The present invention is directed to a locked bone fixation assembly, and in particular to an assembly that allows for a surgeon-selected angle of the bone screw relative to the fixation device.
Orthopedic fixation devices, both internal and external, are frequently coupled to bone using fasteners such as screws, threaded bolts or pins. For example, bone plates may be secured to bone with bone screws, inserted through plate holes. Securing the screws to the plate provides a fixed angle relationship between the plate and screw and reduces incidences of loosening. One method of securing the screw to the plate involves the use of so-called “expansion-head screws,” U.S. Pat. No. 4,484,570 discloses an expansion-head screw with a head that has a recess, the walls of which contain a number of slits. After an expansion-head screw has been inserted into a bone through a hole in the fixation device, a locking screw is inserted into the recess to expand the walls of the recess to lock the screw to the fixation device (such as a plate, internal fixator, nail, or rod). Another method of securing the screw to the plate involves the use of conical heads as shown in U.S. Pat. Nos. 5,053,036; 5,151,103; and 6,206,881, which disclose conical screw holes, adapted to receive screws having conical heads of a predetermined cone angle, such that the plate will not slide down the heads of the screws. A third method of securing the screw to the plate involves the use of so-called “locking screws,” A locking screw has threading on an outer surface of its head that matches with corresponding threading on the surface of a plate hole to lock the screw to the plate. Bone plates having threaded holes for accommodating locking screws are known, as shown in U.S. Pat. Nos. 5,709,686, and 6,730,091.
In addition to securing the screw to the fixation device, it is also often desirable to insert the screws at an angle relative to the fixation device selected by the surgeon. The prior art discloses a number of these so-called “polyaxial” systems, most of which utilize a bushing located in a hole in the fixation device to provide for locking at different degrees of angulation of the screw relative to the fixation device. For example, U.S. Pat. No. 5,954,722 discloses a polyaxial (selected variable axis) locking plate that includes a plate hole having a bushing rotatable within the hole. As a screw is inserted into bone through the bushing and plate hole, a threaded tapered head of the screw engages a threaded internal surface of the bushing to expand the bushing against the wall of the plate hole, thereby friction locking the screw at the desired angular orientation with respect to the plate. U.S. Pat. No. 6,575,975 discloses a polyaxial locking plate that includes a plate hole, having a a bushing rotatable within the hole, a fastening screw and a locking screw. The head of the fastening screw includes a radial wall that allows for outward expansion so that outwardly expanding the sidewall of the bushing so that the fastening screw is locked to the bushing and fixation device. A similar device is disclosed in U.S. Pat. No. 7,273,481.
Some others of the so-called “polyaxial” systems utilize a ring located in a hole in the fixation device. For example, U.S. Pat. No. 6,454,769 discloses a plate system and method of fixation comprising a bone plate, a bone screw and a ring, said ring being expandable against the bone plate to fix the bone screw at a selected angle relative to the bone plate.
These multi-component traditional plate assemblies can be cumbersome and tedious to manipulate during surgery to achieve the most desirable angle for directing the bone screw into the patient. U.S. Pat. No. 6,955,677 and U.S. Pat. Publ. Nos. 2005/0165400 and 2005/0277937 disclose additional polyaxial systems.
The present invention is directed to a plate for fixation to a target portion of bone to be treated, comprising a first fixation element receiving opening extending therethrough from a proximal surface which, when the plate is coupled to the target portion of bone in a desired configuration, faces away from the bone to a distal surface which, when in the desired configuration, faces the bone, the first fixation element receiving opening including a plurality of columns distributed about a circumference thereof, each of the columns extending from the proximal to the distal surface and a plurality of radially expanded sections separating adjacent ones of the columns from one another in combination with a plurality of projections formed on the columns, the projections extending from surfaces of the columns along portions of a path extending helically about an inner surface of the first fixation element receiving opening, shapes of the surfaces of the columns on which the projections are formed being selected so that, when engaged by a head of a bone fixation element to be locked into the first fixation element receiving opening, the projections engage a thread of a head of the bone fixation element to lock the bone fixation element in the first fixation element receiving opening at any user selected angle within a permitted range of angulation.
The present invention, which may be further understood with reference to the following description and the appended drawings, relates to devices for treating fractures and, in particular, to internal fixation devices for treating fractures. Exemplary embodiments of the present invention describe an improved bone fixation assembly that allows a surgeon to select an angle of a bone screw relative to a plate in a single action. The assembly uses only two components so that no rings, bushings or expansion head screws are needed. It will be understood by those of skill in the art that although the exemplary embodiments are described in regard to a screw/pin and a plate, the device may fix a fracture using any known fixation element.
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In an exemplary embodiment, the opening 106 may include four columns 132, spaced about the circumference of the opening 106 substantially equidistant from one another with widths of the scalloped portions 130 being substantially equal to one another. It will be understood by those of skill in the art however, that the opening 106 may include any number of columns 132 arranged in any number of patterns. Furthermore, those skilled in the art will understand that the columns 132 do not have to be equidistant from one another (i.e., they may be spaced about the circumference of the opening 106 by varying distances) and they may have different widths as well.
The first portion 134 preferably extends radially inward from the proximal surface 126 at an angle corresponding to the maximum angulation of the screw relative to the central axis of the opening. In this embodiment, this angle may be between 0° to 45° or, more preferably, between 0° and 15° depending on the desired angulation. The first portion 134 further includes a plurality of columns of threads 140 extending from a surface of the first portion 134 into the opening 106. Each column 132 may include at least two individual threads 140. However, it will be understood by those of skill in the art that the columns 132 may include any number of threads 140. The threads 140 are adapted and configured to engage the threading 116 of the head 108 and extend, for example, along paths which, if continued across the gaps formed by the scalloped portions 130, would form a helical threading with a substantially constant pitch corresponding to the threading 116 of the head 108 of the screw or pin 102. Alternatively, the threads 140 on each of the columns 132 may be positioned along the first portion 134 arranged substantially symmetrically with respect to the threads 140 of the other columns 132. Furthermore, the threads 140 are rounded to facilitate engagement with the threading 116 of the head 108 of the screw or pin 102 as would be understood by those skilled in the art.
The second portion 136 extends radially outward from the distal end 138 of the first portion 134 toward the distal surface 128 of the plate 104 at an angle ranging from 0° to 45°, but preferably approximately 15° relative to the central axis of the opening 106 such that the substantially conic portion formed by the second portions 136 of the plurality of columns 132 is adapted and configured to accommodate the proximal end 114 of the shaft 110 at varying angles. A length of the first portion 134 may be substantially longer than a length of the second portion 136, permitting the head 108 of the screw 102 to be fixed within the opening 106 of the plate 102.
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In use, a plate 104 as described above is located in a desired position adjacent to a portion of bone to be stabilized. As indicated above, depending upon the bone being treated, it may be desirable to insert a screw or pin 102 through the opening 106 co-axially with the opening 106 or at an angle offset from the central axis of the opening 106. For example, the desired angle of insertion for each of a plurality of screws and/or pins 102 may be determined prior to insertion of the screw or pin 102 to achieve a desired effect on the target portion of bone. Each screw or pin 102 is then inserted into the opening 106 at its desired angle so that the threading 116 of the head 108 engages the threads 140 fixing the screw or pin 102 at this angle relative to the central axis of the opening 106 to fix the plate 104 to the target portion achieving any desired angle locking, etc.
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The head 208 includes a thread 220 formed along an outer surface 222 thereof. The thread 220 may extend from the proximal end 218 to the distal end 216 of the head 208 at a substantially constant pitch to lockingly engage an openings 206. The head 208 may also include a driving element 224 at the proximal end 218, which may be engaged by a driving tool to drive the screw or pin 102 through the opening 206 by rotating the screw or pin 102 about a longitudinal axis of the screw or pin 102. It will be understood by those of skill in the art that although the driving element 224 is shown as a hexagonal recess, the driving element 224 may take any of a variety of shapes and forms. For example, the driving element 224 may be any recess or protrusion so long as the driving element 224 may be engaged by a driving tool to drive the screw or pin 102 into the opening 106.
The distal end 216 of the head 208 may be connected to the proximal end 214 of the shaft 210, but need not include a neck portion with a smaller diameter, as described above in regard to screw or pin 102. The screw or pin 202, does not require an undercut to accommodate any portion of the opening 206 when the screw or pin 202 is angled relative to the central axis of the opening 204. The shaft 210 may also include a threading along any portion of a length of the shaft 210 if desired. As would be understood by those skilled in the art, the threading of the shaft 210 may also be formed at a substantially constant pitch which may be substantially equal to that of the thread 220 so that, as the screw 202 is rotatably threaded into the opening 206, the thread of the shaft 210 advances at the same rate into the bone.
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In a preferred embodiment, the opening 206 may include three columns 232 and three scalloped portions 230 with the columns 232 evenly spaced about the circumference of the opening 206 and the scalloped portions 230 placed between adjacent ones of these columns 232. It will be understood by those of skill in the art, however, that any number of columns 232 and scalloped portions 230 may be employed within the opening 206 so long as the resulting structure permits the desired angulation of the screws or pins 202 therein.
The curvature of the column 232 may be selected based on a variety of factors including, but not limited to, a size of the opening 206, a maximum desired tilt angle of the screw or pin 202 relative to a central axis of the opening 206 and the taper angle of the head 208 of the screw or pin 202. It will be understood by those of skill in the art that an angle of a tangent to the curvature of the proximal portion 234 of the column may be larger than an angle of a tangent of the curvature at the distal portion 236 of the column 232 to accommodate the taper of the head 208. The angle of the tangent to the proximal portion 234 of the column 232 may be determined by adding the maximum desired tilt of the screw or pin 202 relative to the central axis of the opening 206 to the taper angle of the head 208. For example, if the taper angle of the head 208 is 10° and the maximum desired tilt of the screw or pin 102 is 15°, the proximal portion 234 should be formed so that a tangent thereto is at an angle of 25° relative to the central axis. The angle of the tangent to the distal portion 236 may be determined by subtracting the taper angle of the head 208 from the maximum desired tilt angle of the screw or pin 202. Thus, using the same preferred tilt and taper angles described above, the distal portion 236 should be formed to provide a tangent to the surface angled 5° relative to the central axis of the opening 206.
Similar to the opening 106 described above, each of the columns 232 includes a column of threads 242 extending thereacross and separated from one another along a length of the column 232 from the proximal surface 226 to the distal surface 228. The threads 242 extend into the opening 206 in the same manner as a thread would on a known threaded opening. In one embodiment, each thread 242 extends into the opening 206 substantially perpendicularly to a tangent to the surface of the column 232 in a manner similar to the projection of gear teeth from a curved surface while, in an alternate embodiment, each of the threads 242 extends into the opening 106 in substantially parallel planes (e.g., in planes substantially perpendicular to the central axis of the opening 206). Similarly to the threads 140 of the opening 106, the threads 242 extend across each of the columns 232 along paths which, if not separated by the scalloped portions 230, would form a helical path with a pitch selected to facilitate insertion of the screw or pin 102 into the bone as the head 208 is screwed into the opening 206. It will be understood by those of skill in the art, however, that the threads 242 may be positioned in any of a variety of patterns, so long as the threads 242 engage the thread 220 of the head 208, locking the head 208 of the screw or pin 202 in a desired orientation within the opening 206.
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It will be apparent to those skilled in the art that various modifications and variations can be made in the structure and the methodology of the present invention, without departing from the spirit or scope of the invention. Thus, it is intended that the present invention cover the modifications and variations of this invention provided that they come within the scope of the appended claims and their equivalents.
This application claims priority to (1) U.S. Provisional Application Ser. No. 61/000,907 entitled “Variable Angle Locked Bone Plate,” filed on Oct. 30, 2007 and (2) U.S. Provisional Application. Ser. No. 61/084,281, entitled “Variable Angle Locked Bone Plate,” filed on Jul. 29, 2008. The Specifications of the above-identified applications are incorporated herewith by reference.
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/US08/81739 | 10/30/2008 | WO | 00 | 4/28/2010 |
Number | Date | Country | |
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61000907 | Oct 2007 | US | |
61084281 | Jul 2008 | US |