1. Field of the Invention
This invention relates broadly to surgical devices. More particularly, this invention relates to a fracture fixation plate that may be used with K-wires and/or suture material.
2. State of the Art
Fracture fixation plates are common in the industry. Such plates are use to bridge across fractures, stabilizing fragments for healing. Fixation plates may be in the form of fragment plates which are generally used along the diaphysis of long bones or anatomically specific metaphyseal plates which are contoured for the articulating end of long bones. The plates are generally provided with a plurality of screw holes at which the plates can be secured to the bone with screws or other fasteners. The holes may be locking holes, non-locking holes, combination holes (which can be locking or non-locking depending upon the fastener used therethrough), and a combination of any of the above.
It is common for fixation plates to include K-wire holes. Stiff K-wires are often used to temporarily secure a plate to the bone prior to and during fixation by the fasteners. The K-wires are then removed.
In addition, it is known to provide fixed angle K-wire holes that have a cylindrical bore and which are sized to closely fit with K-wires so as to guide K-wires in a predefined angular orientation. Such orientation is closely related to the angle of one or more of the fasteners such that that path of the inserted K-wires anticipates the path of the fasteners. Then, when viewing the plate and inserted K-wires under fluoroscopy, the surgeon is provided with visual indication of whether the fasteners, once inserted, will be properly aligned with the anatomy. See, e.g., US Pub. No. 20050065524 A1 to Orbay.
Furthermore, depending upon the surgical procedure, the surgeon may need to incise the insertions of certain muscles to facilitate reduction of the fractured bone and to provide access for attachment of the plate to the bone. For example, in a procedure to fixate a proximal humeral fracture, the deltoid and pectoralis muscle insertions are commonly incised and after fixing the plate to the bone, the deltoid and pectoralis tendons may be fixed to the plate to reconstruct the musculature. As such, it is known to provide a plate with suture holes for receiving therethrough a suture needle and suture material, e.g., cord or cable. Suture holes are designed differently than K-wires holes. Rather than have structure for fixed angle guidance, the suture holes are heavily chamfered for prevent damage to the suture material.
Thus, fixation plates are often replete with holes with dedicated functionality. Such holes crowd the plate surface, often making it difficult for a surgeon to identify which holes are to be used for which purpose. In addition, there may not be sufficient space on the plate to place the holes at the optimal locations for the desired purposes. In Furthermore, the shear number of holes dedicated to each function may result in a plate that is weaker than desired for the particular application.
U.S. Pub. No. 20050261688 to Grady, Jr. et al. discloses a plate having holes that are indicated to be for either guide wires or suture, thereby reducing the total number of holes. However, there is no disclosure that the holes are intended to guide stiff wires at a fixed angle. In addition, the design of the holes does not permit a suture needle to be inserted between the bone and the bone contacting surface of the plate after the plate is positioned against or attached to the bone. Suture holes which permit suture needle passage after the plate is fixed to the bone generally include a bottom clearance for the needle, as disclosed, e.g., by the Humeral SuturePlate™ from Arthrex Inc. of Naples, Fla.
It is therefore an object of the invention to provide a fracture fixation plate having a multifunctional hole that accommodates a K-wire at a fixed angle and which allows a suture needle to be inserted through the hole even after the plate has been fixed to the bone.
It is another object of the invention to provide a multifunctional hole that reduces the total number of holes required in a plate, thereby maintaining desired plate strength and allowing optimal placement of the holes within the plate.
It is also an object of the invention to provide multifunctional holes to the plate in an arrangement that maintain the longitudinal and torsional stiffness of the plate.
It is a further object of the invention to provide multifunctional holes to the plate in an arrangement that increases flexibility of the plate at specific locations.
It is yet another object of the invention to provide a multifunctional hole configuration that minimizes stress concentration to suture extending therethrough.
It is an object of the invention to provide such multifunctional holes to both metaphyseal plates and diaphyseal plates.
In accord with these objects, which will be discussed in detail below, a bone plate for internal fixation of a bone fracture includes top and bottom surfaces and an edge. At least one multifunctional hole is provided along the edge and communicates between the top and bottom surfaces. The hole generally includes a cylindrical portion for closely receiving and guiding a stiff K-wire in a fixed angle. The hole also includes a lateral channel or recess formed into the bottom surface and an edge of the plate such that a curved suture needle and attached suture material may be passed through the hole and out of the side of the plate even when the plate is fixed to the bone. A plurality of multifunctional holes may be arranged along the edges of the plate, either closely spaced, e.g. in a metaphyseal plate, or spaced apart along sides of a diaphyseal plate. If arranged in a staggered manner along opposed sides, the plate maintains its longitudinal and torsional stiffness, whereas if the multifunctional holes are in an opposing arrangement, the plate develops areas of decreased stiffness at which the plate can bend to conform to the anatomy when coupled to the bone.
Additional objects and advantages of the invention will become apparent to those skilled in the art upon reference to the detailed description taken in conjunction with the provided figures.
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There have been described and illustrated herein several embodiments of a fixation plate. While particular embodiments of the invention have been described, it is not intended that the invention be limited thereto, as it is intended that the invention be as broad in scope as the art will allow and that the specification be read likewise. Thus, while particular embodiments of diaphyseal and metaphyseal plates with multifunctional holes according to the invention have been disclosed, it will be appreciated that the multifunctional holes can be located in plates of other shapes and sizes and which are otherwise adapted for use on various bones. In addition, the locations for the multifunctional holes within the plates can be modified as well, while still being within the scope of the invention. Specifically, a combination of staggered and opposed pairs of multifunctional holes, and more or fewer multifunctional holes (including single holes), spaced relatively closer or farther apart than shown in the exemplar embodiments are within the scope of the invention. Furthermore, while it is preferred that the guide portion guide a K-wire at a fixed angle, it is appreciated that the guide portion may be sized or otherwise configured to guide the K-wire at various angles between the top and bottom surfaces of the plate. It will therefore be appreciated by those skilled in the art that yet other modifications could be made to the provided invention without deviating from its scope as claimed.