Systems and methods for intramedullary nail implantation

Patent metadata

Field	Value
Publication number	US-10299847-B2
Application number	US-201615272850-A
Country	US
Kind code	B2
Filing date	Sep 22, 2016
Priority date	Sep 22, 2016
Publication date	May 28, 2019
Grant date	May 28, 2019

Abstract

Intramedullary nails, systems, and methods. The intramedullary nail may include a generally elongate body extending from a first, distal end to a second, proximal end. The distal end may include one or more openings configured to receive one or more bone anchors that extend transversely through the distal end intramedullary nail, and thereby configured to secure the distal end of the nail. The proximal end may also include one or more openings configured to receive one or more bone anchors that extend transversely through the proximal end of the intramedullary nail, and thereby configured to secure the proximal end of the nail. In some embodiments, the proximal end may further include a cross-locking feature, which includes a second bone anchor that interlocks with a first bone anchor, for example, for enhanced bone purchase and bony fixation.

First claim

We claim:

1. A system for inserting an intramedullary nail into a bone, the system comprising:
an intramedullary nail having a proximal end, a distal end, at least one side surface extending between the proximal end and the distal end, and an aperture through the intramedullary nail; and
an insertion tool comprising:
a handle portion having a guide sheath portion having a lower surface;
a coupling portion extending from the handle portion, the coupling portion configured to removably couple to the proximal end of the intramedullary nail;
a guide sheath hole having a longitudinal axis formed in the guide sheath portion of the handle portion, the longitudinal axis being parallel to the lower surface of the guide sheath portion, and the guide sheath hole configured to receive a guide sheath therethrough, the guide sheath hole positioned such that, when the intramedullary nail is coupled to the coupling portion, the guide sheath hole substantially aligns with the aperture in the intramedullary nail; and
a retention mechanism comprising:
a first retention member positioned along the guide sheath hole and configured to pivotably engage with a second retention member on the guide sheath to restrict movement of the guide sheath with respect to the guide sheath hole; and
a retention release mechanism disposed on the lower surface of the guide sheath portion of the handle portion; wherein the retention mechanism allows movement of the guide sheath in a first direction and restricts movement of the guide sheath in a second direction, wherein the retention mechanism including the first retention member and the retention release mechanism have a unitary body pivotable about a pivot point located between the guide sheath hole and the lower surface of the guide sheath portion of the handle portion.

2. The system of claim 1 , further comprising a guide wire hole configured to receive a guide wire therethrough, wherein the guide wire hole is a first guide wire hole spaced apart from the guide sheath hole and positioned such that, when the intramedullary nail is coupled to the coupling portion, the guide wire hole defines an axis that runs adjacent to the side surface of the intramedullary nail, and the system further comprising a second guide wire hole disposed at a position spaced apart from the first guide wire hole, wherein the axes of the first and second guide wire holes are substantially parallel.

3. The system of claim 1 , further comprising the guide sheath, wherein the guide sheath comprises a lumen configured to receive a fixation device therethrough, and wherein the second retention member is disposed on an outer surface of the guide sheath.

4. The system of claim 1 , wherein the handle portion is configured to engage with the coupling portion at a first end of the handle portion, and wherein the retention release mechanism comprises a release button disposed on a second, opposite end of the handle portion.

5. The system of claim 1 , wherein the first and second retention members comprise corresponding ridges that, when engaged with one another, permit ratcheted movement in one direction only.

6. The system of claim 1 , wherein the aperture in the intramedullary nail is a first aperture, the intramedullary nail comprising a second aperture spaced apart from the first aperture, wherein the system further comprises:
a first fixation device configured to pass through the first aperture; and
a second fixation device configured to pass through the second aperture such that the second fixation device intersects with the first fixation device.

7. The system of claim 6 , wherein the first fixation device comprises a slot, and wherein the second fixation device is configured to pass at least partially through the slot.

8. The system of claim 2 , wherein when first and second guide wires are received in the first and second guide wire holes, respectively, the first and second guide wires extend on opposite sides of the intramedullary nail.

9. The system of claim 1 , wherein the guide sheath is a tube having an outer surface, and the second retention member is on the outer surface of the guide sheath.

10. The system of claim 1 , wherein the handle portion defines a second guide sheath hole, and when the guide sheath is positioned through the second guide sheath hole, the guide sheath is aligned with a distal opening in the intramedullary nail.

11. The system of claim 10 , wherein the second guide sheath hole does not include a retention mechanism.

12. A method for inserting an intramedullary nail into a patient, the method comprising:
disposing a nail into a medullary canal of a patient along a first axis, the nail coupled at its proximal end to a coupling portion of an insertion tool, the insertion tool including a handle portion extending away from the coupling portion, the handle portion having a guide sheath portion having a lower surface;
passing a guide wire through a guide wire hole in the handle portion of the insertion tool along a second axis transverse to the first axis such that the guide wire runs adjacent to a side surface of the nail;
inserting a guide sheath into a guide sheath hole having a longitudinal axis in the guide sheath portion of the handle portion, the longitudinal axis being parallel to the lower surface of the guide sheath portion, the guide sheath being retained in the guide sheath portion of the handle portion with a retention mechanism, wherein the retention mechanism includes a first retention member and a retention release mechanism have a unitary body pivotable about a pivot point located between the guide sheath hole and the lower surface of the guide sheath portion of the handle portion, the retention mechanism allows movement of the guide sheath in a first direction and restricts movement of the guide sheath in a second direction, and
inserting a fixation device through the guide sheath in the handle portion such that the fixation device passes through an aperture formed in the nail; and
releasing the retention mechanism with the retention release mechanism disposed on the lower surface of the guide sheath portion of the handle portion.

13. The method of claim 12 , wherein inserting the fixation device comprises:
inserting the guide sheath through the guide sheath hole such that the first retention member in the guide sheath hole engages with a second retention member on an outer surface of the guide sheath; and
inserting the fixation device through the guide sheath.

14. The method of claim 13 , wherein the first and second retention members comprise corresponding ridges that, when engaged with one another, permit ratcheted movement in one direction only.

15. The method of claim 13 , further comprising disengaging the first and second retention members by actuating the release mechanism disposed on the handle portion.

16. The method of claim 12 , further comprising passing a second guide wire through a second guide wire hole in the handle portion of the insertion tool along a third axis substantially parallel to the second axis.

17. The method of claim 12 , wherein the fixation device is a first fixation device, the method further comprising inserting a second fixation device through a second aperture formed in the nail such that the second fixation device intersects the first fixation device.

18. The method of claim 17 , further comprising inserting a third fixation device through a third aperture formed in a distal portion of the nail.

Assignees

• Globus Medical Inc

Inventors

• Rossney Mark
• Rowe David J
• Jansen David R
• Laird David

Classifications

• A61B17/7275

  with expanding cylindrical parts · CPC title

• A61B17/1721

  for applying pins along or parallel to the axis of the femoral neck · CPC title

• A61B17/725

  with locking pins or screws of special form · CPC title

• A61B17/744

  the longitudinal elements coupled to an intramedullary nail · CPC title

• A61B17/72

  Intramedullary devices, e.g. pins or nails · CPC title