Orthopedic intramedullary nailing system for greater trochanter fixation

Abstract

An intramedullary ("IM") nailing system and corresponding methods for fixing a fracture of the greater trochanter in a patient are disclosed. In some embodiments, the IM nailing system comprises an IM nail and a plate or washer. When in use, the plate or washer includes one or more holes or openings to allow a bone screw to pass through the plate or washer and engage with a corresponding hole formed in the IM nail. Arranged in this manner, when in use, the IM nailing system facilitates the fixation of the patient's greater trochanter by fixing and / or compressing the patient's greater trochanter between the plate or washer and the IM nail.

Description

Technical Field

[0001] Cross - reference to Related Applications This application is a non - provisional application of U.S. Provisional Patent Application No. 63 / 466,415, titled "Orthopedic Intramedullary Nail System for Greater Trochanter Fixation", filed on May 15, 2023, and claims the benefit of its filing date, and the entire disclosure of that application is incorporated herein by reference.

[0002] The present disclosure is directed to orthopedic implants (e.g., intramedullary ("IM") nails) for stabilizing the bone, bone portions, bone fragments, etc. of one or more patients, and more specifically, to an IM nail system arranged and configured to facilitate fixation of a greater trochanter fracture.

Background Art

[0003] Orthopedic fixation devices (implants) can be used, for example, to stabilize injuries, support fracture sites, fuse joints, and / or correct deformities. Orthopedic fixation devices can be permanently or temporarily attached, implanted within the canal or other cavity of a bone, implanted under soft tissue, attached to the outer surface of a bone, or placed externally, and can be attached to the bone at various locations, such as by fasteners such as screws, pins, and / or wires. Some orthopedic fixation devices allow the position and / or orientation of two or more bone fragments, or two or more bones, to be adjusted relative to each other. Orthopedic fixation devices are generally machined or formed from isotropic materials such as metals including, for example, titanium, titanium alloys, stainless steel, cobalt - chromium alloys, and tantalum.

[0004] An intramedullary ("IM") nail is a type of orthopedic fixation device. The main function of an IM nail is to stabilize fracture fragments, thereby enabling load transfer across the fracture site while maintaining the anatomical alignment of the bone. Currently, a number of different commercially available IM nails are available.

[0005] One drawback of IM nails is that during fracture fixation, there may be fracture fragments that cannot be captured using IM nails and screw products. This may be a result of the limited space within the IM nail for the screw hole or bone fragment, which may be too small or too soft to be captured by the available screw. For example, in intertrochanteric fractures treated with cranial medulla nails, the greater trochanteric fragment may not be adequately captured using only the IM nail. If left untreated, the greater trochanteric fragment may lead to bursitis or abductor muscle failure.

[0006] One known solution for treating greater trochanteric fragment fractures in intertrochanteric cases involves the use of additional cables and / or additional bone plates to capture the greater trochanteric fragment. However, the placement of additional cables and / or additional bone plates increases the time and complexity of the surgery, resulting in increased time under anesthesia, which may be considered a greater risk than leaving the greater trochanteric fragment unfixed.

[0007] Therefore, there remains a need to provide an improved orthopedic IM nail system for internal bone fixation, particularly for treating greater trochanteric fractures. This disclosure satisfies this need and provides other benefits and advantages in a novel and non-obvious manner. [Overview of the Initiative]

[0008] This summary is provided to introduce a set of concepts in a simplified form, which will be further described in the following embodiments for carrying out the invention. This summary is not intended to identify any important or essential features of the claimed subject matter, nor is it intended to assist in determining the scope of the claimed subject matter.

[0009] An intramedullary ("IM") nailing system for fixing a greater trochanter fracture in a patient is disclosed. In some embodiments, the IM nailing system comprises an IM nail and a bone plate or washer (the terms bone plate and washer are used interchangeably herein without intent to limit or distinguish). When in use, the washer includes one or more holes or openings to allow a bone screw to pass through the washer and engage with a corresponding hole formed in the IM nail. In this way, the washer is coupled to the IM nail via the bone screw. In some embodiments, the positioning of the washer and bone screw through the washer into the IM nail is guided by a targeting fixture. When positioned in this manner, when in use, the IM nailing system facilitates the fixation of the patient's greater trochanter by fixing and / or compressing the fractured fragment of the patient's greater trochanter between the washer and the IM nail.

[0010] In some embodiments, an intramedullary (IM) nailing system is disclosed that is arranged and configured to facilitate fixation of a greater trochanter fracture. The IM nailing system includes an IM nail, a washer, and a bone screw. The IM nail includes a body, a proximal end portion, a distal end portion, and a plurality of screw openings. The washer includes an outer surface, a bone contact surface, and at least one opening extending between the outer surface and the bone contact surface. When in use, the IM nail is implanted into the intramedullary canal of the patient's femur, and with the bone contact surface of the washer positioned relative to the patient's greater trochanter, the bone screw is inserted through the opening formed in the washer into one of the plurality of screw openings formed in the IM nail.

[0011] In any preceding or succeeding embodiment, the bone screw compresses the greater trochanter between the washer and the IM nail.

[0012] In any preceding or succeeding embodiment, one of a plurality of threaded openings formed within the IM nail is threaded, and the threaded opening is positioned and configured to engage with the threads of a bone screw to compress the greater trochanter between the washer and the IM nail.

[0013] In any prior or subsequent embodiment, the IM nail system further includes a targeting fixture positioned and configured to be coupled to the proximal end portion of the IM nail, the targeting fixture positioned and configured to facilitate alignment between at least one opening formed in a washer and one of a plurality of threaded openings formed in the IM nail.

[0014] In any preceding or subsequent embodiment, the washer includes a central region comprising a plurality of arms extending therefrom, the central region comprising at least one opening.

[0015] In any preceding or subsequent embodiment, at least one opening formed within the washer includes a first and a second opening.

[0016] In any preceding or subsequent embodiment, the bone contact surface of the washer includes a plurality of spikes extending therefrom.

[0017] In any preceding or subsequent embodiment, the washer includes a plurality of suture openings formed therein.

[0018] In some embodiments, a method for fixing the greater trochanter of a patient is also disclosed. The method includes inserting an IM nail into the intramedullary canal of the patient's femur, positioning a washer adjacent to the patient's greater trochanter, and inserting a bone screw through an opening formed in the washer into a threaded opening formed in the IM nail.

[0019] In any preceding or subsequent embodiment, inserting a bone screw compresses the patient's greater trochanter between the washer and the IM nail.

[0020] In any preceding or subsequent embodiment, the threaded opening formed within the IM nail is threaded.

[0021] In any preceding or subsequent embodiment, positioning the washer includes coupling the targeting jig to the IM nail and aligning an opening in the washer with a threaded opening formed in the IM nail using the targeting jig.

[0022] Embodiments of the present disclosure provide numerous advantages. For example, the system and / or method enable fixation of a patient's greater trochanter using an IM nail. In use, a simple and efficient method of fixing and / or compressing a patient's greater trochanter fracture fragment by utilizing an IM nail, a washer, and a bone screw passing through the washer and the IM nail eliminates the need for an increased time under anesthesia and the need to install multiple implants that require a larger incision.

[0023] At least some further features and advantages of embodiments of the present disclosure, as well as the structures and operations of various embodiments of the present disclosure, are described in detail below with reference to the accompanying drawings.

[0024] Here, as an example, a particular embodiment of the disclosed device is described with reference to the following accompanying drawings.

Brief Description of the Drawings

[0025] [Figure 1A] FIG. 1A is a front view of an embodiment of an IM nail system including an IM nail, a washer, and a bone screw according to one or more features of the present disclosure, with the IM nail system shown implanted within a patient's bone. [Figure 1B] FIG. 1B is a side view of the IM nail system shown in FIG. 1A. [Figure 1C] FIG. 1C is a top view of the IM nail system shown in FIG. 1A. [Figure 2A] FIG. 2A is a top view of an embodiment of a washer according to one or more features of the present disclosure, with the washer forming a portion of the IM nail system shown in FIG. 1A. [Figure 2B] FIG. 2B is a bottom view of the washer shown in FIG. 2A. [[ID=�3]] [Figure 2C]Figure 2C is a side view of the washer shown in Figure 2A. [Figure 3A] Figure 3A is a top view of an alternative embodiment of a washer according to one or more features of the present disclosure, the washer forming part of the IM nail system shown in Figure 1A. [Figure 3B] Figure 3B is a side view of the washer shown in Figure 3A. [Figure 4A] Figure 4A is a detailed view of the proximal end portion of an IM nail, the IM nail forming part of the IM nail system shown in Figure 1A. [Figure 4B] Figure 4B is a perspective view of a targeting jig coupled to the IM nail shown in Figure 4A. [Figure 4C] Figure 4C is an alternative perspective view of a targeting jig coupled to the IM nail shown in Figure 4B. **DETAILED DESCRIPTION OF THE INVENTION**

[0026] It should be understood that the drawings are not necessarily to scale and that the disclosed embodiments may be illustrated in schematic and partial views. In certain instances, details that are not necessary for an understanding of the disclosed methods and apparatuses, or that render other details difficult to perceive, may be omitted. It should further be understood that the present disclosure is not limited to the particular embodiments illustrated herein. In the drawings, like reference numerals refer to like elements throughout, unless otherwise noted.

[0027] Herein, various features or similarities of the IM nail system for greater trochanter fracture fixation, and corresponding methods, will be described more fully below with reference to the accompanying drawings illustrating and illustrating one or more features and corresponding methods of the IM nail system. It should be understood that various features or similarities may be used independently or in combination with one another. It should also be understood that the IM nail system and methods disclosed herein may be embodied in many different forms and should not be construed as being limited to the embodiments shown herein. Rather, these embodiments are provided so that this disclosure may convey specific features of the IM nail system and methods to those skilled in the art.

[0028] Various IM nail systems and corresponding methods are disclosed herein, including one or more features arranged and configured to facilitate fixation of greater trochanteric fractures.

[0029] Referring to Figures 1A, 1B, and 1C, embodiments of the IM nailing system 100 according to one or more features of the present disclosure are illustrated. As illustrated, the IM nailing system 100 includes an IM nail 110, a washer or bone plate 130, and at least one bone screw 150 (the terms washer and bone plate are used interchangeably herein without intent to limit or distinguish).

[0030] As will be readily apparent to those skilled in the art during use, the IM nail 110 is positioned and configured to be implanted within the intramedullary canal of the patient's femur. Thus, the IM nail 110 may also be referred to as a femoral nail. Generally, the IM nail 110 includes a body 112, such as a cannula-like body. The body 112 includes a proximal end portion 114 and a distal end portion 116. The proximal end portion 114 and the distal end portion 116 include a number of threaded openings, holes, slots, etc. 118 (terms used interchangeably herein, without intent to limit or distinguish) positioned and configured to receive fasteners, screws, etc. (terms used interchangeably herein, without intent to limit or distinguish). In some embodiments, the threaded openings are threaded. Alternatively, the threaded openings may be threadless or have any other configuration currently known or to be developed in the future. For reasons that will become apparent below, by providing a threaded opening, the IM nail 110 facilitates compression of the fractured fragment of the patient's greater trochanter T without relying on screw fixation to the patient's bone (e.g., femur F).

[0031] When used, the IM nail 110 may be any suitable femoral nail currently known or to be developed in the future. Furthermore, while this disclosure describes and illustrates IM nail systems and corresponding methods for fixing greater trochanter fractures, one or more features of this disclosure may be applicable to other parts of a patient's body. Therefore, this disclosure should not be limited to any particular IM nail or part of a patient's body unless specifically requested.

[0032] Referring to Figures 1A, 1B, and 1C, and further to Figures 2A, 2B, and 2C, the washer 130 includes a first surface or outer surface 132, a second surface or bone contact surface 134, and a hole 136 extending between the first surface 132 and the second surface 134. When in use, with the IM nail 110 implanted in the intramedullary canal of the patient's femur F and the washer 130 positioned relative to the patient's greater trochanter T, the hole 136 formed in the washer 130 can be aligned with one of a plurality of threaded openings 118 formed in the proximal end portion 114 of the body 112 of the IM nail 110. For example, as illustrated in Figures 4A, 4B, and 4C, the targeting jig 200 can be coupled to the proximal end portion 114 of the body 112 of the IM nail 110. Subsequently, using the targeting jig 200, as readily understood by those skilled in the art, the hole 136 formed in the washer 130 can be aligned with one of several screw openings 118 formed in the body 112 of the IM nail 110, so that the bone screw 150 can be inserted through the hole 136 formed in the washer 130 into the screw opening 118 formed in the IM nail 110. When arranged in this manner, during use, a fracture of the greater trochanter T can be fixed by compressing the fractured fragment of the patient's greater trochanter T between the washer 130 and the IM nail 110 via the bone screw 150 (for example, the greater trochanter fracture fragment can be fixed by implanting the target bone screw through the washer and IM nail to apply compression across the entire fragment to promote healing).

[0033] In some embodiments, as illustrated in Figures 2A, 2B, and 2C, the washer 130 may generally take the form of a circular plate having a plurality of arms extending therefrom. For example, as illustrated, the washer 130 may include a central region comprising a plurality of arms extending therefrom, the central region comprising at least one hole 136. When in use, the washer 130 may be arranged and configured to be malleable and / or flexible. For example, the plurality of arms may be flexible relative to the central region so that the washer 130 conforms to the shape of the patient's bone (e.g., the greater trochanter). However, this is only one configuration, and the washer 130 may have any preferred shape and / or configuration that is currently known or may be developed in the future. For example, the washer 130 is illustrated in Figures 2A, 2B, and 2C with a single central opening, but other configurations are conceivable. For example, referring to Figures 3A and 3B, the washer 130 may include multiple screw holes 136, such as first and second screw openings. By providing multiple screw openings, surgeons have increased flexibility in positioning the washer 130 on the patient's greater trochanter T to accommodate different fracture patterns and the patient's anatomical structure.

[0034] In some embodiments, as shown, the second or bone-facing surface 134 of the washer 130 may include a plurality of spikes 138 extending therefrom to facilitate increased contact (e.g., gripping) with the patient's greater trochanter T.

[0035] Furthermore, and / or, in some embodiments, the washer 130 may include a plurality of suture openings 140 for reattaching soft tissue.

[0036] As previously mentioned, referring to Figures 4A, 4B, and 4C, the use of the targeting fixture 200 and the IM nail system 100 is shown with the fixture 200 providing a targeting track through the IM nail 110. When in use, the targeting fixture 200 may be used to facilitate a screw hole track for the placement of the washer 130.

[0037] In this configuration, the surgeon can implant the IM nail 110 into the intramedullary canal of the patient's femur F during use. Subsequently, using a targeting jig 200, or other targeting mechanisms currently known or to be developed in the future, the surgeon can position a washer 130 on the patient's greater trochanter T and insert a bone screw 150 into the IM nail 110 through the washer 130 to fix and / or compress the fractured fragment of the patient's greater trochanter T. For example, during use, the IM nail 110 may include a threaded opening formed therein to receive the bone screw 150. In this configuration, the greater trochanter and / or fracture can be compressed between the washer 130 and the IM nail 110 by inserting the bone screw 150 into the threaded opening formed in the IM nail 110 through an opening 136 formed in the washer 130.

[0038] The above description has a wide range of applications. Therefore, any consideration of the embodiments is for illustrative purposes only and is not intended to suggest that the scope of this disclosure, including the claims, is limited to these exemplary embodiments. In other words, while exemplary embodiments of this disclosure are detailed herein, it will be understood that the concepts of the present invention can be embodied and used in various other ways, and that the appended claims are intended to be interpreted to include such modifications, unless limited by the prior art.

[0039] As used herein, the terms “a” or “an” precede an object that refers to one or more objects. Therefore, the terms “a” (or “an”), “one or more,” and “at least one” may be used interchangeably as described herein. The use of “includes,” “equips,” or “possesses,” and their variations as used herein, means to include the items and their equivalents listed thereafter, as well as any additional items. Thus, the terms “includes,” “equips,” or “possesses,” and their variations are non-restrictive and may be used interchangeably as described herein. The phrases “at least one,” “one or more,” and “and / or” as used herein are non-restrictive expressions that are both conjunctive and disjunctive in their application.

[0040] All directional references (e.g., proximal, distal, up, down, upward, downward, left, right, lateral, longitudinal, front, back, top, bottom, superior, downward, vertical, horizontal, radial, axial, clockwise, and counterclockwise) are used solely for identification purposes to aid the reader's understanding of the Disclosure, particularly with respect to its location, orientation, or use, and do not create any limitation. Connection references (e.g., attachment, joining, connection, and joining) should be interpreted broadly and may include intermediate members between assemblies of elements and relative movement between elements unless otherwise indicated. Thus, connection references do not necessarily mean that two elements are directly connected and fixed to each other. Identifying references (e.g., primary, secondary, first, second, third, fourth, etc.) are not intended to indicate importance or priority and are used to distinguish one feature from another. The drawings are for illustrative purposes only, and the dimensions, locations, order, and relative sizes reflected in the drawings attached herein may be changed.

Claims

1. An intramedullary ("IM") nailing system arranged and configured to facilitate fixation of a greater trochanter fracture, An IM nail comprising a main body, a proximal end portion, a distal end portion, and multiple screw openings, A washer comprising an outer surface, a bone contact surface, and at least one opening extending between the outer surface and the bone contact surface, Equipped with a bone screw, An IM nail system in which, when in use, the IM nail is implanted into the intramedullary canal of the patient's femur, the bone contact surface of the washer is positioned relative to the patient's greater trochanter, and the bone screw is inserted through the opening formed in the washer into one of the plurality of screw openings formed in the IM nail.

2. The IM nail system according to claim 1, wherein the bone screw compresses the greater trochanter between the washer and the IM nail.

3. The IM nail system according to claim 1, wherein one of the plurality of threaded openings formed in the IM nail is threaded, and the threaded opening is positioned and configured to engage with the threads of the bone screw to compress the greater trochanter between the washer and the IM nail.

4. The IM nail system according to claim 1, further comprising a targeting jig positioned and configured to be coupled to the proximal end portion of the IM nail, wherein the targeting jig is positioned and configured to facilitate alignment between the at least one opening formed in the washer and one of the plurality of screw openings formed in the IM nail.

5. The IM nail system according to claim 1, wherein the washer comprises a central region including a plurality of arms extending therefrom, and the central region includes the at least one opening.

6. The IM nail system according to claim 1, wherein the at least one opening formed within the washer includes a first and a second opening.

7. The IM nail system according to claim 1, wherein the bone contact surface of the washer includes a plurality of spikes extending therefrom.

8. The IM nail system according to claim 1, wherein the washer includes a plurality of suture openings formed therein.

9. A method for fixing the greater trochanter of a patient, Inserting an IM nail into the intramedullary canal of the patient's femur, Position the washer adjacent to the greater trochanter of the aforementioned patient, A method comprising inserting a bone screw into a threaded opening formed in the IM nail through an opening formed in the washer.

10. The method according to claim 9, wherein inserting the bone screw compresses the greater trochanter of the patient between the washer and the IM nail.

11. The method according to claim 10, wherein the threaded opening formed in the IM nail has threads.

12. The method according to claim 9, wherein positioning the washer includes connecting a targeting jig to the IM nail and using the targeting jig to align the opening in the washer with the threaded opening formed in the IM nail.

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