Proximal Humeral Fracture Reduction with Jacking Device
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Solution Overview
Problem
Current methods for reducing and fixing proximal humeral fractures, such as intramedullary nailing and closed reduction with percutaneous pinning, often result in inadequate fixation, damage to soft tissues, and complications like soft tissue stripping and malalignment, especially in osteoporotic patients.
Innovation Solution
A method using a locking plate with a jacking device that pushes the humeral head from an inferior aspect to align it with the shaft, minimizing the need for multiple pins and reducing soft tissue stripping, combined with radiolucent retractors for fluoroscopic visualization during surgery.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If intramedullary nailing is used to reduce and fix proximal humeral fractures, then fixation is achieved, but the rotator cuff is damaged and articular cartilage is destroyed
Solution Approach 1:
The patent uses a bone plate as an intermediary device that bridges the fracture without requiring intramedullary insertion. The plate is fixed to the external surface of the bone, avoiding penetration into the medullary cavity and thus preventing damage to the rotator cuff and articular cartilage while still providing stable fixation
2Ease of operation
If closed reduction with percutaneous pinning is used, then fracture reduction is achieved, but patient compliance is required and soft tissue stripping occurs
Solution Approach 1:
The patent replaces the percutaneous pinning mechanical system with a bone plate and screw fixation system. Instead of using multiple pins inserted through the skin, a single bone plate with screws provides more reliable fixation without requiring patient compliance for pin care, while still achieving fracture reduction
3Manufacturing precision
If manual manipulation is used to reduce fracture malalignment, then alignment is achieved, but enlarged incisions are required and soft tissue stripping occurs
Solution Approach 1:
The patent applies preliminary action by using the bone plate itself as a reduction tool. The bone plate is contoured to match the anatomical shape of the humerus and includes features that guide proper alignment during fixation. As the plate is secured with screws, it inherently reduces the fracture malalignment without requiring separate manual manipulation steps that would necessitate enlarged incisions
4Reliability
If multiple pins are used for provisional fixation, then fracture stability is achieved, but device complexity increases and soft tissue damage worsens
Solution Approach 1:
The patent merges the provisional fixation function and definitive fixation function into a single bone plate device. Instead of using multiple separate pins for provisional stabilization followed by additional hardware for definitive fixation, the bone plate serves both purposes simultaneously, reducing device complexity and the number of surgical steps required
Data Source
AI summary
A method for reducing and fixing fractures, for example, a proximal humeral fracture. A jacking device is releasably attached to a locking plate that presses against an inferior aspect of the head to rotate the head into anatomic alignment. Suture material is stitched into the soft tissue superior to the head and pulls the superior end of the head and guides and steers the head. The suture material is passed through suture holes in the superior end of the plate. The jacking device is positioned to hold the head in an anatomic neck/shaft angle, thereby allowing the head to be fixed to the locking plate. In one such embodiment, a swivel bushing in the plate receives the jacking device and allows the angle of the device to be adjusted as desired. To aid in the fluoroscopic visualization during surgery, a radiolucent retractor is used to avoid blocking the surgeon's view.