US20050075637A1 - Interlocking IM nails with outer screw - Google Patents
Interlocking IM nails with outer screw Download PDFInfo
- Publication number
- US20050075637A1 US20050075637A1 US10/816,674 US81667404A US2005075637A1 US 20050075637 A1 US20050075637 A1 US 20050075637A1 US 81667404 A US81667404 A US 81667404A US 2005075637 A1 US2005075637 A1 US 2005075637A1
- Authority
- US
- United States
- Prior art keywords
- nail
- screw
- headless
- screws
- nails
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
- A61B17/725—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with locking pins or screws of special form
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary pins, nails or other devices
Definitions
- IM Nail Intramedullary Nail
- Standard interlocking technique is used to place each of the screws into the nail.
- these screws are headless (versus a headed screw used in current techniques).
- the screwdriver for placing the headless screw remains attached to this headless screw after insertion.
- a decision is made on the length of the outer screw (the one that encapsulates the headless screw) to be placed so that the intramedullary nail is kept at a fixed distance from the cortex of the bone.
- the headless screw is then over drilled with a canulated drill.
- the canulated outer screw is then placed over the modular screwdriver and then over the headless screw.
- the outer screw engages threads on the nail, locking the outer screw to the nail.
- the opening of the nail may be tapered such that it allows the outer screw a perpendicular insertion to the nail.
- the screw may also be tapered to all interlock with the IM Nail.
- a small thin sleeve may be on the outer screw that will allow for centering the headless screw in the nail opening. This will eliminate the play of the headless screw within the nail.
- a similar outer screw can be placed from the contra lateral side where the anatomy will allow it. Having screws on opposing sides of the IM Nail, will help to center the nail and guarantee locking and increases cortical purchase of the screws.
- the current methods of fracture reduction are:
- interlocking IM Nails One of the current method of interlocking IM Nails is to solely use screws, which can result in loss of reduction because of the inherent play in screw-nail interface.
- a second way of interlocking IM Nails is to cap the screw at the contra lateral cortex, which increases fixation in the cortical bone; however, does not help the screw-nail interface; additionally, pressure applied by the capping on one end may cause the distal end to move out of position.
- a third available way of interlocking IM Nails is to have the hole of the IM Nail lined with rubber to provide a more grippable material for the screws; however, the inherent play in rubber does not provide sufficient locking.
- the rubber line IM Nails also have the possible for foreign body reactions with flaking of the rubber.
- This new mechanism with the headless screw and outer screw, locks the screw in place to eliminate this play and result in a more stable form of fixation.
- a sleeve on the outer end of the screw will aid in centering of the screw.
- the option of placing an outer screw on both sides of the IM Nail offers a possibly stronger fixation with increased ability to center the IM Nail.
- This invention provides for a new method for locking Intramedullary Nails (IM Nails) with headless screws for performing interlocking with the IM Nail.
- the headless screw is over drilled with a canulated drill.
- a subsequent, outer screw is placed such that it encapsulates this headless screw.
- the outer screw engages threads on the nail, locking the outer screw to the nail.
- This method and design eliminates play in the screw-nail interface and result in a more stable form of fixation.
- the headless screw may also have a sleeve on the outer end which will aid in centering of the IM Nail.
- the outer screw may also be placed from the contra lateral side where the anatomy will allow it.
- Page 1 Diagram of Insertion of the first headless screw into Intramedullary nail
- Page 2 Diagram of over drilling around the headless screw with canulated drill.
- Page 3 Diagram of insertion and interlocking of outer screw to inner screw and Intramedullary Nail
- the IM Nails and screws are manufactured with cobalt-chrome, titanium or other materials for strength and durability.
- the current methods do not address screw-nail interface locking and can cause loss in reduction.
- the IM Nail is secured by headless screws and canulated outer screws that cap the headless screws; this will secure and eliminate movement of the screws to the IM Nail.
- the screwdriver for placing the headless screw remains attached to this headless screw after insertion.
- the headless screw is then over drilled with a canulated drill.
- the outer screw is then placed over the modular screwdriver and then over the headless screw.
- the outer screw engages threads on the nail, locking the outer screw to the nail.
- the opening of the nail may be tapered such that it allows the outer screw a perpendicular insertion to the nail.
- the screw may also be tapered such that it can also interlock with the IM Nail.
- a small thin sleeve may be on the outer screw that will allow for centering the headless screw in the nail opening. This will eliminate the play of the headless screw within the nail.
- a similar outer screw can be placed from the contra lateral side where the anatomy will allow it.
Abstract
This invention is a mechanism and design that uses headless screws that interlock with the Intramedullary Nail. Canulated outer screws engage the threads of the headless screws and further locks into the Intramedullary Nail. A sleeve on the outer end of the headless screw will aid in centering of the IM Nail. This process may be repeated contra laterally for optimal fixation and centering of the IM Nail when allowed by the anatomy. This mechanism ensures no play in the screw-nail interface which is inherent in current interlocking designs.
Description
- Provisional Patent Application No.: 60/459,952 with a filing date of Apr. 4, 2003 (submitted by inventor of this application)
- U.S. Pat. No. 6,019,761, dated Feb. 1, 2000 suggests interlocking by using guidewire that goes in through the IM Nail holes, up or down the IM Nail and out the next hole.
- U.S. Pat. No. 6,524,314, dated Feb. 25, 2003 suggests interlocking by using 2 lag screws and a locking screw through the IM Nail.
- An Intramedullary Nail (IM Nail) is inserted into the cortical bone. Standard interlocking technique is used to place each of the screws into the nail. However, these screws are headless (versus a headed screw used in current techniques). The screwdriver for placing the headless screw remains attached to this headless screw after insertion. A decision is made on the length of the outer screw (the one that encapsulates the headless screw) to be placed so that the intramedullary nail is kept at a fixed distance from the cortex of the bone.
- The headless screw is then over drilled with a canulated drill. The canulated outer screw is then placed over the modular screwdriver and then over the headless screw. The outer screw engages threads on the nail, locking the outer screw to the nail. The opening of the nail may be tapered such that it allows the outer screw a perpendicular insertion to the nail. The screw may also be tapered to all interlock with the IM Nail.
- Additionally, a small thin sleeve may be on the outer screw that will allow for centering the headless screw in the nail opening. This will eliminate the play of the headless screw within the nail. Upon surgeon's discretion, a similar outer screw can be placed from the contra lateral side where the anatomy will allow it. Having screws on opposing sides of the IM Nail, will help to center the nail and guarantee locking and increases cortical purchase of the screws.
- Not Applicable
- Not Applicable
- The current methods of fracture reduction are:
-
- Casts/braces
- Plates:
- Conventional
- Locking
- External fixation
- Intramedullary Nails
- Intramedullary Nails have several advantages over other forms of fixation:
-
- they are less invasive than plates;
- they have a lower infection rate;
- nails are stronger than the plates;
- nails have a mechanical advantage compared to plates;
- the screws used with nails are more resistant to breakage due to the decreased moment arm;
- screws may be placed in different planes;
- nails have a high rate of union;
- nails allow for anatomic reduction;
- cast/braces immobilize the limb and do not allow early motion;
- external fixators have a risk of pin tract infections.
- One of the current method of interlocking IM Nails is to solely use screws, which can result in loss of reduction because of the inherent play in screw-nail interface. A second way of interlocking IM Nails is to cap the screw at the contra lateral cortex, which increases fixation in the cortical bone; however, does not help the screw-nail interface; additionally, pressure applied by the capping on one end may cause the distal end to move out of position. A third available way of interlocking IM Nails is to have the hole of the IM Nail lined with rubber to provide a more grippable material for the screws; however, the inherent play in rubber does not provide sufficient locking. The rubber line IM Nails also have the possible for foreign body reactions with flaking of the rubber.
- This new design, with threaded guidewire in between the screws, locks the screw in place to eliminate this play and result in a more stable form of fixation.
- Two other patented ways of interlocking IM Nails were found, however, neither are currently marketed:
-
- An interlocking Intramedullary Nail (U.S. Pat. No. 6,524,314, granted Feb. 25, 2003) provides for a different mechanism, using 2 lag screws and a locking screw. This product is currently not marketed; however, this would be a difficult mechanism because there are only a couple of safe zones where screws can be placed. With the addition of 2 screws placed for fixation, it may be difficult to find safe zones. Additionally, the may cross thread early prohibiting further insertion.
- An interlocking Intramedullary Nail (U.S. Pat. No. 6,019,761, granted Feb. 1, 2000) provides for interlocking by placing a guidewire through one screw hole up to and out of the next. This patent also relies on drilling holes versus already manufactured holes and dropping wires through the holes and using the screws to cause the wires to interlock to the screws. This patent has a complete different means by which the interlocking would occur and be enhanced.
- This new mechanism, with the headless screw and outer screw, locks the screw in place to eliminate this play and result in a more stable form of fixation. A sleeve on the outer end of the screw will aid in centering of the screw. Additionally, the option of placing an outer screw on both sides of the IM Nail offers a possibly stronger fixation with increased ability to center the IM Nail.
- This invention provides for a new method for locking Intramedullary Nails (IM Nails) with headless screws for performing interlocking with the IM Nail. The headless screw is over drilled with a canulated drill. A subsequent, outer screw is placed such that it encapsulates this headless screw. The outer screw engages threads on the nail, locking the outer screw to the nail. This method and design eliminates play in the screw-nail interface and result in a more stable form of fixation. The headless screw may also have a sleeve on the outer end which will aid in centering of the IM Nail. The outer screw may also be placed from the contra lateral side where the anatomy will allow it.
- Page 1: Diagram of Insertion of the first headless screw into Intramedullary nail
-
- 1.Cortical bone
- 2.Intramedullary Nail
- 3.Headless screw
- 4.Modulated screwdriver
- Page 2: Diagram of over drilling around the headless screw with canulated drill.
-
- 1.Headless screw
- 2.Modulated screwdriver
- 3.Are of over drilling around headless screw
- 4.Intramedullary Nail
- Page 3: Diagram of insertion and interlocking of outer screw to inner screw and Intramedullary Nail
-
- 1.Canulated outer screw
- 2.Optional sleeve with variable length
- 3.Dotted line showing canulated outer screw to be placed over headless screw
- 4.Engaged outer screw over headless screw
- 5.Place where outer screw interlocks with Intramedullary Nail
- 6.Intramedullary Nail
- 7.Placement of additional optional outer screw on the contra lateral side
- The IM Nails and screws are manufactured with cobalt-chrome, titanium or other materials for strength and durability. The current methods do not address screw-nail interface locking and can cause loss in reduction. In this invention, the IM Nail is secured by headless screws and canulated outer screws that cap the headless screws; this will secure and eliminate movement of the screws to the IM Nail.
- The screwdriver for placing the headless screw remains attached to this headless screw after insertion. A decision is made on the length of the outer screw (the one that encapsulates the headless screw) to be placed so that the intramedullary nail is kept at a fixed distance from the cortex of the bone. The headless screw is then over drilled with a canulated drill. The outer screw is then placed over the modular screwdriver and then over the headless screw. The outer screw engages threads on the nail, locking the outer screw to the nail. The opening of the nail may be tapered such that it allows the outer screw a perpendicular insertion to the nail. The screw may also be tapered such that it can also interlock with the IM Nail.
- Additionally, a small thin sleeve may be on the outer screw that will allow for centering the headless screw in the nail opening. This will eliminate the play of the headless screw within the nail. Upon surgeon's discretion, a similar outer screw can be placed from the contra lateral side where the anatomy will allow it.
- Current methods of interlocking IM Nails do not eliminate the screw-nail interface play. Therefore, current methods can result in loss of reduction of the fracture. This method and design in locking eliminates play in the screw-nail interface and results in a more stable form of fixation.
Claims (1)
1. A mechanism to secure Intramedullary Nails by using headless screws to interlock with the Intramedullary Nail with a canulated outer screw that engages the headless screw's threads and further locks onto the Intramedullary Nail. This process may be repeated contra laterally. This mechanism immobilizes the Intramedullary Nail to maintain fracture reduction and aids in centering of the IM Nail.
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/816,674 US20050075637A1 (en) | 2003-04-04 | 2004-04-02 | Interlocking IM nails with outer screw |
US11/803,456 US7621913B2 (en) | 2003-04-04 | 2007-05-16 | Interlocking intramedullary nails with outer screw |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US45995203P | 2003-04-04 | 2003-04-04 | |
US10/816,674 US20050075637A1 (en) | 2003-04-04 | 2004-04-02 | Interlocking IM nails with outer screw |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US11/803,456 Division US7621913B2 (en) | 2003-04-04 | 2007-05-16 | Interlocking intramedullary nails with outer screw |
Publications (1)
Publication Number | Publication Date |
---|---|
US20050075637A1 true US20050075637A1 (en) | 2005-04-07 |
Family
ID=34396059
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/816,674 Abandoned US20050075637A1 (en) | 2003-04-04 | 2004-04-02 | Interlocking IM nails with outer screw |
US11/803,456 Expired - Fee Related US7621913B2 (en) | 2003-04-04 | 2007-05-16 | Interlocking intramedullary nails with outer screw |
Family Applications After (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US11/803,456 Expired - Fee Related US7621913B2 (en) | 2003-04-04 | 2007-05-16 | Interlocking intramedullary nails with outer screw |
Country Status (1)
Country | Link |
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US (2) | US20050075637A1 (en) |
Cited By (10)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20080287951A1 (en) * | 2007-03-22 | 2008-11-20 | Stoneburner James D | Segmented intramedullary structure |
US20090157079A1 (en) * | 2004-07-15 | 2009-06-18 | Wright Medical Technology, Inc. | Intramedullary fixation assembly and devices and methods for installing the same |
WO2011159902A3 (en) * | 2010-06-18 | 2012-04-05 | Kettering Univerisity | An easily implantable and stable nail-fastener for skeletal fixation and method |
US8652136B2 (en) | 2011-08-15 | 2014-02-18 | Zimmer, Gmbh | Femoral fracture fixation device |
US8668695B2 (en) | 2008-10-15 | 2014-03-11 | Zimmer Gmbh | Intramedullary nail |
US8771272B2 (en) | 2010-06-18 | 2014-07-08 | Kettering University | Easily implantable and stable nail-fastener for skeletal fixation and method |
KR101451520B1 (en) | 2013-08-20 | 2014-10-17 | (주)티디엠 | Interlocking intramedullary nail |
US20160022340A1 (en) * | 2014-07-22 | 2016-01-28 | Virginia Commonwealth University | Medial column (meco) fixation device, method, and system |
US9597129B2 (en) | 2007-05-25 | 2017-03-21 | Zimmer Gmbh | Reinforced intramedullary nail |
US20190223925A1 (en) * | 2018-01-25 | 2019-07-25 | Advanced Orthopaedic Solutions, Inc. | Bone nail |
Families Citing this family (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CA2667776C (en) * | 2006-11-17 | 2015-01-20 | Synthes Usa, Llc | Intramedullary nail including stable locking bolts |
CN103976798A (en) | 2009-02-04 | 2014-08-13 | Mid公司 | A system, method and apparatus for implementing dental implants |
US9622798B2 (en) * | 2009-02-17 | 2017-04-18 | Gregory Merrell | Intramedullary compression rod |
DE102009030177B4 (en) * | 2009-06-24 | 2018-04-26 | Aesculap Ag | Medullary nail and implant for fixing a medullary nail |
US9283057B2 (en) | 2011-02-02 | 2016-03-15 | Mid Corp. | System, apparatus and method for implementing implants |
US10492803B2 (en) | 2016-09-22 | 2019-12-03 | Globus Medical, Inc. | Systems and methods for intramedullary nail implantation |
US11083503B2 (en) | 2016-09-22 | 2021-08-10 | Globus Medical, Inc. | Systems and methods for intramedullary nail implantation |
US11633219B2 (en) | 2019-06-26 | 2023-04-25 | Globus Medical, Inc. | Fenestrated pedicle nail |
Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4467794A (en) * | 1982-02-08 | 1984-08-28 | Ernest Maffei | Intramedulary bone-setting assembly |
US5769852A (en) * | 1993-04-27 | 1998-06-23 | Medevelop Ab | Implantable anchoring element and anchoring assembly for prostheses |
US6126662A (en) * | 1998-10-09 | 2000-10-03 | Carmichael; Robert P. | Bone implant |
US20030040747A1 (en) * | 2001-08-24 | 2003-02-27 | Dean John C. | Interlocking intramedullary nail |
US6736818B2 (en) * | 1999-11-11 | 2004-05-18 | Synthes (U.S.A.) | Radially expandable intramedullary nail |
US20040127898A1 (en) * | 2002-11-04 | 2004-07-01 | Michael Adam | Bone fixing system |
US20040147930A1 (en) * | 2002-12-19 | 2004-07-29 | Nils Zander | Osteosynthetic aid |
Family Cites Families (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
GB9113578D0 (en) * | 1991-06-24 | 1991-08-14 | Howmedica | Intramedullary intertrochanteric fracture fixation appliance |
GB0102488D0 (en) * | 2001-01-31 | 2001-03-14 | Grampian Univ Hospitals | Bone Fixture Apparatus |
-
2004
- 2004-04-02 US US10/816,674 patent/US20050075637A1/en not_active Abandoned
-
2007
- 2007-05-16 US US11/803,456 patent/US7621913B2/en not_active Expired - Fee Related
Patent Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4467794A (en) * | 1982-02-08 | 1984-08-28 | Ernest Maffei | Intramedulary bone-setting assembly |
US5769852A (en) * | 1993-04-27 | 1998-06-23 | Medevelop Ab | Implantable anchoring element and anchoring assembly for prostheses |
US6126662A (en) * | 1998-10-09 | 2000-10-03 | Carmichael; Robert P. | Bone implant |
US6736818B2 (en) * | 1999-11-11 | 2004-05-18 | Synthes (U.S.A.) | Radially expandable intramedullary nail |
US20030040747A1 (en) * | 2001-08-24 | 2003-02-27 | Dean John C. | Interlocking intramedullary nail |
US20040127898A1 (en) * | 2002-11-04 | 2004-07-01 | Michael Adam | Bone fixing system |
US20040147930A1 (en) * | 2002-12-19 | 2004-07-29 | Nils Zander | Osteosynthetic aid |
Cited By (21)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20090157079A1 (en) * | 2004-07-15 | 2009-06-18 | Wright Medical Technology, Inc. | Intramedullary fixation assembly and devices and methods for installing the same |
US9451971B2 (en) * | 2004-07-15 | 2016-09-27 | Agilent Technologies, Inc. | Intramedullary fixation assembly and devices and methods for installing the same |
US20090228007A1 (en) * | 2007-03-22 | 2009-09-10 | Osteolign, Inc. | Segmented intramedullary system and methods |
US20090228008A1 (en) * | 2007-03-22 | 2009-09-10 | Osteolign, Inc. | Segmented intramedullary system and apparatus |
US8128627B2 (en) | 2007-03-22 | 2012-03-06 | Sonoma Orthopedic Products, Inc. | Segmented intramedullary system and apparatus |
US20080287951A1 (en) * | 2007-03-22 | 2008-11-20 | Stoneburner James D | Segmented intramedullary structure |
US8430879B2 (en) | 2007-03-22 | 2013-04-30 | Sonoma Orthopedic Products, Inc. | Segmented intramedullary structure |
US8496658B2 (en) | 2007-03-22 | 2013-07-30 | Sonoma Orthopedic Products, Inc. | Segmented intramedullary structure |
US9597129B2 (en) | 2007-05-25 | 2017-03-21 | Zimmer Gmbh | Reinforced intramedullary nail |
US8668695B2 (en) | 2008-10-15 | 2014-03-11 | Zimmer Gmbh | Intramedullary nail |
US9474557B2 (en) | 2008-10-15 | 2016-10-25 | Zimmer Gmbh | Intramedullary nail |
WO2011159902A3 (en) * | 2010-06-18 | 2012-04-05 | Kettering Univerisity | An easily implantable and stable nail-fastener for skeletal fixation and method |
US8771272B2 (en) | 2010-06-18 | 2014-07-08 | Kettering University | Easily implantable and stable nail-fastener for skeletal fixation and method |
CN103025254A (en) * | 2010-06-18 | 2013-04-03 | 凯特林大学 | An easily implantable and stable nail-fastener for skeletal fixation and method |
US8287540B2 (en) | 2010-06-18 | 2012-10-16 | Kettering University | Easily implantable and stable nail-fastener for skeletal fixation and method |
US8652136B2 (en) | 2011-08-15 | 2014-02-18 | Zimmer, Gmbh | Femoral fracture fixation device |
KR101451520B1 (en) | 2013-08-20 | 2014-10-17 | (주)티디엠 | Interlocking intramedullary nail |
US20160022340A1 (en) * | 2014-07-22 | 2016-01-28 | Virginia Commonwealth University | Medial column (meco) fixation device, method, and system |
US9943347B2 (en) * | 2014-07-22 | 2018-04-17 | Virginia Commonwealth University | Medial column (MECO) fixation device, method, and system |
US20190223925A1 (en) * | 2018-01-25 | 2019-07-25 | Advanced Orthopaedic Solutions, Inc. | Bone nail |
US10932828B2 (en) * | 2018-01-25 | 2021-03-02 | Advanced Orthopaedic Solutions, Inc. | Bone nail |
Also Published As
Publication number | Publication date |
---|---|
US7621913B2 (en) | 2009-11-24 |
US20070260247A1 (en) | 2007-11-08 |
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Legal Events
Date | Code | Title | Description |
---|---|---|---|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |