Compression nut and system for treating bone
Patent Information
- Application Number
- CN202180034650.6
- Authority / Receiving Office
- CN · China
- Patent Type
- Patents(China)
- Current Assignee / Owner
- Priority Date
- 2020-03-11
- Filing Date
- 2021-03-11
- Publication Date
- 2026-09-15
- Estimated Expiration
- 2041-03-11
Smart Images
Figure CN115551425B_ABST
Abstract
Description
Technical Field
[0001] This disclosure relates to a compression nut, system, and method for treating bone. Background Technology
[0002] Fractures of long bones, such as the femur, can be treated with an intramedullary nail inserted through the medullary canal of the bone after the fracture has been reduced as needed. In some cases, particularly for distal condylar fractures, retrograde nails that can be inserted into the medullary canal from the distal end of the bone can be used to treat the bone. Locking screws are inserted through locking holes that extend laterally through the intramedullary nail to fix the nail to the bone and / or provide additional stability to the bone. Summary of the Invention
[0003] This disclosure relates to a compression nut for treating bone. The nut includes a head and a body extending longitudinally from the head to a free end. The body includes external threads along the outer surface of a threaded portion of the body, the body being separated from the head via an unthreaded portion. The nut also includes a channel extending longitudinally through the body. The channel includes internal threads extending along the inner surface of the channel, the internal threads being configured to threadedly engage an end of a locking screw received therein.
[0004] In one embodiment, the free end includes cutting teeth configured to cut the bone when the clamping nut is driven into the bone.
[0005] In one embodiment, the tips of the cutting teeth are angled toward the direction of rotation, and the clamping nut rotates in that direction to be driven into the bone.
[0006] In one embodiment, the portion of the internal thread adjacent to the head includes an enlarged crest for engaging a corresponding enlarged thread crest portion of a locking screw received therein.
[0007] In one embodiment, a portion of the internal thread near the free end includes an enlarged crest that is configured to deform when it receives a threaded locking screw therein.
[0008] In one embodiment, the unthreaded portion of the body includes a stepped hysteresis such that a portion of the unthreaded portion adjacent to the head has a larger diameter than the remainder of the unthreaded portion.
[0009] In one embodiment, the head includes one or more holes extending therethrough, each of the one or more holes being configured to receive an anchor screw therein, such that when the anchor screw is received therein, the axis of the anchor screw extends along the outer surface of the body of the compression nut.
[0010] In one embodiment, when the head includes more than one hole, each of these holes is equidistant from its adjacent holes.
[0011] In one embodiment, the clamping nut further includes an anchoring screw received in one or more holes, such that when it is desired to anchor the clamping screw to the bone, the anchoring screw can be rotated relative to the one or more holes to be driven into the bone.
[0012] In one embodiment, a portion of the body deforms radially inward toward its longitudinal axis to create interference with a locking screw threaded therein.
[0013] This disclosure also relates to a system for treating long bones. The system includes: an intramedullary nail capable of insertion through the medullary canal of the bone, the intramedullary nail extending from a proximal end to a distal end and including a locking hole extending through the intramedullary nail along an axis extending at an angle relative to the longitudinal axis of the intramedullary nail; a locking screw configured to be inserted into the bone and through the locking hole, the locking screw including a head portion and an axis extending from the head portion to a free end, the axis including threads extending along the axis; and a first clamping nut configured to be inserted into the bone. The first clamping nut includes a head and a body extending longitudinally from the head to a free end. The body includes a channel and external threads along the outer surface of a threaded portion of the body, the body being separated from the head via an unthreaded portion, the channel extending longitudinally through the body. Internal threads extend along the inner surface of the channel to threadedly engage a portion of the locking screw.
[0014] In one embodiment, the system further includes a second clamping nut configured to be inserted into the bone. The second clamping nut includes a head and a body extending longitudinally from the head to a free end, and a channel extending through the body, the channel of the second clamping nut including internal threads extending thereal for threadedly receiving a portion of the shaft of a locking screw therein.
[0015] In one embodiment, the portion of the thread adjacent to the head of the locking screw includes an enlarged crest, and the internal thread adjacent to the head of the first clamping nut includes a corresponding enlarged crest for engaging the enlarged crest of the locking screw.
[0016] In one embodiment, a portion of the free end of the internal thread near the first clamping nut includes an enlarged crest that is configured to deform when it threadedly receives a locking screw therein.
[0017] In one embodiment, the unthreaded portion of the body of the first clamping nut includes a stepped hysteresis, such that a portion of the unthreaded portion adjacent to the head of the first clamping nut has a larger diameter than the remainder of the unthreaded portion.
[0018] In one embodiment, the head of the first clamping nut includes one or more holes extending therethrough, each of the one or more holes being configured to receive an anchoring screw therein, such that when the anchoring screw is received therein, the axis of the anchoring screw extends along the outer surface of the body of the first clamping nut.
[0019] In one embodiment, the system further includes an anchoring screw received in one or more holes such that when it is desired to anchor the first clamping screw to the bone, the anchoring screw can be rotated relative to the one or more holes to be driven into the bone.
[0020] In one embodiment, a portion of the body of the first clamping nut is deformed radially inward toward its longitudinal axis, resulting in interference with the locking screw when it is threadedly received therein.
[0021] Furthermore, this disclosure relates to a method for treating bone. The method includes: inserting an intramedullary nail into the medullary canal of a long bone through an insertion point located at the distal end of the bone; inserting a first clamping nut through the bone such that a channel of the first clamping nut is substantially longitudinally aligned with a locking hole extending through a distal portion of the intramedullary nail; and driving a locking screw through the bone such that an axis of the locking screw extends through the bone and through the locking hole, a portion of which is threadedly received within and engages the first clamping nut, the locking screw including a head portion from which the axis extends to a free end.
[0022] In one embodiment, driving the locking screw through the bone includes inserting the locking screw into the bone from the side of the bone opposite to the first clamping nut, such that the first clamping nut receives and engages the free end of the shaft.
[0023] In one embodiment, driving the locking screw through the bone includes inserting a shaft through a channel of a first clamping nut such that when the locking screw is fully driven into the bone, the first clamping nut engages a portion of the shaft adjacent to the head portion of the locking screw.
[0024] In one embodiment, the method further includes inserting a second clamping nut into the bone from the side of the bone opposite to the first clamping screw, such that the free end of the locking screw is received within the second clamping nut and threadedly engaged with the second clamping nut. Attached Figure Description
[0025] Figure 1 A side view of a portion of a system according to an exemplary embodiment of this disclosure is shown;
[0026] Figure 2 It shows that according to Figure 1 A side view of the system with a locking screw having a washer;
[0027] Figure 3 It shows that according to Figure 1 Side view of the system's insertion device and clamping nut;
[0028] Figure 4 It shows that according to Figure 1 A perspective view of the system's clamping nut;
[0029] Figure 5 It shows Figure 4 A partial cross-sectional side view of the clamping nut;
[0030] Figure 6 It shows Figure 4 A plan view of the first end of the clamping nut;
[0031] Figure 7 A system according to another exemplary embodiment of this disclosure is shown;
[0032] Figure 8 It shows that according to Figure 7 Part of the system's locking screw;
[0033] Figure 9 It shows that according to Figure 7 A cross-sectional view of the system's clamping nut;
[0034] Figure 10 A cross-sectional view of a clamping nut according to another exemplary embodiment of the present disclosure is shown;
[0035] Figure 11 A cross-sectional view of a clamping nut according to another exemplary embodiment of the present disclosure is shown;
[0036] Figure 12 A side view of a clamping nut according to yet another exemplary embodiment of the present disclosure is shown;
[0037] Figure 13 A side view of a clamping nut according to an alternative embodiment of the present disclosure is shown;
[0038] Figure 14 A side view of a clamping nut according to another alternative embodiment of this disclosure is shown;
[0039] Figure 15 A side view of a clamping nut according to another exemplary embodiment of the present disclosure is shown;
[0040] Figure 16 It shows that according to Figure 15 A cross-sectional view of the clamping nut;
[0041] Figure 17It shows that according to Figure 15 A plan view of the end of the clamping nut;
[0042] Figure 18 A side view of a system according to another exemplary embodiment of this disclosure is shown;
[0043] Figure 19 It shows that according to Figure 18 Side view of the system's clamping nut;
[0044] Figure 20 It shows Figure 19 A cross-sectional view of the clamping nut;
[0045] Figure 21 It shows Figure 19 A plan view of the end of the clamping nut;
[0046] Figure 22 It shows that according to Figure 18 A side view of the system's insertion device;
[0047] Figure 23 A side view of a clamping nut according to another exemplary embodiment of the present disclosure is shown;
[0048] Figure 24 It shows Figure 23 A cross-sectional view of the clamping nut;
[0049] Figure 25 A side view of the clamping nut according to an alternative embodiment is shown;
[0050] Figure 26 It shows Figure 25 Another view of the clamping nut, rotated approximately 90 degrees around its longitudinal axis;
[0051] Figure 27 A side view of a clamping nut according to another exemplary embodiment of the present disclosure is shown;
[0052] Figure 28 It shows Figure 27 A cross-sectional view of the clamping nut;
[0053] Figure 29 It shows Figure 27 A plan view of the end of the clamping nut;
[0054] Figure 30 A side view of a clamping nut according to yet another exemplary embodiment of the present disclosure is shown;
[0055] Figure 31 It shows Figure 30 A cross-sectional view of the clamping nut; and
[0056] Figure 32 It shows Figure 30 A plan view of the end of the clamping nut. Detailed Implementation
[0057] This disclosure is understood with reference to the following description and accompanying drawings, wherein like reference numerals refer to similar elements. This embodiment relates to the treatment of bone, and more specifically to the treatment of long bones. An exemplary embodiment describes a system comprising: an intramedullary nail configured for insertion through a medullary canal of a long bone (e.g., the femur); a locking screw capable of insertion through a locking hole extending laterally through the intramedullary nail; and a clamping nut configured to engage a threaded end of the locking screw.
[0058] Locking screws and compression nuts work together to provide additional stability, fixation, and / or compression, for example, at the distal end of a bone. An exemplary embodiment describes a compression nut including a head portion and a body portion, the body portion including a channel configured to threadedly receive the threaded end of a locking screw. The compression nut of this embodiment also includes external threads only along the distal portion of the body portion to compress the bone fragment without rotating the distal bone fragment.
[0059] Although exemplary embodiments specifically illustrate and describe a retrograde femoral nail system, those skilled in the art will understand that the systems disclosed herein can be used to treat any of a variety of long bones, such as, for example, the humerus or tibia. Furthermore, although exemplary embodiments show and describe locking screws and clamping nuts providing stability and / or compression toward the distal end of the bone, those skilled in the art will understand that locking screws and clamping nuts can be used to provide additional stability / compression at any part of the bone. It should be noted that, as used herein, the terms proximal and distal are intended to refer to directions corresponding to the proximal and distal ends of the bone, respectively, as will be understood by those skilled in the art.
[0060] like Figures 1 to 6As shown, a system 100 according to an exemplary embodiment of this disclosure includes: an intramedullary nail 102 configured for insertion through the medullary canal of a long bone (e.g., the femur); and a locking screw 104 and a clamping nut 106 for securing, for example, the distal end 108 of the intramedullary nail 102 relative to the bone to provide stability and / or compression to the bone. The locking screw 104 is configured for insertion from a first side of the bone through a locking hole 110 extending laterally through a portion of the intramedullary nail 102. The clamping nut 106 includes a head 114 and a body 116 extending therefrom, the body 116 being configured to engage the free end 118 of the locking screw 104 from a second side of the bone opposite the first side to provide additional stability, fixation, and / or compression to the portion of the bone from which the locking screw 104 extends.
[0061] The body 116 includes an external thread 120 extending around and along a portion 122 of the body 116 separated from the head 114, such that when the body 116 of the clamping nut 106 is inserted into the bone to engage the free end 118 of the locking screw 104, compression of the bone is provided while preventing rotation of fractured portions of the bone. In one exemplary embodiment, the clamping nut 102 can be inserted into the bone using an insertion device 124 including a drive end 126 sized, shaped, and configured to engage a corresponding portion of a drive recess 128, as will be understood by those skilled in the art.
[0062] The intramedullary nail 102 extends from the distal end 108 to the proximal end (not shown). In one exemplary embodiment, the intramedullary nail 102 is a retrograde femoral nail configured to be inserted through the medullary canal of the femur via an insertion point located at the distal end of the bone. As those skilled in the art will understand, the size and shape of the intramedullary nail 102 in this embodiment are set and configured to correspond to the size and shape of the medullary canal of the bone.
[0063] In one embodiment, the locking hole 110 extends laterally through the distal portion 132 of the nail 102 and is configured to receive a locking screw 104 therein to provide stability, for example, at the distal end of the femur. The locking hole 110 extends through the distal portion 132 along an axis angled relative to the longitudinal axis of the nail 102. In one embodiment, the locking hole 110 extends through the distal portion 132 along an axis substantially perpendicular to the longitudinal axis of the nail 102. In another embodiment, the locking hole 110 extends through the distal portion 132 along an axis not perpendicular to the longitudinal axis of the nail 102. Although the exemplary embodiments describe a single locking hole 110, those skilled in the art will understand that the intramedullary nail 102 may include more than one locking hole 110, each of which is configured to receive a locking screw 104 therein.
[0064] like Figure 2 As shown, the locking screw 104 according to an exemplary embodiment is a standard bone screw, which, as those skilled in the art will understand, includes a head portion 134 and a shaft 136 extending therefrom to a free end 118. The shaft 136 includes threads 138 thereon, such that the locking screw 104 can be inserted into the bone and through a locking hole 110 by rotation of the locking screw 104 about its longitudinal axis. As those skilled in the art will understand, the locking screw 104 can be driven into the bone using an actuator, which, for example, is capable of engaging a drive recess within the head portion 134. The size and shape of the actuator and the drive recess can be correspondingly set such that, when engaged, rotation of the actuator will correspondingly rotate the locking screw 104 to drive the locking screw into the bone. The locking screw 104 is capable of being inserted into the bone and through the locking hole 110 such that, when fully inserted, the head portion 134 abuts against the cortex of the bone along a first side, and the length of the locking screw 104 extends substantially through the width of the bone.
[0065] like Figures 3 to 6 As shown, a clamping nut 106 extends from a first end 130 to a second free end 140 and includes a head 114 and a body 116 extending from the head 114 to the second end 140. The body 116 includes a channel 142 extending longitudinally therein from the second end 140. The channel 142 is configured to receive the free end 118 of a locking screw 104 therein and includes an internal thread 144 along its inner surface 146. The internal thread 144 corresponds to the thread 138 of the locking screw 104, such that when rotated about the axis 136 of the locking screw 104, the internal thread 144 of the clamping nut 106 engages the thread 138 of the locking screw 104.
[0066] According to this embodiment, the free end 140 of the body 116 includes a plurality of cutting teeth 148 extending around a surface 150 of a clamping nut 106, which face the cortex of the bone when the clamping nut 106 is inserted into the bone. The cutting teeth 148 include sharp edges to facilitate cutting the bone when the body 116 of the clamping nut 106 is inserted into the bone. In one embodiment, the tips 149 of the cutting teeth 148 are angled in a direction corresponding to the rotational direction in which the clamping nut 106 will rotate to drive the clamping nut 106 into the bone. Each cutting tooth 148 is defined by a first edge 151 and a second edge 153, which are angled relative to the tip 149 toward each other. In one example, the first edge 151 may extend substantially parallel to the longitudinal axis of the clamping nut 106, while the second edge 153 is angled toward the tip 149 relative to it.
[0067] As described above, the body 116 of the compression nut 106 also includes an external thread 120 extending along a portion 122 of the body 116 around an outer surface 152, the body being separated from the head 114 via a threadless portion 123. The threaded portion 122 may have an exemplary range of 1 mm to 5 mm, and the threadless portion 123 may have an exemplary range of 0 mm to 15 mm. In one embodiment, the threaded portion 122 extends near the free end 140. Thus, when the compression nut 106 is driven into the bone, the external thread 120 engages the bone when the compression nut 106 is threaded over the locking screw 104 to provide compression to the bone while also preventing fractured portions of the bone from rotating along, for example, a second side of the bone. Specifically, the clamping nut 106 can be driven to the second side of the bone opposite to the first side, such that the longitudinal axis of the clamping nut 106 is substantially aligned with the longitudinal axis of the locking screw 104, which has been inserted through the locking hole, such that when the clamping nut 106 is driven into the bone, the body 116 is threaded over the free end 118 of the locking screw 104.
[0068] Similar to the locking screw 104, the head 114 of the clamping nut 106 includes a drive recess 128 capable of engaging an actuator (such as, for example, an insertion device 124) that drives the clamping nut 106 into the bone via rotation of the clamping nut 106. In one embodiment, the drive recess 128 opens to and communicates with a channel 142. In this embodiment, each of the drive recess 128 and the channel 142 is axially aligned with the longitudinal axis of the clamping nut 106. In an exemplary embodiment, the drive recess 128 includes a central portion 154 and a plurality of engagement recesses 156 extending radially therefrom. In one embodiment, each engagement recess 156 may be equidistantly spaced from each other. The size and shape of the central portion 154 and the plurality of engagement recesses 156 may be set and configured such that a correspondingly sized and shaped drive tip 126 of an insert can be received and engaged therewith, such that rotation of the insertion device 124 about its longitudinal axis correspondingly rotates the clamping nut 106.
[0069] In one embodiment, the insertion device 124 includes a handle portion 160 and a shaft 162 extending therefrom to a drive tip 126. As described above, the drive tip 126 is sized and shaped to be received within a drive recess 128 of a clamping nut 106. Specifically, the drive tip 126 includes a plurality of radially outwardly extending protrusions 164 extending from the shaft 162, each protrusion 164 being received in a corresponding engagement recess in an engagement recess 156 of the drive recess 128. In one embodiment, the plurality of protrusions 164 correspond to a plurality of recesses 156.
[0070] According to an exemplary method, system 100 can be used to treat fractures of long bones, and specifically, to treat fractures of the distal femur. In this embodiment, an intramedullary nail 102 is inserted through the distal end of the femur such that the distal portion 132 of the intramedullary nail 102 is received within the distal end of the femur. A guide hole can be drilled in the distal end of the bone using, for example, a drill bit, such that the guide hole extends through the bone and through the locking hole 110 of the intramedullary nail. Once the guide hole has been drilled, a guide wire can be inserted through the guide hole such that the tip of the guide wire extends from the outer surface of the bone on a first and second side.
[0071] In one embodiment, the clamping nut 106 slides on a guide wire and is inserted into the bone. Specifically, when the clamping nut 106 is rotated about its longitudinal axis using, for example, an insertion device 124, cutting teeth 148 at the free end 140 of the body 116 of the clamping nut 106 cut into the bone. The clamping nut 106 is driven into the bone until the body 116 is received within the bone and the head 114 abuts against the outside of the bone on a second side. Although not shown, those skilled in the art will understand that the drill bit for drilling the guide hole and / or the guide wire for guiding the clamping nut 106 can be aimed and guided into the bone and through the locking hole 110 by using an aiming arm or other similar device coupled to, for example, the distal end 108 of an intramedullary nail 102, as will be understood by those skilled in the art.
[0072] When the compression nut 106 is inserted into the bone, the guide wire can be removed from the bone, and the locking screw 104 can be inserted from a first side of the bone through a guide hole. The locking screw 104 is driven through the guide hole and through the locking hole 110 of the intramedullary nail 102 until the free end 118 of the shaft 136 is received within the channel 142 of the compression nut 106, and the internal thread 144 extending along the channel 142 of the compression nut 106 is threadedly engaged along the thread 138 of the free end 118. The shaft 136 extends through the bone, and the head portion 134 of the locking screw 104 abuts against the cortex along the first side of the bone. Although the head portion 134 is described as abutting against the bone, those skilled in the art will understand that a washer 158 may be placed between the head portion 134 and the cortex of the bone. Once the locking screw 104 and the compression nut 106 have been inserted into the bone to engage with each other, final compression can be controlled by further rotating one of the locking screw 104 and the compression nut 106.
[0073] According to another exemplary system 1100, such as Figures 7 to 9As shown, system 1100 includes two clamping nuts 1106 (1106a, 1106b) which can be used to secure both ends of locking screw 1104 to increase the stability of the screw construction. Locking screw 1104 may be substantially similar to locking screw 1104, including a head portion 1134 and a shaft 1136 having threads 1138 extending along its outer surface. In one embodiment, as... Figure 8 As shown, thread 1138 includes an enlarged crest 1139 along shaft 1136 adjacent to head 1134 relative to the remainder of shaft 1136.
[0074] Each of the two clamping nuts 1106 may be substantially similar to the nut 106 of system 100, including an external thread 1120 along a portion 1122 of a body 1116, which is separated from the head 1114 via a threadless portion 1123. However, in this embodiment, as Figure 9 As shown, the internal thread 1144 along the channel 1142 extending through the body 1116 of the clamping nuts 1106a and 1106b matches the thread 1138 along the shaft 1136 of the locking screw 1104 to facilitate the assembly of the first clamping nut 1106a and the locking screw 1104. Specifically, a portion of the internal thread 1144 along a portion 1143 of the channel 1142 adjacent to the head 1114 corresponds to the enlarged thread crest 1139 of the shaft 1136.
[0075] Similar to the exemplary method described above with respect to system 100, when using system 1100, an intramedullary nail 1102 can be inserted into the bone, and a guide hole drilled in the bone passes through a locking hole 1110 that extends laterally through a portion of the intramedullary nail 102. However, in this embodiment, a first nut 1106a is inserted along a first side of the bone through the cortex until the head portion 1114 of the first nut 1106 contacts the cortex along the first side. The free end of a locking screw 1104 is inserted into the head portion 1114 of the first nut 1106a and passes through the body 1116 of the nut 1106a, such that the shaft 1136 of the locking screw 1104 engages with the internal threads of the body 1116. Because the thread 1138 of the shaft 1136 matches the internal thread 1144 of the first clamping nut 1106a, the locking screw 1104 can be easily moved longitudinally relative to the first nut 1106a until the free end extends beyond the body 1116 and the head portion 1134 of the locking screw 1104 abuts against the head portion 1114 of the first nut 1106a. In other words, the enlarged thread crest 1139 resides within and engages with the portion 1143 of the channel 1142 adjacent to the head 1114 of the clamping nut 1106a.
[0076] Once the locking screw 1104 has been inserted through the first nut 1106a and into the bone, as described above, the second nut 1106b can be inserted along the second side of the bone opposite the first side through the skin to engage the free end of the locking screw 1104. Alternatively, the second clamping nut 1106b can be inserted into the bone from the second side before the locking screw 1104 is inserted, such that the locking screw is inserted into the bone through the first clamping nut 1106b until the free end of the shaft 1136 is received within and engaged with the body 1116 of the second clamping nut 1106b. Those skilled in the art will understand that inserting the clamping nuts 1106a and 1106b into the bone and engaging the free end of the shaft 1136 with the second clamping nut 1106b is substantially similar to the insertion of the nut 106 as described above with respect to system 100.
[0077] like Figure 10 As shown, a clamping nut 206 according to another exemplary embodiment is substantially similar to clamping nut 106 (except as indicated below) and can be used in conjunction with intramedullary nails and locking screws, as described above with respect to system 100. Similar to clamping nut 106, clamping nut 206 is configured to engage the free end of a locking screw, which may be substantially similar to locking screw 104 as described above with respect to system 100. Clamping nut 206 includes a head 214 and a body 216 extending longitudinally therefrom to a free end 240. Similar to clamping nut 106, clamping nut 206 includes an external thread 220 extending along a threaded portion 222 of body 216, the body being separated from head 214 via an unthreaded portion 223 of body 216. Similar to clamping nut 106, clamping nut 206 also includes a channel 242 extending longitudinally from free end 240, the channel 242 including an internal thread 244 configured to receive and engage the end of the locking screw therein.
[0078] However, in this embodiment, a portion of the internal thread 244 includes an enlarged crest 245 configured to prevent or reduce postoperative loosening of the clamping nut 206, which may be caused by cyclic loads on the components (e.g., the intramedullary nail, locking screw, and clamping nut 206). Specifically, when the free end of the locking screw 104 is threadedly engaged with the channel 242 of the clamping nut 206, the enlarged crest 245 deforms to lock the locking screw relative to the clamping nut 206 once the locking screw and clamping nut 206 are fully assembled. The enlarged crest 245 extends only along a portion of the thread 244 to facilitate the initial assembly of the locking screw and clamping nut 206. In one embodiment, the enlarged crest 245 may extend along a single turn of the thread 244. However, those skilled in the art will understand that the portion of the thread along which the enlarged crest 245 extends can be varied as needed.
[0079] like Figure 11 As shown, a clamping nut 306 according to another exemplary embodiment may be substantially similar to clamping nuts 106, 206 as described above, except as indicated below. Similarly, clamping nut 306 includes a head 314 and a body 316 extending longitudinally therefrom to a free end 340. The body 316 includes an external thread 320 extending along a threaded portion 322, which is separated from the head 314 via a non-threaded portion 323. However, in this embodiment, the non-threaded portion 323 includes a stepped hysteresis 366 such that a portion 368 of the non-threaded portion 323 immediately adjacent to the head 314 has a larger diameter than the remaining portion 370 of the non-threaded portion 323. The smaller diameter of the remaining portion 370 allows the nut to compress without rotating the bone plate, while the portion 368 with the larger diameter maintains stability by engaging the cortex of the bone, filling the bone region removed via the external thread 320 during insertion of the clamping nut 306 into the bone.
[0080] like Figure 12 As shown, a clamping nut 406 according to another exemplary embodiment is substantially similar to the clamping nuts 106-306 described above, except as indicated below, including a head 414 and a body 416 extending longitudinally therefrom to a free end 440. The body 416 includes external threads 420 extending along a threaded portion 422, and is separated from the head 414 via a threadless portion 423. However, in this embodiment, the clamping nut 406 also includes a plurality of holes 472 extending through the head 414, each hole 472 being configured to receive a screw 474 therein to enhance rotational stability and increase surface area in the bone. The clamping nut 406 may be particularly useful in demanding bone regions (e.g., osteoporotic bone) or in demanding fracture patterns to improve load transfer.
[0081] Each hole in the bore 472 extends axially through the head 414, and in one embodiment, this axis is angled relative to the longitudinal axis of the clamping nut 406. The bore 472 extends through a portion of the periphery of the drive recess / channel surrounding the clamping nut 406, such that when the screw 474 is inserted through the bore 472, the shaft 476 of the screw 474 extends around the periphery of the body 416 of the clamping nut 406 to extend into the bone, thereby providing enhanced anchorage of the clamping nut 406 in the bone. In one embodiment, the screw 474 may be a self-drilling / self-tapping screw. However, the screw 474 may have various different lengths, diameters, pitches, and / or tips. The bore 472 may have any of a variety of configurations configured to receive any of a variety of different types of screws 474. For example, the bore 472 may be a threadless bore, a one-way threaded bore, or a variable-angle bore.
[0082] Although the clamping nut 406 is described and shown as including a plurality of holes 472, according to alternative embodiments, such as Figure 13 As shown, the clamping nut 406a may include a single hole 472a extending through the head 414a of the clamping nut 406a, such that a larger self-tapping screw 474a may be inserted through the hole 472a to anchor the clamping nut 406a to the bone.
[0083] According to another example, such as Figure 14 The clamping nut 406b shown may be substantially similar to the nuts 406, 406a described above, except as described below. Instead of inserting a screw through one or more holes 472b extending through the head 414b of the clamping nut 406b during bone surgery, the clamping nut 406 includes a screw 474b pre-captured within the holes 472b, thus saving valuable time during surgery. Specifically, the screw 474b is assembled / received within the holes 472b before the clamping nut 406b is inserted into the bone. Thus, when the clamping nut 406b is inserted into the bone, the surgeon or other user can drive one or more pre-assembled screws 474b into the bone.
[0084] like Figures 15 to 17 As shown, a clamping nut 506 according to another exemplary embodiment of this disclosure may be substantially similar to the clamping nuts 106-406 described above, except as described below, including a head 514 and a body 516 extending therefrom to a free end 540. The body 516 includes an external thread 520 extending along a threaded portion 522, and is separated from the head 514 via a threadless portion 523. The body 516 also includes a channel 542 extending therethrough, configured to receive the free end of a locking screw, as described above with respect to system 100. However, in this embodiment, the body 516 deforms in a direction orthogonal to the longitudinal axis of the clamping nut 516 to create interference with the locking screw that engages therewith, thereby reducing loosening of the clamping nut 506 during dynamic loading on the system.
[0085] In one embodiment, the body 516 is deformed after both the external thread 520 and the internal thread along the channel 542 are manufactured during the manufacture of the clamping nut 506. The body 516 deforms toward the longitudinal axis from two or more directions orthogonal to the longitudinal axis of the clamping nut 506. In one embodiment, as... Figure 15 As shown, when the body 516 deforms in two directions, the opposite sides of the body 516 (e.g., diameters opposite each other) press inward toward each other. In another embodiment, the body 516 deforms in four directions (e.g., ... Figures 16 to 17 As shown), each of these directions applies a force at approximately a 90-degree angle to each other.
[0086] However, those skilled in the art will understand that deformation of the body 516 can be caused by forces applied from any number of directions from any of the various configurations positioned relative to each other. Those skilled in the art will also understand that... Figures 16 to 17 The enlarged deformation of the body 516 is shown, and the body 516 is deformed sufficiently to cause interference with the locking screw without preventing the clamping nut 506 and the locking screw from rotating relative to each other, or the clamping nut 506 from rotating into the bone. In the above exemplary embodiment, the clamping nut 506 may have an exemplary deformation of 0.1 mm to 1 mm.
[0087] like Figures 18 to 22 As shown, system 600 according to another exemplary embodiment of this disclosure may be substantially similar to system 100 described above. System 600 similarly includes: an intramedullary nail 602 configured to be inserted through the medullary canal of a long bone; and a locking screw 604 and a compression nut 606 for securing, for example, the distal end 608 of the intramedullary nail 602 relative to the bone to provide stability and / or compression to the bone. The locking screw 604 is configured to be inserted through a locking hole 610 extending laterally through a portion of the intramedullary nail 602 from a first side of the bone toward a second side of the bone.
[0088] The intramedullary nail 602 and locking screw 604 are substantially similar to those described above with respect to system 100. The clamping nut 606 is also substantially similar to clamping nut 106, comprising a head 614 and a body 616 extending therefrom. However, in this embodiment, the body 616 includes a first portion 623 and a second portion 622. The first portion 623 includes an outer surface 652 that tapers from the head 624 toward the second portion 622, which has a substantially uniform cross-section along its length. The first portion 623 provides a tapered transition from the head 614 along the body 616 to provide better fit with bone geometry and prevent soft tissue irritation. System 600 may also include an insertion device 624 comprising a drive tip 626 whose size and shape are specifically set and configured to engage a drive recess 628 of clamping nut 606, as will be described in further detail below.
[0089] The clamping nut 606 includes a head 614 and a body 616 extending therefrom to a free end 640. As described above, the body 616 also includes a first portion 623 that tapers from the head 614 toward a second portion 622. In one embodiment, the outer surface 652 of the first portion 623 is substantially conical, while the second portion 622 is substantially cylindrical. An external thread 620 extends along both the first portion 623 and the second portion 622, the second portion including the free end 640. Similar to the clamping nut 106, the free end 640 includes cutting teeth 648 to facilitate cutting bone when the clamping nut is inserted therein. The clamping nut 606 also includes a channel 642 extending therethrough, the channel 642 including an internal thread 644 that extends thereal to engage, for example, thread 638, along the free end of the shaft 636 of the locking screw 604.
[0090] like Figure 21 As shown, the head 614 of the clamping nut 606 includes a drive recess 628 configured to engage the drive tip 626 of the insertion device 624. However, the drive recess 628 comprises a plurality of recesses 656 extending into the head 614, each recess 656 configured to receive a corresponding portion of the drive tip 626 of the insertion device 624. The recesses 656 extend into the head 614 around the periphery of the channel 642. In one embodiment, each recess 656 may be equidistant from adjacent recesses 656. In one embodiment, as... Figure 21 As shown, each recess 656 has a substantially circular cross-section. However, those skilled in the art will understand that the recesses 656 of the drive recess 628 can be configured in any of a plurality of orientations and can have any of a plurality of shapes and sizes, provided that the drive recess is configured to receive and engage the drive tip 626 of the corresponding size and shape of the insertion device 624.
[0091] like Figure 22 As shown, the insertion device 624 may be substantially similar to the insertion device 124, including a handle portion 660 and a shaft 662 extending therefrom. The shaft 662 may include a channel extending therethrough, such that in one embodiment, the shaft 662 is substantially tubular. The shaft 662 extends from the handle portion 660 to a drive tip 626, the drive tip 662 including a plurality of forks 664 extending from an end face 663 of the shaft 662. Each fork 664 extends substantially parallel to the longitudinal axis of the shaft 662 and is sized and shaped to be received within a corresponding recess 656 of a clamping nut 606, such that when the fork 664 is received within the recess 656, a rotational force applied to the insertion device 624 will correspondingly rotate the clamping nut 606 to drive the clamping nut 606 into the bone.
[0092] Those skilled in the art will understand that inserting the various components of system 600 into bone requires extensive X-rays to control the progress of the locking screw 604 and / or the clamping nut 606 in the bone. In one embodiment, the shaft 662 of the insertion member 624 includes a mark 625 along the length of the shaft 662, such that the position of the mark 625 relative to, for example, a portion of an aiming arm (through which the shaft 662 passes to insert the clamping nut 606 into the bone) indicates to the surgeon or other user the progress of the clamping nut 606 in the bone.
[0093] like Figures 23 to 24 As shown, a clamping nut 706 according to another exemplary embodiment of this disclosure may be substantially similar to clamping nut 606, as described above with respect to system 600, and may be used in substantially the same manner with intramedullary nail 602 and locking screw 604. Similar to clamping nut 606, clamping nut 706 includes a head 714 and a body 716 extending therefrom, the body 716 including a first transition tapered portion 723 extending from the head 714 to a second portion 722. External threads 720 extend along both the first portion 723 and the second portion 722. Clamping nut 706 also includes a channel 742 extending therethrough, the channel 742 including internal threads 744 extending therefrom, such that clamping nut 706 can be threaded over, for example, the free end of locking screw 604.
[0094] However, to enhance the engagement between the locking screw and the clamping nut 706, the body 716 includes a plurality of slots 780 extending through its wall 782, which is defined by the inner surface of the channel 742 and the outer surface of the body 716, such that the interior of the channel 742 opens to the exterior of the clamping nut 706 via the slots 780. The slots 780 allow the body 716 to deform relative to the locking screw to provide controlled interference between them. In one embodiment, the slots 780 extend through a second portion 722 of the body 716.
[0095] In one embodiment, the slot 780 may extend laterally through the wall 782 of the body 716 to allow deformation of the body 716, which creates a mismatch of spring load between the internal thread 744 of the clamping nut 706 and the thread of the locking screw received therein. In this embodiment, the slot 780 extends substantially perpendicularly to the longitudinal axis of the clamping nut 706, extending around a portion of the circumference of the body 716. In an exemplary embodiment, the portion of the circumference of the body 716 may be 90° to 170°. Furthermore, the mismatch of spring load may occur due to compression or stretching of the clamping nut 706 during manufacturing.
[0096] Multiple slots 780 extend around a portion of the circumference of the body 716 and along a portion of the length of the body 716. In one embodiment, adjacent slots of the multiple slots 780 may be offset relative to each other along the length of the body 716. The lateral configuration of the slots 780 allows the body 716 to expand or compress longitudinally along the longitudinal axis of the clamping nut 706 and to bend relative to the longitudinal axis of the clamping nut 706 or to twist about the longitudinal axis of the clamping nut 706, resulting in a mismatch of pitch and / or orientation between the external thread of the locking screw and the internal thread 744 of the clamping nut 706. This interference between the clamping nut 706 and the locking screw retains the clamping nut 706 on the locking screw 704 to prevent / reduce loosening of the clamping nut 706 after the procedure.
[0097] In alternative implementation schemes, such as Figures 25 to 26 As shown, the clamping nut 706a may be substantially similar to the clamping nut 706 described above, including a plurality of lateral slots 780a extending through its body 716a. However, adjacent slots 780a are not offset from each other along the length of the body 716a, but may be substantially aligned along the length of the body 716a. Adjacent slots 780a may or may not extend around corresponding portions of the circumference of the body 716a, ranging between approximately 90° and 170°.
[0098] In another implementation, such as Figures 27 to 29 As shown, the clamping nut 806 may be substantially similar to the clamping nuts 706, 706a described above. However, the clamping nut 806 includes a body 816 having slots 880 extending longitudinally through the wall 882 of the body 816, rather than transverse slots. Each slot 880 extends substantially parallel to the longitudinal axis of the clamping nut 806 along a portion of the length of the body 816. In one embodiment, the slots 880 are arranged in pairs, and a portion 884 of the body 816 extending between the first slot 880a and the second slot 880b in each pair of slots 880 is radially deformed inward toward the longitudinal axis of the clamping nut 806 to create a desired interference between the clamping nut 806 and the locking screw received within its channel 842. The distance between the first slot 880a and the second slot 880b in each pair of slots 880 may be from 0.3 mm to 3 mm.
[0099] In one embodiment, the clamping nut 806 includes four pairs of slots 880 to define four deformable portions 884. Each slot in each pair of slots 880 may be equidistant from adjacent slots in that pair of slots 880. However, those skilled in the art will understand that the clamping nut 806 may include any number of slot pairs 880 to define any number of deformable portions 884 having any of a variety of configurations. In the above embodiment, the portion 884 between the first slot 880a and the second slot 880b is deformed during manufacturing.
[0100] Figures 30 to 32 Another embodiment of the clamping nut 1806 is shown, which includes a longitudinal slot 1880 extending through the wall 1882 of the body 1816 of the clamping nut 1806. However, the longitudinal slots 1880 are not arranged in pairs. Instead, a portion 1884 of the body between adjacent slots 1880 deforms radially inward toward the longitudinal axis of the clamping nut 1806, such that a larger portion of the body 1816 deforms relative to the clamping nut 1806. In one embodiment, the clamping nut 1806 includes four longitudinal slots 1880, each longitudinal slot being equidistant from adjacent slots 1880. However, those skilled in the art will understand that the slots 1880 may be arranged around and along the body 1816 in any of a variety of configurations to define the deformed portion 1884.
[0101] Although the above embodiments show and describe the clamping nut 706 (706a and 806, 1806) including a transverse or longitudinal slot 780, those skilled in the art will understand that the slot 780 may have any of a variety of sizes, shapes, and configurations, as long as the slot 780 is configured to allow deformation of the body 716 of the clamping nut 706, which would result in interference between the clamping nut 706 and the locking screw threadedly received therein. For example, in another embodiment, the clamping nut may include a slot that extends helically through the wall of a portion of the body.
[0102] Those skilled in the art will understand that modifications and variations can be made to the structure and method of the embodiments without departing from the spirit or scope of the embodiments of the present invention. Therefore, the embodiments of the present invention are intended to cover various modifications and variations of these embodiments, provided that they fall within the scope of the appended claims or their equivalents.
Claims
1. A compression nut for treating bone, comprising: A head and a body, the body extending longitudinally from the head to a free end, the body including a first portion having an outer surface tapering from the head toward a second portion, and external threads extending along both the outer surfaces of the first and second portions of the body; and A channel extending longitudinally through the body and including an internal thread extending along the inner surface of the channel, the internal thread being configured to threadily engage a portion of a locking screw within the channel. The second part has a substantially uniform cross-section along its length. The clamping nut further includes a plurality of slots extending through a wall of the body, the wall being defined by an inner surface of the channel and an outer surface of the body, such that the channel opens to the outside of the clamping nut via the slots. The plurality of slots extend through the second portion of the body. Each of the plurality of slots extends longitudinally along a portion of the length of the body, and The plurality of slots are arranged in pairs such that the longitudinal portion of the body extending between the first and second slots in each pair of slots deforms radially inward toward the longitudinal axis of the clamping nut.
2. The clamping nut according to claim 1, wherein, The free end includes cutting teeth configured to cut the bone when the clamping nut is driven into the bone.
3. The clamping nut according to claim 1, wherein, The first part of the body is substantially conical, and the second part of the body is substantially cylindrical.
4. A system for treating long bones, comprising: An intramedullary nail capable of being inserted through the medullary canal of bone, the intramedullary nail extending from a proximal end to a distal end and including a locking hole extending through the intramedullary nail along an axis that extends at an angle relative to the longitudinal axis of the intramedullary nail; A locking screw configured to be inserted into the bone and pass through the locking hole, the locking screw including a head portion and an axis extending from the head portion to a free end, the axis including threads extending along the axis; and A clamping nut, comprising a head and a body extending longitudinally from the head to a free end, the body including a first portion having an outer surface tapering from the head toward a second portion, external threads extending along both the outer surfaces of the first and second portions of the body, a channel extending longitudinally through the clamping nut, and including internal threads extending along a portion of the inner surface of the channel to threadedly engage a portion of a locking screw in the channel. The second part has a substantially uniform cross-section along its length. The clamping nut includes a plurality of slots extending through the wall of the body, such that the channel opens through the slots to the outside of the clamping nut. The plurality of slots extend through the second portion of the body. Each of the plurality of slots in the clamping nut extends longitudinally along a portion of the length of the body, and The plurality of slots are arranged in pairs such that the longitudinal portion of the body extending between the first and second slots in each pair of slots deforms radially inward toward the longitudinal axis of the clamping nut.
5. The system of claim 4 further includes an insertion device, the insertion device comprising a handle member and a shaft extending from the handle member to an end including a drive tip.
6. The system according to claim 5, wherein, The drive tip includes a plurality of forks extending longitudinally from the end face of the shaft.
7. The system according to claim 6, wherein, The clamping nut includes a drive recess extending into the head of the clamping nut, the drive recess including a plurality of recesses extending around the periphery of the channel, each of the recesses being sized, shaped and configured to receive a corresponding fork among the forks therein.
8. The system according to claim 7, wherein, Each of the plurality of recesses has a circular cross-section.
Citation Information
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