Osteosynthesis plate comprising through-openings which are inclined in relation to the plane of the plate

An osteosynthesis plate is described, which is suitable for treating jaw fractures. The osteosynthesis plate has a plane of the plate as well as two plate sections 12, 14 with associated longitudinal axes 16, 18 extending substantially within the plane of the plate and inclined or staggered with respect to one another. Through openings 20, 22 inclined to the plane of the plate are formed in each of the two plate sections 12, 14. The angular alignments of the through openings 20, 22 within the plane of the plate differ with respect to a longitudinal axis 16 serving as reference line from one another by less than approximately 60°. In applications in the jaw region this slight deviation of the angular alignments permits an intraoral securement of the osteosynthesis plate. A transbuccal access through the cheek can thus be dispensed with.

CROSS-REFERENCE TO RELATED APPLICATION

The instant application claims priority to and all the advantages of International Patent Application No. PCT/EP2006/006365, filed on Jun. 30, 2006, which claims priority to German Patent Application No. 10 2005 032 026.0, filed on Jul. 8, 2005, the entire specifications of both of which are expressly incorporated herein by reference.

FIELD OF THE INVENTION

The present invention relates to an osteosynthesis plate with through openings inclined relative to the plane of the plate. Such osteosynthesis plates can be used to treat fractures in the region of the head and in particular to treat jaw fractures.

BACKGROUND OF THE INVENTION

Osteosynthesis plates for the treatment of fractures have been known for more than 100 years. The most commonly used osteosynthesis plates have a linear (or elongated) shape and are provided with a plurality of through openings running perpendicular to the plane of the plate. In order to fix an osteosynthesis plate to a bone or bone fragment fastening elements (normally bone screws) are inserted through the through openings into the bone or bone fragment.

For individual cases it has proved convenient to form the through openings inclined relative to the plane of the plate. Often the provision of through openings inclined relative to the plane of the plate is connected with specific anatomical features or with special requirements, such as the generation of compression forces acting at specific angles.

In a linear osteosynthesis plate the alignment of through openings inclined relative to the plane of the plate can in principle be uniquely described by two angles α and β. This situation will now be described with reference toFIGS. 17 and 18.

As illustrated inFIG. 17, a first angle α denotes the inclination of a through opening O with respect to a line S perpendicular to the plane of the plate. The plane of the plate inFIG. 10is inclined perpendicular to the plane of the drawing. A second angle β denotes according toFIG. 18an angular alignment of the through opening O within the plane of the plate with respect to a plate longitudinal axis L. The plane of the plate runs inFIG. 18parallel to the plane of the drawing.

The angles α and β provide an unambiguous angular characterisation by restricting the first angle α to the range from 0° to 90° and having the second angle β run from 0° to 360°. In the following discussion all angles are given in the anticlockwise direction and relative to a directed reference line (for example relative to a plate longitudinal axis pointing in a specific direction).

In U.S. Pat. No. 5,588,674 in FIGS. 5 and 6 a linear osteosynthesis plate is illustrated, which comprises a total of four through openings inclined to the plane of the plate. Each of these four through openings intersects the plane of the plate approximately at an angle of inclination α=45°. The inclined through opening26bhas an angular alignment β=0° with respect to a plate longitudinal axis pointing to the free end21of the osteosynthesis plate20. The remaining three inclined through openings have an opposite angular alignment β=180°.

From DE 199 62 317 A1 a linear osteosynthesis plate is known with two through openings aligned perpendicular to the plane of the plate and two through openings inclined to the plane of the plate. In this osteosynthesis plate the two through openings inclined to the plane of the plate have in each case an angle of inclination α of approximately 65° with respect to a straight line perpendicular to the plane of the plate. The angular alignment within the plane of the plate is in the case of the first inclined through opening β=0° with respect to the plate longitudinal axis, and in the case of the second inclined through opening β=180°.

From Christian Krenkel, Biomechanics and Osteosynthesis of Condylar Neck Fractures of the Mandible, Quintessence Publishing Co., Inc. Carol Stream, Ill., 1994, pp. 56 to 60, further linear osteosynthesis plates are known, which are used to treat fractures of the lower jaw. Since for aesthetic reasons (in order to avoid facial scars) fractures in the region of the lower jaw should be treated by surgical intervention from underneath the jaw, the through openings of the osteosynthesis plates are formed inclined to the plane of the plate. In the proposed osteosynthesis plates the angle of inclination α is between 30° and 90°. The angular alignment β of the through openings is either 0°, 45°, 90° or 135°.

The object of the invention is to provide an osteosynthesis plate for the treatment of fractures, in particular fractures in the region of the head such as lower jaw fractures, which can be fixed in a simple manner and with improved functionality to the bone.

SUMMARY OF THE INVENTION

This object is achieved by an osteosynthesis plate with a plane of the plate, with a linear first section with a first longitudinal axis and extending substantially within the plane of the plate, with a linear second section with a second longitudinal axis and extending substantially within the plane of the plate inclined or staggered with respect to the first section, with at least one first through opening in the first section, which is inclined to the plane of the plate and has with respect to the first longitudinal axis a first angular alignment within the plane of the plate, and at least one second through opening in a second section, which is inclined to the plane of the plate and has with respect to the first longitudinal axis of the first section a second angular alignment within the plane of the plate, wherein the first and second angular alignments with respect to the first longitudinal axis differ from one another by less than about 60°.

Although the osteosynthesis plate at least in the basic state or as-supplied state extends substantially within a general plane of the plate, this does not prevent the plate or individual sections of the plate from being bent outwards from the plane of the plate before or during use. Thus, it may be convenient to adapt the osteosynthesis plate before its securement to a bone and/or bone fragment, by bending it to match the specific anatomical features of the fracture region. This matching is as a rule carried out by the operating surgeon. It is however also possible for the osteosynthesis plate to be bent outwards to some extent from the general plane of the plate already in the as-supplied state, so as to match anatomical features. Such osteosynthesis plates are included in the scope of protection of the invention.

The angular alignments of the first through opening and of the second through opening with respect to the first longitudinal axis serving as reference axis may be identical or different. Often angular alignments differing somewhat from one another by more than 0° or more than 10° (up to about 60° or up to about 45°) with respect to the first longitudinal axis are suitable for purposes of manipulation. It is also possible for the first angular alignment to be inclined to the first longitudinal axis and/or for the second angular alignment to be inclined to the second longitudinal axis. This means in the diagram inFIG. 18that the angle β is chosen to be different from 0° and also different from 180°. Thus, the angle β can be chosen to be between approximately 10° and 170°, or between approximately 190° and 350°.

The angles of the first through opening and of the second through opening inclined to the plane of the plate (i.e. the angle of inclination α in the diagram ofFIG. 17) can be chosen to be identical or different. The first through opening can intersect the plane of the plate at an angle of inclination of approximately 20° to 80°. Also, an angle of inclination within the range from approximately 30° to 70° is also feasible. The angle of inclination at which the second through opening intersects the plane of the plate can likewise vary in these angular ranges from approximately 20° to 80° or from approximately 30° to 70°.

According to a first variant the first angular alignment to the first longitudinal axis is between approximately +90° and −90°, between approximately +60° and −60° or between approximately +40° and −40° (for example with respect to a direction facing away from the second section or facing towards a free end of the first section). According to a second variant, which can be combined with the first variant, the second angular alignment with respect to the second longitudinal axis is between approximately 60° and 180° or between approximately 70° and 130° (for example with respect to a direction facing away from the first section or a direction facing towards a free end of the second section). According to a third variant, which can be combined with the first variant, the second angular alignment to the second longitudinal axis is between approximately 180° and 300° or between approximately 220° and 290° (for example with respect to a direction facing away from the first section or a direction facing towards a free end of the second section). The second variant and the third variant can be used for osteosynthesis plates for different halves of the body (right/left).

The first section and the second section can directly adjoin one another or can be connected to one another by one or more connecting sections. The connecting sections can have a linear or bent shape.

In the case of a second section inclined to the first section, the angle between the first section and the second section can be between approximately 90° to 160° and in particular between approximately 110° to 150°. The first section and the second section (or their longitudinal axes) can also run parallel and staggered with respect to one another. In this case at least one connecting section is provided between the first section and the second section. The at least one connecting section can extend inclined or perpendicular to the first and second section.

In order to enable a surgeon to carry out more easily the already mentioned matching of the osteosynthesis plate to the relevant anatomical features, the osteosynthesis plate can comprise at least one bending region of reduced plate thickness and/or reduced plate width and/or of meandering shape. According to a first variant the bending region (for example as connecting section) is formed at the transition between the first section and the second section. According to a second variant, which can be combined with this first variant, the bending region is provided between two adjacent through openings.

The osteosynthesis plate is dimensioned depending on the surgical situation in each case. In particular, in cases involving the lower jaw region the first section of the osteosynthesis plate can have a length between approximately 3 and 100 mm (for example between 5 and 60 mm and preferably between 6 and 25 mm) and the second section can have a length between approximately 3 and 100 mm (for example between 5 and 60 mm and preferably between 6 and 25 mm). The overall length of the plate can vary between 6 and 200 mm.

The osteosynthesis plate can in the region of the first section and/or in the region of the second section have a maximum plate thickness between approximately 0.5 and 3.5 mm. In one possible configuration the plate thickness is chosen so that a head of a fastening element (in any case most of it) can be sunk or embedded in the plate. In order to support the embedding of the head, the at least one first through opening and/or the at least one second through opening can include underneath a plate surface a stop means for the head of the fastening element.

In order to provide a reliable securement of the osteosynthesis plate, a plurality (for example at least 2 to approximately 5) first through openings and a plurality (for example at least 2 to approximately 5) second through openings are provided. In this connection the mutual interspacing of the first through openings can be different from the mutual interspacing of the second through openings. This arrangement is particularly convenient if the length of the first section differs from the length of the second section. The through openings can have a diameter of approximately 1.5 to 3.5 mm, preferably approximately 2 to 3 mm.

DESCRIPTION OF PREFERRED EMBODIMENTS

The osteosynthesis plate according to the invention is discussed hereinafter with the aid of several embodiments. Identical and corresponding elements are identified here by the same reference numeral.

FIGS. 1 and 2show in each case a plan view of a first embodiment of an osteosynthesis plate10in different alignments.FIGS. 3 to 7andFIGS. 8A and 8Bshow further views of this osteosynthesis plate10.

The osteosynthesis plate10consists of titanium and is suitable in particular for treating jaw fractures (in particular fractures in the region of the mandibular angle). The osteosynthesis plate10illustrated inFIGS. 1 to 7,8A and8B is a plate for the right-hand mandibular angle. The plate illustrated inFIG. 9is intended for the left-hand mandibular angle. The left-hand osteosynthesis plate ofFIG. 9is the mirror image counterpart of the right-hand osteosynthesis plate10. For this reason the description of the right-hand osteosynthesis plate10applies, apart from a few exceptions, also to the left-hand osteosynthesis plate according toFIG. 9. The exceptions will be discussed in more detail in connection with the description ofFIG. 9.

The osteosynthesis plate10according to the first embodiment extends in the as-supplied state within a general plane of the plate, which inFIGS. 1 and 2runs parallel to the plane of the drawing. The osteosynthesis plate10has two adjoining linear plate sections12,14with associated longitudinal axes16,18. The two plate sections12,14run inclined to one another within the plane of the plate. As can be seen fromFIG. 1, the angle of intersection between the longitudinal axes14,16of the two plate sections12,14is approximately 130° in the illustrated embodiment. The length of the plane section12(measured from the point of intersection of the two longitudinal axes16,18up to the free end of the section12) is approximately 14 mm, and the length of the plate section14(measured from the point of intersection of the two longitudinal axes16,18up to the free end of the section14) is approximately 10 mm.

Three identically shaped through openings20are formed in the plate section12, and three likewise identically shaped through openings22are formed in the plate section14. The through openings20,22have a diameter of 2.4 mm in the narrowest region.

The through openings20in the plate section12intersect the plane of the plate at an angle of inclination α=60°. This situation can be seen inFIG. 3, which shows a section along the line A-A ofFIG. 1. The through openings22of the plate section14intersect the plane of the plate similarly at an angle of inclination of alpha=60°. This can be seen inFIG. 4, which shows a section along the line B-B ofFIG. 2. As regards the definition of the angle α, reference should be made toFIG. 17.

The through openings20of the plate section12have within the plane of the plate an angular alignment of β=0° with respect to the longitudinal axis16. The angular alignment with respect to the longitudinal axis16is determined in the direction of a free end of the plate section12. The through openings22of the plate section14have within the plane of the plate an angular alignment of β=270° with respect to the longitudinal axis18(and in the direction of the free end of the plate section14). The through openings22have an angular alignment β=40° with respect to the longitudinal axis16of the plate section12(again referred to the direction of the free end of the plate section12). The angular alignment of β=40° of the through openings22of the plate section14with respect to the longitudinal axis16of the plate section12is shown inFIG. 1. As regards the determination of the angle β, reference should be made toFIG. 18.

In the osteosynthesis plate10according toFIGS. 1 to 7,8A and8B the through openings20consequently have an angular alignment in the plane of the plate of β=0° and the through openings22have an angular alignment in the plane of the plate of β=40° (in each case referred to the longitudinal axis16of the plate section12). The difference in the angular alignments of the through openings20and of the through openings22within the plane of the plate is therefore approximately 40°.

As can readily be recognised especially inFIGS. 3 and 4, the through openings20in the plate section12(just as the through openings22in the plate section14) have an internal diameter that reduces in a step-wise manner in the direction of the lower side of the plate24. In this way a bearing surface26acting as a stop means for the head of a securement element is formed in each case within the through openings20,22. The bearing surface26is formed underneath the plate surface28and above the lower side of the plate24. Since in any case the lowest region of the bearing surface26(cf.FIG. 5) lies underneath the plate surface28, the head of a securement element inserted into the through openings20,22can be sunk at least partly in the osteosynthesis plate10.

InFIG. 8Ait can clearly be seen that the shanks50of bone screws48in the plate section12run up to the different angular alignment (Δβ=40°) substantially parallel to the shanks50of bone screws48in the plate section14. Furthermore, it can readily be seen in the illustration according toFIG. 8Athat the heads52of the bone screws48are accommodated sunk relative to the upper side of the plate.

With respect toFIG. 8Bit should also be mentioned that the auxiliary lines16′,18′ shown there and running perpendicular to the longitudinal axes14,16serve to illustrate the angular alignment region β. As shown inFIG. 8B, the angular alignment β with respect to the auxiliary lines16′,18′ can vary by ±90°, preferably by approximately 60°.

The planar osteosynthesis plate10in the as-supplied state has a plurality of bending regions of reduced plate thickness or reduced plate width. These bending regions enable the surgeon to adapt and match the osteosynthesis plate10to the anatomical features in the fracture region. In this connection the osteosynthesis plate10can by means of suitable tools such as bending forceps be bent within the plane of the plate as well as outwardly from the plane of the plate.

A first bending region30of the osteosynthesis plate10is according toFIG. 1arranged at the transition between the plate section12and the plate section14. As can be seen from the side view according toFIG. 6, the osteosynthesis plate10has in the bending region30a minimal width and a lower height than in regions outside the bending region30. This step-wise reduction of the plate thickness (from a maximum ca. 2 mm outside the bending region30to ca. 1.5 mm in the bending region30) and of the plate width facilitates the bending of the osteosynthesis plate10by the surgeon.

A plurality of second bending regions32are according toFIG. 1formed in each case between two adjacent through openings20of the plate section12and also between two adjacent through openings22of the plate section14. These further bending regions32are formed by regions of reduced plate width.

FIG. 9shows the left-hand osteosynthesis plate10of a plate system, which also includes the right-hand osteosynthesis plate described above with reference toFIGS. 1 to 7,8A and8B. As already mentioned, the left-hand osteosynthesis plate10is the mirror symmetrical counterpart to the right-hand osteosynthesis plate. Accordingly the basic difference compared to the right-hand osteosynthesis plate is that the through openings22of the plate section14have a different angular alignment within the plane of the plate. Whereas in the right-hand plate the corresponding angular alignment β=270°, the through openings22of the left-hand osteosynthesis plate10have with respect to the longitudinal axis18and in the direction of the free end of the plate section14, a mirror image-forming angular alignment β=90°. The difference in the angular alignments of the through openings22of the plate section14and of the through openings20of the plate section12(in each case referred to the longitudinal axis16) is a constant 40°.

FIG. 10shows a further embodiment of an osteosynthesis plate10for treating fractures in the jaw region. The osteosynthesis plate10has two plate sections12,14, which are arranged parallel and staggered with respect to one another. Between the two plate sections12,14is provided a connecting section40, running inclined to each of these sections12,14. The connecting section40intersects the two plate sections12,14at an angle of in each case approximately 140°.

Three identical through openings20,22are formed in each case in each of the two plate sections12,14. The through openings20,22intersect the plane of the plate at an angle of inclination α=45°. With respect to the longitudinal axis16of the plate section12and in the direction of the free end of the plate section12the angular alignment β of the through openings20within the plane of the plate is β=135°. The angular alignment β of the through openings22with respect to the longitudinal axis18of the plate section14and in the direction of the free end of the plate section14is β=45°. Referred to the longitudinal axis16of the plate section12and the free end of the plate section12, the angular alignment β of the through openings22of the plate section14is β=135°. The angular alignments of the through openings20and of the through openings22therefore coincide with respect to the longitudinal axis16of the plate section12.

A further embodiment of an osteosynthesis plate10for treating fractures of the mandibular angle is illustrated inFIGS. 11A and 11B. The illustrated osteosynthesis plate10is substantially identical to the osteosynthesis plate10discussed with reference toFIGS. 1 to 7,8A and8B, except as regards the angular alignments of the through openings. For this reason only the differences will be discussed hereinafter.

A further embodiment of an osteosynthesis plate10is illustrated inFIGS. 11A and 11B. In this embodiment the two plate sections12,14again enclose an angle of 130°. The through openings20,22have in each case an angle of inclination α=60° with respect to the plane of the plate. The angular alignment of the through openings20of the plate section12within the plane of the plate (and referred to the free end of the plate section12) is in this embodiment 90°. As in the first embodiment, the through openings22of the plate section14within the plane of the plate have with respect to the longitudinal axis18(and in the direction of the free end of the plate section14) an angular alignment of β=270°. The difference of the angular alignments of the through openings20and of the through openings22within the plane of the plate is approximately 50°. The angular alignments of the through openings20and22can vary from the specified angular alignments by ±90°, preferably by approximately ±60°.

A further embodiment of an osteosynthesis plate10is illustrated inFIGS. 12A and 12B, with a total of three plate sections12,14,14′ and a total length of approximately 40 mm. The osteosynthesis plate10has a substantially fork-shaped configuration. The two plate sections14,14′ run parallel and staggered with respect to the longitudinal axis16of the section12. The plate section12is connected to the plate sections14,14′ by a connecting section40,40′ bent in each case in the shape of a quarter circle.

The fork-shaped configuration of the osteosynthesis plate10is determined by the fact that the two plate sections14,14′ accommodate a nerve between them (for example in the region of the lower jaw). In this way damage to the nerve due to the bone screw48can be avoided.

The through openings20of the plate section12of the osteosynthesis plate10and also the through openings20,20′ of the plate sections14,14′ intersect the plane of the plate in each case at an angle of inclination α=60°. The through openings20of the plate section12have within the plane of the plate an angular alignment β=0° with respect to the longitudinal axis16and in the direction of a free end of the plate section12. The through openings22,22′ of the plate sections14,14′ have within the plane of the plate an angular alignment β=180° relative to the respective longitudinal axis18,18′ (and in the direction of the respective free end of the plate section14,14′. The through openings22,22′ have an angular alignment β=0° with respect to the longitudinal axis16of the plate section12(again referred to the direction of the free end of the plate section12). The difference in the angular alignments of the through openings20and of the through openings22,22′ within the plane of the plate is therefore 0°.

A further embodiment of an osteosynthesis plate10is illustrated inFIGS. 13A and 13B. The osteosynthesis plate10illustrated there has a substantially grid-shaped configuration with two plate sections12,14running parallel and staggered with respect to one another. The plate sections12,14are joined to one another in the region of oppositely located through openings20,22by in each case a connecting section40. In the example illustrated inFIGS. 13A and 13B, with two times three through openings20,22(i.e. three per plate section12,14), three connecting sections40are therefore provided. The connecting sections40run parallel to one another and in this example intersect the plate section12,14at a right angle. A modification of the osteosynthesis plate10illustrated inFIGS. 13A and 13Bcould have, instead of two times three through openings, two times four or three times four through openings.

The through openings20,22of the osteosynthesis plate10ofFIGS. 13A and 13Bintersect the plane of the plate in each case at an angle of inclination α=60°. The through openings20of the plate section12have within the plane of the plate an angular alignment β=90°/270° with respect to a longitudinal axis of the plate section12(in the example ofFIGS. 13A and 13Bthere is no preferred direction). The through openings22of the plate section14have the same angle of alignment β=90°/270° with respect to a longitudinal axis of the plate section14. Accordingly the difference in the angular alignments of the through openings20and of the through openings22within the plane of the plate is 0°.

A further osteosynthesis plate10with two plate sections12,14is illustrated inFIGS. 14A and 14B. The two plate sections12,14have a common longitudinal axis16and are connected to one another via a meandering (U-shaped) bent connecting section40. The osteosynthesis plate10can in the application state be positioned in such a way that the U-shaped bent connecting section40extends around a nerve. In a modification of the osteosynthesis plate10according toFIGS. 14A and 14B, at least one bone screw through opening is provided in the region of the connecting section40.

The through openings20,22intersect the plane of the plate in each case at an angle of inclination α=60°. The through openings20of the plate section12have within the plane of the plate an angular alignment β=90° with respect to the common longitudinal axis16(and in the direction of the free end of the plate section12). The through openings22of the plate section14have an angular alignment β=270° with respect to the common longitudinal axis16and with respect to the free end of the plate section14. The difference in the angular alignments of the through openings20and of the through openings22within the plane of the plate is consequently 0°.

FIGS. 14A and 14Bshow the osteosynthesis plate10in the base state. According to a further embodiment of the invention the osteosynthesis plate10can in the region of the connecting section40(which then acts as bending region) be deformed in such a way that the plate section12is inclined relative to the plate section14.

A further osteosynthesis plate10is illustrated inFIGS. 15A and 15B. The osteosynthesis plate10has in the base state illustrated inFIG. 15Aa linear configuration with a total of eight through openings20. The through openings20intersect the plane of the plate at an angle α=60° and have within the plane of the plate an angular alignment β=90°/270° (there is no preferred direction). The angular alignment β can vary by ±90°, preferably by approximately ±60°, with respect to the auxiliary line16′ shown inFIG. 15B.

FIG. 15Bshows the osteosynthesis plate10in the bent application state. The osteosynthesis plate10is in this example secured in the region of the front side of the lower jawbone (therefore in the chin region) and its bent shape matches the contour of this bone. Since the through openings20,22point inclined upwards, the screws48can be inserted intraorally (and in particular inclined from above).

The osteosynthesis plate according toFIGS. 15A,15B can according to a further embodiment of the invention be deformed within the plane of the plate similarly as shown inFIG. 10, in such a way that two linear plate sections running parallel and staggered with respect to one another are formed.

A further osteosynthesis plate10is illustrated inFIG. 16. The osteosynthesis plate10has a linear configuration and comprises two plate sections12,14connected to one another via a connecting section shaped as a bending region30. The through openings20,22of the plate sections12,14have an angle of inclination α=60° with respect to the plane of the plate. The angular alignments of the through openings20,22are in each case β=180° with respect to the free ends of the respective plate section12,14. The difference in the angular alignments of the through openings20and of the through openings22is accordingly 180°.

According to an embodiment of the invention the osteosynthesis plate10illustrated inFIG. 16is bent at the site of the bending region30in such a way that the two plate sections12,14are inclined to one another in a substantially V-shaped manner.

The osteosynthesis plates discussed with reference toFIGS. 1 to 11Bare suitable for the intraoral treatment of fractures of the mandibular angle. The osteosynthesis plates described with reference toFIGS. 12A to 16are suitable for the intraoral treatment of jaw fractures in jaw regions spaced from the mandibular angle, for example in the region of the chin or condylus.

The existence of two or more plate sections that are aligned non-linearly with respect to one another enables even complicated jaw fractures to be treated by means of a single osteosynthesis plate. The alignment of the individual through openings in the plane of the plate and perpendicular thereto is chosen in the embodiments in such a way that the osteosynthesis plates can be fastened in situ by an intraoral surgical intervention, i.e. through the mouth. No transbuccal access (i.e. through the cheek) is therefore necessary in order to place in position the osteosynthesis plates of the embodiments and secure them by means of suitable securement elements such as monocortical bone screws.

On account of the special alignment of the through openings the surgeon is able to place in position an osteosynthesis plate intraorally, carry out if necessary preliminary drillings, and then secure the osteosynthesis plate by means of several bone screws, all without the need for a transbuccal access. Conventional (longitudinally extended) straight instruments such as blades and drills are sufficient for carrying out these steps. The use of curved instruments can be dispensed with. A further advantage of the alignment of the through openings specified in the embodiments is the fact that the surgeon, despite the intraoral access, has a good field of view and can thus see exactly where he is drilling and where the bone screws are placed.

Although the invention has been described with the aid of several embodiments of osteosynthesis plates for treating jaw fractures, the osteosynthesis plates according to the invention are also suitable for minimal invasive treatment of other fractures in the head region (for example the face).

On the basis of the above description and discussion the person skilled in the art will be able to employ numerous changes, additions and modifications that are still covered by the invention. The scope of protection of the invention is limited solely by the accompanying patent claims.