Flexible plate fixation of bone fractures

• US 8,992,583 B2
• Filed: 07/20/2012
• Issued: 03/31/2015
• Est. Priority Date: 06/23/2010
• Status: Active Grant

• Current Assignee: Zimmer Incorporated (Zimmer Biomet Holdings, Inc.)
• Original Assignee: Zimmer Incorporated (Zimmer Biomet Holdings, Inc.)
• Inventors: Bottlang, Michael, Madey, Steven M.
• Primary Examiner(s): Yang, Andrew
• Assistant Examiner(s): Chang, Olivia C
• Application Number:
  US13/554,119
• Publication Number:
  US 20130006310A1
• Time in Patent Office: 984 Days
• Field of Search: 606/289, 606/291
• US Class Current: 606/289
• CPC Class Codes: A61B 17/8004 with means for distracting or compressing the bone or bones
• CPC Class Codes: A61B 17/8038 the additional component being inserted in the screw head
• CPC Class Codes: A61B 17/8047 wherein the additional element surrounds the screw head in the plate hole A61B17/8052 takes precedence
• CPC Class Codes: A61B 17/8085 with pliable or malleable elements or having a mesh-like structure, e.g. small strips A61B17/8071, A61B17/8076 take precedence
• CPC Class Codes: A61B 17/863 with thread interrupted or changing its form along shank, other than constant taper
• CPC Class Codes: A61B 2560/00 Constructional details of operational features of apparatus; Accessories for medical measuring apparatus

Abstract

Embodiments provide methods, apparatuses, and systems for fixation of a fractured bone. In various embodiments, the systems and plates may provide elastic suspension of the receiving holes relative to the osteosynthesis plate. This elastic suspension may promote load distribution between the screws that connect a bone segment to the plate, thereby reducing stress risers and load shielding effect. In addition, stress at the screw holes, and within the construct as a whole, is reduced by incorporation of these elastic elements in the plate. Additionally, in some embodiments, for instance if fracture healing by callus formation is desired, elastic suspension of the receiving holes relative to the osteosynthesis plate may enable small, controlled amounts of relative motion between bone fragments connected by the plate, which may promote fracture healing by callus formation.

Claims

1. A method for flexible plate fixation of a bone fracture, the method comprising:

approximately aligning two or more fractured bone members;

applying a bone plate across the fracture with a plurality of fixation elements that rigidly connect to receiving holes in the plate, each of the receiving holes including at least one surface projection for engagement with the fixation elements, wherein the bone plate comprises a plurality of flexible elements connecting the receiving holes to the plate, each of the flexible elements formed by one or more slots extending through the plate and at least partially surrounding a periphery of one of the receiving holes; and

rigidly fixing the fixation elements to the receiving holes in the plate;

wherein the flexible elements are configured to permit axial translation relative to the receiving holes within a plane parallel to an upper or lower plane of the bone plate, after the fixation elements have been rigidly fixed to the receiving holes in the plate; and

wherein the flexible elements are configured to substantially prevent translation of the bone plate relative to the receiving holes in a direction substantially perpendicular to the upper or lower plane of the bone plate.

2. The method of claim 1, wherein the method permits principally longitudinal axial motion across a bone fracture.

3. A method of claim 1, wherein the method allows selective angulation of screws through angulation of the receiving hole with respect to the plate.

4. The method of claim 1, wherein the method permits substantially symmetric motion of the fracture gap.

5. The method of claim 1, wherein the method further comprises forming a plate resulting in principally longitudinal axial motion in a stiffness range of b 200-1200 N/mm.

6. The method of claim 1, wherein the flexible elements are formed integral to the bone plate.

7. The method of claim 1, wherein the flexible elements provide an elastic interface between the receiving holes and the bone plate.

8. The method of claim 1, wherein the surface projection is a thread.

9. The method of claim 1, wherein the one or more slots extend from an outer surface of the bone plate to a bone-facing surface of the bone plate.

10. The method of claim 9, wherein the one or more slots do not penetrate through a longitudinal edge of the bone plate.

11. A method of reducing stress concentrations at a screw-bone interface comprising:

aligning two or more fractured bone members; and

applying a bone plate across the fracture with a plurality of screws;

thereby reducing stress concentrations at the screw-bone interface, wherein the bone plate comprises;

an outer surface and a bone-facing surface;

a plurality of fixation elements that connect to one or more receiving holes in the bone plate, each of the one or more receiving holes including at least one thread; and

one or more slots at least partially circumscribing a periphery of one or more receiving holes and not penetrating through a longitudinal edge of the bone plate, wherein the one or more slots form a spring element, the spring element at least partially surrounding the receiving hole and permitting axial translation of the bone plate relative to the one or more receiving holes within a plane that is substantially parallel to an upper or lower surface of the bone plate, but substantially preventing motion of the bone plate relative to the one or more receiving holes in a direction that is substantially perpendicular to the upper or lower surface of the bone plate after the fixation elements have been rigidly fixed to the receiving holes in the plate.

12. A method of reducing stresses during loading by allowing principally longitudinal motion to increase duration of load attenuation, the method comprising:

aligning two or more fractured bone members defining a fracture; and

applying a bone plate across the fracture with a plurality of screws, thereby reducing stress concentrations at a screw-bone interface, wherein the bone plate comprises;

an outer surface and a bone-facing surface;

a plurality of fixation elements that connect to one or more receiving holes in the bone plate, each of the one or more receiving holes including at least one thread; and

one or more slots extending through the plate from the outer surface to the bone-facing surface, the one or more slots at least partially circumscribing a periphery of one or more receiving holes and not penetrating through a longitudinal edge of the bone plate, wherein the one or more slots form a spring element, the spring element at least partially surrounding the receiving hole and permitting axial translation of the bone plate relative to the one or more receiving holes within a plane that is substantially parallel to an upper or lower surface of the bone plate, but substantially preventing motion of the bone plate relative to the one or more receiving holes in a direction that is substantially perpendicular to the upper or lower surface of the bone plate after the fixation elements have been rigidly fixed to the receiving holes in the plate.