Patent Document:

in this description the expression &# 34 ; constraining end &# 34 ; is used to indicate the part of the graft constraint device which actually constrains the graft material . the expression &# 34 ; fastening end &# 34 ; is used to indicate the part of the graft constraint device which receives the fastening means for securing the device to a stable bone cortex . the first embodiment of the invention shown in fig1 and 2 consists of a graft constraint device 10 having one constraining end 12 and one fastening end 13 . the graft constraint device 10 is applied to a stable bone cortex of the radius 17 with fastening means . in this embodiment the fastening means is a screw 11 and a washer 14 . in other embodiments the fastening means is only a screw , i . e . no washer is needed . the constraining end 12 of the graft constraint device 10 is formed into a plate 15 covering the opening into which the graft material 1 is inserted . in this embodiment and as viewed in fig2 the plate 15 is broader than the fastening end 13 . the size and design of the plate 15 is determined based on the conditions at the actual site of application , such as the positions and sizes of the fractures and fragments . thus , in some embodiments the plate 15 may have the same width or even be narrower than the fastening end 13 . at the outer end of the plate 15 pointed projections 16 are furnished for engagement with bone cortex . in another embodiment ( not shown ) the plate has no pointed projections . the graft constraint device 10 is secured to the radius 17 after the graft material has been placed . in a further embodiment ( not shown ) the plate has the form of a mesh or is furnished with multiple openings to allow ingrowth of blood vessels in the graft material . also in the second embodiment , shown in fig3 the graft constraint device 20 has a fastening end 23 and a constraining end 22 . the fastening end 23 is similar to the fastening end 13 of the first embodiment and has an opening 26 for receiving a fastening means . the constraining end 22 comprises malleable fingers 25 , which allow contouring to the uneven anatomical site of application . the openings between the fingers 25 allow ingrowth of blood vessels into the grafting material . in the third embodiment , shown in fig4 the graft constraint device 30 is a wire bent into a u - shape . the diameter of the wire is preferably between 0 . 010 &# 34 ; to 0 . 250 &# 34 ;. the base of the &# 34 ; u &# 34 ; forms the fastening end 33 and the upper part of the &# 34 ; fingers &# 34 ; 35 of the &# 34 ; u &# 34 ; forms the constraining end 32 . this graft constraint device 30 is fastened at stable bone cortex by means of a screw 11 and washer 14 . also this embodiment is malleable enough to allow contouring to the actual site of application and allow ingrowth of blood vessels into the grafting material 1 . as an option , pointed projections cooperating with bone cortex are furnished at the outer ends of the fingers 35 of the graft constraint device 30 made of a wire bent into a u - shape . the pointed projections may be formed by bending the outer part of the wires 35 . the site of the bend decides how far into , or even through , the graft the projections will go . as a further option a small plate ( fig7 ) is placed between the extraosseous surface of the radius and the fingers 35 of the u . in this way the load of the graft constraint device is spread over a wider area . in its most simple embodiment the plate 50 is a simple straight plate . in further embodiments the plate is furnished with means to constrain the plate from migrating . the means to constrain the plate from migrating may have any suitable form such as the plate having a raised area 51 between the fingers 35 of the u , forming two seats 52 for receiving the fingers 35 of the u , or having two small holes placed near the distal edge of the plate to allow passage for the pointed projections of the bent fingers 35 of the u . if needed said plate is bent to conform to the dorsal surface . the fourth embodiment shown in fig5 and 6 is especially intended for use with synthetic graft materials . one example of such material is synthetic &# 34 ; bone paste &# 34 ; made by norian corp . the bone paste is injected into the osseous defect and allowed to harden . a graft constraint device according to the previous embodiments would constrain the material , but would not prevent the graft material from displacing proximally within the bone itself . the graft constraint device 40 according to this embodiment is u - shaped with the base of the &# 34 ; u &# 34 ; forming the fastening end 43 . the fastening end 43 receives a screw 41 and washer 44 for securing the device to stable bone cortex . the constraint end 42 of the device 40 has the form of fingers 45 bent downward to project into the graft material 1 . in use the fingers 45 are placed in the graft material while it is still soft . then the synthetic graft material is allowed to harden around the fingers 45 projecting into the graft material . in further embodiments ( not shown ) the constraining end is a combination of the above embodiment and one of the previous embodiments . thus , it has several &# 34 ; fingers &# 34 ; of which at least one projects into the graft material and at least one lies over the graft material . the graft constraint device is made thin and may in some embodiments be formed to follow the contour of the site of application , to minimize any discomfort for the patient . the graft constraint device is unobtrusive to avoid irritation of the adjacent soft tissue . a person skilled in the art realizes that the graft constraint device , at the same time as being soft enough to contour , has sufficient stiffness for its intended purpose as a buttress . in the embodiments shown in the figures screws with or without washers are used as fastening means . a person skilled in the art perceives that other fastening means may be used . thus , in other embodiments pins , wires , blades , staples , brackets or indirect coaption with another device scurely attached to the stable bone is used instead of screws to apply the device to a stable bone cortex . as an option , pointed projections cooperating with bone cortex are furnishedat the constraining end 12 , 22 , 32 , 42 of the graft constraint device 10 , 20 , 30 , 40 according to the different embodiments . the form of these pointed projections varies in that they may be pointed or not , and may be long enough to pass through a hole placed in the graft , such as a small hole drilled through a piece of cortical bone graft . such an application would further constrain the graft material from slipping under the device . the above description has referred to but a limited number of embodiments of the present invention , but it will be readily perceived by a person skilled in the art that the present invention encompasses a large number of embodiments without departing from the spirit and scope of the appended claims .

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