U.S. patent application number 14/949185 was filed with the patent office on 2016-05-26 for strut plate and cabling system.
The applicant listed for this patent is Stryker European Holdings I, LLC. Invention is credited to Michael Mckee, Emil Schemitsch.
Application Number | 20160143663 14/949185 |
Document ID | / |
Family ID | 54704954 |
Filed Date | 2016-05-26 |
United States Patent
Application |
20160143663 |
Kind Code |
A1 |
Schemitsch; Emil ; et
al. |
May 26, 2016 |
STRUT PLATE AND CABLING SYSTEM
Abstract
A bone plate assembly and method of utilizing same are
disclosed. The assembly includes at least two plates affixed to the
bone in two different locations. One of the plates includes a
porous bone in-growth surface, and may be entirely porous. The
assembly may further include at least one bone screw and cable for
affixing the plates to the bone. In the method of use, the plates
may be affixed by the screws and/or cables and the plate including
the porous surface may be left in place after bone is allowed to
grow therein.
Inventors: |
Schemitsch; Emil;
(Thornhill, CA) ; Mckee; Michael; (Mississauga,
CA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Stryker European Holdings I, LLC |
Kalamazoo |
MI |
US |
|
|
Family ID: |
54704954 |
Appl. No.: |
14/949185 |
Filed: |
November 23, 2015 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
62083491 |
Nov 24, 2014 |
|
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|
Current U.S.
Class: |
606/71 ;
606/281 |
Current CPC
Class: |
A61B 17/8625 20130101;
A61B 17/683 20130101; A61B 17/80 20130101; A61B 17/864 20130101;
A61B 17/82 20130101; A61B 2017/00004 20130101 |
International
Class: |
A61B 17/68 20060101
A61B017/68; A61B 17/82 20060101 A61B017/82; A61B 17/86 20060101
A61B017/86; A61B 17/80 20060101 A61B017/80 |
Claims
1. A bone plate assembly for fixing a fracture of a bone
comprising: a first bone plate attached to the bone; and a second
bone plate attached to the bone, the second bone plate including a
porous bone in-growth surface.
2. The bone plate assembly of claim 1, wherein the first and second
bone plates are attached to opposite sides of the bone.
3. The bone plate assembly of claim 1, further comprising at least
one screw extending through the first bone plate and into the bone
and at least one cable extending around the first and second
plates.
4. The bone plate assembly of claim 3, wherein the at least one
screw is cannulated and the at least one cable extends
therethrough.
5. The bone plate assembly of claim 3, wherein the first plate
includes a channel or slot and the at least one cable extends
through the channel or slot.
6. The bone plate assembly of claim 1, wherein the second bone
plate is entirely porous.
7. The bone plate assembly of claim 1, wherein the bone in-growth
surface is attached to a solid portion.
8. The bone plate assembly of claim 1, wherein the first and second
plates are metallic.
9. A method of fixing a fracture of a bone comprising the steps of:
attaching a first plate to the bone so that the first plate spans
at least a portion of the fracture; attaching a second plate to the
bone so that the second plate spans at least a portion of the
fracture; and allowing bone to grow into at least a portion of the
second plate.
10. The method of claim 9, further comprising the step of removing
the first plate subsequent to the allowing step.
11. The method of claim 9, wherein the second plate includes a
porous bone in-growth surface.
12. The method of claim 9, wherein the attaching the first plate
step includes inserting at least one bone screw through the first
plate and into the bone.
13. The method of claim 12, wherein the attaching steps include
wrapping at least one cable around the first and second plates.
14. The method of claim 13, wherein the cable is placed through the
at least one screw.
15. The method of claim 13, wherein the cable is placed through a
channel or slot formed in the first plate.
16. A bone plate assembly for fixing a fracture of a bone
comprising: a first bone plate attached to the bone; a second bone
plate attached to an opposite side of the bone, the second bone
plate being formed entirely of a porous bone in-growth material;
and at least one screw extending through the first bone plate and
into the bone and at least one cable extending around the first and
second plates.
17. The bone plate assembly of claim 16, wherein the first plate
includes a channel or slot and the at least one cable extends
through the channel or slot.
18. The bone plate assembly of claim 16, wherein the first and
second plates are metallic.
19. The bone plate assembly of claim 16, further comprising a
plurality of screws and cables.
20. The bone plate assembly of claim 16, wherein the first and
second bone plates are formed of different materials.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] The present application claims the benefit of U.S.
provisional patent application No. 62/083,491 filed Nov. 24, 2014,
the disclosure of which is incorporated herein by reference.
BACKGROUND OF THE INVENTION
[0002] The present invention pertains to orthopedic bone plates,
and in particular, orthopedic bone plates with bone in-growth
capabilities.
[0003] A common method utilized in repairing fractures of bones
includes affixing bone plates to the bone with screws. Generally,
the plates are oriented so that portions thereof are placed on
either side of the fracture and screws are placed through at least
one bone screw hole of each bone plate portion. Depending upon the
particular anatomical area of the fracture, different plate designs
exist. For instance, plates designed for use on the distal and
proximal portions of long bones such as the femur or tibia may
include a shaft and a head, with screw holes extending through
each.
[0004] One issue that is often faced by surgeons is the tendency of
bone screws inserted through bone plates to back out of the bone
plate and/or bone after implantation. Many different bone plate
configurations have been designed to prevent such occurrences. For
instance, it has been known for some time to thread portions of the
bone screws to the plate holes to prevent the unwanted back out.
Likewise, different secondary fixation elements (e.g., caps or the
like) have been utilized in prior art plates.
[0005] Another issue faced by surgeons is often encountered in
repairing perio-prosthetic fractures, which are fractures that
occur around an implanted prosthesis (e.g., those utilized in total
hip, total knee, or total shoulder arthroplasty). Because of the
already implanted prosthesis, and the tendency of the fractures to
be somewhat complicated, perio-prosthetic fractures are typically
complex and difficult to treat with conventional methods. For
instance, in placing screws through a bone plate, it can be
difficult for a surgeon to both navigate around the already
implanted prosthesis and capture each of the bone fragments of the
fracture.
[0006] Therefore, there exists a need for a bone plate and cabling
system capable of treating fractures such as perio-prosthetic
fractures, as well as providing an alternative to bone screws which
have a tendency to back out.
BRIEF SUMMARY OF THE INVENTION
[0007] A first aspect of the present invention is a bone plate
assembly for fixing a fracture of a bone. The bone plate assembly
includes a first bone plate attached to the bone and a second bone
plate attached to the bone. The second bone plate includes a porous
bone in-growth surface.
[0008] In one embodiment of the first aspect the first and second
bone plates are attached to opposite sides of the bone. The
assembly may further include at least one screw extending through
the first bone plate and into the bone and at least one cable
extending around the first and second plates. The at least one
screw may be cannulated and the at least one cable may extend
therethrough. The first plate may include a channel or slot and the
at least one cable may extend through the channel or slot. The
second bone plate may be entirely porous, or the bone in-growth
surface may be attached to a solid portion. The first and second
plates may be metallic, polymeric or any other suitable
material.
[0009] A second aspect of the present invention is a method of
fixing a fracture of a bone including the steps of attaching a
first plate to the bone so that the first plate spans at least a
portion of the fracture, attaching a second plate to the bone so
that the second plate spans at least a portion of the fracture and
allowing bone to grow into at least a portion of the second
plate.
[0010] Other embodiments of the second aspect may further include
the step of removing the first plate subsequent to the allowing
step. The second plate may include a porous bone in-growth surface.
The attaching the first plate step may include inserting at least
one bone screw through the first plate and into the bone. The
attaching steps may include wrapping at least one cable around the
first and second plates. The cable may be placed through the at
least one screw, a channel or slot or a cable plug.
BRIEF DESCRIPTION OF THE DRAWINGS
[0011] A more complete appreciation of the subject matter of the
present invention and of the various advantages thereof can be
realized by reference of the following detailed description in
which references made to the accompanying drawings in which:
[0012] FIG. 1 is a perspective view of a bone plate and cabling
system according to one embodiment of the present invention
attached to a femur.
[0013] FIG. 2 is another perspective view of the bone plate and
cabling construct of FIG. 1 focusing on a different plate of the
construct.
[0014] FIG. 3 is a cross sectional view taken along line D-D of
FIG. 2.
[0015] FIG. 4 is a cross sectional view taken along line B-B of
FIG. 1.
DETAILED DESCRIPTION
[0016] The present invention addresses both above-noted needs, by
providing a bone plate and cabling system that does not rely solely
upon bone screws inserted through the plate. Rather, the present
invention makes use of porous plates that can be initially affixed
via a novel cabling system and thereafter allow for bone ingrowth
into the plates to support the construct. Although the porous bone
plates disclosed herein are described as being constructed of
porous metal foam, it is contemplated that the bone plates may be
of many different types of materials, including, but limited,
ceramics, plastics or the like. It is also contemplated to utilize
the porous bone plates of the present invention in conjunction with
more standard bone plates known in the art.
[0017] FIGS. 1 and 2 depict a femur 1 with a bone plate and cabling
system 10 attached thereto. System 10, as shown, includes a first
bone plate 12 and a second bone plate 14 (best shown in FIG. 2).
Bone plate 12 is standard bone with a plurality of bone plate holes
16 that are shown both as exhibiting circular and elongate forms.
Of course, the holes may exhibit any shape or construct known in
the art, including, without limitation, oblong compression holes,
threaded holes and holes that include deformable structures.
Likewise, any number of holes may be provided on plate 12 in
connection with the present invention. Additionally, plate 12
includes at least one channel or slot 18 that is sized and shaped
to accept and retain a cable of the type discussed more fully
below. As shown, plate 12 is designed for use in connection with a
distal femur, but can exhibit many different configurations
depending upon the bone that requires repair.
[0018] On the other hand, bone plate 14 is shown constructed of
porous material, with no holes formed therethrough. The porous
material is preferably designed to allow for bone to grow directly
into plate 14 after implantation. Although shown as consisting
largely of the porous material, plate 14 can be only partially
formed of the porous material. Specifically, in other embodiments,
bone plate 14 may include an underside surface that is of a porous
construction, so that when placed against the bone it can
facilitate bone in-growth from the affected bone into the plate. In
such a case, the remainder of the plate can be of a more solid
construction.
[0019] As shown, the porous metallic construction of bone plate 14
was created utilizing a laser remelting process ("LRM"). In fact,
it is contemplated to form the entirety of plate 14 with such a
process, including any solid portions that may be included therein.
Those solid portions could alternatively be formed through more
conventional processes (e.g., molding, forging, etc. . . . ) and a
porous lower or bone contacting surface can be later affixed
thereto via a process like LRM. Without limitation, the LRM
processes disclosed in U.S. Pat. Nos. 7,537,664 and 8,147,861; U.S.
Patent Application Publications Nos. 2006/0147332, 2007/0142914,
2008/0004709; and U.S. patent application Ser. Nos. 13/441,154 and
13/618,218, the disclosures of which are hereby incorporated by
reference herein, can be utilized. It is also contemplated to form
any porous surface via a laser etching procedure.
[0020] Also depicted in FIGS. 1 and 2 is a cabling system that
includes plurality of cables 20a-d and at least one cannulated
screw 22. As shown, the cables may be situated so as to extend
through screw 22 and around plate 12 and the femur (cable 20a),
around both plates 12 and 14 (cables 20b and 20d) and through
channel or slot 18 and around plate 14 (cable 20c). Of course,
other configurations are also contemplated depending upon the bone
being repaired and the plates being utilized.
[0021] Screw 22 not only allows for the fixation of plate 12 to the
bone, but also its cannulation allows for passage of cable 20a
therethrough so that the cable only needs to wrap around the
affected bone on one side thereof. This is further shown in the
cross sectional view of FIG. 3. Although screw 22 is shown as a one
piece screw, it is contemplated that the screw can include a
modular head or the like. In addition, it is contemplated for one
or more of plate holes 16 to be designed such that they are not
only sized and shaped to receive the screws, but also allow
polyaxial movement of the screws with respect to the plate.
Above-mentioned channel or slot 18 is sized, shaped and oriented to
receive and guide a cable placed therethrough. The channel or slot
18 can be of an open or closed design, the latter of which entirely
retains the cable therein. Of course, although only a single
channel or slot is shown included on plate 12, any number of them
may be provided on a given plate.
[0022] In use, a surgeon will place plate 12 against an affected
bone (such as femur 1), so that different portions of the plate
span any fracture(s) in the bone. Thereafter screws, such as screws
22, may be placed through the plate and into the bone. Cables 20a-d
may then be applied to the construct and plate 14 may be introduced
to the opposite side of the bone from plate 12. It is also
contemplated to place plate 14 in other positions than directly
opposite to plate 12 (e.g., to the side of the bone). Upon
tightening of the cables, plates 12 and 14 are fixed in
position.
[0023] In the case of a peri-prosthetic fracture, care must be
taken as to the placement of any screws so as not to interfere with
the already implanted prosthesis. However, it is possible through
the use of the plates, screws and cables of the present invention
properly stabilize the fracture without the need for screws
extending into each bone fragment. Rather, less screws can be
utilized when utilizing cables 26. The cables act to stabilize the
fracture, much like multiple screws would in the case of a standard
bone plate use. This is especially true in the context of
peri-prosthetic fractures, where the amount of bone screws that can
be utilized is limited.
[0024] In situations in which bone plates 12 and 14 are utilized,
the use of two plates allows for a stable fixation of the bone
fracture via plate 12, while bone is allowed to grow into plate 14.
After proper bone growth, a surgeon may elect to remove bone plate
12 from the fracture site, thereby leaving what is effectively
become a continuous bone/plate 14 construct. It is, of course,
contemplated that the plates may be placed on many different
portions of the bone, as well as to leave both plates in place for
an extended period of time. Additionally, it is contemplated to
utilize only plate 14 with one or more cables at least initially
holding it in place. After proper bone growth into plate 14, the
cables may be removed. It is to be understood that plate 14 could
also be designed to work in conjunction with screws, like screw 22,
or to include one or more channels or slots like are discussed
above. Any holes provided in plates 12 or 14 could also accept a
cable plug, which can provide an additional mechanism for
associating the plate with a cable. For instance, it is envisioned
to utilize with plates 12 or 14 any of the cables plugs disclosed
in U.S. Pat. No. 8,142,434, U.S. Patent Application Publication No.
2014/0107710 and U.S. Provisional Application No. 62/035,074, the
disclosures of which are hereby incorporated by reference
herein.
[0025] Although the invention herein has been described with
reference to particular embodiments, it is to be understood that
these embodiments are merely illustrative of the principles and
applications of the present invention. It is therefore to be
understood that numerous modifications may be made to the
illustrative embodiments and that other arrangements may be devised
without departing from the spirit and scope of the present
invention as defined by the appended claims.
* * * * *