U.S. patent application number 12/251821 was filed with the patent office on 2009-07-09 for long bone fixation system and methods.
Invention is credited to Edward A. Perez.
Application Number | 20090177240 12/251821 |
Document ID | / |
Family ID | 40845195 |
Filed Date | 2009-07-09 |
United States Patent
Application |
20090177240 |
Kind Code |
A1 |
Perez; Edward A. |
July 9, 2009 |
LONG BONE FIXATION SYSTEM AND METHODS
Abstract
A method of stabilizing a fractured bone includes: a) providing
a first support member in a medullary canal of a fractured bone; b)
providing a second support member outside the fractured bone; c)
providing a transverse connector adapted to link the first support
member to the second support member in an angle-stable connection;
d) connecting the transverse connector to the first and second
support members in an angle-stable connection; e) providing one or
more bone screws adapted to be connected to the second support
member in an angle-stable connection; and f) implanting the bone
screws such that the shank of the screw is implanted in the
fractured bone while the head of the screw is connected to the
second support member in an angle-stable connection. The system
provides superior fixation of long bones that allows for early
functional range of motion without loss of alignment or
fixation.
Inventors: |
Perez; Edward A.; (Memphis,
TN) |
Correspondence
Address: |
WOODARD, EMHARDT, MORIARTY, MCNETT & HENRY LLP
111 MONUMENT CIRCLE, SUITE 3700
INDIANAPOLIS
IN
46204-5137
US
|
Family ID: |
40845195 |
Appl. No.: |
12/251821 |
Filed: |
October 15, 2008 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
60999181 |
Oct 16, 2007 |
|
|
|
Current U.S.
Class: |
606/86R ;
606/286; 606/64; 606/65 |
Current CPC
Class: |
A61B 17/7233
20130101 |
Class at
Publication: |
606/86.R ;
606/286; 606/64; 606/65 |
International
Class: |
A61B 17/56 20060101
A61B017/56; A61B 17/58 20060101 A61B017/58 |
Claims
1. A method of stabilizing a fractured long bone in a medical
patient, the method comprising: a) providing an intramedullary nail
having a first aperture passing radially through the nail and
adapted to receive a transverse connector in an angle-stable
connection, and implanting said intramedullary nail in a fractured
long bone; b) providing a locking plate having a first aperture
adapted to receive a transverse connector in an angle-stable
connection, and a second aperture adapted to receive a bone screw
in an angle-stable connection, and positioning said locking plate
against the outside surface of said fractured long bone; c)
providing a first transverse connector having a head-end and a
shank, said head-end being adapted to be received in the first
aperture of said locking plate in an angle-stable connection, and
said shank being adapted to be received by said radial aperture of
said intramedullary nail in an angle-stable connection, d)
providing a bone screw having a head-end adapted to be received in
the second aperture of said locking plate in an angle-stable
connection; e) driving said first transverse connector through said
first aperture in the locking plate, through at least a portion of
the fractured bone, and through said radial aperture of said
intramedullary nail; f) locking said head-end of said first
transverse connector to said locking plate in an angle-stable
connection; g) locking said shank of said first transverse
connector to said intramedullary nail in an angle-stable
connection; and h) driving said bone screw through said second
threaded aperture in said locking plate and into said long bone
without passing through said intramedullary nail; and i) locking
the head-end of said bone screw to said locking plate in an
angle-stable connection.
2. The method of claim 1 wherein said transverse connector has a
roughened shank.
3. The method of claim 2 wherein said transverse connector has a
threaded shank.
4. The method of claim 1 wherein said intramedullary nail includes
an axial aperture passing axially into the nail adjacent said
radial aperture and adapted to receive a locking screw.
5. The method of claim 1 wherein locking plate includes at least
three threaded apertures, and wherein at least two bone screws are
screwed into the bone and locked in said plate.
6. The method of claim 1 wherein said intramedullary nail has at
least two radial apertures passing radially through the nail;
wherein said locking plate has at least three threaded apertures
adapted to receive a threaded head-end of a bone implant; and
wherein at least two transverse connectors having a threaded
head-end adapted to fit a threaded aperture of said locking plate
are driven through threaded apertures in the locking plate, through
at least a portion of the fractured bone, and through radial
apertures of said intramedullary nail.
7. The method of claim 1 wherein said fractured long bone is a
fractured femur.
8. The method of claim 1 wherein said radial aperture in said
intramedullary nail is not threaded.
9. An assembly for reducing and stabilizing a fracture in a long
bone, comprising: a) an intramedullary nail having at least one
radial aperture passing radially through the nail and adapted to
receive a bone screw, and at least one threaded, axial aperture
passing axially into the nail adjacent a radial aperture and
adapted to receive a locking screw; b) a locking plate having at
least two threaded apertures adapted to receive a threaded head-end
of a bone implant; c) at least one transverse connector having a
threaded head-end adapted to fit a threaded aperture of said
locking plate; d) at least one bone screw having a threaded
head-end adapted to fit a threaded aperture of said locking plate;
and e) a locking screw threaded to match the threaded axial
aperture of said intramedullary nail, and effective for locking the
shank of a transverse connector to the intramedullary nail.
10. The assembly of claim 8 wherein said transverse connector has a
roughened shank.
11. The assembly of claim 9 wherein said transverse connector has a
threaded shank.
12. The assembly of claim 8 wherein locking plate includes at least
three threaded apertures, and wherein said assembly includes at
least two bone screws adapted to be screwed into a long bone and
locked in said plate.
13. The assembly of claim 8 wherein said intramedullary nail has at
least two radial apertures passing radially through the nail;
wherein said locking plate has at least three threaded apertures
adapted to receive a threaded head-end of a bone implant; and
wherein the assembly includes at least two transverse connectors,
wherein each of said transverse connectors has a threaded head-end
adapted to fit a threaded aperture of said locking plate and is
sized to pass through a threaded aperture in the locking plate,
through at least a portion of the fractured bone, and through a
radial aperture of said intramedullary nail.
14. A method of stabilizing a fractured bone in a medical patient,
comprising: a) providing a first structural support member in a
medullary canal of a fractured bone; b) providing a second
structural support member outside said fractured bone; c) providing
a transverse connector adapted to link said first structural
support member to said second structural support member in an
angle-stable connection; d) connecting said transverse connector to
said first structural support member in an angle-stable connection;
e) connecting said transverse connector to said second structural
support member in an angle-stable connection; f) providing one or
more bone screws adapted to be connected to said second support
member in an angle-stable connection; g) implanting said bone
screws such that at least a portion of the shank of said bone
screws is implanted in said fractured bone, and said bone screw is
connected to said second support member in an angle-stable
connection.
15. The method of claim 13 wherein said first structural support
member comprises an intramedullary nail.
16. The method of claim 14 wherein said intramedullary nail
comprises a femoral nail.
17. The method of claim 14 wherein said intramedullary nail
includes a radial aperture adapted to facilitate connecting said
transverse connector to said first structural support member in an
angle-stable connection.
18. The method of claim 14 wherein said intramedullary nail
includes an axial aperture adapted to facilitate connecting said
transverse connector to said first structural support member in an
angle-stable connection.
19. The method of claim 13 wherein said second structural support
member comprises a plate.
20. The method of claim 18 wherein said plate includes apertures
adapted to facilitate locking said bone screws to said plate in an
angle-stable manner.
Description
[0001] This application claims the benefit of U.S. Provisional
Application No. 60/999,181, filed Oct. 16, 2007, which is hereby
incorporated by reference.
FIELD OF THE INVENTION
[0002] The present invention relates generally to systems and
methods for stabilizing fractured long bones, such as a fracture of
the distal femur.
BACKGROUND OF THE INVENTION
[0003] Trauma to the diaphyseal segment or the distal segment of
the femur may result in simple or complex fractures that require
treatment by surgical means. Typically, a metal pin or plate is
used to reduce the fracture and stabilize the bone while healing
occurs.
[0004] For example, one method of treating distal femur fractures
utilizes an intramedullary nail (or, alternatively, an IM pin or
rod) which is inserted into the bone marrow canal and span a
fracture in the bone. Such IM nails are designed to share the load
with the bone and to assist with aligning and stabilizing the bone.
In some such IM nail systems one or more screws or bolts are used
to prevent movement of the nail with respect to the bone in an
attempt to maintain proper alignment while the fracture heals. Most
commonly, one screw or bolt is positioned below the fracture (near
the distal end of the bone), while another screw or bolt may be
positioned above the fracture. FIG. 1 shows an illustrative prior
art intramedullary nail system.
[0005] Alternatively, locked plate systems have been used to treat
bone fractures. Such locked plate systems typically comprise a
plate that lies outside and against the bone, with at least two
clusters of bone screws passing through holes in the plate and into
the bone. One of the screw clusters attaches to the bone above the
fracture, while another screw cluster attaches to the bone below
the fracture. At least some of the holes in the plate are threaded,
and at least some of the bone screws have threaded "heads" that
engage the threaded plate holes to "lock" the screws to the plate.
When the screws are tightened the plate is "locked" to the bone
above and below the fracture, thus providing the desired fracture
reduction and stabilization. FIG. 2 shows an illustrative prior art
locked plate fixation system.
[0006] Neither the prior art intramedullary nail systems nor the
prior art locked plate systems provide an optimal fixation system
for many long bone fractures. While the intramedullary nail systems
may be relatively easy to use, the reduction and stabilization they
provide may not be optimal since the nail typically has limited
contact with the distal portion of the bone. While locked plate
systems may provide improved contact with the bone, they may be
difficult to align and are generally less easy to use.
Additionally, locked plate systems have a biomechanical
disadvantage since they are offset relative to the axis of the bone
they are attempting to stabilize.
[0007] It can be seen from the above that a need exists for
improved methods and devices to secure distal fixation of long
bones that allows for early functional range of motion without loss
of alignment or fixation. The present invention addresses that
need.
SUMMARY OF THE INVENTION
[0008] In one aspect of the present invention there is provided a
method of stabilizing a fractured bone, and particularly a long
bone such as a femur, in a medical patient. The method generally
comprises:
[0009] a) providing a first structural support member in a
medullary canal of a fractured bone;
[0010] b) providing a second structural support member outside said
fractured bone;
[0011] c) providing a transverse connector adapted to link said
first structural support member to said second structural support
member in an angle-stable connection;
[0012] d) connecting said transverse connector to said first
structural support member in an angle-stable connection;
[0013] e) connecting said transverse connector to said second
structural support member in an angle-stable connection;
[0014] f) providing one or more bone screws adapted to be connected
to said second support member in an angle-stable connection;
[0015] g) implanting said bone screws such that at least a portion
of the shank of said bone screws is implanted in said fractured
bone, and said bone screw is connected to said second support
member in an angle-stable connection.
[0016] In one embodiment of this first aspect of the invention the
first structural support member is an intramedullary nail and the
second structural support member is a locking plate. The
intramedullary nail may have a radial aperture adapted to receive
the transverse connector.
[0017] One preferred embodiment of this first aspect of the
invention may be characterized as follows:
[0018] a) providing an intramedullary nail having a first aperture
passing radially through the nail and adapted to receive a
transverse connector and to hold said transverse connector in an
angle-stable connection, and implanting said intramedullary nail in
a fractured long bone;
[0019] b) providing a locking plate having a first aperture adapted
to receive a transverse connector in an angle-stable connection,
and a second aperture adapted to receive a bone screw in an
angle-stable connection, and positioning said locking plate against
the outside surface of said fractured long bone;
[0020] c) providing a first transverse connector having a head-end
and a shank, said head-end being adapted to be received in the
first aperture of said locking plate in an angle-stable connection,
and said shank being adapted to be received by said radial aperture
of said intramedullary nail,
[0021] d) providing a bone screw having a head-end adapted to be
received in the second aperture of said locking plate in an
angle-stable connection;
[0022] e) driving said first transverse connector through said
first aperture in the locking plate, through at least a portion of
the fractured bone, and through said radial aperture of said
intramedullary nail;
[0023] f) connecting said head-end of said first transverse
connector to said locking plate in an angle-stable connection;
[0024] g) connecting said shank of said first transverse connector
to said intramedullary nail in an angle-stable connection; and
[0025] h) driving said bone screw through said second threaded
aperture in said locking plate and into said long bone without
passing through said intramedullary nail; and
[0026] i) connecting the head-end of said bone screw to. said
locking plate in an angle-stable connection.
[0027] In other preferred embodiments of this first aspect of the
present invention the intramedullary nail includes a second
aperture passing axially into the nail adjacent the radial aperture
and adapted to receive a locking screw to assist in locking the
transverse connector to the nail.
[0028] In other preferred embodiments of this first aspect of the
present invention the first aperture of the locking plate is a
threaded aperture adapted to receive a threaded head-end of a
transverse connector.
[0029] In other preferred embodiments of this first aspect of the
present invention the second aperture of the locking plate is a
threaded aperture adapted to receive a threaded head-end of a bone
screw.
[0030] In a second aspect of the present invention there is
provided an apparatus for stabilizing a fractured long bone in a
medical patient. The apparatus comprises:
[0031] a) a first structural support member adapted to be implanted
in a medullary canal of a fractured bone;
[0032] b) a second structural support member adapted to be
implanted outside said fractured bone;
[0033] c) a transverse connector adapted to link said first
structural support member to said second structural support member
in an angle-stable connection; and
[0034] d) one or more bone screws adapted to be connected to said
second support member in an angle-stable connection.
[0035] In one embodiment of this second aspect of the invention the
first structural support member is an intramedullary nail and the
second structural support member is a locking plate.
[0036] In one preferred embodiment of this second aspect of the
invention the intramedullary nail has a first aperture passing
radially through the nail and adapted to receive a transverse
connector in an angle-stable connection.
[0037] In another embodiment of this second aspect of the invention
the second structural support member is a locking plate having a
first aperture adapted to receive a transverse connector in an
angle-stable connection, and a second aperture adapted to receive a
bone screw in an angle-stable connection.
[0038] In another embodiment of this second aspect of the invention
the transverse connector has a head-end and a shank, with the
head-end being adapted to be received in the first aperture of said
locking plate in an angle-stable connection, and the shank being
adapted to be received by said radial aperture of said
intramedullary nail in an angle-stable connection.
[0039] When implanted, the apparatus forms a four-part locked
system wherein the plate is locked to the intramedullary nail
through the transverse connector, and is further locked to the bone
with locked bone screws. The system provides superior fixation of
long bones that allows for early functional range of motion without
loss of alignment or fixation.
DESCRIPTION OF THE DRAWINGS
[0040] FIG. 1 shows a prior art intramedullary nail system.
[0041] FIG. 2 shows a prior art locked plate system.
[0042] FIG. 3 shows an intramedullary nail as implanted in one
embodiment of the present invention.
[0043] FIG. 4 shows a locking plate as positioned in one embodiment
of the present invention.
[0044] FIG. 5 shows a transverse connector as used in one
embodiment of the present invention.
[0045] FIG. 6 shows an axial locking screw locking a transverse
connector to the intramedullary nail of one embodiment of the
present invention.
[0046] FIG. 7 shows an end view of a femur having a locking plate
and a transverse connector locked to an intramedullary nail
according to one embodiment of the present invention.
[0047] FIG. 8 shows locking bone screw as used in one embodiment of
the present invention.
[0048] FIG. 9 shows the locked construct wherein the locking plate
is locked to the intramedullary nail of one embodiment of the
present invention.
[0049] FIG. 10 shows an embodiment in which two transverse
connectors are used to connect the locking plate to the
intramedullary nail of the present invention.
[0050] FIG. 11 shows an embodiment in which two locking plates and
two transverse connectors are locked to the intramedullary nail of
the present invention.
[0051] FIG. 12 shows another embodiment in which two locking plates
and two transverse connectors are locked to the intramedullary nail
of the present invention.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0052] For the purposes of promoting an understanding of the
principles of the invention, reference will now be made to certain
embodiments and specific language will be used to describe the
same. It will nevertheless be understood that no limitation of the
scope of the invention is thereby intended, such alterations and
further modifications in the illustrated device, and such further
applications of the principles of the invention as illustrated
therein being contemplated as would normally occur to one skilled
in the art to which the invention relates.
[0053] As indicated above, one aspect of the present invention
relates to an assembly and method for stabilizing a fractured bone
in a medical patient. The bone may be in a human or animal patient.
Representative bones that may be treated by the inventive method
include the femur, humerus, tibia, and ulna, with fractures of the
distal femur being particularly appropriate for treatment by the
inventive system and methods.
[0054] The inventive system and methods find particular utility for
treating fractures to the diaphyseal segment or the distal segment
of the femur. Use in other bones, or potentially in other segments
of a femur, may also be appropriate depending on the specifics of
the case. For example, the system and methods of the present
invention may be employed in hindfoot fusion cases, where it may be
desired to fuse from the calcaneus through the talus into the
tibia.
[0055] The inventive assembly includes a first structural support
member adapted to be implanted in a medullary canal of a fractured
bone, a second structural support member adapted to be implanted
outside said fractured bone, a transverse connector adapted to link
said first structural support member to said second structural
support member in an angle-stable connection, and one or more bone
screws adapted to be connected to said second support member in an
angle-stable connection. The components are linked together to
provide a four-part construct that locks together in angle-stable
connections. That is, the first structural support member in the
medullary canal of a fractured bone is linked to the second
structural support member outside the fractured bone by means of a
transverse connector that connects the two structural support
members together in an angle-stable connection. The bone screws are
similarly linked to the second support member in an angle-stable
connection, so that all four elements of the construct are locked
together and loads are shared among the four components.
[0056] As indicated above, the first structural support member is
preferably an intramedullary nail. The intramedullary nail may be
of any size and diameter appropriate to stabilize the fracture of a
particular medical patient. It is anticipated that the inventive
method will find great utility with reducing and stabilizing
fractures of the human femur, and for such applications nails
having a diameter of between 9 mm and 15 mm, and a length of
between 240 mm and 480 mm, are commonly used.
[0057] The intramedullary nail may have at least one aperture
passing radially through the nail to receive the transverse
connector and to hold it in an angle-stable connection. The radial
aperture may be unthreaded, and may be sized to receive the
transverse connector that connects the locking plate to the nail.
Such an aperture may be round, or it may be oblong or another
shape. In some embodiments a round aperture having a diameter of
about 5 mm is used.
[0058] At least one threaded aperture passing axially into the nail
adjacent the radial aperture(s) may also be provided in the nail.
The axial aperture may be threaded to receive a set (locking)
screw, and may be positioned adjacent to the radial aperture to
allow the set/locking screw to be used to lock a transverse
connector that passes through the radial aperture. The set screw
used in the axial aperture may be threaded to match the threads of
the axial aperture to allow the screw to be tightened against the
radial aperture, thus locking the transverse connector to the
nail.
[0059] It is to be appreciated that neither the radial aperture,
nor the axial aperture, nor the locking screw are required in
alternative embodiments of the first structural support member of
the present invention, as long as an alternative structure is
provided to allow the transverse connector to be "locked" to the
support (e.g., the nail) in an angle-stable connection.
[0060] The second element of the inventive system is a structural
support that will be positioned on the outside of the fractured
bone. In one embodiment this support is a locking plate. The
locking plate is adapted to be placed on the outside of the bone to
stabilize the fracture when connected to the intramedullary nail
via one or more transverse connectors, and is also adapted to
engage bone screws that further stabilize the device.
[0061] The locking plate may include a plurality of threaded
apertures to receive the threaded heads of bone screws and the
transverse connector(s), and to hold the same in an angle-stable
connection. As with the first structural support member though,
threaded apertures are not required in embodiments that have
alternative structures effective for "locking" the transverse
connector and/or the bone screws to the locking plate in an
angle-stable connection. Additional threaded or unthreaded
apertures may also be provided in the locking plate.
[0062] The third element of the inventive system is the transverse
connector(s). These connectors preferably have shanks effective for
passing through the fractured bone ands connecting to the first
structural support member (e.g., the nail) , and "head" portions
effective for connecting the nail to the locking plate in an
angle-stable connection.
[0063] The shank(s) of the transverse connector(s) is adapted to
span the distance between the first structural support member
(e.g., the nail) and the second structural support member (e.g.,
the locking plate) and to lock those two components together in an
angle-stable connection. An appropriate shank length is selected
according to the size of the bone and the patient, with shank
lengths of between 50 mm and 100 mm being appropriate for may adult
patients when the system is implanted in a femur. Shank diameters
of 4 mm to 7 mm are preferably used.
[0064] The shank of the connector may be roughened to facilitate
locking the connector to the nail in an angle-stable connection. In
some embodiments the shank(s) of the transverse connector(s) are
"roughened" by providing a threaded shank, which may additionally
facilitate driving the connector through the bone.
[0065] The "head" or "head-end" portion of the transverse
connector(s) may include threads effective for locking the
connector to a locking plate via a threaded aperture in the plate.
Such threads may be provided in the literal "head" of the
connector, or they may be provided in the portion of the shank that
abuts the head of the connector. In either case the "head-end" of
the transverse connector is threaded to engage threaded apertures
in the locking plate. When the threaded head-end of the connector
is locked into the locking plate and the shank of the connector is
locked to the intramedullary nail with a set (locking) screw, the
locking plate/connector/nail assembly provides a locked construct
effective to stabilize a fractured long bone. As indicated above
though, threads are not required in embodiments that have
alternative structures effective for "locking" the transverse
connector to the locking plate in an angle-stable connection.
[0066] The final element of the inventive system is the bone
screws. Such bone screws are adapted to connect to the second
structural support (the locking plate) in an angle-stable
connection. In one embodiment the bone screws may have threaded
heads to engage threaded apertures in the locking plate.
[0067] The bone screws are sized according to the specific surgical
use, with screws having a diameter of 4 mm to 7 mm, and a length of
14 mm to 100 mm, being most commonly employed. Self-tapping
cancellous and/or cortical screws are preferred for some
applications. As with the transverse connectors, in some
embodiments the literal "head" of the screw is not threaded, with
the threads for engaging the locking plate residing in the upper
portion of the screw shank where the shank abuts the literal screw
head.
[0068] It is to be appreciated that the components used in the
assembly may be made of any biocompatible material having
sufficient strength to stabilize a fractured bone in a human or
animal patient. Most preferably the assembly will be made of
titanium or stainless steel.
[0069] To generally describe the method of using the bone fixation
system of the present invention, the first structural support
member (for example, an intramedullary nail) is implanted in a
patient in the bone marrow canal of a long bone. The second
structural support member (for example, a locking plate) is
positioned on the outside surface of the bone. The transverse
connector (which may have a threaded head) is used to connect the
first structural support member to the second structural support
member in an angle-stable connection. More particularly, the
transverse connector may be driven through a threaded aperture of
the locking plate, through the fractured bone, and through the
unthreaded radial aperture of the intramedullary nail. The threaded
head of the transverse connector may then be tightened to lock the
connector to the locking plate. An axial locking screw is screwed
into the threaded axial aperture of the intramedullary nail to lock
the shank of the transverse connector to the nail. One or more bone
screws are screwed through additional threaded apertures of the
locking plate and into the long bone without passing through the
intramedullary nail.
[0070] It is to be appreciated that the transverse connector
connects the first structural support member (e.g., the nail) to
the second structural support member (e.g., the locking plate) in
an angle-stable connection. Such as connection may be referred to
as a "locked" connection, and generally indicates that the two
elements are not free to twist or rotate relative to each other.
This "locking" feature makes the construct more stable than the
systems of the prior art, and provides superior stabilization as
forces are efficiently shared and transferred throughout the
construct.
[0071] More particularly describing the preferred embodiments of
the present invention with reference to the Figures, a first
structural support member such as an intramedullary nail 11 is
implanted in the bone marrow canal of a bone 17 of a human or
animal patient, as shown generally in FIG. 1. In the illustrated
embodiment the bone 17 is a human femur, although the inventive
method may be used to reduce and stabilize other long bone
fractures. In the illustrated embodiment a radial aperture 12 is
provided in nail 11 to receive a transverse connector. An axial
aperture 13 having threads 15 may be provided in nail 11 adjacent
radial aperture 12.
[0072] A second structural support member such as a locking plate
21 is positioned on the outside of the bone, as illustrated in FIG.
4. At least one threaded aperture 22 sized to receive a transverse
connector may be provided in locking plate 21, as may be additional
threaded apertures 23 sized to receive bone screws.
[0073] A transverse connector 31 is driven through aperture 22,
through the bone 17, and through radial aperture 12 of nail 11 as
illustrated in FIG. 5. When the locking plate has threaded
apertures to receive and lock the transverse connector in an
angle-stable connection, the connector 31 may be screwed tight so
that the threaded head-end portion 35 of connector 31 engages the
threads 25 of the threaded aperture 22 of locking plate 21, thus
locking connector 31 to locking plate 21.
[0074] A locking screw 18 may be driven into axial aperture 13 of
nail 11 so that locking screw 18 locks onto the surface of
transverse connector 31, as illustrated in FIG. 6. When connector
31 has a roughened surface, such as the illustrated threaded
surface, the locking screw may deform the surface of the connector
to securely lock connector 31 to nail 11. An end view of the
construct showing set screw 13 engaging transverse connector 31 is
provided as FIG. 7.
[0075] One or more bone screws 41 are driven through apertures 23
of locking plate 21 to engage bone 17, as illustrated in FIG. 8.
These bone screws preferably have threaded head-ends to engage
threaded apertures in the locking plate, thus allowing the bone
screws to further lock the plate to the bone.
[0076] The assembly provides a locked construct in which nail 11 is
locked to connector 31 and locking plate 21 as illustrated in FIG.
9. When the nail is locked to the plate via locked transverse
connectors, and when the plate is locked to the bone via locking
bone screws, the construct forms a four-part locked system that
provides superior fixation of long bones that allows for early
functional range of motion without loss of alignment or
fixation.
[0077] In alternative embodiments two or more transverse connectors
31 a and 3 lb may be used to connect locking plate 21 to nail 11,
as illustrated in FIG. 10. Similarly, two or more locking plates
21a and 21b may be used with multiple connectors 21a and 21b, as
illustrated in FIG. 11. Such multiple locking plates 21a and 21b
are preferably each provided with threaded apertures 23 to
cooperate with multiple bone screws 41, as illustrated in FIG.
12.
[0078] It is to be appreciated that the assembly may be implanted
using either a retrograde or an antegrade approach. Guides,
reamers, and other devices to facilitate implantation of the
various components may be used as would be appreciated by persons
skilled in the art.
[0079] While the invention has been illustrated and described in
detail in the drawings and foregoing description, the same are to
be considered as illustrative and not restrictive in character, it
being understood that only certain preferred embodiments have been
shown and described, and that all changes and modifications that
come within the spirit of the invention are desired to be
protected.
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