Surgery – Instruments – Orthopedic instrumentation
Patent
1996-12-18
1998-07-14
Buiz, Michael
Surgery
Instruments
Orthopedic instrumentation
606 62, 606 64, 606 96, A61B 1756
Patent
active
057797056
DESCRIPTION:
BRIEF SUMMARY
BACKGROUND OF THE INVENTION
1. Field of the Invention
This invention relates to surgical intramedullary nails for stabilizing condylar and supracondylar fractures, particularly of the distal femur or humerus.
2. Description of Related Art
The use of inert metal rods or tubes inserted into the intramedullary cavity of long bones in order to stabilise fractures is well established in orthopaedic and veterinary practice. These rods or tubes are usually referred to as "nails".
Fractures in the middle third of a long bone may be effectively stabilized with a simple intramedullary nail.
The effectiveness of this method may be increased by the use of cross bolts or screws passing through pre-drilled holes in the nail, so as to achieve better hold on the proximal and distal bone fragments.
Nails with cross bolts have become known as "locking" or "locked" nails. These nails have broadened the use of the method to fractures extending well into the proximal or distal ends.
The insertion of the cross bolts/screws may be facilitated by the use of a guide jig which attaches temporarily to the end of the intramedullary nail, but this is not invariable and many systems require at least some of the cross bolts/screws to be inserted freehand.
In cases where the fracture is in the vicinity of the condylar region of the femur or humerus, difficulties may be encountered in stabilizing the distal condylar fragments in relation to the shaft of the bone.
SUMMARY
The present invention comprises an intramedullary surgical nail designed for retrograde or reversed insertion into the distal end of the femur or humerus. It incorporates a unique staggered/crossed or "Cruciate" configuration of holes, so that two distal locking bolts may be inserted. This arrangement permits the locking bolts to cross and overlap so that each condyle may be ripped by an individual bolt. Both condyles are thereby stabilized in relation to the shaft of the bone, along which the intramedullary nail passes.
The nails may also incorporate further pre-formed holes at their proximal ends so that further cross bolts may be inserted to improve the fixation of the nail with respect to the more proximal femoral or humeral shaft. Such further holes are usually arranged so that when cross bolts are inserted, they extend at right angles to the nail.
BRIEF DESCRIPTION OF THE DRAWINGS
Features of the femoral and humeral nails in accordance with the invention and a jig for introducing the nails and locking bolts are illustrated in the accompanying drawings:
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
FIG. 1 is a perspective view of a nail according to the present invention showing its location in a femur;
FIG. 2 is a view similar to FIG. 1 except without the femur;
FIG. 3 is an axial view of a nail according to the present invention;
FIG. 4 is a lateral view of the nail according to the present invention;
FIG. 5 is a lateral view of the nail according to the present invention showing the femur;
FIG. 6 is a perspective view of a jig according to the present invention;
FIGS. 7(a) through 7(d) show approximate linear demensions and angular configurations of the distal locking bolts according to the present invention; and
FIG. 8 is a perspective view of a nail according to the present invention showing its position in the distal end of the humerus.
FIG. 1 is a perspective view of the nail 10, showing its location in the distal end of a femur after insertion, and with locking bolts 21,26 in position passing through pre-drilled holes 20,25. Free holes 30,35 for insertion of proximal locking bolts are also shown.
FIG. 2 is a similar view of the nail shown in FIG. 1, but without the femur shown.
Alternative patterns of distal locking bolts are shown in FIGS. 1 and 2.
In FIG. 1, locking bolts are shown with smooth shanks 212, 262 which are an easy sliding fit in predrilled holes in the nail 20, 25. These locking bolts have coarse threads 211, 261 which grip the bone of the femoral condyles.
In FIG. 2, locking bolts of an alternative design are shown which have ful
REFERENCES:
patent: 4473069 (1984-09-01), Kolmert
patent: 4622959 (1986-11-01), Marcus
patent: 4911153 (1990-03-01), Border
patent: 5443466 (1995-08-01), Shah
patent: 5549610 (1996-08-01), Russell et al.
patent: 5609595 (1997-03-01), Pennig
Buiz Michael
Woo Julian W.
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