Anatomical distal radius fracture fixation plate and methods of using the same

• US 20040193164A1
• Filed: 09/17/2003
• Published: 09/30/2004
• Est. Priority Date: 03/27/2003
• Status: Active Grant

• Current Assignee: Biomet Incorporated (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Depuy Products Incorporated (Johnson & Johnson)
• Inventors: Orbay, Jorge L.
• Granted Patent: US 7,857,838 B2
• Time in Patent Office: Days
• US Class Current: 606/281
• CPC Class Codes: A61B 17/8057 the interlocking form comprising a thread
• CPC Class Codes: A61B 17/8061 specially adapted for particular bones A61B17/70 and A61B17/74 take precedence
• CPC Class Codes: A61B 17/809 with bone-penetrating elements, e.g. blades or prongs bone staples A61B17/0642; intramedullary nails with a plate at an end A61B17/7233
• CPC Class Codes: A61B 17/8095 Wedge osteotomy devices
• CPC Class Codes: A61B 17/863 with thread interrupted or changing its form along shank, other than constant taper
• CPC Class Codes: A61B 2017/565 for surgical correction of axial deviation, e.g. hallux valgus or genu valgus

Abstract

A fixation plate includes a set of threaded peg holes adapted to individually receive fixation pegs therethrough and non-threaded alignment holes having a relatively smaller diameter than the peg holes and preferably sized to closely receive a K-wire. The alignment holes are located between the peg holes. One peg hole is configured for aligning the plate during an osteotomy procedure, while other peg holes are configured for use after fracture reduction and receive K-wires to temporarily secure the plate to the bone and determine whether pegs inserted through adjacent respective peg holes will be properly located before drilling relatively larger holes for such pegs.

Claims

1. A fixation plate, comprising:

a substantially rigid plate defining a first set of threaded peg holes adapted to individually receive fixation pegs therethrough and at least one non-threaded first alignment hole, each of said peg holes having a first diameter, and said at least one first alignment hole having a second relatively smaller diameter sized to closely receive a K-wire, each said at least one first alignment hole being located between peg holes.

2. A fixation plate according to claim 1, wherein:

said at least one first alignment hole defining a tangent line which is substantially coincident with a line tangent to said first set of threaded peg holes.

3. A fixation plate according to claim 1, wherein:

said plate has a body and a head, with said head angled upward relative to said body, and said first set of peg holes is provided in said head.

4. A fixation plate according to claim 3, wherein:

said head includes a second set of threaded peg holes provided distally relative to said first set.

5. A fixation plate according to claim 4, wherein:

said head includes a distal non-threaded alignment hole between two pegs of said second set of peg holes.

6. A fixation plate according to claim 5, wherein:

said distal alignment hole has an upper circular opening and a lower laterally oblong opening.

7. A fixation plate according to claim 3, wherein:

said head and body together generally form a T-shaped plate configuration, and said head includes a lower surface, a lateral side, a medial side and a central portion, and said lower surface at said lateral and medial sides is directed upward relative to said lower surface at said central portion.

8. A fixation plate according to claim 7, wherein:

said direction of said later and medial sides of said lower surface is formed by a chamfer of said lower surface.

9. A fixation plate according to claim 7, wherein:

said head includes an upper surface, and said upper and lower surfaces are chamfered.

10. A fixation plate, comprising:

a substantially rigid plate having a body and a head, with said head angled upward relative to said body, said head defining a first set of longitudinally displaced threaded peg holes and a first non-threaded alignment hole substantially smaller in diameter than said peg holes and laterally displaced between two peg holes of said first set of peg holes.

11. A fixation plate according to claim 10, wherein:

said head defines a second set of longitudinally displaced threaded peg holes longitudinally displaced relative said first set, and a second non-threaded alignment hole substantially smaller in diameter than said second set of peg holes and laterally displaced between two peg holes of said second set of peg holes.

12. A fixation plate according to claim 10, wherein:

said first set of threaded peg holes and said first alignment hole are all obliquely orientated in at least on dimension relative to each other.

13. A fixation plate according to claim 10, wherein:

said first set of threaded peg holes and said first alignment hole are all obliquely orientated in two dimensions relative to each other.

14. A fixation plate according to claim 10, wherein:

said alignment hole has an upper circular opening and a lower laterally oblong opening.

15. A fixation plate, comprising:

a substantially rigid plate defining first and second sets of longitudinally displaced threaded peg holes, wherein said peg holes of said first set laterally alternate with said peg holes of said second set.

16. A fixation plate according to claim 15, wherein:

said plate has a body and a head, with said head angled upward relative to said body, and said first and second sets of peg holes are provided in said head.

17. A fixation plate according to claim 16, wherein:

said plate includes a proximal non-threaded alignment hole laterally located between two peg holes of said first set of threaded peg holes, said proximal alignment hole having a substantially smaller diameter than said peg holes.

18. A fixation plate according to claim 17, wherein:

said plate includes a distal non-threaded alignment hole laterally located between two peg holes of said second set of threaded peg holes, said distal alignment hole having a diameter substantially smaller than a diameter of said peg holes of said second set.

19. A fixation plate according to claim 18, wherein:

said distal alignment hole has a circular upper opening and a laterally oblong lower opening.

20. A fixation plate according to claim 17, wherein:

said peg holes define axes which are obliquely angled relative to each other, and said proximal alignment hole is at an oblique angle relative to said peg holes.

21. A substantially rigid fixation plate for stabilization of a distal radius bone fracture, comprising:

a) an elongate body portion;

b) a transverse head portion angled relative to said body portion, wherein said head and body portions are sized for use over the distal radius bone fracture; and

c) stabilization means to prevent said head portion from rocking on the distal radius prior to mechanically coupling said head portion to the bone.

22. A fixation plate according to claim 21, wherein:

said head portion has a lower surface, and said stabilization means includes a contour of said lower surface which defines three planes of contact.

23. A fixation plate according to claim 22, wherein:

said head portion includes an upper surface, and said upper and lower surfaces are chamfered.

24. A fixation plate according to claim 22, wherein:

said medial portion includes a distal extension relative to said lateral portion.

25. A fixation plate according to claim 21, wherein:

said head portion includes threaded peg holes which individually receive fixation pegs therethrough.

26. A system for fracture fixation of the distal radius, comprising:

a) a plate having a first portion and a second portion angled relative to said first portion, said first portion defining at least one screw hole, and said head defining a plurality of threaded peg holes and at least one substantially smaller non-threaded alignment hole situated between two adjacent peg holes;

b) at least one screw sized for insertion into said at least one screw hole;

c) a plurality of pegs each having a threaded head and a shaft, said pegs sized insertion into said peg holes; and

d) at least one K-wire, wherein said alignment hole is sized to closely receive said K-wire.

27. A system according to claim 26, wherein:

said head of said plate includes stabilization means to prevent said head portion from rocking on the distal radius prior to mechanically coupling said head portion to the bone.

28. A method for treating a distal radius fracture, comprising:

a) reducing the fracture;

b) positioning a volar plate over the fracture, the plate including a body portion and a head portion angled relative to the body portion, the plate including a plurality of non-threaded alignment holes sized to closely receive a K-wire;

c) drilling K-wires through alignment holes of the plate and into the radius bone both proximal and distal of the fracture to temporarily secure the plate to the bone;

d) examining whether the location of the drilled K-wires is correct;

e) if the location is incorrect, removing the K-wires and relocating at least one of the plate and K-wires, and repeating steps c) and d); and

f) if the location is correct, more permanently securing the plate to the bone.

29. A method according to claim 28, wherein:

said examining includes examining under fluoroscopy.

30. A method according to claim 28, wherein:

said more permanently securing includes securing the plate to the bone with both pegs and screws.

31. A method according to claim 28, further comprising:

after step f), removing the K-wires from the bone.

32. A method of performing correction of a deformity at a metaphysis of a long bone, comprising:

a) drilling a K-wire substantially parallel to an articular surface of the long bone such that one end of the K-wire is located within or through the bone and the other end of the K-wire is free;

b) providing a plate having a longitudinally displaced body and head portions which are angled relative to each other, the head portion including an alignment hole sized to closely receive the K-wire;

c) at the alignment hole, sliding the plate over the free end of the K-wire;

d) coupling the head portion to the bone distal of the fracture; and

e) cutting the bone at or adjacent the metaphysis;

f) levering the body portion of the plate to reorient the metaphysis relative to a diaphyseal portion of the long bone; and

g) coupling the body portion of the plate to the long bone.

33. A method according to claim 32, wherein:

said providing a plate includes providing a plate with an alignment hole having a circular upper opening and a laterally oblong lower opening.

34. A method according to claim 32, wherein:

the head portion of the plate includes a plurality of threaded peg holes, and said coupling the head portion includes to the bone includes drilling holes in the bone in alignment with the threaded peg holes, and inserting pegs into the peg holes and drilled holes.

35. A method according to claim 34, wherein:

said drilling includes drilling holes which are oblique in at least two dimensions relative to each other.

36. A method according to claim 34, wherein:

the body portion of the plate includes screw holes, and said coupling the body portion to the long bone includes inserting screws into the screw holes and long bone.