The present subject matter relates generally to surgical devices and more specifically to devices, system and methods for fracture fixation and/or other orthopedic procedures.
Many bony fractures require stabilization that cannot be provided by external splints or casts—internal fixation is therefore required. Bone plates are among the most common artificial orthopedic implants and are commonly used to stabilize and internally fixate bony fractures.
A conventional bone plate is essentially a rigid metal plate drilled with guide holes through which bone screws can be passed. Bone screws are usually inserted through the mounting holes and threaded into the bone above and below the fracture to fix the bone plate, thereby stabilizing and fixating the fracture. In some cases, the bone plate may be removed after healing—although in many cases the plate and associated fixation devices are left permanently implanted.
In traditional plates, a bone plate is pressed onto the bone surface by one or more screws, with the tightening torque of the bone screw typically determining the level of securement and/or “friction” between the plate and bone. While this may lead to a well secured plate at the time of surgical implantation, healing, bone remodeling and/or cyclic loading of the plate and/or bone screws can lead to undesirable loosening of the bone plate and/or displacement of bone fragments. Moreover, the large, required contact surfaces of some bone plates can disturb and/or interrupt blood circulation in treated bone regions.
Accordingly, there is need for further improvement in bone plate systems and related surgical implants, and the present subject matter is such improvement.
The following presents a simplified summary of the subject matter in order to provide a basic understanding of some aspects of the subject matter. This summary is not an extensive overview of the subject matter. It is intended to neither identify key or critical elements of the subject matter nor delineate the scope of the subject matter. Its sole purpose is to present some concepts of the subject matter in a simplified form as a prelude to the more detailed description that is presented later.
In accordance with various aspects of the present subject matter, systems, devices and/or methods are disclosed which may be useful in bone and/or joint repair procedures or other orthopedic procedures.
In various applications, the disclosed implant components can comprise various medical materials, including the use of one or various combinations of titanium, chrome cobalt, stainless steel, silicone, poly (ether ether ketone) (PEEK), ultra-high molecular-weight polyethylene (UHMWPE), polylactic acid, apatites and/or various 3D printable materials. Where a plurality of different materials may be used in a single implant, the employment of mixed materials in the implant construction may enhance the strength and/or durability of a desired implant design, as well as allow for improved surgical outcomes and/or greatly reduced complication rates.
If desired, implant components could be constructed from a variety of modular components, including modular components comprising different materials. If desired, such modular components could be provided in a kit form for selection and/or assembly in a surgical theatre and/or in situ during a surgical procedure. If desired, various components may be removable and replaceable.
Disclosed herein are a variety of implant components that can be utilized during an orthopedic surgical procedure to repair and/or stabilize an injured or diseased bone region of a patient. Various surgical methods for assembling such implant components and/or for implanting or placement of the various devices and/or components described herein are also described, including the insertion and placement of implants between and/or along fractured regions of a long bone, as within bones and/or between joint surfaces.
In accordance with another aspect of the present subject matter, various methods for manufacturing devices and/or components thereof, as set for within any of the details described with the present application, are provided and/or contemplated herein.
While embodiments and applications of the present subject matter have been shown and described, it would be apparent that other embodiments, applications and aspects are possible and are thus contemplated and are within the scope of this application.
The following description and the annexed drawings set forth in detail certain illustrative aspects of the subject matter. These aspects are indicative, however, of but a few of the various ways in which the principles of the subject matter may be employed and the present subject matter is intended to include all such aspects and their equivalents. Other objects, advantages and novel features of the subject matter will become apparent from the following detailed description of the subject matter when considered in conjunction with the drawings
Various surgical methods for preparing anatomical surfaces and/or for implanting or placement of the various devices and/or components described herein may also be described, including the insertion and/or placement of implants between and/or along damaged and/or diseased regions of a patient's long bone.
The foregoing and other features and advantages of the present subject matter will become apparent to those skilled in the art to which the present subject matter relates upon reading the following description with reference to the accompanying drawings.
The following description and the annexed drawings set forth in detail certain illustrative aspects of the subject matter. These aspects are indicative, however, of but a few of the various ways in which the principles of the subject matter may be employed and the present subject matter is intended to include all such aspects and their equivalents. Other objects, advantages and novel features of the subject matter will become apparent from the following detailed description of the subject matter when considered in conjunction with the drawings.
The disclosure and the various features and advantageous details thereof are explained more fully with reference to the non-limiting embodiments and examples that are described and/or illustrated in the accompanying drawings and detailed in the following description. It should be noted that the features illustrated in the drawings are not necessarily drawn to scale, and features of one embodiment may be employed with other embodiments as the skilled artisan would recognize, even if not explicitly stated herein. Descriptions of well-known components and processing techniques may be omitted so as to not unnecessarily obscure the embodiments of the disclosure. The examples used herein are intended merely to facilitate an understanding of ways in which the disclosure may be practiced and to further enable those of skill in the art to practice the embodiments of the disclosure. Accordingly, the examples and embodiments herein should not be construed as limiting the scope of the disclosure. Moreover, it is noted that like reference numerals represent similar parts throughout the several views of the drawings.
The terms “including,” “comprising” and variations thereof, as used in this disclosure, mean “including, but not limited to,” unless expressly specified otherwise. The terms “a,” “an,” and “the,” as used in this disclosure, mean “one or more,” unless expressly specified otherwise.
Devices and/or device components that are disclosed in communication with each other need not necessarily be in continuous communication with each other, unless expressly specified otherwise. In addition, devices that are in direct contact with each other may contact each other directly or indirectly through one or more intermediary articles or devices.
Although process steps, method steps, or the like, may be described in a sequential order, such processes and methods may be configured in alternate orders. In other words, any sequence or order of steps that may be described does not necessarily indicate a requirement that the steps be performed in that order. The steps of the processes or methods described herein may be performed in any order practical. Further, some steps may be performed simultaneously.
When a single device or article is described herein, it will be readily apparent that more than one device or article may be used in place of a single device or article. Similarly, where more than one device or article is described herein, it will be readily apparent that a single device or article may be used in place of the more than one device or article. The functionality or the features of a device or article may be alternatively embodied by one or more other devices or articles which are not explicitly described as having such functionality or features.
Certain exemplary embodiments will now be described to provide an overall understanding of the principles of the structure, function, manufacture, and use of the devices and methods disclosed herein. One or more examples of these embodiments are illustrated in the accompanying drawings. Those of ordinary skill in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the scope of the present invention is defined solely by the claims. The features illustrated or described in connection with one exemplary embodiment may be combined with the features of other embodiments. Such modifications and variations are intended to be included within the scope of the present invention.
The present invention provides various devices, systems and methods for treating various anatomical structures of long bones and/or other areas of human and/or animal bodies. While the disclosed embodiments may be particularly well suited for use during surgical procedures for the repair, fixation and/or support of long bones, it should be understood that various other anatomical locations of the body may benefit from various features of the present invention.
In various disclosed embodiments, a primary objective of the disclosed invention can be to increase the resistance of a bone plate to various types of sliding motion relative to the bone surface, for both conventional, non-locked plates as well as locked plates, which will desirably create more stable fixation constructs and prevent unwanted motion in a targeted anatomical region. In various embodiments, this will desirably preserve an anatomic reduction and/or preserving the blood supply of the treated region, while providing for an early and safe mobilization of the affected anatomy.
In fracture fixation, creating a stable construct is generally desirable to allow the broken bones and/or bone fragments to reattach and/or heal. In some scenarios, if there is excessive motion between the elements of the fixation construct and/or the treated anatomy, the bones will not heal and/or the construct fails. In many examples, fracture fixation with construct failure can occur where the screws and/or plates have lost “purchase,” and in some cases, the hardware itself has broken. Such failures can include screw toggle; screw backout; fatigue, strain and/or work hardening of various components, plate bending and/or fracture, various combinations thereof and/or a variety of other failure modes.
In some instances, commercially available fixation plates and/or related components might benefit from modification in light of the inventions disclosed herein, and the modification of such plates to incorporate the concepts of the present intention are contemplates herein. Such modifications may include a variety of steps, which can include the addition and/or removal of material to create a plurality of projections, including roughened and/or textured features, to the bone facing surface proximate to one or more fixation devices or securement locations on the plate. Desirably, the addition and/or removal of such material to form such features will not affect the overall dimensions of the fixation plate and/or the plate rigidity to a significant degree, yet these features can dramatically improve the fatigue performance and/or overall durability of the plate and related fixation elements post surgery.
As best shown in
In various studies using conventional stainless steel or titanium bone plates, an average coefficient of friction between the plate and human or animal long bones has been experimentally determined to be μ=0.37, with an average torque applied to bone screws by a trauma surgeon of T=5.6 in-lb or 0.632 N-m. In many instances, this amount of torque has a limitation due to overall bone strength, and thus the Normal force from
As depicted in
In various embodiments, a bone plate or components thereof can be formed using a variety of techniques, including by forging, casting, milling and/or extruding into sheet, tube and/or pipe form, as well as by weaving and/or braiding of component thread or “rope” into an implant by a variety of techniques. Plate shapes or surface features therein may be manufactured using subtractive manufacturing techniques (i.e., machining, milling and/or surface roughening), as well as by using additive manufacturing techniques (i.e., surface coating, brazing, welding, bonding, deposition on various material surfaces and/or even by 3D laser printing of structures). If desired, a bone plate or portions thereof may even be formed using curing or other light/energy activation techniques, such as where a slurry of liquid polymer, ceramic and/or metal particles may be UV cured to create a 3-dimensional structure and/or layer on the bone plate. In various embodiments, materials may be utilized in block form, in sheets, columns and bars, in cable or braided form, in mesh form, or in a textured surface coating, in powder form, in granular form and/or as a surface filler and/or coating. In some cases, a surface layer may be formed, placed and/or deposited on an external surface of an existing bone implant.
An experimental comparison of smooth and textured bone plates similar to those depicted in
Right
In various embodiments, features of the disclosed invention could be incorporated into virtually any type of plate currently used to achieve bony stability, including traditional compression plates, limited contact compression plates, locking plates, spine plates such as anterior vertebral plates, reconstruction plates, etc. It is believed that almost any bone contacting plate or implant could potentially benefit from the higher force of resistive friction provided by the present invention, and such improvements to existing device designs are contemplated herein.
It should also be understood that the specific materials comprising the disclosed bone plates may not be critical in some embodiments, as these improvements may be useful in devices comprising materials such as stainless steel, titanium, cobalt chromium, as well as newer materials such as amorphous metals and bulk metallic glass. Virtually any implant material may have the potential to be improved as described herein, and some materials may further incorporate some or all of the benefits described herein due to ease of manufacturing in order to achieve optimal friction patterning.
Desirably, the enhancement of the coefficient of friction between the plate and bone by changing the surface of the plate that is contacting the bony surface will greatly enhance the resulting force of resistive friction, both statically and dynamically. Many possible textures or surface features, including external projections such as “pyramid type” points, ridges, chevrons, treads, etc., may significantly improve such friction, while other patterns such as inward facing or “negative” patterns (i.e., inward or “relief” type patterns machined into a bone-facing surface of the implant) may similarly be useful in various embodiments, and these patterns are contemplated herein as well.
While the plate to bone fixation herein is described in conjunction with screw fixation, it should be understood that various other fixation modalities may be utilized with the various embodiments described herein, including the use of other fixation devices (i.e., pins, staples, etc.) as well as adhesives and/or non-penetrating securement mechanism such as clamps, etc. In various embodiments, the disclosed screws may function in the same way as existing plate and screw fixation constructs by achieving unicortical or bicortical compression through torque, translating to a normal force between the plate and bone to “squeeze” these two materials together. Compression of the plate to the bone may also be achieved by clamps in certain fixation scenarios, which could then be secured by traditional non-locking or locking screws.
Statistical analysis of this experimental data was performed with a 2-tailed T-test, which demonstrated that roughening and/or texturing the bone contact surface of the plate had a significant impact on increases of the coefficient of friction, and also on increased force of friction (See
Desirably, the disclosed surface enhancement of orthopedic surgical plates and/or similar devices will increase the securement due to the force of resistive friction at the bone/plate interface in order to create a more stable construct and greatly reduce wear to and/or fracture of the system components. In addition to allowing the plate to accommodate higher loading, the present invention can significantly reduce toggle and/or fracture of the bone screws—greatly enhancing the utility of the disclosed devices and well as existing system forces that may be modified in accordance with various teachings of the present invention.
In various embodiments, a proposed design may include the creation of a “textured” surface proximate to a securement device (i.e., bone screw) in order to enhance the coefficient of friction between the plate and the bone near that location in order to limit motion and increase stability of various fixation constructs.
In various embodiments, the implants and/or portions may comprise a variety of surgically acceptable materials, including radiopaque and/or radiolucent materials, other materials or combinations of such materials. Radiolucent materials can include, but are not limited to, polymers, carbon composites, fiber-reinforced polymers, plastics, combinations thereof and the like. Radiopaque materials are traditionally used to construct devices for use in the medical device industry. Radiopaque materials can include, but are not limited to, metal, aluminum, stainless steel, titanium, titanium alloys, cobalt chrome alloys, combinations thereof and the like.
In accordance with various aspects of the present subject matter, bone-contacting surfaces of the various implant components described herein may optionally include coatings that are highly osteo-inductive and/or osteoconductive to desirably facilitate and/or promote fixation to adjacent living bone surfaces, if desired.
If desired, a surgical “kit” could include bone plate components of differing shapes and/or sizes constructed from the same or a variety of different materials, including plates having a variety of different bone anchors and/or interface surfaces, including bone ingrowth surfaces. If desired, such implants and/or the components thereof could be provided in a kit form for selection and/or assembly in situ during a surgical procedure. If desired, various components may be removable and/or replaceable.
In accordance with another aspect of the present subject matter, various methods for manufacturing implants and/or components thereof, as set for within any of the details described with the present application, may be provided.
While embodiments and applications of the present subject matter have been shown and described, it would be apparent that other embodiments, applications and aspects are possible and are thus contemplated and are within the scope of this application.
In various embodiments, a surgical tool kit could include a plurality of bone plate implants and one or more modular components for the system. The various components of these systems could optionally be provided in kit form, with a medical practitioner having the option to select an appropriately sized and/or shaped implant and/or modular components to address a desired surgical situation.
Note that, in various alternative embodiments, variations in the position and/or relationships between the various figures and/or modular components are contemplated, such that different relative positions of the various modules and/or component parts, depending upon specific module design and/or interchangeability, may be possible. In other words, different relative adjustment positions of the various components may be accomplished via adjustment in separation and/or surface angulation of one of more of the components to achieve a variety of resulting implant configurations, shapes and/or sizes, thereby accommodating virtually any expected anatomical variation.
Of course, method(s) for manufacturing the various modular components and/or surgical devices and related components and implanting a bone plate into a patent are contemplated and are part of the scope of the present application.
While embodiments and applications of the present subject matter have been shown and described, it would be apparent to those skilled in the art that many more modifications are possible without departing from the inventive concepts herein. The subject matter, therefore, is not to be restricted except in the spirit of the appended claims.
All references, including publications, patent applications, and patents, cited herein are hereby incorporated by reference to the same extent as if each reference were individually and specifically indicated to be incorporated by reference and were set forth in its entirety herein.
The various headings and titles used herein are for the convenience of the reader and should not be construed to limit or constrain any of the features or disclosures thereunder to a specific embodiment or embodiments. It should be understood that various exemplary embodiments could incorporate numerous combinations of the various advantages and/or features described, all manner of combinations of which are contemplated and expressly incorporated hereunder.
The use of the terms “a” and “an” and “the” and similar referents in the context of describing the invention are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. The terms “comprising,” “having,” “including,” and “containing” are to be construed as open-ended terms (i.e., meaning “including, but not limited to,”) unless otherwise noted. Recitation of ranges of values herein are merely intended to serve as a shorthand method of referring individually to each separate value falling within the range, unless otherwise indicated herein, and each separate value is incorporated into the specification as if it were individually recited herein. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g., i.e., “such as”) provided herein, is intended merely to better illuminate the invention and does not pose a limitation on the scope of the invention unless otherwise claimed. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of the invention.
Preferred embodiments of this invention are described herein, including the best mode known to the inventor for carrying out the invention. Variations of those preferred embodiments may become apparent to those of ordinary skill in the art upon reading the foregoing description. The inventor expects skilled artisans to employ such variations as appropriate, and the inventor intends for the invention to be practiced otherwise than as specifically described herein. Accordingly, this invention includes all modifications and equivalents of the subject matter recited in the claims appended hereto as permitted by applicable law. Moreover, any combination of the above-described elements in all possible variations thereof is encompassed by the invention unless otherwise indicated herein or otherwise clearly contradicted by context.
This application claims the benefit of U.S. Provisional Application No. 63/171,910 entitled “ORTHOPAEDIC FRICTION PLATE,” filed Apr. 7, 2021, the disclosure of which is incorporated by reference herein in its entirety.
Number | Date | Country | |
---|---|---|---|
63171910 | Apr 2021 | US |