SYSTEMS AND METHODS FOR PERFORMING ANKLE ARTHRODESIS IN A HUMAN PATIENT
The present disclosure relates to systems and methods for ankle arthrodesis where the joint between the tibia and the talus of a human patient can be immobilzed. The system in one aspect can comprise an antero-lateral plate and an antero-medial plate.
1 . A system for immobilizing the joint between the tibia and the talus of a human patient, the system comprising:
an antero-lateral plate secured to an anterior face of the tibia and the talus, the antero-lateral plate including a tibio-lateral strip and a talo-lateral tab interconnected by a link zone; and
an antero-medial plate secured to an anterior face of the tibia and the talus, the antero-medial plate including a tibio-medial strip and a talo-medial tab interconnected by a link zone.
2 . A system according to claim 1 , wherein the antero-lateral plate is shaped so that at least one portion of the tibio-lateral strip rests substantially against the anterior lateral face of the tibia that is situated towards the outside of the body of the patient relative to the anterior tibial crest and the talo-lateral tab rests substantially against the talus.
3 . A system according to claim 2 , wherein the antero-lateral plate has a shape that is significantly twisted so as to match the outline of the anterior side face of the tibia and the outline of the neck of the talus
4 . A system according to claim 1 , wherein the antero-medial plate is shaped so that at least one portion of the tibio-medial strip rests substantially against the anterior medial face of the tibia that is situated towards the inside of the body of the patient relative to the anterior tibial crest and the talo-medial tab rests substantially against the talus.
5 . A system according to claim 1 , wherein the link zone of the antero-medial plate is designed to come into register with at least a portion of the tibial pilon, the link zone having a shape that is substantially complementary to the shape of the portion of the tibial pilon.
6 . A system according to claim 1 , wherein the antero-medial plate has a shape that is significantly twisted so as to match the outline of the anterior medial face of the tibia and the outline of the neck of the talus;
7 . A system according to claim 1 , wherein the tibio-medial strip has a shape that is substantially arcuate so as to match both the outline of the anterior medial face of the tibia and the outline of at least one portion of the tibial pilon.
8 . A system according to claim 1 , wherein the antero-medial plate has, as seen in profile, substantially the shape of a spoon.
9 . A system according to claim 1 , wherein the talo-medial tab extends in a main longitudinal direction that is inclined towards the outside of the body of the patient relative to a main longitudinal direction in which the tibio-medial strip extends.
10 . A system according to claim 1 , further comprising at least a first anchor member provided with a head and with a bone anchor shank that extends from the head, the tibio-medial strip being provided with at least a first orifice provided with a first bearing surface against which the head is designed to come into abutment, the bearing surface being shaped so that the anchor shank can extend in a direction enabling it to pass both through the tibia and through the talus.
11 . A system according to claim 10 , wherein the first bearing surface extends in a midplane disposed slantingly relative to a main longitudinal direction in which the tibio-medial strip extends.
12 . A system according to claim 10 , wherein the first bearing surface has a substantially rounded shape so as to make it possible to adjust the orientation of the first anchor member relative to the tibio-medial strip.
13 . A system according to claim 10 , wherein the tibio-medial strip is provided with a plurality of orifices, each of which is designed to be associated with a corresponding anchor member, the orifice that is closest to the link zone of the antero-medial plate corresponding to the first orifice.
14 . A system according to claim 13 , wherein the shank of the first anchor member has a diameter that is significantly grater than the diameter of the shanks of the other anchor members.
15 . A system according to claim 1 , further comprising compression tool for compressing the joint between the tibia and the talus, the compression tool comprising:
a first jaw configured to be fastened temporarily to the tibia;
a second jaw configured to be fastened temporarily to one of the antero-lateral plate or to the antero-medial plate; and
a closure device configured to bring the first and second jaws closer together.
16 . A system according to claim 15 , wherein one or both of the antero-lateral plate and the antero-medial plate is/are provided with a tapped hole into which either the second jaw itself or a piece mounted on the second jaw is configured to be screwed.
17 . A system according to claim 15 , wherein the tapped hole is provided in the tibio-lateral strip or in the tibio-medial strip, preferably towards the free end of the strip.
18 . An antero-lateral plate for immobilizing the joint between the tibia and the talus of a human patient, the antero-lateral plate having an anatomical shape that substantially matches the shape of portions of the tibia and the talus of the human patient that are situated towards the outside of the body of the patient relative to the anterior tibial crest.
19 . An antero-lateral plate for use in a system for immobilizing the joint between the tibia and the talus of a human patient, the antero-lateral plate comprising:
a tibio-lateral strip having an elongated shape, wherein at least one portion of the tibio-lateral strip rests substantially against the anterior lateral face of the tibia that is situated towards the outside of the body of the patient relative to the anterior tibial crest;
a talo-lateral tab having a shape such that the talo-lateral tab rests substantially against the neck of the talus; and
a link zone interconnecting the tibio-lateral strip to the talo-lateral tab, the link zone having a curved shape so as to match the outline of the tibial pilon.
20 . An antero-medial plate for use in a system for immobilizing the joint between the tibia and the talus of a human patient, the antero-medial plate having an anatomical shape that substantially matches the shape of portions of the tibia and the talus of the human patient that are situated towards the inside of the body of the patient relative to the anterior tibial crest.
21 . An antero-medial plate for use in a system for immobilizing the joint between the tibia and the talus of a human patient, the antero-medial plate comprising;
a tibio-medial strip having a shape such that at least one portion of the tibio-medial strip rests substantially against the anterior medial face of the tibia that is situated towards the inside of the body of the patient relative to the anterior tibial crest;
a talo-medial tab having a shape such that the talo-medial tab rests substantially against the neck of the talus; and
a link zone interconnecting the tibio-medial strip to the talo-medial tab, the link zone having a curved shape so as to match the outline of the tibial pilon.
22 . A system for immobilizing the joint between the tibia and the talus of a human patient, the system comprising:
an antero-lateral plate, itself comprising a tibio-lateral strip and a talo-lateral tab interconnected by a link zone, the tibio-lateral strip, the talo-lateral tab, and the link zone being shaped so that at least one portion of the tibio-lateral strip rests substantially against the anterior lateral face of the tibia that is situated towards the outside of the body of the patient relative to the anterior tibial crest and the talo-lateral tab rests substantially against the talus; and
an antero-medial plate, itself comprising a tibio-medial strip and a talo-medial tab interconnected by a link zone, the tibio-medial strip, the talo-medial tab, and the link zone being shaped so that at least one portion of the tibio-medial strip rests substantially against the anterior medial face of the tibia that is situated towards the inside of the body of the patient relative to the anterior tibial crest and the talo-medial tab rests substantially against the talus.
23 . A method for immobilizing the joint between the tibia and the talus of a human patient, the method comprising:
creating a longitudinal anterior incision in an anterior tendon of the tibia of the patient;
exposing the distal tibia and the neck of the talus;
implanting an antero-lateral plate against an anterior side face of the tibia that is situated towards the outside of the body of the patient relative to the anterior tibial crest; and
implanting an antero-medial plate against an anterior medial face of the tibia that is situated towards the inside of the body of the patient relative to the anterior tibial crest.
24 . A method according to claim 23 , wherein implanting the antero-lateral plate comprises:
positioning a plate having a talo-lateral tab and a tibio-lateral strip against an anterior side face of the tibia;
fastening the talo-lateral tab to the neck of the talus; and
fastening the tibio-lateral strip to the anterior lateral face of the tibia.
25 . A method according to claim 24 , wherein implanting the antero-lateral plate further comprises compressing the joint between the tibia and the talus between the steps of fastening the talo-lateral tab to the neck of the talus and fastening the tibio-lateral strip to the anterior lateral face of the tibia, the compressing comprising:
temporarily fastening a first jaw of a compression tool to the tibia;
temporarily fastening a second jaw of the compression tool to the antero-lateral plate; and
exerting a force on the compression tool to move the first jaw and the second jaw of the compression tool closer together.
26 . A method according to claim 23 , wherein implanting an antero-medial plate comprises implanting a plate having a shape that is significantly twisted so as to match the outline of the anterior medial face of the tibia and the outline of the neck of the talus.
27 . A method according to claim 23 , wherein implanting an antero-medial plate comprises:
positioning a plate having a talo-medial tab and a tibio-medial strip against an anterior medial face of the tibia;
fastening the talo-medial tab to the neck of the talus; and
fastening the tibio-medial strip to the anterior medial face of the tibia.
28 . A method according to claim 27 , wherein implanting the antero-medial plate further comprises compressing the joint between the tibia and the talus between the steps of fastening the talo-medial tab to the neck of the talus and fastening the tibio-medial strip to the anterior medial face of the tibia, the compressing comprising:
temporarily fastening a first jaw of a compression tool to the tibia;
temporarily fastening a second jaw of the compression tool to the antero-medial plate; and
exerting a force on the compression tool to move the first jaw and the second jaw of the compression tool closer together.