Washer-Type Clip With Posterior Extension For Greater Tuberosity Fixation
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Solution Overview
Problem
Surgical treatment of multi-fragmentary proximal humerus fractures faces challenges due to poor bone quality and complex physiological loads, particularly in securely fixing the greater tuberosity fragment, with existing systems lacking stability and strength in soft-tissue fixation and risking washer rotation.
Innovation Solution
A washer-type clip with a posterior extension and variable-angle screw fixation, along with a malleable plate that can be inserted after initial screw placement and reshaped to provide secure fixation of the greater tuberosity fragment and soft tissue re-fixation, preventing washer rotation through multiple suture holes and dual screw fixation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Strength
If a washer is used to improve the screw-bone interface, then the surface area is increased and the risk of screw head cortex penetration is reduced, but the stability and strength in soft-tissue fixation is limited and washer rotation may occur
Solution Approach 1:
The patent combines the washer function with additional soft-tissue fixation features by integrating suture holes and tabs into the washer structure itself, creating a multi-functional component that provides both bone interface protection and reliable soft-tissue attachment
Solution Approach 2:
The washer is designed to perform multiple functions: protecting the bone surface from screw head penetration, providing a stable interface for soft-tissue fixation through integrated suture holes, and preventing rotation through tab structures that can engage with surrounding tissues
2Ease of operation
If proximal screws are used to re-fixate soft tissues by means of suture wrap around the threaded portion, then soft tissue fixation is achieved, but the fixation lacks stability and strength in case of off-centric loads
Solution Approach 1:
The washer acts as an intermediary component between the screw and the soft tissue, providing a stable attachment point that distributes loads more effectively than direct suture wrap around the threaded portion, particularly for off-centric loads
3Device complexity
If limited access fixation of the posterior aspect of the greater tuberosity is used, then the procedure is simpler, but the fixation reliability is compromised
Solution Approach 1:
The washer includes a posterior extension with tabs that can be separately positioned and secured to provide additional fixation points on the posterior aspect of the greater tuberosity, allowing staged or selective fixation without requiring complex simultaneous procedures
Data Source
AI summary
A plate configured for placement on an outer surface of a bone includes a plate-shaped body comprised of a malleable material and having an outer perimeter, wherein a portion of the outer perimeter defines an open-ended peripheral seat configured to be located beneath a portion of a head of a fastener, wherein the portion of the outer perimeter defining the open-ended peripheral seat has an open end and an opposite terminal end, the terminal end sized to interact with a single fastener. A surgical method includes inserting a fastener into a bone such that a head of the fastener is not in contact with an outer surface of the bone, placing the plate such that the open-ended peripheral seat is disposed beneath a portion of the head of the fastener, and inserting the fastener further into the bone to contact the head of the fastener to the plate.