This invention relates to the field of treating bone fractures and more particularly to a device for treating a complex bone fracture.
The treatment of complex bone fractures has moved beyond the antiquated treatments of full-body casts and traction.
Instead, the use of screws and plates helps surgeons to fix fractures in position, allowing the patient to regain partial mobility while the bone mends.
But the use of mechanical fracture supports, such as plates, is complicated by bones with complex shapes, such as the pelvis.
Current methods require the surgeon to contour, or bend, a plate during surgery, the plate intended to match the contour of the patient’s bone.
This contouring is difficult and imperfect, and can result in fractures that are only partially reduced. The imperfect contouring can cause loss of reduction obtained prior to applying the plate. This increases healing time and decreases patient mobility.
What is needed is a device that contours to the bone, the device then locked into shape and affixed to the bone.
The self-contouring plate for bone fractures allows a surgeon to bridge a bone fracture, primarily in bones of complex shape where the use of plates or screws is difficult.
The self-contouring plate is formed from a series of similar or identical rigid elements, the elements able to bend and rotate with respect to each other. This flexibility is initially helpful as the surgeon contours the device to the shape of the bone. When the desired shape is reached, the elements are locked into place.
The length of device is adjusted by adding or removing elements, much like a necklace. Each element of the self-contouring plate includes a ball that extends away from a body, a cavity for receiving the ball of the neighboring plate, and a screw to compress the ball within the cavity.
Each element can rotate in three directions – swivel left and right, or yaw; tilt forward and backward, or pitch; and rotate about its centerline, or roll. This freedom of rotation is created by the ball-and-socket connection that joins each element to the next. When the desired arrangement and angles are reached, the ball is squeezed with a cap screw, or compression screw, fixing the ball-and-socket joint in position. Restated, the ball-and-socket joint has both a locked position or condition, and an unlocked position or condition.
The ball-and-socket connection allows for a full range of motion. The preferred embodiment has the ability swivel in 45 degrees of yaw, tilt in between 45– and 90-degrees of pitch, and rotate in 360 degrees of roll.
One or more screw holes in each element allow placement of bone screws, fixing the device to the underlying bone.
The entire device is intended for permanent internal implantation, directly against the bone. The device does not protrude through muscle or skin, and does not have elements that remain external to the body.
The centerline of each element of the device is preferably consistent, with the centerline of the ball matching that of the centerline of the body. When installation is complete, there are no protruding elements that could cause discomfort by aggravating the surrounding tissues. Stated differently, in the preferred embodiment the thickness of the device is substantially consistent, without protruding elements.
The self-contouring plate is strengthened by being positioned against the surface of the bone. The plates and connections are directly against the surface of the bone, avoiding rotational moments that would increase the force against the plates. This is in contrast to the prior art devices, which were placed partially outside the patient’s skin, resulting in traumatic and uncomfortable pins that passed through the patient’s bone and muscle. The prior art placed the points of rotation away from the bone, thus requiring a thicker mechanism to compensate for the resulting rotational forces.
The self-contouring plate includes a solid ball, without a through-hole for a fixation screw. The result is a stronger ball connection with more material. The ball is preferably spherical, with the only interruption to its surface being the neck that connects the ball to the body of the plate.
Additionally, by using a solid ball, the greatest range of movement is possible. Requiring placement of a fastener through the ball limits angular rotation of the ball because the hole in the ball must line up with a second hole for receipt of the fastener.
This additional range of motion is helpful in complex fractures, such as fractures of the pelvis and acetabulum and fractures of the distal radius.
The invention can be best understood by those having ordinary skill in the art by reference to the following detailed description when considered in conjunction with the accompanying drawings in which:
Reference will now be made in detail to the presently preferred embodiments of the invention, examples of which are illustrated in the accompanying drawings. Throughout the following detailed description, the same reference numerals refer to the same elements in all figures.
Referring to
Each self-contouring plate 1 includes a body 10, tapering to a neck 12 followed by a head 50.
The body 10 includes a non-threaded hole 14 with optional chamfer 16 along the upper perimeter of the non-threaded hole 14. In alternative embodiments, the hole 14 is threaded.
The rear of the body 10 includes a socket 18 to receive a ball 50 of the next self-contouring plate 1.
A compression screw 40 acts to fix the position of the ball 50 within the socket 18 after placement of the self-contouring plate 1.
Referring to
Multiple self-contouring plates 1 are affixed in a series, allowing the device to span a fracture.
The heads 50 are fixed within the sockets 18 of subsequent self-contouring plate 1.
Adjacent self-contouring plates 1 can be placed at angles with respect to each other, shown here as a swiveling left and right, or yawing 70.
Each body 10 is optionally fixed in place using a bone screw 60.
Referring to
The head 50 sits within the socket 18, with the self-contouring plates 1 able to rotate at the connection between the head 50 and the socket 18.
A linear gap 36 exists between the bodies 10 of the adjacent self-contouring plates 1. By varying the length of the neck, the linear gap 36 may be changed, which is one way of creating greater tolerance between adjacent self-contouring plates 1, and thus allowing for greater angular deviations.
Swiveling left and right is shown as yawing 70.
Referring to
A single self-contouring plate 1 is shown in cross-section. The body 10 tapers to a neck 12, with head 50.
The hole 14 passes through the body 10, with optional chamfer 16.
The socket 18 includes a cup 20 that will support a head 50, and a compression screw 40 that will grip the head.
A centerline 34 passes through the self-contouring plate 1, splitting the head 50, neck 12, and body 10.
Referring to
Multiple self-contouring plates 1 are shown connected in series, tilted with respect to each other. Tilting forward and backward is shown as pitching 72. Rotation about its centerline 34 (see
Referring to
A series of self-contouring plates 1 are connected to bridge a fracture line 102 in a pelvis 100. The compression screws 40 are omitted to better show the angled position of the plates 1 with respect to each other.
Referring to
Again shown is a series of self-contouring plates 1, connected to bridge a fracture line 102 in a pelvis 100. The pelvis 100 is curved, but the series of self-contouring plates 1 compensates, following the curvature.
The compression screws 40 are omitted to better show the angled position of the plates 1 with respect to each other.
Referring to
The socket 18 includes a cup 20, in which a head 50 can sit.
The socket 18 includes threaded walls 22.
Referring to
The compression screw 40 has threads 44 that interface with the threaded walls 22 of the socket 18. The compression screw 40 includes an inverted cup 42 to grip the head 50, and a recess 46 allowing for insertion of a hex head screwdriver or other bit to control rotation of the compression screw 40.
Referring to
The compression screw 40 is set in place, compressing the ball 50 into the cup 20, thus preventing further rotation.
Referring to
The socket 18 is shown with cup 20 and threaded walls 22. The cup is shown separated into two halves, creating a lower gap 24.
Referring to
The self-contouring plate 1 is shown with a compression screw 40, the compression screw centerline 48 set at ninety degrees with respect to the centerline 34.
Referring to
The self-contouring plate 1 is shown with a compression screw 40, the compression screw centerline 48 set at less than ninety degrees with respect to the centerline 34. Specifically, the compression screw 40 is angled toward the head 50. The result is that the neck upward rotation gap 52 of the embodiment in
Equivalent elements can be substituted for the ones set forth above such that they perform in substantially the same manner in substantially the same way for achieving substantially the same result.
It is believed that the system and method as described and many of its attendant advantages will be understood by the foregoing description. It is also believed that it will be apparent that various changes may be made in the form, construction, and arrangement of the components thereof without departing from the scope and spirit of the invention or without sacrificing all of its material advantages. The form herein before described being merely exemplary and explanatory embodiment thereof. It is the intention of the following claims to encompass and include such changes.