Intramedullary arthrodesis nail and method of use

• US 9,095,440 B2
• Filed: 09/17/2009
• Issued: 08/04/2015
• Est. Priority Date: 09/17/2008
• Status: Active Grant

• Current Assignee: Skeletal Dynamics LLC
• Original Assignee: Skeletal Dynamics LLC
• Inventors: Orbay, Jorge L., Norman, Thomas H., Salcedo, Juan, Litke, Ronald
• Primary Examiner(s): Robert, Eduardo C
• Assistant Examiner(s): ECKMAN, MICHELLE CHRISTINE
• Application Number:
  US12/561,805
• Publication Number:
  US 20100130978A1
• Time in Patent Office: 2,147 Days
• Field of Search: 606 62- 68, 606/60, 606281-299, 411/437
• US Class Current: 1/1
• CPC Class Codes: A61B 17/1717 for applying intramedullary nails or pins
• CPC Class Codes: A61B 17/1725 for applying transverse screws or pins through intramedullary nails or pins
• CPC Class Codes: A61B 17/1782 for the hand or wrist
• CPC Class Codes: A61B 17/72 Intramedullary pins, nails or other devices A61B17/744 takes precedence
• CPC Class Codes: A61B 17/7225 for bone compression
• CPC Class Codes: A61B 17/7241 the nail having separate elements through which screws pass
• CPC Class Codes: A61B 17/7283 with special cross-section of the nail
• CPC Class Codes: A61B 17/7291 for small bones, e.g. in the foot, ankle, hand or wrist
• CPC Class Codes: A61F 2/4261 for wrists
• CPC Class Codes: A61F 2002/30062 (bio)absorbable, biodegradable, bioerodable, (bio)resorbable, resorptive
• CPC Class Codes: A61F 2002/30331 made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2002/30481 using a locking clip
• CPC Class Codes: A61F 2002/30507 using a threaded locking member, e.g. a locking screw or a set screw
• CPC Class Codes: A61F 2002/30538 for adjusting angular orientation
• CPC Class Codes: A61F 2002/3054 about a connection axis or implantation axis for selecting any one of a plurality of radial orientations between two modular parts, e.g. Morse taper connections, at discrete positions, angular positions or continuous positions
• CPC Class Codes: A61F 2002/30622 Implant for fusing a joint or bone material
• CPC Class Codes: A61F 2002/30774 internally-threaded
• CPC Class Codes: A61F 2002/30777 Oblong apertures
• CPC Class Codes: A61F 2002/4264 for radio-carpal joints
• CPC Class Codes: A61F 2210/0004 bioabsorbable
• 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 2250/0006 : for adjusting angular orientation

Abstract

A device is provided including a distal nail portion and a proximal nail portion that can be connected to each other to attain a rigid configuration. The device is placed internally within the medullary cavities of at least two bones forming a joint to accomplish arthrodesis of the joint. The device is placed intramedullarily to minimize incision size, excessive bone resection and post-operative tendon damage and tenderness. Additionally, a method for using the device is provided that includes placing and affixing the distal nail in a bone of a joint, placing the proximal nail in another bone of a joint, connecting the distal nail to the proximal nail, doing the desired geometrical adjustments, affixing the proximal nail to the distal nail by tightening the connection and affixing the proximal nail to the other bone of the joint to attain a rigid configuration.

Claims

1. An intramedullary arthrodesis nail comprising:

a distal nail portion;

a proximal nail portion, separate from said distal nail portion;

at least one of said proximal nail portion and said distal nail portion including at least one longitudinal slot therethrough configured to receive a fastener into the slot from the top of the slot for fastening said nail portion to a bone of a joint, said fastener having a thread defining a shape and a pitch, and said at least one longitudinal slot including two opposing, grooved parallel side walls and two unthreaded end walls enclosing the slot at each end, the grooves on each of said parallel side walls having a shape and a pitch configured to match said shape and pitch of said fastener, all of said grooves being disposed parallel to each other and parallel to the longitudinal axis of the nail portion, and wherein the grooves on a first of said parallel side walls are vertically displaced one-half of said pitch relative to the grooves on the second, opposite, side wall; and

a connector portion connectable between said distal nail portion and said proximal nail portion to fix the distal nail portion to the proximal nail portion.

2. A method for using the intramedullary arthrodesis nail of claim 1, comprising the steps of:

(a) inserting the distal nail portion into the medullary cavity of at least a first bone of a joint;

(b) inserting the proximal nail portion into the medullary cavity of another bone of the same joint;

(c) adjusting the position of the proximal nail portion relative to the distal nail portion;

(d) fastening the proximal nail portion to the bone; and

(e) fastening the distal nail portion to the proximal nail portion after at least steps (a)-(c).

3. The method of claim 2, wherein step (e) occurs before step (d).

4. The method of claim 2, wherein step (e) occurs after step (d).

5. The method of claim 2, wherein at least step (d) is performed using a drill guide.

6. The method of claim 5, wherein:

the drill guide includes a body portion having a plurality of holes therethrough, each hole defining an axis; and

upon attaching the drill guide body to the proximal nail portion, the axis of each hole is co-planar with and perpendicular to the longitudinal axis of the proximal nail portion.

7. The method of claim 2, further comprising the step of (f) fastening the distal nail portion to the bone.

8. The method of claim 7, wherein:

at least steps (d) and (f) are performed with a drill guide including a body portion having a plurality of holes therethrough, each hole defining an axis; and

upon attaching the drill guide body to each of the distal nail portion and the proximal nail portion, the axis of each hole is co-planar with and perpendicular to the longitudinal axis of the respective nail portion.

9. The intramedullary nail of claim 1, including at least a second longitudinal slot located proximally to said at least one longitudinal slot, said second longitudinal slot sized and positioned such that an insert received in said second longitudinal slot will contact a fastener passing through said at least one longitudinal slot.

10. The intramedullary arthrodesis nail according to claim 1, wherein

each of said distal nail portion and said proximal nail portion include an internally splined head portion, defining a first number, not less than one, of internal splines, and

said connector portion has a first end and a second end, each of said ends including a second number, not less than one, of external splines adapted to engage one or more internal splines in said head portions of said distal nail portion and said proximal nail portion.

11. The intramedullary arthrodesis nail of claim 10, wherein said intermediate connector portion is straight.

12. The intramedullary arthrodesis nail of claim 10, wherein said intermediate connector portion is curved or angled.

13. The intramedullary arthrodesis nail according to claim 10, wherein said first number of internal splines is greater than one and said second number of external splines is the same number as said first number of internal splines.

14. The intramedullary arthrodesis nail according to claim 10, wherein said first number of internal splines is different from said second number of external splines.

15. The intramedullary arthrodesis nail of claim 14, wherein said first number of internal splines is one and said second number of external splines is two.

16. The intramedullary arthrodesis nail of claim 14, wherein said first number of internal splines is two and said second number of external splines is one.

17. The intramedullary arthrodesis nail of claim 14, wherein said first number of internal splines is twelve and said second number of external splines is twenty.

18. The intramedullary arthrodesis nail of claim 10, wherein each said head portions includes a threaded aperture for receiving at least a portion of a set screw therein, said set screws engaging said connector portion to fix said connector portion to said distal nail portion and to said proximal nail portion.