Note: Within nine months of the publication of the mention of the grant of the European patent in the European PatentBulletin, any person may give notice to the European Patent Office of opposition to that patent, in accordance with theImplementing Regulations. Notice of opposition shall not be deemed to have been filed until the opposition fee has beenpaid. (Art. 99(1) European Patent Convention).

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(12) EUROPEAN PATENT SPECIFICATION

(45) Date of publication and mention of the grant of the patent: 23.09.2015 Bulletin 2015/39

(21) Application number: 10784405.2

(22) Date of filing: 23.11.2010

(51) Int Cl.:A61B 17/80 (2006.01) A61F 5/058 (2006.01)

(86) International application number: PCT/US2010/057712

(87) International publication number: WO 2011/063368 (26.05.2011 Gazette 2011/21)

(54) FLEXIBLE MAXILLO-MANDIBULAR FIXATION DEVICE

FLEXIBLE MAXILLOMANDIBULÄRE FIXIERVORRICHTUNG

DISPOSITIF DE FIXATION MAXILLO-MANDIBULAIRE FLEXIBLE

(84) Designated Contracting States: AL 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 RS SE SI SK SM TR

(30) Priority: 23.11.2009 US 263542 P

(43) Date of publication of application: 03.10.2012 Bulletin 2012/40

(73) Proprietor: Synthes GmbH4436 Oberdorf (CH)

(72) Inventors: • FRIGG, Robert

CH-4513 Langendorf (CH)• RICHTER, Jens

CH-4436 Oberdorf (CH)• LEUENBERGER, Samuel

CH-4436 Oberdorf (CH)

• CORNELIUS, Carl, Peter80337 Munich (DE)

• HAMEL, RossWest ChesterPA 19380 (US)

(74) Representative: Klunker . Schmitt-Nilson . HirschPatentanwälte Destouchesstraße 6880796 München (DE)

(56) References cited: EP-A1- 0 654 250 WO-A1-99/05982WO-A1-2009/055537 WO-A1-2010/025263WO-A2-2004/045389 US-A- 5 250 048US-A- 5 752 958 US-A- 6 086 365US-A1- 2009 148 804 US-B1- 6 257 884

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Description

BACKGROUND

[0001] The fixation or stabilization of the upper and low-er dental occlusal arches to each other is known as in-termaxillary fixation (IMF) and also known as maxillo-mandibular fixation (MMF). MMF has historically beenincluded in the treatment of fracture, orthognathic, andreconstructive jaw procedures. Various methods forachieving MMF are known in the art.[0002] Circumdental wiring techniques include metal-lic wires that are placed around one or more teeth andthen twisted in various methods to secure the teeth. Wiresor twisted pairs of wires can form cables and be twistedto each other to stabilize the dental arch. Loops formedon mandibular teeth can be wired to loops formed aroundmaxillary teeth in order to stabilize the top dentition tothe bottom dentition. While the materials used in circum-dental wiring are relatively inexpensive, the technique istedious and time consuming. The wires also can interferewith dental hygiene.[0003] Another conventional technique includes archbars that are used in combination with wiring. Specifical-ly, a metal bar is preformed to correspond with the cur-vature of the dental arch. Wires are then passed aroundthe teeth and over the bar, and then twisted to the bar.This is performed at multiple locations along the bar toprovide stability around the dental arch. Since the barstypically have bent or formed hooks on them for securingwire, the hooks can be used for wiring the upper arch barto the lower arch bar. Elastic bands can also be used tofix the upper arch bar to the lower arch bar. Unfortunately,this technique is time consuming, and interferes with den-tal hygiene.[0004] Another conventional technique involves plac-ing a plurality of screws in the mandible or maxilla inregions that avoid the tooth roots. The screw heads maycontain through holes. The screw head serves as an areaaround which wires may be wrapped, and the holes canfacilitate the passage of wire through the heads. Thus,wires may be secured to adjoining sets of screws to pro-vide MMF. This system unfortunately suffers from a lackof overall structural stability which can be necessary, forinstance, when addressing fractures around the teeth.[0005] A bone fixation device for intermaxillary fixationis disclosed in US 6,086,365. The device includes a den-tal splint that is directly bonded by cement to the teeth ofa patient for temporarily fixing and immobilizing the pa-tient’s jaws during and following oral surgery. The splintincludes an arch band having a back side surface forreceiving a deposit of bonding cement and a facial sidesurface from which multiple ligature studs project for en-gaging ligature wires.

SUMMARY

[0006] In accordance with one embodiment, a bone

fixation system includes first and second bone fixationdevices. Each of the first bone fixation device and thesecond bone fixation device is specified in claim 1.

BRIEF DESCRIPTION OF THE DRAWINGS

[0007] The foregoing summary, as well as the followingdetailed description, is better understood when read inconjunction with the appended drawings. For the purposeof illustrating the maxillo-mandibular fixation device andrelated method thereof, there is shown in the drawingsexemplary embodiments; however, the maxillo-mandib-ular fixation device and related methods are not limitedto the specific embodiments and methods disclosed. Likereference numerals refer to corresponding parts through-out the several embodiments of the drawings, in which:

Fig. 1 is a perspective view of a maxillo-mandibularfixation system including a pair of fixation devicesattached to the maxilla and mandible of a patient,and secured together;Fig. 2A is a perspective view of a bone fixation bodyconstructed in accordance with one example em-bodiment in a neutral configuration;Fig. 2B is a sectional elevation view of the fixationdevice illustrated in Fig. 2A taken along the line 2B-2B;Fig. 3A is a front view of the fixation device illustratedin Fig. 2A in the neutral configuration;Fig. 3B is a front view of the fixation device illustratedin Fig. 3A, but shown in a compressed configuration;Fig. 3C is a front elevation view of the fixation deviceillustrated in Fig. 3A, but shown in an expanded con-figuration;Fig. 4 is a sectional elevation view of the fixationdevice illustrated in Fig. 2A, taken along line 4-4;Fig. 5 is a sectional elevation view of the fixationdevice similar to Fig. 4, but illustrated in accordancewith an alternative embodiment;Fig. 6 is a sectional elevation view of the mandibularfixation device illustrated in Fig. 2A, implanted in themanner illustrated in Fig. 1, and taken along line 6-6of Fig. 1 to show the fixation of the device to themandible;Fig. 7 is a front elevation view of a bone fixation bodyconstructed in accordance with an alternative em-bodiment;Fig. 8 is a front elevation view of a bone fixation bodyconstructed in accordance with another alternativeembodiment; andFig. 9 is a front elevation view of a bone fixation bodyconstructed in accordance with another alternativeembodiment.

DETAILED DESCRIPTION OF ILLUSTRATIVE EM-BODIMENTS

[0008] For convenience, the same or equivalent ele-

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ments in the various embodiments illustrated in the draw-ings have been identified with the same reference nu-merals. Certain terminology is used in the following de-scription for convenience only and is not limiting. Thewords "right", "left", "upper," and "lower" designate direc-tions in the drawings to which reference is made. Thewords "inward", "inwardly", "outward", "outwardly," "up-ward," "upwardly," "downward," and "downwardly" referto directions toward and away from the geometric centerof the device and/or designated parts thereof. The termi-nology intended to be non-limiting includes the above-listed words, derivatives thereof and words of similar im-port.[0009] Referring initially to Figs. 1 and 2A-B, a bonefixation, or stabilization, system 20 is configured to pro-vide maxillo-mandibular fixation (MMF) for assisting therepairing of an injury to the maxillo-mandibular region.For instance, when the mandible 24 and/or maxilla 26 isfractured at a fracture location 37, it is desirable to sta-bilize the broken bone segments by fixing or stabilizingthe maxilla and the mandible relative to each other. Thefixation system 20 includes a pair of fixation devices 22and 22’, including bone fixation bodies 29 and 29’, oneor more fasteners 35 that attach each fixation body 29and 29’ to underlying bone, and one or more securementdevices 23 that connect, or secure the fixation devices22 and 22’ to each other. The fasteners 35 can includebone screws or any other type of fastener suitable forattaching the fixation bodies 29 and 29’ to underlyingbone. Thus, the fixation devices 22 and 22’ can be se-cured to the mandible 24 and the maxilla 26, respectively,of a patient. The suitable securement device 23 can se-cure the fixation bodies 29 and 29’ to each other, therebyfixing the mandible 24 and the maxilla 26 with respect torelative movement.[0010] Specifically, each fixation body 29 and 29’ in-cludes a respective plurality of flexible links 31 and 31’extending between a respective plurality of longitudinallyspaced interfaces 33 and 33’. The pluralities of flexiblelinks 31 and 31’ extend upwardly and downwardly in analternating pattern between the interfaces 33 and 33’,thereby defining respective pluralities of valleys 30 and30’ and crests 32 and 32’ between opposed ends of thefixation bodies 29 and 29’. The interfaces 33 and 33’ de-fined at respective valleys 30 and 30’ and crests 32 and32’ can be configured as connection or attachment loca-tions. In the illustrated configuration, the interfaces 33and 33’ at the valleys 30 and 30’ are configured as at-tachment locations having apertures 34 and 34’, respec-tively. The apertures 34 and 34’ can be configured toreceive the fasteners 35. For example, the apertures 34and 34’ of the illustrated configuration are threaded soas to provide screw holes that receive fasteners 35 in theform of bone screws. Accordingly, the valleys 30 and 30’are configured as attachment locations that can be at-tached to underlying bone, for instance via the bonescrews. The interfaces 33 and 33’ at the crests 32 and32’ are configured as connection, or securement loca-

tions which can be secured to each other to in turn securethe fixation devices 22 and 22’ with respect to each other.In the illustrated configuration, the interfaces 33 and 33’at the crests 32 and 32’ are defined as securement loca-tions having tangs 36 and 36’ that extend outwardly fromthe crests 32 and 32’ in a direction generally towards andin between the immediately adjacent valleys 30 and 30’,respectively. The tangs 36 and 36’ can be configured toreceive a securement device, for instance the secure-ment device 23, so as to secure the tangs 36 and 36’ toeach other. The securement device 23 can be providedas a suitable wire, elastic band, or any other alternativesecurement apparatus as desired.[0011] The mandibular and maxillo fixation devices 22and 22’ can be identically or substantially identically con-structed from a bone fixation device 40 (see Fig. 2A), andoriented as desired when implanted into the mandible 24and maxilla 26 of a patient to provide the fixation devices22 and 22’. Thus, the vertical orientations of the fixationdevices 22 and 22’ are inverted with respect to each otherin the illustrated configuration. In particular, the mandib-ular fixation device 22 is oriented such that the pluralityof crests 32 are positioned above the plurality of valleys30, and the maxillo fixation device 22’ is oriented suchthat the plurality of crests 32’ is positioned below the plu-rality of valleys 30’. The maxillo-mandibular fixation sys-tem 20 will now be described with reference to the bonefixation device 40 as illustrated in Fig. 2A.[0012] The bone fixation device 40 is illustrated as ori-ented in a vertical plane defined by a longitudinal direction"L" and transverse direction "T" that is perpendicular tothe longitudinal direction, and has a thickness in a lateraldirection "A" that is perpendicular to the longitudinal andtransverse directions L and T, respectively. The bonefixation device 40 is elongate along the longitudinal di-rection L before the fixation device 40 is curved, bent, orotherwise configured to align with, for instance, the man-dible or maxilla prior to implantation. Thus, while the de-scription of the bone fixation device 40 is made with ref-erence to the illustrated configuration of the fixation de-vice 40, the description applies equally to orientationsachieved when the fixation device 40 is configured forimplantation, for instance, in the maxilla or mandible ofa patient.[0013] Unless otherwise specified herein, the terms"lateral," "longitudinal," and "transverse" are used to de-scribe the orthogonal directional components of the bonefixation device 40 and its components as illustrated inFig. 2A. The terms "inner," "outer," and derivatives there-of with respect to a specified directional component areused herein with respect to a given apparatus to refer todirections along the directional component toward andaway from the center of the apparatus, respectively.[0014] It should be appreciated that while the longitu-dinal and transverse directions are illustrated as extend-ing along a vertical plane, and that the lateral directionis illustrated as extending along a horizontal plane, thatthe planes that encompass the various directions may

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differ during use, depending, for instance, on the desiredorientation of the bone fixation device 40 when implantedin a patient. Accordingly, while certain directional termsare used herein to describe the bone fixation device 40as illustrated merely for the purposes of clarity and con-venience, it should appreciated that these orientationsmay change during use.[0015] Therefore, while the bone fixation device 40 isdescribed with respect to an orientation such that its base(i.e., its valleys) is disposed below its crest (i.e., itscrests), it can be subsequently oriented as desired (forinstance with the base disposed above the crest whenproviding the maxillo fixation device 22’) when implantedin the patient. It should thus be understood that while thebone fixation device 40 is described in its illustrated ori-entation with reference to implantation in the mandible24, it can alternatively be implanted in the maxilla 26 orany other desired bone structures that are to be fixedrelative to each other.[0016] With continuing reference to Fig. 2A, the bonefixation device 40 includes a flexible bone fixation body42, which can also be referred to as a fixation plate or afixation body, and a plurality of fasteners 44 configuredto attach the fixation body 42 to underlying bone. Thefixation body 42 is illustrated as defining opposed firstand second longitudinally outer ends 43 and 45, respec-tively, and opposed inner and outer lateral surfaces 57and 59. The inner surface 57 faces the gum surroundingthe bone structure to which the fixation body 42 is at-tached, and the outer surface 59 faces a direction oppo-site the inner surface 57. The fixation body 42 includesa plurality of sequential links 46 A-E that can be integrallyconnected as illustrated, or can alternatively be discreetlyattached to each other. The links 46A and 46E defineouter links, while the links 46B-D define inner links dis-posed between the outer links 46A and 46E. In one em-bodiment, the fixation body 42 is formed by wire electricaldischarge machining (wire EDM), though the body canbe formed from any alternative fabrication process. Thefixation bodies 42 and 42’ (see Figs. 8-9) can be con-structed from any suitable biocompatible material includ-ing but not limited to commercially pure titanium, titaniumalloy such as TAN, stainless steel, reinforced plastics,polymers such as polyether ether ketone (PEEK) or PE,and the like.[0017] As illustrated, the fixation body 42 includes fivelinks 46A-E, though any number of links can be usedsuch that reliable fixation can be achieved to a patient’smandible or maxilla, such as three links, four links, or fivelinks. Referring to Fig. 2B, the links 46A-E have a rec-tangular cross-section that is elongate in the verticalplane defined by the transverse T and longitudinal L di-rections. Specifically, the links 46A-E include opposedelongate edges 47 and minor edges 49. The elongateedges 47 can have any length as desired, such as about1 mm while the minor edges 49 can have any length asdesired, such as about 0.6 mm. The links 46A-E can de-fine a lateral thickness as desired, such as approximately

0.6 mm in accordance with one embodiment. Of course,it may be desirable to eliminate sharp corners or edgesthat could cause injury to surrounding tissue when im-planted in a patient. The size and shape of the links 46impart flexibility to the fixation body 42, thereby allowingthe fixation body 42 to assume multiple sizes, and alsoallowing for variable positioning of the fixation device 40when implanted in the patient. In this regard, it should beappreciated that the links 46A-E can alternatively defineany suitable alternative geometric size and shape as de-sired. One or more of the links 46A-E can be similarly oridentically or substantially identically constructed, andwill now be described with reference to the link 46B.[0018] In particular, referring again to Fig. 2A, the link46B includes a pair of opposed first and second sidemembers 48 and 50. Each side member defines respec-tive longitudinally inwardly curved upper ends 52 and 54and opposed longitudinally outwardly curved lower ends56 and 58. The upper ends 52 and 54 of the side members48 and 50 of the link 46B are joined at a first interface53, so as to form a crest 51 of the fixation body 42. Thecrest 51 is continuously curved about a laterally extend-ing axis, such that the crest 51 presents a convex surfacewith respect to a downwardly directed view of the top ofthe fixation body 42. Of course, it should be appreciatedthat the crest 51 could assume any alternative shape asdefined by the upper ends 52 and 54 of the side members48 and 50, or as defined by a separate structure that joinsthe upper ends 52 and 54, either directly or indirectly.[0019] The side members 48 and 50 are longitudinallyspaced from each other, and extend linearly so as to flarelongitudinally outward from each other along a downwarddirection from their respective upper ends 52 and 54 totheir lower ends 56 and 58 in the illustrated embodiment.Thus, the first side member 48 flares longitudinally out-ward toward the first outer end 43 of the fixation body 42in a downward direction along the side member 48. Like-wise, the second side member 50 flares longitudinallyoutward toward the second outer end 45 of the body ina downward direction along the side member 50. In theillustrated embodiment, the side members 48 and 50 flareequally outward with respect to a transverse midline TMof the link 46B at a desired angle θ anywhere between0° and 90°, for instance between 0° and 45°, such asapproximately 14°.[0020] The lower end 56 of the first side member 48 ofthe link 46B is connected to the lower end 58 of the sidemember 50 of the adjacent link 46A at a second interface53to form a valley 60 of the fixation body 42, and thelower end 58 of the side member 50 of the link 46B isconnected to the lower end 56 of the side member 48 ofthe adjacent link 46C at a third interface 53 to likewiseform another valley 60 of the fixation body 42. The valleys60 are continuously curved about a laterally extendingaxis, such that the valley presents a convex surface withrespect to an upwardly directed view of the bottom of thefixation body 42. Of course, it should be appreciated thatthe valleys could assume any alternative shape as de-

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fined by the lower ends 56 and 58 of the side members48 and 50, or as defined by a separate structure that joinsthe lower ends 56 and 58 of adjacent links, either directlyor indirectly. The side members 48 and 50 of each linkare integrally connected to the complementary sidemembers of the adjacent links at the interfaces 53, thoughthey could alternatively be discreetly attached to eachother at the interfaces 53. Furthermore, the side mem-bers 48 and 50 can assume any size and shape as de-sired that connects the crest 51 to the valleys 60, eitherdirectly or indirectly.[0021] The fixation body 42 can define any desired lon-gitudinal distance, or width W between adjacent valleys60, and therefore between adjacent crests 51, such asapproximately 20 mm, and any desired transverse heightH between the lower edge of the valley 60 and the upperedge of the crest 51, such as approximately 17.6 mm.The fixation body 42 can be configured such that a spatialrelationship is defined between the respective crests 51and/or valleys 60. For example, the spatial relationshipcan be defined such that the width W between each ofthe crests 51 and the width W between each of the valleys60 is uniform throughout the fixation body 42, as illustrat-ed. Alternatively, the spatial relationship can be definedwith two or more crests 51 separated by different widthsW, two or more valleys 60 separated by different widthsW, or any combination thereof. Of course spatial rela-tionships with respect to the height H between the crests51 and the valleys 60 can also be defined.[0022] It should be appreciated that although the links46A-E of the illustrated configuration are all the samesize and shape, that one or more, up to all of the links46A-E of the fixation body 42 can have different sizesand/or shapes, for example having different widths W,heights H, or any combination thereof. It should furtherbe appreciated that the links 46A-E need not all have thesame cross-section, as defined between the elongateedges 47 and the minor edges 49. For example, it maybe desirable to configure one or more of the links 46A-Ewith different lateral thicknesses, for instance to controlthe deformation characteristics of particular links whenthe fixation body 42 is flexed inwardly or outwardly in thelongitudinal direction L, or otherwise shaped prior to im-plantation in a patient, as described in more detail below.Furthermore, the cross section within an individual linkcan be varied along one or more portions between itsrespective adjacent valleys 60.[0023] It should be appreciated that the links 46A-Edefine an undulating fixation body 42 shaped in a wave-form having wave segments that are proportional innumber to the number of links 46. While five links 46A-E are illustrated, the fixation body 42 can include anynumber of links 46A-E as desired. Each link 46A-E isillustrated as defining a crest 51 of the wavelike structure,and a portion of a valley 60 of one or more adjacent wave-like structures. It should also be appreciated that the lon-gitudinal widths W and transverse heights H can varybetween adjacent crests and valleys. For instance, one

or more of the crests 51 can have a height H greater orlesser than that of one or both of the immediately adjacentcrests.[0024] The side member 48 of the outer link 46A dis-posed at the first end 43 of the fixation body 42 terminatesat its lower end 56, while the side member 50 of the outerlink 46E disposed at the second end 45 of the fixationbody 42 terminates at its lower end 58. Alternatively, itshould be appreciated that a half-link could be disposedat the opposed outer ends 43 and 45, such that eachhalf-link would terminate at their respective upper ends52 and 54, or at any alternative location along theirlengths as desired. In the illustrated embodiment, thelower end 56 of the side member 48 of the outer link 46Aand the lower end 58 of the side member 50 of the outerlink 46E terminate at respective bone attachment loca-tions 70, as will be described in more detail below.[0025] The fixation body 42 includes a plurality of boneattachment locations 70 that facilitate attachment of thefixation body to the underlying bone. For instance, asdescribed above, the fixation body 42 can be attachedto an underlying mandible or maxilla, or any alternativebone structure, such that a bone fracture is disposed be-tween the opposed outer ends 43 and 45 of the fixationbody 42. Accordingly, in the instance of mandibular ormaxillo fixation, when a pair of fixation bodies 42 are se-cured to each other in the manner described above withrespect to Fig. 1, the broken bone segments are relativelyimmobilized to facilitate healing.[0026] In the illustrated embodiment, the bone attach-ment locations 70 are provided as screw holes 72 ex-tending laterally through the fixation body 42 at the re-spective valleys 60, though one or more alternatively con-figured attachment locations can be provided in any suit-able manner so as to facilitate attachment of the fixationbody 42 to underlying bone. The screw holes 72 can besized to threadedly receive corresponding fasteners 44,provided in one embodiment as bone screws 74. Specif-ically, referring to Fig. 6, the fixation body 42 includes abeveled inner surface 76 that defines each screw hole72, and is sized and shaped to receive a correspondinglybeveled outer surface 78 of a screw head 80. The beveledsurface 76 is positioned such that the screw head 80does not protrude outwardly from the fixation body 42when fully seated in the screw hole 72. As illustrated, thescrew head 80 is flush with the outer surface 59 of thefixation body 42, though the screw head 80 could alter-natively be inwardly recessed or slightly outwardly pro-truding with respect to the outer surface 59 of the fixationbody 42.[0027] Of course, the screw hole 72 could assume oneof numerous configurations, such that the inner surface76 can be beveled straight, or rounded at any desiredradius, for instance approximately 3.6 mm. Alternativelystill, the inner surface 76 need not be beveled, and canextend laterally in a direction parallel to the outer surfaceof the screw head 80. As another example, while theinner surface 76 is illustrated as smooth and flat, the inner

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surface 76 could alternatively be threaded to threadedlyengage corresponding threads of the screw head 80,such that the screw 74 would be self-locking within thescrew hole 72. It should also be appreciated that the bonescrews 74 can be self-drilling, or could alternatively beinsertable into a pre-drilled hole as appreciated by onehaving ordinary skill in the art. The fixation device 40 canfurther include a collar that surrounds the screw hole 72at the inner surface 57 of the fixation body 42, such thatthe collar would be disposed between the fixation body42 and the underlying bone structure. The collar wouldthus provide a stand-off that spaces the fixation body 42from the patient’s gum when the bone screws 74 are fullyinserted into the underlying bone.[0028] As described above, the links 46A-E are con-structed so as to impart a flexibility to the fixation body42. Specifically, the fixation body can bend about a trans-verse axis to conform generally with dental arches of pa-tients of different sizes and shapes, thereby allowing thebone screws 74 to be inserted into the screw holes 72and screwed into an underlying mandible or maxilla, asillustrated in Fig. 1. Furthermore, referring to Figs. 3A-C,the links 46A-E can allow the fixation body 42 to flexlongitudinally.[0029] For instance, Figs. 2A and 3A illustrate the fix-ation body 42 in an initial relaxed, or neutral configuration,whereby the fixation body is in its as-manufactured con-figuration prior to inward or outward flexing along the lon-gitudinal direction L. In the neutral configuration, the fix-ation body 42 can define any longitudinal distance LI asdesired between the opposed longitudinally outermostedges, such as approximately 100 mm.[0030] However, as shown in Fig. 3B, a longitudinallyinwardly directed force can be applied to one or more,including all, of the links 46, thereby compressing thecrests 51 and/or valleys 60 and achieving a reduced lon-gitudinal length LR of the fixation body 42 to a distanceless than the initial distance LI, as desired. The fixationbody 42 can be configured such that when the length ofthe fixation body 42 is adjusted by longitudinal compres-sion, the longitudinal distance, or spacing between thecrests 51 and/or valleys 60 (i.e., the width W (Fig. 2A)between adjacent crests 51 and/or valleys 60) in the com-pressed configuration of the fixation body 42 is preservedwith respect to the relaxed or neutral configuration of thefixation body 42. In other words the spacing, or width Wbetween adjacent crests 51 and/or valleys 60 of the fix-ation body 42 will be smaller after the longitudinal com-pression, but the crests 51 and/or valleys 60 can maintaintheir spatial relationship; for instance the crests 51 canstill be spaced apart equally as they were in the neutralconfiguration, and the and valleys 60 can also be spacedapart equally as they were in the neutral configuration.[0031] Additionally, as shown in Fig. 3C, a longitudi-nally outwardly directed force can be applied to one ormore, up to all, of the links 46, thereby extending thecrests 51 and/or valleys 60 and achieving an extended,or expanded longitudinal length LE of the fixation body

42 to a distance greater than the initial distance LI, asdesired. The fixation body 42 can be configured such thatwhen the length of the fixation body 42 is adjusted bylongitudinal expansion, the longitudinal distance, orspacing between the crests 51 and/or valleys 60 (i.e., thewidth W between adjacent crests 51 and/or valleys 60)in the expanded configuration of the fixation body 42 ispreserved with respect to the neutral configuration of thefixation body 42. In other words the spacing, or width Wbetween adjacent crests 51 and/or valleys 60 of the fix-ation body 42 will be greater after the longitudinal expan-sion, but the crests 51 and/or valleys 60 can maintaintheir spatial relationship; for instance the crests 51 canstill be spaced apart equally as they were in the neutralconfiguration, and the and valleys 60 can also be spacedapart equally as they were in the neutral configuration. Itshould be appreciated that the fixation body 42 can beconfigured such that the transverse height H betweenthe crests 51 and/or valleys 60 after the fixation body 42is compressed and/or expanded is similarly preservedwith respect to the neutral configuration of the fixationbody 42.[0032] It should therefore be appreciated that the boneattachment locations 70 can remain aligned with the un-derlying bone even as the fixation body 42 is flexed lon-gitudinally inward and/or outward. Furthermore, the boneattachment locations 70 can be aligned or substantiallyaligned with each other along a longitudinal axis LA evenas the fixation body 42 is flexed longitudinally inward andoutward. In one embodiment, the fixation body 42 canstretch or compress lengthwise longitudinally an amountbetween 5% and 50% with respect to its length in therelaxed position, for instance between 10% and 40%,and more particularly between 20% and 30%, and moreparticularly still about 23%. The fixation body 42 can fur-ther stretch or compress height-wise transversely by anysuitable percentage with respect to its height in the re-laxed position, such as between 1% and 25%, for in-stance between 5% and 15%, and more particularlyabout 11%. It should be appreciated that when the body42 is stretched longitudinally, the body 42 tends to shrinkor compress transversely, and vice versa. Furthermore,when the body 42 is compressed longitudinally, the body42 tends to stretch transversely, and vice versa.[0033] Thus, the configuration of the fixation body 42can be adjusted in situ while implanting the fixation device40 in the patient. For instance, the fixation body 42 canbe sized and configured as desired based on the size ofthe underlying bone segments to be fixed. Additionally,the fixation body 42 can be sized and configured to placethe connection locations in a desired position prior to fas-tening the fixation body 42 to underlying bone. Further-more, the side members 48 and 50 allow the fixation body42 to be bent or otherwise configured in the vertical planeas well, for instance, when aligning the fixation body 42with underlying bone. While the fixation body 42 is flex-ible, the continuity between adjacent links 46 providessufficient stiffness when the fixation device 40 is affixed

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to underlying bone and attached to a complementary fix-ation device in a fixation system.[0034] It should be appreciated that the fixation body42 can be constructed so as to allow the fixation body 42to extend and/or compress as desired. In this regard, thefixation body 42 includes at least two side members thatare longitudinally spaced from each other by an interface53 that can expand and compress in response to expan-sive and compressive forces. As illustrated, the interfac-es 53 are curved surfaces (e.g., the crests 51 and valleys60) whose curvature can be increased and reducedthrough flexing, though the interfaces 53 can alternativelyinclude angled connections between the side members48 and 50. The compressive and expansive deformationof the fixation body 42 can be plastic, or can alternativelybe elastic such that the deformed shape is retained whenthe fixation body 42 is attached to the underlying boneat the attachment locations 70. Of course, the height ofthe fixation body 42 may increase slightly when the fix-ation body 42 is compressed, and may decrease slightlywhen the fixation body 42 is extended.[0035] Referring again to Fig. 2A and also to Fig. 4,the fixation device 42 further includes a plurality of con-nection, or securement locations 82 configured to facili-tate connecting, or securing together a pair of fixationdevices 40 that are inversely oriented, for instance whenimplanted in a mandible and maxilla, respectively. In theillustrated configuration, the securement locations 82 aredisposed at the longitudinal midpoint, or apex of the crest51 of each of the links 46A-E. However, it should be ap-preciated that alternatively, the securement locations 82can be disposed anywhere on the fixation body 42 asdesired. The securement locations 82 can be configuredto allow a securement member, such as the securementmember 23 described above with respect to Fig. 1, toconnect a pair of fixation bodies 42 to each other so asto restrict relative movement of the bone underlying theconnected fixation bodies 42.[0036] The securement locations 82 are provided inthe illustrated embodiment as tangs 84 extending downfrom the apex of each crest 51 of the fixation body 42.Otherwise stated, the tangs 84 extend in a generallytransverse direction from the crest 51 toward a longitu-dinal axis LA that extends through the screw holes 72.One or more, up to all, of the tangs 84 can also includelongitudinally or laterally extending segments as well, ifdesired. For instance, in the illustrated embodiment, eachof the tangs 84 includes a first segment 86 that extendstransversely down from the transverse inner edge of theapex of the crest 51. A second, or spacer segment 88extends transversely downward and laterally outwardfrom the lower end of the first segment 86. A third seg-ment 90 extends transversely downward from the lowerand laterally outer end of the spacer segment 88.[0037] Thus, a securement device, such as the secure-ment device 23 described above, can engage the lowersurface of the spacer segment 88 and laterally inner sur-face of the third segment 90 when fixing or stabilizing a

pair of mandibular and maxillo fixation bodies 42 to eachother. Alternatively or additionally, the securement de-vice 23 can engage the laterally inner surface of the firstsegment 86 and the laterally outer surface of the crest51. For instance, a wire can be wrapped around the tang84 and/or link 46. Alternatively or additionally, an elasticband can be seated at one end between the tang 84 andthe crest 51. Because securement devices 23 can beattached at multiple locations along the length of the fix-ation body 42, the resulting forces associated with cou-pling the securement devices 23 to a complementary fix-ation body 42 distributes the resulting forces substantiallyequally across the length of the fixation body 42.[0038] Alternatively, referring now to Fig. 5, one ormore, up to all, of the tangs 84’ can include a single seg-ment 86’ constructed similarly with respect to the seg-ment 86, thus extending vertically down from the crest51 in the manner describe above. Thus the tang 84’ doesnot include any lateral or longitudinal directional compo-nents. The securement device 23 can be wrappedaround the segment 86’ in the case of a wire, for instance,or can be seated between the segment 86’ and the crest51 in the case of an elastic band. Alternatively still, itshould be appreciated that the securement locations 82can include the crest 51 itself, without any tangs 84 orother additional structure. For instance, a plurality of elas-tic bands could be slid along the wavelike form of thefixation body 42 to locations at respective crests 51 priorto implantation of the fixation body 42 into underlyingbone. Alternatively, a wire could be wrapped around thecrests 51 of opposed fixation bodies 51 prior to or afterimplantation of the fixation bodies 42. Alternatively still,the securement location 82 could be provided as an ap-erture extending laterally through the links 46A-E, for in-stance at their crests 51.[0039] The fixation device 40 was illustrated and de-scribed above in accordance with one embodiment, itbeing appreciated that numerous alternative embodi-ments are contemplated.[0040] For instance, referring to now Fig. 7, the fixationbody can include auxiliary links, and can alternatively oradditionally include securement locations that are posi-tioned differently than the securement locations 82 de-scribed above. As illustrated in Fig. 7, the fixation body42 can include auxiliary links 92 connected between ad-jacent links 46. The auxiliary links 92 can extend betweenthe first and second side members 48 and 50 of adjacentlinks 46 at any respective desired locations along the firstand second side members 48 and 50, respectively. Forinstance, in the illustrated embodiment, the auxiliary links92 extend between the first and second side members48 and 50 at locations proximate to, or at, the respectiveupper ends 52 and 54 of the first and second side mem-bers 48and 50. The auxiliary links 92 are illustrated asextending transversely upward and inward from the sidemembers 48 and 50 toward an auxiliary crest 94 that isshaped substantially as described above with respect tothe crests 51. Thus, the auxiliary crest 94 presents a con-

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vex surface with respect to a downwardly directed viewof the top of the fixation body 42, though the auxiliarycrest 94 could assume any alternative shape as desired.The auxiliary crests 94 allow the auxiliary links 92 to ex-pand and contract as described above with respect toFigs. 3A-C, though the auxiliary links 92 can be config-ured to add an amount of stiffness to the fixation body42 with respect to the fixation body 42 as illustrated inFig. 2A without the auxiliary links 92. The auxiliary crests94 can be positioned longitudinally midway between thecrests 51 of the links 46A-E, which can be referred to as"primary" links 46A-E when the fixation body 42 includesthe auxiliary links 92.[0041] As illustrated in Fig. 7, one or more, up to all ofthe auxiliary links 92 can be configured as auxiliary se-curement locations 96, constructed differently or as de-scribed above with respect to the securement locations82. The auxiliary securement locations 96 can be provid-ed anywhere along the auxiliary links 92, such as at theapexes of the auxiliary crests 94. Thus, for instance, theauxiliary securement locations 96 can be configured toallow a securement member, such as the securementmember 23 described above with respect to Fig. 1, toconnect a pair of fixation bodies 42 to each other so asto restrict relative movement of the bone underlying theconnected fixation bodies 42. In the illustrated embodi-ment, the auxiliary securement locations 96 are providedas tangs 98 that extend from the auxiliary crests 94 asdescribed above with respect to tangs 84 and 84’ extend-ing from respective crests 51. It should be appreciatedthat the auxiliary securement locations 96 can be provid-ed in addition to the securement locations 82, as an al-ternative to the securement locations 82, or that any com-bination of the securement locations 82 and/or the aux-iliary securement locations 96 can be provided as de-sired.[0042] Referring now to Fig. 8, a portion of a fixationbody 42’ is illustrated as including a plurality of links 46’that are shaped differently with respect to the straightside members 48 and 50 of the links 46A-E illustrated inFig. 2A. For instance, as illustrated, the side members48’ and 50’ of a given link 46’ can be longitudinally in-wardly curved toward each other from their respectivelower end 56’ and 58’ near their respective valleys 60’ ina transverse upward direction along the side members48’ and 50’ toward the crest 51’, then longitudinallycurved outwardly away from each other in a continuingtransverse upward direction, and finally longitudinallycurved inwardly toward each other again at the respec-tive upper ends 52’ and 54’ of the side members 48’ and50’ near the crest 51’. It should be appreciated that theillustrated curvature of the side members 48’ and 50’ isan example of alternative curvature for the links 46’, andthat the side members 48’ and 50’ can be configured withany other alternative curvature as desired. It should fur-ther be appreciated that the fixation body 42 of a fixationdevice 40 can be configured entirely of links 46’, therebyproviding a fixation body 42’, or can be configured with

any combination of the links 46’ and the links 46 as de-scribed above with reference to Figs. 2A-B, as desired.The curved side members 48’ and 50’ can be configuredto allow the fixation body 42’ to flex in the transversedirection. Accordingly, when a pair of fixation devices 40having fixation bodies 42’ are secured to each other asillustrated in Fig. 1, the fixation devices 40 can flex towardeach other in response to the forces applied by the se-curement device 23. It should be appreciated that thefixation body 42’ can further include auxiliary links and/orauxiliary securement locations as described above withreference to Fig. 7.[0043] Furthermore, as described above, the lowerend 56 of the side member 48 of the outer link 46A andthe lower end 58 of the side member 50 of the outer link46E terminate at respective bone attachment locations70, as illustrated in Fig. 2A. Accordingly, as illustrated inFig. 2A, the bone fixation device 40 can terminate at out-ermost bone attachment locations 70. Alternatively, asillustrated in Fig. 9, in which the bone fixation device 40’includes three links 46A’-C’, the outermost links 46A’ and46C’ are attached to outermost securement locations 82’via arms 50" and 48", respectively. The arms 50" and 48"extend longitudinally outwardly from the ends 43’ and 45’of the fixation body 42’, between lower arm ends 56" and58" and upper arm ends 52" and 54", respectively. How-ever, it should be appreciated that the bone fixation de-vice 40’ as illustrated in Fig. 9 could be constructed asdescribed above with reference to Fig. 2A, or any alter-native embodiments described herein. Thus, the outer-most securement locations 82’ are disposed longitudi-nally outward with respect to the outermost bone attach-ment locations 70’. As illustrated, the fixation body 42’can include four bone attachment locations 70’ as illus-trated, or any alternative number of bone attachment lo-cations 70’ as desired. The outermost securement loca-tions 82’ can be disposed above, below, or at a transverseheight substantially equal to that of the other securementlocations 82’ of the bone fixation device 40’. In the illus-trated embodiment, the outermost securement locations82’ are disposed at a transverse height below that of theother securement locations 82’ of the bone fixation device40’.[0044] The outermost securement locations 82’ can beprovided as hooks 83’ extending in the longitudinal-trans-verse plane, or any alternative plane as desired, for ex-ample from the upper arm ends 52" and 54" of the arms50" and 48", respectively. Thus, a securement device,such as device 23 described above, can engage thehooks 83’ of opposed fixation bodies 42’ when fixing orsecuring a pair of mandibular and maxillo fixation bodies42’ to each other. In this regard, it should be appreciatedthat any of the securement locations described hereincould comprise hooks or any alternative structure suita-ble for connecting, or securing a pair of fixation devicesas described above.[0045] Thus, it should be appreciated that fixation bod-ies can be provided in accordance with multiple embod-

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iments. Therefore, a kit can be provided that includes aplurality of fixation devices, or portions thereof, includingfixation bodies constructed in accordance with all or aportion of any of the embodiments described herein. Forexample, the kit can include one or more fixation bodies42 or 42’, having different numbers of links, different di-mensions, such as overall length, link width, height, andlateral thickness, and differently configured links (for in-stance differently configured side members 48, 48’, 50,and 50’, securement locations 82, 82’, and 96, and/orauxiliary links 92). Therefore, the fixation bodies in a kitcan have one or more varying characteristic such as sizeand/or shape.. For instance, a first kit can be providedhaving one or more fixation bodies whose components,for instance the links and/or the securement locations,are of a first size or shape, and other fixation bodieswhose components are of a second size or shape differ-ent than the first size or shape. Thus, the kit can accom-modate multiple maxillo-mandibular fixation proceduresinvolving substantial anatomical variability.[0046] Methods are disclosed for implanting the vari-ous embodiments of the fixation device 40. Generally,the methods include the steps of adjusting an orientation(e.g., directional or angular) of the fixation device 40 de-pending on the anatomy of the underlying bone structure.For instance, a maxillo fixation device will be verticallyinverted with respect a mandibular fixation device. It isto be understood that certain steps of the methods de-scribed herein can be omitted, combined, performed si-multaneously, or performed in a different order. In thisregard, it should be appreciated that the maxillo-mandib-ular fixation devices of the type described above can beprovided as a kit that is configured to be implemented forthe purposes of maxillo-mandibular fixation using themethods described below.[0047] According to one method of providing fixationto a bone or bone segments of a mandible, a first fixationdevice such as the fixation device 40 may be adapted byimparting a curvature as desired to correspond to thedental arch. The fixation device 40 can further be extend-ed or compressed in the longitudinal direction and/or thetransverse direction to align the screw holes 72 with adesired fixation location on the underlying bone. Thusthe configuration of the fixation body 42 may be adaptedto achieve the proper shape and fit for a bone fixation.The fixation body 42 can then be implanted by insertingthe fasteners 44 into the underlying bone.[0048] Next, a second fixation device 40 can be im-planted in a second bone structure that is to be fixed withrespect to the bone structure that underlies the first fix-ation body 40. For instance, a second fixation body 42can be implanted into the maxilla in the manner describedabove, but in an orientation that is vertically inverse withrespect to the first fixation device 40. It should be appre-ciated that either the first and/or second fixation deviceis implanted over a fracture such that the device(s) attacha first bone segment to a second bone segment that hasbeen fractured from the first bone segment.

[0049] Once the first and second fixation bodies areimplanted into the underlying bone structure, the secure-ment devices 23 are attached to the securement loca-tions of the first and second fixation bodies. In a preferredembodiment, the securement devices 23 are attachedbetween two vertically aligned, or substantially aligned,crests 51. It should be appreciated that the crests 51 ofeach fixation body can define the shortest vertical dis-tance between the fixation bodies 40, thereby allowingfor a securement device 23 that has a short length be-tween the fixation bodies 40.[0050] The illustrated embodiments are directed to abone fixation system that may be implanted to assist inrepairing a fractured bone. The fixation system has par-ticular utility as mandibular or maxillo fixation system,which benefits from accurate anatomical shape and fit.[0051] The foregoing description is provided for thepurpose of explanation and is not to be construed aslimiting the invention. While various embodiments havebeen described with reference to preferred embodimentsor preferred methods, it is understood that the wordswhich have been used herein are words of descriptionand illustration, rather than words of limitation. Further-more, although the embodiments have been describedherein with reference to particular structure, methods,and embodiments, the invention is not intended to belimited to the particulars disclosed herein. Moreover, anyof the embodiments described above can incorporateany structures or features of any of the other embodi-ments described above, as desired. Those skilled in therelevant art, having the benefit of the teachings of thisspecification, may effect numerous modifications to theinvention as described herein, and changes may bemade without departing from the scope of the inventionas defined by the appended claims.

Claims

1. A bone fixation device comprising:

a bone fixation body (42) extending in a planedefined by a longitudinal direction (L) and atransverse direction (T) that is perpendicular tothe longitudinal direction (L), having a thicknessin a lateral direction (A) that is perpendicular tothe longitudinal and transverse directions (L, T),and having a bone facing inner lateral surface(57) and an opposed outer lateral surface (59),the bone fixation body (42) further comprising aplurality of bone attachment locations (70)spaced longitudinally along a length of the bonefixation body (42), the length defined betweenopposed first and second ends (43, 45),characterized in that the bone fixation body(42) comprises a plurality of interconnected links(46) extending in the longitudinal direction (L)between the opposed first and second ends (43,

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45), the links (46) defining a plurality of longitu-dinally arranged crests (51) and a plurality oflongitudinally arranged valleys (60) that definea spatial relationship therebetween; the pluralityof crests (51) being transversely spaced fromthe plurality of valleys (60), wherein the links (46)are flexible in the longitudinal direction (L), suchthat when the length of the fixation body (42) isadjusted, the plurality of crests (51) and the plu-rality of valleys (60) continue to define the spatialrelationship although the spacing between ad-jacent crests (51) and/or adjacent valleys (60)changes.

2. The bone fixation device as recited in claim 1, where-in the bone fixation body (42) further comprises asecurement location (82), the securement location(82) configured to engage with a securement device(23) that fixes the bone fixation body (42) with respectto a second bone fixation body (42).

3. The bone fixation device as recited in claim 2, where-in the securement location (82) is disposed at thecrest (51) of one of the links (46).

4. The bone fixation device as recited in claim 3, where-in the securement location (82) comprises a tang(84) extending transversely from the crest (51) be-tween the crest (51) and one or more valleys (60)adjacent the crest (51).

5. The bone fixation device as recited in claim 2, where-in the bone fixation body (42) further comprises aplurality of securement locations (82), each of theplurality of securement locations (82) disposed at arespective one of the plurality of crests (51), andwherein each of the plurality of bone attachment lo-cations (70) is disposed at a respective one of theplurality of valleys (60).

6. The bone fixation device as recited in claim 5, where-in each link (46) of the plurality of links (46) comprisesfirst and second side members (48, 50), the first sidemember (48) extending between an upper end dis-posed at a respective crest (51) of the plurality ofcrests (51) and an opposed lower end disposed ata respective first valley (60) of the plurality of valleys(60), the second side member (50) extending be-tween an upper end disposed at the respective crest(51) and an opposed lower end disposed at a re-spective second valley (60) of the plurality of valleys(60), andwherein the respective first and second valleys (60)are adjacent each other along the bone fixation body(42).

7. The bone fixation device as recited in claim 6, where-in the first and second side members (48, 50) extend

linearly or are curved between the respective crest(51) and the respective first and second valleys (60).

8. The bone fixation device as recited in claim 6, where-in first and second arms (48", 50") extend longitudi-nally from the first and second ends (43, 45) of thefixation body (42), respectively, the first and secondarms (48", 50") extending between respective lowerends (56", 58") disposed at the first and second ends(43, 45) of the fixation body (42), respectively, andrespective upper ends (52", 54").

9. The bone fixation device as recited in claim 8, where-in first and second hooks (83’) are disposed at theupper ends (52", 54") of the first and second arms(48", 50"), respectively, the first and second hooks(83’) configured to engage with a securement device(23).

10. The bone fixation device as recited in claim 1, where-in the bone fixation body (42) further comprises aplurality of auxiliary links (92), each of the auxiliarylinks (92) extending between first and second adja-cent crests (51) of the plurality of crests (51) anddefining a respective auxiliary crest (94).

11. The bone fixation device as recited in claim 10,wherein the bone fixation body (42) further compris-es a securement location (96) configured to engagewith a securement device (23) that fixes the bonefixation body (42) with respect to a second bone fix-ation body (42), the securement location (96) dis-posed at the auxiliary crest (94) of one of the auxiliarylinks (92).

12. The bone fixation device as recited in claim 1, where-in the spatial relationship comprises an equal dis-tance between the crests (51), and an equal distancebetween the valleys (60), or wherein the spatial re-lationship comprises unequal distances betweentwo or more of the plurality of crests (51), or whereinthe spatial relationship comprises unequal distancesbetween two or more of the plurality of valleys (60).

13. A maxillo-mandibular fixation kit comprising:

first and second bone fixation devices, compris-ing a first bone fixation body (42) and a secondbone fixation body (42), respectively, the firstand second bone fixation bodies (42) extendingin a plane defined by a longitudinal direction (L)and a transverse direction (T) that is perpendic-ular to the longitudinal direction (L), having athickness in a lateral direction (A) that is perpen-dicular to the longitudinal and transverse direc-tions (L, T), and having a bone facing inner lat-eral surface (57) and an opposed outer lateralsurface (59),

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the first bone fixation body (42) including a firstplurality of bone attachment locations (70)spaced longitudinally along a length of the bonefixation body (42), the length defined betweenfirst and second opposed ends (43, 45), and afirst plurality of securement locations (82), andthe second bone fixation body (42) including asecond plurality of bone attachment locations(70) spaced longitudinally along a length of thesecond bone fixation body (42), the length de-fined between first and second opposed ends(43, 45) of the second bone fixation body (42),and a second plurality of securement locations(82),wherein the first and second pluralities of se-curement locations (82) are configured to en-gage with a securement device (23) that fixesthe first bone fixation body (42) with respect tothe second bone fixation body (42),characterized in thatthe first bone fixation body (42) includes a firstplurality of interconnected links (46) extendingin the longitudinal direction (L) between the op-posed first and second ends (43, 45), the firstplurality of links (46) defining a plurality of lon-gitudinally arranged crests (51) and a pluralityof longitudinally arranged valleys (60) that de-fine a spatial relationship therebetween, the plu-rality of crests (51) being transversely spacedfrom the plurality of valleys (60), wherein thelinks (46) of the first plurality of links (46) areflexible in the longitudinal direction (L), such thatwhen the length of the fixation body (42) is ad-justed, the plurality of crests (51) and the plural-ity of valleys (60) continue to define the spatialrelationship although the spacing between ad-jacent crests (51) and/or adjacent valleys (60)changes; andthe second bone fixation body (42) includes asecond plurality of interconnected links (46) ex-tending in the longitudinal direction (L) betweenthe opposed first and second ends (43, 45) ofthe second bone fixation body (42), the secondplurality of links (46) defining a plurality of lon-gitudinally arranged crests (51) and a pluralityof longitudinally arranged valleys (60) that de-fine a spatial relationship therebetween, the plu-rality of crests (51) being transversely spacedfrom the plurality of valleys (60), wherein thelinks (46) of the second plurality of links (46) areflexible in the longitudinal direction (L), such thatwhen the length of the fixation body (42) is ad-justed, the plurality of crests (51) and the plural-ity of valleys (60) continue to define the spatialrelationship although the spacing between ad-jacent crests (51) and/or adjacent valleys (60)changes.

14. The maxillo-mandibular fixation kit as recited in claim13, wherein the second bone fixation body (42) dif-fers from the first bone fixation body (42) accordingto at least one of the following:

the second plurality of interconnected links (46)has a different quantity of links (46) than the firstplurality of interconnected links (46);the second plurality of bone attachment loca-tions (70) has a different quantity of bone attach-ment locations (70) than the first plurality of boneattachment locations (70);the second plurality of bone attachment loca-tions (70) is spaced differently than the first plu-rality of bone attachment locations (70);the second plurality of securement locations(82) has a different quantity of securement lo-cations (82) than the first plurality of securementlocations (82);the links (46) of the second plurality of intercon-nected links (46) have a different shape than thelinks (46) of the first plurality of interconnectedlinks (46);the first bone fixation body (42) further includesa plurality of auxiliary links (92) extending be-tween respective crests (51) of the first pluralityof interconnected links (46); andthe second bone fixation body (42) further in-cludes a plurality of auxiliary links (92) extendingbetween respective crests (51) of the secondplurality of interconnected links (46).

Patentansprüche

1. Knochenfixiervorrichtung, umfassend:

einen Knochenfixierkörper (42), der sich in einerEbene erstreckt, die durch eine Längsrichtung(L) und eine Querrichtung (T), die senkrecht zurLängsrichtung (L) ist, definiert ist, der eine Dickein einer seitlichen Richtung (A), die senkrechtzur Längs- und Querrichtung (L, T) ist, aufweist,und der eine zum Knochen weisende innereseitliche Oberfläche (57) und eine gegenüber-liegende äußere seitliche Oberfläche (59) auf-weist, wobei der Knochenfixierkörper (42) desWeiteren eine Mehrzahl von Knochenbefesti-gungsstellen (70) umfasst, die längs entlang ei-ner Länge des Knochenfixierkörpers (42) beab-standet sind, wobei die Länge zwischen gegen-überliegenden ersten und zweiten Enden (43,45) definiert ist,dadurch gekennzeichnet, dass der Knochen-fixierkörper (42) eine Mehrzahl von miteinanderverbundenen Bindegliedern (46) umfasst, diesich in der Längsrichtung (L) zwischen den ge-genüberliegenden ersten und zweiten Enden

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(43, 45) erstrecken, wobei die Bindeglieder (46)eine Mehrzahl von längs angeordneten Bergen(51) und eine Mehrzahl von längs angeordnetenTälern (60) definieren, die eine räumliche Be-ziehung dazwischen definieren, wobei die Mehr-zahl von Bergen (51) von der Mehrzahl von Tä-lern (60) quer beabstandet ist, wobei die Binde-glieder (46) in der Längsrichtung (L) flexibelsind, so dass, wenn die Länge des Fixierkörpers(42) angepasst wird, die Mehrzahl von Bergen(51) und die Mehrzahl von Tälern (60) weiter dieräumliche Beziehung definieren, obwohl sichdie Abstände zwischen benachbarten Bergen(51) und/oder benachbarten Tälern (60) ändert.

2. Knochenfixiervorrichtung nach Anspruch 1, wobeider Knochenfixierkörper (42) des Weiteren eine Si-cherungsstelle (82) umfasst, wobei die Sicherungs-stelle (82) eingerichtet ist, mit einer Sicherungsvor-richtung (23) zusammenzuwirken, die den Knochen-fixierkörper (42) bezüglich eines zweiten Knochen-fixierkörpers (42) fixiert.

3. Knochenfixiervorrichtung nach Anspruch 2, wobeisich die Sicherungsstelle (82) Amberg (51) eines derBindeglieder (46) befindet.

4. Knochenfixiervorrichtung nach Anspruch 3, wobeidie Sicherungsstelle (82) einen Dorn (84) umfasst,der sich quer von dem Berg (51) zwischen den Berg(51) und einem oder mehreren Tälern (60) benach-bart zu den Berg (51) erstreckt.

5. Knochenfixiervorrichtung nach Anspruch 2, wobeider Knochenfixierkörper (42) des Weiteren eineMehrzahl von Sicherungsstellen (82) umfasst, wobeisich jede der Mehrzahl von Sicherungsstellen (82)an einem entsprechenden der Mehrzahl von Bergen(51) befindet, undwobei sich jede der Mehrzahl von Knochenbefesti-gungsstellen (70) an einem entsprechenden derMehrzahl von Tälern (60) befindet.

6. Knochenfixiervorrichtung nach Anspruch 5, wobeijedes Bindeglied (46) der Mehrzahl von Bindeglie-dern (46) ein erstes und zweites Seitenelement (48,50) umfasst, wobei sich das erste Seitenelement(48) zwischen einem oberen Ende, das sich an ei-nem entsprechenden Berg (51) der Mehrzahl vonBergen (51) befindet, und einem gegenüberliegen-den unteren Ende, das sich an einem entsprechen-den ersten Tal (60) der Mehrzahl von Tälern (60)befindet, erstreckt, wobei sich das zweite Seitene-lement (50) zwischen einem oberen Ende, das sichan einem entsprechenden Berg (51) befindet, undeinem gegenüberliegenden unteren Ende, das sichan einem entsprechenden zweiten Tal (60) derMehrzahl von Tälern (60) befindet, erstreckt, und

wobei das entsprechende erste und zweite Tal (60)entlang des Knochenfixierkörpers (42) zueinanderbenachbart sind.

7. Knochenfixiervorrichtung nach Anspruch 6, wobeisich das erste und zweite Seitenelement (48, 50)zwischen dem entsprechenden Berg (51) und dementsprechenden ersten und zweiten Tal (60) linearerstrecken oder gekrümmt sind.

8. Knochenfixiervorrichtung nach Anspruch 6, wobeisich ein erster und zweiter Arm (48", 50") längs vondem ersten bzw. zweiten Ende (43, 45) des Fixier-körpers (42) erstrecken, wobei sich der erste undzweite Arm (48", 50") zwischen entsprechenden un-teren Enden (56", 58"), die sich am ersten bzw. zwei-ten Ende (43, 45) des Fixierkörpers (42) befinden,und entsprechenden oberen Enden (52", 54") erstre-cken.

9. Knochenfixiervorrichtung nach Anspruch 8, wobeisich ein erster und zweiter Haken (83’) an den oberenEnden (52", 54") des ersten bzw. zweiten Arms (48",50") befinden, wobei der erste und zweite Haken(83’) eingerichtet sind, mit einer Sicherungsvorrich-tung (23) zusammenzuwirken.

10. Knochenfixiervorrichtung nach Anspruch 1, wobeider Knochenfixierkörper (42) des Weiteren eineMehrzahl von Hilfsbindegliedern (92) umfasst, wobeisich jedes der Hilfsbindeglieder (92) zwischen erstenund zweiten benachbarten Bergen (51) der Mehr-zahl von Bergen (51) erstreckt und einen entspre-chenden Hilfsberg (94) definiert.

11. Knochenfixiervorrichtung nach Anspruch 10, wobeider Knochenfixierkörper (42) des Weiteren eine Si-cherungsstelle (96) umfasst, die eingerichtet ist, miteiner Sicherungsvorrichtung (23) zusammenzuwir-ken, die den Knochenfixierkörper (42) bezüglich ei-nes zweiten Knochenfixierkörpers (42) fixiert, wobeisich die Sicherungsstelle (96) am Hilfsberg (94) ei-nes der Hilfsbindeglieder (92) befindet.

12. Knochenfixiervorrichtung nach Anspruch 1, wobeidie räumliche Beziehung eine gleiche Distanz zwi-schen den Bergen (51) und eine gleiche Distanz zwi-schen den Tälern (60) umfasst, oder wobei die räum-liche Beziehung ungleiche Distanzen zwischen zweioder mehreren der Mehrzahl von Bergen (51) um-fasst, oder wobei die räumliche Beziehung ungleicheDistanzen zwischen zwei oder mehreren der Mehr-zahl von Tälern (60) umfasst.

13. Maxillär-mandibuläres Fixierset, umfassend:

eine erste und zweite Knochenfixiervorrichtung,umfassend einen ersten Knochenfixierkörper

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(42) bzw. einen zweiten Knochenfixierkörper(42), wobei sich der erste und zweite Knochen-fixierkörper (42) in einer Ebene erstrecken, diedurch eine Längsrichtung (L) und eine Querrich-tung (T), die senkrecht zur Längsrichtung (L) ist,definiert sind, eine Dicke in einer seitlichen Rich-tung (A), die senkrecht zur Längs- und Querrich-tung (L, T) ist, aufweisen, und eine zum Knochenweisende innere seitliche Oberfläche (57) undeine gegenüberliegende äußere seitliche Ober-fläche (59) aufweisen,wobei der erste Knochenfixierkörper (42) eineerste Mehrzahl von Knochenbefestigungsstel-len (70), die längs entlang einer Länge des Kno-chenfixierkörpers (42) beabstandet sind, wobeidie Länge zwischen ersten und zweiten gegen-überliegenden Enden (43, 45) definiert ist, undeine erste Mehrzahl von Sicherungsstellen (82)enthält,wobei der zweite Knochenfixierkörper (42) einezweite Mehrzahl von Knochenbefestigungsstel-len (70), die längs entlang einer Länge des Kno-chenfixierkörpers (42) beabstandet sind, wobeidie Länge zwischen ersten und zweiten gegen-überliegenden Enden (43, 45) des zweite Kno-chenfixierkörpers (42) definiert ist, und einezweite Mehrzahl von Sicherungsstellen (82) ent-hält,wobei die erste und zweite Mehrzahl von Siche-rungsstellen (82) eingerichtet sind, mit einer Si-cherungsvorrichtung (23) zusammenzuwirken,die den ersten Knochenfixierkörper (42) bezüg-lich des zweiten Knochenfixierkörpers (42) fi-xiert.dadurch gekennzeichnet, dassder erste Knochenfixierkörper (42) eine ersteMehrzahl von miteinander verbundenen Binde-gliedern (46) enthält, die sich in der Längsrich-tung (L) zwischen den gegenüberliegenden ers-ten und zweiten Enden (43, 45) erstrecken, wo-bei die erste Mehrzahl von Bindegliedern (46)eine Mehrzahl von längs angeordneten Bergen(51) und eine Mehrzahl von längs angeordnetenTälern (60) definieren, die eine räumliche Be-ziehung dazwischen definieren, wobei die Mehr-zahl von Bergen (51) von der Mehrzahl von Tä-lern (60) quer beabstandet ist, wobei die Binde-glieder (46) der ersten Mehrzahl von Bindeglie-dern (46) in der Längsrichtung (L) flexibel sind,so dass, wenn die Länge des Fixierkörpers (42)angepasst wird, die Mehrzahl von Bergen (51)und die Mehrzahl von Tälern (60) weiter dieräumliche Beziehung definieren, obwohl sichdie Abstände zwischen benachbarten Bergen(51) und/oder benachbarten Tälern (60) ändert,undder zweite Knochenfixierkörper (42) eine zweiteMehrzahl von miteinander verbundenen Binde-

gliedern (46) enthält, die sich in der Längsrich-tung (L) zwischen den gegenüberliegenden ers-ten und zweiten Enden (43, 45) des zweitenKnochenfixierkörpers (42) erstrecken, wobei diezweite Mehrzahl von Bindegliedern (46) eineMehrzahl von längs angeordneten Bergen (51)und eine Mehrzahl von längs angeordneten Tä-lern (60) definieren, die eine räumliche Bezie-hung dazwischen definieren, wobei die Mehr-zahl von Bergen (51) von der Mehrzahl von Tä-lern (60) quer beabstandet ist, wobei die Binde-glieder (46) der zweiten Mehrzahl von Binde-gliedern (46) in der Längsrichtung (L) flexibelsind, so dass, wenn die Länge des Fixierkörpers(42) angepasst wird, die Mehrzahl von Bergen(51) und die Mehrzahl von Tälern (60) weiter dieräumliche Beziehung definieren, obwohl sichdie Abstände zwischen benachbarten Bergen(51) und/oder benachbarten Tälern (60) ändert.

14. Maxillär-mandibuläres Fixierset nach Anspruch 13,wobei sich der zweite Knochenfixierkörper (42) vomersten Knochenfixierkörper (42) gemäß zumindesteines der folgenden unterscheidet:

die zweite Mehrzahl von miteinander verbunde-nen Bindegliedern (46) hat eine unterschiedli-che Anzahl von Bindegliedern (46) als die ersteMehrzahl von miteinander verbundenen Binde-gliedern (46),die zweite Mehrzahl von Knochenbefestigungs-stellen (70) hat eine unterschiedliche Anzahlvon Knochenbefestigungsstellen (70) als dieerste Mehrzahl von Knochenbefestigungsstel-len (70),die zweite Mehrzahl von Knochenbefestigungs-stellen (70) ist unterschiedlich beabstandet alsdie erste Mehrzahl von Knochenbefestigungs-stellen (70),die zweite Mehrzahl von Sicherungsstellen (82)hat eine unterschiedliche Anzahl von Siche-rungsstellen (82) als die erste Mehrzahl von Si-cherungsstellen (82),die Bindeglieder (46) der zweiten Mehrzahl vonmiteinander verbundenen Bindegliedern (46)haben eine unterschiedliche Form als die Bin-deglieder (46) der ersten Mehrzahl von mitein-ander verbundenen Bindegliedern (46),der erste Knochenfixierkörper (42) enthält desWeiteren eine Mehrzahl von Hilfsbindegliedern(92), die sich zwischen entsprechenden Bergen(51) der ersten Mehrzahl von miteinander ver-bundenen Bindegliedern (46) erstrecken, undder zweite Knochenfixierkörper (42) enthält desWeiteren eine Mehrzahl von Hilfsbindegliedern(92), die sich zwischen entsprechenden Bergen(51) der zweiten Mehrzahl von miteinander ver-bundenen Bindegliedern (46) erstrecken.

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Revendications

1. Dispositif de fixation osseuse comprenant :

un corps de fixation osseuse (42) s’étendantdans un plan défini par une direction longitudi-nale (L) et une direction transversale (T) qui estperpendiculaire à la direction longitudinale (L),ayant une épaisseur dans une direction latérale(A) qui est perpendiculaire aux directions longi-tudinale et transversale (L, T) et ayant une sur-face latérale interne faisant face à l’os (57) etune surface latérale externe opposée (59), lecorps de fixation osseuse (42) comprenant enoutre une pluralité d’emplacements de fixationd’os (70) espacés longitudinalement le longd’une longueur du corps de fixation osseuse(42), la longueur étant définie entre les premièreet seconde extrémités (43, 45) opposées,caractérisé en ce que le corps de fixation os-seuse (42) comprend une pluralité de liaisonsinterconnectées (46) s’étendant dans la direc-tion longitudinale (L) entre les première et se-conde extrémités (43, 45) opposées, les liaisons(46) définissant une pluralité de crêtes (51)agencées de manière longitudinale et une plu-ralité de creux (60) agencés de manière longi-tudinale qui définissent une relation spatiale en-tre eux ; la pluralité de crêtes (51) étant trans-versalement espacées de la pluralité de creux(60), dans lequel les liaisons (46) sont flexiblesdans la direction longitudinale (L), de sorte quelorsque la longueur du corps de fixation (42) estajustée, la pluralité de crêtes (51) et la pluralitéde creux (60) continuent pour définir la relationspatiale bien que l’espacement entre les crêtes(51) adjacentes et/ou les creux (60) adjacents,change.

2. Dispositif de fixation osseuse selon la revendication1, dans lequel le corps de fixation osseuse (42) com-prend en outre un emplacement d’arrimage (82),l’emplacement d’arrimage (82) étant configuré pourse mettre en prise avec un dispositif d’arrimage (23)qui fixe le corps de fixation osseuse (42) par rapportà un second corps de fixation osseuse (42).

3. Dispositif de fixation osseuse selon la revendication2, dans lequel l’emplacement d’arrimage (82) est dis-posé au niveau de la crête (51) de l’une des liaisons(46).

4. Dispositif de fixation osseuse selon la revendication3, dans lequel l’emplacement d’arrimage (82) com-prend une queue (84) s’étendant transversalementà partir de la crête (51) entre la crête (51) et les unou plusieurs creux (60) adjacents à la crête (51).

5. Dispositif de fixation osseuse selon la revendication2, dans lequel le corps de fixation osseuse (42) com-prend en outre une pluralité d’emplacements d’arri-mage (82), chacun de la pluralité d’emplacementsd’arrimage (82) étant disposé au niveau d’une crêterespective d’une pluralité de crêtes (51), etdans lequel chacun de la pluralité d’emplacementde fixation d’os (70) est disposé au niveau d’un creuxrespectif de la pluralité de creux (60).

6. Dispositif de fixation osseuse selon la revendication5, dans lequel chaque liaison (46) de la pluralité deliaisons (46) comprend des premier et second élé-ments latéraux (48, 50), le premier élément latéral(48) s’étendant entre une extrémité supérieure dis-posée au niveau d’une crête (51) respective de lapluralité de crêtes (51) et une extrémité inférieureopposée disposée au niveau d’un premier creux (60)respectif de la pluralité de creux (60), le second élé-ment latéral (50) s’étendant entre une extrémité su-périeure disposée au niveau de la crête (51) respec-tive et une extrémité inférieure opposée disposée auniveau d’un second creux (60) respectif de la plura-lité de creux (60), etdans lequel les premier et second creux (60) respec-tifs sont adjacents l’un par rapport à l’autre le longdu corps de fixation osseuse (42).

7. Dispositif de fixation osseuse selon la revendication6, dans lequel les premier et second éléments laté-raux (48, 50) s’étendent de manière linéaire ou sontincurvés entre la crête (51) respective et les premieret second creux (60) respectifs.

8. Dispositif de fixation osseuse selon la revendication6, dans lequel les premier et second bras (48" , 50")s’étendent longitudinalement à partir des premièreet seconde extrémités (43, 45) du corps de fixation(42), respectivement, les premier et second bras(48" , 50" ) s’étendant entre des extrémités inférieu-res (56" , 58" ) respectives disposées au niveau despremière et seconde extrémités (43, 45) du corps defixation (42), respectivement, et les extrémités su-périeures (52", 54") respectives.

9. Dispositif de fixation osseuse selon la revendication8, dans lequel des premier et second crochets (83’)sont disposés au niveau des extrémités supérieures(52" , 54") des premier et second bras (48", 50"),respectivement, les premier et second crochets (83’)étant configurés pour se mettre en prise avec undispositif d’arrimage (23).

10. Dispositif de fixation osseuse selon la revendication1, dans lequel le corps de fixation osseuse (42) com-prend en outre une pluralité de liaisons auxiliaires(92), chacune des liaisons auxiliaires (92) s’étendantentre les première et seconde crêtes (51) adjacentes

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de la pluralité de crêtes (51) et définissant une crêteauxiliaire (94) respective.

11. Dispositif de fixation osseuse selon la revendication10, dans lequel le corps de fixation osseuse (42)comprend en outre un emplacement d’arrimage (96)configuré pour se mettre en prise avec un dispositifd’arrimage (23) qui fixe le corps de fixation osseuse(42) par rapport à un second corps de fixation os-seuse (42), l’emplacement d’arrimage (96) étant dis-posé au niveau de la crête auxiliaire (94) de l’unedes liaisons auxiliaires (92).

12. Dispositif de fixation osseuse selon la revendication1, dans lequel la relation spatiale comprend une dis-tance identique entre les crêtes (51) et une distanceidentique entre les creux (60), ou dans lequel la re-lation spatiale comprend des distances inégales en-tre deux ou plus de la pluralité de crêtes (51), oudans lequel la relation spatiale comprend des dis-tances inégales entre deux ou plusieurs de la plura-lité de creux (60).

13. Kit de fixation maxillo-mandibulaire comprenant :

des premier et second dispositifs de fixation os-seuse, comprenant un premier corps de fixationosseuse (42) et un second corps de fixation os-seuse (42) respectivement, les premier et se-cond corps de fixation osseuse (42) s’étendantdans un plan défini par une direction longitudi-nale (L) et une direction transversale (T) qui estperpendiculaire à la direction longitudinale (L),ayant une épaisseur dans une direction latérale(A) qui est perpendiculaire aux directions longi-tudinale et transversale (L, T) et ayant une sur-face latérale interne faisant face à l’os (57) etune surface latérale externe opposée (59),le premier corps de fixation osseuse (42) com-prenant une première pluralité d’emplacementsde fixation d’os (70) espacés longitudinalementle long d’une longueur du corps de fixation os-seuse (42), la longueur étant définie entre lespremière et seconde extrémités opposées (43,45) et une première pluralité d’emplacementsd’arrimage (82), etle second corps de fixation osseuse (42) com-prenant une seconde pluralité d’emplacementsde fixation d’os (70) espacés longitudinalementle long d’une longueur du second corps de fixa-tion osseuse (42), la longueur étant définie entreles première et seconde extrémités opposées(43, 45) du second corps de fixation osseuse(42), et une seconde pluralité d’emplacementsd’arrimage (82),dans lequel les première et seconde pluralitésd’emplacements d’arrimage (82) sont configu-rés pour se mettre en prise avec un dispositif

d’arrimage (23) qui fixe le premier corps de fixa-tion osseuse (42) par rapport au second corpsde fixation osseuse (42),caractérisé en ce que :

le premier corps de fixation osseuse (42)comprend une première pluralité de liaisonsinterconnectées (46) s’étendant dans la di-rection longitudinale (L) entre les premièreet seconde extrémités opposées (43, 45),la première pluralité de liaisons (46) définis-sant une pluralité de crêtes (51) agencéeslongitudinalement et une pluralité de creux(60) agencés de manière longitudinale quidéfinissent une relation spatiale entre eux,la pluralité de crêtes (51) étant espacées demanière transversale par rapport à la plu-ralité de creux (60), dans lequel les liaisons(46) de la première pluralité de liaisons (46)sont flexibles dans la direction longitudinale(L), de sorte que lorsque la longueur ducorps de fixation (42) est ajustée, la pluralitéde crêtes (51) et la pluralité de creux (60)continuent à définir la relation spatiale bienque l’espacement entre les crêtes (51) ad-jacences et/ou les creux (60) adjacents,change ; etle second corps de fixation osseuse (42)comprend une seconde pluralité de liaisonsinterconnectées (46) s’étendant dans la di-rection longitudinale (L) entre les premièreet seconde extrémités opposées (43, 45)du second corps de fixation osseuse (42),la seconde pluralité de liaisons (46) définis-sant une pluralité de crêtes (51) agencéesde manière longitudinale et une pluralité decreux (60) agencés de manière longitudina-le qui définissent une relation spatiale entreeux, la pluralité de crêtes (51) étant espacéede manière transversale par rapport à la plu-ralité de creux (60), dans lequel les liaisons(46) de la seconde pluralité de liaisons (46)sont flexibles dans la direction longitudinale(L), de sorte que lorsque la longueur ducorps de fixation (42) est ajustée, la pluralitéde crêtes (51) et la pluralité de creux (60)continuent à définir la relation spatiale bienque l’espacement entre les crêtes (51) ad-jacentes et/ou les creux (60) adjacents,change.

14. Kit de fixation maxillo-mandibulaire selon la reven-dication 13, dans lequel le second corps de fixationosseuse (42) diffère du premier corps de fixation os-seuse (42) selon au moins un élément des élémentssuivants :

la seconde pluralité de liaisons interconnectées

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(46) a une quantité de liaisons (46) différente dela première pluralité de liaisons interconnectés(46) ;la seconde pluralité d’emplacements de fixationd’os (70) a une quantité d’emplacements de fixa-tion d’os (70) différente de la première pluralitéd’emplacements de fixation d’os (70) ;la seconde pluralité d’emplacements de fixationd’os (70) est espacée différemment de la pre-mière pluralité d’emplacements de fixation d’os(70) ;la seconde pluralité d’emplacements d’arrimage(82) a une quantité d’emplacements d’arrimage(82) différente de la première pluralité d’empla-cements d’arrimage (82) ;les liaisons (46) de la seconde pluralité deliaisons interconnectées (46) ont une forme dif-férente des liaisons (46) de la première pluralitéde liaisons interconnectées (46) ;le premier corps de fixation osseuse (42) com-prend en outre une pluralité de liaisons auxiliai-res (92) s’étendant entre des crêtes (51) respec-tives de la première pluralité de liaisons inter-connectées (46) ; etle second corps de fixation osseuse (42) com-prend en outre une pluralité de liaisons auxiliai-res (92) s’étendant entre des crêtes (51) respec-tives de la seconde pluralité de liaisons inter-connectées (46).

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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 Europeanpatent document. Even though great care has been taken in compiling the references, errors or omissions cannot beexcluded and the EPO disclaims all liability in this regard.

Patent documents cited in the description

• US 6086365 A [0005]