown in FIG 3A to 3C, accommodating the presence of a diaphyseal extension on an epiphyseal bone fragment, such as diaphyseal extension 36 of epiphyseal bone fragment 34 shown in FIG 2. First subpart moiety 62A comprises semi-cylindrically shaped interior face 64A. Semi-cylindrically shaped interior face 64A is configured to engage to intramedullary nail 30.

[0113] In some embodiments, first subpart moiety 62A of segmental member 60 further comprises interlockable face 66A. Interlockable face 66A is configured to engage to a portion of respective interlockable face 66B of counterpart subpart moiety 62B. In some embodiments, first subpart moiety 62A of segmental member 60 for partial diaphyseal reconstruction further comprises at least two structural elements, operationally connectable to fasteners 74.

[0114] In some embodiments, segmental member 60 for partial diaphyseal reconstruction comprises second subpart moiety 62B. Second subpart moiety 62B of segmental member 60 is typically essentially similar to second subpart moiety 42B shown in FIG 3A to 3C. Second subpart moiety 62B of segmental member 60 comprises semi- cylindrically shaped interior face 64B. Semi-cylindrically shaped interior face 64B is configured to engage to intramedullary nail 30.

[0115] In some embodiments, second subpart moiety 62B of segmental member 60further comprises interlockable face 66B. A portion of interlockable face 66B is configured to engage to respective interlockable face 66A of first subpart moiety 62A. A portion of interlockable face 66B is configured to engage to the respective longitudinal faces of a diaphyseal extension, such as longitudinal faces 37 of diaphyseal extension 36 on epiphyseal bone fragment 34 shown in FIG 2.

[0116] In some embodiments, second subpart moiety 62B of segmental member 60 further comprises exterior circumferential face 68. Exterior circumferential face 68 is configured to approximately match an exterior profile of a respective epiphyseal recession, such as epiphyseal recession 38 on epiphyseal bone fragment 34 shown in FIG 2, and / or with the respective profile of another segmental member (not shown) for partial and / or compete diaphyseal reconstruction.

[0117] In some embodiments, second subpart moiety 62B of segmental member 60 further comprises a pair of essentially planar flanking faces, such as planar flanking face 70A. It should be acknowledged that since segmental member 60 is configured for partial diaphyseal reconstruction, the flanking faces, such as planar flanking face 70A, are configured to adjoin partial flanking faces of a respective epiphyseal bone fragment, such as proximal flanking face 39 of epiphyseal recession 38 of epiphyseal bone fragment 34 shown in FIG 2, and / or to the respective flanking face of another segmental member (not shown) for partial and / or complete diaphyseal reconstruction.

[0118] In some embodiments, second subpart moiety 62B of segmental member 60 further comprises at least two structural elements 72. At least two structural elements 72 are operationally connectable to fasteners. In some examples, at least two structural elements 72 are through apertures including any types of orifices penetrating first subpart moiety 62B.

[0119] In some embodiments, segmental member 60 for partial diaphyseal reconstruction comprises at least two fasteners 74. Fasteners 74 are operationally connectable to structural elements of respectively first and second subpart moieties 62A and 62B. Fasteners 74 are typically essentially similar to fasteners 54 shown in FIG 3A to 3C.

[0120] In some embodiments, the flanking faces, such as planar flanking face 70A, of second-part moiety 62B comprise a pair of longitudinal locking trunnions 76A and 76B and pair of apertures, such as aperture 78A. Longitudinal locking trunnion 76A of planar flanking face 70A of segmental member 60 is insertable into the respective aperture of aplanar flanking face of another segmental member (not shown), adjoined to segmental member 60; whereas longitudinal locking trunnion 76B of another segmental member (not shown), adjoined to segmental member 60, is insertable into aperture 78A of planar flanking face 70A of segmental member 60, thereby preventing rotation of segmental member 60, relative to another segmental member adjoined to segmental member 60.

[0121] It should be acknowledged that any one of trunnions 76A or 76B of segmental member 60 shown in FIG 4A to 4D, trunnions 56A, 56B, 56C or 56D of segmental member 40 shown in FIG 3A to 3C, as well as for that matter any other locking trunnions disclosed in this specification are merely optional. It should be acknowledged that any locking trunnion disclosed in this specification is optionally modular and / or retrievable, such as a pin insertable into aperture. Locking trunnion is optionally absent in terminal segmental members, namely segmental members the flanking faces of which, such as flanking faces 50A and 50C or 50B and 50D of segmental member 40 shown in FIG 3A to 3D or flanking face 70A of segmental member 60 shown in FIG 4A to 4C, facing towards the face of a bone fragment, such as flanking face 33 of epiphyseal bone fragment 32 shown in FIG 2, and / or the proximal face epiphyseal recession 38 of epiphyseal bone fragment 32 shown in FIG 2.

[0122] In some embodiments, each segmental member 60 is configured to assume a closed configuration, in which first and second subpart moieties 62A and 62B are fastened one to another by fasteners 74, so that interlockable faces 66A and 66B of respectively first and second subpart moieties 62A and 62B are adjoined one to another, whereas semi- cylindrically shaped interior faces 64A and 64B of respectively first and second subpart moieties 62A and 62B are engaged to intramedullary nail 30, thereby rendering each segmental member 60 readily connectable onto intramedullary nail 30.

[0123] In accordance with some embodiments of the present invention, reference is now made to FIG 5A to 5C, respectively showing perspective, top and side views of segmental member 80 of intercalary endoprosthetic placeholder, configured for complete diaphyseal reconstruction of a bone after segmental skeletal resection of the diaphyseal portion of the bone, in an exploded open configuration. Segmental member 80 for complete diaphyseal reconstruction is readily connectable onto an intramedullary nail, such as standard intramedullary nail 30 shown in FIG 2. The particular segmental member 80 for partial diaphyseal reconstruction of the embodiment of FIG 5A to 5C illustrates various features and / or elements that may be interchangeable with features and / or elements of any other embodiment described in the specification.

[0124] In some embodiments, segmental member 80 for complete diaphyseal reconstruction comprises first and second subpart moieties 82A and 82B, comprising semi- cylindrically shaped interior faces 84A and 82B, configured to engage to intramedullary nail 30. In some embodiments, first and second subpart moieties 82A and 82B of segmental member 80 are typically essentially similar to first and second subpart moieties 42A and 42B shown in FIG 3A to 3C.

[0125] In some embodiments, first and second subpart moieties 82A and 82B of segmental member 80 further comprise interlockable faces 86A and 86B, configured to engage one to another, as well as exterior circumferential faces 88A and 88B, configured to approximately match an exterior profile of a respective epiphyseal bone fragment and / or another segmental member 80 for complete diaphyseal reconstruction.

[0126] In some embodiments, first subpart moiety 82A of segmental member 80 further comprises a pair of essentially planar flanking faces, such as face 90A; whereas second subpart moiety 82B of segmental member 80 comprises a pair of essentially planar flanking faces, such as face 90C. The flanking faces 90A and 90C are configured to adjoin flanking faces of a respective epiphyseal bone fragment, such as flanking face 33 of epiphyseal bone fragment 32 shown in FIG 2, and / or a flanking face of another segmental member (not shown) for complete reconstruction, and / or the combination of a distal face of a diaphyseal extension, such as the distal face diaphyseal extension 36 of epiphyseal bone fragment 32 shown in FIG 2, with a respective flanking face of another segmental member (not shown) for partial diaphyseal reconstruction.

[0127] In some embodiments, segmental member 80 for partial diaphyseal reconstruction comprises at least two fasteners 94. Fasteners 94 are operationally connectable to structural elements of respectively first and second subpart moieties 82A and 82B. Fasteners 94 are typically essentially similar to fasteners 54 shown in FIG 3A to 3C.

[0128] In some embodiments, the flanking faces, such as planar flanking faces 90A and 90C of first and second subpart moieties 82A and 82B of segmental member 80 further comprise a pair of longitudinal locking trunnions 76A and 76C as well as 96B and 96D. In some embodiments, the flanking faces, such as planar flanking faces 90A and 90C of first and second subpart moieties 82A and 82B of segmental member 80 further comprise a pair of apertures, such as aperture 98A and 98C. Longitudinal locking trunnion 96A of planar flanking face 90A of segmental member 80 is insertable into the respective aperture of a planar flanking face of another segmental member (not shown), adjoined to segmentalmember 80; whereas longitudinal locking trunnion 96B, on the opposite planar flanking face of another segmental member (not shown), adjoined to segmental member 80, is insertable into aperture 98A of planar flanking face 90A of segmental member 90, thereby preventing rotation of segmental member 80, relative to another segmental member adjoined to segmental member 80.

[0129] In some embodiments, each segmental member 80 is configured to assume a closed configuration, in which first and second subpart moieties 82A and 82B are fastened one to another by fasteners 94, so that interlockable faces 86A and 86B of respectively first and second subpart moieties 82A and 82B are adjoined one to another, whereas semi- cylindrically shaped interior faces 84A and 84B of respectively first and second subpart moieties 82A and 82B are engaged to intramedullary nail 30, thereby rendering each segmental member 80 connected onto intramedullary nail 30. In some embodiments, segmental member 80 is configured to assume an open configuration, in which first and second subpart moieties 82A and 82B are spaced apart one from another, thereby rendering each segmental member 80 disengaged from intramedullary nail 30.

[0130] In accordance with some embodiments of the present invention, reference is now made to FIG 6A and 6B, respectively showing perspective and side views of segmental member 100 of intercalary endoprosthetic placeholder, configured for complete diaphyseal reconstruction of a bone after segmental skeletal resection of the diaphyseal portion of the bone, in a rotatably open configuration. Segmental member 100 for complete diaphyseal reconstruction is readily connectable onto an intramedullary nail, such as standard intramedullary nail 30 shown in FIG 2. The particular segmental member 100 for partial diaphyseal reconstruction of the embodiment of FIG 6A and 6B illustrates various features and / or elements that may be interchangeable with features and / or elements of any other embodiment described in the specification.

[0131] In some embodiments, segmental member 100 for complete diaphyseal reconstruction comprises first and second subpart moieties 102A and 102B, comprising semi-cylindrically shaped interior faces 104A and 104B, configured to engage to intramedullary nail 30. In some embodiments, first and second subpart moieties 102A and 102B of segmental member 100 are typically essentially similar to first and second subpart moieties 42A and 42B shown in FIG 3A to 3C.

[0132] In some embodiments, first and second subpart moieties 102A and 102B of segmental member 100 further comprise interlockable faces 106A and 106B, configured to engage one to another, as well as exterior circumferential faces 108A and 108B, configuredto approximately match an exterior profile of a respective epiphyseal bone fragment and / or another segmental member 100 for complete diaphyseal reconstruction.

[0133] In some embodiments, first subpart moiety 102A of segmental member 100 further comprises a pair of essentially planar flanking faces, such as face 110A; whereas second subpart moiety 102B of segmental member 100 comprises a pair of essentially planar flanking faces, such as face 110C. Flanking faces 110A and 110C are configured to adjoin flanking faces of a respective epiphyseal bone fragment, such as flanking face 33 of epiphyseal bone fragment 32 shown in FIG 2, and / or a flanking face of another segmental member (not shown) for complete diaphyseal reconstruction, and / or the combination of a distal face of a diaphyseal extension, such as the distal face of diaphyseal extension 36 of epiphyseal bone fragment 32 shown in FIG 2, with a respective flanking face of another segmental member (not shown) for partial diaphyseal reconstruction.

[0134] In some embodiments, first and second subpart moieties 102A and 102B of segmental member 100 further comprise at least one structural element 112A and 112B connectable to fastener 114. In some embodiments, segmental member 100 for partial diaphyseal reconstruction comprises at least one fastener 114. Fastener 114 is operationally connectable to structural elements of respectively first and second subpart moieties 102A and 102B. Fastener 114 is typically essentially similar to fasteners 54 shown in FIG 3A to 3C.

[0135] In some embodiments, the flanking faces, such as flanking faces 110A and 110C of first and second subpart moieties 102A and 102B of segmental member 100 further comprise a pair of longitudinal locking trunnions 116A and 116C, as well as a pair of apertures, such as aperture 118A and 118C. Longitudinal locking trunnion 116A of planar flanking face 110A of segmental member 100 is insertable into the respective aperture of a planar flanking face of another segmental member (not shown), adjoined to segmental member 100; whereas the longitudinal locking trunnion, on the opposite planar flanking face of another segmental member (not shown), adjoined to segmental member 100, is insertable into aperture 118A of planar flanking face 100A of segmental member 100, thereby preventing rotation of segmental member 100, relative to another segmental member adjoined to segmental member 100.

[0136] In some embodiments, segmental member 100 for complete diaphyseal reconstruction comprises a hinge mechanism configured for connecting first subpart moiety 102A to second subpart moiety 102B. First subpart moiety 102A of segmental member 100 comprises at least one hinge element 120A. Second subpart moiety 102B of segmentalmember 100 comprises at least one structural hinge element 120B. At least one hinge element 120A of first subpart moiety 102A is configured to form operational connection with a respective hinge element 120B of second subpart moiety 102B.

[0137] In some embodiments, the segmental member hinge further comprises an interconnecting component operationally connecting hinge element 120A of first subpart moiety 102Ato hinge element 120B of second subpart moiety 102B. In some embodiments, hinge element 120A of first subpart moiety 102A is of a self-interlocking type with hinge element 120B of second subpart moiety 102B, such as a spherical member insertable into a matching semi-spherical recess.

[0138] In some embodiments, segmental member 100 for complete diaphyseal reconstruction is configured to assume an angularly open configuration. Segmental member 100 angularly opened up, allowing first subpart moiety 102A to move away from second subpart moiety 102B in the direction of arrow 122, thereby rendering first and second subpart moieties 102A and 102B readily appendable to and conveniently mountable onto intramedullary nail 30, while essentially connected one to another.

[0139] In some embodiments, the operational connection between first and second subpart moieties 102A and 102B is characterized by at least one degree of freedom in movement of subpart moieties 102A and 102B one relative to another, whilst first and second subpart moieties 132A and 132B remain essentially connected together. The degree of freedom in movement of segmental member 100 comprises the freedom of angularly displacing first and second subpart moieties 102A and 102B one relative to another, so that interlockable faces 106A and 106B, of first and second subpart moieties 102A and 102B, form an angle one relative to another, ranging between 15 and 270 degrees.

[0140] In accordance with some embodiments of the present invention, reference is now made to FIG 7A and 7B, respectively showing perspective and side views of segmental member 130 of intercalary endoprosthetic placeholder, configured for complete diaphyseal reconstruction of a bone after segmental skeletal resection of the diaphyseal portion of the bone, in a rotatably open configuration. Segmental member 130 for complete diaphyseal reconstruction is readily connectable onto an intramedullary nail, such as standard intramedullary nail 30 shown in FIG 2. The particular segmental member 130 for partial diaphyseal reconstruction of the embodiment of FIG 7A and 7B illustrates various features and / or elements that may be interchangeable with features and / or elements of any other embodiment described in the specification.

[0141] In some embodiments, segmental member 130 for complete diaphyseal reconstruction comprises first and second subpart moieties 132A and 132B, comprising semi-cylindrically shaped interior faces 134A and 134B, configured to engage to intramedullary nail 30. In some embodiments, first and second subpart moieties 132A and 132B of segmental member 130 are typically essentially similar to first and second subpart moieties 42A and 42B shown in FIG 3A to 3C.

[0142] In some embodiments, first and second subpart moieties 132A and 132B of segmental member 130 further comprise interlockable faces 136A and 136B, configured to engage one to another, as well as exterior circumferential faces 138A and 138B, configured to approximately match an exterior profile of a respective epiphyseal bone fragment and / or another segmental member 130 for complete diaphyseal reconstruction.

[0143] In some embodiments, first subpart moiety 132A of segmental member 130 further comprises a pair of essentially planar flanking faces, such as face 140A; whereas second subpart moiety 132B of segmental member 130 comprises a pair of essentially planar flanking faces, such as face 140C. Flanking faces 140A and 140C are configured to adjoin flanking faces of a respective epiphyseal bone fragment, such as flanking face 33 of epiphyseal bone fragment 32 shown in FIG 2, and / or a flanking face of another segmental member (not shown) for complete diaphyseal reconstruction, and / or the combination of a distal face of a diaphyseal extension, such as the distal face of diaphyseal extension 36 of epiphyseal bone fragment 32 shown in FIG 2, with a respective flanking face of another segmental member (not shown) for partial diaphyseal reconstruction.

[0144] In some embodiments, first and second subpart moieties 132A and 132B of segmental member 130 further comprise at least one structural element 142A and 142B connectable to fastener 144. In some embodiments, segmental member 130 for partial diaphyseal reconstruction comprises at least one fastener 144. Fastener 144 is operationally connectable to structural elements of respectively first and second subpart moieties 132A and 132B. Fastener 144 is typically essentially similar to fasteners 54 shown in FIG 3A to 3C.

[0145] In some embodiments, the flanking faces, such as planar flanking faces 140A and 140C of first and second subpart moieties 132A and 132B of segmental member 130 further comprise a pair of longitudinal locking trunnions 146A and 146C, as well as a pair of apertures, such as aperture 148A and 148C. Longitudinal locking trunnion 146A of planar flanking face 140A of segmental member 130 is insertable into the respective aperture of a planar flanking face of another segmental member (not shown), adjoined to segmentalmember 130; whereas the longitudinal locking trunnion, on the opposite planar flanking face of another segmental member (not shown), adjoined to segmental member 130, is insertable into aperture 148A of planar flanking face 130A of segmental member 130, thereby preventing rotation of segmental member 130, relative to another segmental member adjoined to segmental member 130.

[0146] In some embodiments, segmental member 130 for complete diaphyseal reconstruction comprises a hinge mechanism configured for connecting first subpart moiety 132A to second subpart moiety 132B. First subpart moiety 132A of segmental member 130 comprises an at least one hinge element. Second subpart moiety 132B of segmental member 130 comprises at least one structural hinge element 150B. The at least one hinge element of first subpart moiety 132A is configured to form operational connection with a respective hinge element 150B of second subpart moiety 132B.

[0147] In some embodiments, the segmental member hinge further comprises an interconnecting component operationally connecting the hinge element of first subpart moiety 132Ato hinge element 150B of second subpart moiety 132B. In some embodiments, the hinge element of first subpart moiety 132A is of a self-interlocking type with hinge element 150B of second subpart moiety 132B, such as a spherical member insertable into a matching semi-spherical recess.

[0148] In some embodiments, segmental member 130 for complete diaphyseal reconstruction is configured to assume a rotatably open configuration. Segmental member 130 rotatably opens aside, rotating first subpart moiety 132A away from second subpart moiety 132B in the direction of arrow 152.

[0149] In some embodiments, the operational connection between first and second subpart moieties 132A and 132B is characterized by at least one degree of freedom in movement of subpart moieties 132A and 132B one relative to another, whilst first and second subpart moieties 132A and 132B remain essentially connected together. The degree of freedom in movement of segmental member 130 comprises the freedom of rotatably moving first and second subpart moieties 132A and 132B one relative to another, while interlockable faces 136A and 136B of first and second subpart moieties 132A and 132B remain essentially paralleling, thereby rendering segmental member 130 readily appendable to and conveniently mountable onto intramedullary nail 30.

[0150] In accordance with some embodiments of the present invention, reference is now made to FIG 8, showing a partial perspective view of exemplary assembly of modularintercalary endoprosthetic placeholder 180, on intramedullary nail 30 anchored into epiphyseal bone fragment 34, shown in FIG 2, and segmental member 60 for partial diaphyseal reconstruction in a closed configuration, connected onto intramedullary nail 30. FIG 8 illustrating the process of assembling modular intercalary endoprosthetic placeholder 180 for partial diaphyseal reconstruction. The process of assembling modular intercalary endoprosthetic placeholder 180 for partial diaphyseal reconstruction illustrated on FIG 8 shows various features and / or elements that may be interchangeable with features and / or elements of any other embodiment described in the specification.

[0151] In some embodiments, segmental member 60 for partial diaphyseal reconstruction, shown in FIG 4A to 4C, comprises a first subpart moiety and second subpart moiety 62B. Second subpart moiety 62B of segmental member 60 comprises interlockable face 66B facing the longitudinal faces of the diaphyseal extension 36, such as longitudinal faces 37 of diaphyseal extension 36, shown on FIG 2, and semi-cylindrically shaped interior face 64B engaging to intramedullary nail 30.

[0152] One flanking face of segmental member 60, such as flanking face 70A of segmental member 60, for partial diaphyseal reconstruction, shown in FIG 4A to 4C, faces towards and is adjoined to a partial flanking face of epiphyseal bone fragment 34, such as proximal flanking face 39 of epiphyseal recession 38 of epiphyseal bone fragment 34 shown in FIG 2.

[0153] Flanking face 70B of segmental member 60 faces towards and is configured to adjoin to the flanking face of another segmental member (not shown), such as segmental member 40 for complete diaphyseal reconstruction, shown in FIG 3A to 3D.

[0154] In accordance with some embodiments of the present invention, reference is now made to FIG 9, showing a perspective view of exemplary assembly 180 of intramedullary nail 30 anchored into epiphyseal bone fragments 32 and 34, segmental members 40A, 40B, 40C and 40D for complete diaphyseal reconstruction, segmental member 60 for partial diaphyseal reconstruction, in a closed configuration radially connected onto intramedullary nail 30, as well as segmental member 100 for complete diaphyseal reconstruction, in an open configuration, radially appendable to intramedullary nail 30. Any features and / or elements of the embodiment of FIG 8 may be interchangeable with features and / or elements of any other embodiment described in the specification.

[0155] In some embodiments, segmental members 40A, 40B, 40C and 40D are in a closed configuration, in which first and second subpart moieties 42A and 42B of each oneof segmental members 40A, 40B, 40C and 40D are fastened one to another by fasteners 54, so that interlockable faces thereof, such as interlockable faces 46A and 46B shown in FIG 3A to 3D, of first and second subpart moieties 42A and 42B facing each other; whereas semi-cylindrically shaped interior faces thereof, such as semi-cylindrically shaped interior faces 44A and 44B shown in FIG 3A to 3D of first and second subpart moieties 42A and 42B are engaged to intramedullary nail 30. Segmental members 40A, 40B, 40C and 40D are mounted onto intramedullary nail 30. In some embodiments, segmental members 40A, 40B, 40C and 40D are essentially similar to segmental member 40, shown in FIG 3A to 3D. In some embodiments, segmental member 60 is essentially similar to segmental member 60, shown in FIG 4A to 4C.

[0156] FIG 9 further shows exemplary segmental member 100 of assembly 180 in an open configuration. In some embodiments, segmental member 100 for complete diaphyseal reconstruction is configured to assume an angularly open configuration. In some embodiments, segmental member 100 is essentially similar to segmental member 100, shown in FIG 6A and 6B. Segmental member 100 angularly opens allowing first subpart moiety 102A to move away from second subpart moiety 102B in the direction of arrow 200.

[0157] In some embodiments, first and second subpart moieties 102A and 102B of segmental member 100 are radially appendable to intramedullary nail 30 whilst being essentially connected to each other by the hinge and secured by fastener 114.

[0158] Any segmental members described in this specification are preferably provided as a kit-of-parts, where each part is single-packed and presterilized. The kit-of- parts optionally comprises first and second subpart moieties of segmental members. The kit-of-parts optionally includes different sizes and thickness of first and second subparts.

[0159] In accordance with some embodiments of the present invention, reference is now made to FIG 13A to 15B, showing assembly 300 for prosthetic reconstruction of long bone defects. Any features and / or elements of the embodiment of FIG 13A to 15B may be interchangeable with features and / or elements of any other embodiment described in the specification.

[0160] In some embodiments, assembly 300 comprises intramedullary nail 30. In one embodiment, such as shown in FIG 13A and 13B, both flanking portions 302A and 302B of intramedullary nail 30 are anchored within two respective epiphyseal fragments 304A and 304B of a bone.

[0161] In another embodiments, such as shown in FIG 14A and 14B, first flankingportion 302A of intramedullary nail 30 is anchored within distal epiphyseal fragment 304A of a bone, whereas second flanking portion 302B is configured to connect to proximal epiphyseal fragment reconstruction artificial implant 306.

[0162] In another embodiment, such as shown in FIG 15A and 15B, first flanking portion 302A is anchored within proximal epiphyseal fragment 304B of a bone, whereas second flanking portion 302B is configured to connect to distal epiphyseal fragment reconstruction artificial implant 308.

[0163] In some embodiments, such as shown in FIG 14Ato 15B, proximal epiphyseal fragment reconstruction artificial implant 306 and / or distal epiphyseal fragment reconstruction artificial implant 308, are readily connectable onto intramedullary nail 30.

[0164] In some embodiments, as shown in FIG 13B, assembly 300 further includes at least one segmental member 310 for complete diaphyseal reconstruction and / or at least one segmental member 310 for partial reconstruction, each configured to assume a longitudinal segment of a diaphyseal absent portion of the bone.

[0165] In some embodiments, each segmental member 310 comprises a first subpart moiety. The subpart moieties comprise a semi-cylindrically shaped interior face configured to engage intramedullary nail 30. In some embodiments, the subpart moieties further comprise an interlockable face, an exterior circumferential face, essentially planar flanking faces and / or at least one structural element operationally connectable to a fastener.

[0166] In some embodiments, each of the segmental members is configured to assume an open configuration, in which the first and second subpart moieties are spaced apart, and a closed configuration, in which the first and second subpart moieties are fastened one to another so that the interlockable faces are engaged and the semi- cylindrically shaped interior faces are engaged to intramedullary nail 30.In some embodiments, an exterior surface of intramedullary nail 30 comprises at least one structural element, configured to form a firm connection with an interior face of at least one epiphyseal fragment reconstruction artificial implant 306 and / or 308.

[0167] In some embodiments, an interior face of at least one epiphyseal fragment reconstruction artificial implant / s, such as reconstruction artificial implant / s 306 and / or 308 shown in FIG 14A to 15B, comprises at least one structural element configured to form a firm connection with an exterior surface of intramedullary nail 30. In some embodiments, such as shown in FIG 13B, an interior face of the subpart moieties and an exterior surface of intramedullary nail 30 form an interlocking arrangement.

[0168] In some examples, at least one epiphyseal fragment reconstruction artificial implant comprises an internal female taper that receives the respective flanking portion of intramedullary nail 30, forming a Morse taper junction. In other examples, a ring-nut housed in at least one epiphyseal fragment reconstruction artificial implant advances in a locking direction and draws the opposed taper faces into rigid contact. The taper engagement establishes axial seating and rotational indexing, while a positive stop within at least one epiphyseal fragment reconstruction artificial implant limits insertion depth.

[0169] In another example, at least one epiphyseal fragment reconstruction artificial implant comprises a bayonet receptacle operationally connectable to a complementary male bayonet structure on the respective flanking portion of intramedullary nail 30. In some examples, axial insertion continues until bayonet lugs contact an internal stop element that defines the insertion depth. Such an interface enables rapid assembly with indexed orientation and does not require screw threading into bone.

[0170] In yet another example, at least one epiphyseal fragment reconstruction artificial implant comprises a keyed spline bore and the flanking portion of intramedullary nail 30 comprises a complementary terminal dowel. Axial insertion of the terminal dowel into the keyed bore establishes rotational indexing and prevents relative torsion. A draw bolt is optionally seated within at least one epiphyseal fragment reconstruction artificial implant, engages a blind internal thread of flanking portion and advances to clamp with at least one epiphyseal fragment reconstruction artificial implant.In still another example, at least one epiphyseal fragment reconstruction artificial implant comprises transverse pin bores dimensioned for alignment with at least one transverse locking aperture of a flanking portion of the nail. In some examples, cross-pins are advanced through pre-drilled metaphyseal tunnels of the epiphyseal fragment and through the aligned features of the flanking portion of the nail, so as to create a pin-locked arrangement. The pin-locked arrangement provides shear resistance and rotational control while intramedullary nail 30 carries axial load.WORKING EXAMPLES

[0171] Example 1 - Implantation of intramedullary nail, prior to the installation of the intercalary segmental endoprosthetic placeholder

[0172] FIG 10A to 10D show images of a working example of the intramedullary nail for the intercalary segmental endoprosthetic placeholder of the present invention. An exemplary intramedullary nail 200 was implanted into respective epiphyseal femoral fragments 202A and 202B. Intramedullary nail 200 is shown between two respective epiphyseal bone fragments 202A and 202B of a bone and was fixed with at least one screw 204, wherein a part of at least one nail passes through intramedullary nail 200 via the apertures.

[0173] A female 72 year old patient was diagnosed with a pathological fracture, due to an echinococcal cyst of right femoral diaphysis. The 72 years old female patient underwent surgery on 1 January 2020. The surgical procedure included an intercalary resection of femoral diaphysis, a reconstruction of the latter with Trigen Meta-Tan(R) antegrade trochanteric intramedullary nail 200 and interlocking screws 204 (Smith and Nephew), as shown in FIG 10A to 10C.

[0174] A female 61 year old patient was diagnosed with pathological insufficiency fracture through irradiated bone of left proximal femur and S / P intercalary resection of diaphyseal metastatic carcinoma of cervix. The 61 years old patient was scheduled for reconstruction with cemented intramedullary nail and postoperative radiation therapy. The 61 years old patient underwent surgery on 29 July 2020. The surgical procedure included a removal of broken implant, an intercalary resection of femoral diaphysis, a reconstruction with Trigen Meta-Tan(R) antegrade trochanteric intramedullary nail 200 and interlocking screws 204 (Smith and Nephew).

[0175] Example 2 - An experimental segmental member of intercalary endoprosthetic placeholder

[0176] FIG 11 shows an exemplary segmental member 206 of intercalary endoprosthetic placeholder. Exemplary segmental members 206 included first subpart moiety 208A and second subpart moiety 208B connected by hinge 210. First subpart moiety 208A of exemplary segmental member 206 included interlockable face 212A and semi- cylindrically shaped interior face 214A, whereas second subpart moiety 208B of exemplary segmental members 206 included interlockable 212B face and semi-cylindrically shaped interior face 214B. Segmental member 206 for complete diaphyseal reconstruction wasreadily connectable onto intramedullary nail 200 shown in FIG 10A to 10D.

[0177] Segmental member 206 shown in FIG 11 was made of Titanium Ti64Gr5. Segmental member 206 shown in FIG 11 has been manufactured by an OS M-290 3D printer. A plurality of segmental members, such as segmental member 206 shown in FIG 11, have been manufactured from the material and by the means of set forth supra.

[0178] Example 3 - An experimental assembly of intercalary endoprosthetic placeholder

[0179] FIG 12A to 12D show images of a working example of an assembly of intercalary endoprosthetic placeholder of the present invention. A plurality of exemplary segmental members 206A, 206B, 206C has been mounted onto intramedullary nail 200 in situ, to form the intercalary segmental endoprosthetic placeholder, during the surgery on the 72 years old patient. The reconstruction of the femoral diaphysis was performed with intramedullary nail 200 and screws 204 as well as with plurality of segmental members 206A, 206B and 206C shown in FIG 12A and 12B. The cavities and / or pores of segmental members 206A, 206B and 206C were filled with autologous iliac bone graft.

[0180] One year and 31 days after surgery on the 72 years old patient, ambulation with full weight-bearing on the operated lower extremity and a stable construct with massive bone formation 218 were observed, as shown in FIG 12C and 12D.

[0181] A plurality of exemplary segmental members has been mounted onto the intramedullary nail in situ, to form the intercalary segmental endoprosthetic placeholder, during the surgery on the 61 years old patient.

[0182] Seven months and 16 days after surgery on the 61 years old female patient, ambulation with full weight-bearing on the operated lower extremity, a stable construct, radiological evidence of initial bone formation around the construct, attributed to the poor blood supply to the heavily irradiated surgical field, were observed.

[0183] It will be appreciated by persons skilled in the art that the present invention is not limited by what has been particularly shown and described herein above. Rather the scope of the invention is defined by the claims which follow:

Claims

CLAIMS1 . An assembly of modular intercalary endoprosthetic placeholder comprises:(a) an intramedullary nail, wherein flanking portions of said intramedullary nail are anchored within two respective epiphyseal fragments of a bone, wherein diaphyseal portion of said bone is at least partially absent and wherein respective portion of said intramedullary nail is exposed;(b) a plurality of segmental members selected from the group consisting of: at least one segmental member for complete diaphyseal reconstruction and at least one segmental member for partial reconstruction; wherein each one of said segmental members configured to assume a longitudinal segment of a diaphyseal absent portion of said bone; wherein each one of said segmental members comprising:(I) a first subpart moiety comprising:(i) a semi-cylindrically shaped interior face, configured to engage to said intramedullary nail;(ii) an interlockable face, configured to engage to a respective interlockable face of a counterpart moiety;(iii) an exterior circumferential face, configured to approximately match an exterior profile of a respective epiphyseal bone fragment;(iv) a pair of essentially planar flanking faces, configured to adjoin flanking faces of said respective epiphyseal bone fragment and / or another segmental member;(v) at least one structural element operationally connectable to a fastener;(II) a second subpart moiety comprising:(i) a semi-cylindrically shaped interior face, configured to engage to said intramedullary nail;(ii) an interlockable face, configured to engage to a respective interlockable face of a counterpart moiety;(iii) at least one structural element operationally connectable to a fastener; wherein each one of said plurality of segmental members is configured to assume a configuration selected from the group consisting of:(iv) an open configuration, wherein said first and second subpart moieties are spaced apart one from another;(v) a closed configuration, wherein said first and second subpart moieties arefastened one to another by at least one fastener, so that said interlockable faces of said first and second subpart moieties are engaged one to another and said semi-cylindrically shaped interior faces of said first and second subpart moieties are engaged to said intramedullary nail; wherein said segmental members are readily connectable onto said intramedullary nail.

2. The assembly of modular intercalary endoprosthetic placeholder, as in claim 1 , further comprises at least one fastener operationally connectable to said structural elements of said first and second subpart moieties.

3. The assembly of modular intercalary endoprosthetic placeholder, as in any one of the claims 1 or 2, wherein said segmental members comprise a longitudinal locking trunnion.

4. The assembly of modular intercalary endoprosthetic placeholder, as in any one of the claims 1 to 3, wherein said segmental members comprise a porous matrix.

5. The assembly of modular intercalary endoprosthetic placeholder, as in any one of the claims 1 to 4, wherein said segmental members comprise an osteogenesis promoting substance.

6. The assembly of modular intercalary endoprosthetic placeholder, as in any one of the claims 1 to 5, wherein said at least one fastener is of a self-interlocking type.

7. The assembly of modular intercalary endoprosthetic placeholder, as in claim 6, wherein said at least one fastener is integral to at least one of said first and second subpart moieties.

8. The assembly of modular intercalary endoprosthetic placeholder, as in any one of the claims 1 to 7, wherein an operational connection between said first and second subpart moieties is characterized by at least one degree of freedom in movement of said subpart moieties one relative to another, while said subpart moieties remain essentially connected one to another.

9. The assembly of modular intercalary endoprosthetic placeholder, as in any one of the claims 1 to 8, wherein said first and second subpart moieties of said plurality of segmental members are readily appendable to and thereby conveniently mountable onto said intramedullary nail.

10. The assembly of modular intercalary endoprosthetic placeholder, as in claim 8, wherein a degree of freedom in said operational connection comprises a freedom of rotationally displacing said subpart moieties one relative to another.

11. The assembly of modular intercalary endoprosthetic placeholder, as in claim 8, wherein a degree of freedom in said operational connection comprises a freedom of angularly displacing said subpart moieties one relative to another.

12. The assembly of modular intercalary endoprosthetic placeholder, as in any one of the claims 1 to 11 , wherein an exterior surface of said intramedullary nail comprises at least one structural element, configured to form a firm connection with said semi- cylindrically shaped interior faces of said subpart moieties.

13. The assembly of modular intercalary endoprosthetic placeholder, as in any one of the claims 1 to 12, wherein said semi-cylindrically shaped interior faces of said subpart moieties comprise at least one structural element configured to form a firm connection with an exterior surface of said intramedullary nail.

14. The assembly of modular intercalary endoprosthetic placeholder, as in any one of the claims 1 to 13, wherein said semi-cylindrically shaped interior faces of said subpart moieties and an exterior surface of said intramedullary nail form an interlocking arrangement.

15. The assembly of modular intercalary endoprosthetic placeholder, as in any one of the claims 1 to 13, wherein said semi-cylindrically shaped interior faces of said subpart moieties and an exterior surface of said intramedullary nail form a frictional engagement.

16. A method of assembling a modular intercalary endoprosthetic placeholder comprises: (a) providing an intramedullary nail;(b) providing a kit-of-parts comprising:(I) a plurality of segmental members selected from the group consisting of: at least one segmental member for complete diaphyseal reconstruction and at least one segmental member for partial reconstruction; wherein each one of said segmental members comprising:(i) a first subpart moiety and a second subpart moiety, wherein each one of said subpart moieties comprising:(ii) a semi-cylindrically shaped interior face, configured to engage to said intramedullary nail;(iii) an interlockable face, configured to engage to a respective interlockable face of a counterpart moiety;(iv) an exterior circumferential face;(v) a pair of essentially planar flanking faces;(vi) at least one structural element connectable to a fastener;(vii) at least one hinge element configured to form operational connection with a respective hinge element a counterpart moiety;(II) at least one fastener operationally connectable to said structural elements of said first and second subpart moieties;(III) at least one hinge element configured to form operational connection with a respective hinge element a counterpart moiety;(c) appending said plurality of segmental members to said intramedullary nail, in an open configuration, wherein said first and second subpart moieties are spaced apart one from another;(d) forming an operational connection between said first and second subpart moieties by essentially connecting said subpart moieties one to another by said fasteners;(e) altering a configuration of said plurality of segmental members from said open configuration to a closed configuration, wherein said first and second subpart moieties are fastened one to another by said fasteners; thereby readily connecting said plurality of segmental members onto said intramedullary nail and assembling said modular intercalary endoprosthetic placeholder.

17. The method, as in claim 16, wherein said segmental members further comprises at least one fastener operationally connectable to said structural elements of said first and second subpart moieties.

18. The method, as in any one of the claims 16 or 17, wherein said segmental members comprise a longitudinal locking trunnion.

19. The method, as in any one of the claims 16 to 18, wherein said segmental members comprise a porous matrix.

20. The method, as in any one of the claims 16 to 19, wherein said segmental members comprise an osteogenesis promoting substance.

21. The method, as in any one of the claims 16 to 20, wherein said at least one fastener is of a self-interlocking type.

22. The method, as in any one of the claims 16 to 21 , wherein said at least one fastener is integral to at least one of said first and second subpart moieties.

23. The method, as in any one of the claims 16 to 22, wherein said operational connection between said first and second subpart moieties is characterized by at least one degree of freedom in movement of said subpart moieties one relative to another, while said subpart moieties remain essentially connected one to another.

24. The method, as in any one of the claims 16 to 23, wherein said first and second subpart moieties of said plurality of segmental members are readily appendable to and thereby conveniently mountable onto said intramedullary nail.

25. The method, as in claim 23, wherein said degree of freedom in said operational connection comprises a freedom of rotationally displacing said subpart moieties one relative to another.

26. The method, as in claim 23, wherein said degree of freedom in said operational connection comprises a freedom of angularly displacing said subpart moieties one relative to another.

27. The method, as in any one of the claims 16 to 26, wherein an exterior surface of said intramedullary nail comprises at least one structural element, configured to form a firmconnection with said semi-cylindrically shaped interior faces of said subpart moieties.

28. The method, as in any one of the claims 16 to 27, wherein said semi-cylindrically shaped interior faces of said subpart moieties comprise at least one structural element configured to form a firm connection with an exterior surface of said intramedullary nail.

29. The method, as in any one of the claims 16 to 28, wherein said semi-cylindrically shaped interior faces of said subpart moieties and an exterior surface of said intramedullary nail form an interlocking arrangement.

30. The method, as in any one of the claims 16 to 29, wherein said semi-cylindrically shaped interior faces of said subpart moieties and an exterior surface of said intramedullary nail form a frictional engagement.

31. A segmental member for assembling a modular intercalary endoprosthetic placeholder, configured to assume a shape of a longitudinal segment of a diaphyseal absent portion of a bone, comprises:(a) a first subpart moiety comprising:(I) a semi-cylindrically shaped interior face, configured to engage to said intramedullary nail;(II) an interlockable face, configured to engage to a respective interlockable face of a counterpart moiety;(III) an exterior circumferential face, configured to approximately match an exterior profile of a respective epiphyseal bone fragment;(IV) a pair of essentially planar flanking faces, configured to adjoin flanking faces of said respective epiphyseal bone fragment and / or another segmental member;(V) at least one structural element operationally connectable to a fastener;(b) a second subpart moiety comprising:(I) a semi-cylindrically shaped interior face, configured to engage to said intramedullary nail;(II) an interlockable face, configured to engage to a respective interlockable face of a counterpart moiety;(III) at least one structural element operationally connectable to a fastener;(IV) a pair of essentially planar flanking faces, configured to adjoin flanking faces ofsaid respective epiphyseal bone fragment and / or another segmental member; wherein said segmental member is configured to assume a configuration selected from the group consisting of:(i) an open configuration, wherein said first and second subpart moieties are spaced apart one from another;(ii) a closed configuration, wherein said first and second subpart moieties are fastened one to another by at least one fastener, so that said interlockable faces of said first and second subpart moieties are engaged one to another; wherein said segmental member is readily connectable onto an intramedullary nail; wherein in said closed configuration, said semi-cylindrically shaped interior faces of said first and second subpart moieties are engaged to an exterior surface of said intramedullary nail; wherein said segmental member is selected from the group consisting of: a segmental member for complete diaphyseal reconstruction and segmental member for partial reconstruction.

32. The segmental member, as in claim 31 , further comprises at least one fastener operationally connectable to said structural elements of said first and second subpart moieties.

33. The segmental member, as in any one of the claims 31 or 32, wherein said segmental members comprise a longitudinal locking trunnion.

34. The segmental member, as in any one of the claims 31 to 33, wherein said segmental members comprise a porous matrix.

35. The segmental member, as in any one of the claims 31 to 34, wherein said segmental members comprise an osteogenesis promoting substance.

36. The segmental member, as in any one of the claims 31 to 35, wherein said at least one fastener is of a self-interlocking type.

37. The segmental member, as in claim 36, wherein said at least one fastener is integral to at least one of said first and second subpart moieties.

38. The segmental member, as in any one of the claims 31 to 37, wherein an operational connection between said first and second subpart moieties is characterized by at least one degree of freedom in movement of said subpart moieties one relative to another, while said subpart moieties remain essentially connected one to another.

39. The segmental member, as in any one of the claims 31 to 38, wherein said first and second subpart moieties of said plurality of segmental members are readily appendable to and thereby conveniently mountable onto said intramedullary nail.

40. The segmental member, as in claim 38, wherein a degree of freedom in said operational connection comprises a freedom of rotationally displacing said subpart moieties one relative to another.

41. The segmental member, as in claim 38, wherein a degree of freedom in said operational connection comprises a freedom of angularly displacing said subpart moieties one relative to another.

42. The segmental member, as in any one of the claims 31 to 41 , wherein an exterior surface of said intramedullary nail comprises at least one structural element, configured to form a firm connection with said semi-cylindrically shaped interior faces of said subpart moieties.

43. The segmental member, as in any one of the claims 31 to 42, wherein said semi- cylindrically shaped interior faces of said subpart moieties comprise at least one structural element configured to form a firm connection with an exterior surface of said intramedullary nail.

44. The segmental member, as in any one of the claims 31 to 43, wherein said semi- cylindrically shaped interior faces of said subpart moieties and an exterior surface of said intramedullary nail form an interlocking arrangement.

45. The segmental member, as in any one of the claims 31 to 43, wherein said semi- cylindrically shaped interior faces of said subpart moieties and an exterior surface of said intramedullary nail form a frictional engagement.

46. An assembly for prosthetic reconstruction of long bone defects comprises:(a) an intramedullary nail, wherein at least one of the following is held true:(I) both flanking portions of said intramedullary nail are anchored within two respective epiphyseal fragments of a bone;(II) a first flanking portion of said intramedullary nail is anchored within a distal epiphyseal fragment of a bone, whereas second flanking portion of said intramedullary nail is configured to connect to a proximal epiphyseal fragment reconstruction artificial implant;(III) first flanking portion of said intramedullary nail is anchored within a proximal epiphyseal fragment of a bone, whereas second flanking portion of said intramedullary nail is configured to connect to a distal epiphyseal fragment reconstruction artificial implant;(b) at least one epiphyseal fragment reconstruction artificial implant selected from the group consisting of: said proximal epiphyseal fragment reconstruction artificial implant and said distal epiphyseal fragment reconstruction artificial implant; wherein said at least one epiphyseal fragment reconstruction artificial implant is readily connectable onto said intramedullary nail.

47. The assembly as in claim 46, further comprises a plurality of segmental members selected from the group consisting of: at least one segmental member for complete diaphyseal reconstruction and at least one segmental member for partial reconstruction; wherein each one of said segmental members configured to assume a longitudinal segment of a diaphyseal absent portion of said bone; wherein each one of said segmental members comprising:(a) a first subpart moiety comprising:(I) a semi-cylindrically shaped interior face, configured to engage to said intramedullary nail;(II) an interlockable face, configured to engage to a respective interlockable face of a counterpart moiety;(III) an exterior circumferential face, configured to approximately match an exterior profile of a respective epiphyseal bone fragment;(IV) a pair of essentially planar flanking faces, configured to adjoin flanking faces of said respective epiphyseal bone fragment and / or another segmental member;(V) at least one structural element operationally connectable to a fastener;(b) a second subpart moiety comprising:(I) a semi-cylindrically shaped interior face, configured to engage to said intramedullary nail;(II) an interlockable face, configured to engage to a respective interlockable face of a counterpart moiety;(III) at least one structural element operationally connectable to a fastener; wherein each one of said plurality of segmental members is configured to assume a configuration selected from the group consisting of:(i) an open configuration, wherein said first and second subpart moieties are spaced apart one from another;(ii) a closed configuration, wherein said first and second subpart moieties are fastened one to another by said fasteners, so that said interlockable faces of said first and second subpart moieties are engaged one to another and said semi-cylindrically shaped interior faces of said first and second subpart moieties are engaged to said intramedullary nail; wherein said segmental members are readily connectable onto said intramedullary nail.

48. The assembly, as in any one of the claims 46 or 47 wherein an exterior surface of said intramedullary nail comprises at least one structural element, configured to form a firm connection with an interior face of said at least one epiphyseal fragment reconstruction artificial implant.

49. The assembly, as in any one of the claims 46 to 48, wherein an interior face of said at least one epiphyseal fragment reconstruction artificial implant comprises at least one structural element configured to form a firm connection with an exterior surface of said intramedullary nail.

50. The assembly, as in any one of the claims 46 to 49, wherein an interior face of said subpart moieties and an exterior surface of said intramedullary nail form an interlocking arrangement.

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