FIXATION SYSTEM BETWEEN A MEDICAL DEVICE AND AT LEAST ONE PORTION OF A BONE
20220323124 ยท 2022-10-13
Inventors
- Pierre Vacher (Thorens Glieres, FR)
- Thibault Goyallon (Annecy, FR)
- Eric Vittecoq (Groisy, FR)
- Arnaud Dodelin (Bihorel, FR)
- Yvan Arlettaz (Monthey, FR)
- Benoit Schenck (Oberhausbergen, FR)
- Maxime Antoni (Strasbourg, FR)
- Christophe Alepee (Lyon, FR)
- Christophe Depres (Charvonnex, FR)
Cpc classification
A61B17/7241
HUMAN NECESSITIES
International classification
Abstract
The invention relates to a fixation system between a medical device and at least one portion of a bone, characterised in that it comprises an elongate portion intended to be inserted into the bone, in particular into the medullary cavity and/or into the proximal or distal ends, the elongate portion having a wall consisting of meshes through which at least one fixing member can pass, according to a position and orientation that are not predefined, and which apply, by elastic, plastic or elastic-plastic deformation, a transverse and/or axial pressure force onto the fixing member, the fixing member being intended to also pass through the portion of the bone in order to ensure rigid fixation between the bone and the medical device.
Claims
1. A medical device comprising a system for fixing to at least one portion of a bone, wherein the medical device comprises an elongate portion intended to be inserted in the bone, in particular in the medullary cavity and/or in the proximal or distal ends, the elongate portion has a wall consisting of meshes designed to be passed through by at least one fixing member, in a position and an orientation that are not predefined, while exerting by elastic, plastic or elastoplastic deformation, a transverse and/or axial pressure force on said fixing member, the fixing member being intended to also pass through the portion of the bone to ensure rigid fixing between the bone and the medical device.
2. The medical device according to claim 1, wherein the meshes are defined by a lattice formed by a plurality of rigid strands.
3. The medical device according to claim 2, wherein the lattice is made with strands with circular cross-sections.
4. The medical device according to claim 1 wherein the elongate portion is tubular.
5. The medical device according to claim 1, wherein the elongate portion is coated with a film to prevent bone growth inside said elongate portion or filled with a material which does not oppose the passage of the fixing members, but which prevents bone growth.
6. The medical device according to claim 1, wherein the fixing member is a screw.
7. The medical device according to claim 1, wherein one of the dimensions of the meshes is in a tight fit with the cross-section of the fixing member so as to exert a transverse pressure on the fixing member.
8. The medical device according to claim 6, wherein the meshes have thicknesses in tight fit with the pitch of the screw so as to exert an axial pressure force on the screw as it passes through the meshes.
9. The medical device according to claim 1 wherein the medical device is an intramedullary nail or a prosthetic stem.
10. A method for manufacturing the medical device of claim 1, wherein the method consists of producing the elongate portion by a three-dimensional printing technique.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0024] Other characteristics and advantages of the invention will become apparent from the following description, which is given by way of non-limiting indication and made with reference to the appended figures, in which:
[0025]
[0026]
[0027]
DETAILED DESCRIPTION OF THE INVENTION
[0028] The invention relates to a system for fixing a medical device (1) to at least one portion of a bone. The invention has, for example, an advantageous application for resetting and compressing bone fragments on a bone, but also for fixing to a bone, any type of medical device (1) intended to be inserted into the medullary cavity of a bone and/or to be housed in the proximal or distal end of the bone.
[0029] To this end, according to the invention, the medical device (1) intended to be fixed to a bone, or to which bone fragments are intended to be fixed, comprises an elongate portion (2) intended to be inserted into the medullary cavity of the bone and/or to be housed in the proximal or distal ends.
[0030] The elongate portion (2) can either constitute the medical device (1) itself, when it is intended to fix bone fragments thereto, or can constitute a part of a medical device (1), for example, a part of a prosthetic stem or of an intramedullary nail, which are intended to be inserted into the medullary cavity and fixed to the bone.
[0031] To this end, the elongate portion (2), which is preferably tubular, has a wall consisting of non-expandable meshes (4) adapted to be passed right through, by one or more fixing members (3), such as screws, clips, tips, etc., according to a position and an orientation that are not predefined, and by exerting, by deformation, a pressure force, in particular transverse and/or axial, on said fixing members (3).
[0032] The meshes (4) are, for example, defined by a lattice (5) formed by a plurality of rigid strands (5b). The rigid strands (5b) can be braided and independent of each other at the intersections between the different strands (5b).
[0033] In this way, it is possible to produce a rigid, non-expandable elongate portion (2) with meshes (4) of controlled dimensions, while making it possible to adapt to any type of fixing member (3), whatever its orientation, since, given that the strands (5b) are independent of one another at the intersections, the strands can move apart while continuing to exert the pressure force against the fixing member .
[0034] In another configuration, the rigid strands (5b) can be braided and secured to one another at the intersections between the different strands (5b).
[0035] The invention thus makes it possible to fix the medical device (1) to a portion of a bone, or bone fragments on the medical device (1), by means of the fixing members (3) passing through the bone and the elongate portion (2) of the medical device (1).
[0036] The invention makes it possible for the surgeon to freely choose the position (height, inclination and eccentricity) of the fixing members (3), while being able to avoid using a fitting ancillary or an inspection radiograph. The fixing members (3) can pass through the meshes (4) of the elongate portion (2) in a position and an orientation which are not predefined, i.e. not necessarily in a diametral plane, not necessarily perpendicular to the axis of the elongate portion, at the discretion of the surgeon.
[0037] In practice, during use, a fixing member (3) passes through a portion of the bone and then passes right through the elongate portion (2), penetrating successively into two meshes (4), which exert a pressure, in particular transverse and/or axial, on said fixing member (3), in particular because one of their dimensions is in a tight fit with the fixing member (3). For example, when the width of the meshes (4) is in a tight fit, that is to say substantially less by a few tenths or hundredths of a millimetre with respect to the section of the fixing member (3), the meshes (4) exert a transverse pressure on the fixing member (3). For example, when the fixing member (4) is in the form of a screw, one of the dimensions of the meshes (4), in particular the width of the meshes (4), can be in a tight fit with the thread root diameter of the screw in order to exert a transverse pressure on the screw.
[0038] Alternatively or in combination, the thickness of the meshes (4) can be in a tight fit, i.e. substantially greater by a few hundredths or tenths of a millimetre with respect to the screw thread so as to exert, by deformation, an axial force on the screw.
[0039] According to one particular embodiment, the elongate portion (2) is produced, for example, from a planar grid wound to have a generally cylindrical shape, with or without axial welding.
[0040] An advantageous technique consists, in reference to the figures, in manufacturing, by additive manufacture, layer by layer, a tube, a portion of which is produced by a lattice (5) with a plurality of rigid strands (5b), for example with circular cross-sections.
[0041] Moreover, the ends of the strands (5b) are fixedly connected to one another at the two ends of the elongate portion (2). The three-dimensional printing technique makes it possible to easily produce this embodiment and to completely control the shape and the dimension of the meshes (4) in order to completely adjust the transverse and/or axial pressure forces on the fixing member.
[0042] The geometry of the meshes (4) is adapted to that of the fixing members (3). This geometry makes it possible to generate, by the deformation of the meshes (4), a transverse and/or axial pressure on the fixing members (3), making it possible to lock them in the elongate portion (2). The insertion forces of said fixing members (3) must remain moderate, while ensuring an adjusted assembly, without clearance, allowing a slight deformation of the mesh (4).
[0043] In order to facilitate disassembly, the elongate portion (2) can be coated with a film, not shown, to prevent bone growth within said elongate portion (2), or can be filled with a material which does not oppose the passage of the fixing members (3), but which prevents bone growth.
[0044] According to different embodiments, the meshes (4) can be made by laser multi-drilling the elongate portion (2), or else from an expanded metal, without moving away from the scope of the invention.
[0045] It is clear from the above that the invention does indeed provide a system for fixing a medical device (1) to at least one portion of a bone, possibly making it possible to avoid using an fitting ancillary or of an external viewfinder. To carry out the fixing, the surgeon chooses the number and the orientation of the fixing members (3), being certain to be able to penetrate the elongate portion (2) to carry out the locking. The invention makes it possible to fix bone fragments, while making it possible to reduce or even avoid the use of sutures and thus to reduce or even eliminate the risk of necrosis.