Modular intramedullary fixation system and insertion instrumentation

• US 6,168,595 B1
• Filed: 12/20/1999
• Issued: 01/02/2001
• Est. Priority Date: 02/11/1997
• Status: Expired due to Fees

• Current Assignee: Orthomatrix, Inc.
• Original Assignee: Orthomatrix, Inc.
• Inventors: Durham, Alfred A., Daily, Robert L., Shappley, Benjamin R., Fandrich, Gregory S., Terrill-Grisoni, Lauralan
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): REIP, DAVID OWEN
• Application Number:
  US09/467,773
• Time in Patent Office: 379 Days
• Field of Search: 606/62, 606/63, 606/64, 606/67, 606/68, 606/96, 606/98
• US Class Current: 606/64
• CPC Class Codes: A61B 17/1707 using electromagnetic effects, e.g. with magnet and external sensors
• CPC Class Codes: A61B 17/1721 for applying pins along or parallel to the axis of the femoral neck
• CPC Class Codes: A61B 17/1725 for applying transverse screws or pins through intramedullary nails or pins
• CPC Class Codes: A61B 17/744 the longitudinal elements coupled to an intramedullary nail

Abstract

An intramedullary nail for use in combination with a proximal bone screw. The nail includes an elongated body having a proximal end and a distal end with a central axis extending between the proximal end and the distal end. The proximal end of the body has a transverse slot therethrough, the transverse slot therethrough with contour for allowing the proximal bone screw to be inserted through the transverse slot and through the proximal end of the body with the longitudinal axis of the proximal bone screw located at an angle to the central axis of the body of the nail within a range between an acute angle on either side of a plane extending transverse to the central axis of the body of the nail.

Claims

1. A modular intramedullary fixation system comprising:

(a) an intramedullary nail including an elongated body having a proximal end and a distal end;

the proximal end of the body of the intramedullary nail having a transverse aperture therethrough;

the body of the intramedullary nail having a central axis extending between the proximal and distal ends thereof, the proximal end of the body of the intramedullary nail having a cavity extending along the central axis thereof toward the distal end thereof and having a protuberance within the cavity thereof at a location adjacent the transverse aperture, and

(b) an intramedullary nail insert for insertion into the cavity of the proximal end of the body of the intramedullary nail, the intramedullary nail insert including an elongated body having a proximal end and a distal end;

the body of the intramedullary nail insert having a transverse aperture therethrough for alignment with the transverse aperture through the proximal end of the body of the intramedullary nail when the intramedullary nail insert is inserted in to the cavity of the proximal end of the body of the intramedullary nail with the distal end of the body of the intramedullary nail insert engaging the protuberance within the cavity of the proximal end of the body of the intramedullary nail so that force is transferred between the intramedullary nail insert and intramedullary nail.

2. The modular intramedullary fixation system of claim 1 in which the body of the intramedullary nail insert has a second transverse aperture therethrough for alignment with the transverse aperture through the proximal end of the body of the intramedullary nail when the intramedullary nail insert is inserted into the cavity of the proximal end of the body of the intramedullary nail;

each of the transverse apertures through the intramedullary nail insert having a central axis.

3. The modular intramedullary fixation system of claim 1 in which is included means for insuring alignment of the transverse aperture through the body of the intramedullary nail insert with the transverse aperture through the proximal end of the body of the intramedullary nail when the intramedullary nail insert is inserted into the cavity of the proximal end of the body of the intramedullary nail.

4. The modular intramedullary fixation system of claim 1 in which the cavity of the proximal end of the body of the intramedullary nail has contour with a non-circular cross section;

and in which the body of the intramedullary nail insert has a contour with a non-circular cross section that substantially corresponds to the shape of the contour of the cavity of the proximal end of the body of the intramedullary nail to insure alignment of the transverse aperture through the body of the intramedullary nail insert with the transverse aperture through the proximal end of the body of the intramedullary nail when the intramedullary nail insert is inserted into the cavity of the proximal end of the body of the intramedullary nail.

5. A modular intramedullary fixation system comprising:

(a) an intramedullary nail including an elongated body having a proximal end and a distal end;

the proximal end of the body of the intramedullary nail having a transverse aperture therethrough;

the body of the intramedullary nail having a central axis extending between the proximal and distal ends thereof;

the proximal end of the body of the intramedullary nail having a cavity extending along the central axis thereof toward the distal end thereof; and

(a) an intramedullary nail insert for insertion into the cavity of the proximal end of the body of the intramedullary nail, the intramedullary nail insert including an elongated body having a proximal end and distal end, the body of the intramedullary nail insert having a transverse aperture therethrough for alignment with the transverse aperture through the proximal end of the body of the intramedullary nail when the intramedullary nail insert is inserted into the cavity of the proximal end of the body of the intramedullary nail, the body of the intramedullary nail insert having a second transverse aperture therethrough for alignment with the transverse aperture through the proximal end of the body of the intramedullary nail when the intramedullary nail insert is inserted in to the cavity of the proximal end of the body of the intramedullary nail, each of the transverse apertures through the intramedullary nail insert having a central axis;

the central axes of each of the transverse apertures through the intramedullary nail insert are parallel to one another and perpendicular to the central axis of the body of the intramedullary nail insert.

6. A modular intramedullary fixation system comprising:

(a) an intramedullary nail including an elongated body having a proximal end and a distal end;

the proximal end of the body of the intramedullary nail having a transverse aperture therethrough;

the body of the intramedullary nail having a central axis extending between the proximal and distal ends thereof, the proximal end of the body of the intramedullary nail having a cavity extending along the central axis thereof toward the distal end thereof; and

(b) an intramedullary nail insert for insertion into the cavity of the proximal end of the body of the intramedullary nail the intramedullary nail insert including an elongated body having a proximal end and a distal end;

the body of the intramedullary nail insert having a transverse aperture therethrough for alignment with the transverse aperture through the proximal end of the body of the intramedullary nail when the intramedullary nail insert is inserted into the cavity of the proximal end of the body of the intramedullary nail;

the body of the intramedullary nail insert having a second transverse aperture therethrough for alignment with the transverse aperture through the proximal end of the body of the intramedullary nail when the intramedullary nail insert is inserted in to the cavity of the proximal end of the body of the intramedullary nail;

each of the transverse apertures through the intramedullary nail insert having a central axis;

the central axes of each of the transverse apertures through the intramedullary nail insert are parallel to one another and angled relative to the central axis of the body of the intramedullary nail.

7. A modular intramedullary fixation system comprising:

(a) an intramedullary nail including an elongated body having a proximal end and a distal end, the proximal end of the body of the intramedullary nail having a transverse aperture therethrough;

the body of the intramedullary nail having a central axis extending between the proximal and distal ends thereof;

the proximal end of the body of the intramedullary nail having a cavity extending along the central axis thereof toward the distal end thereof;

the transverse aperture through the proximal end of the body of the intramedullary nail having contour with an S-shape cross section; and

(b) an intramedullary nail insert for insertion into the cavity of the proximal end of the body of the intramedullary nail, the intramedullary nail insert including an elongated body having a proximal end and a distal end;

the body of the intramedullary nail insert having a transverse aperture therethrough for alignment with the transverse aperture through the proximal end of the body of the intramedullary nail when the intramedullary nail insert in inserted into the cavity of the proximal end of the body of the intramedullary nail.

8. A modular intramedullary fixation system comprising:

(a) an intramedullary nail including an elongated body having a proximal end and a distal end;

the proximal end of the body of the intramedullary nail having a transverse aperture therethrough;

the body of the intramedullary nail having a central axis extending between the proximal and distal ends thereof;

the proximal end of the body of the intramedullary nail having a cavity extending along the central axis thereof toward the distal ends thereof, the cavity of the proximal end of the body of the intramedullary nail having a contour with a non-circular cross section; and

(b) an intramedullary nail insert for insertion into the cavity of the proximal end of the body of the intramedullary nail, the intramedullary nail insert including an elongated body having a proximal end and a distal end;

the body of the intramedullary nail insert having a transverse aperture therethrough for alignment with the transverse aperture through the proximal end of the body of the intramedullary nail when the intramedullary nail insert is inserted into the cavity of the proximal end of the body of the intramedullary nail;

the body of the intramedullary nail insert having a contour with a non-circular cross section that substantially corresponds to the shape of the contour of the cavity of the proximal end of the body of the intramedullary nail to insure alignment of the transverse aperture through the body of the intramedullary nail insert with the transverse aperture through the proximal end of the body of the intramedullary nail when the intramedullary nail insert is inserted into the cavity of the proximal end of the body of the intramedullary nail.

9. The modular intramedullary fixation system of claim 8 in which the intramedullary nail cap has a flush top for positioning flush with the proximal end of the intramedullary nail when fixing the intramedullary nail insert within the cavity of the proximal end of the body of the intramedullary nail.

10. The modular intramedullary fixation system of claim 8 in which the intramedullary nail cap has an extended top for extending above the proximal end of the intramedullary nail when fixing the intramedullary nail insert within the cavity of the proximal end of the body of the intramedullary nail.

11. A modular intramedullary fixation system comprising:

(a) an intramedullary nail including an elongated body having a proximal end and a distal end;

the proximal end of the body of the intramedullary nail having a transverse aperture therethrough;

the body of the intramedullary nail having a central axis extending between the proximal and distal ends thereof, the proximal end of the body of the intramedullary nail having a cavity extending along the central axis thereof toward the distal end thereof, and

(b) an intramedullary nail insert for insertion into the cavity of the proximal end of the body of the intramedullary nail, the intramedullary nail insert including an elongated body having a proximal end and a distal end;

the body of the intramedullary nail insert having a transverse aperture therethrough for alignment with the transverse aperture through the proximal end of the body of the intramedullary nail when the intramedullary nail insert is inserted into the cavity of the proximal end of the body of the intramedullary nail;

the intramedullary nail insert having a deformable portion for allowing active dynamic intramedullary fixation.

12. In combination, a modular intramedullary fixation system and a magnetic positioner instrumentation including a target magnet;

the modular intramedullary fixation system comprising;

(a) an intramedullary nail including an elongated body having a proximal end and a distal end;

the body of the intramedullary nail having a transverse aperture through the proximal end thereof and a transverse aperture through the distal end thereof;

the body of the intramedullary nail having a central axis extending between the proximal and distal ends thereof and having a cavity extending the entire length thereof along the central axis thereof for allowing the target magnet of the magnetic positioner instrumentation to be positioned within the cavity of the body of the intramedullary nail adjacent the transverse aperture through the distal end thereof and having a protuberance within the cavity thereof at a location adjacent the transverse aperture;

(b) an intramedullary nail insert for insertion into the cavity of the body of the intramedullary nail, the intramedullary nail insert including an elongated body having a proximal end and a distal end;

the body of the intramedullary nail insert having a transverse aperture therethrough for alignment with the transverse aperture through the proximal end of the body of the intramedullary nail when intramedullary nail insert is inserted into the cavity of the proximal end of the body of the intramedullary nail with the distal end of the body of the intramedullary nail insert engaging the protuberance within the cavity of the proximal end of the body of the intramedullary nail so that force is transferred between the intramedullary nail insert and the intramedullary nail; and

(c) an intramedullary nail cap for fixing the intramedullary nail insert within the cavity of the proximal end of the body of the intramedullary nail.

13. Insertion handle instrumentation for use with an intramedullary nail including an elongated body having a longitudinal axis having a proximal end with an aperture therein and having an exterior surface, and with proximal locking screws for locking the intramedullary nail to bone, the insertion handle instrumentation comprising:

(a) a body having a first end and a second end, and having an aperture through the first end thereof;

(b) attachment means for gripping the exterior surface of the proximal end of the intramedullary nail to attach the intramedullary nail to the body with the aperture through the body coincident with the aperture in the proximal end of the intramedullary nail for allowing access into the aperture in the proximal end of the intramedullary nail through the aperture in the body;

the attachment means being moveable between a first position for attaching the intramedullary nail to the first end of the body and a second position for releasing the intramedullary nail from the body;

the attachment means having an axis for alignment with the longitudinal axis of the elongated body of the intramedullary nail when attaching the intramedullary nail to the first end of the body; and

(c) control means for moving the attachment means between the first and second positions, the control means having a control member located remote from the first end of the body and offset from the axis of the attachment means for allowing the surgeon to move the attachment means to the second position and thereby release the intramedullary nail from a location remote from the first end of the body offset from the axis of the attachment means, and offset from the longitudinal axis of the elongated body of the intramedullary nail.

14. In combination, an intramedullary nail having a hollow posterior end with a threaded portion, an insert for being inserted into the hollow posterior end of the intramedullary nail, a cap with a threaded portion for being screwed into the threaded portion of the hollow posterior end of the intramedullary nail, and insertion instrumentation for inserting the insert and the cap into the hollow posterior end of the intramedullary nail, the insertion instrumentation comprising:

(a) an inner shaft having a first end for being attached to the insert so that rotation of the inner shaft will cause the insert to rotate, and having a second end; and

(b) an outer shaft having a first end for being attached to the cap so that rotation of the outer shaft will cause the cap to rotate, having a second end, and having an aperture extending completely therethrough for allowing the inner shaft to extend therethrough so that the inner shaft can rotate within the aperture in the outer shaft independently of the rotation of the outer shaft.