the implantable orthopedic device 1 , shown in a perspective view in fig1 and 2 , essentially comprises a support structure 2 ( schematically shown herein ), in which is arranged a circular through - orifice 3 receiving a fixing screw 4 . this support structure 2 is for example comprised by a 2 to 3 mm thickness plate delimited by an upper face 2 ′ and a lower face 2 ″. the screw 4 is intended to be inserted into the orifice 3 on the upper face 2 ′ side , and to go out of it by the lower face 2 ″, the latter being intended to rest against the receiving bone material ( not shown ). generally , the support plate 2 can comprise several through - orifices 3 suitably arranged one relative to the other . this type of orthopedic implant is particularly intended to be positioned in a fractured bone ( not shown ), for example a radius epiphysis . it can be seen in fig3 and 4 that the through - orifice 3 extends through a housing 5 in which a nut 6 able to cooperate with a mating thread of the fixing screw 4 is positioned and caught . the nut 6 comprises a certain freedom degree within its receiving housing 5 , according to a predetermined acceptable tilting domain , so as to provide an efficient locking of the fixing screw 4 at the end of the screwing into the receiving bone material , whatever the admissible orientation of the axis 4 ′ thereof relative to the axis 5 ′ of the associated through - orifice 3 . further , this nut 6 is locked in rotation within its receiving housing 5 so as to be prevented from rotating around its axis 6 ′. the central wall of the through - orifice 3 delimits the above mentioned receiving housing 5 . the through - orifice 3 and the housing 5 have the same axis 5 ′. the receiving housing 5 of the nut 6 is particularly delimited at the upper part thereof ( i . e . on the surface 2 ′ side of the support 2 ) by a surface 5 a having a generally truncated sphere shape and at the lower part thereof by a surface 5 b also having a truncated sphere shape ( this surface 5 b being intended to position on the receiving bone material side ). surfaces 5 a and 5 b are concentric ; they are centered at a point located on the axis 5 ′ of the orifice 3 , within the thickness of the support 2 . the upper part 5 a has a radius greater than that of the lower part 5 b ; also , the diameter of the upper through - edge 3 a of the through - orifice 3 is greater than that of the lower through - edge 3 b thereof . more precisely , the upper part 5 a of the housing 5 is obtained by a suitable working of the support structure 2 ; this upper part 5 a is then integral with the support structure 2 so that the resistance thereof to thrust forces is optimized . the lower part 5 b of the housing 5 is formed by the central surface of an add - on clip 7 shown in details in fig4 . this clip 7 , once suitably add - on , enables the locking of the nut 6 within its receiving housing 5 . said clip 7 is in the form of an opened circular ring provided with a slot 8 providing thereof a certain radial elasticity in order it to be embedded within the support structure 2 . on its external periphery , this clip 7 is provided with a peripheral rib or embossment 9 able to embed in a circular groove 10 suitably arranged within the receiving housing 5 . the nut 6 , being in the form of a complete ring , comprises a generally truncated sphere shaped peripheral surface or contour 11 which mates with to upper part 5 a of the receiving housing 5 . this peripheral surface 11 is provided with cavities or recesses 12 a ( which are three here ) within which fit mating embossments 12 b forming kinds of tenons arranged on the upper part 5 a of the housing 5 . the cooperation between these elements 12 a and 12 b ensure that the nut 6 , once suitably positioned in its receiving housing 5 , will be locked in rotation around its axis 6 ′; these tenons 12 b and recesses 12 a are structured to enable a certain mobility of the nut 6 within the housing 5 , and in particular to enable a certain tilting of the axis 6 ′ thereof relative to axis 5 ′ of the housing 5 , in a predetermined acceptable domain . the central orifice 13 of the nut 6 is provided with a thread 14 ( extending around the symmetry axis 6 ′). as for the screw 4 , it comprises a screw head 15 and a screw body 16 . the screw head 15 comprises a , upper part 15 a provided with a thread 17 intended to engage with the mating thread 14 of the nut 6 at the end of the screwing of the screw 6 . this screw head 15 also comprises a lower part 15 b whose contour has a generally truncated sphere shape mating with the lower part 5 b of the receiving housing 5 . as for the screw body 16 , it comprises a thread 18 that extends all over the length thereof and that is shaped to cooperate with the receiving bone material . structural and dimensional characteristics of this screw body 16 having the thread 18 are adapted to make possible for it to pass through the threaded orifice 13 of the nut 6 , and , more generally , through the orifice 3 of the support plate 2 . in particular , the external diameter of the thread 18 is provided smaller than the external diameter of the thread 17 of the screw head 15 , and also smaller than the diameter of the through - opening 3 b of the orifice 3 . moreover , the head thread 17 consists of 2 screw threads which are shifted by ½ turn and whose pitch is the same as that of the thread 14 of the nut 6 and that of body thread 18 . the screw head 15 is so shaped to totally fit within the thickness of the support structure 2 , in such a way non to project beyond the upper face 2 ′ at the end of the screwing , as shown in fig1 . for this purpose , the height of the screw head 15 , i . e . the distance between the free end of its upper part 15 a and the lower end of its lower part 15 b , is lower or equal to the height of the through - orifice 3 . in practice , firstly , a nut 6 is suitably positioned within each of the receiving housings 5 of the support structure 2 , in order that the peripheral surface 11 thereof comes opposite to the upper part 5 a of said receiving housing 5 and that the recesses 12 a thereof accommodate one of the mating tenons 12 b . next , these nuts 6 are caught within their respective receiving housings 5 by the fitting of the closing clips 7 . this support structure 2 , provided with nuts 6 , is then able to be implanted by the practitioner in order to treat for example a fracture of a patient . for this purpose , he can firstly use a drilling bush , before the fitting of screws , to initiate positioning holes within the bone material , through the orifices 3 . next , the practitioner can introduce and screw a fixing screw 4 through each of the through - orifices 3 , with the adapted tilting relative to the axis of said orifice 3 ( in the limits of the acceptable tilting domain ). this tilting possibility is particularly related to the fact that the nut 6 has a freedom degree in its receiving housing 5 , said nut coming then “ automatically ” in alignment with the fixing screw 4 . the angular adjustment of the screw 4 is possible within a conical volume having an apex angle preferably included between 20 ° and 30 °, the axis thereof being merged with the axis 5 ′ of the through - orifice 3 . the practitioner continues to screw the screw 4 until the screw head 15 enter within the orifice 3 / housing 5 assembly ( fig1 to 3 ). then , as can be seen in fig3 , the thread 17 of the screw head 15 comes to cooperate with the mating thread 14 of the nut 6 . at the end of screwing , the lower part 15 b of the screw head 15 comes to rest on the mating surface of the lower part 5 b of the receiving housing 5 ( it should be noted that the resting of the support structure 2 on the receiving bone material helps the clip 7 to stay - on ); and that particular cooperation tends to separate the nut 6 from the lower part 5 a of the housing 5 . this separation phenomenon leads the nut contour 11 to come into forced rest against the mating upper part 5 a of the housing 5 ; the lower part 15 b of the screw head 15 also comes into a forced rest against the mating lower part 5 b of the housing 5 . this double forced rest “ in separation direction ”, or “ in expansion direction ”, makes it possible for the screw 4 to be locked through its receiving orifice 3 ; the strength of the locking is notably function of the screwing force applied by the practitioner during this final screwing step . in this final configuration , the contact of the truncated sphere shaped surfaces 5 a and 5 b of the receiving housing 5 with the mating surfaces 11 and 15 b of the nut 6 and of the screw head 15 , simultaneously , enables obtaining an efficient and quality tightening , whatever the tilting of the axis 4 ′ of the screw 4 and of the axis 6 ′ of the nut 6 relative to the axis 5 ′ of the orifice 3 / housing 5 assembly ( in the acceptable tilting domain ). in this final configuration , the screw head 15 is totally embedded in the thickness of the support structure 2 , without any particular protrusion beyond the upper surface 2 ′ of the support 2 . according to the needs , the practitioner will just have to exert a sufficient unscrewing force to provide the unscrewing of the screws in order to completely remove them from the receiving bone material . generally , this particular implantable orthopedic device structure is interesting in that it enables obtaining an efficient locking of the screw within the orifice / receiving housing assembly . further , this type of structure is interesting in that it is particularly compact and is able to embody support plates whose thickness is limited to a few millimeters ( in the order of 2 to 3 mm thick ).
the device includes a support structure having an orifice that delimits a seat for receiving a nut intended to cooperate with a locking screw . the seat comprises an upper part and a lower part , both shaped as truncated spheres and concentric to each other . furthermore , the nut has a spherical contour , and the screw head has a lower part , also with a spherical contour , and an upper part provided with a thread . the upper and lower parts of the screw head cooperate respectively with the complementary thread of the nut and with the lower part of the receiving seat such that , in the final phase of screwing the spherical contour of the nut bears against the upper spherical part of the seat , and of the lower part of the screw head against the lower spherical part of the seat .