WO2002071963A1 - Guide plate for 95° angled plates in orthopedic surgery - Google Patents

Guide plate for 95° angled plates in orthopedic surgery Download PDF

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Publication number
WO2002071963A1
WO2002071963A1 PCT/MX2001/000020 MX0100020W WO02071963A1 WO 2002071963 A1 WO2002071963 A1 WO 2002071963A1 MX 0100020 W MX0100020 W MX 0100020W WO 02071963 A1 WO02071963 A1 WO 02071963A1
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WO
WIPO (PCT)
Prior art keywords
plate
guide
nail
implant
female
Prior art date
Application number
PCT/MX2001/000020
Other languages
Spanish (es)
French (fr)
Inventor
Jesús Ramón PIÑA PAEZ
Original Assignee
Pina Paez Jesus Ramon
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Pina Paez Jesus Ramon filed Critical Pina Paez Jesus Ramon
Publication of WO2002071963A1 publication Critical patent/WO2002071963A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17Guides or aligning means for drills, mills, pins or wires
    • A61B17/1728Guides or aligning means for drills, mills, pins or wires for holes for bone plates or plate screws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/808Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms

Definitions

  • the problem lies in the fact that it begins by placing the nail, and having no instrument that gives us the exact orientation, this is left with a deviation of one to several degrees, which affects the final position of the plate in a bad alignment of this with respect to the bone surface.
  • an instrument of the same material as mentioned above was designed to guarantee the exact placement of the angled plates of 95 °, first stabilizing the fracture and showing in advance the position that the plate will have and the definitive implant nail; which we have called PLACA - GUIA and which is composed of two basic components. 1.- Main male (No. 1, figure 1) .2.- Female assembly (No. 2, figures 1), and it is intended to protect by means of the present application since there is no other with these characteristics that give us a solution in an exact, safe and effective way to the problem described above. This being the main advantage of the new instrument.
  • GUIDE PLATE The details and characteristics of the GUIDE PLATE are clearly shown in the following description and in the drawings of figures 1 to 4.
  • the GUIDE PLATE consists essentially of two components and is
  • Female assembly component (No.2, figure 1).
  • the main male component (No. 1) consists of a 10-hole condylar plate with characteristics and arrangement thereof to the self-compression ones to which the nail blade has been separated and in its place at the 0 angular end it he has welded a plate perpendicular to this, 2.5 mm. thick, square U-shaped (No. 3, Fig 1), 30mm. long X 16 mm. wide and 6.5 mm. high by its internal surface, and at the ends of its vertical branches have an eyebrow of 2.5mm. (No. 4, Fig 1) towards the outer side and that they cover it in all its extension and end in a stop (No 5, Fig 1) proximal to the end welded to the condylar plate.
  • the female assembly component (No 2, Fig 1) whose shape is a square C of 30 mm. long X 16 mm. in the opening of its branches which assemble in mirror with the main piece and that together with it or form a cube whose light (No 6, Fig 1) of 30mm. X 16 mm X 6.5mm which will serve to accommodate the guide chisel (KT22, cat. AESCULAP) and whose direction will be given by the orientation of said attachment that will be of entry at 85 ° with respect to the main axis of the GUIDE PLATE and exit of 95 ° angle complementary to the previous (No. 7, fig. 1).
  • Said female component 5 (No 2) has two 1.5mm ducts on its outer and distal face. in diameter (No.

Abstract

Whenever placement of 95° angled plates is indicated in orthopedic surgery, the plate is frequently misaligned in relation to the bone due to the fact that there is no instrument to accurately and reliably guide the guide nail when it is initially introduced since current techniques and instruments are only visual. The inventive implant is precisely indicated for the treatment of certain femur fractures. To solve the above-mentioned problem, a guide plate comprising two main components is provided: 1.- The main male plate, on which bone fragments are reduced in a coherent and safe manner, shows beforehand the position the definitive implant will adopt thereby solving the problem of plate-bone misalignment. 2.- The dismountable female plate together with the above-mentioned plate form a tunnel for the guide chisel thereby solving the problem of plate nail alignment and enabling visualization of the exact position of the definitive implant by placing the implant through the guide plate while preserving alignment of the bones and remaining in correct position.

Description

PLACA GUIA PARA PLACAS ANGULADAS DE 95° EN CIRUGÍA ORTOPÉDICA . Antecedentes. GUIDE PLATE FOR ANGLE PLATES 95 ° IN ORTHOPEDIC SURGERY. Background.
Hasta el momento actual, en la practica de Cirugía Ortopédica, para la colocación de las placas anguladas de 95° cuando este implante este indicado, tenemos como ayuda de orientación los instrumentos diseñados por Asociación Suiza para el estudio de la Osteosintesis (AO). Siendo básicamente estos; el orientador de ángulo ( KT5 catalogo de AESCULAP ) guía para clavo ( KT20 cat. AESCULAP) y clavo guía (KT22 cat. AESCULAP). Con la técnica AO descrita en su manual de osteosintesis, esta orientación solo es del orden visual. Por lo que se dificulta la colocación exacta del implante, resultando en un gran porcentaje de los casos una mala orientación de la placa. Por lo que algunos cirujanos han optado por no utilizar las placas anguladas de 95°, particularmente creemos que es un buen implante para algunas fracturas de fémur. El problema radica, en que se inicia por colocar el clavo, y al no tener un instrumento que nos de la orientación exacta, este queda con una desviación de uno a varios grados, lo que repercute en la posición final de la placa en una mala alineación de esta con respecto a la superficie ósea. Con la finalidad de dar solución al problema descrito se ideo un instrumento del mismo material de los anteriores mencionados que nos garantice la colocación exacta de las placas anguladas de 95°, estabilizando primeramente la fractura y mostrando de antemano la posición que tendrá la placa y el clavo del implante definitivo; al cual le hemos denominado PLACA - GUIA y que esta integrada por dos componentes básicos. 1.- Principal macho ( No. 1, figura 1).2.- Ensamble hembra ( No. 2, figuras 1), y se pretende proteger por medio de la presente solicitud ya que no hay otro con estas características que nos de solución de una manera exacta, segura y eficaz al problema antes descrito. Siendo esta la i principal ventaja del nuevo instrumento. So far, in the practice of Orthopedic Surgery, for the placement of angled plates of 95 ° when this implant is indicated, we have as guidance guidance the instruments designed by the Swiss Association for the study of Osteosynthesis (AO). Being basically these; the angle guide (KT5 AESCULAP catalog) nail guide (KT20 cat. AESCULAP) and guide nail (KT22 cat. AESCULAP). With the AO technique described in your osteosynthesis manual, this orientation is only of the visual order. Therefore, the exact placement of the implant is difficult, resulting in a large percentage of cases a bad orientation of the plate. As some surgeons have chosen not to use 95 ° angled plates, we particularly believe that it is a good implant for some femur fractures. The problem lies in the fact that it begins by placing the nail, and having no instrument that gives us the exact orientation, this is left with a deviation of one to several degrees, which affects the final position of the plate in a bad alignment of this with respect to the bone surface. With the purpose of solving the problem described, an instrument of the same material as mentioned above was designed to guarantee the exact placement of the angled plates of 95 °, first stabilizing the fracture and showing in advance the position that the plate will have and the definitive implant nail; which we have called PLACA - GUIA and which is composed of two basic components. 1.- Main male (No. 1, figure 1) .2.- Female assembly (No. 2, figures 1), and it is intended to protect by means of the present application since there is no other with these characteristics that give us a solution in an exact, safe and effective way to the problem described above. This being the main advantage of the new instrument.
Descripción de la Invención.Description of the Invention
Los detalles y características de la PLACA GUIA, se muestran claramente en la siguiente descripción y en los dibujos de las figuras 1 al 4.The details and characteristics of the GUIDE PLATE are clearly shown in the following description and in the drawings of figures 1 to 4.
La PLACA GUIA consta esencialmente de dos componentes y seThe GUIDE PLATE consists essentially of two components and is
5 describen como: 1.- Componente principal macho (No. 1, figura 1) y 2.-5 describe as: 1.- Main male component (No. 1, figure 1) and 2.-
Componente de ensamble hembra ( No.2,figura 1).Female assembly component (No.2, figure 1).
El componente principal macho (No.l) consta de una placa condilar de 10 agujeros con características y disposición de los mismos a las de auto compresión a la cual se le ha separado la hoja del clavo y en su lugar en el 0 extremo angular se le ha soldado una placa en sentido perpendicular a este, de 2.5 mm. de grueso , en forma de U cuadrada (No. 3, Fig 1), de 30mm. de largo X 16 mm. de ancha y 6.5 mm. de alto por su superficie interna, y en los extremos de sus ramas verticales tienen una ceja de 2.5mm. (No. 4, Fig 1) hacia el lado exterior y que la recorren en toda su 5 extensión y terminan en un tope (No 5, Fig 1) proximal al extremo soldado a la placa condilar.The main male component (No. 1) consists of a 10-hole condylar plate with characteristics and arrangement thereof to the self-compression ones to which the nail blade has been separated and in its place at the 0 angular end it he has welded a plate perpendicular to this, 2.5 mm. thick, square U-shaped (No. 3, Fig 1), 30mm. long X 16 mm. wide and 6.5 mm. high by its internal surface, and at the ends of its vertical branches have an eyebrow of 2.5mm. (No. 4, Fig 1) towards the outer side and that they cover it in all its extension and end in a stop (No 5, Fig 1) proximal to the end welded to the condylar plate.
El componente de ensamble hembra (No 2, Fig 1) cuya forma es de una C cuadrada de 30 mm. de largo X 16 mm. en la abertura de sus ramas las cuales ensamblan a espejo con la pieza principal y que junto con ella o forman un cubo cuya luz ( No 6, Fig 1) de 30mm. X 16 mm. X 6.5mm. que servirá para alojar al cincel guía (KT22,cat. AESCULAP) y cuya dirección estará dada por la orientación de dicho aditamento que será de entrada a 85° con respecto al eje principal de la PLACA GUIA y salida de 95° ángulo complementario al anterior (No. 7, fig. 1). Dicho componente 5 hembra (No 2) presenta en su cara exterior y distal dos conductos de 1.5mm. de diámetro (No. 8 fig 1) que la recorren paralelamente a lo largo de los 30mm. centrados y separados por 16 mm.. Entre medio de dichos conductos en su parte proximal a la de la unión con la placa presenta una escotadura de 6mm. de radio (No. 9 de la fig. 1) y en la parte opuesta una cresta de 6mm. de alto por lOmm. de largo y 3mm. de ancho (No. 10 fig.l) y que al ensamblar las dos piezas hembra-macho se forma un instrumento representado en la figura No. 2 al que hemos denominadoThe female assembly component (No 2, Fig 1) whose shape is a square C of 30 mm. long X 16 mm. in the opening of its branches which assemble in mirror with the main piece and that together with it or form a cube whose light (No 6, Fig 1) of 30mm. X 16 mm X 6.5mm which will serve to accommodate the guide chisel (KT22, cat. AESCULAP) and whose direction will be given by the orientation of said attachment that will be of entry at 85 ° with respect to the main axis of the GUIDE PLATE and exit of 95 ° angle complementary to the previous (No. 7, fig. 1). Said female component 5 (No 2) has two 1.5mm ducts on its outer and distal face. in diameter (No. 8 fig 1) that run it parallel along of 30mm. centered and separated by 16 mm. Between these ducts in its proximal part to that of the junction with the plate it has a 6mm recess. radius (No. 9 of fig. 1) and on the opposite side a 6mm crest. high by 10mm. long and 3mm. wide (No. 10 fig.l) and that when assembling the two male-female pieces an instrument is represented in Figure No. 2 which we have called
PLACA GUIA. GUIDE PLATE.
Método para usar la PLACA GUÍA.Method to use the GUIDE PLATE.
En las fracturas de fémur; intertrocantereas, subtrocantereas, supracondileas (No 11, Fig 5), y en las osteotomías de las mismas regiones y en cuyas osteosintesis se utilice las placas angulares de 95°, con las técnicas quirúrgicas ya conocidas y expuestos los fragmentos óseos (No 12, Fig 5), con la PLACA GUIA ensamblada (figuras 3 y 4), esta servirá como soporte para reducir de manera anatómica dichas fracturas (figura 5), lo que nos da una gran ventaja al método conocido anteriormente, y colocando la PLACA GUIA en la posición adecuada (No 1, Fig 5) se pasan los dos clavillos de Kirschner o Steinmann de 1.5mm. (No 13, Fig 6), por los conductos que presenta el ensamble hembra y pasándolos por la totalidad del hueso (No 14, fig. 6) lo que nos permite una visualización directa de la posición y dirección que seguirá el clavo guía (KT22), pudiendo en este momento hacer las correcciones pertinentes al caso si se necesitaran, así como pasar tornillos (No 15, Fig 6) de ser necesarios para darle mayor solidez al sistema, ya que la disposición de los agujeros es la misma que la de las placas anguladas estos tornillos servirán para el implante definitivo, siendo otra ventaja al método anteriormente usado. Si todo es correcto se retiran los clavillos y se procede a la introducción del clavo guía KT22 (No 16, Fig. 7) pudiendo controlar la profundidad requerida a través de la escotadura del ensamble (No. 9 , Fig. 7), se retira el clavo guía y los tornillos si se hubieran utilizado con la PLACA GUIA, y con el implante definitivo, placa angulada de 95° (No 17, Fig 8), montada en el impactor extractor KT26, Cat. AESCULAP (No 18, Fig 8) se procede a la introducción del mismo (Fig. 8) a través del cubo de luz de la PLACA GUIA lo que nos asegura que ocupara la posición exacta de la misma, y hasta donde lo permita esta.(Fig.9), en este momento se retira el componente hembra (No 2, Fig 9) jalándolo de la cresta (No 10, Fig.9), y deslizando el componente principal macho (No 1) a la cara anterior del hueso (Fig.10) manteniendo ; esta posición con las pinzas de reducción se termina de introducir el implante definitivo (No 17, Fig.l 1) quedando este en la posición correcta se fija con los tornillos correspondientes (No 15) al hueso. In the fractures of the femur; intertrocantereas, subtrocantereas, supracondylar (No 11, Fig 5), and in osteotomies of the same regions and in whose osteosynthesis the angular plates of 95 ° are used, with the known surgical techniques and exposed the bone fragments (No 12, Fig 5), with the GUIDE PLATE assembled (Figures 3 and 4), this will serve as a support to anatomically reduce these fractures (Figure 5), which gives us a great advantage to the previously known method, and placing the GUIDE PLATE in the proper position (No 1, Fig 5) the two Kirschner or Steinmann 1.5mm pins are passed. (No 13, Fig 6), through the conduits that the female assembly presents and passing them through the entire bone (No 14, fig. 6) which allows us a direct visualization of the position and direction that the guide nail will follow (KT22 ), being able at this time to make the pertinent corrections if necessary, as well as to pass screws (No 15, Fig 6) if necessary to give greater strength to the system, since the arrangement of the holes is the same as that of the angled plates these screws will serve for the definitive implant, being another advantage to the previously used method. If everything is correct, the pins are removed and the guide nail KT22 (No. 16, Fig. 7) is introduced, being able to control the required depth through the recess of the assembly (No. 9, Fig. 7), it is removed the guide nail and screws if they had been used with the GUIDE PLATE, and with the definitive implant, 95 ° angled plate (No 17, Fig 8), mounted on the KT26 extractor impactor, Cat. AESCULAP (No 18, Fig 8 ) the same is introduced (Fig. 8) through the light cube of the GUIDE PLATE which ensures us that occupies the exact position of the same, and as far as this is permitted (Fig. 9), at this time the female component (No 2, Fig 9) is removed by pulling it from the crest (No 10, Fig. 9), and sliding the main male component (No 1) to the anterior bone face (Fig. 10) keeping; This position with the reduction forceps is finished by introducing the definitive implant (No. 17, Fig. 1), leaving it in the correct position, fixed with the corresponding screws (No. 15) to the bone.

Claims

Reivindicaciones.Claims
Habiendo descrito suficientemente mi invención, lo considero como novedad y por lo tanto reclamo como de mi exclusiva propiedad lo contenido en las siguientes cláusulas: 1.- PLACA GUIA para placas angulares de 95°, en cirugía ortopédica, que la conforman dos componentes básicos; .1.- principal macho y 2.- ensamble hembra.Having sufficiently described my invention, I consider it as a novelty and therefore claim as my exclusive property contained in the following clauses: 1.- GUIDE PLATE for 95 ° angular plates, in orthopedic surgery, which are made up of two basic components; .1.- main male and 2.- female assembly.
El componente principal macho esta formado por una placa angular de 95° de 10 agujeros de auto compresión a la que se le ha retirado la hoja del clavo, quedando solamente la placa la cual esta caracterizada por un aditamento que se le ha soldado en el extremo angular y perpendicular a este, dicho aditamento consiste en una placa en forma de U cuadrada que en sus ramas verticales tienen una ceja o reborde hacia el lado externo que la recorren en toda su extensión terminando en un tope proximal al punto de unión con la placa angulada.The main male component is formed by a 95 ° angular plate with 10 self-compression holes to which the nail blade has been removed, leaving only the plate which is characterized by an attachment that has been welded at the end angular and perpendicular to this, said attachment consists of a square U-shaped plate that in its vertical branches has an eyebrow or flange towards the external side that travel it in its entire extension ending at a stop proximal to the point of union with the plate angled
El componente de ensamble hembra cuya forma es de una C cuadrada y sus ramas ensamblan a espejo con las cejas del componente macho ya descrito, y junto con este forman un túnel que sirve para alojar al cincel guía de una manera que entre a 85° con respecto a los ejes principales placa - aditamento y con salida de 95° ángulo correspondiente a la hoja del clavo de los implantes angulares de 95°, lo que nos asegura que no habrá variación en la posición final placa-clavo. El componente de ensamble hembra presenta en su cara externa dos conductos que la recorren en toda su extensión y servirán para alojar los clavillos guías de Steinmann, que nos darán la orientación del cincel guía, en medio de estos conductos en el extremo proximal a la placa presenta una escotadura que servirá para controlar la profundidad del cincel guía, en el extremo opuesto presenta una cresta que sirve para manipularThe female assembly component whose shape is a square C and its branches mirror together with the eyebrows of the male component already described, and together with this form a tunnel that serves to accommodate the guide chisel in a way that enters 85 ° with with respect to the main axes plate - attachment and with an exit of 95 ° angle corresponding to the nail blade of the 95 ° angular implants, which assures us that there will be no variation in the final nail-plate position. The female assembly component has on its external face two ducts that run along its entire length and will serve to house the Steinmann guide pins, which will give us the orientation of the guide chisel, in the middle of these ducts at the end proximal to the plate It has a recess that will serve to control the depth of the guide chisel, at the opposite end it presents a crest that serves to manipulate
HOJA DE SUSTITUCIÓN (REGLA 26) por deslizamiento este componente hembra.SUBSTITUTE SHEET (RULE 26) by sliding this female component.
2.- Mejoras a las guías para clavos guías, caracterizadas por el sistema hembra- macho desmontable y los conductos de orientación para los clavillos guías.2.- Improvements to the guides for guide nails, characterized by the detachable male-female system and the orientation ducts for the guide pins.
HOJA DE SUSTITUCIÓN (REGLA 26) SUBSTITUTE SHEET (RULE 26)
PCT/MX2001/000020 2001-03-14 2001-03-29 Guide plate for 95° angled plates in orthopedic surgery WO2002071963A1 (en)

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MX000007 2001-03-14
MX0100007 2001-03-14

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WO2006053573A2 (en) * 2004-11-18 2006-05-26 Mohamed Khairy El Gamal Femoral targeting device for internal fixation of femoral fractures
US7229445B2 (en) 2004-06-21 2007-06-12 Synthes (Usa) Bone plate with bladed portion
US7951176B2 (en) 2003-05-30 2011-05-31 Synthes Usa, Llc Bone plate
EP2515780A2 (en) * 2009-12-22 2012-10-31 Toby Orthopaedics, Llc Bone plate and tool assembly and method for use thereof
US9254154B2 (en) 2011-03-03 2016-02-09 Toby Orthopaedic, Inc. Anterior lesser tuberosity fixed angle fixation device and method of use associated therewith
US9271776B2 (en) 2010-10-05 2016-03-01 Toby Orthopaedics, Inc. System and method for facilitating repair and reattachment of comminuted bone portions
US9283008B2 (en) 2012-12-17 2016-03-15 Toby Orthopaedics, Inc. Bone plate for plate osteosynthesis and method for use thereof
US9402667B2 (en) 2011-11-09 2016-08-02 Eduardo Gonzalez-Hernandez Apparatus and method for use of the apparatus for fracture fixation of the distal humerus
US9730797B2 (en) 2011-10-27 2017-08-15 Toby Orthopaedics, Inc. Bone joint replacement and repair assembly and method of repairing and replacing a bone joint
US9757240B2 (en) 2010-10-27 2017-09-12 Toby Orthopaedics, Inc. System and method for fracture replacement of comminuted bone fractures or portions thereof adjacent bone joints
US10188522B2 (en) 2011-10-27 2019-01-29 Toby Orthopaedics, Inc. System for replacement of at least a portion of a carpal articular surface of a radius
US10335211B2 (en) 2004-01-26 2019-07-02 DePuy Synthes Products, Inc. Highly-versatile variable-angle bone plate system
US10342586B2 (en) 2003-08-26 2019-07-09 DePuy Synthes Products, Inc. Bone plate
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US10772665B2 (en) 2018-03-29 2020-09-15 DePuy Synthes Products, Inc. Locking structures for affixing bone anchors to a bone plate, and related systems and methods
US10820930B2 (en) 2016-09-08 2020-11-03 DePuy Synthes Products, Inc. Variable angle bone plate
US10905476B2 (en) 2016-09-08 2021-02-02 DePuy Synthes Products, Inc. Variable angle bone plate
US10925651B2 (en) 2018-12-21 2021-02-23 DePuy Synthes Products, Inc. Implant having locking holes with collection cavity for shavings
US11013541B2 (en) 2018-04-30 2021-05-25 DePuy Synthes Products, Inc. Threaded locking structures for affixing bone anchors to a bone plate, and related systems and methods
US11026727B2 (en) 2018-03-20 2021-06-08 DePuy Synthes Products, Inc. Bone plate with form-fitting variable-angle locking hole
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US11291484B2 (en) 2004-01-26 2022-04-05 DePuy Synthes Products, Inc. Highly-versatile variable-angle bone plate system

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US9308034B2 (en) 2003-05-30 2016-04-12 DePuy Synthes Products, Inc. Bone plate
US11419647B2 (en) 2003-05-30 2022-08-23 DePuy Synthes Products, Inc. Bone plate
US7951176B2 (en) 2003-05-30 2011-05-31 Synthes Usa, Llc Bone plate
US10653466B2 (en) 2003-05-30 2020-05-19 DePuy Synthes Products, Inc. Bone plate
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US11291484B2 (en) 2004-01-26 2022-04-05 DePuy Synthes Products, Inc. Highly-versatile variable-angle bone plate system
US7229445B2 (en) 2004-06-21 2007-06-12 Synthes (Usa) Bone plate with bladed portion
WO2006053573A3 (en) * 2004-11-18 2006-07-13 Gamal Mohamed Khairy El Femoral targeting device for internal fixation of femoral fractures
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