Surgical implant for fusion between two bone portions and a clamping ancillary for clamping such a surgical implant

Abstract

A surgical implant which includes: a first anchoring portion comprising two first arms movable between an inserting position and an anchoring position, in which the first arms are spread apart so as to be anchored in a first bone; a second anchoring portion to be anchored in the second bone; and an intermediate portion connecting the first anchoring portion to the second anchoring portion. The intermediate portion comprises: a recess; and a first connecting portion and a second connecting portion that are remote from one another. Bringing the first connecting portion and second connecting portion closer together moves the first arms from the inserting position thereof to the anchoring position thereof.

Claims

1. A surgical implant, intended to enable fusion between a first bone portion and a second bone portion, the surgical implant comprising at least: a first anchoring portion configured to be anchored in the first bone portion, the first anchoring portion including at least two first branches the first branches being displaceable between: an introduction position, in which the respective ends of the first branches define a first introduction distance, so as to enable the introduction of the first branches inside the first bone portion, and an anchoring position, in which the respective ends of the first branches define a first anchoring distance larger than the first introduction distance, so that the first branches are adapted to anchor the first anchoring portion inside the first bone portion, a second anchoring portion configured to be anchored in the second bone portion, an intermediate portion connecting the first anchoring portion to the second anchoring portion; the surgical implant wherein: the intermediate portion includes at least: a recess, a first linking portion disposed between the first anchoring portion and the second anchoring portion, and a second linking portion disposed between the first anchoring portion and the second anchoring portion the first linking portion and the second linking portion being arranged on either side of said at least one recess so that the first linking portion is distant from the second linking portion and the intermediate portion is shaped so that bringing together the first linking portion and the second linking portion displaces the first branches from their introduction position to their anchoring position.

2. The surgical implant according to claim 1, wherein the second anchoring portion includes at least two second branches, the second branches being displaceable between: an introduction position, in which the respective ends of the second branches define a second introduction distance, so as to enable the introduction of the second branches inside the second bone portion, and an anchoring position, in which the respective ends of the second branches define a second anchoring distance larger than the second introduction distance so that the second branches are adapted to anchor the second anchoring portion inside the second bone portion, wherein the intermediate portion is shaped so that bringing together the first linking portion and the second linking portion displaces the second branches from their introduction position to their anchoring position.

3. The surgical implant according to claim 1, wherein the intermediate portion is plastically deformable so that a plastic deformation of the intermediate portion bringing together the first linking portion and the second linking portion displaces the first branches and/or the second branches from their introduction position(s) to their anchoring position(s).

4. The surgical implant according to claim 1, wherein the intermediate portion is elastically deformable so that an elastic expansion of the intermediate portion bringing together the first linking portion and the second linking displaces the first branches and/or the second branches from their introduction position(s) to their anchoring position(s).

5. The surgical implant according to claim 1, wherein each of the first branches has a generally elongated shape, and wherein the first branches are substantially parallel in their introduction position and form substantially a V in their anchoring position.

6. The surgical implant according to claim 2, wherein the intermediate portion further includes a first joining portion joining at least two first branches a second joining portion joining at least two second branches the first linking portion and the second linking portion being arranged respectively on either side of the first joining portion and on either side of the second joining portion.

7. The surgical implant according to claim 1, wherein at least one recess has an oblong shape, the length of which extends generally between the first anchoring portion and the second anchoring portion.

8. The surgical implant according to claim 1, wherein at least one recess presents a narrow area and a large area which is larger than the narrow area, the widths being measured between the first linking portion and the second linking portion.

9. The surgical implant according to claim 1, wherein the first linking portion presents a first face which is convex and which is oriented toward the second linking portion, the first face having a profile formed by an arc of circle the radius of which is larger than 20 mm, and wherein the second linking portion presents a second face which is convex and which is oriented toward the first linking portion, the second face having a profile formed by an arc of circle the radius of which is larger than 20 mm.

10. The surgical implant according to claim 1, wherein at least the intermediate portion is composed of a material selected in the group constituted by: a titanium alloy, according to the standard ISO 5832-2 or ASTM F67, and a stainless steel according to the standard ISO 58321.

11. The surgical implant according to claim 1, wherein the intermediate portion further includes at least two abutments extending in protrusion on two opposite outer faces of the intermediate portion.

12. A clamping ancillary configured to clamp at least one surgical implant according to claim 1, the clamping ancillary comprising at least two jaws and at least one joint connecting said at least two jaws the clamping ancillary wherein each jaw presents a respective housing having a shape complementary to a respective linking portion so as to grip a respective outer face of the intermediate portion, and in that said at least one joint is configured so that a displacement of the jaws results in bringing together the first linking portion and the second linking portion.

13. The clamping ancillary according to claim 12, wherein said at least one joint includes a latch presenting at least one locking notch, the joint being movable between: an open position, in which the jaws define a space allowing the installation of the surgical implant, a retaining position, in which the jaws grip the respective outer faces of the intermediate portion so that the clamping ancillary retains the surgical implant, a clamping position, in which the jaws clamp the intermediate portion so as to obtain said approach.

14. The clamping ancillary according to claim 13, wherein the latch is linked to one of the jaws by a pivot link, and wherein the latch presents a handling portion, configured to allow a surgeon to handle the latch so as to move the joint between the open position, the retaining position and the clamping position.

Description

(1) The present invention will be better understood and its advantages will appear in the light of the description that follows, given only as a non-limiting example and made with reference to the appended drawings, in which:

(2) FIG. 1 is a front view of a surgical implant in accordance with the invention, in the introduction configuration;

(3) FIG. 2 is a perspective view of the surgical implant of FIG. 1, in the introduction configuration;

(4) FIG. 3 is a front view of the surgical implant of FIG. 1, in the anchoring configuration;

(5) FIG. 4 is a view at a larger scale of the detail IV in FIG. 1;

(6) FIG. 5 is a view at a larger scale of the detail V in FIG. 3;

(7) FIG. 6 is a side view of the surgical implant of FIG. 1;

(8) FIG. 7 is a view similar to FIG. 6 of a surgical implant in accordance with a variant of the invention;

(9) FIG. 8 is a perspective view of a clamping ancillary in accordance with the invention and configured to hold then clamp the surgical implant of FIG. 1;

(10) FIG. 9 is a perspective view of the clamping ancillary of FIG. 8 retaining the surgical implant of FIG. 1;

(11) FIG. 10 is a view at a larger scale of the detail X in FIG. 9;

(12) FIGS. 11A and 11B are schematic views at a larger scale of the center of FIG. 4; FIGS. 11A and 11B illustrate two different positions for clamping the surgical implant;

(13) FIG. 12 is a side view of a portion of the clamping ancillary of FIG. 8 in an open position;

(14) FIG. 13 is a view similar to FIG. 12 illustrating the clamping ancillary of FIG. 12 in a retaining position;

(15) FIG. 14 is a view similar to FIG. 12 illustrating the clamping ancillary of FIG. 12 in a position following the clamping position of FIG. 13;

(16) FIG. 15 is a view similar to FIG. 12 illustrating the clamping ancillary of FIG. 12 in a clamping position;

(17) FIG. 16 is a schematic view of the surgical implant of FIG. 1 in the introduction configuration; and

(18) FIG. 17 is a view similar to FIG. 16 illustrating the surgical implant of FIG. 1 in the anchoring configuration.

(19) FIGS. 1, 2, 3, 4, 5 and 6 illustrate a surgical implant 1 intended to enable fusion between a first bone portion and a second bone portion. In the example of FIGS. 16 and 17, the first bone portion and the second bone portion are respectively a proximal phalanx P1 and a middle phalanx P2 of a toe.

(20) The surgical implant 1 comprises a first anchoring portion 10 and a second anchoring portion 20, which are respectively configured to be anchored in the proximal phalanx P1 and in the intermediate phalanx P2.

(21) The first anchoring portion 10 includes two first branches 11 and 12. The first branches 11 and 12 are displaceable between an introduction position (FIGS. 1, 2, 4, 16) and an anchoring position (FIGS. 3, 5, 17).

(22) In the introduction position (FIG. 1, 4, 16), the respective ends 11.1 and 12.1 of the first branches 11 and 12 define a first introduction distance D10.1. The first introduction distance D10.1 is relatively small, so as to enable the introduction of the first branches 11 and 12 inside the proximal phalanx P1, as shown in FIG. 16. In the example of FIGS. 1 to 6, the first introduction distance D10.1 is equal to about 0.4 mm and the first anchoring distance D10.2 is equal to about 6 mm.

(23) In the anchoring position (FIGS. 3, 5, 17), the respective ends 11.1 and 12.1 of the first branches 11 and 12 define a first anchoring distance D10.2 which is larger than the first introduction distance D10.1. Since the first anchoring distance D10.2 is relatively large, the first branches 11 and 12 are adapted to anchor the first anchoring portion 10 inside the proximal phalanx P1.

(24) Each of the first branches 11 and 12 have a generally elongated shape and are substantially parallel in their introduction position (FIGS. 1, 4, 16) and substantially form a tightened U in their introduction position (FIGS. 1, 4, 16). The first branches 11 and 12 form substantially a V in their anchoring position (FIGS. 3, 5, 17), in this instance an angular sector A11.12 of about 30 degrees.

(25) In addition, the surgical implant 1 comprises an intermediate portion 40 which connects the first anchoring portion 10 to the second anchoring portion 20. The intermediate portion 40 extends between the first anchoring portion 10 and the second anchoring portion 20.

(26) The second anchoring portion 20 includes two second branches 21 and 22. Hence, the surgical implant 1 has four branches 11, 12, 21 and 22, namely two on each side of the intermediate portion 40. The second branches 21 and 22 are displaceable between an introduction position (FIGS. 1, 4, 16) and an anchoring position (FIGS. 3, 5, 17).

(27) Each of the second branches 21 and 22 have a generally elongated shape and are substantially parallel in their introduction position (FIGS. 1, 4, 16) and form substantially a tightened U in their introduction position (FIGS. 1, 4, 16). The second branches 21 and 22 form substantially a V in their anchoring position (FIGS. 3, 5, 17), in this instance an angular sector A21.22 of about 40 degrees.

(28) Hence, the surgical implant 1 has generally a tightened H shape when the first branches 11 and 22 and the second branches 21 and 22 are in their introduction positions (FIGS. 1, 4, 16), and an X shape when the first branches 11 and 12 and the second branches 21 and 22 are in their anchoring positions (FIGS. 3, 5, 17).

(29) In the introduction position (FIGS. 1, 4, 16), the respective ends 21.1 and 22.1 of the second branches 21 and 22 define a second introduction distance D20.1. The second introduction distance D20.1 is relatively small, so as to enable the introduction of the second branches 21 and 22 inside the intermediate phalanx P2. In the example of FIGS. 1 to 6, the second introduction distance D20.1 is equal to about 1.5 mm and the second anchoring distance D20.2 is equal to about 4.3 mm.

(30) In the anchoring position (FIGS. 3, 5, 17), the respective ends 21.1 and 22.1 of the second branches 21 and 22 define a second anchoring distance D20.2 which is larger than the second introduction distance D20.1. Since the second anchoring distance D20.2 is relatively large, the second branches 21 and 22 are adapted to anchor the second anchoring portion 20 inside the middle phalanx P2.

(31) The intermediate portion 40 includes: a first joining portion 41 which joins together the two first branches 11 and 12, a first linking portion 42, which is disposed between the first anchoring portion 10 and the second anchoring portion 20, and a second linking portion 44, which is disposed between the first anchoring portion 10 and the second anchoring portion 20.

(32) The first linking portion 42 and the second linking portion 44 are arranged on either side of the recess 48 so that the first linking portion 42 is distant from the second linking portion 44. The first linking portion 42 extends substantially between the first branch 11 and the second anchoring portion 20. The second linking portion 44 extends substantially between the second branch 12 and the second anchoring portion 20.

(33) The intermediate portion 40 further includes a recess 48 which herein presents a closed contour. In the example of FIGS. 1 to 6, the recess 48 has an oblong shape, the length L48 of which extends generally between the first anchoring portion 10 and the second anchoring portion 20. The intermediate portion 40 further includes a second joining portion 46 which joins together the second branches 21 and 22. The first linking portion 42 and the second linking portion 44 are arranged on either side of the recess 48. The first linking portion 42 and the second linking portion 44 are arranged respectively on either side of the first joining portion 41 and on either side of the second joining portion 46.

(34) As shown in FIGS. 1 and 4, the closed contour of the recess 48 is defined by the first linking portion 42, by the second linking portion 44, by the first joining portion 41 and by the second joining portion 46.

(35) The intermediate portion 40 is shaped so that an approach between the first linking portion 42 and the second linking portion 44 displaces the first branches 11 and 12 from their introduction position to their anchoring position.

(36) In the example of FIGS. 1 to 6, the intermediate portion 40 is plastically deformable so that a plastic deformation of the intermediate portion 40 bringing the first linking portion 42 closer to the second linking portion 44 displaces the first branches 11 and 12 from their introduction position (FIGS. 1, 4, 16) to their anchoring position (FIGS. 3, 5, 17).

(37) In the example of FIGS. 1 to 5, the plastic deformation of the intermediate portion 40 brings the first linking portion 42 and the second linking portion 44 into contact, thereby displacing the first branches 11 and 12 from the introduction position (FIGS. 1, 4, 16) to the anchoring position (FIGS. 3, 5, 17). As shown in FIGS. 3 and 5, after the plastic deformation, the first linking portion 42 touches the second linking portion 44.

(38) The intermediate portion 40 is composed of a grade 2 titanium allow (titanium T40) according to the standard ISO 5832-2 or ASTM F67. The plastic deformation herein is carried out in the homogeneous plastic deformation domain of the material composing the intermediate portion 40.

(39) The comparison of FIGS. 4 and 5 shows the approximation bringing into contact the first linking portion 42 and the second linking portion 44 resulting from the plastic deformation of the intermediate portion 40.

(40) Similarly to the displacement of the first branches 11 and 12, the intermediate portion 40 is plastically deformable so that a plastic deformation of the intermediate portion 40 bringing the first linking portion 42 closer to the second linking portion 44 displaces the second branches 21 and 22 from their introduction position (FIGS. 1, 4, 16) to their anchoring position (FIGS. 3, 5, 17).

(41) The first branches 11 and 12 are longer than the second branches 21 and 22. The ratio between a length of the first branches 11 and 12 and a length of the second branches 21 and 22 is herein thought to be equal to about 3. The first branches 11 and 12 have the same length. The second branches 21 and 22 have the same length.

(42) The length of each first branch 11 or 12 is herein equal to about 11 mm. The length of each second branch 21 or 22 is herein equal to about 4 mm. The intermediate portion 40 has herein a length, measured along the longitudinal direction of a first branch 11 or 12, equal to about 5 mm. The intermediate portion 40, the first anchoring portion 10 and the second anchoring portion 20 have a thickness E1 equal to about 1.5 mm.

(43) Each first branch 11 or 12 and each second branch 21 and 22 presents, on a respective outer face, notches 11.5, 12.5 and 21.5, 22.5, which are configured to anchor the surgical implant 1 respectively in the proximal phalanx P1 and in the middle phalanx P2. On each end portion of a respective first 11, 12 or second 21, 22 branch, there are notches 11.5, 12.5, 21.5 and 22.5 in the form of harpoons.

(44) In the example of FIGS. 1 to 6, the surgical implant 1 is monolithic. Hence, like the intermediate portion 40, the first branches 11 and 12 and the second branches 21 and 22 are composed of a grade 2 titanium alloy according to the standard ISO 5832-2 or ASTM F67.

(45) As shown in FIGS. 3 and 5, after the plastic deformation, the first linking portion 42 touches the second linking portion 44, in such a manner that the recess 48 is reduced or even non-existent.

(46) The first linking portion 42 presents a first face 42.1 which is convex and which is oriented toward the second linking portion 44. The first face 42.1 has a profile formed by an arc of circle the radius of which is herein equal to about 35 mm.

(47) Similarly, the second linking portion 44 presents a second face 44.2 which is convex and which is oriented toward the first linking portion 42. The second face 44.2 has a profile formed by an arc of circle the radius of which is herein equal to about 35 mm.

(48) In addition, the intermediate portion 40 further includes four abutments 51, 52, 53 and 54 which extend in protrusion on two respective outer faces 55, 56 of the intermediate portion 40 which are opposite to each other. The abutments 51 and 52 extend in protrusion on the outer face 55, and the abutments 53 and 54 extend in protrusion on the outer face 56. The two abutments 51 and 52 are located on the side of the first branches 11 and 12, whereas the abutments 53 and 54 are located on the side of the second branches 21 and 22.

(49) Each outer face 55 or 56 of the intermediate portion 40 presents, next to the abutments 51, 52, 53, 54, non-represented friction means, notches or roughnesses, which are configured to grip, by friction, the jaws of a clamping ancillary.

(50) FIG. 7 illustrates a surgical implant 101 in accordance with a variant of the invention. The surgical implant 101 is similar to the surgical implant 1, with the exception of the notable differences mentioned hereinafter. The surgical implant 101 comprises a first anchoring portion 110, a second anchoring portion 120 and an intermediate portion 140. The first anchoring portion 110 includes two first branches 111 and 112 similar to the first branches 11 and 12 of the surgical implant 1. The second anchoring portion 120 includes two second branches 121 and 122 similar to the second branches 21 and 22 of the surgical implant 1.

(51) The surgical implant 101 differs from the surgical implant 1, because the first branches 111 and 112 extend along a first longitudinal direction X1, whereas the second branches 121 and 122 extend along a second longitudinal direction X2. Thus, the first branches 111 and 112 and the second branches 121 and 122 form together an angle A.

(52) The angle A is herein equal to about 170 degrees in a plane containing the first longitudinal direction X1 and the second longitudinal direction X2. The angle A is herein represented in the plane of FIG. 7, which is parallel to the plane containing the first longitudinal direction X1 and the second longitudinal direction X2.

(53) FIGS. 8, 9, 10, 12, 13, 14 and 15 illustrate a clamping ancillary 200 in accordance with the invention, which is configured to clamp the surgical implant 1 or 101. The clamping ancillary 200 comprises two jaws 201 and 202 and a joint 204. The joint 204 connects the jaws 201 and 202. The clamping ancillary 200 further comprises two gripping bars 205 and 206. Each gripping bar 205 or 206 is secured to a respective jaw 201 or 202.

(54) Each jaw 201 or 202 defines a respective housing 201.1 or 202.1 having a shape complementary to a respective linking portion 42 or 44, so that each jaw 201 or 202 can grip a respective outer face 55 or 56 of the intermediate portion 40. In the example of FIGS. 1 to 6, each of the first linking portion 42 and of the second linking portion 44 have a section with a rectangular profile. Hence, in the example of FIGS. 8 to 15, each respective housing 201.1 or 202.1 defined by the jaws 201 and 202 is generally parallelepipedic with a rectangular profile open on one side, as shown in FIG. 8.

(55) The joint 204 is configured so that a displacement of the jaws 202 and 204 results in a plastic deformation of the intermediate portion 40 bringing the first linking portion 42 closer to the second linking portion 44.

(56) The joint 204 includes a latch 210 which presents two locking notches 211 and 212. The jaw 205 presents a lug 205.5 configured to cooperate with the locking notches 211 and 212 by form-fitting. The latch 210 is linked to the jaw 206 by a pivot link 214. The latch 210 presents a handling portion 210.1, which is configured to allow a surgeon to handle the latch 210 so as to move the joint 204.

(57) The joint 204 is movable between: an open position (FIGS. 8 and 12), in which the jaws 201 and 202 define a space 215 enabling the installation of the surgical implant 1; in the open position, the lug 205.5 does not cooperate yet with the locking notches 211 and 212; a retaining position (FIGS. 9, 10 and 13), in which the jaws 201 and 202 grip the respective outer faces 55 and 56 of the intermediate portion 40 so that the clamping ancillary 200 retains the surgical implant 1; in the retaining position, the lug 205.5 is engaged between the locking notches 211 and 212; a clamping position (FIG. 15), in which the jaws 201 and 202 clamp the intermediate portion 40 so as to achieve the intended plastic deformation; in the clamping position, the lug 205.5 is cleared from the locking notches 211 and 212, so that the lug 205.5 is located below the locking notches 211 and 212.

(58) Thanks to the handling portion 210.1, the surgeon can handle the latch 210 so as to move the joint 204 between the open position (FIGS. 8 and 12), the retaining position (FIGS. 9, 10 and 13) and the clamping position (FIG. 15). The figure illustrates the clamping ancillary 200 in a position following the clamping position (FIG. 13).

(59) FIG. 11A illustrates a first clamping position of the surgical implant 1 with respect to the ancillary one 200. The resultant of the clamping forces exerted by the jaws 201 and 202 on the surgical implant 1 is generally carried by a resultant axis A.

(60) In this first clamping position, the resultant axis A passes substantially through the middle of the recess 48, along a longitudinal direction generally defined by the first branches 11 and 12 in the introduction positions (FIGS. 1, 2 and 4).

(61) In this first clamping position, the clamping forces exerted by the jaws 201 and 202 on the surgical implant 1 are uniformly distributed on the intermediate portion 40. Thus, the plastic deformation of the first branches and of the second branches could be symmetrical in the case where the first branches and the second branches are symmetrical.

(62) FIG. 11B illustrates a second clamping position of the surgical implant 1 with respect to the ancillary one 200. The resultant of the clamping forces exerted by the jaws 201 and 202 on the surgical implant 1 is generally carried by the resultant axis A.

(63) In this second clamping position, unlike the first clamping position illustrated in FIG. 11A, the resultant axis A does not pass through the middle of the recess 48, but closer to the second anchoring portion 20.

(64) In this second clamping position, the clamping forces exerted by the jaws 201 and 202 on the surgical implant 1 are not uniformly distributed on the intermediate portion 40. Thus, the plastic deformation of the first branches and of the second branches is not symmetrical. The second branches would be spaced apart further than the first branches.

(65) FIGS. 16 and 17 illustrate the surgical implant 1 respectively before and after the plastic deformation of the intermediate portion 40, therefore respectively before and after spacing apart the first branches 11 and 12 and of the second branches 21 and 22. Hence, FIG. 16 illustrates the first branches 11 and 12 and the second branches 21 and 22 in their introduction positions, whereas FIG. 17 illustrates the first branches 11 and 12 and the second branches 21 and 22 in their anchoring positions.

(66) Of course, the present invention is not limited to the particular examples described in the present application. Other embodiments within the reach of those skilled in the art may also be considered without departing from the scope of the present invention.