(19)
(11)EP 2 419 045 B1

(12)EUROPEAN PATENT SPECIFICATION

(45)Mention of the grant of the patent:
05.09.2018 Bulletin 2018/36

(21)Application number: 10765321.4

(22)Date of filing:  18.04.2010
(51)Int. Cl.: 
A61D 1/00  (2006.01)
A61B 17/80  (2006.01)
(86)International application number:
PCT/US2010/031531
(87)International publication number:
WO 2010/121233 (21.10.2010 Gazette  2010/42)

(54)

APPARATUS AND METHOD FOR MEDIAL COMPARTMENT CORRECTION

VORRICHTUNG UND VERFAHREN ZUR KORREKTUR MEDIALER KOMPARTMENTS

APPAREIL ET PROCÉDÉ POUR CORRECTION DE COMPARTIMENT MÉDIAL


(84)Designated Contracting States:
AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HR HU IE IS IT LI LT LU LV MC MK MT NL NO PL PT RO SE SI SK SM TR

(30)Priority: 18.04.2009 US 170622 P

(43)Date of publication of application:
22.02.2012 Bulletin 2012/08

(73)Proprietor: Kyon Pharma, Inc.
Boston, Massachusetts 02128 (US)

(72)Inventor:
  • PFEIL, Ingo Michael
    01465 Langebruck (DE)

(74)Representative: Bailey, Jennifer Ann et al
Marks & Clerk LLP Alpha Tower Suffolk Street Queensway
Birmingham B1 1TT
Birmingham B1 1TT (GB)


(56)References cited: : 
EP-A1- 0 100 114
EP-A1- 1 754 452
US-A1- 2005 171 544
EP-A1- 1 754 452
FR-A1- 2 294 685
  
  • HARASEN, GREG.: 'Arthrodesis - Part 1: The carpus' CANADIAN VETERINARY JOUMAL, [Online] vol. 43, August 2002, pages 641 - 643 Retrieved from the Internet: <URL:http://www.pubmedcentral.nih.gov/artic lerender.fcgi?articl=339412> [retrieved on 2010-06-10]
  
Note: Within nine months from the publication of the mention of the grant of the European patent, any person may give notice to the European Patent Office of opposition to the European patent granted. Notice of opposition shall be filed in a written reasoned statement. It shall not be deemed to have been filed until the opposition fee has been paid. (Art. 99(1) European Patent Convention).


Description

TECHNICAL FIELD (field of the invention)



[0001] The present invention relates to an apparatus and method for correcting misalignments of the medial compartment of the ulna and the humerus in the foreleg of dogs and other animals. More particularly, it relates to a device for repositioning the head end of the ulna in the foreleg of a dog or other animal in order to properly align the medial compartment with the end of the humerus.

BACKGROUND OF THE INVENTION



[0002] The present invention relates to correction of misalignments in the elbow of dogs and other animals. Arthritis of the elbow joint is the most common cause of foreleg lameness in dogs. Most of the arthritic diseases of the elbow are considered forms of dysplasia. Common causes of c include fragmented coronoid process (FCP) and medial compartment disease
(MCD). In FCP, the most common form of elbow dysplasia in dogs, a fragment of bone and cartilage of the ulna is broken off. The fragment may move and cause additional damage to the joint. Furthermore, the broken bone changes the relationship between abutting surfaces of the humerus and ulna. This changed relationship causes a misalignment of the forces affecting the joint, particularly when loaded. The misaligned forces can cause cartilage damage and/or further damage to the bones.

[0003] Treatment for FCP requires removal of any bone fragments. However, this may not be sufficient if the joint has been otherwise damaged. If the joint has been severely damaged or the bones are misaligned, further damage to the joint and ongoing lameness are likely. One method for correcting problems with the elbow joint is to replace all or part of the joint. However, elbow replacement requires extensive and complicated surgery. A canine carpal arthrodesis plate is described in EP1754452. FR2294685 discloses an artificial hip joint, while EP0100114 describes a plate for bone derotation. Despite the existence of various elbow prostheses, none has proven safe and effective for routine use.

[0004] Sliding humeral osteotomy has been proposed by Dr. Schultz at the Orthopedic Research Laboratory of the University of California. The procedure realigns the humerus to shift the forces off an area of cartilage damage. In this procedure, the humerus is cut above the elbow. A plate is used to reposition portions of the humerus bone. However, this procedure merely changes the direction of the forces. It does not adjust the angles between the humerus and the ulna nor align the interacting surfaces.

DISCLOSURE OF INVENTION



[0005] The present invention is defined by claim 1. Embodiments are provided by the dependent claims.

[0006] There is described a procedure for realigning the humerus and ulna bones in the elbow to correct for the changed geometry of the head of the ulna from FCP or other damage to the elbow joint. The ulna is cut below the elbow. The upper part of the ulna is angled so that the head is properly aligned with the humerus. The parts of the ulna are connected together to hold them at the new angles.

[0007] The elbow joint may be imaged when in a loaded condition. Imaging may be done by x-ray or any other known imaging process. The image of the elbow joint is used to determine the error in alignment of the humerus and ulna bones. The necessary change in the angle of upper portion of the ulna is determined based upon the misalignment shown in the image. The ulna may be lengthened as part of the realignment.

[0008] A plate may be used to reconnect the portions of the ulna where it is cut. The plate has a flat portion and an angled portion. The upper portion of the ulna may be attached to the angled portion of the plate. The lower portion of the ulna may be attached to the flat portion of the plate. The plate can be attached to the parts of the ulna using bone screws. According to the present disclosure, plates are created with angled portions at different angles. The plate used depends upon the desired adjustment in the angle of the head of the ulna.

DESCRIPTION OF THE DRAWINGS



[0009] 

Fig. 1 is a view of the humerus and ulna in the elbow of a dog having elbow dysplasia. Fig. 2 is a perspective view of a plate according to an embodiment of the present invention.

Fig. 3 is a cross sectional view of the plate of Fig. 2.

Fig. 4 is a view of a plate according to an embodiment of the invention attached to the ulna.


BEST MODE FOR CARRYING OUT THE INVENTION



[0010] Fig. 1 illustrates the problems caused by elbow dysplasia in dogs. The humerus 2 and ulna 3 bones are shown at their interaction in the elbow 1. The radius is not shown to provide a better view of the interaction between the humerus 2 and ulna 3. The elbow 1 is illustrated with the medial side 5 on the right and lateral side 4 on the left. The portion of the ulna 3a behind the humerus 2 is shown in dashed form. In a normal elbow, the humerus and ulna are aligned. When the joint is loaded, i.e, when the dog is standing, the humerus is supported evenly across the head of the ulna. However, with elbow dysplasia, as shown in Fig. 1, the bones do not interact evenly. A portion 6 of the ulna 3 is lower and does not contact the humerus 2. The lower portion of the ulna may be caused when a piece of bone is broken off, such as from FCP. It may also result from loss of cartilage. It may also be caused by poor formation of the elbow or misalignment of the bones. Regardless of the reason for the deficiency, there is a misalignment of the angle of the bones at their point of contact. The angle 10 illustrates the possible misalignment of the joint. The angle 10 represents the difference in angles between the head of the humerus 2 and the ulna 3. Typically, the misalignment occurs at the medial compartment, as illustrated in Fig. 1, but could be on the lateral side as well. The misalignment is most pronounced, and may only occur when the joint is loaded. The misalignment should be visible in an x-ray of the joint. Of course, other types of imaging, such as MRI or CT scan, could be used to view the joint and any misalignment.

[0011] Figs. 2 and 3 illustrate a plate 100 for use in correcting a misalignment of the humerus and ulna. The plate 100 is elongated. It is similar to other types of plates for attaching to bones. It may be of any material, but is preferably a metal. The surface may be formed or treated to allow bone in-growth or on-growth. The plate 100 has a first side 101 and a second side 102 opposite the first side 101. The first side 101 is preferably flat. The second side 102 has a non-planar surface in order to contact the bone. The other sides 103, 104 may also be planar, or may have various other shapes. As is known with bone plates, the sides 103, 104 may be curved about screw holes 130, 131. The plate 100 has a plurality of screw holes 130, 131 for receiving bone screws to attach the plate to a bone. Preferably, the screw holes 130, 131 are recessed so that the heads of the screws are positioned below the first side 101 of the plate. Of course, other types of screw holes could be used. Any type of bone screw, including locking and non-locking screws, can be used to attach the plate 100 to the bone. Different types of screws could be used in different holes. The plate 100 in Figs. 2 and 3 has been illustrated with six screw holes 130, 131. However, any number of screw holes could be used.

[0012] The second side 102 of the plate is shaped to create two different portions 110, 120 of the plate. In the first portion 110, the second side 102 is substantially parallel to the first side 101. In the second portion 120, the second side 102 is at an angle 140 relative to the first side 101. An angled portion 115 connects the widest part of the second portion 120 with the first portion 110. Preferably, the angled portion 115 is steep and provides a narrow transition between the portions. The angled portion may be substantially perpendicular to the first side 101.
The angle 140 of the second portion 120 of the plate 100 may be at any angle. Preferably, plates are constructed with different angles.
In order to correct the misalignment of the humerus and ulna, the image of the joint is used to determine the angle 10 (Fig. 1) of the misalignment. A plate 100 with a similar angle 140 is selected. The portion of the ulna 3 below the joint is exposed through disattachment or moving the necessary muscles and/or ligaments. As illustrated in Fig. 4, the ulna 3 is cut 20. Preferably, the cut 20 is straight across and perpendicular to the ulna 3. However, other types of cuts could be used. Preferably, the cut is not close to the head of the ulna. The distance from the head of the ulna must be sufficient to allow space for the second portion 120 of the plate 100. The plate 100 is positioned beside the ulna and attached thereto. The plate 100 may be attached to either the medial side or lateral side of the ulna, depending upon the desired adjustment to the angle. Since in most instances the medial side is lower, the plate would be positioned on the lateral side of the ulna. In attaching the plate 100, the ulna 3 may be spaced apart at the cut. Typically, the ulna has been broken or worn. This results in the ulna being shorter than the radius. The shorter ulna causes additional misalignments in the elbow. When correcting the misalignment between the ulna and the humerus, the length of the ulna can also be corrected to adjust for any difference with the radius. The plate 100 is attached to the parts 3', 3" of the ulna in the ordinary manner. Screws 135, 136 are positioned in the holes 130, 131. The plate 100 may be clamped to the parts of the bone before attachment with the screws to maintain the desired positions.


Claims

1. A plate (100) for adjusting the angle of the medial compartment of the ulna, the plate (100) comprising:

a substantially planar first side (101);

a non-planar second side (102) that is opposite the first side (101); and

a plurality of screw holes formed in the plate (100) from the first side (101) of the plate (100) to the second side (102) of the plate (100) for receiving screws to attach the plate (100) to bone,

wherein:

the second side (102) is shaped to create a first portion (110) and a second portion (120);

in the first portion (110) of the plate (100) the second side (102) comprises a plurality of planar surface regions which lie in a plane that is substantially parallel to a portion of the first side (101);

in the second portion (120) of the plate (100) the second side (102) comprises a plurality of planar surface regions which lie in a plane that is angled relative to a portion of the first side (101);

in the second portion (120) the distance between the first side (101) and the second side (102) increases from an end of the plate (100) towards the first portion (110) such that the second portion (120) is widest proximal to the first portion (110); and

the plate (100) further comprising an angled portion (115) that connects the widest part of the second portion (120) with the first portion (110).


 
2. The plate (100) according to claim 1, wherein the first side (101) comprises a first edge and the non-planar second side (102) comprises a second edge, wherein the first edge and the second edge (a) are opposite one another and (b) spaced further apart from one another around each of the plurality of the screw holes (130, 131) than between each of the plurality of screw holes (130, 131).
 
3. A plurality of plates for correcting medial compartment misalignment comprising a plate (100) according to claim 1, wherein
said angled portion (115) has an angle that is different in each of the plurality of the plates.
 


Ansprüche

1. Platte (100) zum Einstellen des Winkels des medialen Kompartments der Ulna, wobei die Platte (100) umfasst:

eine im Wesentlichen ebene erste Seite (101);

eine nicht-ebene zweite Seite (102), welche der ersten Seite (101) gegenüberliegt; und

eine Mehrzahl von Schraublöchern, welche in der Platte (100) von der ersten Seite (101) der Platte (100) zur zweiten Seite (102) der Platte (100) zum Aufnehmen von Schrauben gebildet sind, um die Platte (100) an einem Knochen zu befestigen,

wobei:

die zweite Seite (102) geformt ist, um einen ersten Abschnitt (110) und einen zweiten Abschnitt (120) zu bilden;

im ersten Abschnitt (110) der Platte (100) die zweite Seite (102) eine Mehrzahl von ebenen Oberflächenbereichen umfasst, welche in einer Ebene liegen, welche im Wesentlichen zu einem Abschnitt der ersten Seite (101) parallel sind;

im zweiten Abschnitt (120) der Platte (100), die zweite Seite (102) eine Mehrzahl von ebenen Oberflächenbereichen umfasst, welche in einer Ebene liegen, welche relativ zu einem Abschnitt der ersten Seite (101) geneigt ist;

im zweiten Abschnitt (120), der Abstand zwischen der ersten Seite (101) und der zweiten Seite (102) von einem Ende der Platte (100) zum ersten Abschnitt (110) so zunimmt, dass der zweite Abschnitt (120) am breitesten proximal zum ersten Abschnitt (110) ist; und

die Platte (100) ferner einen abgewinkelten Abschnitt (115) umfasst, welcher den breitesten Teil des zweiten Abschnitts (120) mit dem ersten Abschnitt (110) verbindet.


 
2. Platte (100) nach Anspruch 1, wobei die erste Seite (101) eine erste Kante und die nicht-ebene zweite Seite (102) eine zweite Kante umfasst, wobei die erste Kante und die zweite Kante (a) sich gegenüberliegen und (b) voneinander um jedes der Mehrzahl von Schraubenlöchern (130, 131) weiter beabstandet sind als zwischen jedem der Mehrzahl von Schraubenlöchern (130, 131).
 
3. Mehrzahl von Platten zur Korrektur von Fehlausrichtungen medialer Kompartments, umfassend eine Platte (100) nach Anspruch 1, wobei
der abgewinkelte Abschnitt (115) einen Winkel aufweist, welche in jeder der Mehrzahl von Platten unterschiedlich ist.
 


Revendications

1. Plaque (100) pour ajuster l'angle du compartiment médial du cubitus, la plaque (100) comprenant :

un premier côté sensiblement plan (10) ; et

un deuxième côté non plan (102) opposé au premier côté (11) ; et

plusieurs trous de vis formés dans la plaque (100), du premier côté (101) de la plaque (100) vers le deuxième côté (102) de la plaque (100), pour recevoir des vis en vue de fixer la plaque (100) sur un os ;

dans laquelle :

le deuxième côté (102) est formé de sorte à créer une première partie (110) et une deuxième partie (120) ;

dans la première partie (110) de la plaque (100), le deuxième côté (102) comprend plusieurs régions de surface planes situées dans un plan sensiblement parallèle à une partie du premier côté (101) ;

dans la deuxième partie (120) de la plaque (100), le deuxième côté (102) comprend plusieurs régions de surface planes situées dans un plan incliné par rapport à une partie du premier côté (101)

dans la deuxième partie (120), la distance entre le premier côté (101) et le deuxième côté (102) est accrue d'une extrémité de la plaque (100) vers la première partie (110), de sorte que la deuxième partie (120) a une largeur maximale à proximité de la première partie (110) ; et

la plaque (100) comprend en outre une partie inclinée (115) connectant la partie la plus large de la deuxième partie (120) à la première partie (110).


 
2. Plaque (100) selon la revendication 1, dans laquelle le premier côté (101) comprend un premier bord, le deuxième côté non plan (102) comprenant un deuxième bord, le premier bord et le deuxième bord (a) étant opposés l'un à l'autre et (b) étant espacés davantage l'un de l'autre autour de chacun des plusieurs tous de vis (130, 131) qu'entre chacun des plusieurs trous de vis (130, 131).
 
3. Plusieurs plaques pour corriger un désalignement du compartiment médial, comprenant une plaque (100) selon la revendication 1, dans lesquelles :
ladite partie inclinée (115) forme un angle différent dans chacune des plusieurs plaques.
 




Drawing






REFERENCES CITED IN THE DESCRIPTION



This list of references cited by the applicant is for the reader's convenience only. It does not form part of the European patent document. Even though great care has been taken in compiling the references, errors or omissions cannot be excluded and the EPO disclaims all liability in this regard.

Patent documents cited in the description