Guide assembly for intramedullary fixation and method of using the same

• US 7,588,577 B2
• Filed: 07/15/2004
• Issued: 09/15/2009
• Est. Priority Date: 07/15/2004
• Status: Active Grant

• Current Assignee: Wright Medical Technology Incorporated (Stryker Corporation)
• Original Assignee: Wright Medical Technology Incorporated (Stryker Corporation)
• Inventors: Warburton, Mark J., Tan, Virak, Smith, Aaron C., Capo, John T., Fencl, Robert M.
• Primary Examiner(s): Barrett; Thomas C
• Assistant Examiner(s): Yang; Andrew
• Application Number:
  US10/891,738
• Publication Number:
  US 20060015123A1
• Time in Patent Office: 1,888 Days
• Field of Search: 606/62, 606/64, 606/86, 606 96- 99, 606/63, 606 65- 68, 403/13, 403/14
• US Class Current: 606/96
• 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 17/1622 Drill handpieces A61B17/1626, A61B17/1628 take precedence
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/1725 for applying transverse screws or pins through intramedullary nails or pins
• CPC Class Codes: A61B 17/1735 for rasps or chisels
• CPC Class Codes: A61B 17/72 Intramedullary pins, nails or other devices A61B17/744 takes precedence
• CPC Class Codes: A61B 17/7266 with fingers moving radially outwardly
• CPC Class Codes: A61B 17/7283 with special cross-section of the nail
• CPC Class Codes: A61B 17/848 Kirschner wires, i.e. thin, long nails
• CPC Class Codes: A61B 17/8605 Heads, i.e. proximal ends projecting from bone
• CPC Class Codes: A61B 17/863 with thread interrupted or changing its form along shank, other than constant taper
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 17/921 for intramedullary devices
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable
• CPC Class Codes: A61B 2090/034 abutting on parts of the device itself
• CPC Class Codes: A61B 2090/062 penetration depth

Abstract

An intramedullary fixation assembly usable with different long bone types and a guide assembly for guiding deployment of the intramedullary fixation assembly. The intramedullary fixation assembly includes a fixation member that has ends and a curved body extending between the ends. The curved body of the fixation member has a radius of curvature configured to extend through the medullary canal regardless of the long bone anatomy. Fasteners fix the fixation member to the bone fragments and are guided by a guide assembly. The guide assembly includes a guide body defining openings configured to guide the fasteners through openings defined in the fixation member and into the bone fragments. A fixation end of the guide body includes a pair of opposing, converging surfaces that are configured to engage in a positive fit with an exposed end of the fixation member accessible through the side aperture in the first fragment.

Claims

1. A method of repairing a fractured long bone, wherein the long bone includes a medullary canal, said method comprising:

defining a side aperture in the long bone subjacent cartilage and near an end of the long bone, said side aperture extending into the medullary canal of the long bone;

attaching a guide attachment member of a guide frame to an end of a fixation member, including;

mating a pair of opposite, generally converging surfaces defined on the guide attachment member with opposite, generally converging surfaces defined on the end of the fixation member; and

extending a guide attachment fastener through the guide frame and securing the guide attachment fastener to the fixation member so as to draw the converging surfaces of the guide attachment member and the end of the fixation member together into a positive fit;

inserting the fixation member through the side aperture until the fixation member is positioned in the medullary canal and side aperture with the guide frame attached thereto; and

advancing bone fasteners through guide openings defined in the guide frame, the long bone and into openings defined in the fixation member so as to secure fragments of the long bone together, wherein advancing comprises advancing a bone fastener through a guide opening defined in the guide attachment fastener.

2. A method of claim 1, further comprising extending a screw guide into one of the guide openings defined in the guide frame and wherein advancing bone fasteners includes advancing the fasteners through an opening defined in the screw guide.

3. A method of claim 1, wherein advancing the bone fasteners includes advancing one of the bone fasteners at an angle into a position subjacent an articular surface of the long bone.

4. A method of claim 1, further comprising attaching a targeting guide to the guide frame with a positive fit, said targeting guide defining at least one guide opening, and advancing one of the bone fasteners through the guide opening, the long bone and into the one of the openings defined in the fixation member.

5. A method of claim 4, further comprising extending a temporary fastener through a temporary fastener opening defined in the targeting guide so as to temporarily secure the guide frame prior to advancing the bone fasteners.

6. A method of claim 4, wherein attaching the targeting guide comprises slidably engaging the targeting guide with the guide frame.

7. A method of claim 1, further comprising inserting a broach having a size and shape similar to the fixation member through the side aperture and into the medullary canal prior to inserting the fixation member.

8. A method of claim 1, wherein advancing bone fasteners include advancing all of the bone fasteners for the procedure with the guide frame.

9. The method of claim 1, further comprising attaching a handle to the guide attachment member prior to inserting the fixation member through the side aperture.

10. The method of claim 9, further comprising detaching the handle from the guide attachment member after inserting the fixation member in the medullary canal and side aperture.

11. A method of claim 1, wherein extending a guide attachment fastener comprises threading the guide attachment fastener into a threaded opening defined in the exposed end of the fixation member.

12. A method of repairing a fractured long bone, wherein the long bone includes a medullary canal, said method comprising:

defining a side aperture in the long bone subjacent cartilage and near an end of the long bone, said side aperture extending into the medullary canal of the long bone;

providing a fixation member sized for insertion into the medullary canal of the long bone, the fixation member defining at least one opening sized for passage of bone fasteners into the fixation member;

providing a guide assembly comprising a guide frame having a first end and a second end, the guide frame defining at least one fastener guide opening therethrough proximal to the first end;

a guide attachment member extending from the guide frame proximal to the first end thereof and defining an opening therethrough, wherein the guide attachment member is configured for forming a positive fit between the guide attachment member and a mating surface of the fixation member, wherein the guide attachment member defines one or more prongs adapted for forming a positive fit with the mating surface of the fixation member;

attaching the guide attachment member to the fixation member such that the guide attachment member achieves a positive fit with the fixation member;

inserting a guide attachment fastener through the opening of the guide attachment member and securing the guide attachment fastener to the fixation member;

inserting the fixation member through the side aperture until the fixation member is positioned in the medullary canal with the guide assembly attached thereto; and

advancing a bone fastener through each of said at least one fastener guide openings defined in the guide frame, through the long bone, and into said at least one opening defined in the fixation member, wherein advancing comprising advancing a bone fastener through a guide opening defined in the guide attachment fastener.

13. The method of claim 12, further comprising attaching a targeting guide to the guide frame proximal to the second end of the guide frame, said targeting guide defining at least one fastener guide opening, and advancing a bone fastener through each of said fastener guide openings, through the long bone, and into an opening defined in the fixation member.

14. A method of claim 13, further comprising extending a temporary fastener through a temporary fastener opening defined in the targeting guide so as to temporarily secure the guide frame prior to advancing the bone fastener.

15. A method of claim 13, wherein attaching the targeting guide comprises slidably engaging the targeting guide with the guide frame.

16. A method of claim 12, further comprising extending a screw guide into each of the at least one fastener guide openings defined in the guide frame, wherein advancing a bone fastener includes advancing the bone fastener through an opening defined in the screw guide.

17. A method of claim 12, wherein advancing the bone fastener includes advancing the bone fastener at an angle into a position subjacent an articular surface of the long bone.

18. A method of claim 12, further comprising inserting a broach having a size and shape similar to the fixation member through the side aperture and into the medullary canal prior to inserting the fixation member.

19. A method of claim 12, wherein advancing a bone fastener includes advancing all of the bone fasteners for the procedure with the guide frame.

20. A method of claim 12, wherein extending a guide attachment fastener comprises threading the guide attachment fastener into a threaded opening defined in the exposed end of the fixation member.

21. A method of claim 12, further comprising attaching a handle to the guide attachment member prior to inserting the fixation member through the side aperture.

22. A method of claim 21, further comprising detaching the handle from the guide attachment member after inserting the fixation member in the medullary canal and side aperture.

23. A method of repairing a fractured long bone, wherein the long bone includes a medullary canal, said method comprising:

defining a side aperture in the long bone subjacent cartilage and near an end of the long bone, said side aperture extending into the medullary canal of the long bone;

providing a fixation member sized for insertion into the medullary canal of the long bone, the fixation member defining at least one opening sized for passage of bone fasteners into the fixation member;

providing a guide assembly comprising a guide frame having a first end and a second end, the guide frame defining at least one fastener guide opening therethrough proximal to the first end;

a guide attachment member extending from the guide frame proximal to the first end thereof and defining an opening therethrough, wherein the guide attachment member is configured for forming a positive fit between the guide attachment member and a mating surface of the fixation member, wherein the guide attachment member defines a plurality of prongs or indentations adapted for forming a positive fit with the mating surface of the fixation member, wherein the plurality of prongs or indentations are spaced around the circumference of the opening in the guide attachment member;

attaching the guide attachment member to the fixation member such that the guide attachment member achieves a positive fit with the fixation member;

inserting a guide attachment fastener through the opening of the guide attachment member and securing the guide attachment fastener to the fixation member;

inserting the fixation member through the side aperture until the fixation member is positioned in the medullary canal with the guide assembly attached thereto; and

advancing a bone fastener through each of said at least one fastener guide openings defined in the guide frame, through the long bone, and into said at least one opening defined in the fixation member, wherein advancing comprises advancing a bone fastener through a guide opening defined in the guide attachment fastener.

24. The method of claim 23, further comprising attaching a targeting guide to the guide frame proximal to the second end of the guide frame, said targeting guide defining at least one fastener guide opening, and advancing a bone fastener through each of said fastener guide openings, through the long bone, and into an opening defined in the fixation member.

25. A method of claim 24, further comprising extending a temporary fastener through a temporary fastener opening defined in the targeting guide so as to temporarily secure the guide frame prior to advancing the bone fastener.

26. A method of claim 24, wherein attaching the targeting guide comprises slidably engaging the targeting guide with the guide frame.

27. A method of claim 23, further comprising extending a screw guide into each of the at least one fastener guide openings defined in the guide frame, wherein advancing a bone fastener includes advancing the bone fastener through an opening defined in the screw guide.

28. A method of claim 23, wherein advancing the bone fastener includes advancing the bone fastener at an angle into a position subjacent an articular surface of the long bone.

29. A method of claim 23, further comprising inserting a broach having a size and shape similar to the fixation member through the side aperture and into the medullary canal prior to inserting the fixation member.

30. A method of claim 23, wherein advancing the bone fastener includes advancing all of the bone fasteners for the procedure with the guide frame.

31. A method of claim 23, wherein extending a guide attachment fastener comprises threading the guide attachment fastener into a threaded opening defined in the exposed end of the fixation member.

32. A method of claim 23, further comprising attaching a handle to the guide attachment member prior to inserting the fixation member through the side aperture.

33. A method of claim 32, further comprising detaching the handle from the guide attachment member after inserting the fixation member in the medullary canal and side aperture.

34. A method of repairing a fractured long bone, wherein the long bone includes a medullary canal, said method comprising:

defining a side aperture in the long bone subjacent cartilage and near an end of the long bone, said side aperture extending into the medullary canal of the long bone;

providing a fixation member sized for insertion into the medullary canal of the long bone, the fixation member defining at least one opening sized for passage of bone fasteners into the fixation member;

providing a guide assembly comprising a guide frame having a first end and a second end, the guide frame defining at least one fastener guide opening therethrough proximal to the first end;

a guide attachment member extending from the guide frame proximal to the first end thereof and defining an opening therethrough, wherein the guide attachment member is configured for forming a positive fit between the guide attachment member and a mating surface of the fixation member, wherein the guide attachment member defines a plurality of prongs or indentations adapted for forming a positive fit with the mating surface of the fixation member, wherein the plurality of prongs or indentations are spaced around the circumference of the opening in the guide attachment member;

attaching the guide attachment member to the fixation member such that the guide attachment member achieves a positive fit with the fixation member;

inserting a guide attachment fastener through the opening of the guide attachment member and securing the guide attachment fastener to the fixation member;

attaching a handle to the guide attachment member prior to insertion of the fixation member;

inserting the fixation member through the side aperture until the fixation member is positioned in the medullary canal with the guide assembly attached thereto;

detaching the handle from the guide attachment member after inserting the fixation member in the medullary canal and side aperture; and

advancing a bone fastener through each of said at least one fastener guide openings defined in the guide frame, through the long bone, and into said at least one opening defined in the fixation member.

35. A method of claim 34, further comprising extending a screw guide into each of the at least one fastener guide openings defined in the guide frame, wherein advancing a bone fastener includes advancing the bone fastener through an opening defined in the screw guide.

36. A method of claim 34, wherein advancing the bone fastener includes advancing the bone fastener at an angle into a position subjacent an articular surface of the long bone.

37. A method of claim 34, further comprising attaching a targeting guide to the guide frame proximal to the second end of the guide frame, said targeting guide defining at least one fastener guide opening, and advancing a bone fastener through each of said fastener guide openings, through the long bone, and into an opening defined in the fixation member.

38. A method of claim 37, further comprising extending a temporary fastener through a temporary fastener opening defined in the targeting guide so as to temporarily secure the guide frame prior to advancing the bone fasteners.

39. A method of claim 37, wherein attaching the targeting guide comprises slidably engaging the targeting guide with the guide frame.

40. A method of claim 34, further comprising inserting a broach having a size and shape similar to the fixation member through the side aperture and into the medullary canal prior to inserting the fixation member.

41. A method of claim 34, wherein advancing the bone fastener includes advancing all of the bone fasteners for the procedure with the guide frame.

42. A method of claim 34, wherein extending a guide attachment fastener comprises threading the guide attachment fastener into a threaded opening defined in the exposed end of the fixation member.