Humeral intramedullary nail

Abstract

A humeral intramedullary nail can include a length extending between a first end and a second end, wherein the length includes a longitudinal axis. The humeral intramedullary nail can also include a distal portion adjacent the first end, a proximal portion adjacent the second end, and a first oblong distal hole formed through the distal portion. The first distal hole can be configured to receive a first fastening member in a first direction transverse to the longitudinal axis. The humeral intramedullary nail can further include a second distal hole formed through the distal portion. The second distal hole can be closer to the first end than the first oblong distal hole and configured to receive a second fastening member in a second direction transverse to the longitudinal axis. The humeral intramedullary nail can further include a plurality of proximal holes formed through the proximal portion.

Description

Background Technology

[0001] The skeletal system comprises many different types of bones, which in turn require different orthopedic treatment options. For example, the repair of fractures of long bones (such as the femur and humerus) often uses intramedullary nails. These implants are elongated structures designed to fit within the medullary canal or space of the bone shaft (i.e., the center of the bone) to stabilize the fracture. Screws are typically used in conjunction with intramedullary nails to hold them in place within the bone. While screws are usually inserted through the bone into both the distal and proximal portions of the nail, different bones and nail sizes require different screw placements.

[0002] For example, intramedullary nails for the humerus require specific screw placement to avoid medical complications (e.g., undesirable contact with nerves, blood vessels, tissues (e.g., tendons), other biological materials, and the like). Particular attention is paid to the biceps tendon and radial nerve in the humerus. Furthermore, the anatomy varies among patients, requiring a degree of flexibility in screw placement while maintaining optimal screw stability.

[0003] Therefore, there is a need for an improved intramedullary nail, especially for the humerus. Summary of the Invention

[0004] While not necessarily limited to a specific nail configuration, this disclosure describes examples of short humeral intramedullary nails configured to receive specific placement of fastening members therein. Such fastening members are individually inserted into different holes along the length of the intramedullary nail. The multiple holes comprise holes of various sizes and shapes along various planes of the intramedullary nail. This hole configuration of the intramedullary nail is designed to increase stability by providing more locking options and to reduce the risk of interference with biological material such as the biceps tendon and radial nerve.

[0005] According to one aspect of this disclosure, an intramedullary nail for the humerus includes a length, a distal portion, a proximal portion, a plurality of distal holes, and a plurality of proximal holes. The length extends between a first end and a second end and includes a longitudinal axis. The distal portion is adjacent to the first end. The proximal portion is adjacent to the second end. The plurality of distal holes includes a first elliptical distal hole and a second distal hole. The first elliptical distal hole is formed through the distal portion and is configured to receive a first fastening member in a first direction transverse to the longitudinal axis. The second distal hole is formed through the distal portion and is closer to the first end than the first elliptical distal hole, and is configured to receive a second fastening member in a second direction transverse to the longitudinal axis. The plurality of proximal holes are formed through the proximal portion.

[0006] In other embodiments of this aspect, the humeral intramedullary nail may include a third distal hole formed through the distal portion. The third distal hole is configured to receive a third fastening member in a third direction transverse to the longitudinal axis and is located further from the first end than the first and second holes. The second and third fastening members may be threaded screws. The first and second directions are rotatable between 1 degree and 89 degrees. Multiple proximal holes may be transverse to the longitudinal axis. Multiple proximal holes may be configured to receive fastening members.

[0007] According to another aspect of this disclosure, the humeral intramedullary nail includes a first end, a second end, a distal portion, a proximal portion, a length, and a plurality of holes. The second end extends from the first end. The distal portion is adjacent to the first end. The proximal portion is adjacent to the second end. The length extends between the first and second ends and has a longitudinal axis. The plurality of holes extend through the length, wherein the plurality of holes are transverse to the longitudinal axis and are configured to each receive a fastening member. The plurality of holes includes a first distal hole, a second distal hole, and a third distal hole. The second distal hole is the hole closest to the first end among the plurality of holes and is rotated 1 degree to 89 degrees relative to the first distal hole about the longitudinal axis of the nail.

[0008] In other embodiments of this aspect, the third distal hole may be the second closest hole to the first end among a plurality of holes, and the first distal hole is the third closest hole to the first end among a plurality of holes. The third distal hole may be elliptical. The fastening member may be a threaded screw. The plurality of holes may include a first proximal hole, a second proximal hole, a third proximal hole, a fourth proximal hole, and a fifth proximal hole. The first proximal hole is the hole closest to the second end among the plurality of holes. The second proximal hole is located between the first proximal hole and the third proximal hole. The fourth proximal hole is located between the third proximal hole and the fifth proximal hole. The fifth proximal hole is the fifth closest hole to the second end among the plurality of holes. The second proximal hole may be rotated 74 degrees relative to the first proximal hole about a longitudinal axis. The third proximal hole may be rotated 325 degrees relative to the first proximal hole about a longitudinal axis. The fourth proximal hole may be rotated 290 degrees relative to the first proximal hole about a longitudinal axis. The fifth proximal hole may be rotated 355 degrees relative to the first proximal hole about a longitudinal axis.

[0009] According to another aspect of this disclosure, a humeral screw includes a first end, a second end, a length, and a plurality of holes. The first end has a distal portion adjacent to the first end. The second end has a proximal portion adjacent to the second end. The length lies between the first end and the second end and includes a longitudinal axis. The plurality of holes extend through the length and are transverse to the longitudinal axis and are configured to each receive a fastening member. The plurality of holes includes a first distal hole, a second distal hole, and a third distal hole. The second distal hole is the hole closest to the first end along the longitudinal axis among the plurality of holes and is rotated at least one degree about the longitudinal axis relative to the first distal hole.

[0010] In other embodiments of this aspect, the plurality of holes may include a third distal hole, which is the second closest hole to the first end among the plurality of holes. The third distal hole may be elliptical. The fastening member may be a threaded screw. The plurality of holes may include a first proximal hole, a second proximal hole, a third proximal hole, a fourth proximal hole, and a fifth proximal hole. The first proximal hole may be the hole closest to the second end among the plurality of holes. The second proximal hole may be between the first and third proximal holes. The fourth proximal hole may be between the third and fifth proximal holes. The fifth proximal hole may be the fifth closest hole to the second end among the plurality of holes. The first, second, third, fourth, and fifth proximal holes may be rotatable relative to each other about a longitudinal axis. The second proximal hole may be rotated 74 degrees relative to the first proximal hole about a longitudinal axis. The third proximal hole may be rotated 325 degrees relative to the first proximal hole about a longitudinal axis, and the fourth proximal hole may be rotated 290 degrees relative to the first proximal hole about a longitudinal axis. The fifth proximal hole may be rotated 355 degrees relative to the first proximal hole about a longitudinal axis. Attached Figure Description

[0011] The features, aspects, and advantages of the invention will be better understood by referring to the following description, appended claims, and drawings, wherein: Figure 1 This is an illustration of a side view of an intramedullary nail for the humerus according to an embodiment of the present disclosure.

[0012] Figure 2 yes Figure 1 A side view of the intramedullary nail of the humerus, with the fastening member inserted therein.

[0013] Figure 3A yes Figure 1 Another side view of the intramedullary nail of the humerus, where no fastening member is inserted.

[0014] Figure 3B yes Figure 1 Another side view of the intramedullary nail of the humerus, with the fastening member inserted therein.

[0015] Figure 4A yes Figure 1 Another side view of the intramedullary nail of the humerus, where no fastening member is inserted.

[0016] Figure 4B yes Figure 1 Another side view of the intramedullary nail of the humerus, with the fastening member inserted therein.

[0017] Figure 5 yes Figure 1 A cross-sectional view of an intramedullary nail in the humerus, without any inserted fasteners.

[0018] Figure 6A yes Figure 1Another side view of the intramedullary nail of the humerus, with the proximal fastening member inserted therein.

[0019] Figure 6B yes Figure 1 Another side view of the intramedullary nail of the humerus, with the distal fastening member inserted therein.

[0020] Figure 6C yes Figure 1 Another side view of the intramedullary nail of the humerus, in which the proximal and distal fastening members are inserted.

[0021] Figure 7 yes Figure 1 A magnified stereoscopic view of the proximal portion of the intramedullary nail in the humerus.

[0022] Figure 8 for Figure 7 Another three-dimensional view of the proximal portion.

[0023] Figure 9 yes Figure 7 Top view of the proximal portion.

[0024] Figure 10A yes Figure 7 Another top view of the proximal portion, in which the proximal fastening member is inserted.

[0025] Figure 10B yes Figure 7 Another top view of the proximal portion, in which the distal fastening member is inserted.

[0026] Figure 10C yes Figure 7 Another top view of the proximal portion, in which the proximal fastening member and the distal fastening member are inserted.

[0027] Figure 11 yes Figure 1 A top view of the distal portion of the intramedullary nail in the humerus.

[0028] Figure 12 yes Figure 1 A three-dimensional view of the proximal portion of an intramedullary nail in the humerus.

[0029] Figure 13 yes Figure 1 A side view of an intramedullary nail for the humerus, in which a fastening member is inserted and inserted into the humerus (shown as partially transparent). Detailed Implementation

[0030] In describing preferred embodiments of the invention, specific terminology will be used for clarity. However, the invention is not intended to be limited to any particular terminology used herein, and it should be understood that each particular term includes all technical equivalents that operate in a similar manner to achieve a similar purpose. In the drawings and the following description, the term "proximal" means closer to the heart, and the term "distal" means farther from the heart. The term "anterior" means towards the front of the body or face, and the term "posterior" means towards the back of the body. The term "medial" means towards the midline of the body, and the term "lateral" means away from the midline of the body. It should be further understood that the intramedullary nail described herein can include both left and right nails. The embodiments described herein should not be construed as limited to left or right nails. Rather, embodiments discussed, such as those with a left nail, should also be construed as including right nails.

[0031] Various disclosed embodiments include systems and methods for inserting intramedullary nails and their screws. The intramedullary nail includes a plurality of holes along its length configured to receive fastening members to stabilize desired bone. The holes include proximal and distal holes, with the proximal holes adjacent to the proximal portion of the intramedullary nail and the distal holes adjacent to the distal portion of the intramedullary nail. The holes are transverse to the longitudinal axis of the intramedullary nail, and some of these holes are rotated relative to each other about the longitudinal axis. Specifically, the distal holes include three distal holes, with the first distal hole rotated to be in a plane different from the other two distal holes. Figure 10B As shown, the first distal hole is rotated 30 degrees relative to the other distal holes by a first angle 181, but the rotation angle can be between at least 1 degree and 89 degrees, 91 degrees and 179 degrees, 181 degrees and 269 degrees, and 271 degrees and 359 degrees. The distal hole further includes a second distal hole, which is an elliptical distal hole. The length of the elliptical distal hole allows the fastening member to be inserted along the hole at various lengths, thereby allowing dynamic locking. The proximal holes include five proximal holes, all of which are rotated to be in different planes from each other.

[0032] The configuration of different hole placements along the length of the intramedullary nail, and the elliptical shape of the second distal hole, allows for greater bone stability and a reduced risk of interference with biological material (e.g., the biceps tendon and radial nerve). This is advantageous because it allows for more fastening members to be inserted into the intramedullary nail to stabilize the bone, while mitigating the risk of undesirable contact with biological material. Specifically, variations in the placement of the first distal hole relative to the elliptical distal hole allow the fastening member to avoid undesirable contact with biological material (e.g., nerves) during and after insertion. Furthermore, the elliptical distal hole achieves similar results because the fastening member can be inserted into the elliptical distal hole at different points depending on the location of biological material in any given patient.

[0033] Depending on the fracture, the insertion of the distal fastening member can target either a distal elliptical or distal circular foramen. Specifically, unstable fractures may have an intramedullary nail configuration focused on stability, where the fastening member can be inserted at least into the circular distal foramen. For fractures where stability is less critical, dynamization can be prioritized, such that no fastening member is inserted into the circular distal foramen, but rather the elliptical distal foramen has a fastening member inserted therein. According to one embodiment, the fastening member can be inserted into both the circular and elliptical distal foramina, wherein the fastening member fastened to the circular foramen can be removed after a period of time, leaving only the elliptical foramen fastening member attached, thus causing dynamization. It should be understood that the humeral intramedullary nail may also include a second elliptical distal foramen. In one embodiment, the second elliptical distal foramen is rotated to lie in a different plane than the first elliptical distal foramen. This configuration allows for greater stability during dynamization than a single elliptical distal foramen configuration because it further restricts the degrees of freedom of the intramedullary nail within the patient.

[0034] on the whole, Figures 1 to 13 An intramedullary nail 100 with fastening members of different configurations in an insertion hole is shown.

[0035] Figure 1 This is an illustration of a schematic side view of an intramedullary nail 100 according to an embodiment. The depicted intramedullary nail 100 includes a shaft 120 extending about a longitudinal axis 125. The shaft 120 extends between a first end or distal end 121 and a second end or proximal end 122. The shaft 120 includes a distal portion 123 adjacent to the first end 121 and a proximal portion 124 adjacent to the second end 122, wherein each of the distal and proximal portions has a plurality of holes. In an embodiment, the holes are formed transversely to the longitudinal axis 125 through the shaft 120. Each hole is configured to receive a fastening member, such as, but not limited to, a screw (e.g., a...). Figure 2 (As shown), nails, bolts, anchors, rivets, any other fasteners, combinations thereof, and the like. Each of the fastening components passes completely through the nail 100 in a direction transverse to the longitudinal axis 125. Although holes of different sizes and shapes are conceivable, circular holes 101, 103, 111 to 115 each have a diameter 134 of approximately 4.5 mm and a tolerance of approximately +0.3 mm. The circular holes are configured to enable static locking. Although the shaft 120 can be of various sizes and shapes, the length of the shaft 120 between the first end 121 and the second end 122 is approximately 130 mm.

[0036] The distal portion 123 of shaft 120 includes a first distal bore 101, a second distal bore 102, and a third distal bore 103. As shown, the orientation of the first distal bore 101 is rotated relative to the other distal bores. It can be rotated at least one degree relative to the other distal bores, but as shown, it is offset by thirty degrees relative to the other distal bores. The rotation of the first distal bore 101 relative to the other distal bores at least prevents the fastening member from contacting nerves (e.g., but not limited to, the radial nerve, median nerve, ulnar nerve, musculocutaneous nerve, posterior nerve, lateral nerve, and the like). The first distal bore 101 can also be rotated to avoid other undesirable contact or reduce the chance of undesirable contact with arteries, veins, other nerves, tissues, tendons, other biological materials, medical implants, combinations thereof, and the like. Furthermore, having bores in different planes allows for greater stability by providing more locking options and increases resistance to bending. As shown in the figure, the first distal hole 101 is the hole closest to the first end 121 among the multiple holes, the second distal hole 102 is the hole second closest to the first end 121 among the multiple holes, and the third distal hole 103 is the hole third closest to the first end 121 among the multiple holes.

[0037] The second distal hole 102 is an elliptical hole, such as, but not limited to, a slot. The elliptical aperture is configured to enable dynamic positioning. Specifically, the elliptical nature of the second distal hole 102 allows the fastening member to be dynamically positioned, enabling the intramedullary nail to move and the fracture to be resolved while maintaining torsional stability. As a non-limiting example, the fastening member can be inserted near the distal portion of the elliptical hole 102 such that, when the bone is compressed, the fastening member moves proximally within the elliptical hole 102.

[0038] The first length 131, measured between the center of the first curve of the second end 122 and the second distal hole 102, is approximately 91.5 mm. The second length 132, measured between the center of the second curve of the second end 122 and the second distal hole 102, is approximately 97.5 mm. The width 133 of the second distal hole 102 is approximately 4.1 mm, and the tolerance of the width 133 is approximately +0.1 mm. The elliptical nature of the second distal hole 102 allows the fastening member to be inserted into the hole at different points along the width 133.

[0039] The proximal portion of shaft 120 includes a first proximal bore 111, a second proximal bore 112, a third proximal bore 113, a fourth proximal bore 114, and a fifth proximal bore 115. These proximal bores rotate relative to each other about a longitudinal axis 125. Specifically, the first proximal bore 111 is positioned at 29 degrees, the second proximal bore 112 at 103 degrees, the third proximal bore 113 at 354 degrees, the fourth proximal bore 114 at 319 degrees, and the fifth proximal bore 115 at 24 degrees. Alternatively, the proximal bores can be positioned as follows: Figure 10AAs shown, the second proximal hole 112 is rotated by a first angle 171 of 74 degrees relative to the first proximal hole 111 in a first direction about the longitudinal axis 125; the third proximal hole 113 is rotated by a second angle 172 of 109 degrees relative to the second proximal hole 112 in a second direction opposite to the first direction about the longitudinal axis 125 in a second direction; the fourth proximal hole 114 is rotated by a third angle 173 of 35 degrees relative to the third proximal hole 113 in a second direction about the longitudinal axis 125 in a second direction; the fifth proximal hole 115 is rotated by a fourth angle 174 of 65 degrees relative to the fourth proximal hole 114 in a first direction about the longitudinal axis 125 in a first direction; and the first proximal hole 111 is rotated by a fifth angle 175 of 5 degrees relative to the fifth proximal hole 115 in a first direction about the longitudinal axis 125. Figure 1 As shown in the embodiment, the first direction is clockwise. In other embodiments, the first direction is counterclockwise.

[0040] The first proximal hole 111 is inclined at an angle 135° to be non-perpendicular to the longitudinal axis 125. In some embodiments, the angle 135 is approximately 5 degrees, such that the angle between the longitudinal axis 125 and the axis of the proximal hole 111 passing through the shaft 120 is 85 degrees and 95 degrees. In another embodiment, the second proximal hole 112 is also inclined at an angle 135°, wherein the angle 135° is 5 degrees.

[0041] As shown in the figure, the first proximal hole 111 is the hole closest to the second end 122 among the multiple holes; the second proximal hole 112 is the second closest hole to the second end 122 among the multiple holes; the third proximal hole 113 is the third closest hole to the second end 122 among the multiple holes; the fourth proximal hole 114 is the fourth closest hole to the second end 122 among the multiple holes; and the fifth proximal hole 115 is the fifth closest hole to the second end 122 among the multiple holes. This results in the fifth proximal hole 115 being closer to the second end 122 than any of the distal holes. In other words, the fifth proximal hole 115 is farther from the first end 121 than any of the distal holes.

[0042] The distance 136 between the second end 122 and the center of the first proximal hole 111 is approximately 9.5 mm. The distance 137 between the second end 122 and the center of the second proximal hole 112 is approximately 15 mm. The distance 138 between the second end 122 and the center of the third proximal hole 113 is approximately 20 mm. The distance 139 between the second end 122 and the center of the fourth proximal hole 114 is approximately 25.5 mm. The distance 140 between the second end 122 and the center of the fifth proximal hole 115 is approximately 30 mm.

[0043] Figure 2 This is a first side view of an intramedullary nail with a fastening member 100 inserted therein, according to an embodiment.

[0044] Multiple holes are configured to each receive a fastening member. The fastening members are configured to be positioned within each of the multiple holes to intersect the longitudinal axis 125. As shown, the fastening members are positioned substantially equidistantly within the intramedullary nail 100 such that the length of the fastening member exposed from each opening of the hole is similar. However, the fastening members are not limited to this configuration; they can also be positioned at various other lengths along their length within the holes. For example, a patient's humerus may have varying or uneven thickness, requiring the fastening members to be positioned non-equidistantly within their respective holes to provide the desired support. Furthermore, different placements of the fastening members within the holes provide a wider range of support configurations depending on the fracture (e.g., fracture type, fracture severity, fracture angle, etc.). The dimensions of the fastening members themselves can also vary. Specifically, the dimensions of all fastening members can vary relative to the patient's humerus (e.g., size, age, sex, etc.) and relative to each other (i.e., proximal fastening member relative to distal fastening member).

[0045] The fastening components may include screws (e.g., distal screw 150 and proximal screw 160). The intramedullary nail 100 may include screws of various configurations, such as... Figure 3B As shown.

[0046] The distal screw 150 is configured to be received by any distal hole (e.g., the second distal hole 102). The distal screw 150 can be used in each of a plurality of distal holes, such that all, some, or no distal holes have a distal screw 150 inserted therein. In an embodiment, the distal screw 150 can be received by any proximal hole.

[0047] The proximal screw 160 is configured to be received by any proximal foramen. The proximal screw 160 can be used in each of a plurality of proximal foramen, such that all, some, or no proximal foramen has a proximal screw 160 inserted therein. Up to three of the inserted proximal screws 160 are configured to support fixation of the larger tubercle, up to one of the inserted proximal screws 160 is configured to support fixation of the smaller tubercle, and up to one of the proximal screws 160 is configured to support fixation of the calcar. It should be understood that the proximal screws 160 can be inserted in any other configuration or combination. As a non-limiting example, two of the three proximal screws 160 are used to support the larger tubercle, zero of the one proximal screw 160 is used to support the smaller tubercle, and one of the one proximal screws 160 is used as a calcar screw. In embodiments, the proximal screw 160 can be received by any distal foramen.

[0048] The elliptical nature of the distal hole 102 allows the distal screw 150 to be positioned at various lengths along the slot. This variability in placement allows for desired placement within the patient, as the anatomy of the humerus may differ from patient to patient. Furthermore, the elliptical shape of the distal hole 102 allows the fastening member (e.g., the distal screw 150) to be inserted into a dynamic position such that the fractured humerus can be compressed as the distal screw 150 moves proximally within the elliptical hole.

[0049] The variability in the number of distal screws 150 and proximal screws 160 used in the intramedullary nail 100 allows for more desirable configurations. Specifically, by inserting the screws into holes where there is no risk of unwanted contact, unwanted contact with biological material can be avoided while still providing support.

[0050] Shaft 120 includes a distal cross section 125 and a proximal cross section 126. The distal cross section 125 is adjacent to the first end 121 and the distal portion 123, while the proximal cross section 126 is adjacent to the second end 122 and the proximal portion 124. The distal cross section 125 has a diameter of approximately 8 mm, while the proximal cross section 126 has a diameter of approximately 10 mm. Shaft 120 includes an intermediate cross section 127 between the distal cross section 125 and the proximal cross section 126. The intermediate cross section 127 has a diameter that gradually tapers from the diameter of the proximal cross section 126 to the diameter of the distal cross section 125.

[0051] Figures 3A to 3B These are different side views of the intramedullary nail 100, including ( Figure 3B ) and none ( Figure 3A Insert the screw. (For example) Figure 3B As shown, the intramedullary nail 100 has all distal screws 150 and proximal screws 160 inserted through it. The intramedullary nail 100 includes a first proximal screw 161, a second proximal screw 162, a third proximal screw 163, a fourth proximal screw 164, a fifth proximal screw 165, a first distal screw 151, a second distal screw 152, and a third distal screw 153. The proximal screws 161-165 are inserted into corresponding proximal holes 111-115, such that the first proximal hole 111 receives the first proximal screw 161, and so on. Similarly, the distal screws 151-153 are inserted into corresponding distal holes 101-103, such that the first distal hole 101 receives the first distal screw 151, and so on. The proximal and distal screws can also be inserted in any other configuration to support the humerus while avoiding the undesirable risk of contact with certain biological materials. As a non-limiting example, the first proximal hole 111 may receive, for example, a third proximal screw 163, a fifth proximal screw 165, or a first distal screw 151. Figures 4A to 4B Similar to Figures 3A to 3B However, the images were taken on different sides of the intramedullary nail 100.

[0052] Figure 5 This is a cross-sectional view of an intramedullary nail 100 according to an embodiment. As shown, the intramedullary nail 100 includes a first probe hole 501, a second probe hole 502, and a third probe hole 503. The first probe hole 501 extends from an opening at a second end 122 along a portion of the longitudinal length of the intramedullary nail 100. The second probe hole 502 extends from the end of the first probe hole 501 opposite to the end extending from the opening at the second end 122. The second probe hole 502 extends at least along a portion of the longitudinal length of the intramedullary nail 100, defining a plurality of proximal foramina. The third probe hole 503 extends from the end of the second probe hole 502 opposite to the end adjacent to the first probe hole 501 to an opening at the first end 121. The third probe hole 503 extends at least along a portion of the longitudinal length of the intramedullary nail 100, defining a plurality of distal foramina.

[0053] Figure 7 This is a three-dimensional view of the proximal portion of the intramedullary nail 100. As shown, the proximal portion includes multiple circumferences, multiple ridges, and multiple depressions. The multiple circumferences include a first circumference 210, a second circumference 220, a third circumference 230, a fourth circumference 240, and a fifth circumference 250. The multiple ridges include a first ridge 201, a second ridge 202, and a third ridge 203. The multiple depressions include a first depression 204, a second depression 205, and a third depression 206. The multiple ridges and depressions are located between the first circumference 210 and the second circumference 220. Together, the multiple ridges and depressions form a ring shape. Individually, the first ridge 201 is located between the second depression 205 and the third depression 206 along the center line of the ring shape, the second ridge 202 is located between the first depression 204 and the third depression 206 along the center line, and the third ridge 203 is located between the first depression 204 and the second depression 205 along the center line.

[0054] The first circumference 210 is the circumference of most of the outer surface of the distal portion 123 of the shaft 120. The third circumference 230 is the inner circumference of the shaft 120 with a first thickness extending inward from the first circumference 210, and is the circumference of most of the surface of the first probe 501. The fifth circumference 250 is the circumference of most of the surface of the second probe 502, and is the inner circumference of the shaft 120 with a second thickness extending inward from the first circumference 210, and is further inward than the third circumference 230. The sixth circumference 260 is the circumference of most of the third probe 503, and is an inner circumference of varying thickness extending from the center and the outer surface of the distal portion 123 of the shaft 120.

[0055] The second circumference 220 lies between the first circumference 210 and the third circumference 230. Between the second circumference 220 and the third circumference 230 is a tapered length, similar to those found in countersunk holes. The fourth circumference 240 lies between the third circumference 230 and the fifth circumference 250, and includes another tapered length. Ridges 201-203 each have rounded edges adjacent to the first circumference 210 and the second circumference 220.

[0056] Figure 8 This is another perspective view of the proximal portion of the intramedullary nail 100 according to an embodiment. The perspective view of the proximal portion depicts a fourth ridge 207 and a fourth recess 208. The fourth ridge 207 and the fourth recess 208 are positioned between a third circumference 230 and a fifth circumference 250. The fourth ridge 207 and the fourth recess 208 together form an annular shape. Figure 9 This is a top view of the proximal portion 124.

[0057] The first probe hole 501 is configured to receive the end cap after the intramedullary nail 100 is inserted into the humerus. Multiple ridges and multiple recesses are configured to receive attachment portions of the insertion device, such that rotation of the intramedullary nail 100 relative to the insertion device is constrained during insertion. The third probe hole 503 is configured to receive the guidewire during the insertion process of the intramedullary nail 100.

[0058] The second probe 502 is configured to receive at least one polymer sleeve. The polymer sleeve is configured to enclose any fastening member inserted into the proximal hole to secure the inserted fastening member to the intramedullary nail 100. Specifically, the polymer sleeve helps to prevent the inserted fastening member from exiting the intramedullary nail 100. In this embodiment, a polymer sleeve is not used.

[0059] Figure 10C yes Figure 7 Another top view of the proximal portion, in which the proximal fastening member and the distal fastening member are inserted. Specifically, Figure 10CThe angles of the proximal fastening member relative to the centerline 190 along the second recess 205 and the third recess 206 are shown. A first angle 191 depicts the angle between the first proximal screw 161 and the centerline 190, and is 61 degrees. A second angle 192 depicts the angle between the second proximal screw 162 and the centerline 190, and is 23 degrees. A third angle 193 depicts the angle between the third proximal screw 163 and the centerline 190, and is 96 degrees. A fourth angle 194 depicts the angle between the fourth proximal screw 164 and the centerline 190, and is 131 degrees. A fifth angle 195 depicts the angle between the fifth proximal screw 165 and the centerline 190, and is 66 degrees. Of course, in other embodiments, these angle values ​​may differ from those specifically shown in the figures.

[0060] Figure 11 This is a bottom view of the distal portion 123 of the intramedullary nail 100. Figure 12 This is a perspective view of the distal portion. As shown, the distal portion 123 includes a seventh circumference 270. The seventh circumference 270 is the circumference of the outer surface of the shaft 120 at the first end 121. The seventh circumference 270 has rounded edges.

[0061] A method for repairing a humeral fracture according to this disclosure includes inserting a humeral nail proximally into the intramedullary canal of the humerus. After incision, an entry point is made (e.g., with an awl) and the humerus is enlarged. Subsequently, the intramedullary nail is inserted into the humerus. According to one embodiment, the intramedullary nail 100 is inserted into the humerus using a target device, a nail-retaining screw, and a slotting hammer. The target device is configured to guide and lock the distal and proximal screws in the intramedullary nail 100 to be inserted. In another embodiment, a fastening member is inserted using a freehand technique. In yet another embodiment, a fastening member is inserted using an antegrade technique. All fastening members are configured for lateral insertion to reduce the risk of interference with the biceps tendon and radial nerve. After the fastening member is inserted, an end cap is inserted at the second end 122 of the intramedullary nail 100. The end cap and the second end have an M7 pitch thread.

[0062] Figure 13 This is a side view showing an intramedullary nail with fastening members inserted into the humerus. As shown, the intramedullary nail 100 is positioned within the humerus 1300, with a proximal screw 1360 and a distal screw 1350 inserted therein. The proximal screw 1360 and distal screw 1350 are configured to be substantially placed within the bone material. The heads of the proximal screw 1360 and distal screw 1350 are configured to be positioned externally to the humerus 1300.

[0063] The fastening member is configured to provide fixation for bone fragments (e.g., but not limited to, lesser tuberosity, greater tuberosity, humeral talus, head, biceps groove, surgical neck, etc., and any combination thereof). As shown, the distal screw 1360 is shorter than the proximal screw 1360 to accommodate the general anatomy of the humerus, where the proximal portion (i.e., head and neck) has a larger radius than the more central portion (i.e., tuberosity). However, this disclosure is not limited to this configuration. In some embodiments, the distal screw 1350 may be longer than the proximal screw 1360, and the proximal screw 1360 may be shorter than the distal screw 1350. In yet another embodiment, the distal and proximal screws may be interchangeably positioned in any configuration. As a non-limiting example, five proximal holes may include a plurality of distal screws 1350 and a plurality of proximal screws 1360.

Claims

1. An intramedullary nail for the humerus, comprising: The length extends between a first end and a second end, wherein the length includes a longitudinal axis; The distal portion is adjacent to the first end; The proximal portion is adjacent to the second end; A first elliptical distal hole is formed through the distal portion and is configured to receive a first fastening member in a first direction transverse to the longitudinal axis. A second distal hole is formed through the distal portion, the second distal hole being closer to the first end than the first elliptical distal hole and configured to receive a second fastening member in a second direction transverse to the longitudinal axis, the second direction being different from the first direction; as well as Multiple proximal holes are formed through the proximal portion.

2. The intramedullary nail of claim 1, further comprising a third distal hole formed through the distal portion, the third distal hole being configured to receive a third fastening member in a third direction transverse to the longitudinal axis and being further from the first end than the first hole and the second hole.

3. The intramedullary nail of claim 2, wherein the second fastening member and the third fastening member are threaded screws.

4. The intramedullary nail of claim 2, wherein the second direction of the second distal hole is rotated 30 degrees relative to one of the first direction or the third direction.

5. The intramedullary nail of claim 2, wherein the second direction of the second distal hole is rotated 30 degrees relative to the first direction of the first elliptical distal hole, and the first direction is rotated 0 degrees relative to the third direction of the third distal hole.

6. The intramedullary nail of claim 1, wherein the first direction and the second direction are rotated between 1 degree and 89 degrees.

7. The intramedullary nail of claim 1, wherein the plurality of proximal holes are transverse to the longitudinal axis.

8. The intramedullary nail of claim 5, wherein the plurality of proximal holes are configured to receive fastening members.

9. An intramedullary nail for the humerus, comprising: First end; The second end extends from the first end; The distal portion is adjacent to the first end; The proximal portion is adjacent to the second end; The length, which is between the first end and the second end, includes a longitudinal axis; A plurality of holes extending through the length, wherein the plurality of holes are transverse to the longitudinal axis and configured to each receive a fastening member, the plurality of holes including a first distal hole, a second distal hole and a third distal hole, the second distal hole being the hole closest to the first end of the plurality of holes, the second distal hole being rotated 1 degree to 89 degrees relative to the first distal hole about the longitudinal axis.

10. The intramedullary nail of claim 9, wherein the third distal hole is the second closest hole to the first end among the plurality of holes, and the first distal hole is the third closest hole to the first end among the plurality of holes.

11. The intramedullary nail of claim 10, wherein the third distal hole is elliptical and the fastening member is a threaded screw.

12. The intramedullary nail of claim 9, wherein the plurality of holes further comprises a first proximal hole, a second proximal hole, a third proximal hole, a fourth proximal hole, and a fifth proximal hole, wherein the first proximal hole is the hole closest to the second end among the plurality of holes, the second proximal hole is between the first proximal hole and the third proximal hole, the fourth proximal hole is between the third proximal hole and the fifth proximal hole, and the fifth proximal hole is the hole fifth closest to the second end among the plurality of holes.

13. The intramedullary nail of claim 12, wherein the second proximal hole is rotated 74 degrees relative to the first proximal hole about the longitudinal axis, the third proximal hole is rotated 325 degrees relative to the first proximal hole about the longitudinal axis, the fourth proximal hole is rotated 290 degrees relative to the first proximal hole about the longitudinal axis, the fifth proximal hole is rotated 355 degrees relative to the first proximal hole about the longitudinal axis, the second distal hole is rotated 30 degrees relative to either the first distal hole or the third distal hole, and the third distal hole is rotated 0 degrees relative to the first distal hole.

14. A humeral screw, comprising: A first end, the first end having a distal portion adjacent to the first end; The second end has a proximal portion adjacent to the second end; The length is between the first end and the second end, wherein the length includes a longitudinal axis; A plurality of holes extending through the length, wherein the plurality of holes are transverse to the longitudinal axis and configured to each receive a fastening member, the plurality of holes including a first distal hole, a second distal hole and a third distal hole, the second distal hole being the hole closest to the first end along the longitudinal axis, the second distal hole being rotated at least one degree relative to the first distal hole about the longitudinal axis.

15. The intramedullary nail of claim 14, wherein the plurality of holes includes a third distal hole, the third distal hole being the second closest hole to the first end among the plurality of holes.

16. The intramedullary nail of claim 15, wherein the third distal hole is elliptical.

17. The intramedullary nail of claim 14, wherein the fastening member is a threaded screw.

18. The intramedullary nail of claim 14, wherein the plurality of holes further comprises a first proximal hole, a second proximal hole, a third proximal hole, a fourth proximal hole, and a fifth proximal hole, wherein the first proximal hole is the hole closest to the second end among the plurality of holes, the second proximal hole is between the first proximal hole and the third proximal hole, the fourth proximal hole is between the third proximal hole and the fifth proximal hole, and the fifth proximal hole is the hole fifth closest to the second end among the plurality of holes.

19. The intramedullary nail of claim 18, wherein the second proximal hole is rotated 74 degrees relative to the first proximal hole about the longitudinal axis, the third proximal hole is rotated 325 degrees relative to the first proximal hole about the longitudinal axis, the fourth proximal hole is rotated 290 degrees relative to the first proximal hole about the longitudinal axis, and the fifth proximal hole is rotated 355 degrees relative to the first proximal hole about the longitudinal axis.

20. The intramedullary nail of claim 14, wherein the second distal hole is rotated 30 degrees relative to the first distal hole about the longitudinal axis, and the third distal hole is rotated 0 degrees relative to the first distal hole about the longitudinal axis.

Images