Contoured bone plate with locking screw for bone compression, particularly across a tarsometatarsal joint

Patent metadata

Field	Value
Publication number	US-12161371-B2
Application number	US-202217577202-A
Country	US
Kind code	B2
Filing date	Jan 17, 2022
Priority date	Jan 18, 2021
Publication date	Dec 10, 2024
Grant date	Dec 10, 2024

Abstract

A method of applying a bone plate across a tarsometatarsal joint or two different portions of a metatarsal may involve positioning a bone plate across a separation between two bone portions. The bone plate can have at least two fixation holes and a bend between the holes. A locking screw can be inserted through one or both holes that has a head thread and a shaft thread, where the shaft thread has a pitch greater than a pitch of the head thread. The locking screw can be screwed into an underlying bone portion until the bend in the bone plate is deformed.

First claim

The invention claimed is:

1. A method of applying a bone plate across a separation between a first bone portion and a second bone portion, the method comprising:
positioning a bone plate across a separation between a first bone portion and a second bone portion, the bone plate having a first fixation hole, a second fixation hole, and a bend between the first fixation hole and the second fixation hole, wherein positioning the bone plate across the separation comprises positioning the bend over the separation with a gap between a bone-facing surface of the bone plate and the separation;
inserting a locking screw through the first fixation hole, wherein the locking screw has a head with a head thread and a shaft with a shaft thread, the locking screw has a compression ratio greater than 1.0, and the first fixation hole includes threading for engaging with the head thread;
screwing the locking screw into the first bone portion under the first fixation hole until the head thread of the locking screw is partially engaged with the threading defined by the first fixation hole; and
further screwing the locking screw into the first bone portion, thereby deforming the bend in the bone plate toward the separation.

2. The method of claim 1 , wherein the first bone portion is a metatarsal or a cuneiform, the second bone portion as an other of the metatarsal or cuneiform, and the separation is a tarsometatarsal joint.

3. The method of claim 1 , wherein the first bone portion and the second bone portion are two portions of a metatarsal and the separation is a cut between the two portions.

4. The method of claim 1 , wherein the compression ratio of the locking screw is at least 1.5.

5. The method of claim 4 , wherein the compression ratio is greater than 1.9.

6. The method of claim 4 , wherein the bone plate defines a thickness ranging from 1.0 mm to 2 mm.

7. The method of claim 1 , further comprising, prior to screwing the locking screw into the first bone portion, provisionally fixating the first bone portion to the second bone portion by at least inserting a fixation pin through an end face of the first bone portion and into an end face of the second bone portion.

8. The method of claim 1 , further comprising inserting a screw through the second fixation hole and screwing the screw into the second bone portion under the second fixation hole.

9. The method of claim 8 , wherein:
the second screw also comprises a head with a head thread and a shaft with a shaft thread, the second screw having a compression ratio greater than 1.0;
the second fixation hole includes threading for engaging with the head thread of the second screw; and
screwing the second screw into the second bone portion comprises screwing the second screw until the head thread of the second screw is partially engaged with the threading defined by the second fixation hole, and further screwing the second screw into the second bone portion.

10. The method of claim 1 , wherein:
the gap between the bone-facing surface of the bone plate and the separation is at least 1.75 mm, and
further screwing the locking screw into the first bone portion, thereby deforming the bend in the bone plate toward the separation, comprises reducing the gap to a distance less than 1.5 mm.

11. The method of claim 1 , wherein deforming the bend in the bone plate toward the separation comprises establishing an asymmetrically distributed load across an end of the first bone portion and an end of the second bone portion, wherein the asymmetrically distributed load has a greater magnitude on a side of the first bone portion and the second bone portion opposite a side against which the bone plate is positioned.

12. The method of claim 1 , wherein the bone plate has a length defining a longitudinal axis, the first fixation hole is spaced from the second fixation hole with the first fixation hole on one side of the separation and the second fixation hole on an other side of the separation.

13. The method of claim 12 , wherein the bone plate further comprises a third fixation hole positioned between the first fixation hole and a first terminal end of the bone plate and a fourth fixation hole positioned between the second fixation hole and a second terminal end of the bone plate.

14. The method of claim 13 , wherein the first fixation hole, the second fixation hole, the third fixation hole, and the fourth fixation hole are co-axial with each other along the longitudinal axis of the bone plate.

15. The method of claim 12 , wherein the bone plate further comprises at least one branch extending outwardly from the longitudinal axis of the bone plate to define at least one of a Y-shape, an L-shape, a T-shape, and a U-shape.

16. The method of claim 1 , further comprising, prior to inserting the locking screw through the first fixation hole,
screwing a driving pin through the first fixation hole into the first bone portion under the first fixation hole, the driving pin extending from a proximal end to a distal end, and the driving pin including threading adjacent the distal end and an enlarged region having a cross-sectional size larger than a cross-sectional size of the first fixation hole proximal spaced from the distal end,
wherein screwing the driving pin through the first fixation hole comprises screwing the driving pin through the first fixation hole and into the first bone portion under the first fixation hole at least until the enlarged region presses against a top side of the bone plate, thereby deforming the bend in the bone plate toward the separation.

17. The method of claim 1 , wherein the bone plate has a length defining a longitudinal axis, the first fixation hole is spaced from the second fixation hole with the first fixation hole on one side of the separation and the second fixation hole on an other side of the separation, and the bone plate further comprises a third fixation hole positioned between the first fixation hole and a first terminal end of the bone plate and a fourth fixation hole positioned between the second fixation hole and a second terminal end of the bone plate.

18. The method of claim 17 , further comprising:
inserting a first driving pin through the first fixation hole into the first bone portion,
inserting a second driving pin through the second fixation hole into the second bone portion,
inserting a third driving pin through the third fixation hole into the first bone portion, and
removing the first driving pin from the first fixation hole prior to inserting the locking screw through the first fixation hole, wherein inserting the locking screw through the first fixation hole comprises inserting the locking screw through the first fixation hole with the second driving pin inserted through the second fixation hole and the third driving pin inserted through the third fixation hole.

19. The method of claim 18 , wherein the locking screw comprises a first locking screw and further comprising a second locking screw, the second locking screw has a head with a head thread and a shaft with a shaft thread, the second locking screw having a compression ratio greater than 1.0, and the second fixation hole includes threading for engaging with the head thread of the second locking screw; and
further comprising:
inserting the second locking screw through the second fixation hole and screwing the second locking screw into the second bone portion under the second fixation hole until the head thread of the second locking screw is engaged with the threading defined by the second fixation hole; and
after

Assignees

• Treace Medical Concepts Inc

Inventors

• Dayton Paul
• Hatch Daniel
• May Jason
• Scanlan Sean
• Ferguson Joe

Classifications

• A61B17/8085

  with pliable or malleable elements or having a mesh-like structure, e.g. small strips (A61B17/8071, A61B17/8076 take precedence) · CPC title

• A61B17/8052

  immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded · CPC title

• A61B17/8004

  with means for distracting or compressing the bone or bones · CPC title

• A61B17/8863 Primary

  Apparatus for shaping or cutting osteosynthesis equipment by medical personnel · CPC title

• A61B17/848

  Kirschner wires, i.e. thin, long nails · CPC title