WO2006039900A1 - Cerclageanordnung für die fixation einer knochenfraktur mit einer eine anzahl von durchgehenden löchern aufweisenden platte - Google Patents
Cerclageanordnung für die fixation einer knochenfraktur mit einer eine anzahl von durchgehenden löchern aufweisenden platte Download PDFInfo
- Publication number
- WO2006039900A1 WO2006039900A1 PCT/DE2005/001808 DE2005001808W WO2006039900A1 WO 2006039900 A1 WO2006039900 A1 WO 2006039900A1 DE 2005001808 W DE2005001808 W DE 2005001808W WO 2006039900 A1 WO2006039900 A1 WO 2006039900A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- cerclageanordnung
- plate
- pin
- head
- bone
- Prior art date
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/82—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/842—Flexible wires, bands or straps
Definitions
- the invention relates to a Cerclageitan Aunt specified in the preamble of claim 1 Art.
- Cerclage restarte used in the stabilizing plate, in the plate round or elongated holes are present, in which the Cerclage reconstructe intervene.
- the heads of the Cerc ⁇ pins have in turn - transversely directed - through openings through which cerclage and / or cerclage wires can be ge leads, which wrap around the bone area to be stabilized.
- holders for cerclage wires are known from US Pat. Nos. 5,810,824 and 6,520,965, which holders can be used exclusively together with bone screws.
- bone screws are always necessary for fixation, which presupposes their attachment, that the fracture area also provides a corresponding hold for them.
- the solutions presented here are therefore only usable to a limited extent.
- the invention in the characterizing part of claim 1 invention is therefore based on the object, the aforementioned Cerclagelink train such that on the one hand the fixation effect is improved and on the other hand, a wide range of uses regardless of the fracture found is possible.
- the Cerclageq has a shaft which has a projecting through the plate end so that it engages in the bone area to be fixed, early on a significant fixation of the fracture occurs - and even before the individual Cerclageb applications are finally tightened. Screws can if necessary be additionally screwed into the existing round or dynamic slots of the plate, if required by the circumstances. But they are not necessary from the beginning.
- the shaft is advantageously provided at its end with a tip or a tapered aus ⁇ designed in a rounding aus ⁇ designed, he finds his way into a specially provided by a conventional bone drill prepared hole particularly easy.
- the Cerclagex according to an advantageous embodiment of the invention in the region of the head has a direction transverse to the direction of the pin and transverse to the direction of the opening groove, the pin by means of an impactor - if necessary - easily be driven into the prepared opening.
- the aforesaid groove can then reach as far as the cone-shaped or rounded region without impairing the strength of the head.
- the entire design of the pin is thus opti ⁇ optimized that the pulling action of a relatively wide band, which produces a uniformly distributed contact pressure on the bone, is also optimally introduced into the pin, which together with the plate causes a stable fixation, in which local overloads of verwen ⁇ Deten material are avoided.
- the arrangement according to the invention consisting of pin and cerclage band, can also be used without a plate. This results in an extremely versatile usability - if one considers that additional bone screws can be used as needed - but their use is not a condition.
- pens are individually packaged with a cerclage band (sterile), so that the doctor depending on the application - always the necessary number of pens and tapes together.
- a cerclage band sterile
- the Cerclage request invention preferably consists of a kör ⁇ pervertable implant material, in particular an alloy such as CrNi or CrMo.
- the cerclageting according to the invention has a tip protruding through the plate, which is introduced into a prepared bore provided in the bone area and placed together with the stabilizing plate on or above the fracture, a secure prefixing is ensured. Subsequently, the cerclage bands or wires are pushed and fixed through the openings of the cerclage reconstructe so that the fracture is stably fixed on both sides of the fracture.
- FIG. 1 shows the Cerclage arrangement according to the invention
- FIG. 2 shows a Cerclage deposit in perspective view, as part of the arrangement shown in Figure 1; 2a shows a first variant of Cerclage depositss shown in Fig. 2 as well as
- Fig. 1 the Cerclageking arrangement according to the invention is given cafege ⁇ .
- the fracture area of a bone 1 shown by dash-dot lines is fixed by means of a stabilization plate 2, a cerclage band 3 (also shown in phantom) and a Cerclageting 10.
- the Cerclageting 10 has a cylindrical head 11 with a Quer ⁇ opening 12 and a semi-circular groove 13 into which an im- pactor, so the impact tool is used. Below the head 11, a cone section 14 is provided, which fits into the countersinks of the oblong holes in the stabilization plate 3. Next, a cylindrical shaft 15 with a tip 16 available.
- the Cerclageting 10 is for the fixation of a bone fracture vorge ⁇ provided with a number of through holes plate, said provided in the head of the pin and transverse to the direction of the pin having opening 12 for passing a Cerc- lagebandes or wire serves by the Groove 13, the opening 12 is divided into two areas, so that the insertion of the tape in the ⁇ ff ⁇ voltage is easy to observe.
- the groove 13 provided in the region of the head 11 is directed transversely to the direction of the pin and transversely to the direction of the opening 12.
- the groove 13 is rounded in depth, in particular half-round designed.
- the Cerclageting 10 further includes a shaft 15 which has a projecting through the plate 2 end so that it can be fixed in the engages the bone area.
- the Cerclageking is further provided in the region of its shaft at its end with a tip 16 or tapered in a rounding or blunt ending designed.
- the two variants are shown in the figures 2a and 2c - as partial representations of Fig. 2, wherein the shaft 15 is alternatively provided with a ver ⁇ rounded tip 16a (Fig. 2a) or a blunt end 16b (Fig. 2b).
- the selection of the configuration of the end takes place ent ⁇ the desired application, wherein the strength of the pin tes increases with increasing blunting, while a zu ⁇ increasing tapering of the end facilitates insertion into a found hole.
- an intermediate solution is selected here, as it corresponds, for example, to the exemplary embodiment according to FIG. 2b.
- a conical or rounded region 14 which widens from the pin to the head and, in particular, inserts a round or oblong hole area of the plate into the rounding area.
- the insertion takes place by first placing the stabilizing plate 2 on or above the fracture, through which holes 12 a blind hole having a defined depth and smaller diameter than the shaft 15 is introduced, and then the Cerclageit 10 is inserted into the bone by means of an impactor is easily taken.
- the Cerclageting 10 is preferably made of a stainless steel for surgical purposes, for example, CrNi or CrMo or another suitable for implantation metal alloy herge ⁇ .
- the cerclage band is formed by a flexible metal band which also consists of an implantable material. It is - after it is pulled through the head of the pin and around the bone connected to a loop, at its ends corresponding connecting means are provided. These preferably consist of an eyelet into which the end of the band is inserted and then bent sharply and ceremonies ⁇ out.
- Packaging units are each formed by a sterile tape wrapped together with a surgical tape, so that on the one hand the required parts are easily assembled for each application - on the other hand, however, a different stocking with too many variants is avoided.
- the invention is not limited by the embodiment shown, but can also be used advantageously in other combinations.
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Neurology (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
Description
Claims
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/718,748 US8685025B2 (en) | 2004-10-07 | 2005-10-07 | Cerclage arrangement for fixing a bone fracture, comprising a plate that is provided with a number of continuous holes |
DE112005003167T DE112005003167A5 (de) | 2004-10-07 | 2005-10-07 | Cerclageanordnung für die Fixation einer Knochenfraktur mit einer eine Anzahl von durchgehenden Löchern aufweisenden Platte |
EP05804251A EP1796562A1 (de) | 2004-10-07 | 2005-10-07 | Cerclageanordnung für die fixation einer knochenfraktur mit einer eine anzahl von durchgehenden löchern aufweisenden platte |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE202004015582.6 | 2004-10-07 | ||
DE202004015582U DE202004015582U1 (de) | 2004-10-07 | 2004-10-07 | Cerclagestift für die Fixation von Stabilisierungsplatten |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2006039900A1 true WO2006039900A1 (de) | 2006-04-20 |
Family
ID=33547438
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/DE2005/001808 WO2006039900A1 (de) | 2004-10-07 | 2005-10-07 | Cerclageanordnung für die fixation einer knochenfraktur mit einer eine anzahl von durchgehenden löchern aufweisenden platte |
Country Status (4)
Country | Link |
---|---|
US (1) | US8685025B2 (de) |
EP (1) | EP1796562A1 (de) |
DE (1) | DE202004015582U1 (de) |
WO (1) | WO2006039900A1 (de) |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8968318B2 (en) | 2007-02-28 | 2015-03-03 | DePuy Synthes Products, LLC | Grooved crimp with a set screw |
CN107174328A (zh) * | 2017-07-01 | 2017-09-19 | 河北瑞鹤医疗器械有限公司 | 缝合固定用缝线孔及大结节解剖型钢板 |
Families Citing this family (15)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8034085B2 (en) * | 2004-05-28 | 2011-10-11 | Depuy Spine, Inc. | Non-fusion spinal correction systems and methods |
US8469966B2 (en) | 2004-09-23 | 2013-06-25 | Smith & Nephew, Inc. | Systems, methods, and apparatuses for tensioning an orthopedic surgical cable |
US7909826B2 (en) * | 2005-03-24 | 2011-03-22 | Depuy Spine, Inc. | Low profile spinal tethering methods |
WO2010132217A1 (en) * | 2009-05-12 | 2010-11-18 | Synthes Usa, Llc | Bone fixation element with self-retaining cable tie |
TR201006773A2 (tr) * | 2010-08-16 | 2011-06-21 | Çağri Köse Kami̇l | Çektirme (translasyon) özellikli pedikül vidası uygulama metodu. |
US9084644B2 (en) | 2011-02-02 | 2015-07-21 | DePuy Synthes Products, Inc. | Bone fixation assembly |
US9101426B2 (en) | 2012-10-11 | 2015-08-11 | Stryker Trauma Sa | Cable plug |
WO2015183485A1 (en) | 2014-05-30 | 2015-12-03 | DePuy Synthes Products, Inc. | Bone fixation assembly |
US10499968B2 (en) | 2014-08-08 | 2019-12-10 | Stryker European Holdings I, Llc | Cable plugs for bone plates |
US9795421B2 (en) | 2015-07-07 | 2017-10-24 | K2M, Inc. | Spinal construct with flexible member |
EP3375394B1 (de) * | 2017-03-13 | 2021-10-13 | Biedermann Technologies GmbH & Co. KG | Kabelrückhalteeinsatz und knochenplattenanordnung mit solch einem kabelrückhalteeinsatz |
US11185353B2 (en) | 2018-03-22 | 2021-11-30 | Orthopediatrics Corp. | Anchors for vertebral body |
US20200397489A1 (en) | 2019-06-24 | 2020-12-24 | Nextremity Solutions, Inc. | Fracture fixation system and method |
US11925397B2 (en) | 2020-06-25 | 2024-03-12 | Medartis Ag | System and method for bone fixation |
US11998252B2 (en) | 2020-11-18 | 2024-06-04 | Medartis Ag | System and method for bone fixation |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO1993003681A1 (en) * | 1991-08-27 | 1993-03-04 | Howmedica Inc. | Cerclage wire positioning insert |
US5607430A (en) | 1995-08-25 | 1997-03-04 | Biomet, Inc. | Bone stabilization implant having a bone plate portion with integral cable clamping means |
US5810824A (en) | 1997-02-13 | 1998-09-22 | Chan; Kwan-Ho | Surgical fastener assembly and method for bone fracture fixation |
US6520965B2 (en) | 2001-05-23 | 2003-02-18 | Alan Chervitz | Apparatus and method for orthopedic fixation |
Family Cites Families (29)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US525891A (en) * | 1894-09-11 | Fastener for electric wires | ||
US4146022A (en) * | 1977-11-16 | 1979-03-27 | Ronald A. Johnson | Fracture fixation by cerclage utilizing cortical bone tack and pull-out tension device |
US4790303A (en) * | 1987-03-11 | 1988-12-13 | Acromed Corporation | Apparatus and method for securing bone graft |
US4887596A (en) * | 1988-03-02 | 1989-12-19 | Synthes (U.S.A.) | Open backed pedicle screw |
FR2645732B1 (fr) * | 1989-04-13 | 1997-01-03 | Cotrel Yves | Implant vertebral pour dispositif d'osteosynthese |
US5976159A (en) * | 1995-02-24 | 1999-11-02 | Heartport, Inc. | Surgical clips and methods for tissue approximation |
US5662653A (en) * | 1996-02-22 | 1997-09-02 | Pioneer Laboratories, Inc. | Surgical rod-to-bone attachment |
US6616451B1 (en) * | 1997-06-20 | 2003-09-09 | Biolase Technology, Inc. | Electromagnetic radiation emitting toothbrush and dentifrice system |
US6162055A (en) * | 1998-02-13 | 2000-12-19 | Britesmile, Inc. | Light activated tooth whitening composition and method of using same |
US6110172A (en) * | 1998-07-31 | 2000-08-29 | Jackson; Roger P. | Closure system for open ended osteosynthesis apparatus |
US6155832A (en) * | 1998-12-04 | 2000-12-05 | Wiesel; Peter E. | Methods and apparatus for whitening teeth |
US6616447B1 (en) * | 2000-11-15 | 2003-09-09 | Biolase Technology, Inc. | Device for dental care and whitening |
JP3486631B2 (ja) * | 2001-03-30 | 2004-01-13 | ウシオ電機株式会社 | 変色歯牙漂白装置 |
US7354448B2 (en) * | 2001-11-29 | 2008-04-08 | Palomar Medical Technologies, Inc. | Dental phototherapy methods and compositions |
US6902397B2 (en) * | 2002-08-01 | 2005-06-07 | Sunstar Americas, Inc. | Enhanced dental hygiene system with direct UVA photoexcitation |
US7862597B2 (en) * | 2002-08-22 | 2011-01-04 | Warsaw Orthopedic, Inc. | System for stabilizing a portion of the spine |
US6752627B2 (en) * | 2002-09-13 | 2004-06-22 | Chang Gung University | Light emitting tooth brush having whitening and sterilizing effects |
FR2844719B1 (fr) * | 2002-09-24 | 2004-11-19 | Francois Duret | Dispositif electro-chimique pour le blanchiment d'un corps |
WO2004028393A1 (en) * | 2002-09-24 | 2004-04-08 | Twilight Teeth, Inc. | Mouthpiece devices and methods to allow uv whitening of teeth |
CA2505719A1 (en) * | 2002-11-15 | 2004-06-03 | Discus Dental, Inc. | Tooth bleaching process |
US7004756B2 (en) * | 2003-01-24 | 2006-02-28 | Ultradent Products, Inc. | Pre-shaped dental trays and treatment devices and methods that utilize such dental trays |
US20060141422A1 (en) * | 2004-04-20 | 2006-06-29 | K Philp Graham Jr | Method and apparatus for tooth whitening |
US20050038428A1 (en) * | 2003-07-30 | 2005-02-17 | Kelman David C. | Methods and devices for retaining cerclage cable |
US20070015112A1 (en) * | 2003-08-29 | 2007-01-18 | Mark Hochman | Teeth whitening apparatus and method |
US20050053898A1 (en) * | 2003-09-09 | 2005-03-10 | The Procter & Gamble Company | Illuminated electric toothbrushes and methods of use |
US20050050659A1 (en) * | 2003-09-09 | 2005-03-10 | The Procter & Gamble Company | Electric toothbrush comprising an electrically powered element |
US20050170316A1 (en) * | 2004-01-29 | 2005-08-04 | Russell Bruce M. | Toothbrush for detecting the presence of plaque |
AU2005314712A1 (en) * | 2004-12-09 | 2006-06-15 | Palomar Medical Technologies, Inc. | Oral appliance with heat transfer mechanism |
US20070020584A1 (en) * | 2005-07-20 | 2007-01-25 | Madray George W | Dental treating process using a treatment agent, dental tray, and a catalytic source |
-
2004
- 2004-10-07 DE DE202004015582U patent/DE202004015582U1/de not_active Expired - Lifetime
-
2005
- 2005-10-07 US US11/718,748 patent/US8685025B2/en not_active Expired - Fee Related
- 2005-10-07 EP EP05804251A patent/EP1796562A1/de not_active Withdrawn
- 2005-10-07 WO PCT/DE2005/001808 patent/WO2006039900A1/de active Application Filing
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO1993003681A1 (en) * | 1991-08-27 | 1993-03-04 | Howmedica Inc. | Cerclage wire positioning insert |
US5607430A (en) | 1995-08-25 | 1997-03-04 | Biomet, Inc. | Bone stabilization implant having a bone plate portion with integral cable clamping means |
US5810824A (en) | 1997-02-13 | 1998-09-22 | Chan; Kwan-Ho | Surgical fastener assembly and method for bone fracture fixation |
US6520965B2 (en) | 2001-05-23 | 2003-02-18 | Alan Chervitz | Apparatus and method for orthopedic fixation |
Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8968318B2 (en) | 2007-02-28 | 2015-03-03 | DePuy Synthes Products, LLC | Grooved crimp with a set screw |
US9510882B2 (en) | 2007-02-28 | 2016-12-06 | DePuy Synthes Products, Inc. | Grooved crimp with a set screw |
US10512497B2 (en) | 2007-02-28 | 2019-12-24 | DePuy Synthes Products, Inc. | Grooved crimp with a set screw |
CN107174328A (zh) * | 2017-07-01 | 2017-09-19 | 河北瑞鹤医疗器械有限公司 | 缝合固定用缝线孔及大结节解剖型钢板 |
CN107174328B (zh) * | 2017-07-01 | 2020-03-24 | 河北瑞鹤医疗器械有限公司 | 缝合固定用缝线孔及大结节解剖型钢板 |
Also Published As
Publication number | Publication date |
---|---|
US20080300599A1 (en) | 2008-12-04 |
DE202004015582U1 (de) | 2004-12-23 |
EP1796562A1 (de) | 2007-06-20 |
US8685025B2 (en) | 2014-04-01 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
WO2006039900A1 (de) | Cerclageanordnung für die fixation einer knochenfraktur mit einer eine anzahl von durchgehenden löchern aufweisenden platte | |
EP0701419B1 (de) | Osteosynthese-hilfsmittel zur versorgung subtrochanterer, pertrochanterer und schenkelhalsfrakturen | |
DE60308953T2 (de) | Nähfadenanker | |
DE69720177T2 (de) | Markraumnagel für die Versorgung von Frakturen der Hüfte | |
EP1339335B1 (de) | Vorrichtung zur fixation von knochen, insbesondere von wirbelkörpern relativ zueinander | |
DE102004027881B4 (de) | Knochenschraube und Osteosynthesevorrichtung | |
EP1082063B1 (de) | Chirurgische blindniete mit schliesselement | |
EP1725177B1 (de) | Repositionswerkzeug | |
DE3916198C2 (de) | ||
EP0711132A1 (de) | Gabelplatte | |
WO2007093147A1 (de) | Klammerartiges implantat zur osteosynthese | |
DE102013104887A1 (de) | Osteosyntheseplatte sowie System zur Osteosynthese | |
DE102011109677B4 (de) | Plattensystem zur zervikalen Stabilisation und Fixation | |
DE102019000965B4 (de) | Knochenverankerungsvorrichtung für den Pedikelzugang | |
WO2002011629A1 (de) | Vorrichtung zum einführen von medizinischen mitteln | |
WO2019001990A1 (de) | Verlängerungsvorrichtung für einen knochenanker | |
EP0423280A1 (de) | Fixierungssystem für röhrenknochenfrakturen. | |
EP2814406B1 (de) | Vorrichtung zum applizieren eines chirurgischen clips | |
DE102007016459B4 (de) | Implantatset | |
DE9310668U1 (de) | Schraubendreher | |
DE202004009073U1 (de) | Knochenschraube und Osteosynthesevorrichtung | |
EP2292148B1 (de) | Knochenanker | |
EP2029037B1 (de) | Femurkopf-implantat | |
EP1018317B1 (de) | System zur Positionierung eines intramedulären Kraftträgers, insbesondere Marknagels | |
WO2003053265A1 (de) | Modularer knochennagel |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AK | Designated states |
Kind code of ref document: A1 Designated state(s): AE AG AL AM AT AU AZ BA BB BG BR BW BY BZ CA CH CN CO CR CU CZ DE DK DM DZ EC EE EG ES FI GB GD GE GH GM HR HU ID IL IN IS JP KE KG KM KP KR KZ LC LK LR LS LT LU LV LY MA MD MG MK MN MW MX MZ NA NG NI NO NZ OM PG PH PL PT RO RU SC SD SE SG SK SL SM SY TJ TM TN TR TT TZ UA UG US UZ VC VN YU ZA ZM ZW |
|
AL | Designated countries for regional patents |
Kind code of ref document: A1 Designated state(s): BW GH GM KE LS MW MZ NA SD SL SZ TZ UG ZM ZW AM AZ BY KG KZ MD RU TJ TM AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HU IE IS IT LT LU LV MC NL PL PT RO SE SI SK TR BF BJ CF CG CI CM GA GN GQ GW ML MR NE SN TD TG |
|
121 | Ep: the epo has been informed by wipo that ep was designated in this application | ||
WWE | Wipo information: entry into national phase |
Ref document number: 2005804251 Country of ref document: EP |
|
WWP | Wipo information: published in national office |
Ref document number: 2005804251 Country of ref document: EP |
|
WWE | Wipo information: entry into national phase |
Ref document number: 1120050031675 Country of ref document: DE |
|
REF | Corresponds to |
Ref document number: 112005003167 Country of ref document: DE Date of ref document: 20070920 Kind code of ref document: P |
|
WWE | Wipo information: entry into national phase |
Ref document number: 11718748 Country of ref document: US |