Patient-Specific Bone Plate Guiding Instrument
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Solution Overview
Problem
Current methods for positioning bone plates in corrective osteotomies face challenges such as unstable contact between the plate and bone, leading to inaccurate positioning and difficulty in maintaining pre-operative plans, especially with abnormal anatomy and the use of locking plates which can cause bone necrosis due to snug fits.
Innovation Solution
Patient-specific guiding instruments with anatomy engagement surfaces and plate engagement features that securely attach to bone plates, ensuring accurate positioning by incorporating locking features and detachable guide parts, manufactured via additive manufacturing to fit unique patient anatomy.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Manufacturing precision
If patient-specific plates are used to ensure stable contact with bone, then positioning accuracy is improved, but manufacturing cost and complexity increase
Solution Approach 1:
The system divides the solution into two separate components: a standard bone plate and a patient-specific guiding instrument. The guiding instrument is customized to fit the patient's anatomy and is used only during surgery to ensure accurate positioning, while the bone plate itself remains a standard, easily manufactured component. This segmentation allows positioning accuracy to be improved through customization without permanently increasing the complexity of the bone plate manufacturing.
Solution Approach 2:
The patient-specific guiding instrument is manufactured in advance based on pre-operative planning and patient-specific anatomy. This preliminary action ensures that the correct positioning strategy is prepared before surgery, allowing the actual bone plate to be a standard component that simply needs to be positioned accurately during the procedure using the pre-made guiding instrument.
2Ease of operation
If locking plates are used to attach bone fragments, then ease of operation is improved, but positioning accuracy deteriorates due to lack of stable contact
Solution Approach 1:
The patient-specific guiding instrument acts as an intermediary between the surgeon's positioning actions and the bone plate. It provides the stable, anatomy-specific contact that ensures accurate positioning, while still allowing the locking plate mechanism to function for easy attachment. The guiding instrument mediates between the need for stable contact and the ease of locking plate operation.
3Manufacturing precision
If patient-specific implants are manufactured to fit anatomy, then positioning accuracy is improved, but risk of bone necrosis increases due to snug fit
Solution Approach 1:
The system separates the function of achieving positioning accuracy from the function of providing structural support. The patient-specific guiding instrument provides the customized fit for accurate positioning during surgery, while the standard bone plate provides structural support with appropriate clearance from the bone. This segmentation allows positioning accuracy to be improved without the bone plate causing necrosis through excessive contact.
4Manufacturing precision
If pre-drilled holes are used for screw placement, then positioning accuracy is improved, but reliability deteriorates as screws can divert from the drilled tunnel
Solution Approach 1:
The patient-specific guiding instrument serves as a mediator that guides the screw placement process. It provides physical guidance structures that ensure screws follow the intended trajectory through both cortical and trabecular bone. The guiding instrument compensates for the potential divergence issue by providing continuous directional guidance along the screw path, rather than relying solely on the initial pre-drilled hole.
Data Source
Figure 1A~1B
Figure 2
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AI summary
Described herein are guiding instruments for use in surgical procedures involving the positioning of a bone plate. Furthermore methods for the manufacture of such instruments and methods for positioning a bone plate are also provided.