Dynamic Nail-Plate Fixation for Proximal Femur Stability
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Solution Overview
Problem
Current fracture fixation systems for complex proximal femur fractures, such as intramedullary nails and lateral plates, face challenges including non-unions, varus malalignments, hardware failures, and high complication rates due to unfavorable biomechanics and limited clinical acceptance.
Innovation Solution
A fracture fixation system comprising an intramedullary nail with a non-circular proximal nail hole and a lateral plate with non-circular peg and plate holes, allowing for dynamic locking and migration, combined with distal dynamic locking via elongated holes, to enhance biomechanical stability and healing.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional intramedullary nails or lateral plates are used for complex proximal femur fractures, then the treatment is straightforward and commonly applied, but the biomechanical performance is insufficient leading to hardware failures and non-unions
Solution Approach 1:
The patent combines an intramedullary nail and lateral plate into a single integrated construct. The nail provides intramedullary support while the plate offers lateral stabilization, creating a composite fixation system that leverages the biomechanical advantages of both implant types simultaneously. This merged system resolves the contradiction by achieving superior reliability through combined mechanics rather than relying on a single complex device.
Solution Approach 2:
The fixation system uses a composite construction combining intramedullary and extramedullary components. The nail and plate are made from different structural configurations optimized for their respective functions, creating a composite fixation system that achieves enhanced biomechanical performance compared to either component alone, thereby improving reliability without requiring a single overly complex device.
2Adaptability or versatility
If a lateral plate is used when the proximal nail entry portal is inaccessible, then alternative fixation is provided, but the biomechanical performance remains insufficient and complication rates are high
Solution Approach 1:
The integrated nail-plate system serves multiple functions simultaneously: the nail provides intramedullary support and load sharing, while the plate offers lateral stabilization and varus prevention. This multi-functional construct adapts to complex fracture patterns and inaccessible entry portals while maintaining high reliability through its dual-component design that addresses multiple biomechanical requirements.
Solution Approach 2:
By merging the nail and plate into an integrated system, the invention provides adaptability for cases where traditional single-implant approaches fail. The combined construct can be configured to accommodate inaccessible entry portals while maintaining biomechanical integrity, thereby improving both adaptability and reliability simultaneously.
3Ease of operation
If conventional lateral plates are used for complex fractures, then the procedure is simpler to implement, but rotation prevention is insufficient leading to varus malalignment
Solution Approach 1:
The integrated nail-plate system combines rotational control mechanisms from both implant types. The intramedullary nail provides internal rotational stability while the lateral plate offers external stabilization. This merged approach maintains procedural simplicity while significantly improving alignment stability and preventing varus malalignment better than conventional plates alone.
4Ease of manufacture
If traditional fixation methods are used with comminuted lateral wall, then standard procedures are applied, but proper plate placement is not achieved resulting in hardware failure
Solution Approach 1:
The integrated system allows for localized adaptation to comminuted lateral wall anatomy. The plate can be positioned to bypass severely comminuted areas while the nail provides support within the medullary canal. This local quality approach maintains standard procedural elements while adapting the fixation construct to specific anatomical challenges, thereby improving hardware reliability without abandoning established surgical techniques.
Data Source
AI summary
A fracture fixation system includes an intramedullary nail having a proximal nail hole, wherein an inner surface of the proximal nail hole has a non-circular shape in a plane perpendicular to an axis along which the proximal nail hole extends; a plate having an inner surface for placement against a surface of a bone, the plate defining a proximal plate hole adjacent a proximal end of the plate extending through the plate; and a peg extending along a peg axis and configured for insertion into the proximal nail hole, wherein a body of the peg has an outer surface defining a non-circular shape in a plane perpendicular to the peg axis, the peg further including a lateral end adjacent to the body and configured to engage the proximal plate hole, the lateral end having a reduced cross-section that is smaller than a maximum cross-section of the body of the peg.