Surgical fastener assembly

• US 5,976,139 A
• Filed: 07/17/1996
• Issued: 11/02/1999
• Est. Priority Date: 07/17/1996
• Status: Expired due to Term

• Current Assignee: Orthopedic Designs North America, Inc.
• Original Assignee: Dale G. Bramlet
• Inventors: Bramlet, Dale G.
• Primary Examiner(s): REIP, DAVID OWEN
• Application Number:
  US08/680,620
• Time in Patent Office: 1,203 Days
• Field of Search: 606/66, 606/65, 606/68, 606/67, 606/63, 606/64, 606/62, 606/60, 606/61, 606/72, 606/73, 606/69, 606/70, 606/71
• US Class Current: 606/66
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/1721 for applying pins along or parallel to the axis of the femoral neck
• CPC Class Codes: A61B 17/746 the longitudinal elements coupled to a plate opposite the femoral head
• CPC Class Codes: A61B 17/8004 with means for distracting or compressing the bone or bones
• 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 17/864 hollow, e.g. with socket or cannulated
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable
• CPC Class Codes: A61B 2017/00862 elastic or resilient
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0425 the anchor or the separate member comprising threads, e.g. a set screw in the anchor
• CPC Class Codes: A61B 2017/0429 the barbs being expanded by a mechanical mechanism which also locks them in the expanded state
• CPC Class Codes: A61B 2017/0433 the anchor or the separate member comprising threads, e.g. a set screw or a worm gear for moving spreading members
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/8655 with special features for locking in the bone
• CPC Class Codes: A61F 2/30767 Special external or bone-contacting surface, e.g. coating for improving bone ingrowth
• CPC Class Codes: A61F 2/3601 for replacing only the epiphyseal or metaphyseal parts of the femur, e.g. endoprosthetic femoral heads or necks directly fixed to the natural femur by internal fixation devices non-prosthetic internal fixation devices for the femoral head or neck A61B17/74
• CPC Class Codes: A61F 2/4241 for hands, e.g. fingers
• CPC Class Codes: A61F 2/4606 of wrists or ankles; of hands, e.g. fingers; of feet, e.g. toes
• CPC Class Codes: A61F 2002/30112 : Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2002/30131 : horseshoe- or crescent- or C-shaped or U-shaped
• CPC Class Codes: A61F 2002/30143 : hexagonal
• CPC Class Codes: A61F 2002/30153 : rectangular
• CPC Class Codes: A61F 2002/30154 : square
• CPC Class Codes: A61F 2002/3021 : frustoconical
• CPC Class Codes: A61F 2002/30217 : hollow cones, e.g. tubular-like cones
• CPC Class Codes: A61F 2002/30224 : cylindrical
• CPC Class Codes: A61F 2002/30235 : tubular, e.g. sleeves
• CPC Class Codes: A61F 2002/30276 : frustopyramidal
• CPC Class Codes: A61F 2002/30332 : Conically- or frustoconically-shaped protrusion and recess
• CPC Class Codes: A61F 2002/30359 : Pyramidally- or frustopyramidally-shaped protrusion and recess
• CPC Class Codes: A61F 2002/30405 : made by screwing complementary threads machined on the parts themselves
• CPC Class Codes: A61F 2002/30433 : using additional screws, bolts, dowels, rivets or washers e.g. connecting screws
• CPC Class Codes: A61F 2002/30487 : Circumferential cooperating grooves and beads on cooperating lateral surfaces of a mainly longitudinal connection
• CPC Class Codes: A61F 2002/305 : Snap connection
• CPC Class Codes: A61F 2002/30525 : Worm gears
• CPC Class Codes: A61F 2002/30571 : Leaf springs
• CPC Class Codes: A61F 2002/30574 : with an integral complete or partial collar or flange
• CPC Class Codes: A61F 2002/30579 : with mechanically expandable devices, e.g. fixation devices
• CPC Class Codes: A61F 2002/30616 : Sets comprising a plurality of prosthetic parts of different sizes or orientations
• CPC Class Codes: A61F 2002/30624 : Hinged joint, e.g. with transverse axle restricting the movement
• CPC Class Codes: A61F 2002/30632 : with rotation-limiting stops, e.g. projections or recesses
• CPC Class Codes: A61F 2002/30772 : Apertures or holes, e.g. of circular cross section
• CPC Class Codes: A61F 2002/30774 : internally-threaded
• CPC Class Codes: A61F 2002/30795 : Blind bores, e.g. of circular cross-section
• CPC Class Codes: A61F 2002/30805 : Recesses of comparatively large area with respect to their low depth
• CPC Class Codes: A61F 2002/3085 : with a threaded, e.g. self-tapping, bone-engaging surface, e.g. external surface
• CPC Class Codes: A61F 2002/4243 : for interphalangeal joints, i.e. IP joints
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/0033 : made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2220/0041 : using additional screws, bolts, dowels or rivets, e.g. connecting screws
• CPC Class Codes: A61F 2230/0004 : Rounded shapes, e.g. with rounded corners
• CPC Class Codes: A61F 2230/0013 : Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
• CPC Class Codes: A61F 2230/0017 : Angular shapes
• CPC Class Codes: A61F 2230/0019 : rectangular
• CPC Class Codes: A61F 2230/0021 : square
• CPC Class Codes: A61F 2230/0067 : conical
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2230/0086 : Pyramidal, tetrahedral, or wedge-shaped
• CPC Class Codes: A61F 2310/00017 : Iron- or Fe-based alloys, e.g. stainless steel
• CPC Class Codes: A61F 2310/00023 : Titanium or titanium-based alloys, e.g. Ti-Ni alloys
• CPC Class Codes: A61F 2310/00029 : Cobalt-based alloys, e.g. Co-Cr alloys or Vitallium
• CPC Class Codes: A61F 2310/00179 : Ceramics or ceramic-like structures
• CPC Class Codes: Y10S 606/902 : Cortical plate specifically adapted for a particular bone
• CPC Class Codes: Y10S 606/907 : Composed of particular material or coated

Abstract

A surgical fastener assembly for coupling first and second bone portions across a fracture therebetween including an elongated anchor or bone screw insertable within the first bone such that one end portion of the anchor is disposed on one side of the fracture while a second end portion of the anchor is disposed on an opposite side of the fracture. A guide having a sleeve-like projection is fixedly secured to the second bone. The sleeve-like projection on the guide moves slidably along and is guided by the second end portion of the anchor. A compression screw assembly serves to operably secure the guide to the anchor such that the bone portions secured to each are maintained in compressive relationship relative to each other. A screw assembly for maintaining the guide in fixed relation relative to the bone portion to which it is secured is also disclosed.

Claims

1. A surgical fastener assembly for coupling first and second bone portions across a fracture therebetween, said fastener assembly comprising:

an elongated anchor endwise insertable within the first bone portion such that a first end portion of said anchor is disposed on one side of the fracture while a second end portion of the anchor is disposed on an opposite side of the fracture, wherein a threaded elongated bore extends within said anchor;

a guide adapted to be fixedly secured to the second bone portion, with a projection on said guide being guided by and along the second end portion of said anchor;

a cannulated fastener including an enlarged head portion and an externally threaded shank portion with an elongated bore extending through said head and shank portions and opening at opposite ends of said fastener, wherein, in an operative position, the shank portion of said fastener extends into threaded engagement with said anchor while the head portion of said fastener operably engages with said guide such that rotation of said fastener draws the first and second bone portions into compressive relationship relative to each other; and

a retainer positioned within said bore extending within said anchor, the retainer being threadably associated with the second end of said anchor and positionable relative to said fastener for releasably locking said fastener to prevent axial displacement of said guide in a direction away from said anchor.

2. The surgical fastener assembly according to claim 1 wherein said retainer is engagable by a tool extendable through the bore of said fastener to position said retainer relative to said fastener.

3. The surgical fastener assembly according to claim 1 wherein said anchor is formed from a material chosen from a class comprised of:

titanium, a titanium alloy, stainless steel, or a cobalt chromium alloy.

4. The surgical fastener assembly according to claim 1 wherein said guide is formed from a material chosen from a class comprised of:

titanium, a titanium alloy, stainless steel, or a cobalt chromium alloy.

5. The surgical fastener assembly according to claim 1 wherein said retainer defines an axial bore configured to operably engage with a tool whereby turning movement can be imparted to said retainer.

6. The surgical fastener assembly according to claim 1 wherein said anchor has external threading extending over and along an axial length thereof for fastening said anchor within the first bone portion.

7. The surgical fastener assembly according to claim 6 wherein the second end of said anchor is configured to releasably accommodate a driving tool capable of imparting turning movements to said anchor such that the external threading thereon engages the bone substance of the first bone portion.

8. The surgical fastener assembly according to claim 1 wherein said guide defines a recess sized to accommodate the head portion of said fastener therewithin and such that no portion of said fastener extends axially beyond said guide after said guide is fastened to said anchor.

9. The surgical fastener assembly according to claim 1 wherein said guide and said anchor are releasably fastened to each other to prevent relative rotation therebetween.

10. A surgical fastener assembly for coupling first and second bone portions across a fracture therebetween, said fastener assembly comprising:

an elongated anchor endwise insertable within the first bone portion such that a first end region of said anchor is disposed on one side of the fracture while a second end region of the anchor is disposed on an opposite side of the fracture and wherein said anchor includes external threading extending along a lengthwise portion thereof for effecting securement of said anchor within the first bone portion;

a series of pins operably associated with said first end of said anchor for movement between extended and retracted positions, wherein when pins are in said retracted position they have no operable anchoring effect between said anchor and the first bone portion, and wherein when said pins are in said extended position they radially extend outwardly from said anchor while remaining in operable association therewith thereby securing said anchor within the first bone portion;

a mechanism for positively moving said pins in opposite directions between said extended and retracted positions;

a guide adapted to be fixedly secured to the second bone portion, with a projection on said guide being guided by and along the second end region of said anchor;

a fastener including an enlarged head portion and an externally threaded shank portion wherein, in an operative position, the shank portion of said fastener extends into threaded engagement with said anchor while the head portion of said fastener operably engages with said guide such that rotation of said fastener draws the first and second bone portions into relationship relative to each other.

11. The surgical fastener assembly according to claim 10 wherein said anchor is formed from a material chosen from the class comprised of:

titanium, a titanium alloy, stainless steel, or a cobalt chromium alloy.

12. The surgical fastener assembly according to claim 10 wherein each pin in said series of pins is formed from a material chosen from the class comprised of:

titanium, a titanium alloy, stainless steel, or a cobalt chromium alloy.

13. The surgical fastener assembly according to claim 10 wherein each pin in said series of pins is carried by said anchor for endwise displacement between said extended and retracted positions.

14. The surgical fastener assembly according to claim 10 wherein the second end of said anchor is configured to releasably accommodate a driving tool capable of imparting turning movements to said anchor.

15. The surgical fastener assembly according to claim 10 wherein said mechanism comprises a manually operated driver for effecting positive displacement of said pins in each direction between extended and retracted positions.

16. The surgical fastener assembly according to claim 10 further comprising a retainer carried toward and by the second end of said anchor and positionable relative to said fastener for releasably locking said fastener against inadvertent rotation thereby preventing axial displacement of the guide in a direction away from said anchor.

17. The surgical fastener assembly according to claim 10 wherein each pin in said series of pins has an arcuate configuration between opposite ends thereof.

18. The surgical fastener assembly according to claim 10 wherein said pins are equally disposed about an elongated axis of said anchor.

19. The surgical fastener assembly according to claim 10 wherein said anchor and said guide are configured with cooperating instrumentalities for preventing rotation relative to each other.

20. A surgical fastener assembly for coupling first and second bone portions across a fracture therebetween, said fastener assembly comprising:

an elongated anchor endwise insertable within the first bone portion such that a first end region of said anchor is disposed on one side of the fracture while a second end region of the anchor is disposed on an opposite side of the fracture;

a series of pins operably associated with said first end of said anchor for movement between extended and retracted positions, wherein when said pins are in said retracted position they have no operable anchoring effect between said anchor and the first bone portion, and wherein when said pins are in said extended position they radially extend outwardly from said anchor while remaining in operable association therewith thereby securing said anchor within the first bone portion;

a mechanism for positively moving said pins in opposite directions between said extended and retracted positions, wherein said mechanism comprises a driver mounted for free rotation within a cavity defined toward the first end of said anchor, said driver having external threading for engaging serrations on each of said pins whereby each pin is endwise and positively displaced in either direction of travel upon as a function of turning movements being imported to said driver;

a guide adapted to be fixedly secured to the second bone portion, with a projection on said guide being guided by and along the second end region of said anchor;

a fastener including an enlarged head portion and an externally threaded shank portion wherein, in an operative position, the shank portion of said fastener extends into threaded engagement with said anchor while the head portion of said fastener operably engages with said guide such that rotation of said fastener draws the first and second bone portions into relationship relative to each other.

21. The surgical fastener assembly according to claim 20 wherein said driver is configured at a trailing end thereof to releasably accommodate a tool adapted to impart turning movements to said driver.

22. The surgical fastener assembly according to claim 21 wherein said fastener is configured with an elongated axial bore for allowing said tool to pass endwise therethrough into operable engagement with said driver.

23. The surgical fastener assembly according to claim 22 further comprising a retainer carried toward and by the second end of said anchor and positionable relative to said fastener for releasably locking said fastener against inadvertent rotation thereby preventing axial displacement of the guide in a direction away from said anchor, said retainer defining an axial bore allowing endwise passage of said tool endwise therethrough.

24. A surgical fastener assembly for coupling first and second bone portions across a fracture therebetween, said fastener assembly comprising:

an elongated anchor endwise insertable within the first bone portion such that a first end region of said anchor is disposed on one side of the fracture while a second end region of the anchor is disposed on an opposite side of the fracture and wherein said anchor defines a series of axially elongated channels each channel having a blind forward end and an opposite end opening to the periphery of said anchor;

a series of pins, said pins accommodated within said series of axially elongated channels for endwise sliding movement therewithin and wherein said pins are operably associated with said first end of said anchor for movement between extended and retracted positions, wherein when said pins are in said retracted position they have no operable anchoring effect between said anchor and the first bone portion, and wherein when said pins are in said extended position they radially extend outwardly from said anchor while remaining in operable association therewith thereby securing said anchor within the first bone portion;

a mechanism for positively moving said pins in opposite directions between said extended and retracted positions;

a guide adapted to be fixedly secured to the second bone portion, with a projection on said guide being guided by and along the second end region of said anchor;

a fastener including an enlarged head portion and an externally threaded shank portion wherein, in an operative position, the shank portion of said fastener extends into threaded engagement with said anchor while the head portion of said fastener operably engages with said guide such that rotation of said fastener draws the first and second bone portions into relationship relative to each other.

25. The surgical fastener according to claim 24 wherein said channels are located in equally spaced relation relative to each other and about an elongated axis of said anchor.

26. The surgical fastener assembly according to claim 24 wherein each channel has a curvilinear configuration between opposite ends thereof.

27. A surgical fastener assembly for coupling first and second bone portions across a fracture therebetween said fastener assembly comprising:

an axially elongated bone screw defining an elongated axis and having external threading for anchoring a leading end of said bone screw endwise within the first bone portion such that the leading end portion of said anchor is disposed on one side of the fracture while a trailing end portion of the bone screw is disposed on an opposite side of the fracture, said bone screw defining an elongated bore and a series of axially elongated openings disposed about said axis, each opening being configured to intersect with said bore between opposite ends thereof and one end opening to the exterior of the bone screw;

a series of elongated pins configured for endwise reception and movement within said series of openings defined by said bone screw such that a lengthwise portion of each pin passes proximate to the elongated axis of said screw and moves between a retracted position, wherein said pins offer no operable anchoring effect for said bone screw, and an extended position, wherein said pins radially extend outwardly from said screw to significantly enhance anchorage of said screw within the bone;

a manually operated mechanism for effecting positive displacement of said pins in opposite direction relative to each other;

a guide adapted to be fixedly secured to the second bone portion, with a projection on said guide being guided by and along the second end portion of said bone screw; and

a fastener including an enlarged head portion and an externally threaded shank portion, wherein the shank portion of said fastener extends into threaded engagement with the trailing end portion of said bone screw while the head portion of said fastener operably engages with said guide such that rotation of said fastener draws the first and second bone portions into relationship relative to each other.

28. The surgical fastener assembly according to claim 27 wherein said bone screw is formed from a material chosen from the class comprised of:

titanium, a titanium alloy, stainless steel, or a cobalt chromium alloy.

29. The surgical fastener assembly according to claim 27 wherein each pin in said series of pins is formed from a material chosen from the class comprised of:

titanium, a titanium alloy, stainless steel, or a cobalt chromium alloy.

30. The surgical fastener assembly according to claim 27 wherein the trailing end portion of said bone screw is configured to releasably accommodate a driving tool capable of imparting turning movements to said bone screw.

31. The surgical fastener assembly according to claim 27 wherein said mechanism comprises a manually operated driver for effecting positive displacement of said pins in each direction between extended and retracted positions.

32. The surgical fastener assembly according to claim 27 wherein said mechanism comprises a driver mounted for free rotation within said elongated bore toward the leading end portion of said bone screw, said driver having external threading for engaging serrations on each of said pins whereby each pin is endwise and positively displaced in either direction of travel upon as a function of turning movements being imparted to said driver.

33. The surgical fastener assembly according to claim 32 wherein said driver is configured at a trailing end thereof to releasably accommodate a tool adapted to impart turning movements to said driver.

34. The surgical fastener assembly according to claim 33 wherein said fastener is configured with an elongated axial bore for allowing said tool to pass endwise therethrough into operable engagement with said driver.

35. The surgical fastener assembly according to claim 33 further comprising a retainer carried toward and by the trailing end portion of said bone screw and positionable relative to said fastener for releasably locking said fastener against inadvertent rotation thereby preventing axial displacement of the guide in a direction away from said bone screw, said retainer defining an axial bore allowing endwise passage of said tool endwise therethrough.

36. The surgical fastener assembly according to claim 27 further comprising a retainer carried toward and by the trailing end portion of said bone screw and positionable relative to said fastener for releasably locking said fastener against inadvertent rotation thereby preventing axial displacement of the guide in a direction away from said bone screw.

37. The surgical fastener assembly according to claim 27 wherein each pin in said series of pins has an arcuate configuration between opposite ends thereof.

38. The surgical fastener assembly according to claim 27 wherein said pins are equally disposed about and relative to an elongated axis of said bone screw.

39. The surgical fastener assembly according to claim 27 wherein said bone screw defines a series of axially elongated channels for accommodating the pins for endwise sliding movement therewithin, each channel having a blind forward end and an opposite end opening to the periphery of said bone screw.

40. The surgical fastener assembly according to claim 39 wherein said channels are located in equally spaced relation relative to each other and about an elongated axis of said bone screw.

41. The surgical fastener assembly according to claim 39 wherein each channel has a curvilinear configuration between opposite ends thereof.

42. The surgical fastener assembly according to claim 27 wherein said bone screw and said guide are configured with cooperating instrumentalities for preventing rotation relative to each other.

43. A hip pinning system for compressively interconnecting first and second fractured bones segments, said hip pinning system comprising:

an axially elongated bone screw defining an elongated axis and having external threading extending axially therealong for anchoring a leading end portion of said bone screw endwise within the first bone segment such that the leading end portion of said bone screw is disposed on one side of the fracture while a trailing end portion of said bone screw is disposed on an opposite side of the fracture, said bone screw defining an elongated axial bore and a series of elongated arcuate openings intersecting with said bore between opposite ends thereof and having one end opening to an exterior of said bone screw;

a series of elongated and arcuate shaped pins configured for endwise reception within said series of arcuate openings defined by said bone screw such that a lengthwise portion of each pin passes through said bore and is movable between a retracted position, wherein said pins offer substantially no anchoring effect, and an extended position, wherein said pins radially extend from said bone screw to significantly enhance securement of said bone screw within said bone;

a driver arranged for turning movement in said bore of the bone screw and which is operably associated with each pin whereby turning movements of said driver positively effects endwise and substantially concomitant displacement of said pins in opposite directions within their respective openings and radially relative to said bone screw as a function of the direction of rotation of said driver;

a guide adapted to be fixedly secured to the second bone segment, with a projection on said guide being guided by and along the trailing end portion of said bone screw; and

a fastener including an enlarged head portion and an externally threaded shank portion, wherein the shank portion of said fastener extends into threaded engagement with the trailing end portion of said bone screw while the head portion of said fastener operably engages with said guide such that rotation of said fastener draws the first and second bone segments into compressive relationship relative to each other.

44. The hip pinning system according to claim 43 wherein said bone screw is configured toward the trailing end portion thereof to releasably accommodate a driving tool.

45. The hip pinning system according to claim 43 wherein the leading end portion of said bone screw is generally pointed to facilitate insertion and self-tapping of the bone screw into the substance of the first bone segment.

46. The hip pinning system according to claim 43 wherein the bore defined by said bone screw is configured with a blind cavity portion extending axially along said axis toward the leading end portion of said bone screw and an internally threaded portion arranged in axially adjacent relation relative to each other, said internally threaded portion opening to the trailing end of said bone screw.

47. The hip pinning system according to claim 46 wherein said driver is arranged for free turning movements within the blind cavity portion of the bore defined by said bone screw.

48. The hip pinning system according to claim 43 wherein said driver includes an axially elongated externally threaded member having leading and trailing ends.

49. The hip pinning system according to claim 48 wherein the trailing end portion of said axially elongated member is configured to releasably accommodate a driving tool capable of imparting turning movements to said driver.

50. The hip pinning system according to claim 49 wherein said fastener is configured with an elongated axial bore for allowing said tool to pass endwise therethrough into operable engagement with said driver.

51. The hip pinning system according to claim 50 further comprising a retainer carried toward and by the trailing end portion of said bone screw and positionable relative to said fastener for releasably locking said fastener against inadvertent rotation thereby preventing axial displacement of the guide in a direction away from said bone screw, said retainer defining an axial bore allowing endwise passage of said tool endwise therethrough.

52. The hip pinning system according to claim 43 further comprising a retainer carried toward and by the trailing end portion of said bone screw and positionable relative to said fastener for releasably locking said fastener against inadvertent rotation thereby preventing axial displacement of the guide in a direction away from said bone screw.

53. A surgical fastener for coupling first and second bone portions together across a fracture, comprising:

an anchor member, said anchor member including external threading extending along a first portion thereof and having a bore extending substantially axially therethrough between first and second ends of the anchor member wherein, when in an operative position, the first portion of the anchor member including the first end thereof is mounted in the first bone portion and a second portion of the anchor member extends away from the first bone portion into the second bone portion;

a guide adapted to be fixedly coupled to the second bone portion, wherein the guide includes a sleeve which, in the operative position, is received around the second portion of the anchor member;

a compression screw which, in the operative position, engages an abutting surface of the guide and extends into the bore to threadably engage the anchor member so that rotation of the compression screw in a first direction draws the guide toward the anchor member while rotation of the compression screw in a second direction opposite to the first direction allows movement of the guide member with respect to the anchor member;

a pin movably received within the anchor member for movement between an insertion/retraction position in which the pin is received within the anchor member and an extended position in which at least a tissue anchoring end of the pin extends from an outer surface of the anchor member; and

a pin retraction/extension mechanism extending from the anchor member to the guide for moving, in an extension mode, the tissue anchoring end of the pin away from the insertion/retraction position and, in a retraction mode for drawing the tissue anchoring end of the pin toward the insertion/retraction position.