The present disclosure relates generally to medical plates and fasteners.
In order to help mend fractured or broken bones or to assist in correcting deformities, a physician, or other suitable healthcare provider, may position the fractured or broken bone into its normal alignment and hold the bone together with a surgical implant. In some implementations, these surgical implants include a plate and fasteners, such as, for example, screws, nails, wires, etc., that extend through or from the plate and secure the plate to the bone. Often, these surgical implants are internally fixated to the fractured or broken bone, which may result in surgical procedures occurring in tight spaces and at difficult angles.
The surgical implant assembly described herein provides a variable angle locking fastener and plate for enhanced securing and mending of fractured bones or for correcting deformities. The surgical implant assembly includes a plate and a first screw. The plate includes at least one aperture extending through the plate between opposite surfaces of the plate. The screw comprises a head and a body, the head including at least one head thread configured to engage with the plate at the aperture and the body including at least one body thread configured to engage a bone material.
According to an aspect of the present invention, the at least one head thread has a first pitch and the at least one body thread has a second pitch that is different than the first pitch. When the plate is disposed at a surface of the bone material and the screw is rotatably driven into the bone material, the pitch difference between the first pitch of the at least one head thread of the head and the second pitch of the at least one body thread of the body enables the plate to one selected from the group consisting of (i) lift away from the surface of the bone material and (ii) compress down onto the surface of the bone material. Optionally, for example, a plate may be provided and if it is desired to have the plate spaced from the bone material, a first fastener or screw may be selected that lifts the plate away from the surface of the bone material as the first screw is rotatably driven into the bone material. And if it is desired to have the plate tight against the bone material, a second fastener or screw may be selected that compresses the plate down onto the surface of the bone material as the second screw is rotatably driven into the bone material. Optionally, a third fastener or screw may be provided and selected with the head pitch substantially matching the body pitch, such that the plane neither lifts away from the bone material or compresses onto the bone material as the third screw is rotatably driven into the bone material.
According to another aspect of the present invention, the head of the screw includes a plurality of head threads configured to engage with the plate at the aperture. The plurality of head threads provide a plurality of thread entry points for threading into the plate. The plurality of head threads are configured to, when the plate is disposed at a surface of the bone material and the screw is rotatably driven into the bone material, enable the plate to one selected from the group consisting of (i) lift away from the surface of the bone material, (ii) compress down onto the surface of the bone material, and (iii) neither compress down onto the surface of the bone material nor lift away from the surface of the bone material.
According to another aspect of the present invention, the plate includes a plurality of circumferentially spaced apart protrusions established at and extending into the aperture. Each of the plurality of protrusions includes a plurality of buttresses. The buttresses of each protrusion include at least two buttresses spaced apart between the opposite surfaces of the plate, with each of the buttresses being parallel to the opposite surfaces of the plate. The screw includes a head and a body. The head includes at least one head thread configured to engage with the plurality of buttresses.
The buttresses of the plate are configured to allow for the screw to be rotatably driven into the plate (and into the bone of a patient) at different angles, without cross-threading of the threads of the screw in the plate. The spaced apart stepped buttresses provide a series of steps or parapets or castellations spaced so that the thread of the screw can pass through the spaces between adjacent ones of the steps or parapets or castellations at various angles, and thus allow for threads of the screw head to be received at different spaces between the buttresses or parapets to allow for the screw to be effectively rotatably driven into the plate at different angles. The thread pitch of the plate-engaging head threads of the screw is selected to provide lifting of the plate away from the bone as the screws are fully driven into and seated at the plate or compression of the plate at the bone as the screws are fully driven into and seated at the plate, or a neutral securing of the plate at the bone.
Optionally, the spaced apart buttresses may be formed at the screw head, and the threads (or spaced apart partial threads) may be formed in the plate, such that the engagement of the buttresses of the screw with the threads of the plate allow for the screw to be rotatably driven through the plate at different angles.
Further areas of applicability will become apparent from the description provided herein. The description and specific examples in this summary are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure.
Example configurations will now be described more fully with reference to the accompanying drawings. Example configurations are provided so that this disclosure will be thorough, and will fully convey the scope of the disclosure to those of ordinary skill in the art. Specific details are set forth such as examples of specific components, devices, and methods, to provide a thorough understanding of configurations of the present disclosure. It will be apparent to those of ordinary skill in the art that specific details need not be employed, that example configurations may be embodied in many different forms, and that the specific details and the example configurations should not be construed to limit the scope of the disclosure.
Referring to
For example, the plate 12, with the screws screwed into the bone and the head threads engaging the plate 12 (as also discussed below), may be spaced from the bone material 16 by a height or gap H12 which may be less than 0.5 mm, such as, for example, approximately 0.3 mm (such as shown in
Referring to
The plate 12 has a pair of apertures 24 extending therethrough. While two apertures 24 are shown and described, it should be understood that any suitable number of apertures may be implemented. For example, the plate 12 may include a single aperture 24 or three or more apertures (and the plate may be used with a corresponding number of screws or fasteners 14), depending on the particular application. As shown in
The central aperture 26 may include a central axis A26 and the radial apertures 28 may be formed with central axes parallel to the central axis A26, as can be seen in
The plurality of protrusions 30 are formed between the radial apertures 28 so that they extend or protrude into and partially define the shape of the larger aperture 24 but do not extend or protrude into the central aperture 26. As shown in
Each of the buttresses 32 of each protrusion 30 is formed at a respective height H32 relative to the bottom surface 20 of the plate 12 (
The central aperture 26 has a central axis A26 and the buttresses 32 of each protrusion 30 may be formed at an angle relative to the central axis A26. For example, and such as shown in
The buttresses thus cooperate to form a plurality of parallel steps or parapets or castellations (that are parallel to one another and parallel to the top and/or bottom surface of the plate or normal to the central axis A26 of the aperture of the plate) that function to provide a pseudo-helical configuration for the threads of the screw to engage. In other words, the steps or buttresses provide a series of parapets or castellations that are spaced apart so that a thread of the screw can pass through the notches between adjacent ones at various angles. The buttresses 32 thus cooperate with one another to effectively provide multiple potential thread paths for the threads of the fastener or screw 14 so that the screw 14 may be rotatably driven into the plate 12 at different angles, as discussed below.
The apertures 24 and buttresses 32 may be formed by any suitable process and in any suitable manner. For example, the plate 12 may be formed as a solid, unitary component and then the apertures 24 may be subsequently formed in the plate 12. For example, the central aperture 26 may be formed or drilled through the plate and then the radial apertures may be formed or drilled through the plate around the central aperture, leaving the protrusions between the radial apertures and outboard of the central aperture, whereby each of the protrusions may be machined or ground to form the respective vertically spaced apart buttresses. As another example, the apertures 24 and protrusions and buttresses 30 may be formed approximately simultaneously with the plate 12 via, e.g., forging, stamping, molding, or the like.
In the illustrated embodiment, the implant assembly 10 includes two screws 14 for rotatably driving into a respective aperture 24 of the plate 12 and into the bone of the patient. Each of the screws 14 includes a head 34 and a threaded body 36 extending from the head 34. The head 34 and the body 36 are generally cylindrical and formed around a central axis A14. The head 34 includes a plurality of head threads or entry threads 38 and the body 36 has one or more body threads 42. The head 34 also includes a drive or socket 40 that is configured to receive or otherwise engage a tool or driver to rotatably drive the screw 14 into the bone and plate. The socket 40 may be any suitable socket to receive any suitable tool, such as, for example, a star driver, an Allen wrench, a screwdriver, or the like. The body thread 42 is sized to be received through the central aperture 26 of the plate and is configured to thread into the bone of the patient while the head threads 38 are configured to engage the buttresses 32 of the aperture 24 of the plate 12, as discussed below.
The head threads 38 are formed with an outer edge of the threads 38 being at an angle relative to the central axis A14, such as, for example, an angle of approximately 14 degrees relative to the central axis A14 (so as to generally correspond with the angle of the buttresses formed along the aperture 24), as can be seen in
The head threads 38 are configured to engage the buttresses 32 of the protrusions 30 when the screw 14 is inserted through the aperture 24 of the plate 12. The head threads comprise one or more threads, such as two threads or three threads. In the illustrated embodiment, the head threads 38 comprise three head threads or entry threads and include a first entry thread 38a, a second entry thread 38b, and a third entry thread 38c. The entry threads 38a-c allow the screws 14 to engage the buttresses 32 at any one or more of the entry threads 38a-c, which, in conjunction with the varying heights H32 of the buttresses 32, allows the screws 14 to engage the plate straight in (i.e., with the central axis of the screw 14 being parallel to the central axis of the aperture 26 of the plate, such as shown in
Such a configuration allows a physician or other healthcare provider to screw or thread the screws 14 into the bone material 16 at any suitable angle, such as, for example, an angle between 0 and 15 degrees relative to the central axis of the aperture 26 of the plate, which extends normal to or perpendicular to the plane of the plate. Each screw 14 may operate independently of the other screw 14, i.e., one of the screws 14 may be at an angle of 0 degrees relative to the central axis A26 of the central aperture 26 and the other screw 14 may be at an angle of about 15 degrees (or other angle depending on the configuration of the buttresses of the plate and the head thread pitch) relative to the central axis A26 of the central aperture 26 of the plate 12, as can be seen in
The body 36 of the screw includes one or more body threads 42 (with the illustrated embodiment having a single body thread 42) extending around the central axis A14 of the screw 14 and along the body of the screw. The body thread 42 is formed with a pitch P42 that is, in some implementations, less than the pitch P38 of the head threads 38. The pitch P42 of the body threads 42 may be different than the pitch P38 of the head threads 38 so that the plate 12 may be spaced from the bone material 16 (if the pitch of the body threads is less than the pitch of the head threads) or may be drawn into tighter contact with the bone (if the pitch of the body threads is greater than the pitch of the head threads) when the screws 14 are screwed into the bone material 16. By having the pitch of the body threads be less than the pitch of the head threads, the screws may operate opposite to a compression screw in that the plate 12 may lift slightly from the bone as the body threads are screwed into the bone and the head threads 38 engage the buttresses 32 and lock the screw 14 to the plate 12 when the screw head is fully seated at or fully driven into the plate. Optionally, the pitches of the head threads and the body threads may correspond, whereby the plate compression/lift may be neutral and the plate will be affixed at the bone at the degree of pressure at the bone that was set prior to the head threads engaging the buttresses.
In some implementations, the pitch P42 of the body threads 42 is between 0.9 mm and 1.9 mm, such as, for example, approximately 1.4 mm. The height or gap H12 between the plate 12 and the bone material 16 (when the screws are screwed into the bone and fully seated into the plate) can be calculated by subtracting the pitch P42 of the body threads 42 from the pitch P38 of the head threads 38 and dividing that difference by 2. For example, if the pitch P38 of the head threads 38 is equal to 2 mm and the pitch P42 of the body threads 42 is equal to 1.4 mm, then the gap or height H12 (the gap between the lower surface of the plate and the bone) would be equal to 0.3 mm (2−1.4=0.6, and 0.6/2=0.3 mm).
During use of the screws and plate, the plate is positioned at a fractured bone and the screws may be threaded into the bone (at opposite sides of the fracture) to affix the plate at the bone. The body thread of each screw is received through the central aperture of the plate and threaded into the bone (optionally via a self-tapping threading process or via threading into a pilot hole drilled into the bone). As the screw is threaded further into the bone, the head threads engage the stepped buttresses of the plate. Due to the different pitches of the body thread and head threads, the head threads function to move the plate relative to the bone as the screw is further screwed into the bone and plate and fully seated or screwed into the plate. For example, with the pitch of the head threads or entry threads being greater than the pitch of the body thread, the plate is drawn back from or raised from the bone as the screw is further screwed into the bone and plate and fully seated or screwed into the plate.
Therefore, the screw and plate configuration allows for the screw or screws to be threaded into the bone of the patient and driven into the plate at different angles. The screw and plate configuration, with the pitch of the head threads being greater than the pitch of the body thread, provides for spacing the plate slightly away from the bone when the screws are fully driven into the plate and into the bone. The screw and plate configuration thus provides for enhanced attachment of the plate to the bone of a patient that allows for different angles of the screws and that may reduce or prevent necrosis under the plate and/or damage to periosteal tissue.
By providing a plate with fasteners having different head thread pitches (relative to the body pitch), the plate and fastener assembly or kit or system can be used in different applications, depending on the desired end result. For example, if it is desired to have a gap between the plate and the surface of the bone, a fastener may be selected that has its head thread pitch greater than the body thread pitch. Alternatively, if it is desired to have the plate tight against the surface of the bone, a fastener may be selected that has its body thread pitch greater than the head thread pitch. The plate and fasteners may be provided as a unit or kit, whereby the healthcare provider can select the appropriate fastener or screw for the particular patient application.
Although shown and described as having spaced apart buttresses or castellations formed in and along the passageway of the plate, with the threads of the screw engaging the buttresses as the screw is rotatably driven into the bone and plate, it is envisioned that the screw head may have spaced apart buttresses or castellations formed around the head, with the plate having threads or partial threads formed in and along the passageway. For example, and such as shown in
The plate 112 has a pair of apertures 124 extending therethrough. As shown in
In the illustrated embodiment, the implant assembly 110 includes two screws 114 for rotatably driving into a respective aperture 124 of the plate 112 and into the bone of the patient. Each of the screws 114 includes a head 134 and a threaded body 136 extending from the head 134. The body 136 has a body thread or threads 142 formed therealong. The body thread 142 is sized to be received through the central aperture 126 of the plate and is configured to thread into the bone of the patient. The head 134 includes a drive or socket 140 that is configured to receive or otherwise engage a tool or driver to rotatably drive the screw 114 into the bone and plate.
The head 134 also includes a plurality of spaced apart protrusions or buttresses 138 protruding radially outward (such as six sets of protrusions spaced around the head of the screw). The buttresses or steps or parapets or castellations 138 are vertically spaced apart between the top and bottom of the head portion of the screw. The buttresses 138 are parallel to one another and are generally perpendicular to the longitudinal axis of the screw. In other words, and as can be seen with reference to
The head buttresses 138 are configured to engage the partial threads 130 of the plate when the screw 114 is inserted and rotatably driven through the aperture 124 of the plate 112. The spaced apart buttresses of the screw head and the spaced apart partial threads of the plate engage one another in a manner that allows the screw to be rotatably driven through the plate in a direction perpendicular to the plate or at an acute angle relative to the plate, such as in a manner similar as described above. The screws 114 and plate 112 may be otherwise similar to the screws 14 and plate 12, discussed above, such that a detailed description of the screws and plates need not be repeated herein.
The foregoing description has been provided for purposes of illustration and description. It is not intended to be exhaustive or to limit the disclosure. Individual elements or features of a particular configuration are generally not limited to that particular configuration, but, where applicable, are interchangeable and can be used in a selected configuration, even if not specifically shown or described. The same may also be varied in many ways. Such variations are not to be regarded as a departure from the disclosure, and all such modifications are intended to be included within the scope of the disclosure.
The present application claims the filing benefits of U.S. provisional application Ser. No. 62/950,154, filed Dec. 19, 2019, and U.S. provisional application Ser. No. 62/937,925, filed Nov. 20, 2019, which are hereby incorporated herein by reference in their entireties.
Number | Date | Country | |
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62950154 | Dec 2019 | US | |
62937925 | Nov 2019 | US |