Method and apparatus for bone fixation with secondary compression

• US 20030069582A1
• Filed: 07/12/2002
• Published: 04/10/2003
• Est. Priority Date: 03/30/2001
• Status: Active Grant

• Current Assignee: Depuy Synthes Products Incorporated (Johnson & Johnson)
• Original Assignee: Triage Medical, Inc (Johnson & Johnson)
• Inventors: Culbert, Brad S.
• Granted Patent: US 6,887,243 B2
• Time in Patent Office: Days
• US Class Current: 606/65
• CPC Class Codes: A61B 17/16 Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans arthroscopic bone cutters A61B17/320016; dental implant drills potentially for other surgical use A61C8/0089; bone grinders A61F2/4644, A22C17/06; A61B17/1662 takes precedence over all other subgroups except A61B17/17
• CPC Class Codes: A61B 17/1615 Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
• CPC Class Codes: A61B 17/68 Internal fixation devices , including fasteners and spinal fixators, even if a part thereof projects from the skin bone staples A61B17/0642
• CPC Class Codes: A61B 17/742 having one or more longitudinal elements oriented along or parallel to the axis of the neck
• CPC Class Codes: A61B 17/744 the longitudinal elements coupled to an intramedullary nail
• CPC Class Codes: A61B 17/84 Fasteners therefor or fasteners being internal fixation devices
• CPC Class Codes: A61B 17/846 Nails or pins, i.e. anchors without movable parts, holding by friction only, with or without structured surface A61B17/72, A61B17/86 take precedence
• CPC Class Codes: A61B 17/864 hollow, e.g. with socket or cannulated
• CPC Class Codes: A61B 17/8685 comprising multiple separate parts
• CPC Class Codes: A61B 17/869 characterised by an open form, e.g. wire helix
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches

Abstract

Disclosed is a fracture fixation device, for reducing and compressing fractures in a bone. The fixation device includes an elongate body. An axially moveable proximal anchor is carried by the proximal end of the fixation device and comprises a tubular sleeve that includes a plurality of graduations positioned on an outer surface of the tubular sleeve. The device is rotated into position across the femoral neck and into the femoral head, and the proximal anchor is distally advanced to lock the device into place. In certain embodiments, the elongated body includes a distal anchor with a distal cutting tip.

Claims

1. A bone fixation device, comprising:

an elongate body, having a proximal end and a distal end;

a helical anchor on the distal end of the elongated body;

a retention structure on the elongated body that is proximal to the helical anchor; and

a proximal anchor, moveably carried by the body and comprising a tubular sleeve including a plurality of graduations positioned on an outer surface of the tubular sleeve;

wherein the proximal anchor is movable in the distal direction with respect to the body, the retention structure resists proximal movement of the proximal anchor with respect to the body.

2. A bone fixation device as in claim 1, wherein the elongated body comprises a first portion and a second portion that are detachably coupled to each other at a junction and the proximal anchor, in a first position, extends distally past the junction between the first portion and the second portion.

3. A bone fixation device as in claim 2, further comprising an anti-rotational structure on the first portion of the elongated body, the anti-rotational structure preventing rotational movement of the first portion of the elongated body with respect to the proximal anchor.

4. A bone fixation device as in claim 3, further comprising a rotational coupling on the second portion of the body.

5. A bone fixation device as in claim 2, further comprising a first threaded portion on a proximal portion of the first portion and a second threaded portion on a distal portion of the second portion, the first threaded portion and the second threaded portion configured to detachably couple the first and second portions to each other at a junction.

6. A bone fixation device as in claim 1, further comprising a rotational coupling on the proximal anchor.

7. A bone fixation device as in claim 1, wherein the first retention structure comprises a series of ridges or grooves.

8. A bone fixation device as in claim 7, further comprising a second retention structure on the interior of the tubular sleeve for cooperating with the first retention structure on the body.

9. A bone device as in claim 8, further comprising a transverse flange extending radially outwardly from the tubular sleeve.

10. A bone device as in claim 9, wherein the flange is angularly moveable with respect to a longitudinal axis of the tubular sleeve.

11. A bone fixation device, comprising:

an elongate body, having a proximal end and a distal end;

a helical anchor on the distal end of the elongated body;

the helical anchor including a distal cutting tip;

a retention structure on the elongated body that is proximal to the helical anchor; and

a proximal anchor, moveably carried by the body and comprising a tubular sleeve;

wherein the proximal anchor is movable in the distal direction with respect to the body, the retention structure resists proximal movement of the proximal anchor with respect to the body.

12. A bone fixation device as in claim 11, wherein the distal anchor comprises an elongated member that is spirally wrapped about a central core that defines a central lumen.

13. A bone fixation device as in claim 12, wherein and the distal cutting tip comprises a cutting face that cuts across the elongated member and the central core.

14. A bone fixation device as in claim 13, wherein the cutting face defines at least a first cutting edge and a second cutting edge, the first cutting edge extending along the outside diameter of the central lumen while the second cutting edge extends generally along the outside diameter of the central core.

15. A bone fixation device as in claim 14, wherein the first and second cutting edges are generally parallel to a longitudinal axis of the fixation device.

16. A bone fixation device as in claim 14, wherein the cutting face defines a third cutting edge that is formed by an intersection of an upper flank of the elongated member with the cutting face.

17. A bone fixation device as in claim 16, wherein the cutting face defines a fourth cutting edge that is formed by an intersection of a lower flank of the elongated member.

18. A bone fixation device as in claim 17, wherein the cutting tip further comprises a second cutting face that cuts through the central core and defines a fifth cutting edge that connects follows the outside diameter of the central core.

19. A method of fixing an anchor to a bone, comprising the steps of:

providing a fixation device having a radially outwardly extending element thereon;

cutting a helical path into a bone; and

rotating the element along the helical path.

20. A method of fixing an anchor to a bone as in claim 19, wherein the element comprises a helical thread.

21. A method of fixing an anchor to a bone as in claim 19, comprising providing a proximal anchor and advancing the proximal anchor distally along the fixation device to compress the fracture.

22. A method of fixing an anchor to a bone as in claim 21, wherein the advancing step comprises advancing a fixation device having an elongate body with a helical anchor on a distal end and a plurality of retention structures proximal to the helical anchor for engaging an axially movable proximal anchor.

23. A method of fixing an anchor to a bone as in claim 21, wherein the advancing a proximal anchor step comprises axially advancing the proximal anchor without rotating the proximal anchor with respect to the fixation device.

24. A method of fixing an anchor to a bone as in claim 21, wherein the advancing a proximal anchor step comprises axially advancing the proximal anchor by rotating the proximal anchor with respect to the fixation device.

25. A method of treating a femoral fracture of a femur, comprising the steps of:

placing an elongated member across the fracture to determine a desired depth of a fixation device;

rotating the fixation device into the femur until a distal anchor of the fixation device reaches the desired depth as indicated by a plurality of graduations provided on a proximal anchor; and

advancing the proximal anchor distally along the fixation device to compress the fracture.

26. A method of treating a femoral fracture as in claim 25, comprising comparing the elongated member to the plurality of graduations on the proximal anchor.

27. A method of treating a femoral fracture as in claim 25, comprising drilling a bore distally into the femur in the direction of the fracture.

28. A method of treating a femoral fracture as in claim 27, wherein the drilling step comprises drilling the bore along an axis which extends through the femoral neck and into the head of the femur.

29. A method of treating a femoral fracture as in claim 27, wherein the placing the elongated member across the fracture step comprises inserting the elongated member into the bore.

30. A method of treating a femoral fracture as in claim 25, wherein the advancing a proximal anchor step comprises axially advancing the proximal anchor without rotating the proximal anchor with respect to the fixation device.

31. A method of treating a femoral fracture as in claim 25, wherein the advancing a proximal anchor step comprises axially advancing the proximal anchor by rotating the proximal anchor with respect to the fixation device.

32. A method of treating a femoral fracture as in claim 25, wherein the fracture is a femoral neck fracture, an intertrochanteric fracture or a subtrochanteric fracture.

33. A method of securing a first bone fragment to a second bone fragment, comprising the steps of:

placing an elongated member across the first and second bone fragments to determine a desired depth of a fixation device;

advancing a first portion of the fixation device through the first bone fragment and into the second bone fragment until a distal anchor of the fixation device reaches the desired depth as indicated by a plurality of graduations provided on a second portion of the fixation device; and

axially advancing the second portion of the fixation device to engage the first fragment.

34. A method of securing a first bone fragment to a second bone fragment as in claim 33, comprising comparing the elongated member to the plurality of graduations on the proximal anchor.

35. A method of securing a first bone fragment to a second bone fragment as in claim 33, comprising drilling a bore through the first bone fragment in the direction of the second bone fragment.

36. A method of securing a first bone fragment to a second bone fragment as in claim 35, wherein placing the elongated member across the fracture step comprises inserting the elongated member into the bore.

37. A method of securing a first bone fragment to a second bone fragment as in claim 33, wherein the second bone fragment comprises the head of a femur.

38. A method of securing a first bone fragment to a second bone fragment as in claim 33, wherein the second bone fragment comprises the tibia.

39. A method of securing a first bone fragment to a second bone fragment as in claim 33, wherein the second bone fragment comprises the fibula.

40. A method of securing a first bone fragment to a second bone fragment as in claim 33, wherein the second bone fragment comprises the femur.

41. A method of securing a first bone fragment to a second bone fragment as in claim 33, wherein the first bone fragment comprises the femur.

42. A method of securing a first bone fragment to a second bone fragment as in claim 33, wherein the first bone fragment comprises a condyle.

43. A method of securing a first bone fragment to a second bone fragment as in claim 33, wherein the axially advancing step comprises rotating the second part of the fixation device about a longitudinal axis of the fixation device.

44. A method of securing a first bone fragment to a second bone fragment as in claim 33, further comprising the step of positioning a plate adjacent the first bone fragment and advancing the fixation device through the plate.

45. A method of securing a first bone fragment to a second bone fragment as in claim 33, wherein the drilling step comprises drilling a bore through the first bone fragment and into the second bone fragment.