Suprapatellar Intramedullary Nail Insertion System
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Solution Overview
Problem
Existing methods for inserting and fixing intramedullary nails into bones, particularly in the tibia, often result in bone fragment misalignment due to the quadriceps muscle pulling the proximal bone fragment askew when the knee is bent at 90 degrees, leading to inefficiencies in fracture stabilization.
Innovation Solution
A system comprising a flexible sleeve and a retaining member that allows for the insertion of an intramedullary nail through the suprapatellar region of the leg, with the knee flexed between 10 to 20 degrees, minimizing muscle pull and utilizing a combination of flexible and rigid sleeves to protect tissues and guide instrumentation, thereby stabilizing the nail within the medullary canal.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If the knee is bent at 90 degrees during nail insertion, then the insertion path is more accessible, but the quadriceps muscle pulls the proximal bone fragment askew causing misalignment
Solution Approach 1:
The patent applies preliminary action by pre-positioning the intramedullary nail in the medullary canal before the quadriceps muscle can pull the proximal bone fragment askew. The nail is inserted first when the knee is at 90 degrees for accessibility, establishing a stable reference axis before muscle contraction occurs during subsequent fixation steps.
Solution Approach 2:
The intramedullary nail serves as an intermediary element that maintains alignment between the proximal and distal bone fragments. By occupying the medullary canal and providing a central axis, the nail mediates the relationship between bone fragments during knee movement and muscle contraction, preventing misalignment despite quadriceps pull.
2Manufacturing precision
If the knee is bent at 10-20 degrees during nail insertion, then bone fragment alignment is maintained, but the insertion path becomes less accessible
Solution Approach 1:
The procedure performs the nail insertion action at the optimal 90-degree knee angle where accessibility is maximized, before transitioning to the 10-20 degree angle for fixation. This preliminary insertion at the favorable angle eliminates the need to compromise alignment during the difficult insertion phase.
Solution Approach 2:
The patent employs dynamic adjustment of knee angle throughout the procedure. The knee is positioned at 90 degrees during nail insertion for accessibility, then flexed to 10-20 degrees during anchor placement and fixation to maintain bone fragment alignment. This dynamic repositioning allows each surgical step to be performed at the optimal angle for that specific action.
3Strength
If a rigid sleeve is used for nail insertion, then structural support is provided, but tissue protection is reduced compared to flexible sleeves
Solution Approach 1:
The system employs a composite approach by combining a rigid intramedullary nail with a flexible outer sleeve or guide. The rigid nail provides the necessary structural support for load-bearing and alignment, while the flexible sleeve or guide protects surrounding soft tissues during the insertion process. This composite structure allows both strength and tissue protection requirements to be satisfied simultaneously.
Data Source
AI summary
A system is provided for inserting and securing, through a suprapatellar region of a leg, a nail into a medullary canal of a bone. The system can include a flexible sleeve configured to be partially inserted in the leg. The flexible sleeve can define a leading end and a trailing end spaced apart from the leading end along a first axis. The flexible sleeve can define a first cannulation that extends along the first axis between the leading and trailing ends. The first cannulation can be sized to receive therethrough at least the intramedullary nail. The system can further include a retaining member configured support at least a portion of the flexible sleeve. The retaining member can be configured to position the flexible sleeve through the suprapatellar region of the leg such that the flexible sleeve leading end is aligned with the proximal end of the bone. The intramedullary nail can be insertable through the flexible sleeve and into the medullary canal.