Intramedullary fixation assembly and devices and methods for installing the same

• US 9,451,971 B2
• Filed: 02/19/2009
• Issued: 09/27/2016
• Est. Priority Date: 07/15/2004
• Status: Active Grant

• Current Assignee: Agilent Technologies, Inc.
• Original Assignee: Agilent Technologies, Inc.
• Inventors: Warburton, Mark J., Fencl, Robert M., Capo, John T., Tan, Virak, Smith, Aaron C.
• Primary Examiner(s): SUMMITT, LYNNSY M
• Application Number:
  US12/389,137
• Publication Number:
  US 20090157079A1
• Time in Patent Office: 2,777 Days
• Field of Search: 606/104, 606 62- 68, 606/86.B, 606/99
• US Class Current: 1/1
• CPC Class Codes: A61B 17/1659 Surgical rasps, files, planes, or scrapers
• CPC Class Codes: A61B 17/1668 for the upper femur A61B17/164 takes precedence
• CPC Class Codes: A61B 17/1684 for the shoulder
• CPC Class Codes: A61B 17/1725 for applying transverse screws or pins through intramedullary nails or pins
• CPC Class Codes: A61B 17/72 Intramedullary pins, nails or other devices A61B17/744 takes precedence
• CPC Class Codes: A61B 17/848 Kirschner wires, i.e. thin, long nails
• CPC Class Codes: A61B 17/861 specially shaped for gripping driver
• CPC Class Codes: A61B 17/8875 Screwdrivers, spanners or wrenches
• CPC Class Codes: A61B 2017/0046 with a releasable handle; with handle and operating part separable
• CPC Class Codes: A61B 2017/922 Devices for impaction, impact element
• 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. An intramedullary fixation member for use in repairing a distal radius bone fracture, the distal radius having an articular surface, the intramedullary fixation member comprising:

an elongate fixation member sized for insertion into a medullary canal of the radius, the elongate fixation member having a first end and a second end, the second end adapted for placement within the medullary canal in spaced relation to the articular surface of the distal radius, a concave side and a convex side extending between the first and second ends, the concave and concave sides each defining a radius of curvature, the elongate fixation member defining a first fastener opening proximal to the first end, the first fastener opening extending transversely through the elongate fixation member along a first fastener axis and configured to receive a first fastener therethrough such that the first fastener such that a first fastener received therethrough extends laterally outward of the fixation member, the first end of the fixation member defining additional fastener openings disposed between the first fastener opening and the second end, the additional fastener openings extending transversely through the fixation member along respective additional fastener axes, the additional fastener axes extending at different angles with respect to the first fastener axis and to each other, each of the additional fastener openings being configured to receive an additional fastener therethrough, wherein a first u-shaped slot is defined on a first side of the elongate fixation member and a second u-shaped slot is defined on a second side of the elongate fixation member, wherein the u-shaped slots are sized and configured to couple a driving handle to the elongate fixation member, and wherein a tail section extends from the second end of the fixation member, the tail section having two spaced arms having opposing outer surfaces and configured to be urged laterally outward in respective first and second opposing directions and into contact with a cortical wall defining the medullary canal of the radius, wherein the tail section has a reduced maximum thickness measured across the opposing outer surface of a first one of the spaced arms to the opposing outer surface of a second one of the spaced arms in a first position as compared to a thickness of the first end of the fixation member such that each arm is configured to move from the first position wherein the maximum thickness of the spaced arms measured across the opposing outer surfaces is smaller than the thickness of the first end to a second position laterally outward from the first position, and wherein the tail section is substantially straight;

wherein the intramedullary fixation member further comprises a guide assembly attached to the elongate fixation member by a threaded fastener extending through the first fastener opening.

2. The fixation member of claim 1, wherein the guide assembly is adapted for guiding placement or fixation of the elongate fixation member in the medullary canal.

3. The fixation member of claim 2, wherein the first fastener opening is configured for attachment to the guide assembly and to receive the first fastener.

4. The fixation member of claim 1, wherein the spaced arms include opposing interior planar surfaces.

5. The fixation member of claim 4, wherein the spaced arms further comprise planar side surfaces extending transversely to the opposing interior planar surfaces.

6. The fixation member of claim 1, further comprising an external urging device configured to interact with and urge the spaced arms into contact with the cortical wall.

7. The fixation member of claim 1, wherein a spring bias is configured to urge the spaced arms into contact with the cortical wall.

8. The fixation member of claim 1, wherein a portion of the fixation member proximal to the second end is relatively straight as compared to a portion of the fixation member proximal to the first end thereof.

9. The fixation member of claim 1, wherein at least a portion of the fixation member has a radius of curvature adapted for insertion of the fixation member into the medullary canal of the radius.

10. The fixation member of claim 1, wherein each of the spaced arms extends between a proximal arm end and a distal arm end, the distal arm end being disposed away from the first end and the proximal arm end being disposed between the distal arm end and the first end, and wherein the fixation member further comprises an urging device configured to interact with and actuate the spaced arms, away from the distal arm ends and toward the proximal arm ends, to urge the distal arm ends laterally outward from the first position.

11. The fixation member of claim 10, wherein the urging device is further configured to deactuate the spaced arms, the spaced arms being configured to be responsive to deactuation to move the distal arm ends laterally inward toward the first position.

12. The fixation member of claim 1, wherein each of the spaced arms includes a distal arm end disposed away from the first end, and wherein opposing interior surfaces of the spaced arms are configured to cooperate to define an inter-arm space therebetween, the inter-arm space being configured to receive and retain a threaded urging device therein, the spaced arms being responsive to advancement of the threaded urging device in the inter-arm space to move the distal arm ends laterally outward from the first position.

13. The fixation member of claim 12, wherein the threaded urging device is tapered, the threaded urging device being configured to define an increasing diameter at the inter-arm space upon advancement of the threaded urging device, the inter-arm space cooperating with the increasing diameter of the threaded urging device, upon advancement thereof, to move the distal arm ends laterally outward from the first position.

14. The fixation member of claim 1, wherein the fixation member is configured to have a variable radius of curvature, the radius of curvature decreasing from the first end toward a medial portion, and from the medial portion toward the second end.

15. The fixation member of claim 14, wherein the fixation member tapers in thickness from the first end toward the tail section, the tail section being configured to have a constant maximum thickness defined by the opposing outer surfaces of the spaced arms along a length of the spaced arms.

16. The fixation member of claim 15, wherein each of the spaced arms is configured to have a constant lengthwise thickness, defined by respective opposing inner and outer surfaces thereof along a length of the spaced arms.

17. An intramedullary fixation member for use in repairing a distal radius bone fracture, the distal radius having an articular surface, the intramedullary fixation member comprising:

an elongate fixation member sized for insertion into a medullary canal of the radius, the fixation member having a first end and a second end, the second end adapted for placement within the medullary canal in spaced relation to the articular surface of the distal radius, a concave side and a convex side extending between the first and second ends, the concave and concave sides each defining a radius of curvature, the fixation member defining a first fastener opening proximal to the first end, the first fastener opening extending transversely through the fixation member along a first fastener axis and configured to receive a first fastener therethrough such that the first fastener such that a first fastener received therethrough extends laterally outward of the fixation member, the first end of the fixation member defining additional fastener openings disposed between the first fastener opening and the second end, the additional fastener openings extending transversely through the fixation member along respective additional fastener axes, the additional fastener axes extending at different angles with respect to the first fastener axis and to each other, each of the additional fastener openings being configured to receive an additional fastener therethrough, wherein a first u-shaped slot is defined on a first side of the elongate fixation member and a second u-shaped slot is defined on a second side of the elongate fixation member, wherein the u-shaped slots are sized and configured to couple a driving handle to the elongate fixation member, and wherein a tail section extends from the second end of the fixation member, the tail section having two spaced arms configured to be urged laterally outward in respective first and second opposing directions and into contact with a cortical wall defining the medullary canal of the radius, wherein the first end of the fixation member is attached to a guide assembly adapted for guiding placement or fixation of the elongate fixation member in the medullary canal, the first fastener opening defining a threaded-portion which receives a threaded fastener of the guide assembly, and wherein the tail section is substantially straight.

18. The fixation member of claim 17, wherein the spaced arms include opposing interior planar surfaces.

19. The fixation member of claim 18, wherein the spaced arms further comprise planar side surfaces extending transversely to the opposing interior planar surfaces.

20. The fixation member of claim 17, wherein the first fastener opening further comprises a second threaded portion configured to receive the first fastener.

21. The fixation member of claim 20, wherein the threaded portion defines a diameter and the second threaded portion defines a second diameter that is smaller than the diameter of the threaded portion.

22. An intramedullary fixation member for use in repairing a distal radius bone fracture, the distal radius having an articular surface, the intramedullary fixation member comprising:

an elongate fixation member sized for insertion into a medullary canal of the radius, the fixation member having a first end and a second end, the second end adapted for placement within the medullary canal in spaced relation to the articular surface of the distal radius, a concave side and a convex side extending between the first and second ends, the concave and concave sides each defining a radius of curvature, the fixation member defining a first fastener opening proximal to the first end, the first fastener opening extending transversely through the fixation member along a first fastener axis and configured to receive a first fastener therethrough such that the first fastener such that a first fastener received therethrough extends laterally outward of the fixation member, the first end of the fixation member defining additional fastener openings disposed between the first fastener opening and the second end, the additional fastener openings extending transversely through the fixation member along respective additional fastener axes, the additional fastener axes extending at different angles with respect to the first fastener axis and to each other, each of the additional fastener openings being configured to receive an additional fastener therethrough, wherein a first u-shaped slot is defined on a first side of the elongate fixation member and a second u-shaped slot is defined on a second side of the elongate fixation member, wherein the u-shaped slots are sized and configured to couple a driving handle to the elongate fixation member, wherein a tail section extends from the second end, the tail section having two spaced arms of reduced maximum thickness measured across an opposing outer surface of a first one of the spaced arms to an opposing outer surface of a second one of the spaced arms in a first position as compared to a thickness of the first end of the fixation member, and wherein the two spaced arms are configured to be urged laterally outward in respective first and second opposing directions and into contact with a cortical wall defining the medullary canal of the radius, wherein each arm is configured to move from the first position wherein the thickness of the spaced arms measured across the opposing outer surfaces is smaller than the thickness of the first end of the elongate fixation member to a second position laterally outward from the first position, and wherein the tail section is substantially straight;

wherein the intramedullary fixation member further comprises a guide assembly attached to the elongate fixation member by a threaded fastener extending through the first fastener opening.

23. The fixation member of claim 22, wherein the spaced arms include opposing interior planar surfaces.

24. The fixation member of claim 23, wherein the spaced arms further comprise planar side surfaces extending transversely to the opposing interior planar surfaces.

25. The fixation member of claim 22, wherein the guide assembly is adapted for guiding placement or fixation of the elongate fixation member in the medullary canal, the fixation member being configured to receive the guide assembly in a position overlying the first fastener opening.