Intramedullary Nail Positioning to Prevent Medialization
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Solution Overview
Problem
Current intramedullary nails with nested lag and compression screws face issues with medial movement during fracture compression, which can lead to malreduction and post-operative collapse, especially in unstable fractures, lacking flexibility in securing the nail's position within the intramedullary canal.
Innovation Solution
A surgical technique that allows surgeons to selectively secure or allow the position of the IM nail within the intramedullary canal by inserting a bone screw into a superiorly positioned opening before fracture compression, preventing medialization of the nail, thereby providing flexibility based on fracture type.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Strength
If fracture compression is performed with nested lag and compression screws, then fracture stability is improved, but the IM nail moves medially within the intramedullary canal causing malreduction
Solution Approach 1:
The patent applies preliminary action by securing the IM nail position within the intramedullary canal before performing fracture compression. The method involves inserting the nail, verifying its position, and then proceeding with compression only if the position is acceptable, thereby preventing medialization-induced malreduction while maintaining fracture stability
Solution Approach 2:
The patent implements dynamics by making the IM nail position adjustable rather than fixed. The nail can be positioned medially or laterally within the canal, and the surgeon can select the optimal position based on the specific fracture pattern and anatomical requirements, allowing adaptation to different clinical scenarios
2Manufacturing precision
If the IM nail position is secured within the intramedullary canal, then medialization is prevented, but flexibility in treatment approaches is reduced
Solution Approach 1:
The patent maintains treatment flexibility through a dynamic, stepwise approach. The nail position is initially placed without rigid constraint, allowing the surgeon to adjust it medially or laterally. The decision to secure the position is made dynamically based on intraoperative assessment of fracture reduction quality and anatomical alignment requirements
Solution Approach 2:
The method uses preliminary positioning and verification as a prerequisite before final securing. This preliminary action allows the surgeon to assess whether the nail position is appropriate for the specific fracture type, maintaining adaptability while ensuring precision when needed
Data Source
AI summary
An intramedullary (“IM”) nail and surgical technique or method. The IM nail includes a body including an opening for receiving a lag screw and a compression screw. The body further including one or more screw openings for receiving a bone screw. The surgical technique enables a surgeon to selectively prevent or allow movement (e.g., medialization) of the IM nail within the patient's intramedullary canal. The position of the IM nail can be selectively secured within the patient's intramedullary canal depending on surgeon preference and/or depending on the fracture pattern being treated. In use, the surgeon can elect to either secure the position of the IM nail within the patient's intramedullary canal thereby preventing movement (e.g., medialization) of the IM nail within the patient's intramedullary canal, or the surgeon can allow the IM nail to move (e.g., medialize) within the patient's intramedullary canal.