CA2487571A1 - Intramedullary fixation device for metaphyseal long bone fractures - Google Patents

Intramedullary fixation device for metaphyseal long bone fractures Download PDF

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Publication number
CA2487571A1
CA2487571A1 CA002487571A CA2487571A CA2487571A1 CA 2487571 A1 CA2487571 A1 CA 2487571A1 CA 002487571 A CA002487571 A CA 002487571A CA 2487571 A CA2487571 A CA 2487571A CA 2487571 A1 CA2487571 A1 CA 2487571A1
Authority
CA
Canada
Prior art keywords
fixation device
bone fracture
fracture fixation
threaded
peg
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CA002487571A
Other languages
French (fr)
Other versions
CA2487571C (en
Inventor
Jorge L. Orbay
Javier Castaneda
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Biomet CV Gibraltar
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Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US10/159,611 external-priority patent/US6730090B2/en
Application filed by Individual filed Critical Individual
Publication of CA2487571A1 publication Critical patent/CA2487571A1/en
Application granted granted Critical
Publication of CA2487571C publication Critical patent/CA2487571C/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue
    • A61B17/863—Shanks, i.e. parts contacting bone tissue with thread interrupted or changing its form along shank, other than constant taper
    • 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
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1725—Guides or aligning means for drills, mills, pins or wires for applying transverse screws or pins through intramedullary nails or pins
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1728—Guides or aligning means for drills, mills, pins or wires for holes for bone plates or plate screws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1782—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the hand or wrist
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
    • A61B17/8057—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded the interlocking form comprising a thread

Abstract

A fixation system (10) includes a device having a nail portion (12) and a plate portion (14), preferably horizontally and vertically offset relative to the nail portion by a neck portion (16). The nail portion (12) includes preferably threaded screw holes (24, 26), and the plate portion (14) includes longitudinally displaced peg holes (50, 52, 54), each of which is adapted to orient a peg (56, 58, 60) in a different orientation from the others. The system (10) also includes unicortical screws (28) having a reasonably large head (36) adapted to seat against the outer surface of the bone and a threaded shaft (32) adapted to engage in the screw holes (24, 26), and pegs (56, 58, 60) adapted to engage in the peg holes (50, 52, 54). Where threaded screw holes (24, 26) are used, bone is clamped between the nail portion (12) and the head (36) of the unicortical screws (28, 30). The pegs (56, 58, 60) provide stabilization and support for subchondral fragments. Moreover, as the pegs (56, 58, 60) preferably enter the subchondral fragments from a plurality of directions, additional fixation of the device (10) into the bone is provided.

Claims (56)

1. A bone fracture fixation device, comprising:
a) an elongate nail portion including at least one threaded screw hole extending therein; and b) a plate portion including at least one threaded peg hole extending completely through the plate portion, said plate portion being parallel to but not coaxial with said nail portion.
2. A bone fracture fixation device according to claim 1, wherein:
said nail portion includes at least two longitudinally displaced threaded screw holes which extend completely through the nail portion.
3. A bone fracture fixation device according to claim 1, wherein:
said nail portion includes a relatively rigid portion and a relatively resilient portion, and said at least one screw hole is in said relatively rigid portion.
4. A bone fracture fixation device according to claim 1, wherein:
said nail portion is straight.
5. A bone fracture fixation device according to claim 1, wherein:
said nail portion includes a taper.
6. A bone fracture fixation device according to claim 1, wherein:
said nail portion has a portion with a circular cross-sectional shape.
7. A bone fracture fixation device according to claim 1, wherein:
said plate portion includes a plurality of threaded peg holes.
8. A bone fracture fixation device according to claim 7, wherein:
said plurality of threaded peg holes are longitudinally displaced in said plate portion.
9. A bone fracture fixation device according to claim 7, wherein:
at least one of said plurality of threaded peg holes has an oblique axis relative to the others of said plurality of threaded peg holes.
10. A bone fracture fixation device according to claim 9, wherein:
each of said threaded peg holes has an oblique axis relative to the others.
11. A bone fracture fixation device according to claim 1, wherein:
said nail portion and said plate portion are longitudinally displaced relative to each other.
12. A bone fracture fixation device according to claim 1, wherein:
said at least one threaded screw hole has a first thread pitch, said at least one threaded peg hole has a second thread pitch, and said first and second thread pitches are different.
13. A bone fracture fixation kit, comprising:
a) a fixation device having an elongate intramedullary portion and a plate portion, said intramedullary portion including at least one threaded screw hole and a said plate portion including at least one threaded peg hole;
b) at least one machine screw having a shaft adapted to be threadably received in one of said at least one screw hole and having a head with a flat undersurface, said head being larger than said screw hole; and c) at least one peg having a threaded head and a shaft, said head adapted to be threadably engaged in one of said at least one threaded peg hole.
14. A kit according to claim 13, wherein:
said at least one machine screw has a relatively blunt tip.
15. A kit according to claim 13, wherein:
said at least one peg has a non-threaded shaft.
16. A kit according to claim 13, wherein:
said plate portion includes a plurality of threaded peg holes each having an oblique axis relative to axes of the other peg holes.
17. A kit according to claim 13, wherein:
said at least one machine screw includes screws of different lengths.
18. A bone fracture fixation system, comprising:
a) a fixation device having an elongate intramedullary portion and a plate portion, said intramedullary portion including at least one threaded screw hole and a said plate portion including at least one threaded peg hole;
b) at least one machine screw having a shaft threadably engaged in said at least one screw hole and having a head with a flat undersurface, said head being larger than said screw hole;
and c) at least one peg having a threaded head and a shaft, said head threadably engaged in said at least one threaded peg hole.
19. A fracture fixation system according to claim 18, wherein:
said plate portion includes a plurality of threaded peg holes each having an axis oblique relative to axes of the other peg holes, and said at least one peg includes a plurality of pegs, and said shaft of each of said pegs extends coaxial with one of said axes of said peg holes.
20. A bone fracture fixation kit, comprising:
a) a metal fixation device having an elongate intramedullary portion including a threaded screw hole; and b) a machine screw having a head and a shaft, said head having a flat undersurface which is larger than said threaded screw hole, and said shaft including a tip portion, a body portion, and a clearance portion between said body portion and said head, said body portion having threads adapted to be threadably engaged in said threaded screw hole and defining a first diameter across said threads, said clearance portion having a relatively smooth surface compared with said body portion and a second diameter smaller than said first diameter, and said tip portion having a relatively smooth surface compared with said body portion and a third diameter smaller than said second diameter.
21. A kit according to claim 20, wherein:
said tip portion includes a shallow thread channel continuous with and of the same pitch as said threads of said body portion.
22. A kit according to claim 20, wherein:
said clearance portion includes a shallow thread channel continuous with and of the same pitch as said threads of said body portion.
23. A bone fracture fixation system for fixation of a metaphyseal fracture of a long bone which defines subchondral bone fragments, the long bone having interior and exterior surfaces and a cortex with and an intramedullary region therethrough, said device comprising:
a) a rigid elongate structure adapted to extend within the intramedullary region of the bone;
b) a rigid plate structure adapted for placement on the exterior surface of the bone over the subchondral bone fragments, said plate structure being coupled to said elongate structure;
c) means for clamping said elongate structure against the interior surface of the bone; and d) a framework of shaft-like elements coupled to said plate structure and extending in oblique axes relative to each other so as to provide support for subchondral bone fragments.
24. A bone fracture fixation system according to claim 23, wherein:
said shaft-like elements comprise pegs.
25. A bone fracture fixation device, comprising:
a) an elongate nail portion including a relatively flexible section and a relatively rigid section relatively larger in diameter than said relatively flexible section; and b) a plate portion including a plurality of threaded peg holes, said plate portion being parallel to but not coaxial with said nail portion.
26. A bone fracture fixation device according to claim 25, wherein:
said relatively rigid section of said nail portion is substantially straight.
27. A bone fracture fixation device according to claim 25, wherein:
said relatively flexible section is sized to be inserted into a medullary canal of a radius bone.
28. A bone fracture fixation device according to claim 25, wherein:
said nail portion is substantially circular in cross section.
29. A bone fracture fixation device according to claim 25, wherein:
said relatively flexible section has a tapered diameter along its length.
30. A bone fracture fixation device according to claim 25, wherein:
said relatively rigid section tapers in diameter into said flexible portion.
31. A bone fracture fixation device according to claim 25, wherein:
said nail portion include at least one screw hole.
32. A bone fracture fixation device according to claim 25, wherein:
said peg holes are longitudinally displaced along said plate portion.
33. A bone fracture fixation device according to claim 25, wherein:
said peg holes are each oriented in a discrete direction.
34. A bone fracture fixation device according to claim 33, further comprising:
c) a plurality of pegs, each having a threaded head portion which is threaded in one of said threaded peg holes.
35. A bone fracture fixation device according to claim 25, wherein:
said plate portion is longitudinally and vertically offset relative to said nan portion by a neck portion.
36. A bone fracture fixation device according to claim 25, wherein:
said relatively flexible section includes an end portion provided with a curve.
37. A bone fracture fixation device according to claim 25, wherein:
said plate portion includes a substantially concave lower surface.
38. A bone fracture fixation device according to claim 25, wherein:
said plate portion includes a substantially convex upper surface.
39. A bone fracture fixation device according to claim 38, wherein:
said plate portion includes a substantially concave lower surface.
40. A bone fracture fixation device for use with a plurality of pegs each having a threaded head portion, said device comprising:
a) a proximal elongate nail portion; and b) a distal relatively flatter plate portion including a plurality of longitudinally displaced ' threaded peg holes, said peg holes having axes adapted to provide the pegs inserted into said peg holes in an arrangement in which each peg extends in a discrete direction.
41. A bone fracture fixation device according to claim 40, wherein:
said plate portion is horizontally offset relative to said nail portion.
42. A bone fracture fixation device according to claim 41, wherein:
said plate portion is vertically offset relative to said nail portion.
43. A bone fracture fixation device according to claim 40, wherein:
said nail portion includes a relatively flexible section and a relatively rigid section relatively larger in diameter than said relatively flexible section.
44. A bone fracture fixation device according to claim 40, wherein:
said peg holes are arranged such that each of said pegs extends in a discrete direction.
45. A bone fracture fixation system, comprising:
a) a fixation device including i) a proximal elongate nail portion, and ii) a distal relatively flatter plate portion including a plurality of longitudinally displaced peg holes, said plate portion being horizontally and vertically offset relative to said nail portion;
b) a plurality of pegs individually insertable into a respective one of said peg holes, wherein when each said peg is inserted into its respective peg hole, said peg can be oriented in any of several orientations; and c) means for locking each said peg in any of its orientations.
46. A bone fracture fixation device according to claim 45, wherein:
said nail portion includes a relatively flexible section and a relatively rigid section relatively larger in diameter than said relatively flexible section.
47. A bone fracture fixation device for use with a plurality of pegs each having a threaded head portion, said device comprising:
a) a proximal elongate nail portion; and b) a distal plate portion having upper and lower surfaces which are each non-planar, said plate portion defining a plurality of longitudinally displaced holes.
48. A bone fracture fixation device according to claim 47, wherein:
said plate portion defines three longitudinally displaced holes.
49. A bone fracture fixation device according to claim 47, further comprising:
c) a plurality of pegs each having a threaded head portion, wherein said holes are threaded and define axes adapted to provide said pegs inserted into said peg holes in an arrangement in which at least two of said pegs extends in discrete directions.
50. A bone fracture fixation device according to claim 49, wherein:
said peg holes are arranged such that each of said pegs extends in a discrete direction.
51. A bone fracture fixation device, comprising:
a) a proximal elongate nail portion having a relatively stiff and non-resilient portion; and b) a distal relatively flatter plate portion being parallel and non-coaxial with said relatively stiff and non-resilient portion of said nail portion.
52. A bone fracture fixation device according to claim 51, wherein:
said plate portion includes a plurality of holes.
53. A bone fracture fixation device according to claim 52, wherein:
said holes are threaded.
54. A bone fracture fixation device according to claim 53, wherein:
said holes each have an axis which is provided in a distinct orientation relative to the other axes.
55. A bone fracture fixation device according to claim 52, wherein:
said plate portion includes at least three holes, and said holes are longitudinally displaced along said plate portion.
56. A bone fracture fixation device according to claim 51, wherein:
said nail portion has a portion with a circular cross-section.
CA2487571A 2002-05-30 2003-05-09 Intramedullary fixation device for metaphyseal long bone fractures Expired - Fee Related CA2487571C (en)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US10/159,611 2002-05-30
US10/159,611 US6730090B2 (en) 2000-02-01 2002-05-30 Fixation device for metaphyseal long bone fractures
US10/315,787 US6706046B2 (en) 2000-02-01 2002-12-10 Intramedullary fixation device for metaphyseal long bone fractures and methods of using the same
US10/315,787 2002-12-10
PCT/US2003/014775 WO2003101320A1 (en) 2002-05-30 2003-05-09 Intramedullary fixation device for metaphyseal long bone fractures

Publications (2)

Publication Number Publication Date
CA2487571A1 true CA2487571A1 (en) 2003-12-11
CA2487571C CA2487571C (en) 2011-01-25

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
CA2487571A Expired - Fee Related CA2487571C (en) 2002-05-30 2003-05-09 Intramedullary fixation device for metaphyseal long bone fractures

Country Status (6)

Country Link
US (2) US6706046B2 (en)
EP (1) EP1507486B1 (en)
JP (1) JP4421474B2 (en)
BR (1) BR0311440A (en)
CA (1) CA2487571C (en)
WO (1) WO2003101320A1 (en)

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AU2003234384A1 (en) 2003-12-19
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US20030083661A1 (en) 2003-05-01
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EP1507486B1 (en) 2013-11-06
US20060100624A1 (en) 2006-05-11
US7727264B2 (en) 2010-06-01
JP4421474B2 (en) 2010-02-24
WO2003101320A1 (en) 2003-12-11

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