Apparatus and methods for fracture repair

• US 9,788,870 B2
• Filed: 05/13/2013
• Issued: 10/17/2017
• Est. Priority Date: 01/14/2008
• Status: Active Grant

• Current Assignee: Conventus Orthopaedics, Inc.
• Original Assignee: Conventus Orthopaedics, Inc.
• Inventors: Brenzel, Michael P., Hindrichs, Paul
• Primary Examiner(s): Hammond, Ellen C
• Assistant Examiner(s): Negrellirodrigue, Christina
• Application Number:
  US13/892,476
• Publication Number:
  US 20140128870A1
• Time in Patent Office: 1,618 Days
• Field of Search: 606 62- 64, 606300-321
• CPC Class Codes: A61B 17/70 Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
• CPC Class Codes: A61B 17/7097 Stabilisers comprising fluid filler in an implant, e.g. balloon; devices for inserting or filling such implants disc prostheses made of inflatable chambers or pockets filled with fluid A61F2/441; replacing the nucleus pulposus A61F2002/444
• CPC Class Codes: A61B 17/7225 for bone compression
• CPC Class Codes: A61B 17/7233 with special means of locking the nail to the bone
• CPC Class Codes: A61B 17/725 with locking pins or screws of special form
• CPC Class Codes: A61B 17/7258 with laterally expanding parts, e.g. for gripping the bone
• CPC Class Codes: A61B 17/7275 with expanding cylindrical parts
• CPC Class Codes: A61B 17/863 with thread interrupted or changing its form along shank, other than constant taper
• CPC Class Codes: A61B 17/869 characterised by an open form, e.g. wire helix
• CPC Class Codes: A61B 17/8858 laterally or radially expansible inflatable A61B17/8855
• CPC Class Codes: A61B 2017/8655 with special features for locking in the bone

Abstract

Apparatus and methods for bone fracture repair. The apparatus may include a structural support for positioning a first bone segment relative to a second bone segment. The apparatus may include an anchoring substrate. The anchoring substrate may be configured to compress the first bone segment to the second bone segment. The anchoring substrate may transmit tension from a distal bone segment anchor in the first bone segment to a proximal bone segment anchor in the second bone segment. The apparatus may be configured to be deployed percutaneously in an inner cavity of a bone. The apparatus may be installed in an open fracture. The apparatus may be expanded, self-expanding or configured for mechanically actuation. Some embodiments of the apparatus may include a central axis member that may be used in conjunction with expansion of one or both of the structural support and the anchoring substrate to configure the apparatus.

Claims

1. A method for treating a fractured bone, the fractured bone including segments, the method comprising:

positioning inside a region of the bone an anchor substrate defining an open space within the region;

passing a first anchor from an outside of the fractured bone through a first of the segments and through the anchor substrate;

passing a second anchor from the outside of the fractured bone through a second of the segments and through the anchor substrate;

rotating inside the space a first moveable engagement member having a tip that pivots away from a longitudinal axis of the first anchor; and

rotating inside the space a second moveable engagement member having a tip that pivots away from a longitudinal axis of the second anchor;

wherein the rotating the first moveable engagement member comprises displacing within an elongated member of the first anchor an actuator in contact with the moveable engagement member.

2. The method of claim 1 wherein the rotating a first moveable engagement member comprises rotating a catch out of a slot defined by the elongated member of the first anchor.

3. The method of claim 2 wherein:

the catch is a first catch, the slot is a first slot and the elongated member is a first elongated member; and

the rotating a second moveable engagement member comprises rotating a second catch out of a second slot that is defined by a second elongated member of the second anchor.

4. The method of claim 1 wherein the displacing comprises displacing a threaded shaft.

5. The method of claim 1 wherein the displacing comprises pushing, with the actuator, a beveled surface of the catch, the beveled surface directing the catch away from the elongated member.

6. The method of claim 1 further comprising:

tensioning the first anchor to draw the first bone segment toward the anchor substrate; and

tensioning the second anchor to draw the second bone segment toward the anchor substrate.

7. The method of claim 6 wherein the tensioning the first anchor and the tensioning the second anchor draw the first bone segment and the second bone segment toward each other.

8. The method of claim 6 wherein the tensioning the first anchor and the tensioning the second anchor draw the first bone segment and the second bone segment toward each other from different sides of an intra-articular fracture.

9. The method of claim 1 wherein the rotating inside the space a first moveable engagement member comprises inserting the first anchor into the space until the first movable engagement member tip elastically pivots away from the longitudinal axis of the first anchor.

10. The method of claim 9 wherein the rotating inside the space a second moveable engagement member comprises inserting the second anchor into the space until the second movable engagement member tip elastically pivots away from the longitudinal axis of the second anchor.

11. The method of claim 1 wherein the passing through a first of the segments comprises passing the first anchor through a fragment having an articular surface.

12. The method of claim 11 wherein:

the fragment is a first fragment; and

the passing through a second of the segments comprises passing the second anchor through a segment that includes a second fragment having an articular surface.

13. The method of claim 1 wherein:

the tips of the first moveable engagement member and the second moveable engagement member are first tips;

the first moveable engagement member has a second tip; and

the second moveable engagement member has a second tip.

14. A method for treating a fractured bone, the fractured bone including segments, the method comprising:

positioning inside a region of the bone an anchor substrate defining an open space within the region;

passing through a first of the segments and the anchor substrate a first anchor;

passing through a second of the segments and the anchor substrate a second anchor;

rotating inside the space a first moveable engagement member having a tip that pivots away from a longitudinal axis of the first anchor; and

rotating inside the space a second moveable engagement member having a tip that pivots away from a longitudinal axis of the second anchor;

wherein the rotating a first moveable engagement member comprises rotating a catch out of a slot defined by an elongated member of the first anchor.

15. The method of claim 14 wherein:

the catch is a first catch, the slot is a first slot and the elongated member is a first elongated member; and

the rotating a second moveable engagement member comprises rotating a second catch out of a second slot that is defined by a second elongated member of the second anchor.

16. The method of claim 14 wherein the rotating a first moveable engagement member comprises displacing within the elongated member of the first anchor an actuator in contact with the moveable engagement member.

17. The method of claim 16 wherein the displacing comprises displacing a threaded shaft.

18. The method of claim 16 wherein the displacing comprises pushing, with the actuator, a beveled surface of the catch, the beveled surface directing the catch away from the elongated member.

19. The method of claim 14 further comprising:

tensioning the first anchor to draw the first bone segment toward the anchor substrate; and

tensioning the second anchor to draw the second bone segment toward the anchor substrate.

20. The method of claim 19 wherein the tensioning the first anchor and the tensioning the second anchor draw the first bone segment and the second bone segment toward each other.

21. The method of claim 19 wherein the tensioning the first anchor and the tensioning the second anchor draw the first bone segment and the second bone segment toward each other from different sides of an intra-articular fracture.

22. The method of claim 14 wherein the rotating inside the space a first moveable engagement member comprises inserting the first anchor into the space until the first movable engagement member tip elastically pivots away from the longitudinal axis of the first anchor.

23. The method of claim 22 wherein the rotating inside the space a second moveable engagement member comprises inserting the second anchor into the space until the second movable engagement member tip elastically pivots away from the longitudinal axis of the second anchor.

24. The method of claim 14 wherein the rotating inside the space a first moveable engagement member comprises displacing an actuator shaft along a lumen of the elongated member to push the first movable engagement member.

25. The method of claim 24 wherein:

the elongated member is a first elongated member;

the lumen is a first lumen and the actuator shaft is a first actuator shaft; and

the rotating inside the space a second moveable engagement member comprises displacing a second actuator shaft along a second lumen of a second elongated member of the second anchor to push the second movable engagement member.

26. The method of claim 14 wherein the passing through a first of the segments comprises passing the first anchor through a fragment having an articular surface.

27. The method of claim 26 wherein:

the fragment is a first fragment; and

the passing through a second of the segments comprises passing the second anchor through a segment that includes a second fragment having an articular surface.

28. The method of claim 14 wherein:

the tips of the first moveable engagement member and the second moveable engagement member are first tips;

the first moveable engagement member has a second tip; and

the second moveable engagement member has a second tip.

29. A method for treating a fractured bone, the fractured bone including segments, the method comprising:

positioning inside a region of the bone an anchor substrate defining an open space within the region;

passing through a first of the segments and the anchor substrate a first anchor;

passing through a second of the segments and the anchor substrate a second anchor;

rotating inside the space a first moveable engagement member having a tip that pivots away from a longitudinal axis of the first anchor; and

rotating inside the space a second moveable engagement member having a tip that pivots away from a longitudinal axis of the second anchor;

wherein the rotating a first moveable engagement member comprises displacing within an elongated member of the first anchor an actuator in contact with the moveable engagement member; and

wherein the displacing comprises pushing, with the actuator, a beveled surface of the catch, the beveled surface directing the catch away from the elongated member.

30. The method of claim 29 wherein:

the rotating a first moveable engagement member comprises rotating a catch out of a slot defined by the elongated member;

the catch is a first catch, the slot is a first slot and the elongated member is a first elongated member; and

the rotating a second moveable engagement member comprises rotating a second catch out of a second slot that is defined by a second elongated member of the second anchor.

31. The method of claim 29 wherein the displacing comprises displacing a threaded shaft.

32. The method of claim 29 further comprising:

tensioning the first anchor to draw the first bone segment toward the anchor substrate; and

tensioning the second anchor to draw the second bone segment toward the anchor substrate.

33. The method of claim 32 wherein the tensioning the first anchor and the tensioning the second anchor draw the first bone segment and the second bone segment toward each other.

34. The method of claim 32 wherein the tensioning the first anchor and the tensioning the second anchor draw the first bone segment and the second bone segment toward each other from different sides of an intra-articular fracture.

35. The method of claim 29 wherein the rotating inside the space a first moveable engagement member comprises inserting the first anchor into the space until the first movable engagement member tip elastically pivots away from the longitudinal axis of the first anchor.

36. The method of claim 35 wherein the rotating inside the space a second moveable engagement member comprises inserting the second anchor into the space until the second movable engagement member tip elastically pivots away from the longitudinal axis of the second anchor.

37. The method of claim 29 wherein the rotating inside the space a first moveable engagement member comprises displacing an actuator shaft along a lumen of the elongated member to push the first movable engagement member.

38. The method of claim 37 wherein:

the elongated member is a first elongated member;

the lumen is a first lumen and the actuator shaft is a first actuator shaft; and

the rotating inside the space a second moveable engagement member comprises displacing a second actuator shaft along a second lumen of a second elongated member of the second anchor to push the second movable engagement member.

39. The method of claim 29 wherein the passing through a first of the segments comprises passing the first anchor through a fragment having an articular surface.

40. The method of claim 39 wherein:

the fragment is a first fragment; and

the passing through a second of the segments comprises passing the second anchor through a segment that includes a second fragment having an articular surface.

41. The method of claim 29 wherein:

the tips of the first moveable engagement member and the second moveable engagement member are first tips;

the first moveable engagement member has a second tip; and

the second moveable engagement member has a second tip.

42. A method for treating a fractured bone, the fractured bone including segments, the method comprising:

positioning inside a region of the bone an anchor substrate defining an open space within the region;

passing through a first of the segments and the anchor substrate a first anchor;

passing through a second of the segments and the anchor substrate a second anchor;

rotating inside the space a first moveable engagement member having a tip that pivots away from a longitudinal axis of the first anchor; and

rotating inside the space a second moveable engagement member having a tip that pivots away from a longitudinal axis of the second anchor;

wherein the rotating inside the space a first moveable engagement member comprises inserting the first anchor into the space until the first movable engagement member tip elastically pivots away from the longitudinal axis of the first anchor.

43. The method of claim 42 wherein:

the rotating a first moveable engagement member comprises rotating a catch out of a slot defined by an elongated member of the first anchor;

the catch is a first catch, the slot is a first slot and the elongated member is a first elongated member; and

the rotating a second moveable engagement member comprises rotating a second catch out of a second slot that is defined by a second elongated member of the second anchor.

44. The method of claim 42 wherein the rotating a first moveable engagement member comprises displacing within an elongated member of the first anchor an actuator in contact with the moveable engagement member.

45. The method of claim 44 wherein the displacing comprises displacing a threaded shaft.

46. The method of claim 42 further comprising:

tensioning the first anchor to draw the first bone segment toward the anchor substrate; and

tensioning the second anchor to draw the second bone segment toward the anchor substrate.

47. The method of claim 46 wherein the tensioning the first anchor and the tensioning the second anchor draw the first bone segment and the second bone segment toward each other.

48. The method of claim 46 wherein the tensioning the first anchor and the tensioning the second anchor draw the first bone segment and the second bone segment toward each other from different sides of an intra-articular fracture.

49. The method of claim 42 wherein the rotating inside the space a second moveable engagement member comprises inserting the second anchor into the space until the second movable engagement member tip elastically pivots away from the longitudinal axis of the second anchor.

50. The method of claim 42 wherein the rotating inside the space a first moveable engagement member comprises displacing an actuator shaft along a lumen of an elongated member of the first anchor to push the first movable engagement member.

51. The method of claim 50 wherein:

the elongated member is a first elongated member;

the lumen is a first lumen and the actuator shaft is a first actuator shaft; and

the rotating inside the space a second moveable engagement member comprises displacing a second actuator shaft along a second lumen of a second elongated member of the second anchor to push the second movable engagement member.

52. The method of claim 42 wherein the passing through a first of the segments comprises passing the first anchor through a fragment having an articular surface.

53. The method of claim 52 wherein:

the fragment is a first fragment; and

the passing through a second of the segments comprises passing the second anchor through a segment that includes a second fragment having an articular surface.

54. The method of claim 42 wherein:

the tips of the first moveable engagement member and the second moveable engagement member are first tips;

the first moveable engagement member has a second tip; and

the second moveable engagement member has a second tip.

55. A method for treating a fractured bone, the fractured bone including segments, the method comprising:

positioning inside a region of the bone an anchor substrate defining an open space within the region;

passing through a first of the segments and the anchor substrate a first anchor;

passing through a second of the segments and the anchor substrate a second anchor;

rotating inside the space a first moveable engagement member having a tip that pivots away from a longitudinal axis of the first anchor; and

rotating inside the space a second moveable engagement member having a tip that pivots away from a longitudinal axis of the second anchor;

wherein the rotating inside the space a first moveable engagement member comprises displacing an actuator shaft along a lumen of an elongated member of the first anchor to push the first movable engagement member.

56. The method of claim 55 wherein:

the rotating a first moveable engagement member comprises rotating a catch out of a slot defined by the elongated member;

the catch is a first catch, the slot is a first slot and the elongated member is a first elongated member; and

the rotating a second moveable engagement member comprises rotating a second catch out of a second slot that is defined by a second elongated member of the second anchor.

57. The method of claim 55 wherein the rotating a first moveable engagement member comprises displacing within the elongated member an actuator in contact with the moveable engagement member.

58. The method of claim 57 wherein the displacing comprises displacing a threaded shaft.

59. The method of claim 55 further comprising:

tensioning the first anchor to draw the first bone segment toward the anchor substrate; and

tensioning the second anchor to draw the second bone segment toward the anchor substrate.

60. The method of claim 59 wherein the tensioning the first anchor and the tensioning the second anchor draw the first bone segment and the second bone segment toward each other.

61. The method of claim 59 wherein the tensioning the first anchor and the tensioning the second anchor draw the first bone segment and the second bone segment toward each other from different sides of an intra-articular fracture.

62. The method of claim 55 wherein:

the rotating inside the space a first moveable engagement member comprises inserting the first anchor into the space until the first movable engagement member tip elastically pivots away from the longitudinal axis of the first anchor; and

the rotating inside the space a second moveable engagement member comprises inserting the second anchor into the space until the second movable engagement member tip elastically pivots away from the longitudinal axis of the second anchor.

63. The method of claim 55 wherein:

the elongated member is a first elongated member;

the lumen is a first lumen and the actuator shaft is a first actuator shaft; and

the rotating inside the space a second moveable engagement member comprises displacing a second actuator shaft along a second lumen of a second elongated member of the second anchor to push the second movable engagement member.

64. The method of claim 55 wherein the passing through a first of the segments comprises passing the first anchor through a fragment having an articular surface.

65. The method of claim 64 wherein:

the fragment is a first fragment; and

the passing through a second of the segments comprises passing the second anchor through a segment that includes a second fragment having an articular surface.

66. The method of claim 55 wherein:

the tips of the first moveable engagement member and the second moveable engagement member are first tips;

the first moveable engagement member has a second tip; and

the second moveable engagement member has a second tip.

67. A method for treating a fractured bone, the fractured bone including segments, the method comprising:

positioning inside a region of the bone an anchor substrate defining an open space within the region;

passing a first anchor from an outside of the fractured bone through a first of the segments and through the anchor substrate;

passing a second anchor from the outside of the fractured bone through a second of the segments and through the anchor substrate;

rotating inside the space a first moveable engagement member having a tip that pivots away from a longitudinal axis of the first anchor;

rotating inside the space a second moveable engagement member having a tip that pivots away from a longitudinal axis of the second anchor;

tensioning the first anchor to draw the first bone segment toward the anchor substrate; and

tensioning the second anchor to draw the second bone segment toward the anchor substrate.

68. The method of claim 67 wherein the rotating a first moveable engagement member comprises rotating a catch out of a slot defined by an elongated member of the first anchor.

69. The method of claim 68 wherein:

the catch is a first catch, the slot is a first slot and the elongated member is a first elongated member; and

the rotating a second moveable engagement member comprises rotating a second catch out of a second slot that is defined by a second elongated member of the second anchor.

70. The method of claim 67 wherein the rotating a first moveable engagement member comprises displacing within an elongated member of the first anchor an actuator in contact with the moveable engagement member.

71. The method of claim 70 wherein the displacing comprises displacing a threaded shaft.

72. The method of claim 70 wherein the displacing comprises pushing, with the actuator, a beveled surface of the catch, the beveled surface directing the catch away from the elongated member.

73. The method of claim 67 wherein the tensioning the first anchor and the tensioning the second anchor draw the first bone segment and the second bone segment toward each other.

74. The method of claim 67 wherein the tensioning the first anchor and the tensioning the second anchor draw the first bone segment and the second bone segment toward each other from different sides of an intra-articular fracture.

75. The method of claim 67 wherein the rotating inside the space a first moveable engagement member comprises inserting the first anchor into the space until the first movable engagement member tip elastically pivots away from the longitudinal axis of the first anchor.

76. The method of claim 75 wherein the rotating inside the space a second moveable engagement member comprises inserting the second anchor into the space until the second movable engagement member tip elastically pivots away from the longitudinal axis of the second anchor.

77. The method of claim 67 wherein the rotating inside the space a first moveable engagement member comprises displacing an actuator shaft along a lumen of an elongated member of the first anchor to push the first movable engagement member.

78. The method of claim 77 wherein:

the elongated member is a first elongated member;

the lumen is a first lumen and the actuator shaft is a first actuator shaft; and

the rotating inside the space a second moveable engagement member comprises displacing a second actuator shaft along a second lumen of a second elongated member of the second anchor to push the second movable engagement member.

79. The method of claim 67 wherein the passing through a first of the segments comprises passing the first anchor through a fragment having an articular surface.

80. The method of claim 79 wherein:

the fragment is a first fragment; and

the passing through a second of the segments comprises passing the second anchor through a segment that includes a second fragment having an articular surface.

81. The method of claim 67 wherein:

the tips of the first moveable engagement member and the second moveable engagement member are first tips;

the first moveable engagement member has a second tip; and

the second moveable engagement member has a second tip.

82. A method for treating a fractured bone, the fractured bone including segments, the method comprising:

positioning inside a region of the bone an anchor substrate defining an open space within the region;

passing a first anchor from an outside of the fractured bone through a first of the segments and through the anchor substrate;

passing a second anchor from the outside of the fractured bone through a second of the segments and through the anchor substrate;

rotating inside the space a first moveable engagement member having a tip that pivots away from a longitudinal axis of the first anchor; and

rotating inside the space a second moveable engagement member having a tip that pivots away from a longitudinal axis of the second anchor;

 

wherein;

the tips of the first moveable engagement member and the second moveable engagement member are first tips;

the first moveable engagement member has a second tip; and

the second moveable engagement member has a second tip.

83. The method of claim 82 wherein the rotating a first moveable engagement member comprises rotating a catch out of a slot defined by an elongated member of the first anchor.

84. The method of claim 83 wherein:

the catch is a first catch, the slot is a first slot and the elongated member is a first elongated member; and

the rotating a second moveable engagement member comprises rotating a second catch out of a second slot that is defined by a second elongated member of the second anchor.

85. The method of claim 82 wherein the rotating a first moveable engagement member comprises displacing within an elongated member of the first anchor an actuator in contact with the moveable engagement member.

86. The method of claim 85 wherein the displacing comprises displacing a threaded shaft.

87. The method of claim 85 wherein the displacing comprises pushing, with the actuator, a beveled surface of the catch, the beveled surface directing the catch away from the elongated member.

88. The method of claim 82 further comprising:

tensioning the first anchor to draw the first bone segment toward the anchor substrate; and

tensioning the second anchor to draw the second bone segment toward the anchor substrate.

89. The method of claim 88 wherein the tensioning the first anchor and the tensioning the second anchor draw the first bone segment and the second bone segment toward each other.

90. The method of claim 88 wherein the tensioning the first anchor and the tensioning the second anchor draw the first bone segment and the second bone segment toward each other from different sides of an intra-articular fracture.

91. The method of claim 82 wherein the rotating inside the space a first moveable engagement member comprises inserting the first anchor into the space until the first movable engagement member tip elastically pivots away from the longitudinal axis of the first anchor.

92. The method of claim 91 wherein the rotating inside the space a second moveable engagement member comprises inserting the second anchor into the space until the second movable engagement member tip elastically pivots away from the longitudinal axis of the second anchor.

93. The method of claim 82 wherein the rotating inside the space a first moveable engagement member comprises displacing an actuator shaft along a lumen of an elongated member of the first anchor to push the first movable engagement member.

94. The method of claim 93 wherein:

the elongated member is a first elongated member;

the lumen is a first lumen and the actuator shaft is a first actuator shaft; and

the rotating inside the space a second moveable engagement member comprises displacing a second actuator shaft along a second lumen of a second elongated member of the second anchor to push the second movable engagement member.

95. The method of claim 82 wherein the passing through a first of the segments comprises passing the first anchor through a fragment having an articular surface.

96. The method of claim 95 wherein:

the fragment is a first fragment; and

the passing through a second of the segments comprises passing the second anchor through a segment that includes a second fragment having an articular surface.