Intramedullary nail fixation guides, devices, and methods of use

Patent metadata

Field	Value
Publication number	US-12256949-B2
Application number	US-202117456191-A
Country	US
Kind code	B2
Filing date	Nov 23, 2021
Priority date	Mar 15, 2013
Publication date	Mar 25, 2025
Grant date	Mar 25, 2025

Abstract

Fixation guide devices and methods for positioning and inserting an intramedullary nail are disclosed. The fixation guide devices include a frame with a first end and a second end, a compression device removably coupled to the first end of the frame, and the intramedullary nail secured to a nail attachment apparatus of the frame. An intramedullary nail including a body with a fastening end, a closed end, and at least two openings is also disclosed. A compression device includes a compression member, a knob, and a bolt secured in the knob and rotatably engaging the compression member is also disclosed. An alignment guide is disclosed and includes a base member, an alignment member, and a fixation guide. A method of inserting an intramedullary nail into two bones for fixation of the two bones is also disclosed.

First claim

What is claimed is:

1. A method for using an intramedullary nail for fixation of two bone pieces, comprising:
preparing the two bone pieces for fixation;
drilling over a guidewire to create a cavity for the intramedullary nail in at least one of the two bone pieces;
obtaining a fixation guide device;
inserting the intramedullary nail into the cavity;
engaging a portion of the fixation guide device to the intramedullary nail;
inserting a first guidewire through a first drill sleeve of the fixation guide device and into a distal bone piece of the two bone pieces;
inserting a second drill sleeve into a first drill hole of the fixation guide device;
inserting a second guidewire through the second drill sleeve and into the two bone pieces;
disengaging the intramedullary nail and the fixation guide device;
inserting a first fastener into the distal bone piece and the intramedullary nail; and
inserting a second fastener through the two bone pieces and the intramedullary nail.

2. The method of claim 1 , wherein the intramedullary nail includes a securing screw hole at a first end of the intramedullary nail and at least one peg hole.

3. The method of claim 1 , wherein the fixation guide device includes a frame with at least two drill holes and a compression device.

4. The method of claim 1 , further comprising drilling a first opening over the first guidewire that aligns with a first peg hole in the intramedullary nail.

5. The method of claim 4 , further comprising inserting a first peg into the first opening in the distal bone piece and through the first peg hole.

6. The method of claim 5 , further comprising using the first peg and compression device to compress the two bone pieces.

7. The method of claim 4 , further comprising drilling a second opening over the second guidewire that mates with a second peg hole in the intramedullary nail.

8. The method of claim 7 , further comprising inserting a second peg into a second opening in the two bone pieces and through a second peg hole to secure the two bone pieces.

9. The method of claim 1 , further comprising:
inserting the second drill sleeve into a second drill hole of the fixation guide device and drilling a third opening that aligns with a third peg hole;
inserting a third peg into the third opening and through the third peg hole to secure the two bone pieces; and
verifying stability and position using fluoroscopy.

10. The method of claim 9 , further comprising:
inserting the second drill sleeve into a third drill hole of the fixation guide device and drilling a fourth opening that aligns with a fourth peg hole;
inserting a fourth peg into the fourth opening and through the fourth peg hole to secure the two bone pieces; and
verifying stability and position using fluoroscopy.

11. A method of inserting an intramedullary nail into two bones for fixation of the two bones, comprising:
preparing the two bones for fixation;
securing an alignment guide to the two bones to position a guidewire across the two bones;
drilling over the guidewire to create a cavity for the intramedullary nail that passes through the two bones;
obtaining a fixation guide device;
attaching the intramedullary nail to a compression device of the fixation guide device, the intramedullary nail having a body with a first end and a second end, and further comprising:
a fastening end at the first end of the body, the fastening end comprising:
a first fastening segment extending away from the first end of the body a first distance along a longitudinal axis;
a second fastening segment extending away from the first end of the body a second distance along the longitudinal axis;
an insertion opening extending from the first end into the body along the longitudinal axis of the body; and
an engagement opening extending from the first end through the body to an exterior surface;

at least two openings positioned oblique to the longitudinal axis of the body between the first end and the second end of the body, wherein the at least two openings comprise:
three first openings; and
a second elongated opening, wherein the insertion opening of the fastening end engages the second elongated opening;

inserting the intramedullary nail into the cavity;
inserting a drill sleeve into a drill hole at a second end of the fixation guide device;
detaching the intramedullary nail from the fixation guide device and removing the fixation guide device; and
inserting a locking screw into a securing screw hole.

12. The method of claim 11 , wherein the first distance along the longitudinal axis is greater than the second distance along the longitudinal axis.

13. The method of claim 12 , wherein the first fastening segment is offset from the second fastening segment along the longitudinal axis.

14. The method of claim 13 , wherein a portion of the engagement opening overlaps with a portion of the insertion opening to form an oblique opening at the first end of the body that extends between the first fastening segment and the second fastening segment.

15. The method of claim 14 , wherein the oblique opening intersects and overlaps the longitudinal axis at the first end.

16. The method of claim 15 , wherein the intramedullary nail further comprises a closed end at the second end of the body.

17. The method of claim 11 , further comprising inserting the drill sleeve into a second drill hole at a first end of the fixation guide device.

18. A method of inserting an intramedullary nail into two bones for fixation of the two bones, comprising:
preparing the two bones for fixation;
securing an alignment guide to the two bones to position a guidewire across the two bones;
drilling over the guidewire to create a cavity for the intramedullary nail that passes through the two bones;
obtaining a fixation guide device, the fixation guide device comprising:
a frame having a first end and a second end, the frame further comprising:
at least one drill hole; and
a first arm;

a compression device removably coupled to the first end of the frame and comprising:
a compression member;
a bolt; and
a knob, wherein bolt rotatably engages the compression member at the first end and is secured to the knob at the second end, and the bolt extends through and rotatably couples to a first opening in the first arm of the frame;

attaching the intramedullary nail to the compression device of the fixation guide device;
inserting the intramedullary nail into the cavity;
inserting a drill sleeve into a first drill hole at a second end of the fixation guide device;
inserting the drill sleeve into a second drill hole at a first end of the fixation guide device;
detaching the intramedullary nail from the fixation guide device and removing the fixation guide device; and
inserting a locking screw into a securing screw hole.

Assignees

• Paragon 28 Inc

Inventors

• Dacosta Albert
• Bono Frank
• Houghton Michael
• Sangiovanni Thomas
• Clancy James T
• Chang Thomas

Classifications

• A61B2017/681

  Alignment, compression, or distraction mechanisms · CPC title

• A61B2017/564

  Methods for bone or joint treatment · CPC title

• A61B17/72

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

• A61B17/7291

  for small bones, e.g. in the foot, ankle, hand or wrist · CPC title

• A61B17/1725

  for applying transverse screws or pins through intramedullary nails or pins · CPC title