Described herein are devices and methods for treating bone and other tissue trauma and/or deformities in humans and animals. In particular, the description relates to devices and methods for utilizing compression devices on surgical pins, screws and bone wire such as, for example, a Kirschner Wire or “K-Wire” to facilitate healing after surgery such as, for example, to repair small bones.
Current treatment for injury or deformation of bones such as small metatarsal bones involve fusion techniques typically utilizing a bone wire such as a “K-wire” inserted through the bone fragments and sometimes secured to an anchor bone. The wire is placed through the fractured or displaced bone segments which are then fixated by anchoring the wire to an adjacent anchor bone in the desired alignment for a duration of time to heal, and in most cases, is removed upon completion of the healing process.
Recently, several devices have been developed that incorporate a component that provides compression to the proximal end of the end bone of the treated bone segments containing a bone wire. This compression helps prevent motion and/or loosening of a fixated fractured bone segment or segments. Combined with the anchoring of the bone wire to an adjacent located bone segment, the compression devices attempt to provide more secure placement and stabilization of fractured bones to aid in healing without loosening or movement of the set bones. These devices are not efficient and/or are complex and bulky making their delivery cumbersome for the user and problematic for the patient during healing.
There is a need for devices and methods that can provide more efficient and effective treatment of bone trauma and/or deformities and in particular, small bone trauma and/or deformities. Devices that have been developed to date have failed to adequately provide a simple structure that is easy to use by surgeons. Disclosed are devices and methods that can substantially improve the treatment of small bone injuries and/or deformities. There exists a clear need for compression devices that can be easily adjusted by surgeons both during and subsequent to a procedure. There also exists a need for devices that can be quickly inserted and/or removed in combination with existing techniques, all of which will provide a more efficient procedure, healing time, and higher rate of success.
Broadly, described herein are devices and methods allowing for the fixation of small traumatized or deformed bones and/or tissue through the utilization of a compression device in conjunction with an anchorable bone wire, pin, or screw.
Several embodiments of compression devices are disclosed herein that significantly improve existing procedures for repair of damaged bones and tissue such as, for example, small bones. By way of example, the compression devices described below could be utilized in the repair and fusion of phalangical and metatarsal bones for the purpose of surgically correcting hammertoe deformities.
In the various disclosed embodiments a compression device is inserted onto a bone wire, pin or screw, and slides proximally along the wire, pin or screw towards the treated bone fragments until the desired compression location is achieved. Typically, the desired location for placement of a compression device is through the soft tissue located in the distal area of the most distal bone fragment such as, for example, a toe phalange being treated, and abutting up against that bone segment. Once the desired compression is achieved the disclosed devices are then locked into their position to secure and maintain the desired compression. The compression would be maintained over the healing period. In some preferred embodiments, the compression devices are adjustable during the healing period to account for any loss of the desired compression due to any number of variable factors including but not limited to subsidence of the device, reduction in inflammation, or patient activity.
Each of the examples of the various embodiments described herein will be set forth in the detailed description below. One common utilization of the disclosed devices would be for small bones such as phalanges. However, the disclosed compression devices could be utilized in any bone repair scenario where the compression of damaged bone fragments and/or other tissue during healing is desired. In the preferred embodiment, the compression device includes a slidable component having a flexible end with a pair of parallel reliefs along the distal portion of the device's long axis differentiating the distal portion of the device from the more rigid proximal end of the device. Abutting a modified bone wire on the inner wall of the compression device is a pair of inwardly protruding male tabs that slide along the bone wire until a desired compression is achieved and therefore a location along the bone wire is selected. Located towards the outer middle portion of the device a locking clip or ring is provided that, once the desired location of the compression device on the modified bone wire is reached, the locking clip or ring is then be moved distally to a locking position near the distal end of the device. When the locking clip is moved distally on the compression device it axially locks the compression device by squeezing together the parallel reliefs on the compression devices distal end, forcing the inner male segment tabs of the compression device into the female slots of the modified bone wire.
In an alternative embodiment the compression device contains two or more male locking segments that are located on the inner wall of the compression device. The tabs are chamfered on their proximal end so that as the tabs are moved proximally along the bone wire, the tabs are able to move in and out of the female slots on the bone wire. In the preferred embodiment the modified bone wire includes two smooth portions and two portions with female relief slots. The tabs slide along the smooth portion until the desired compression is achieved. The device could then be rotated 90° so the tabs align and mate with the female slots of the modified wire by turning the compression device body with respect to the modified bone wire. The turning of the final locked assembly causes advancement or retraction depending on the direction of rotation and the screw form of the K-Wires' threaded portion.
Another alternative embodiment includes a spring loaded pressure compression device. This design allows the compression device to slide proximally along a standard bone wire until the desired location for compression is achieved at the distal bone segment. Once in this desired position the compression device cannot slide distally on the bone wire unless the user moves the spring tab into a perpendicular orientation with respect to the devices long axis.
In another alternative embodiment, the compression device includes a slidable component that would be delivered into the desired location on a modified bone wire and a second crimping component that includes a C-clip that would be inserted or placed around the slidable component when the slidable component is properly located on the bone wire. The C-clip would lock into recesses located along the modified bone wire locking the compression device into the proper axial position along the bone wire.
In another alternative embodiment, the compression device's components include a spring clip with multiple inwardly facing locking tabs. In this embodiment, the compression device includes a slidable component that would slide down a modified bone wire to the desired location at the distal end of the bone from which the bone wire protrudes. The bone wire contains a series of female slots or dimples down two parallel and symmetric sides of the wire that match with two or more male locking tabs on the spring clip that protrude from the inner wall of the device. The slidable compression device is advanced along the wire until desired compression and then rotated 90° so that the spring clip locking tabs would lock into the desired bone wire slots, preventing any backward directional movement of the compression device thereby maintaining the desired compression.
In another alternative embodiment the compression device includes a two piece “collet” assembly that would be utilized with a modified threaded bone wire. In this embodiment, the outer portion of the device does not rotate as the inner portion rotates on the wire threads. In one alternative, the device is self tapping rather than threaded. In another alternative the outer component rotates and the inner component remains static. This would prevent twisting or torqueing of the soft tissue envelope or the distal bone abutting the compression device.
In another alternative embodiment a single component compression device slides down a modified bone wire that contains multiple female grooves along its axis.
With this design there is a quadrant relief along the bone wires length. Radially adjacent to the quadrant relief there are radial reliefs in an adjacent quadrant of the bone wire. The first quadrant relief, along the bone wires' long axis, allows the compression device to slide along it when the compression device tab and bone wire relief are aligned. The partial radial reliefs allow the user to rotate the compression device 90° when the desired location on the bone wire is achieved, forcing the inward tab to engage the radial reliefs and locking the device in its desired location. The compressive device's tab may be deformable and when the compression device is rotated the tab could self tap into the bone wire reliefs.
The disclosed compression devices might be utilized in the repair of small bones with internal bone wire applications, or could utilized with external fixators. They could be utilized anywhere compression is desired to facilitate healing of bone or tissue trauma and/or deformity.
Further objects and advantages of the devices, systems, and methods of the present disclosure are more fully set forth in the detailed description and accompanying drawings.
Embodiments or variations are now described by way of example with reference to the accompanying drawings.
a-c show several views of a tabbed bone wire compression device.
c shows a cutaway of a tabbed compression device.
a-b show several different perspectives of a tabbed compression device.
c shows a cutaway of a tabbed compression device.
a-c show an example of a locking clip for use with a tabbed compression device.
a shows a cutaway view of a tabbed compression device on a bone wire with a locking clip in an unlocked position.
b shows a cutaway view of a tabbed compression device on a bone wire with a locking clip in a locked position.
a-c show various perspectives of a modified bone wire.
d shows a cross sectional view of the partially relieved portion of the K-wire.
e shows a side view of four finger or toe bones prior to surgical intervention.
f shows a side view of four finger or toe bones after surgical preparation of the bone joint surfaces that are to undergo fusion.
g shows the insertion of a k-wire antegrade through the three distal finger or toe bones. The threaded proximal end is residing in one of the two bone anchors.
h shows the threading of the k-wire retrograde across the two bone anchors.
i shows the final assembly of a tabbed compression device on a modified bone wire.
a shows a tabbed compression device on a bone wire in an unlocked position.
b shows a tabbed compression device on a bone wire in a locked position.
d-e shows a couple views of a windowed tab compression device.
f show a cutaway view of a windowed tab compression device.
Fig. g-h shows a couple views of a tabbed compression device without locking features.
i shows a cutaway view of a tabbed compression device without locking features.
j shows an isometric view of a tabbed compression device without locking features.
k shows a side view of a tabbed compression device without locking features.
l shows a cutaway view of a tabbed compression device without locking features.
m-n show cutaway views of the tabbed compression device without locking features.
o shows a side view of a single locking tab without a locking feature locked in position along a smooth k-wire.
p shows a cutaway view of a single locking tab without a locking feature locked in position along a smooth k-wire.
q-r show various views of a tabbed compression device with a distal body locking feature.
s shows a cutaway view of a tabbed compression device with a distal body locking feature.
t shows a cross-sectional view of a tabbed compression device with a distal body locking feature.
u-v show a couple side views of a tabbed compression device with another embodiment of a distal body locking feature.
x shows an end view of a tabbed compression device with another embodiment of a distal body locking feature.
a-c show a helical pathway design of a tabbed compression device.
a shows a cutaway view showing the reliefs in the helical pathway tabbed compression device.
b shows a cutaway view of the internal locking tabs in the tabbed compression device.
a-b show two views of a clip utilized with the helical tabbed compression device.
a-b show a cutaway view of a helical tabbed compression device. 11a is unlocked and 11b is locked.
a-b show a helical tabbed compression device on a bone wire. 12a is unlocked and 12b is locked.
a-c show a locking ring utilized for locking the tabbed compression device into position.
a shows the pull ring mechanism for moving the spring clip of the tabbed compression device in an unlocked position.
b shows the pull ring mechanism for moving the spring clip of the tabbed compression device in a locked position.
c-d show cutaway views of the pulling mechanism.
a-b show cutaway views of the locking ring mechanism.
a and b show the pull ring mechanism in a locked,
a-c show various views of a proximal tab compression device that contains several internal male interlocking tabs.
a-c show different views of a multiple tab compression device that contains several internal male interlocking tabs.
a shows a cutaway of a multiple tabbed compression device on a bone wire.
b shows an enlarged view, a cutaway of a multiple tabbed compression device.
a-c show various views of a spring loaded compression device.
a shows a cutaway of a spring loaded compression device on a bone wire.
b shows, an enlarged view, a cutaway of a spring loaded compression device on a bone wire.
a-c show various views of a crimping compression device.
a shows an ISO view of a crimping compression device.
b shows a view of a clip utilized with a crimping compression device.
a and b show two cutaway perspectives of a crimping compression device.
a-c show several views of a crimping compression device on a bone wire.
a-c show various views of a compression device body for use with a spring clip.
a shows an isometric view of a spring clip.
b shows a top view of a spring clip.
c shows a cutaway of a spring clip.
a shows a cutaway of a compression device with spring clip on a bone wire.
b shows an enlarged view of a cutaway of a compression device with spring clip.
a and b show an alternative multi-part compression device with spring clip.
a-c show various views of the inner component of a collet compression device.
a-c show various views of the external component of a collet compression device.
a shows a cutaway of a collet compression device on a bone wire.
b shows a cutaway of a collet compression device.
a-c show various views of the outer component of an alternative embodiment of a collet compression device.
a-c show various views of the inner component of an alternative embodiment of a collet compression device.
a shows a cutaway of an alternative collet compression device on a bone wire.
b shows a cutaway of an alternative collet compression device on a bone wire.
a-c show various views of a quarter turn compression device.
a and b show cutaways of a quarter turn compression device.
a and b show a top view of a bone wire utilized with a quarter turn compression device.
A preferred embodiment of the disclosed bone wire compression apparatus 10 includes a tabbed compression device 103 and a modified bone wire 101 as illustrated in
Adjacent and distal to the unlocked-position groove 201 is a locking mechanism ramp 203 and a locked-position groove 211 that facilitate locking the tabbed compression device 103 into place on the modified bone wire 101 once the desired bone compression and location of the tabbed compression device 103 on the modified bone wire 101 is achieved. As depicted in
While the foregoing embodiment and a variety of embodiments described below each includes a bone wire 101 having female slots 603 receiving the at least one male locking tab 207, alternative embodiments could use smooth bone wires without female slots 603. In such a configuration, the at least one flexible member of the subject compression device 103 would compress against the smooth bone wire in the inward radial direction with sufficient force to resist undesired movement of the compression device 103 relative to the bone wire.
The compression device may include a cap 501 that can be placed on the distal end of the tabbed compression device 103 after it has been placed in the desired location on the modified bone wire 101 as shown in
a and 6b illustrate a modified bone wire 101 for use with a tabbed compression device 103. The modified bone wire 101 has a series of female slots 603 that axially traverse the wire from the distal tip 605 proximally along the modified bone wire 101 to a desired location on the modified bone wire 101. In the disclosed embodiment the female slots cease just distally to bone anchor threads 609. The female relief slots 603 could be placed on the modified bone wire 101 in any location, however, to achieve the locking of the tabbed compression device 103 at the desired location on the modified bone wire 101. As shown in the figures, the female relief slots 603 include separate and distinct depressions, recesses, or cut-outs formed in the modified bone wire 101. From the perspective provided in
A method of application is disclosed for utilizing a bone compression apparatus. In this method a modified bone wire is utilized where the proximal portion of a modified bone wire 101 is threaded 609 and the balance of the wire is non-threaded. The threaded portion is provided in order to allow the clinician to pass this portion of the wire across the joint line of a finger or a toe that is not intended to be fused 617 and provide an anchor from which one can utilize the tabbed compression device 103 to afford a compressive force along the axis of the modified bone wire 101 and facilitate fusion of other joint lines 615 provided along the remaining length of the modified bone wire.
a illustrates the preferred embodiment of the tabbed compression device 103 in an unlocked position while
d-n illustrate an alternative embodiment of the tabbed compression device 103 which does not utilize an external locking component. In this embodiment male window tabs 711 might lock into female reliefs 603 at a desired location on the modified bone wire 101 by a rotation into the reliefs. In one embodiment the internal male tabs 711 might snap into the reliefs as the compression device is moved proximally down the modified bone wire through the use of chamfered shaped tabs 713 as shown in
In one embodiment as shown in
In one variation the compression device 103 might contain internal locking components as shown in
In one alternative embodiment as illustrated in
In another alternative embodiment the tabbed compression device 103 includes a pull ring 1301 as illustrated in
Illustrated in
Another alternative embodiment is illustrated in
In another alternative embodiment the bone wire compression apparatus 10 includes an alternative spring clip compression device 2901 as illustrated in
a and b show an alternative embodiment where separate locking tabs 3201 are placed into the female receiving relief slots 603 and then the locking collar 3205 is placed over metal locking tabs 3201 after the desired location on the modified bone wire 101 is achieved.
a-c, 22a-b, and 23 illustrate an alternative spring loaded binding compression device 2101. This design would allow the alternative spring loaded binding compression device 2101 to slide along a modified bone wire 101 until the desired location for compression is achieved. Once in place, the alternative spring loaded binding compression device 2101 could be reversed on the bone wire distally to adjust the compression by moving the spring tab 2103 towards a perpendicular orientation relative to the modified bone wire axis.
In another embodiment the bone wire compression apparatus 10 is a two part compression device 3401 as shown in
In various embodiments a seal 5201 between a bone wire compression device 5203 as shown in
Another example of an alternative use in the treatment of bone trauma and/or deformities with the disclosed compression devices is disclosed in
Disclosed are just a few of examples of utilizing the compression devices in alternative bone treatment applications. The disclosed compression devices and modified bone wires, pins, and screws could be utilized anywhere, however that compression is desired for bone and/or tissue treatment due to trauma and/or deformity.
It will be appreciated by persons skilled in the art that numerous variations and/or modifications may be made to the described device as specifically shown here without departing from the spirit or scope of that broader disclosure. The various examples are, therefore, to be considered in all respects as illustrative and not restrictive.
This application claims the benefit of the filing date of U.S. Provisional Application No. 61/275,091, filed Aug. 25, 2009, the entirety of which is incorporated herein by reference.
Filing Document | Filing Date | Country | Kind | 371c Date |
---|---|---|---|---|
PCT/US2010/046692 | 8/25/2010 | WO | 00 | 7/20/2012 |
Number | Date | Country | |
---|---|---|---|
61275091 | Aug 2009 | US |