Volar fixation system

• US 6,358,250 B1
• Filed: 02/01/2000
• Issued: 03/19/2002
• Est. Priority Date: 02/01/2000
• Status: Expired due to Term

• Current Assignee: Biomet Incorporated (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Hand Innovations Inc (Johnson & Johnson)
• Inventors: Orbay, Jorge L.
• Primary Examiner(s): Mancene, Gene
• Assistant Examiner(s): Priddy, Michael B.
• Application Number:
  US09/495,854
• Time in Patent Office: 777 Days
• Field of Search: 606/60, 606/69, 606/70, 606/71, 623/21.12
• US Class Current: 606/86.00B
• CPC Class Codes: A61B 17/1728 for holes for bone plates or plate screws
• CPC Class Codes: A61B 17/1782 for the hand or wrist
• 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 17/7208 Flexible pins, e.g. ENDER pins
• CPC Class Codes: A61B 17/80 Cortical plates , i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
• CPC Class Codes: A61B 17/8033 having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
• CPC Class Codes: A61B 17/8052 immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
• CPC Class Codes: A61B 17/8061 specially adapted for particular bones A61B17/70 and A61B17/74 take precedence
• CPC Class Codes: A61B 17/84 Fasteners therefor or fasteners being internal fixation devices
• CPC Class Codes: A61B 17/863 with thread interrupted or changing its form along shank, other than constant taper
• CPC Class Codes: Y10S 606/902 Cortical plate specifically adapted for a particular bone

Abstract

A volar fixation system includes a T-shaped plate intended to be positioned against the volar side of the radial bone, a plurality of bone screws for securing the plate along an non-fractured portion of the radial bone, and a plurality of bone pegs which extend from the plate and into bone fragments of a Colles'"'"' fracture. The plate is a T-shaped plate including a plurality of screw holes and a plurality of threaded peg holes. According to a first preferred aspect of the invention, the peg holes are preferably non-linearly arranged and provided such that the holes are positioned increasingly distal in a medial to lateral direction along the second side. According to a second preferred aspect, axes through the holes are oblique relative to each other and preferably angled relative to each other in two dimensions. The system includes a guide plate which temporarily sits on top of the volar plate and includes holes oriented according to the axes of the peg holes for guiding a drill into the bone fragments at the required orientation. The volar plate is positioned against the radius and screws are inserted through the screw holes to secure the volar plate to the radius. The bone fragments are aligned, and the guide plate assists in drilling pilot hole. The pegs are inserted through the peg holes and into the drilled holes in the bone. The volar fixation system thereby secures the bone fragments in their proper orientation.

Claims

1. A volar fixation plate, comprising:

a substantially rigid plate including a distal head portion and a proximal body portion angled relative to said head portion,

said head portion defining a plurality of threaded peg holes adapted to individually receive fixation pegs therein, said peg holes defining a plurality of axes at least two of which are oblique relative to each other, and

said body portion including at least one screw hole.

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

each of said at least two axes is oblique in two dimensions relative to another of-said at least two axes.

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

said head portion defines a medial side and a lateral side, and said peg holes are arranged in a generally medial to lateral direction wherein successive lateral peg holes are situated distally relative to adjacent peg holes.

4. A volar fixation plate according to claim 1, wherein:

said head portion includes exactly four peg holes.

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

said head portion including a lower surface, and a first of said plurality of peg holes defines a first axis of said plurality of axes directed normal to said lower surface,

a second of said plurality of peg holes defines a second axis of said plurality of axes angled approximately 5°

distal and 7.5°

lateral relative to the first axis,

a third of said plurality of peg holes defines a third axis of said plurality of axes angled approximately 10°

distal and 15°

lateral relative to the first axis, and

a fourth of said plurality of peg holes defines a fourth axis of said plurality of axes angled approximately 20°

distal and 20°

lateral relative to the first axis.

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

said first peg hole is most medial, said second peg hole is laterally adjacent said first peg hole, said third peg hole is laterally adjacent said second peg hole, and said fourth peg hole is laterally adjacent said third peg hole.

7. A volar fixation plate according to claim 1, wherein:

said head portion is angled approximately 18°

relative to said body portion.

8. A volar fixation plate according to claim 1, wherein:

said head portion and said body portion are provided in a substantially T-shaped configuration relative to each other, with said body portion intersecting said head portion.

9. A volar fixation plate according to claim 1, wherein:

said volar plate is made from a titanium alloy.

10. A method of aligning and stabilizing a Colles'"'"' fracture of the radius bone at the wrist, the radius bone having a volar side and a dorsal side, and the fracture including at least one bone fragment, said method comprising:

a) providing a rigid substantially T-shaped plate having a head portion and a body portion intersecting said head portion, said head portion including a plurality of threaded peg holes defining a plurality of axes, at least two of said plurality of axes being oblique in two dimensions relative to another of said at least two axes, and said body portion including a plurality of screw holes;

b) positioning said plate against the volar side of the radius bone;

c) inserting at least one bone screw through at least one of said plurality of screw holes to secure said volar plate to the radius;

d) aligning said at least one bone fragment with the radius;

e) drilling holes through said plurality of peg holes into said at least one fragment;

f) providing a plurality of pegs having an externally threaded head and an elongate shaft; and

g) inserting said pegs through said peg holes and into the drilled holes and threadably securing said threaded heads in said peg holes.

11. A method according to claim 10, wherein:

each of said at least two axes is oblique in two dimensions relative to another of said at least two axes.

12. A method according to claim 10, further comprising:

h) prior to drilling holes, providing and positioning a guide plate on said volar plate, said guide plate having guide holes which when aligned with said peg holes on said volar plate define a guide path for drilling.

13. A method according to claim 12, further comprising:

i) after drilling holes, removing said guide plate.