Surgery – Instruments – Orthopedic instrumentation
Reexamination Certificate
2000-05-05
2002-04-30
Smith, Jeffrey A. (Department: 3732)
Surgery
Instruments
Orthopedic instrumentation
C606S064000
Reexamination Certificate
active
06379359
ABSTRACT:
TECHNICAL FIELD
The present invention relates generally to surgical apparatuses and methods, and more particularly, to a percutaneous intrafocal plate surgical apparatus and method.
RELATED ART
There are a variety of apparatuses and methods presently being used to address metaphyseal fractures. As is well known to those skilled in the art, metaphyseal fractures consist of fractures near the end of a bone in the area of the junction between the tubular shaft of the bone and the spongy, blocky, end portions of the bone known as the metaphysis and epiphysis. Bone fractures in this metaphyseal area, especially fractures that are oblique, tend to cause the fragment to be pulled off to one side of the shaft by the forces applied by the muscles which are, in effect, continually attempting to shorten the bone. A variety of apparatuses and methods for surgically addressing metaphyseal fractures have been developed and are well known in the medical arts. Examples of such apparatuses and methods include, for example, casts, external fixators, pins and plates. Each of these will be discussed hereinafter for a better understanding of the state of the art in apparatuses and methods for addressing metaphyseal bone fractures.
Casts
Casts are used to align metaphyseal fractures that are transverse and to prevent the bone sections from falling off to the side. However, when a fracture is not transverse but oblique, the fracture tends to shorten within the cast and thereby allow displacement and an unsatisfactory outcome. Although casts are often attempted with fractures which might otherwise be treated with the apparatus and method of the invention described and claimed hereinafter, they are frequently unsuccessful and subsequently require that the patient be treated surgically to effect a satisfactory outcome.
External Fixators
External fixators are devices which consist of pins implanted in the bone on opposing sides of the fracture and connected with a metal frame which is external to the patient's limb. The pin insertion site where the pin penetrates the skin and underlying fat, muscle and the like on its way to insertion into the bone becomes a source of pain for a patient as well as a site of infection due to the chronically open wound about the pin during the time that the fracture is healing. Furthermore, in one of the most common locations for this kind of fracture, the distal radius, the pins often irritate the tendons which pass over and about the bone and thus induce stiffness of the fingers because of the patient's reluctance to move his fingers and thereby induce pain from the tendons.
Pins
Percutaneous pins are often used to treat metaphyseal fractures and, in fact, some of the percutaneous pins are inserted intrafocally. These are called “Kapandji” pins. These pins are usually left sticking out through the skin and thus, similarly to the external fixators discussed above, serve as a source of infection and as a source of pain and irritation to neighboring tendons. Pins can, however, be inserted through a small incision and provide an excellent reduction for some metaphyseal fractures.
Plates
Metaphyseal fractures can be addressed quite well with conventional plates. However, a large incision is required to implant a plate and this is known to result in a large scar. Moreover, the plate is known to be a large, broad and lumpy device which can be prominent underneath the underlying tendons and skin and soft tissue, and thus it can many times be painful. In addition, tendons which traverse over plates are often irritated by the plates and this can lead to stiffness.
Thus, despite the existence of a wide variety of conventional apparatuses and methods for surgically addressing a metaphyseal fracture, there remains much room for improvement in the art, particularly for a percutaneous intrafocal plate apparatus and method which is simple, safe and effective for addressing a metaphyseal fracture and which is inserted percutaneously or through a very small incision, that does not protrude through the skin, and which presents a low profile so as not to irritate overlying tissue.
DISCLOSURE OF THE INVENTION
In accordance with the present invention, an intrafocal plate apparatus and method are provided for addressing metaphyseal and similar bone fractures. The apparatus comprises an elongated plate element having a flat plate surface at one end thereof defining a top surface and a bottom surface and a leading end and a trailing end. A longitudinally extending resilient body element depends from the trailing end of the flat surface and defines a shoulder at one end which joins the flat plate surface and an arcuate pin at the other end. The intrafocal plate is formed so that a force applied at the arcuate pin end causes a force to be applied in the opposite direction at the flat plate surface.
Also, in accordance with the present invention, a method for addressing a metaphyseal or similar type of bone fracture is provided utilizing the intrafocal plate described herein above. In a preferred embodiment, the method according to this invention comprises the initial step of providing an intrafocal plate as described herein before. The pin end of the elongated plate element is inserted through a skin incision formed proximate to the metaphyseal bone fracture site and the pin end is intrafocally inserted into the fracture site. Next, the elongated plate element is manipulated as necessary in order to lever the metaphyseal fracture into a reduced position. Finally, the body element of the elongated plate element is pushed into the tubular hollow of the fractured bone such that the pin will resiliently contact the inside wall surface of the tubular hollow at a site opposing the fracture site and thereby cause the shoulder of the elongated plate element to seat in the fracture site and urge the flat plate surface of the elongated plate element against the outside surface of the bone.
It is therefore an object of the present invention to provide a novel intrafocal plate for addressing metaphyseal and similar type fractures and a method for using the same.
It is another object of the present invention to provide an intrafocal plate apparatus and method for using same which can safely and effectively be utilized to address metaphyseal and similar type fractures.
It is another object of the present invention to provide an intrafocal plate apparatus and method for using same which is inserted percutaneously or through a small incision so as not to protrude through the skin and which is stable in use and low profile in construction so as not to irritate overlying tissue.
Some of the objects of the invention having been stated herein above, other objects will become evident as the description proceeds, when taken in connection with the accompanying drawings as best described herein below.
REFERENCES:
patent: 4535764 (1985-08-01), Ebert
patent: 5709682 (1998-01-01), Medoff
patent: 6248109 (2001-06-01), Stoffella
patent: 1057026 (1983-11-01), None
Jenkins & Wilson, P.A.
University of North Carolina at Chapel Hill
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