US20050251142A1 - Distal bone anchors for bone fixation with secondary compression - Google Patents

Distal bone anchors for bone fixation with secondary compression Download PDF

Info

Publication number
US20050251142A1
US20050251142A1 US11/156,932 US15693205A US2005251142A1 US 20050251142 A1 US20050251142 A1 US 20050251142A1 US 15693205 A US15693205 A US 15693205A US 2005251142 A1 US2005251142 A1 US 2005251142A1
Authority
US
United States
Prior art keywords
fixation device
femoral neck
fracture fixation
neck fracture
anchor
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
Application number
US11/156,932
Inventor
Gerard Hoffmann
Victor Cachia
Brad Culbert
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Interventional Spine Inc
Original Assignee
Hoffmann Gerard V
Cachia Victor V
Culbert Brad S
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Hoffmann Gerard V, Cachia Victor V, Culbert Brad S filed Critical Hoffmann Gerard V
Priority to US11/156,932 priority Critical patent/US20050251142A1/en
Publication of US20050251142A1 publication Critical patent/US20050251142A1/en
Assigned to INTERVENTIONAL SPINE, INC. reassignment INTERVENTIONAL SPINE, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: TRIAGE MEDICAL INC.
Abandoned legal-status Critical Current

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/8625Shanks, i.e. parts contacting bone tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74Devices for the head or neck or trochanter of the femur
    • A61B17/742Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74Devices for the head or neck or trochanter of the femur
    • A61B17/742Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • A61B17/744Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to an intramedullary nail
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74Devices for the head or neck or trochanter of the femur
    • A61B17/742Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • A61B17/746Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to a plate opposite the femoral head
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/8685Pins or screws or threaded wires; nuts therefor comprising multiple separate parts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/869Pins or screws or threaded wires; nuts therefor characterised by an open form, e.g. wire helix

Definitions

  • the present invention relates to internal bone fracture fixation devices.
  • the present invention relates to bone fracture fixation devices and methods adapted for fixation, among other fractures, of femoral neck and other proximal femoral fractures.
  • the femur otherwise known as the thigh bone, generally comprises an elongate shaft extending from the hip to the knee.
  • the proximal end of the shaft includes a head, a neck, a greater trochanter and a lesser trochanter.
  • the head of the femur fits into the acetabular cup of the hip bone to form a ball and socket joint at the hip.
  • the distal end of the femur includes a medial condyle and a lateral condyle. The condyles engage an upper end of the tibia to form the knee joint.
  • the femur is the longest and strongest bone in the skeleton. However, portions of the femur are extremely susceptible to fracturing.
  • Pertrochanteric fractures among geriatric patients are the most frequent in connection with those of the region of the neck of the bone.
  • the advanced age and the pathologies which are encountered in these patients make a timely stabilization of skeletal injuries necessary in order to reduce to a minimum the bed confinement and the rehabilitation times.
  • devices and procedures are utilized which minimize complications brought about by the so-called immobilization syndrome, which may be lethal for patients in delicate metabolical circumstances. It is also preferable to reduce to a minimum blood losses related to surgical intervention.
  • the syntheses means utilized must be stable in order to allow the patient to very timely assume a seated position and, two or three days following the intervention, to reassume an erect posture with progressive bearing of weight.
  • Fractures of the femur occur in both the proximal portion of the femur and the distal portion of the femur. Fractures of the proximal portion of the femur (hip fractures) are generally classified as femoral neck fractures (capital or sub-capital), intertrochanteric fractures and subtrochanteric fractures. Fractures of the distal portion of the femur (knee fractures) are referred to as supracondylar fractures.
  • Supracondylar fractures generally extend vertically between the condyles at the lower end of the femur to separate the distal portion of the femur into two main bone fragments.
  • a fracture line may be further comminuted to create a plurality of smaller bone fragments. Fractures of the femur which extend into the neck of the bone are generally more difficult to treat than fractures restricted to the shaft of the femur.
  • Operative treatment of the fractures requires that the fractures be internally fixed and possibly compressed. Fractures of the neck, head or trochanters of the femur have been treated with a variety of compression screw assemblies which include generally a compression plate having a barrel member, a lag screw and a compressing screw.
  • the compression plate is secured to the exterior of the femur and the barrel member is inserted into a predrilled hole in the direction of the femoral head.
  • the lag screw which has a threaded end and a smooth portion is inserted through the barrel member so that it extends across the break and into the femoral head. The threaded portion engages the femoral head.
  • the compressing screw connects the lag screw to the plate. By adjusting the tension of the compressing screw the compression (reduction) of the fracture can be adjusted.
  • elongated implants (nail, screw, pin, etc.) have been developed, which are adapted to be positioned along the longitudinal axis of the femoral neck with a leading (distal) end portion in the femoral head so as to stabilize a fracture of the femoral neck.
  • the elongated implant may be implanted by itself or connected to another implant such as a side plate or intramedullary rod.
  • the leading end portion of the implant typically includes means to positively grip the femoral head bone (external threads, expanding arms, etc.), but the inclusion of such gripping means can introduce several significant problems.
  • implants with sharp edges on the leading end portion exhibit a tendency to migrate proximally towards the hip joint weight bearing surface after implantation. This can occur when the proximal cortical bone has insufficient integrity to resist distal movement of the screw head. Such proximal migration under physiological loading, which is also referred to as femoral head cut-out, can lead to significant damage to the adjacent hip joint.
  • the externally threaded implants can generate large stress concentrations in the bone during implantation which can lead to stripping of the threads formed in the bone and thus a weakened grip.
  • the movable arms of known expanding arm devices are usually free at one end and attached at the other end to the main body of the leading end portion of the implant.
  • a method of securing a first bone fragment to a second bone fragment comprises the steps of drilling a bore through the first bone fragment in the direction of the second bone fragment, and advancing through the bore a fixation device comprising a first portion and a second portion that are coupled to each other.
  • a distal anchor of the fixation device is rotated to secure the fixation device to the second fragment, and the proximal anchor is axially advanced to engage the first fragment and provide compression across the fracture.
  • the second bone fragment comprises the head of a femur.
  • the second bone fragment comprises a tibia, a fibula, a femur, a humurus, a radius, or an ulna.
  • the first bone fragment may comprise a condyle.
  • the method may additionally comprise the step of uncoupling the first portion from the second portion.
  • a femoral neck fracture fixation device comprising an elongate body, having a proximal end and a distal end and a helical anchor on the distal end.
  • the helical anchor is wrapped about a central core or axial lumen.
  • An outer edge of the helical anchor defines an outer boundary and the central core or axial lumen defines a minor diameter.
  • a first retention structure is provided on the body, proximal to the anchor.
  • a proximal anchor is moveably carried by the body. The proximal anchor is movable in the distal direction with respect to the body and the retention structure resists proximal movement of the proximal anchor with respect to the body.
  • a bone fracture fixation device comprising an elongate body having a proximal end and a distal end.
  • a cancellous bone anchor is on the distal end.
  • the cancellous bone anchor comprises a helical flange wrapped about a central core or axial lumen.
  • An outer edge of the helical anchor defines an outer boundary and the central core or axial lumen defines a minor diameter.
  • a proximal anchor is axially movably carried on the body.
  • Complimentary surface structures are provided between the body and the proximal anchor that permit advancing the proximal anchor in the distal direction to provide compression across a fracture but that resist axial proximal movement of the proximal anchor.
  • a method of treating a femoral fracture comprises the steps of drilling at least one and preferably two or three bores distally into the femur in the direction of a fracture, and advancing into each bore a fixation device that comprises a body having a first portion that forms a distal bone anchor and a second portion that forms a proximal end.
  • a proximal component is rotated to engage the distal anchor with the bone distal to the fracture, and a proximal anchor is advanced distally along the fixation device to compress the fracture.
  • a bone fracture fixation device comprises an elongate body having a proximal end and a distal end.
  • the body also includes a helical anchor on the distal end.
  • a first retention structure is on the body located proximal to the anchor.
  • a proximal anchor is moveably carried by the body and has a tubular housing.
  • the tubular housing has at least one barb extending radially outwardly from the tubular housing and defining an engagement surface that lies within a plane that is transverse to a longitudinal axis of the tubular housing.
  • the proximal anchor is movable in the distal direction with respect to the body and the retention structure resists proximal movement of the proximal anchor with respect to the body.
  • the drilling step comprises drilling the bore along an axis which extends into the femoral neck and in the direction of the head of the femur.
  • the advancing a proximal anchor step comprises axially advancing the proximal anchor without rotating the proximal anchor with respect to the fixation device.
  • the femoral fracture may be a femoral neck fracture (e.g., capital or subcapital), an intertrochanteric fracture or a subtrochanteric fracture.
  • FIG. 1 is a posterior elevational posterior cross section through the proximal portion of the femur, having two femoral neck fracture fixation devices positioned therein.
  • FIG. 2 is a posterior cross section as in FIG. 1 , with a modified fixation device positioned therein.
  • FIG. 3A is a side elevational cross section of a fixation device similar to that of FIG. 1 .
  • FIG. 3B is a side elevational cross section of a fixation device similar to that of FIG. 2 .
  • FIG. 3C is a side elevational view of a double helix distal anchor.
  • FIG. 3D is a side elevational view of a “V” thread distal anchor.
  • FIG. 3E is a side elevational view of a buttress thread distal anchor
  • FIG. 3F is a side elevational view of a triple helix distal anchor.
  • FIG. 3G is a side elevational view of a split triple helix distal anchor.
  • FIG. 3H is a side elevational view of a tapered transition thread distal anchor.
  • FIG. 3I is a side elevational view of a tapered thread distal anchor.
  • FIG. 4A is a front elevational perspective view of a modified fixation device of the present invention.
  • FIG. 4B is a front elevational perspective view of a further modification to the fixation device of the present invention.
  • FIG. 5 is an axial cross sectional view through a distal end of a fixation device of the present invention.
  • FIG. 6 is a posterior cross section as in FIG. 1 , with a fixation device and integral proximal plate anchor positioned therein.
  • FIG. 6A is a cross sectional schematic view of a combination proximal anchor and plate in accordance with the present invention.
  • FIG. 7A is a posterior cross section as in FIG. 1 , with a plate and fixation device positioned therein.
  • FIG. 7B is a cross section through a proximal portion of the femur, illustrating the use of a fixation device in combination with a plate.
  • FIG. 7C is a cross section as in FIG. 7B , illustrating the use of a fixation device of the present invention in combination with an intramedullary nail.
  • FIG. 8 is a cross sectional view through an angularly adjustable proximal anchor plate.
  • FIG. 9 is a front perspective view of the proximal anchor plate of FIG. 8 .
  • FIG. 10 is an anterior view of the distal tibia and fibula, with fixation devices across lateral and medial malleolar fractures.
  • fixation devices of the present invention will be disclosed primarily in the context of fractures of the proximal femur, the methods and structures disclosed herein are intended for application in any of a wide variety of bones and fractures, as will be apparent to those of skill in the art in view of the disclosure herein.
  • the bone fixation device of the present invention is applicable in a wide variety of fractures and osteotomies in the hand, such as interphalangeal and metacarpophalangeal arthrodesis, transverse phalangeal and metacarpal fracture fixation, spiral phalangeal and metacarpal fracture fixation, oblique phalangeal and metacarpal fracture fixation, intercondylar phalangeal and metacarpal fracture fixation, phalangeal and metacarpal osteotomy fixation as well as others known in the art.
  • a wide variety of phalangeal and metatarsal osteotomies and fractures of the foot may also be stabilized using the bone fixation device of the present invention.
  • the bone fixation device may be used with or without plate(s) or washer(s), all of which can be either permanent, absorbable, or combinations.
  • Fractures of the fibular and tibial malleoli, pilon fractures and other fractures of the bones of the leg may be fixated and stabilized with the present invention with or without the use of plates, both absorbable or non-absorbing types, and with alternate embodiments of the current invention. Fractures and osteotomies of the mid and hind foot, tarsal arthrodesis and osteotomy, or others as are known to those with skill in the art. One example is the fixation of the medial malleolar avulsion fragment fixation.
  • the fixation device of the present invention may also be used to attach tissue or structure to the bone, such as in ligament reattachment and other soft tissue attachment procedures. Plates and washers, with or without tissue spikes for soft tissue attachment, and other implants may also be attached to bone, using either resorbable or nonresorbable fixation devices depending upon the implant and procedure.
  • the fixation device may also be used to attach sutures to the bone, such as in any of a variety of tissue suspension procedures.
  • peripheral applications for the fixation devices include utilization of the device for fastening soft tissue such as capsule, tendon or ligament to bone. It may also be used to attach a synthetic material such as marlex mesh, to bone or allograft material such as tensor fascia lata, to bone. In the process of doing so, retention of the material to bone may be accomplished with the collar as shown, or the pin and or collar may be modified to accept a suture or other material for facilitation of this attachment.
  • attachment of the posterior tibial tendon to the navicular bone in the Kidner operation may be accomplished using an appropriately sized implant of the present invention along with a washer with distally extending soft tissue spikes.
  • Navicular-cuneiform arthrodesis may be performed utilizing the device and concurrent attachment of the tendon may be accomplished. Attachment of the tendon may be accomplished in the absence of arthrodesis by altering the placement of the implant in the adjacent bone.
  • Ligament or capsule reattachment after rupture, avulsion or detachment, such as in the ankle, shoulder or knee can also be accomplished using the devices disclosed herein.
  • fixation devices can also be used to aid bone fusion between adjacent bones, bone fragments or any of a variety of articulating joints, such as, for example, a first and a second adjacent vertebral bodies of the spine.
  • fixation devices may be used in combination with semi tubular, one-third tubular and dynamic compression plates, both of metallic and absorbable composition, if the collar is modified to match the opening on the plate.
  • the cannulated design disclosed below can be fashioned to accept an antibiotic impregnated rod for the slow adsorption of medication locally. This may be beneficial for prophylaxis, especially in open wounds, or when osteomyelitis is present and stabilization of fracture fragments is indicated.
  • a kit may be assembled for field use by military or sport medical or paramedical personnel.
  • This kit contains an implanting tool, and a variety of implant device size and types.
  • the kit may include additional components such as sterilization or disinfectant materials, a skin stapler, bandages, gloves, and basic tools for emergent wound and fracture treatment.
  • Antibiotic rods may be included for wound prophylaxis during transport.
  • FIG. 1 there is illustrated a posterior side elevational view of the proximal portion of a femur 10 , having a two fixation devices 12 positioned therein.
  • the proximal end of the femur 10 comprises a head 14 connected by way of a neck 16 to the long body or shaft 17 of the femur 10 .
  • the neck 16 is smaller in diameter than the head 14 .
  • the neck 16 and head 14 also lie on an axis which, on average in humans, crosses the longitudinal axis of the body 17 of the femur 10 at an angle of about 126°.
  • the risk of fracture at the neck 16 is thus elevated, among other things, by the angular departure of the neck 16 from the longitudinal axis of the body 17 of femur 10 and also the reduced diameter of the neck 16 with respect to the head 14 .
  • the greater trochanter 18 extends outwardly above the junction of the neck 16 and the body 17 of the femur 10 .
  • On the medial side of the greater trochanter 18 is the trochanteric fossa 20 . This depression accommodates the insertion of the obturator extemus muscle.
  • the lesser trochanter 21 is located posteromedially at the junction of the neck 16 and the body 17 of the femur 10 . Both the greater trochanter 18 and the lesser trochanter 21 serve for the attachment of muscles.
  • the gluteal tuberosity 22 On the posterior surface of the femur 10 at about the same axial level as the lesser trochanter 21 , for the insertion of the gluteus maximus muscle. Additional details of the femur are well understood in the art and not discussed in further detail herein.
  • FIG. 1 illustrates a subcapital femoral neck fracture 24 .
  • Fractures of the proximal portion of the femur 10 are generally classified as capital or subcapital femoral neck fractures, intertrochanteric fractures and subtrochanteric fractures. All of these fractures will be deemed femoral neck fractures for the purpose of describing the present invention.
  • the fixation device 12 comprises a body 28 extending between a proximal end 30 and a distal end 32 .
  • the length, diameter and construction materials of the body 28 can be varied, depending upon the intended clinical application. In embodiments optimized for various fractures in an adult human population, the body 28 will generally be within the range of from about 6 mm to about 150 mm in length after sizing, and within the range of from about 2 mm to about 12 mm in maximum diameter.
  • the major diameter of the helical anchor discussed below, may be within the range of from about 2.0 mm to about 15 mm. In general, the appropriate dimensions of the body 28 will vary, depending upon the specific fracture.
  • shaft diameters in the range of from about 3 mm to about 4.5 mm may be used, and lengths within the range of from about 20 mm to about 70 mm.
  • shaft diameters within the range of from about 3.5 mm to about 8.0 mm may be used with lengths within the range of from about 25 mm to about 70 mm.
  • diameters within the range of from about 2.0 mm to about 4.5 mm may be used with any of a variety of lengths within the range of from about 6 mm to about 70 mm.
  • the body 28 comprises titanium.
  • other metals or bioabsorbable or nonabsorbable polymeric materials may be utilized, depending upon the dimensions and desired structural integrity of the finished fixation device 12 .
  • distal end 32 of the body 28 is provided with a cancellous bone anchor or distal cortical bone anchor 34 . Additional details of the distal bone anchor are described below.
  • distal bone anchor 34 is adapted to be rotationally inserted into the cancellous bone within the head 14 of the femur 10 , to retain the fixation device 12 within the femoral head.
  • the proximal end 30 of the fixation device is provided with a proximal anchor 36 .
  • Proximal anchor 36 is axially distally moveable along the body 28 , to permit compression of the fracture 24 as will be apparent from FIG. 1 and the description below.
  • complementary locking structures such as threads or ratchet like structures between the proximal anchor 36 and the body 28 resist proximal movement of the anchor 36 with respect to the body 28 under normal use conditions.
  • the proximal anchor 36 can be axially advanced along the body 28 either with or without rotation, depending upon the complementary locking structures as will be apparent from the disclosure herein.
  • proximal anchor 36 comprises a housing 38 such as a tubular body, for coaxial movement along the body 28 .
  • the housing 38 is provided with one or more surface structures 40 such as radially inwardly projecting teeth or flanges, for cooperating with complementary surface structures 42 on the body 28 .
  • the surface structures 40 and complementary surface structures 42 permit distal axial travel of the proximal anchor 36 with respect to the body 28 , but resist proximal travel of the proximal anchor 36 with respect to the body 28 .
  • any of a variety of complementary surface structures which permit one way ratchet like movement may be utilized, such as a plurality of annular rings or helical threads, ramped ratchet structures and the like for cooperating with an opposing ramped structure or pawl.
  • Retention structures 42 are spaced axially apart along the body 28 , between a proximal limit 54 and a distal limit 56 .
  • the axial distance between proximal limit 54 and distal limit 56 is related to the desired axial working range of travel of the proximal anchor 36 , and thus the range of functional sizes of the fixation device 12 .
  • the retention structure 42 comprise a plurality of threads, adapted to cooperate with the retention structures 40 on the proximal anchor 36 , which may be a complementary plurality of threads.
  • the proximal anchor 36 may be distally advanced along the body 28 by rotation of the proximal anchor 36 with respect to the body 28 .
  • Proximal anchor 36 may be advantageously removed from the body 28 by reverse rotation, such as to permit removal of the body 28 from the patient.
  • a flange 44 is preferably provided with a gripping structure to permit a removal tool to rotate the flange 44 with respect to the body 28 .
  • Any of a variety of gripping structures may be provided, such as one or more slots, flats, bores or the like.
  • the flange 44 is provided with a polygonal, and, in particular, a pentagonal or hexagonal circumference. See, e.g. FIG. 4A .
  • FIGS. 4A and 4B additionally illustrate a profile modification that can be made on any of the embodiments discussed herein.
  • the retention structures 42 are positioned on a reduced diameter segment 31 .
  • the reduced diameter segment 31 is separated from the remainder of the body 28 by an annular shoulder 29 .
  • This construction allows the outside diameter of the tubular housing 38 to be approximately the same as the outside diameter of the distal portion of body 28 . In this manner, a single diameter bore hole may be formed in the proximal bone segment, to receive both the body 28 and tubular housing 38 with minimal extra tolerance.
  • the body 28 may have the same diameter throughout its axial length with the retention structures 42 formed thereon. In this embodiment, the outside diameter of proximal housing 38 will be larger than the outside diameter throughout the body 28 .
  • the present invention provides a bone fixation device which can provide compression across a fracture throughout a range of motion following the placement of the distal anchor.
  • the distal anchor may be positioned within the cancellous and/or distal cortical bone, and the proximal anchor may be distally advanced throughout a range to provide compression across the fracture without needing to relocate the distal anchor and without needing to initially locate the distal anchor in a precise position with respect to the proximal side of the bone.
  • Providing a working range throughout which tensioning of the proximal anchor is independent from setting the distal anchor allows a single device to be useful for a wide variety of fractures, as well as eliminates the need for accurate device measurement and accurate placement of the distal anchor.
  • the working range is at least about 10% of the overall length of the device, and may be as much as 20% or 30% or more of the overall device length.
  • working ranges of up to about 10 mm may be provided, since estimates within that range can normally be readily accomplished within the clinical setting.
  • a working range in the area of from about 1 mm to about 2 mm may be all that is necessary.
  • the embodiments disclosed herein can be scaled to have a greater or a lesser working range, as will be apparent to those of skill in the art in view of the disclosure herein.
  • the proximal anchor 36 includes a flange 44 that seats against the outer surface of the femur or tissue adjacent the femur.
  • the flange 44 is preferably an annular flange, to optimize the footprint or contact surface area between the flange 44 and the femur.
  • Circular or polygonal shaped flanges for use in femoral head fixation will generally have a diameter of at least about 4 mm greater than the adjacent body 28 and often within the range of from about 4 mm to about 20 mm or more greater than the adjacent body 28 .
  • the flange 44 can be curved to match the curved shape of the femur and further optimize the footprint or contact surface area between the flange 44 and the femur.
  • the bone contacting surface 46 of the flange 44 resides in or approximately on a plane which is inclined with respect to the longitudinal axis of the body 28 .
  • Any of a variety of angular relationships between the bone contacting surface 46 of the flange 44 and the longitudinal axis of the body 28 and housing 38 may be utilized, depending upon the anticipated entrance angle of the body 28 and associated entrance point surface of the femur 10 .
  • the longitudinal axis extending through the head 14 and neck 16 of the human femur is inclined at an angle of approximately 126° from the longitudinal axis of the long body 17 of the femur 10 .
  • Angles between the longitudinal axis of body 28 and tissue contacting surface 46 within the range of from about 90° to about 140° will generally be utilized, often within the range of from about 100° to about 120°, for fixed angle fixation devices.
  • Perpendicular flanges i.e., 90° are illustrated in FIGS. 3A and 3B .
  • the clinician can be provided an array of proximal anchors 36 of varying angular relationships between the bone contacting surface 46 and the longitudinal axis of the body 28 and housing 38 (e.g., 90°, 100°, 110°, 120°, and 130°).
  • a single body 28 can be associated with the array such as in a single sterile package.
  • the clinician upon identifying the entrance angle of the body 28 and the associated entrance point surface orientation of the femur 10 can choose the anchor 36 from the array with the best fit angular relationship, for use with the body 28 .
  • the flange 44 is angularly adjustable with respect to the longitudinal axis of the body 28 .
  • the tubular housing 38 is a separate component from the flange 44 .
  • the housing 38 and the flange 44 preferably include corresponding semi-spherical or radiused surfaces 45 a , and 45 b .
  • the surface 45 b surrounds an aperture 49 in the flange 44 .
  • This arrangement allows the housing 38 to extend through and pivot with respect to the flange 44 .
  • the angular relationship between the bone contacting surface 46 of the flange 44 and the longitudinal axis of the body 28 can vary in response to the entrance angle.
  • the flange 44 is enlarged and includes one or two or more openings 47 for receiving one or two or more femoral shaft screws (not shown).
  • the flange 44 may be elongated anatomically distally parallel to the axis of the femur, so that it functions simultaneously as a plate, as will be discussed in connection with FIG. 6 .
  • the proximal end 30 of the body 28 is preferably additionally provided with rotational coupling 48 , for allowing the body 28 to be rotationally coupled to a driving device.
  • a driving device such as electric drills or hand tools which allow the clinician to manually rotate the cancellous bone anchor 34 into the head of the femur.
  • the rotational coupling 48 may have any of a variety of cross sectional configurations, such as one or more flats or splines.
  • the rotational coupling 48 comprises a proximal projection of the body 28 having a polygonal cross section, such as a hexagonal cross section.
  • the rotational coupling 48 is illustrated as a male component, machined or milled or attached to the proximal end 30 of the body 28 .
  • the rotational coupling may also be in the form of a female element, such as a hexagonal or other noncircular cross sectioned lumen extending throughout a proximal portion or the entire length of the body 28 .
  • the body 28 may be cannulated to accommodate installation over a placement wire as is understood in the art.
  • the cross section of the central cannulation can be made non circular, e.g., hexagonal, to accommodate a corresponding male tool for installation or removal of the device regardless of the location of the proximal break point, as will be discussed.
  • the body 28 may be provided with at least one and preferably two or three or more break points 50 spaced axially apart along the proximal portion of the body 28 .
  • Break points 50 comprise a weakened transverse plane through the body 28 , which facilitate severing of the proximal portion of the body 28 following proper tensioning of the proximal anchor 36 .
  • Break point 50 may be constructed in any of a variety of ways, such as by machining or milling an annular recess into the exterior wall of the body 28 , or created one or more transverse perforations through the body 28 such as by mechanical, laser, or EDM drilling.
  • the body 28 may also be provided with at least one and preferably two or three or moregraduation markings axially spaced along the proximal portion of the body 28 .
  • Such graduation markings can be used to indicate how far the body 28 has been inserted into the bone.
  • Such graduation markings may include indicia indicating the distance (e.g., in millimeters or inches) from the proximal surface of the bone to the distal tip of the distal bone anchor 34 .
  • the distal anchor 34 comprises a helical locking structure 60 for engaging cancellous and/or distal cortical bone.
  • the locking structure 60 comprises a flange that is be wrapped around a central core 62 or an axial lumen, as discussed below.
  • the central core 62 or axial lumen defines a minor diameter of the helical locking structure 60 .
  • the outer edge of the helical flange 60 defines a major diameter or outer boundary of the helical locking structure 60 .
  • the flange extends through at least one and generally from about two to about 50 or more full revolutions depending upon the axial length of the distal anchor and intended application.
  • the flange will generally complete from about 2 to about 20 revolutions.
  • the helical flange 60 is preferably provided with a pitch and an axial spacing to optimize the retention force within cancellous bone, to optimize compression of the fracture.
  • the helical flange 60 of the embodiment illustrated in FIG. 1 is shaped generally like a flat blade or radially extended screw thread.
  • the helical flange 60 can have any of a variety of cross sectional shapes, such as rectangular, triangular or other as deemed desirable for a particular application through routine experimentation in view of the disclosure herein.
  • the ratio of the major diameter to the minor diameter can be optimized with respect to the desired retention force within the cancellous bone and giving due consideration to the structural integrity and strength of the distal anchor 34 .
  • Another aspect of the distal anchor 34 that can be optimized is the shape of the major and minor diameters, which in the illustrated embodiment are generally cylindrical with a tapered distal end 32 .
  • the distal end 32 and/or the outer edges of the helical flange 60 may be atraumatic (e.g., blunt or soft). This inhibits the tendency of the fixation device 12 to migrate anatomically proximally towards the hip joint bearing surface after implantation (i.e., femoral head cut-out). Distal migration is also inhibited by the dimensions and presence of the proximal anchor 36 , which has a larger footprint than conventional screws.
  • the distal anchor 34 comprises an elongated helical locking structure 60 that is spirally wrapped about an axial lumen through at least one and preferably from about two to about 20 or more full revolutions.
  • the axial lumen defines a minor diameter that is generally cylindrical.
  • the elongated body 60 is provided with a pitch and an axial spacing to optimize the retention force within cancellous bone, which optimizes compression of the fracture.
  • the tip 72 of the elongated body 60 may be pointed.
  • this variation is particularly suited for a canulated fixation device 12 . That is, a design wherein a central lumen extends through the body 28 and the distal anchor 34 .
  • FIG. 5 is an axial cross sectional view through a distal anchor of the type illustrated in FIGS. 2 and 3 B.
  • FIG. 5 also illustrates the cross-section of the helical flange which forms the spiral locking structure.
  • the cross-section has a width w, and a height h.
  • the shape, the width w and height h of the elongated body can be varied to optimize the retention force within cancellous bone.
  • the cross section can be circular, square or faceted.
  • w and h are within the range of from about 1 mm to about 8 mm for use in the femoral neck application.
  • the distal anchor 34 forms a double helix comprising two elongated structures 360 , 362 spirally wrapped around an axial lumen through at least one and preferably from about 2 to about 20 or more full revolutions.
  • the shape, the width w and height h of the elongated bodies 360 , 362 along with pitch and an axial spacing can be optimized through routine experimentation to optimize the retention force within cancellous bone, which optimizes compression of the fracture.
  • the diameter of the axial lumen can also be optimized.
  • the tip 364 of helical flanges 360 , 362 may be tapered or pointed to permit easier insertion through self-tapping and self-drilling.
  • the double helix design may be incorporated into any of the designs disclosed elsewhere herein.
  • the elongated structures 360 , 362 have a generally rectangular cross sectional shape with a height and width within the range of about 1.0-4.0 millimeters.
  • the major diameter is in the range of about 4.0-15 millimeters
  • the minor diameter is in the range of about 2.0-8.0 millimeters
  • the pitch is in the range of from about 3 to about 12 threads per inch.
  • the anchor 34 comprises a helical flange 370 having a generally “V” shaped cross-section.
  • the illustrated flange 370 has sides angled at about 60-degrees, forming two load bearing surfaces 372 , 374 and a blunted outer edge 376 .
  • the proximally facing surface 372 carries the axial load to resist pullout.
  • the minor diameter is approximately equal to zero.
  • the minor diameter can be increased giving due consideration to the balance between the desired retention force within the cancellous bone and the structural integrity and strength of the distal anchor 34 .
  • the angle between the two surfaces 372 , 374 along with the pitch and axial spacing of the helical flange 370 are selected to optimize the retention force within cancellous bone, to optimize compression of the fracture.
  • the distal anchor 34 comprises a helical flange 380 having a buttress thread design. That is, the flange 380 has a generally rectangular cross-section, and extends radially outwardly and in some embodiments is inclined proximally to form a proximally concave spiral. This arrangement enhances the pullout strength of the distal anchor 34 because the bearing surfaces 382 , 384 of the flange 380 lie generally perpendicular to the load direction. As with the previous arrangement, the helical flange 380 has a minor diameter that is approximately equal to zero.
  • the minor diameter can be increased minor diameter can increased giving due consideration to the balance between the desired retention force within the cancellous bone and the structural integrity and strength of the distal anchor 34 .
  • the pitch and axial spacing can also be optimized to enhance the retention force within cancellous bone and to optimize compression across the fracture.
  • the distal anchor 34 comprises at least three helical threads or flanges 390 , 392 , 394 spirally wrapped around a generally cylindrical central core 395 , which in the illustrated arrangement also defines the wall of an axial lumen 397 that can extend through the body 28 .
  • the major diameter of the distal anchor 34 is generally cylindrical.
  • the leading tips 396 of the helical flanges 390 , 392 , 394 may be sharpened so as to aid the screw in being self tapping and/or self drilling.
  • the helical flanges 390 , 392 , 394 can be provided with a lower pitch as compared to the arrangement described above. Moreover, as compared to the previous arrangements, this arrangement requires less turns to insert the distal anchor 34 any given axial distance.
  • the pitch of the helical flanges 390 , 392 , 394 may be within the range of from about 2 to about 12 threads per inch.
  • the distal anchor 34 therefore requires fewer turns during insertion to achieve the same axial travel as a single helix thread having a greater pitch.
  • this arrangement leaves more of the bone intact.
  • the distal anchor can include two or four helical flanges such as flanges 390 , 392 , 394 .
  • the number, pitch and axial spacing of the helical flanges can be optimized through routine experimentation in light of the disclosure herein.
  • the minor diameter is about 4.5 millimeters
  • the major diameter is about 7.0 millimeters
  • the pitch is about 5.5 threads per inch.
  • the distal anchor 34 comprises split triple helix distal anchor design that is similar to the arrangement described above. However, in this arrangement, one of the helical flanges is cut through to the axial lumen 397 that is defined by the central core 395 . As such, three flanges 400 , 402 , 403 remain wrapped around the central core 395 . As compared to the previous arrangement, this arrangement leaves more bone intact. As with the previous embodiments, the pitch and axial spacing can be optimized through routine experimentation. A split double helix, with two flanges or threads may also be provided.
  • FIGS. 3H and 3I illustrate more variations of the distal anchor 34 .
  • the distal anchor 34 comprises a generally V-shaped flange 410 that is wrapped around a central core 412 that also defines a central lumen 413 , which can extend through the body 28 .
  • the major diameter of the V-shaped flange 410 is generally cylindrical.
  • the minor diameter of the central core tapers in the distal direction.
  • the central core disappears into the generally cylindrical central lumen 413 at a point in between the proximal and distal ends of the threads, and, in the illustrated embodiment, at approximately the longitudinal center 414 of the distal anchor 34 .
  • This arrangement strengthens the proximal portion 416 of the distal anchor 34 , where stretching and fatigue may be most likely to occur on pullout. It is anticipated that the shape of the flange 410 along with the pitch, axial spacing and the taper of the central core can be optimized through routine experimentation given the disclosure herein.
  • the distal anchor 34 also comprises a V-shaped helical flange 420 that is wrapped around an axial lumen.
  • both the major and minor diameters taper from the proximal end 422 of the anchor 34 to the distal end 424 .
  • the minor diameter is approximately equal to zero.
  • the distal end 424 of tapered distal anchor 34 can provide for self tapping while the proximal end 422 of the anchor 34 provides for self drilling.
  • the shape, pitch, axial spacing of the helical flange 430 and the taper of the major and minor diameters can be further optimized through routine experimentation.
  • the helical flange 430 can be wrapped around a central core that tapers from the proximal end 422 to the distal end 424 .
  • an anti-rotation lock may be provided between the distal anchor and the proximal collar or plate, such as a spline or other interfit structure to prevent relative rotation of the proximal and distal ends of the device following implantation.
  • the clinician first identifies a patient having a fracture to be treated, such as a femoral neck fracture, which is fixable by an internal fixation device.
  • the clinician accesses the proximal femur, reduces the fracture if necessary and selects a bone drill and drills a hole 80 in accordance with conventional techniques.
  • a femoral neck fracture three holes and fixation devices will often be used as has been discussed.
  • the hole 80 has a diameter within the range from about 3 mm to about 8 mm. This diameter may be slightly larger than the diameter of the distal anchor 34 .
  • the hole 80 preferably extends up to or slightly beyond the fracture 24 .
  • a fixation device 12 having an axial length and outside diameter suitable for the hole 80 is selected.
  • the distal end 32 of the fixation device 12 is advanced distally into the hole 80 until the distal anchor 34 reaches the distal end of the hole 80 .
  • the proximal anchor 36 may be carried by the fixation device 12 prior to advancing the body 28 into the hole 80 , or may be attached following placement of the body 28 within the hole 80 .
  • the clinician may use any of a variety of driving devices, such as electric drills or hand tools to rotate the cancellous bone anchor 34 into the head of the femur.
  • proximal anchor 36 While proximal traction is applied to the proximal end 30 of body 28 , such as by conventional hemostats, pliers or a calibrated loading device, the proximal anchor 36 is advanced distally until the anchor 36 fits snugly against the outer surface of the femur or tissue adjacent the femur. Appropriate compression of the fixation device 12 across the fracture is accomplished by tactile feedback or through the use of a calibration device for applying a predetermined load on the implantation device.
  • One advantage of the structure of the present invention is the ability to adjust compression independently of the setting of the distal anchor 34 .
  • the proximal extension 30 of the body 28 is preferably cut off, snapped off, unscrewed or otherwise removed.
  • Body 28 may be cut using conventional saws, cutters or bone forceps which are routinely available in the clinical setting.
  • the fixation device can be selected such that it is sized to length upon tensioning, so that no proximal projection remains.
  • the access site may be closed and dressed in accordance with conventional wound closure techniques.
  • the proximal anchor 36 can include one or more barbs 41 extending radially outwardly from the tubular housing 28 .
  • the barbs 41 may be radially symmetrically distributed about the longitudinal axis of the tubular housing 38 .
  • Each barb 41 is provided with a transverse engagement surface 43 , for anchoring the proximal anchor 36 in the bone.
  • the transverse engagement surface 43 may lie on a plane which is transverse to the longitudinal axis of the tubular housing 38 or may be inclined with respect to the longitudinal axis of the tubular housing 38 . In either arrangement, the transverse engagement surface 43 generally faces the bone contacting surface 46 of the flange 44 . As such, the transverse engagement surface 43 inhibits proximal movement of the proximal anchor 36 with respect to the bone.
  • the barbs 41 allow the bone fixation device to capture “secondary compression” of the fracture.
  • the bone fixation device can be used to provide an initial compression across the fracture when the proximal anchor 36 is appropriately tensioned.
  • the fracture typically undergoes secondary compression, which further compresses the fracture.
  • the barbs 41 prevent proximal movement of the proximal anchor 36 with respect to the bone.
  • the ratchet-type structures 40 , 42 of the proximal anchor 36 and the body 28 allow the proximal anchor 36 to move distally along the body 28 .
  • any slack caused by the secondary compression is taken up by the proximal anchor 36 as the retention structures 40 , 42 prevent proximal movement of the proximal anchor 36 with respect to the body 29 .
  • This device is therefore self tightening after it has been implanted in the patient.
  • the clinician will have access to an array of fixation devices 12 , having, for example, different diameters, axial lengths and angular relationships. These may be packaged one per package in sterile envelopes or peelable pouches, or in dispensing cartridges which may each hold a plurality of devices 12 . Upon encountering a fracture for which the use of a fixation device is deemed appropriate, the clinician will assess the dimensions and load requirements, and select a fixation device from the array which meets the desired specifications.
  • a clinician may want to introduce two or three or more fixation devices 12 into the femoral head 14 to secure the fracture 24 . This may be desirable if the clinician determines that, based upon the nature of the fracture 24 ; there is a possibility that the head 14 of the femur 10 could rotate about a single fixation device 12 . Even minor rotation can inhibit the healing of the fracture. Significant rotation can result in failure of the fixation device or necrosis of the femoral head.
  • Two fixation devices 12 may also be desirable where the direction of the fracture is generally parallel to the axis of implantation as is understood in the art.
  • the proximal anchor 90 comprises an elongated flange 92 , which extends from the housing 93 longitudinally down (anatomically caudad or distally) the body 17 of the femur 10 .
  • the elongated flange 92 preferably includes one or more openings 94 for receiving one or more femoral shaft screws 96 .
  • the flange 92 may or may not extend above (anatomically proximal to) the housing 93 . Elimination of a proximal flange may more easily permit rotational removal of the proximal anchor 36 from the body 28 by reverse rotation in an inclined flange embodiment.
  • FIG. 6A there is illustrated a cross sectional schematic view of an integral proximal anchor 36 and proximal plate.
  • the dimensions and orientation of the proximal anchor 36 may be varied widely, depending upon the intended application.
  • a longitudinal axis of the housing 93 may be inclined or perpendicular with respect to the plane of flange 92 .
  • the flange 92 may have any of a variety of dimensions and profiles, depending upon the intended application.
  • Lengths of the plate 92 in the vertical direction as illustrated on FIG. 6A for use in femoral neck fixation fractures, may range from at least about 0.5 inches to about 10 inches or more.
  • the plate 92 may be planar as illustrated, particularly in small plate embodiments, or may be curved or contoured to improve seating of the plate 92 against the adjacent bone. Plate 92 may be provided with one or more apertures for receiving bone screws or other fixation devices as illustrated in FIGS. 6 and 7 A.
  • the fixation device 12 is schematically illustrated in combination with a conventional plate 100 .
  • the fixation device 12 in FIG. 7A may be identical to the embodiments described elsewhere herein.
  • the fixation device 12 is used with an elongated side support or plate 100 , which extends longitudinally above and below the hole 80 .
  • the elongated side plate 100 includes an opening 102 that preferably has a diameter that is slightly larger than the diameter of the housing 38 .
  • the elongated side plate 100 preferably also includes one or more openings 104 for receiving one or more femoral shaft screws 106 .
  • the elongated side plate 100 spreads the forces exerted by the flange 44 across a larger area of the femur 17 , and affects the distribution of load.
  • the elongated side plate can 100 include one or more openings above the housing 38 for receiving trochanteric anchor screws (not shown).
  • a contoured side plate 100 is illustrated in FIG. 7B .
  • the proximal anchor 36 is also formed with a tapered (e.g. conical or concave outwardly) bone or plate contacting surface on flange 44 .
  • fixation device 12 of the present invention may also be used in combination with intramedullary nails or rods 101 as schematically illustrated in FIG. 7C , as will be understood by those of skill in the art.
  • the fixation device 12 of the present invention may be used in any of a wide variety of anatomical settings beside the proximal femur, as has been discussed.
  • lateral and medial malleolar fractures can be readily fixed using the device of the present invention.
  • FIG. 10 there is illustrated an anterior view of the distal fibula 120 and tibia 122 .
  • the fibula 120 terminates distally in the lateral malleolus 124
  • the tibia 122 terminates distally in the medial malleolus 126 .
  • a fixation device 12 in accordance with the present invention is illustrated as extending through the lateral malleolus 124 across the lateral malleolar fracture 128 and into the fibula 120 .
  • Fixation device 12 includes a distal anchor 34 for fixation within the fibula 120 , an elongate body 28 and a proximal anchor 36 as has been discussed.
  • FIG. 10 also illustrates a fixation device 12 extending through the medial malleolus 126 , across a medial malleolar fracture 130 , and into the tibia 122 .
  • FIG. 10 illustrates fixation of both a lateral malleolar fracture 128 and medial malleolar fracture 130 , either fracture can occur without the other as is well understood in the art. Installation of the fixation devices across malleolar fractures is accomplished utilizing the same basic steps discussed above in connection with the fixation of femoral neck fractures.
  • fixation devices of the present invention may be made from either conventional bioabsorbable materials or conventional non-absorbable materials, combinations thereof and equivalents thereof.
  • natural materials such as allografts may be used.
  • absorbable materials include homopolymers and copolymers of lactide, glycolide, trimethylene carbonate, caprolactone, and p-dioxanone and blends thereof. The following two blends may be useful:
  • the fixation devices may also be made from conventional non-absorbable, biocompatible materials including stainless steel, titanium, alloys thereof, polymers, composites and the like and equivalents thereof.
  • the distal anchor comprises a metal helix
  • the body and the proximal anchor comprise a bioabsorbable material.
  • the distal anchor comprises a bioabsorbable material
  • the body and proximal anchor comprise either a bioabsorbable material or a non-absorbable material.
  • each of the distal anchor and the body comprise a non-absorbable material, connected by an absorbable link. This may be accomplished by providing a concentric fit between the distal anchor and the body, with a transverse absorbable pin extending therethrough. This embodiment will enable removal of the body following dissipation of the pin, while leaving the distal anchor within the bone.
  • the components of the invention may contain one or more bioactive substances, such as antibiotics, chemotherapeutic substances, angiogenic growth factors, substances for accelerating the healing of the wound, growth hormones, antithrombogenic agents, bone growth accelerators or agents, and the like.
  • bioactive substances such as antibiotics, chemotherapeutic substances, angiogenic growth factors, substances for accelerating the healing of the wound, growth hormones, antithrombogenic agents, bone growth accelerators or agents, and the like.
  • bioactive implants may be desirable because they contribute to the healing of the injury in addition to providing mechanical support.
  • the components may be provided with any of a variety of structural modifications to accomplish various objectives, such as osteoincorporation, or more rapid or uniform absorption into the body.
  • osteoincorporation may be enhanced by providing a micropitted or otherwise textured surface on the components.
  • capillary pathways may be provided throughout the body and collar, such as by manufacturing the anchor and body from an open cell foam material, which produces tortuous pathways through the device. This construction increases the surface area of the device which is exposed to body fluids, thereby generally increasing the absorption rate in a bioabsorbable construction.
  • Capillary pathways may alternatively be provided by laser drilling or other technique, which will be understood by those of skill in the art in view of the disclosure herein.
  • the extent to which the anchor can be permeated by capillary pathways or open cell foam passageways may be determined by balancing the desired structural integrity of the device with the desired reabsorption time, taking into account the particular strength and absorption characteristics of the desired polymer.
  • U.S. Pat. No. 6,005,161 is described in U.S. Pat. No. 6,005,161 as a poly(hydroxy) acid in the form of an interconnecting, open-cell meshwork which duplicates the architecture of human cancellous bone from the iliac crest and possesses physical property (strength) values in excess of those demonstrated by human (mammalian) iliac crest cancellous bone.
  • the gross structure is said to maintain physical property values at least equal to those of human, iliac crest, cancellous bone for a minimum of 90 days following implantation.
  • the disclosure of U.S. Pat. No. 6,005,161 is incorporated by reference in its entirety herein.
  • the components of the present invention may be sterilized by any of the well known sterilization techniques, depending on the type of material. Suitable sterilization techniques include heat sterilization, radiation sterilization, such as cobalt 60 irradiation or electron beams, ethylene oxide sterilization, and the like.
  • any of the bone fixation devices of the present invention can be readily varied depending upon the intended application, as will be apparent to those of skill in the art in view of the disclosure herein.
  • the present invention has been described in terms of certain preferred embodiments, other embodiments of the invention including variations in dimensions, configuration and materials will be apparent to those of skill in the art in view of the disclosure herein.
  • all features discussed in connection with any one embodiment herein can be readily adapted for use in other embodiments herein.
  • the use of different terms or reference numerals for similar features in different embodiments does not imply differences other than those which may be expressly set forth. Accordingly, the present invention is intended to be described solely by reference to the appended claims, and not limited to the preferred embodiments disclosed herein.

Abstract

Disclosed is a bone fracture fixation device, such as for reducing and compressing fractures in the proximal femur. The fixation device includes an elongate body with a helical cancellous bone anchor on a distal end. An axially moveable proximal anchor is carried by the proximal end of the fixation device. The device is rotated into position across the fracture or separation between adjacent bones and into the adjacent bone or bone fragment, and the proximal anchor is distally advanced to apply secondary compression and lock the device into place. The device may also be used for soft tissue attachments.

Description

    PRIORITY INFORMATION
  • This invention is a continuation-in-part of U.S. patent application Ser. No. 09/822,803, filed Mar. 30, 2001, the entire contents of which are hereby expressly incorporated herein by reference.
  • BACKGROUND OF THE INVENTION
  • 1. Field of the Invention
  • The present invention relates to internal bone fracture fixation devices. In one application, the present invention relates to bone fracture fixation devices and methods adapted for fixation, among other fractures, of femoral neck and other proximal femoral fractures.
  • 2. Description of the Related Art
  • The femur, otherwise known as the thigh bone, generally comprises an elongate shaft extending from the hip to the knee. The proximal end of the shaft includes a head, a neck, a greater trochanter and a lesser trochanter. The head of the femur fits into the acetabular cup of the hip bone to form a ball and socket joint at the hip. The distal end of the femur includes a medial condyle and a lateral condyle. The condyles engage an upper end of the tibia to form the knee joint. Overall, the femur is the longest and strongest bone in the skeleton. However, portions of the femur are extremely susceptible to fracturing.
  • Pertrochanteric fractures among geriatric patients are the most frequent in connection with those of the region of the neck of the bone. The advanced age and the pathologies which are encountered in these patients make a timely stabilization of skeletal injuries necessary in order to reduce to a minimum the bed confinement and the rehabilitation times. Preferably, devices and procedures are utilized which minimize complications brought about by the so-called immobilization syndrome, which may be lethal for patients in delicate metabolical circumstances. It is also preferable to reduce to a minimum blood losses related to surgical intervention. At the same time, the syntheses means utilized must be stable in order to allow the patient to very timely assume a seated position and, two or three days following the intervention, to reassume an erect posture with progressive bearing of weight.
  • Internal fixation of femoral fractures in general is one of the most common orthopedic surgical procedures. Fractures of the femur occur in both the proximal portion of the femur and the distal portion of the femur. Fractures of the proximal portion of the femur (hip fractures) are generally classified as femoral neck fractures (capital or sub-capital), intertrochanteric fractures and subtrochanteric fractures. Fractures of the distal portion of the femur (knee fractures) are referred to as supracondylar fractures. Supracondylar fractures generally extend vertically between the condyles at the lower end of the femur to separate the distal portion of the femur into two main bone fragments. A fracture line may be further comminuted to create a plurality of smaller bone fragments. Fractures of the femur which extend into the neck of the bone are generally more difficult to treat than fractures restricted to the shaft of the femur.
  • Operative treatment of the fractures requires that the fractures be internally fixed and possibly compressed. Fractures of the neck, head or trochanters of the femur have been treated with a variety of compression screw assemblies which include generally a compression plate having a barrel member, a lag screw and a compressing screw. The compression plate is secured to the exterior of the femur and the barrel member is inserted into a predrilled hole in the direction of the femoral head. The lag screw which has a threaded end and a smooth portion is inserted through the barrel member so that it extends across the break and into the femoral head. The threaded portion engages the femoral head. The compressing screw connects the lag screw to the plate. By adjusting the tension of the compressing screw the compression (reduction) of the fracture can be adjusted.
  • A variety of elongated implants (nail, screw, pin, etc.) have been developed, which are adapted to be positioned along the longitudinal axis of the femoral neck with a leading (distal) end portion in the femoral head so as to stabilize a fracture of the femoral neck. The elongated implant may be implanted by itself or connected to another implant such as a side plate or intramedullary rod. The leading end portion of the implant typically includes means to positively grip the femoral head bone (external threads, expanding arms, etc.), but the inclusion of such gripping means can introduce several significant problems. First, implants with sharp edges on the leading end portion, such as the externally threaded implants, exhibit a tendency to migrate proximally towards the hip joint weight bearing surface after implantation. This can occur when the proximal cortical bone has insufficient integrity to resist distal movement of the screw head. Such proximal migration under physiological loading, which is also referred to as femoral head cut-out, can lead to significant damage to the adjacent hip joint. Also, the externally threaded implants can generate large stress concentrations in the bone during implantation which can lead to stripping of the threads formed in the bone and thus a weakened grip. The movable arms of known expanding arm devices are usually free at one end and attached at the other end to the main body of the leading end portion of the implant. As a result, all fatigue loading is concentrated at the attached ends of the arms and undesirably large bending moments are realized at the points of attachment. In addition, conventional threaded implants generally exhibit insufficient holding power under tension, such that the threads can be stripped out of the femoral head either by overtightening during the implantation procedure or during post operative loading by the patient's weight.
  • Thus, notwithstanding the variety of efforts in the prior art, there remains a need for an orthopedic fixation device with improved locking force such as within the femoral head in a femoral neck application, which resists migration and rotation, and which can be easily and rapidly deployed within the bone.
  • SUMMARY OF THE INVENTION
  • There is provided in accordance with one aspect of the present invention, a method of securing a first bone fragment to a second bone fragment. The method comprises the steps of drilling a bore through the first bone fragment in the direction of the second bone fragment, and advancing through the bore a fixation device comprising a first portion and a second portion that are coupled to each other. A distal anchor of the fixation device is rotated to secure the fixation device to the second fragment, and the proximal anchor is axially advanced to engage the first fragment and provide compression across the fracture.
  • In one application of the method, the second bone fragment comprises the head of a femur. Alternatively, the second bone fragment comprises a tibia, a fibula, a femur, a humurus, a radius, or an ulna. The first bone fragment may comprise a condyle.
  • The method may additionally comprise the step of uncoupling the first portion from the second portion.
  • In accordance with another aspect of the present invention, there is provided a femoral neck fracture fixation device. The device comprises an elongate body, having a proximal end and a distal end and a helical anchor on the distal end. The helical anchor is wrapped about a central core or axial lumen. An outer edge of the helical anchor defines an outer boundary and the central core or axial lumen defines a minor diameter. A first retention structure is provided on the body, proximal to the anchor. A proximal anchor is moveably carried by the body. The proximal anchor is movable in the distal direction with respect to the body and the retention structure resists proximal movement of the proximal anchor with respect to the body.
  • In accordance with a further aspect of the present invention, there is provided a bone fracture fixation device. The device comprises an elongate body having a proximal end and a distal end. A cancellous bone anchor is on the distal end. The cancellous bone anchor comprises a helical flange wrapped about a central core or axial lumen. An outer edge of the helical anchor defines an outer boundary and the central core or axial lumen defines a minor diameter. A proximal anchor is axially movably carried on the body. Complimentary surface structures are provided between the body and the proximal anchor that permit advancing the proximal anchor in the distal direction to provide compression across a fracture but that resist axial proximal movement of the proximal anchor.
  • In accordance with another aspect of the present invention, there is provided a method of treating a femoral fracture. The method comprises the steps of drilling at least one and preferably two or three bores distally into the femur in the direction of a fracture, and advancing into each bore a fixation device that comprises a body having a first portion that forms a distal bone anchor and a second portion that forms a proximal end. A proximal component is rotated to engage the distal anchor with the bone distal to the fracture, and a proximal anchor is advanced distally along the fixation device to compress the fracture.
  • In accordance with another aspect of the invention a bone fracture fixation device comprises an elongate body having a proximal end and a distal end. The body also includes a helical anchor on the distal end. A first retention structure is on the body located proximal to the anchor. A proximal anchor is moveably carried by the body and has a tubular housing. The tubular housing has at least one barb extending radially outwardly from the tubular housing and defining an engagement surface that lies within a plane that is transverse to a longitudinal axis of the tubular housing. The proximal anchor is movable in the distal direction with respect to the body and the retention structure resists proximal movement of the proximal anchor with respect to the body.
  • Preferably, the drilling step comprises drilling the bore along an axis which extends into the femoral neck and in the direction of the head of the femur. In one embodiment, the advancing a proximal anchor step comprises axially advancing the proximal anchor without rotating the proximal anchor with respect to the fixation device. The femoral fracture may be a femoral neck fracture (e.g., capital or subcapital), an intertrochanteric fracture or a subtrochanteric fracture.
  • Further features and advantages of the present invention will become apparent to those of skill in the art in view of the detailed description of preferred embodiments which follows, when considered together with the attached drawings and claims.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • FIG. 1 is a posterior elevational posterior cross section through the proximal portion of the femur, having two femoral neck fracture fixation devices positioned therein.
  • FIG. 2 is a posterior cross section as in FIG. 1, with a modified fixation device positioned therein.
  • FIG. 3A is a side elevational cross section of a fixation device similar to that of FIG. 1.
  • FIG. 3B is a side elevational cross section of a fixation device similar to that of FIG. 2.
  • FIG. 3C is a side elevational view of a double helix distal anchor.
  • FIG. 3D is a side elevational view of a “V” thread distal anchor.
  • FIG. 3E is a side elevational view of a buttress thread distal anchor
  • FIG. 3F is a side elevational view of a triple helix distal anchor.
  • FIG. 3G is a side elevational view of a split triple helix distal anchor.
  • FIG. 3H is a side elevational view of a tapered transition thread distal anchor.
  • FIG. 3I is a side elevational view of a tapered thread distal anchor.
  • FIG. 4A is a front elevational perspective view of a modified fixation device of the present invention.
  • FIG. 4B is a front elevational perspective view of a further modification to the fixation device of the present invention.
  • FIG. 5 is an axial cross sectional view through a distal end of a fixation device of the present invention.
  • FIG. 6 is a posterior cross section as in FIG. 1, with a fixation device and integral proximal plate anchor positioned therein.
  • FIG. 6A is a cross sectional schematic view of a combination proximal anchor and plate in accordance with the present invention.
  • FIG. 7A is a posterior cross section as in FIG. 1, with a plate and fixation device positioned therein.
  • FIG. 7B is a cross section through a proximal portion of the femur, illustrating the use of a fixation device in combination with a plate.
  • FIG. 7C is a cross section as in FIG. 7B, illustrating the use of a fixation device of the present invention in combination with an intramedullary nail.
  • FIG. 8 is a cross sectional view through an angularly adjustable proximal anchor plate.
  • FIG. 9 is a front perspective view of the proximal anchor plate of FIG. 8.
  • FIG. 10 is an anterior view of the distal tibia and fibula, with fixation devices across lateral and medial malleolar fractures.
  • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
  • Although the fixation devices of the present invention will be disclosed primarily in the context of fractures of the proximal femur, the methods and structures disclosed herein are intended for application in any of a wide variety of bones and fractures, as will be apparent to those of skill in the art in view of the disclosure herein. For example, the bone fixation device of the present invention is applicable in a wide variety of fractures and osteotomies in the hand, such as interphalangeal and metacarpophalangeal arthrodesis, transverse phalangeal and metacarpal fracture fixation, spiral phalangeal and metacarpal fracture fixation, oblique phalangeal and metacarpal fracture fixation, intercondylar phalangeal and metacarpal fracture fixation, phalangeal and metacarpal osteotomy fixation as well as others known in the art. A wide variety of phalangeal and metatarsal osteotomies and fractures of the foot may also be stabilized using the bone fixation device of the present invention. These include, among others, distal metaphyseal osteotomies such as those described by Austin and Reverdin-Laird, base wedge osteotomies, oblique diaphyseal, digital arthrodesis as well as a wide variety of others that will be known to those of skill in the art. The bone fixation device may be used with or without plate(s) or washer(s), all of which can be either permanent, absorbable, or combinations.
  • Fractures of the fibular and tibial malleoli, pilon fractures and other fractures of the bones of the leg may be fixated and stabilized with the present invention with or without the use of plates, both absorbable or non-absorbing types, and with alternate embodiments of the current invention. Fractures and osteotomies of the mid and hind foot, tarsal arthrodesis and osteotomy, or others as are known to those with skill in the art. One example is the fixation of the medial malleolar avulsion fragment fixation.
  • The fixation device of the present invention may also be used to attach tissue or structure to the bone, such as in ligament reattachment and other soft tissue attachment procedures. Plates and washers, with or without tissue spikes for soft tissue attachment, and other implants may also be attached to bone, using either resorbable or nonresorbable fixation devices depending upon the implant and procedure. The fixation device may also be used to attach sutures to the bone, such as in any of a variety of tissue suspension procedures.
  • For example, peripheral applications for the fixation devices include utilization of the device for fastening soft tissue such as capsule, tendon or ligament to bone. It may also be used to attach a synthetic material such as marlex mesh, to bone or allograft material such as tensor fascia lata, to bone. In the process of doing so, retention of the material to bone may be accomplished with the collar as shown, or the pin and or collar may be modified to accept a suture or other material for facilitation of this attachment.
  • Specific examples include attachment of the posterior tibial tendon to the navicular bone in the Kidner operation. This application may be accomplished using an appropriately sized implant of the present invention along with a washer with distally extending soft tissue spikes. Navicular-cuneiform arthrodesis may be performed utilizing the device and concurrent attachment of the tendon may be accomplished. Attachment of the tendon may be accomplished in the absence of arthrodesis by altering the placement of the implant in the adjacent bone.
  • Ligament or capsule reattachment after rupture, avulsion or detachment, such as in the ankle, shoulder or knee can also be accomplished using the devices disclosed herein.
  • The fixation devices can also be used to aid bone fusion between adjacent bones, bone fragments or any of a variety of articulating joints, such as, for example, a first and a second adjacent vertebral bodies of the spine.
  • The fixation devices may be used in combination with semi tubular, one-third tubular and dynamic compression plates, both of metallic and absorbable composition, if the collar is modified to match the opening on the plate.
  • The cannulated design disclosed below can be fashioned to accept an antibiotic impregnated rod for the slow adsorption of medication locally. This may be beneficial for prophylaxis, especially in open wounds, or when osteomyelitis is present and stabilization of fracture fragments is indicated.
  • A kit may be assembled for field use by military or sport medical or paramedical personnel. This kit contains an implanting tool, and a variety of implant device size and types. The kit may include additional components such as sterilization or disinfectant materials, a skin stapler, bandages, gloves, and basic tools for emergent wound and fracture treatment. Antibiotic rods may be included for wound prophylaxis during transport.
  • Referring to FIG. 1, there is illustrated a posterior side elevational view of the proximal portion of a femur 10, having a two fixation devices 12 positioned therein. The proximal end of the femur 10 comprises a head 14 connected by way of a neck 16 to the long body or shaft 17 of the femur 10. As illustrated in FIG. 1, the neck 16 is smaller in diameter than the head 14. The neck 16 and head 14 also lie on an axis which, on average in humans, crosses the longitudinal axis of the body 17 of the femur 10 at an angle of about 126°. The risk of fracture at the neck 16 is thus elevated, among other things, by the angular departure of the neck 16 from the longitudinal axis of the body 17 of femur 10 and also the reduced diameter of the neck 16 with respect to the head 14.
  • The greater trochanter 18 extends outwardly above the junction of the neck 16 and the body 17 of the femur 10. On the medial side of the greater trochanter 18 is the trochanteric fossa 20. This depression accommodates the insertion of the obturator extemus muscle. The lesser trochanter 21 is located posteromedially at the junction of the neck 16 and the body 17 of the femur 10. Both the greater trochanter 18 and the lesser trochanter 21 serve for the attachment of muscles. On the posterior surface of the femur 10 at about the same axial level as the lesser trochanter 21 is the gluteal tuberosity 22, for the insertion of the gluteus maximus muscle. Additional details of the femur are well understood in the art and not discussed in further detail herein.
  • FIG. 1 illustrates a subcapital femoral neck fracture 24. Fractures of the proximal portion of the femur 10 are generally classified as capital or subcapital femoral neck fractures, intertrochanteric fractures and subtrochanteric fractures. All of these fractures will be deemed femoral neck fractures for the purpose of describing the present invention.
  • Referring to FIGS. 1-4, the fixation device 12 comprises a body 28 extending between a proximal end 30 and a distal end 32. The length, diameter and construction materials of the body 28 can be varied, depending upon the intended clinical application. In embodiments optimized for various fractures in an adult human population, the body 28 will generally be within the range of from about 6 mm to about 150 mm in length after sizing, and within the range of from about 2 mm to about 12 mm in maximum diameter. The major diameter of the helical anchor, discussed below, may be within the range of from about 2.0 mm to about 15 mm. In general, the appropriate dimensions of the body 28 will vary, depending upon the specific fracture. In rough terms, for a malleolar fracture, shaft diameters in the range of from about 3 mm to about 4.5 mm may be used, and lengths within the range of from about 20 mm to about 70 mm. For condylar fractures, shaft diameters within the range of from about 3.5 mm to about 8.0 mm may be used with lengths within the range of from about 25 mm to about 70 mm. For colles fractures (distal radius and ulna), diameters within the range of from about 2.0 mm to about 4.5 mm may be used with any of a variety of lengths within the range of from about 6 mm to about 70 mm.
  • In one embodiment, the body 28 comprises titanium. However, as will be described in more detail below, other metals or bioabsorbable or nonabsorbable polymeric materials may be utilized, depending upon the dimensions and desired structural integrity of the finished fixation device 12.
  • The distal end 32 of the body 28 is provided with a cancellous bone anchor or distal cortical bone anchor 34. Additional details of the distal bone anchor are described below. In general, in a femoral neck application, distal bone anchor 34 is adapted to be rotationally inserted into the cancellous bone within the head 14 of the femur 10, to retain the fixation device 12 within the femoral head.
  • The proximal end 30 of the fixation device is provided with a proximal anchor 36. Proximal anchor 36 is axially distally moveable along the body 28, to permit compression of the fracture 24 as will be apparent from FIG. 1 and the description below. As will be explained below, complementary locking structures such as threads or ratchet like structures between the proximal anchor 36 and the body 28 resist proximal movement of the anchor 36 with respect to the body 28 under normal use conditions. The proximal anchor 36 can be axially advanced along the body 28 either with or without rotation, depending upon the complementary locking structures as will be apparent from the disclosure herein.
  • In the illustrated embodiment, proximal anchor 36 comprises a housing 38 such as a tubular body, for coaxial movement along the body 28. The housing 38 is provided with one or more surface structures 40 such as radially inwardly projecting teeth or flanges, for cooperating with complementary surface structures 42 on the body 28. The surface structures 40 and complementary surface structures 42 permit distal axial travel of the proximal anchor 36 with respect to the body 28, but resist proximal travel of the proximal anchor 36 with respect to the body 28. Any of a variety of complementary surface structures which permit one way ratchet like movement may be utilized, such as a plurality of annular rings or helical threads, ramped ratchet structures and the like for cooperating with an opposing ramped structure or pawl.
  • Retention structures 42 are spaced axially apart along the body 28, between a proximal limit 54 and a distal limit 56. The axial distance between proximal limit 54 and distal limit 56 is related to the desired axial working range of travel of the proximal anchor 36, and thus the range of functional sizes of the fixation device 12. In one embodiment of the fixation device 12, the retention structure 42 comprise a plurality of threads, adapted to cooperate with the retention structures 40 on the proximal anchor 36, which may be a complementary plurality of threads. In this embodiment, the proximal anchor 36 may be distally advanced along the body 28 by rotation of the proximal anchor 36 with respect to the body 28. Proximal anchor 36 may be advantageously removed from the body 28 by reverse rotation, such as to permit removal of the body 28 from the patient. In this embodiment, a flange 44 is preferably provided with a gripping structure to permit a removal tool to rotate the flange 44 with respect to the body 28. Any of a variety of gripping structures may be provided, such as one or more slots, flats, bores or the like. In one embodiment, the flange 44 is provided with a polygonal, and, in particular, a pentagonal or hexagonal circumference. See, e.g. FIG. 4A.
  • FIGS. 4A and 4B additionally illustrate a profile modification that can be made on any of the embodiments discussed herein. Referring to FIG. 4A, the retention structures 42 are positioned on a reduced diameter segment 31. The reduced diameter segment 31 is separated from the remainder of the body 28 by an annular shoulder 29. This construction allows the outside diameter of the tubular housing 38 to be approximately the same as the outside diameter of the distal portion of body 28. In this manner, a single diameter bore hole may be formed in the proximal bone segment, to receive both the body 28 and tubular housing 38 with minimal extra tolerance. Alternatively, as illustrated in FIG. 4B, the body 28 may have the same diameter throughout its axial length with the retention structures 42 formed thereon. In this embodiment, the outside diameter of proximal housing 38 will be larger than the outside diameter throughout the body 28.
  • Thus, the present invention provides a bone fixation device which can provide compression across a fracture throughout a range of motion following the placement of the distal anchor. The distal anchor may be positioned within the cancellous and/or distal cortical bone, and the proximal anchor may be distally advanced throughout a range to provide compression across the fracture without needing to relocate the distal anchor and without needing to initially locate the distal anchor in a precise position with respect to the proximal side of the bone. Providing a working range throughout which tensioning of the proximal anchor is independent from setting the distal anchor allows a single device to be useful for a wide variety of fractures, as well as eliminates the need for accurate device measurement and accurate placement of the distal anchor. In many applications, the working range is at least about 10% of the overall length of the device, and may be as much as 20% or 30% or more of the overall device length. In the context of a femoral application, working ranges of up to about 10 mm may be provided, since estimates within that range can normally be readily accomplished within the clinical setting. In other applications, such as a metatarsal fracture, a working range in the area of from about 1 mm to about 2 mm may be all that is necessary. The embodiments disclosed herein can be scaled to have a greater or a lesser working range, as will be apparent to those of skill in the art in view of the disclosure herein.
  • The proximal anchor 36 includes a flange 44 that seats against the outer surface of the femur or tissue adjacent the femur. The flange 44 is preferably an annular flange, to optimize the footprint or contact surface area between the flange 44 and the femur. Circular or polygonal shaped flanges for use in femoral head fixation will generally have a diameter of at least about 4 mm greater than the adjacent body 28 and often within the range of from about 4 mm to about 20 mm or more greater than the adjacent body 28. In a modified embodiment, the flange 44 can be curved to match the curved shape of the femur and further optimize the footprint or contact surface area between the flange 44 and the femur.
  • In the illustrated embodiment, the bone contacting surface 46 of the flange 44 resides in or approximately on a plane which is inclined with respect to the longitudinal axis of the body 28. Any of a variety of angular relationships between the bone contacting surface 46 of the flange 44 and the longitudinal axis of the body 28 and housing 38 may be utilized, depending upon the anticipated entrance angle of the body 28 and associated entrance point surface of the femur 10. In general, the longitudinal axis extending through the head 14 and neck 16 of the human femur is inclined at an angle of approximately 126° from the longitudinal axis of the long body 17 of the femur 10. Angles between the longitudinal axis of body 28 and tissue contacting surface 46 within the range of from about 90° to about 140° will generally be utilized, often within the range of from about 100° to about 120°, for fixed angle fixation devices. Perpendicular flanges (i.e., 90°) are illustrated in FIGS. 3A and 3B.
  • The clinician can be provided an array of proximal anchors 36 of varying angular relationships between the bone contacting surface 46 and the longitudinal axis of the body 28 and housing 38 (e.g., 90°, 100°, 110°, 120°, and 130°). A single body 28 can be associated with the array such as in a single sterile package. The clinician upon identifying the entrance angle of the body 28 and the associated entrance point surface orientation of the femur 10 can choose the anchor 36 from the array with the best fit angular relationship, for use with the body 28.
  • In accordance with an optional feature, illustrated in FIGS. 8 and 9, the flange 44 is angularly adjustable with respect to the longitudinal axis of the body 28. More specifically, in this embodiment, the tubular housing 38 is a separate component from the flange 44. The housing 38 and the flange 44 preferably include corresponding semi-spherical or radiused surfaces 45 a, and 45 b. The surface 45 b surrounds an aperture 49 in the flange 44. This arrangement allows the housing 38 to extend through and pivot with respect to the flange 44. As such, the angular relationship between the bone contacting surface 46 of the flange 44 and the longitudinal axis of the body 28 can vary in response to the entrance angle.
  • As an independent feature in FIGS. 8 and 9, the flange 44 is enlarged and includes one or two or more openings 47 for receiving one or two or more femoral shaft screws (not shown). The flange 44 may be elongated anatomically distally parallel to the axis of the femur, so that it functions simultaneously as a plate, as will be discussed in connection with FIG. 6.
  • With reference back to FIGS. 3 a and 3 b, the proximal end 30 of the body 28 is preferably additionally provided with rotational coupling 48, for allowing the body 28 to be rotationally coupled to a driving device. Any of a variety of driving devices may be utilized, such as electric drills or hand tools which allow the clinician to manually rotate the cancellous bone anchor 34 into the head of the femur. Thus, the rotational coupling 48 may have any of a variety of cross sectional configurations, such as one or more flats or splines.
  • In one embodiment, the rotational coupling 48 comprises a proximal projection of the body 28 having a polygonal cross section, such as a hexagonal cross section. The rotational coupling 48 is illustrated as a male component, machined or milled or attached to the proximal end 30 of the body 28. However, the rotational coupling may also be in the form of a female element, such as a hexagonal or other noncircular cross sectioned lumen extending throughout a proximal portion or the entire length of the body 28. Although illustrated as solid throughout, the body 28 may be cannulated to accommodate installation over a placement wire as is understood in the art. The cross section of the central cannulation can be made non circular, e.g., hexagonal, to accommodate a corresponding male tool for installation or removal of the device regardless of the location of the proximal break point, as will be discussed.
  • The body 28 may be provided with at least one and preferably two or three or more break points 50 spaced axially apart along the proximal portion of the body 28. Break points 50 comprise a weakened transverse plane through the body 28, which facilitate severing of the proximal portion of the body 28 following proper tensioning of the proximal anchor 36. Break point 50 may be constructed in any of a variety of ways, such as by machining or milling an annular recess into the exterior wall of the body 28, or created one or more transverse perforations through the body 28 such as by mechanical, laser, or EDM drilling.
  • The body 28 may also be provided with at least one and preferably two or three or moregraduation markings axially spaced along the proximal portion of the body 28. Such graduation markings can be used to indicate how far the body 28 has been inserted into the bone. Such graduation markings may include indicia indicating the distance (e.g., in millimeters or inches) from the proximal surface of the bone to the distal tip of the distal bone anchor 34.
  • In all of the embodiments illustrated herein, the distal anchor 34 comprises a helical locking structure 60 for engaging cancellous and/or distal cortical bone. In the illustrated embodiment, the locking structure 60 comprises a flange that is be wrapped around a central core 62 or an axial lumen, as discussed below. The central core 62 or axial lumen defines a minor diameter of the helical locking structure 60. In a similar manner, the outer edge of the helical flange 60 defines a major diameter or outer boundary of the helical locking structure 60. The flange extends through at least one and generally from about two to about 50 or more full revolutions depending upon the axial length of the distal anchor and intended application. For most femoral neck fixation devices, the flange will generally complete from about 2 to about 20 revolutions. The helical flange 60 is preferably provided with a pitch and an axial spacing to optimize the retention force within cancellous bone, to optimize compression of the fracture.
  • The helical flange 60 of the embodiment illustrated in FIG. 1 is shaped generally like a flat blade or radially extended screw thread. However, it should be appreciated that the helical flange 60 can have any of a variety of cross sectional shapes, such as rectangular, triangular or other as deemed desirable for a particular application through routine experimentation in view of the disclosure herein. The ratio of the major diameter to the minor diameter can be optimized with respect to the desired retention force within the cancellous bone and giving due consideration to the structural integrity and strength of the distal anchor 34. Another aspect of the distal anchor 34 that can be optimized is the shape of the major and minor diameters, which in the illustrated embodiment are generally cylindrical with a tapered distal end 32.
  • The distal end 32 and/or the outer edges of the helical flange 60 may be atraumatic (e.g., blunt or soft). This inhibits the tendency of the fixation device 12 to migrate anatomically proximally towards the hip joint bearing surface after implantation (i.e., femoral head cut-out). Distal migration is also inhibited by the dimensions and presence of the proximal anchor 36, which has a larger footprint than conventional screws.
  • Referring to FIGS. 2 and 3B, a variation of the distal anchor 34 is illustrated. The distal anchor 34 comprises an elongated helical locking structure 60 that is spirally wrapped about an axial lumen through at least one and preferably from about two to about 20 or more full revolutions. The axial lumen defines a minor diameter that is generally cylindrical. As with the previous embodiment, the elongated body 60 is provided with a pitch and an axial spacing to optimize the retention force within cancellous bone, which optimizes compression of the fracture. The tip 72 of the elongated body 60 may be pointed. Although not illustrated, this variation is particularly suited for a canulated fixation device 12. That is, a design wherein a central lumen extends through the body 28 and the distal anchor 34.
  • FIG. 5 is an axial cross sectional view through a distal anchor of the type illustrated in FIGS. 2 and 3B. FIG. 5 also illustrates the cross-section of the helical flange which forms the spiral locking structure. The cross-section has a width w, and a height h. Through routine experimentation, the shape, the width w and height h of the elongated body can be varied to optimize the retention force within cancellous bone. When w is approximately equal to h, the cross section can be circular, square or faceted. In general, w and h are within the range of from about 1 mm to about 8 mm for use in the femoral neck application.
  • With reference to FIG. 3C, another variation of the distal anchor 34 is illustrated. In this arrangement, the distal anchor 34 forms a double helix comprising two elongated structures 360, 362 spirally wrapped around an axial lumen through at least one and preferably from about 2 to about 20 or more full revolutions. As with the previous embodiments, the shape, the width w and height h of the elongated bodies 360, 362 along with pitch and an axial spacing can be optimized through routine experimentation to optimize the retention force within cancellous bone, which optimizes compression of the fracture. The diameter of the axial lumen can also be optimized. The tip 364 of helical flanges 360, 362 may be tapered or pointed to permit easier insertion through self-tapping and self-drilling. The double helix design may be incorporated into any of the designs disclosed elsewhere herein. In one embodiment for use in the femoral neck, the elongated structures 360, 362 have a generally rectangular cross sectional shape with a height and width within the range of about 1.0-4.0 millimeters. In such an embodiment, the major diameter is in the range of about 4.0-15 millimeters, the minor diameter is in the range of about 2.0-8.0 millimeters, and the pitch is in the range of from about 3 to about 12 threads per inch.
  • With reference to FIG. 3D, yet another variation of the distal anchor 34 is illustrated. In this embodiment, the anchor 34 comprises a helical flange 370 having a generally “V” shaped cross-section. The illustrated flange 370 has sides angled at about 60-degrees, forming two load bearing surfaces 372, 374 and a blunted outer edge 376. The proximally facing surface 372 carries the axial load to resist pullout. In this embodiment of the helical flange 370, the minor diameter is approximately equal to zero. Such an arrangement advantageously leaves more bone in place when the distal anchor 34 is inserted into the distal bone fragment such as a portion of the femur 10. However, it should be appreciated that in a modified arrangement the minor diameter can be increased giving due consideration to the balance between the desired retention force within the cancellous bone and the structural integrity and strength of the distal anchor 34. The angle between the two surfaces 372, 374 along with the pitch and axial spacing of the helical flange 370 are selected to optimize the retention force within cancellous bone, to optimize compression of the fracture.
  • Still yet another variation of the distal anchor 34 is illustrated in FIG. 3E. In this variation, the distal anchor 34 comprises a helical flange 380 having a buttress thread design. That is, the flange 380 has a generally rectangular cross-section, and extends radially outwardly and in some embodiments is inclined proximally to form a proximally concave spiral. This arrangement enhances the pullout strength of the distal anchor 34 because the bearing surfaces 382, 384 of the flange 380 lie generally perpendicular to the load direction. As with the previous arrangement, the helical flange 380 has a minor diameter that is approximately equal to zero. However, it should be appreciated that in a modified arrangement the minor diameter can be increased minor diameter can increased giving due consideration to the balance between the desired retention force within the cancellous bone and the structural integrity and strength of the distal anchor 34. As with the previous embodiments, the pitch and axial spacing can also be optimized to enhance the retention force within cancellous bone and to optimize compression across the fracture.
  • Referring to FIGS. 3F and 3G, additional variations of distal anchor 34 are illustrated. With initial reference to FIG. 3F, the distal anchor 34 comprises at least three helical threads or flanges 390, 392, 394 spirally wrapped around a generally cylindrical central core 395, which in the illustrated arrangement also defines the wall of an axial lumen 397 that can extend through the body 28. The major diameter of the distal anchor 34 is generally cylindrical. The leading tips 396 of the helical flanges 390, 392, 394 may be sharpened so as to aid the screw in being self tapping and/or self drilling. In this arrangement, the helical flanges 390, 392, 394 can be provided with a lower pitch as compared to the arrangement described above. Moreover, as compared to the previous arrangements, this arrangement requires less turns to insert the distal anchor 34 any given axial distance.
  • For example, in an embodiment for use in the femoral neck, the pitch of the helical flanges 390, 392, 394 may be within the range of from about 2 to about 12 threads per inch. The distal anchor 34 therefore requires fewer turns during insertion to achieve the same axial travel as a single helix thread having a greater pitch. In addition, this arrangement leaves more of the bone intact. In a modified arrangement, the distal anchor can include two or four helical flanges such as flanges 390, 392, 394. The number, pitch and axial spacing of the helical flanges can be optimized through routine experimentation in light of the disclosure herein. In one dual helical flange embodiment, the minor diameter is about 4.5 millimeters, the major diameter is about 7.0 millimeters and the pitch is about 5.5 threads per inch.
  • In FIG. 3G, the distal anchor 34 comprises split triple helix distal anchor design that is similar to the arrangement described above. However, in this arrangement, one of the helical flanges is cut through to the axial lumen 397 that is defined by the central core 395. As such, three flanges 400, 402, 403 remain wrapped around the central core 395. As compared to the previous arrangement, this arrangement leaves more bone intact. As with the previous embodiments, the pitch and axial spacing can be optimized through routine experimentation. A split double helix, with two flanges or threads may also be provided.
  • FIGS. 3H and 3I illustrate more variations of the distal anchor 34. In FIG. 3H, the distal anchor 34 comprises a generally V-shaped flange 410 that is wrapped around a central core 412 that also defines a central lumen 413, which can extend through the body 28. The major diameter of the V-shaped flange 410 is generally cylindrical. In contrast, the minor diameter of the central core tapers in the distal direction. As such, in the illustrated arrangement, the central core disappears into the generally cylindrical central lumen 413 at a point in between the proximal and distal ends of the threads, and, in the illustrated embodiment, at approximately the longitudinal center 414 of the distal anchor 34. This arrangement strengthens the proximal portion 416 of the distal anchor 34, where stretching and fatigue may be most likely to occur on pullout. It is anticipated that the shape of the flange 410 along with the pitch, axial spacing and the taper of the central core can be optimized through routine experimentation given the disclosure herein.
  • In FIG. 3I, the distal anchor 34 also comprises a V-shaped helical flange 420 that is wrapped around an axial lumen. In this arrangement, both the major and minor diameters taper from the proximal end 422 of the anchor 34 to the distal end 424. At the distal end 424, the minor diameter is approximately equal to zero. In this arrangement, the distal end 424 of tapered distal anchor 34 can provide for self tapping while the proximal end 422 of the anchor 34 provides for self drilling. As with the previous embodiments, the shape, pitch, axial spacing of the helical flange 430 and the taper of the major and minor diameters can be further optimized through routine experimentation. In a modified arrangement, the helical flange 430 can be wrapped around a central core that tapers from the proximal end 422 to the distal end 424.
  • In any of the embodiments herein, an anti-rotation lock may be provided between the distal anchor and the proximal collar or plate, such as a spline or other interfit structure to prevent relative rotation of the proximal and distal ends of the device following implantation.
  • In use, the clinician first identifies a patient having a fracture to be treated, such as a femoral neck fracture, which is fixable by an internal fixation device. The clinician accesses the proximal femur, reduces the fracture if necessary and selects a bone drill and drills a hole 80 in accordance with conventional techniques. In the example of a femoral neck fracture, three holes and fixation devices will often be used as has been discussed. Preferably, the hole 80 has a diameter within the range from about 3 mm to about 8 mm. This diameter may be slightly larger than the diameter of the distal anchor 34. The hole 80 preferably extends up to or slightly beyond the fracture 24.
  • A fixation device 12 having an axial length and outside diameter suitable for the hole 80 is selected. The distal end 32 of the fixation device 12 is advanced distally into the hole 80 until the distal anchor 34 reaches the distal end of the hole 80. The proximal anchor 36 may be carried by the fixation device 12 prior to advancing the body 28 into the hole 80, or may be attached following placement of the body 28 within the hole 80. Once the body 28 is in place, the clinician may use any of a variety of driving devices, such as electric drills or hand tools to rotate the cancellous bone anchor 34 into the head of the femur.
  • While proximal traction is applied to the proximal end 30 of body 28, such as by conventional hemostats, pliers or a calibrated loading device, the proximal anchor 36 is advanced distally until the anchor 36 fits snugly against the outer surface of the femur or tissue adjacent the femur. Appropriate compression of the fixation device 12 across the fracture is accomplished by tactile feedback or through the use of a calibration device for applying a predetermined load on the implantation device. One advantage of the structure of the present invention is the ability to adjust compression independently of the setting of the distal anchor 34.
  • Following appropriate tensioning of the proximal anchor 36, the proximal extension 30 of the body 28 is preferably cut off, snapped off, unscrewed or otherwise removed. Body 28 may be cut using conventional saws, cutters or bone forceps which are routinely available in the clinical setting. Alternatively, the fixation device can be selected such that it is sized to length upon tensioning, so that no proximal projection remains.
  • Following removal of the proximal end 30 of body 28, the access site may be closed and dressed in accordance with conventional wound closure techniques.
  • With reference to FIG. 2, in one arrangement, the proximal anchor 36 can include one or more barbs 41 extending radially outwardly from the tubular housing 28. The barbs 41 may be radially symmetrically distributed about the longitudinal axis of the tubular housing 38. Each barb 41 is provided with a transverse engagement surface 43, for anchoring the proximal anchor 36 in the bone. The transverse engagement surface 43 may lie on a plane which is transverse to the longitudinal axis of the tubular housing 38 or may be inclined with respect to the longitudinal axis of the tubular housing 38. In either arrangement, the transverse engagement surface 43 generally faces the bone contacting surface 46 of the flange 44. As such, the transverse engagement surface 43 inhibits proximal movement of the proximal anchor 36 with respect to the bone.
  • The barbs 41 allow the bone fixation device to capture “secondary compression” of the fracture. As explained above, the bone fixation device can be used to provide an initial compression across the fracture when the proximal anchor 36 is appropriately tensioned. However, as the patient applies weight or stress to the bone post procedure, the fracture typically undergoes secondary compression, which further compresses the fracture. During such secondary compression, the barbs 41 prevent proximal movement of the proximal anchor 36 with respect to the bone. The ratchet- type structures 40, 42 of the proximal anchor 36 and the body 28 allow the proximal anchor 36 to move distally along the body 28. Thus, any slack caused by the secondary compression is taken up by the proximal anchor 36 as the retention structures 40, 42 prevent proximal movement of the proximal anchor 36 with respect to the body 29. This device is therefore self tightening after it has been implanted in the patient.
  • Preferably, the clinician will have access to an array of fixation devices 12, having, for example, different diameters, axial lengths and angular relationships. These may be packaged one per package in sterile envelopes or peelable pouches, or in dispensing cartridges which may each hold a plurality of devices 12. Upon encountering a fracture for which the use of a fixation device is deemed appropriate, the clinician will assess the dimensions and load requirements, and select a fixation device from the array which meets the desired specifications.
  • In some types of fractures such as a femoral neck fracture, a clinician may want to introduce two or three or more fixation devices 12 into the femoral head 14 to secure the fracture 24. This may be desirable if the clinician determines that, based upon the nature of the fracture 24; there is a possibility that the head 14 of the femur 10 could rotate about a single fixation device 12. Even minor rotation can inhibit the healing of the fracture. Significant rotation can result in failure of the fixation device or necrosis of the femoral head. Two fixation devices 12 may also be desirable where the direction of the fracture is generally parallel to the axis of implantation as is understood in the art.
  • Referring to FIG. 6, there is disclosed a variation of the proximal anchor 36 in which the proximal anchor 36 is integrally formed with or attached to a plate. The fixation device 12 in FIG. 6 may otherwise be identical to the embodiments previously discussed. The proximal anchor 90 comprises an elongated flange 92, which extends from the housing 93 longitudinally down (anatomically caudad or distally) the body 17 of the femur 10. The elongated flange 92 preferably includes one or more openings 94 for receiving one or more femoral shaft screws 96. The flange 92 may or may not extend above (anatomically proximal to) the housing 93. Elimination of a proximal flange may more easily permit rotational removal of the proximal anchor 36 from the body 28 by reverse rotation in an inclined flange embodiment.
  • Referring to FIG. 6A, there is illustrated a cross sectional schematic view of an integral proximal anchor 36 and proximal plate. The dimensions and orientation of the proximal anchor 36 may be varied widely, depending upon the intended application. For example, a longitudinal axis of the housing 93 may be inclined or perpendicular with respect to the plane of flange 92. The flange 92 may have any of a variety of dimensions and profiles, depending upon the intended application. Lengths of the plate 92 in the vertical direction as illustrated on FIG. 6A, for use in femoral neck fixation fractures, may range from at least about 0.5 inches to about 10 inches or more. The plate 92 may be planar as illustrated, particularly in small plate embodiments, or may be curved or contoured to improve seating of the plate 92 against the adjacent bone. Plate 92 may be provided with one or more apertures for receiving bone screws or other fixation devices as illustrated in FIGS. 6 and 7A.
  • Referring to FIG. 7A, the fixation device 12 is schematically illustrated in combination with a conventional plate 100. The fixation device 12 in FIG. 7A may be identical to the embodiments described elsewhere herein. The fixation device 12 is used with an elongated side support or plate 100, which extends longitudinally above and below the hole 80. The elongated side plate 100 includes an opening 102 that preferably has a diameter that is slightly larger than the diameter of the housing 38. The elongated side plate 100 preferably also includes one or more openings 104 for receiving one or more femoral shaft screws 106. Advantageously, the elongated side plate 100 spreads the forces exerted by the flange 44 across a larger area of the femur 17, and affects the distribution of load. In an alternate embodiment, the elongated side plate can 100 include one or more openings above the housing 38 for receiving trochanteric anchor screws (not shown).
  • A contoured side plate 100 is illustrated in FIG. 7B. The proximal anchor 36 is also formed with a tapered (e.g. conical or concave outwardly) bone or plate contacting surface on flange 44.
  • The fixation device 12 of the present invention may also be used in combination with intramedullary nails or rods 101 as schematically illustrated in FIG. 7C, as will be understood by those of skill in the art.
  • The fixation device 12 of the present invention may be used in any of a wide variety of anatomical settings beside the proximal femur, as has been discussed. For example, lateral and medial malleolar fractures can be readily fixed using the device of the present invention. Referring to FIG. 10, there is illustrated an anterior view of the distal fibula 120 and tibia 122. The fibula 120 terminates distally in the lateral malleolus 124, and the tibia 122 terminates distally in the medial malleolus 126.
  • A fixation device 12 in accordance with the present invention is illustrated as extending through the lateral malleolus 124 across the lateral malleolar fracture 128 and into the fibula 120. Fixation device 12 includes a distal anchor 34 for fixation within the fibula 120, an elongate body 28 and a proximal anchor 36 as has been discussed.
  • FIG. 10 also illustrates a fixation device 12 extending through the medial malleolus 126, across a medial malleolar fracture 130, and into the tibia 122. Although FIG. 10 illustrates fixation of both a lateral malleolar fracture 128 and medial malleolar fracture 130, either fracture can occur without the other as is well understood in the art. Installation of the fixation devices across malleolar fractures is accomplished utilizing the same basic steps discussed above in connection with the fixation of femoral neck fractures.
  • The fixation devices of the present invention may be made from either conventional bioabsorbable materials or conventional non-absorbable materials, combinations thereof and equivalents thereof. In addition, natural materials such as allografts may be used. Examples of absorbable materials include homopolymers and copolymers of lactide, glycolide, trimethylene carbonate, caprolactone, and p-dioxanone and blends thereof. The following two blends may be useful:
      • (1) the blend of poly(p-dioxanone) and a lactide/glycolide copolymer, as disclosed in U.S. Pat. No. 4,646,741 which is incorporated by reference.
      • (2) the glycolide-rich blend of two or more polymers, one polymer being a high lactide content polymer, and the other being a high glycolide content disclosed in U.S. Pat. No. 4,889,119 which is incorporated by reference.
  • Additional bioabsorbable materials are disclosed in copending application Ser. No. 09/558,057 filed Apr. 26, 2000, the disclosure of which is incorporated in its entirety herein by reference.
  • The fixation devices may also be made from conventional non-absorbable, biocompatible materials including stainless steel, titanium, alloys thereof, polymers, composites and the like and equivalents thereof. In one embodiment, the distal anchor comprises a metal helix, while the body and the proximal anchor comprise a bioabsorbable material. Alternatively, the distal anchor comprises a bioabsorbable material, and the body and proximal anchor comprise either a bioabsorbable material or a non-absorbable material. As a further alternative, each of the distal anchor and the body comprise a non-absorbable material, connected by an absorbable link. This may be accomplished by providing a concentric fit between the distal anchor and the body, with a transverse absorbable pin extending therethrough. This embodiment will enable removal of the body following dissipation of the pin, while leaving the distal anchor within the bone.
  • The components of the invention (or a polymeric coating layer on part or all of the anchor surface), may contain one or more bioactive substances, such as antibiotics, chemotherapeutic substances, angiogenic growth factors, substances for accelerating the healing of the wound, growth hormones, antithrombogenic agents, bone growth accelerators or agents, and the like. Such bioactive implants may be desirable because they contribute to the healing of the injury in addition to providing mechanical support.
  • In addition, the components may be provided with any of a variety of structural modifications to accomplish various objectives, such as osteoincorporation, or more rapid or uniform absorption into the body. For example, osteoincorporation may be enhanced by providing a micropitted or otherwise textured surface on the components. Alternatively, capillary pathways may be provided throughout the body and collar, such as by manufacturing the anchor and body from an open cell foam material, which produces tortuous pathways through the device. This construction increases the surface area of the device which is exposed to body fluids, thereby generally increasing the absorption rate in a bioabsorbable construction. Capillary pathways may alternatively be provided by laser drilling or other technique, which will be understood by those of skill in the art in view of the disclosure herein. In general, the extent to which the anchor can be permeated by capillary pathways or open cell foam passageways may be determined by balancing the desired structural integrity of the device with the desired reabsorption time, taking into account the particular strength and absorption characteristics of the desired polymer.
  • One open cell bioabsorbable material is described in U.S. Pat. No. 6,005,161 as a poly(hydroxy) acid in the form of an interconnecting, open-cell meshwork which duplicates the architecture of human cancellous bone from the iliac crest and possesses physical property (strength) values in excess of those demonstrated by human (mammalian) iliac crest cancellous bone. The gross structure is said to maintain physical property values at least equal to those of human, iliac crest, cancellous bone for a minimum of 90 days following implantation. The disclosure of U.S. Pat. No. 6,005,161 is incorporated by reference in its entirety herein.
  • The components of the present invention may be sterilized by any of the well known sterilization techniques, depending on the type of material. Suitable sterilization techniques include heat sterilization, radiation sterilization, such as cobalt 60 irradiation or electron beams, ethylene oxide sterilization, and the like.
  • The specific dimensions of any of the bone fixation devices of the present invention can be readily varied depending upon the intended application, as will be apparent to those of skill in the art in view of the disclosure herein. Moreover, although the present invention has been described in terms of certain preferred embodiments, other embodiments of the invention including variations in dimensions, configuration and materials will be apparent to those of skill in the art in view of the disclosure herein. In addition, all features discussed in connection with any one embodiment herein can be readily adapted for use in other embodiments herein. The use of different terms or reference numerals for similar features in different embodiments does not imply differences other than those which may be expressly set forth. Accordingly, the present invention is intended to be described solely by reference to the appended claims, and not limited to the preferred embodiments disclosed herein.

Claims (52)

1. A femoral neck fracture fixation device, comprising:
an elongate body, having a proximal end and a distal end;
a helical anchor on the distal end, the helical anchor being wrapped about a minor diameter and an outer edge of the helical anchor defining an outer boundary;
a first retention structure on the body, proximal to the anchor; and
a proximal anchor, moveably carried by the body,
wherein the proximal anchor is movable in the distal direction with respect to the body and the retention structure resists proximal movement of the proximal anchor with respect to the body.
2. A femoral neck fracture fixation device as in claim 1, wherein the helical flange is wrapped about a central core.
3. A femoral neck fracture fixation device as in claim 2, wherein the outer boundary and the minor diameter are generally cylindrical.
4. A femoral neck fracture fixation device as in claim 3, wherein the minor diameter tapers distally.
5. A femoral neck fracture fixation device as in claim 3, wherein at a distal end of the distal anchor the outer boundary tapers.
6. A femoral neck fracture fixation device as in claim 3, wherein the helical flange is a generally flat blade.
7. A femoral neck fracture fixation device as in claim 1, wherein the helical flange comprises at least a first flange, and a second flange.
8. A femoral neck fracture fixation device as in claim 8, wherein the outer boundary and the minor diameter are generally cylindrical.
9. A femoral neck fracture fixation device as in claim 2, wherein the central core includes an axial lumen.
10. A femoral neck fracture fixation device as in claim 9, wherein the helical flange comprises at least a first flange, a second flange, and a third flange.
11. A femoral neck fracture fixation device as in claim 10, wherein the outer boundary and the minor diameter are generally cylindrical.
12. A femoral neck fracture fixation device as in claim 10, wherein at least the third flange is removed so as to expose the axial lumen.
13. A femoral neck fracture fixation device as in claim 12, wherein the outer boundary and the minor diameter are generally cylindrical.
14. A femoral neck fracture fixation device as in claim 9, wherein the central core tapers in a distal direction so as to expose the axial lumen.
15. A femoral neck fracture fixation device as in claim 14, wherein the axial lumen is exposed at approximately a longitudinal center of the distal anchor.
16. A femoral neck fracture fixation device as in claim 1, wherein the helical flange is wrapped about an axial lumen.
17. A femoral neck fracture fixation device as in claim 16, wherein the outer boundary and the minor diameter have a generally cylindrical shape.
18. A femoral neck fracture fixation device as in claim 17, wherein the helical flanges comprises at least a first flange and a second flange spirally wrapped about the axial lumen.
19. A femoral neck fracture fixation device as in claim 18, wherein the first and second flange include sharpened tips.
20. A femoral neck fracture fixation device as in claim 9, wherein minor diameter tapers in a distal direction.
21. A femoral neck fracture fixation device as in claim 20, wherein at a distal end of the distal anchor the minor diameter is approximately equal to zero.
22. A femoral neck fracture fixation device as in claim 20, wherein the outer boundary also tapers in a distal direction.
23. A femoral neck fracture fixation device as in claim 1, wherein the minor diameter is approximately equal to zero.
24. A femoral neck fracture fixation device as in claim 23, wherein the helical flange has a generally V-shaped cross-section.
25. A femoral neck fracture fixation device as in claim 23, wherein the helical flange has a generally rectangular cross-section.
26. A bone fracture fixation device, comprising:
an elongate body having a proximal end and a distal end;
a cancellous bone anchor on the distal end; the cancellous bone anchor comprising a helical flange wrapped about a central core or axial lumen, an outer edge of the helical anchor defining an outer boundary and the central core or axial lumen defining a minor diameter;
a proximal anchor axially movably carried on the body; and
complimentary surface structures in between the body and the proximal anchor that permit advancing the proximal anchor in the distal direction to tighten the fixation device but that resist axial proximal movement of the proximal anchor.
27. A femoral neck fracture fixation device as in claim 26, wherein the helical flange is wrapped about a central core.
28. A femoral neck fracture fixation device as in claim 27, wherein the outer boundary and the minor diameter are generally cylindrical.
29. A femoral neck fracture fixation device as in claim 28, wherein at a distal end of the distal anchor the minor diameter tapers.
30. A femoral neck fracture fixation device as in claim 28, wherein at a distal end of the distal anchor the outer boundary tapers.
31. A femoral neck fracture fixation device as in claim 28, wherein the helical flange is a generally flat blade.
32. A femoral neck fracture fixation device as in claim 27, wherein the helical flange comprises at least a first flange and a second flange.
33. A femoral neck fracture fixation device as in claim 32, wherein the outer boundary and the minor diameter are generally cylindrical.
34. A femoral neck fracture fixation device as in claim 27, wherein the central core defines an axial lumen.
35. A femoral neck fracture fixation device as in claim 34, wherein the helical flange comprises at least a first flange, a second flange, and a third flange.
36. A femoral neck fracture fixation device as in claim 35, wherein the outer boundary and the minor diameter are generally cylindrical.
37. A femoral neck fracture fixation device as in claim 35, wherein at least the third flange is removed so as to expose the axial lumen.
38. A femoral neck fracture fixation device as in claim 37, wherein the outer boundary and the minor diameter are generally cylindrical.
39. A femoral neck fracture fixation device as in claim 34, wherein the central core tapers in a distal direction so as to expose the axial lumen.
40. A femoral neck fracture fixation device as in claim 39, wherein the axial lumen is exposed at approximately a longitudinal center of the distal anchor.
41. A femoral neck fracture fixation device as in claim 26, wherein the helical flange is wrapped about an axial lumen.
42. A femoral neck fracture fixation device as in claim 41, wherein the outer boundary and the minor diameter have a generally cylindrical shape.
43. A femoral neck fracture fixation device as in claim 42, wherein the helical flanges comprises at least a first flange and a second flange spirally wrapped about the axial lumen.
44. A femoral neck fracture fixation device as in claim 43, wherein the first and second flange include sharpened tips.
45. A femoral neck fracture fixation device as in claim 34, wherein minor diameter tapers in a distal direction.
46. A femoral neck fracture fixation device as in claim 45, wherein at a distal end of the distal anchor the minor diameter is approximately equal to zero.
47. A femoral neck fracture fixation device as in claim 45, wherein the outer boundary also tapers in a distal direction.
48. A femoral neck fracture fixation device as in claim 26, wherein the minor diameter is approximately equal to zero.
49. A femoral neck fracture fixation device as in claim 48, wherein the helical flange has a generally V-shaped cross-section.
50. A femoral neck fracture fixation device as in claim 48, wherein the helical flange has a generally rectangular cross-section.
51. A bone fracture fixation device, comprising:
an elongate body, having a proximal end and a distal end;
a helical anchor on the distal end,
a first retention structure on the body, proximal to the anchor; and
a proximal anchor, moveably carried by the body and having a tubular housing, the tubular housing having at least one barb extending radially outwardly from the tubular housing and defining an engagement surface that lies within a plane that is transverse to a longitudinal axis of the tubular housing,
wherein the proximal anchor is movable in the distal direction with respect to the body and the retention structure resists proximal movement of the proximal anchor with respect to the body.
52. A bone fracture fixation device as in claim 51, wherein the proximal anchor includes a flange, which defines a bone contacting surface that generally faces the engagement surface.
US11/156,932 2001-03-30 2005-06-20 Distal bone anchors for bone fixation with secondary compression Abandoned US20050251142A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
US11/156,932 US20050251142A1 (en) 2001-03-30 2005-06-20 Distal bone anchors for bone fixation with secondary compression

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US09/822,803 US6511481B2 (en) 2001-03-30 2001-03-30 Method and apparatus for fixation of proximal femoral fractures
US10/012,687 US6908465B2 (en) 2001-03-30 2001-11-13 Distal bone anchors for bone fixation with secondary compression
US11/156,932 US20050251142A1 (en) 2001-03-30 2005-06-20 Distal bone anchors for bone fixation with secondary compression

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
US10/012,687 Division US6908465B2 (en) 2001-03-30 2001-11-13 Distal bone anchors for bone fixation with secondary compression

Publications (1)

Publication Number Publication Date
US20050251142A1 true US20050251142A1 (en) 2005-11-10

Family

ID=25237023

Family Applications (9)

Application Number Title Priority Date Filing Date
US09/822,803 Expired - Lifetime US6511481B2 (en) 2001-03-30 2001-03-30 Method and apparatus for fixation of proximal femoral fractures
US10/012,687 Expired - Lifetime US6908465B2 (en) 2001-03-30 2001-11-13 Distal bone anchors for bone fixation with secondary compression
US09/991,367 Expired - Lifetime US6890333B2 (en) 2001-03-30 2001-11-13 Method and apparatus for bone fixation with secondary compression
US10/830,631 Expired - Lifetime US7556629B2 (en) 2001-03-30 2004-04-23 Method and apparatus for bone fixation with secondary compression
US11/050,975 Abandoned US20050137595A1 (en) 2001-03-30 2005-02-04 Method and apparatus for spinal fusion
US11/156,932 Abandoned US20050251142A1 (en) 2001-03-30 2005-06-20 Distal bone anchors for bone fixation with secondary compression
US12/267,460 Abandoned US20090069813A1 (en) 2001-03-30 2008-11-07 Method and apparatus for bone fixation with secondary compression
US13/466,350 Expired - Fee Related US8551094B2 (en) 2001-03-30 2012-05-08 Distal bone anchors for bone fixation with secondary compression
US14/023,192 Expired - Fee Related US10111695B2 (en) 2001-03-30 2013-09-10 Distal bone anchors for bone fixation with secondary compression

Family Applications Before (5)

Application Number Title Priority Date Filing Date
US09/822,803 Expired - Lifetime US6511481B2 (en) 2001-03-30 2001-03-30 Method and apparatus for fixation of proximal femoral fractures
US10/012,687 Expired - Lifetime US6908465B2 (en) 2001-03-30 2001-11-13 Distal bone anchors for bone fixation with secondary compression
US09/991,367 Expired - Lifetime US6890333B2 (en) 2001-03-30 2001-11-13 Method and apparatus for bone fixation with secondary compression
US10/830,631 Expired - Lifetime US7556629B2 (en) 2001-03-30 2004-04-23 Method and apparatus for bone fixation with secondary compression
US11/050,975 Abandoned US20050137595A1 (en) 2001-03-30 2005-02-04 Method and apparatus for spinal fusion

Family Applications After (3)

Application Number Title Priority Date Filing Date
US12/267,460 Abandoned US20090069813A1 (en) 2001-03-30 2008-11-07 Method and apparatus for bone fixation with secondary compression
US13/466,350 Expired - Fee Related US8551094B2 (en) 2001-03-30 2012-05-08 Distal bone anchors for bone fixation with secondary compression
US14/023,192 Expired - Fee Related US10111695B2 (en) 2001-03-30 2013-09-10 Distal bone anchors for bone fixation with secondary compression

Country Status (6)

Country Link
US (9) US6511481B2 (en)
EP (1) EP2055252A1 (en)
KR (1) KR100876815B1 (en)
AT (1) ATE432051T1 (en)
DE (1) DE60232440D1 (en)
ES (1) ES2324524T3 (en)

Cited By (46)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060039772A1 (en) * 2003-02-12 2006-02-23 Romano Matthys-Mark Screw with integrated screwdriver
US20060122610A1 (en) * 2004-12-08 2006-06-08 Culbert Brad S Method and apparatus for spinal stabilization
US20060122609A1 (en) * 2004-12-08 2006-06-08 Srdjan Mirkovic Method and apparatus for spinal stabilization
US20080108996A1 (en) * 2001-08-23 2008-05-08 Interventional Spine, Inc. Deployment tool for distal bone anchors with secondary compression
US7824429B2 (en) 2002-07-19 2010-11-02 Interventional Spine, Inc. Method and apparatus for spinal fixation
US20110184471A1 (en) * 2010-01-28 2011-07-28 Warsaw Orthopedic, Inc. Bone anchor with predetermined break point and removal features
US7998176B2 (en) 2007-06-08 2011-08-16 Interventional Spine, Inc. Method and apparatus for spinal stabilization
WO2011060082A3 (en) * 2009-11-10 2011-09-29 Smith & Nephew, Inc. Controlling bone compression
US8398636B2 (en) 2007-04-19 2013-03-19 Stryker Trauma Gmbh Hip fracture device with barrel and end cap for load control
US8715284B2 (en) 2001-03-30 2014-05-06 Interventional Spine, Inc. Method and apparatus for bone fixation with secondary compression
US8734494B2 (en) 2007-04-19 2014-05-27 Stryker Trauma Gmbh Hip fracture device with static locking mechanism allowing compression
US8906022B2 (en) 2010-03-08 2014-12-09 Conventus Orthopaedics, Inc. Apparatus and methods for securing a bone implant
US8961518B2 (en) 2010-01-20 2015-02-24 Conventus Orthopaedics, Inc. Apparatus and methods for bone access and cavity preparation
US9517093B2 (en) 2008-01-14 2016-12-13 Conventus Orthopaedics, Inc. Apparatus and methods for fracture repair
US9522028B2 (en) 2013-07-03 2016-12-20 Interventional Spine, Inc. Method and apparatus for sacroiliac joint fixation
US9522070B2 (en) 2013-03-07 2016-12-20 Interventional Spine, Inc. Intervertebral implant
US9730739B2 (en) 2010-01-15 2017-08-15 Conventus Orthopaedics, Inc. Rotary-rigid orthopaedic rod
US9839530B2 (en) 2007-06-26 2017-12-12 DePuy Synthes Products, Inc. Highly lordosed fusion cage
US9883951B2 (en) 2012-08-30 2018-02-06 Interventional Spine, Inc. Artificial disc
US9895236B2 (en) 2010-06-24 2018-02-20 DePuy Synthes Products, Inc. Enhanced cage insertion assembly
US9913727B2 (en) 2015-07-02 2018-03-13 Medos International Sarl Expandable implant
US9931223B2 (en) 2008-04-05 2018-04-03 DePuy Synthes Products, Inc. Expandable intervertebral implant
US9993349B2 (en) 2002-06-27 2018-06-12 DePuy Synthes Products, Inc. Intervertebral disc
US10022132B2 (en) 2013-12-12 2018-07-17 Conventus Orthopaedics, Inc. Tissue displacement tools and methods
US10058433B2 (en) 2012-07-26 2018-08-28 DePuy Synthes Products, Inc. Expandable implant
US10111695B2 (en) 2001-03-30 2018-10-30 DePuy Synthes Products, Inc. Distal bone anchors for bone fixation with secondary compression
US10390963B2 (en) 2006-12-07 2019-08-27 DePuy Synthes Products, Inc. Intervertebral implant
US10398563B2 (en) 2017-05-08 2019-09-03 Medos International Sarl Expandable cage
US10433977B2 (en) 2008-01-17 2019-10-08 DePuy Synthes Products, Inc. Expandable intervertebral implant and associated method of manufacturing the same
US10500062B2 (en) 2009-12-10 2019-12-10 DePuy Synthes Products, Inc. Bellows-like expandable interbody fusion cage
US10537436B2 (en) 2016-11-01 2020-01-21 DePuy Synthes Products, Inc. Curved expandable cage
US10548741B2 (en) 2010-06-29 2020-02-04 DePuy Synthes Products, Inc. Distractible intervertebral implant
US10888433B2 (en) 2016-12-14 2021-01-12 DePuy Synthes Products, Inc. Intervertebral implant inserter and related methods
US10918426B2 (en) 2017-07-04 2021-02-16 Conventus Orthopaedics, Inc. Apparatus and methods for treatment of a bone
US10940016B2 (en) 2017-07-05 2021-03-09 Medos International Sarl Expandable intervertebral fusion cage
US11344424B2 (en) 2017-06-14 2022-05-31 Medos International Sarl Expandable intervertebral implant and related methods
US11426290B2 (en) 2015-03-06 2022-08-30 DePuy Synthes Products, Inc. Expandable intervertebral implant, system, kit and method
US11426286B2 (en) 2020-03-06 2022-08-30 Eit Emerging Implant Technologies Gmbh Expandable intervertebral implant
US11446156B2 (en) 2018-10-25 2022-09-20 Medos International Sarl Expandable intervertebral implant, inserter instrument, and related methods
US11452607B2 (en) 2010-10-11 2022-09-27 DePuy Synthes Products, Inc. Expandable interspinous process spacer implant
US11510788B2 (en) 2016-06-28 2022-11-29 Eit Emerging Implant Technologies Gmbh Expandable, angularly adjustable intervertebral cages
US11596523B2 (en) 2016-06-28 2023-03-07 Eit Emerging Implant Technologies Gmbh Expandable and angularly adjustable articulating intervertebral cages
US11612491B2 (en) 2009-03-30 2023-03-28 DePuy Synthes Products, Inc. Zero profile spinal fusion cage
US11752009B2 (en) 2021-04-06 2023-09-12 Medos International Sarl Expandable intervertebral fusion cage
US11850160B2 (en) 2021-03-26 2023-12-26 Medos International Sarl Expandable lordotic intervertebral fusion cage
US11911287B2 (en) 2010-06-24 2024-02-27 DePuy Synthes Products, Inc. Lateral spondylolisthesis reduction cage

Families Citing this family (243)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8187303B2 (en) 2004-04-22 2012-05-29 Gmedelaware 2 Llc Anti-rotation fixation element for spinal prostheses
US7674293B2 (en) 2004-04-22 2010-03-09 Facet Solutions, Inc. Crossbar spinal prosthesis having a modular design and related implantation methods
US6974478B2 (en) * 1999-10-22 2005-12-13 Archus Orthopedics, Inc. Prostheses, systems and methods for replacement of natural facet joints with artificial facet joint surfaces
US7691145B2 (en) 1999-10-22 2010-04-06 Facet Solutions, Inc. Prostheses, systems and methods for replacement of natural facet joints with artificial facet joint surfaces
US7686807B2 (en) * 2001-03-22 2010-03-30 Interventional Spine, Inc. Tool for bone fixation device
RU2194274C1 (en) * 2001-09-18 2002-12-10 ЗАО "Нефтегазкомплектсервис" Technology of intratube ultrasonic flaw detection
US20030055316A1 (en) * 2001-09-19 2003-03-20 Brannon James Kevin Endoscopic bone debridement
US6736819B2 (en) * 2001-10-18 2004-05-18 Kishore Tipirneni System and method for fixation of bone fractures
US20100268285A1 (en) * 2001-10-18 2010-10-21 Orthoip, Llc Bone screw system and method for the fixation of bone fractures
US20090131936A1 (en) * 2001-10-18 2009-05-21 Kishore Tipirneni System and method for the fixation of bone fractures
US8828067B2 (en) 2001-10-18 2014-09-09 Orthoip, Llc Bone screw system and method
US8679167B2 (en) * 2001-10-18 2014-03-25 Orthoip, Llc System and method for a cap used in the fixation of bone fractures
US9060809B2 (en) * 2001-10-18 2015-06-23 Orthoip, Llc Lagwire system and method for the fixation of bone fractures
US8702768B2 (en) * 2001-10-18 2014-04-22 Orthoip, Llc Cannulated bone screw system and method
US20100312292A1 (en) * 2001-10-18 2010-12-09 Orthoip, Llc Lagwire system and method for the fixation of bone fractures
US6685706B2 (en) * 2001-11-19 2004-02-03 Triage Medical, Inc. Proximal anchors for bone fixation system
US20030147718A1 (en) * 2002-02-04 2003-08-07 Mcdowell Charles L. Compression fastener assembly
US7179260B2 (en) 2003-09-29 2007-02-20 Smith & Nephew, Inc. Bone plates and bone plate assemblies
US7615070B2 (en) * 2002-10-11 2009-11-10 Spineco, Inc. Electro-stimulation and medical delivery device
PT2284266E (en) * 2002-11-14 2013-12-17 Thermo Fisher Scient Biosciences Inc Sirna targeting tp53
US7517350B2 (en) * 2002-11-20 2009-04-14 Orthopediatrics Corp. Convertible threaded compression device and method of use
US7641677B2 (en) * 2002-11-20 2010-01-05 Orthopediatrics Corp. Compression bone fragment wire
US7175625B2 (en) * 2002-11-25 2007-02-13 Triage Medical Soft tissue anchor and method of using same
US7070601B2 (en) * 2003-01-16 2006-07-04 Triage Medical, Inc. Locking plate for bone anchors
US7094236B2 (en) * 2003-03-25 2006-08-22 Marc Waisman Hybrid interlocking proximal femoral fracture fixation
US6951561B2 (en) * 2003-05-06 2005-10-04 Triage Medical, Inc. Spinal stabilization device
US20040230304A1 (en) 2003-05-14 2004-11-18 Archus Orthopedics Inc. Prostheses, tools and methods for replacement of natural facet joints with artifical facet joint surfaces
US7608104B2 (en) 2003-05-14 2009-10-27 Archus Orthopedics, Inc. Prostheses, tools and methods for replacement of natural facet joints with artifical facet joint surfaces
US7074238B2 (en) 2003-07-08 2006-07-11 Archus Orthopedics, Inc. Prostheses, tools and methods for replacement of natural facet joints with artificial facet joint surfaces
US7799030B2 (en) * 2003-09-08 2010-09-21 Smith & Nephew, Inc. Orthopaedic plate and screw assembly
US7780667B2 (en) * 2003-09-08 2010-08-24 Smith & Nephew, Inc. Orthopaedic plate and screw assembly
US20050055024A1 (en) * 2003-09-08 2005-03-10 James Anthony H. Orthopaedic implant and screw assembly
US8070785B2 (en) * 2003-09-16 2011-12-06 Spineco, Inc. Bone anchor prosthesis and system
KR101036055B1 (en) * 2003-09-18 2011-05-19 신세스 게엠바하 Device for treating femoral fractures
US7618442B2 (en) 2003-10-21 2009-11-17 Theken Spine, Llc Implant assembly and method for use in an internal structure stabilization system
US7967826B2 (en) 2003-10-21 2011-06-28 Theken Spine, Llc Connector transfer tool for internal structure stabilization systems
US7588600B2 (en) * 2003-12-10 2009-09-15 Axiomed Spine Corporation Method for replacing a damaged spinal disc
US20050131406A1 (en) 2003-12-15 2005-06-16 Archus Orthopedics, Inc. Polyaxial adjustment of facet joint prostheses
US7476255B2 (en) 2003-12-30 2009-01-13 Depuy Products, Inc. Soft tissue attachment system and method
US8029548B2 (en) 2008-05-05 2011-10-04 Warsaw Orthopedic, Inc. Flexible spinal stabilization element and system
WO2005084568A1 (en) * 2004-03-03 2005-09-15 Synthes Gmbh Bone fixation means
WO2005092224A1 (en) * 2004-03-11 2005-10-06 Stefan Schwer Reduction tool
US7406775B2 (en) * 2004-04-22 2008-08-05 Archus Orthopedics, Inc. Implantable orthopedic device component selection instrument and methods
US7540874B2 (en) * 2004-05-27 2009-06-02 Trimed Inc. Method and device for use in osteotomy
EP1761184A2 (en) * 2004-07-01 2007-03-14 Smith and Nephew, Inc. Fixation elements
US20060030872A1 (en) * 2004-08-03 2006-02-09 Brad Culbert Dilation introducer for orthopedic surgery
EP3205371B1 (en) 2004-08-03 2019-09-25 DePuy Synthes Products, Inc. Telescopic percutaneous tissue dilation systems and related methods of producing
US9387313B2 (en) * 2004-08-03 2016-07-12 Interventional Spine, Inc. Telescopic percutaneous tissue dilation systems and related methods
US8470004B2 (en) 2004-08-09 2013-06-25 Si-Bone Inc. Apparatus, systems, and methods for stabilizing a spondylolisthesis
US9949843B2 (en) 2004-08-09 2018-04-24 Si-Bone Inc. Apparatus, systems, and methods for the fixation or fusion of bone
US8414648B2 (en) 2004-08-09 2013-04-09 Si-Bone Inc. Apparatus, systems, and methods for achieving trans-iliac lumbar fusion
US8425570B2 (en) 2004-08-09 2013-04-23 Si-Bone Inc. Apparatus, systems, and methods for achieving anterior lumbar interbody fusion
US8388667B2 (en) 2004-08-09 2013-03-05 Si-Bone, Inc. Systems and methods for the fixation or fusion of bone using compressive implants
US20060036251A1 (en) 2004-08-09 2006-02-16 Reiley Mark A Systems and methods for the fixation or fusion of bone
US20180228621A1 (en) 2004-08-09 2018-08-16 Mark A. Reiley Apparatus, systems, and methods for the fixation or fusion of bone
US8444693B2 (en) 2004-08-09 2013-05-21 Si-Bone Inc. Apparatus, systems, and methods for achieving lumbar facet fusion
US9662158B2 (en) 2004-08-09 2017-05-30 Si-Bone Inc. Systems and methods for the fixation or fusion of bone at or near a sacroiliac joint
US20070156241A1 (en) 2004-08-09 2007-07-05 Reiley Mark A Systems and methods for the fixation or fusion of bone
US7476253B1 (en) 2004-08-11 2009-01-13 Biomet Manufacturing Corporation Humeral head preserving implant
AU2005277363A1 (en) 2004-08-18 2006-03-02 Fsi Acquisition Sub, Llc Adjacent level facet arthroplasty devices, spine stabilization systems, and methods
CA2580101A1 (en) * 2004-09-14 2006-03-23 Spineco, Inc. Implant device
US8221461B2 (en) * 2004-10-25 2012-07-17 Gmedelaware 2 Llc Crossbar spinal prosthesis having a modular design and systems for treating spinal pathologies
US20060089711A1 (en) * 2004-10-27 2006-04-27 Medtronic Vascular, Inc. Multifilament anchor for reducing a compass of a lumen or structure in mammalian body
US7569061B2 (en) 2004-11-16 2009-08-04 Innovative Spinal Technologies, Inc. Off-axis anchor guidance system
JP4603047B2 (en) 2004-11-18 2010-12-22 カイエン メディカル インコーポレイテッド Material fixing device
US8496686B2 (en) * 2005-03-22 2013-07-30 Gmedelaware 2 Llc Minimally invasive spine restoration systems, devices, methods and kits
JP2008538518A (en) * 2005-04-05 2008-10-30 トライエイジ メディカル インコーポレイテッド Tissue expansion device and related method
US20060264954A1 (en) * 2005-04-07 2006-11-23 Sweeney Thomas M Ii Active compression screw system and method for using the same
CH697414B1 (en) * 2005-05-13 2008-09-30 Synthes Gmbh Device for the temporary splinting of toes.
US8961516B2 (en) 2005-05-18 2015-02-24 Sonoma Orthopedic Products, Inc. Straight intramedullary fracture fixation devices and methods
US7909825B2 (en) * 2006-11-22 2011-03-22 Sonoma Orthepedic Products, Inc. Fracture fixation device, tools and methods
US9060820B2 (en) 2005-05-18 2015-06-23 Sonoma Orthopedic Products, Inc. Segmented intramedullary fracture fixation devices and methods
WO2010037038A2 (en) 2008-09-26 2010-04-01 Sonoma Orthopedic Products, Inc. Bone fixation device, tools and methods
EP1885263A1 (en) * 2005-05-18 2008-02-13 Sonoma Orthopaedic Products, Inc Minimally invasive actuable bone fixation devices, systems and methods of use
WO2007038560A1 (en) * 2005-09-28 2007-04-05 Smith & Nephew, Inc. Instrumentation for reducing fractures , particularly femoral neck
DE102005053819A1 (en) * 2005-11-11 2007-05-16 Khd Humboldt Wedag Gmbh Rotary kiln burner
WO2007126428A2 (en) 2005-12-20 2007-11-08 Archus Orthopedics, Inc. Arthroplasty revision system and method
US7967861B2 (en) 2006-03-20 2011-06-28 Cayenne Medical, Inc. Devices, systems and methods for material fixation
CA2648490C (en) * 2006-04-06 2014-09-09 Halifax Biomedical Inc. Intramedullary rod with vent
EP2010073A4 (en) * 2006-04-21 2011-05-25 Interventional Spine Inc Method and apparatus for spinal fixation
US20070270801A1 (en) * 2006-04-28 2007-11-22 Elekta Ab (Publ) Adapter, a fixation pin and a method for fixation of a supporting structure to a body part
US8702755B2 (en) 2006-08-11 2014-04-22 Gmedelaware 2 Llc Angled washer polyaxial connection for dynamic spine prosthesis
US8894661B2 (en) * 2007-08-16 2014-11-25 Smith & Nephew, Inc. Helicoil interference fixation system for attaching a graft ligament to a bone
US20080119845A1 (en) * 2006-09-25 2008-05-22 Archus Orthopedics, Inc. Facet replacement device removal and revision systems and methods
US8187276B1 (en) * 2006-09-26 2012-05-29 Zahiri Christopher A Odd angle internal bone fixation device for use in a transverse fracture of a humerus
AU2007333475B2 (en) 2006-10-24 2013-04-04 Cayenne Medical, Inc. Methods and systems for material fixation
US20080108995A1 (en) * 2006-11-06 2008-05-08 Janet Conway Internal bone transport
CA2670438A1 (en) * 2006-11-22 2008-05-29 Sonoma Orthopedic Products, Inc. Curved orthopedic tool
US20080149115A1 (en) * 2006-11-22 2008-06-26 Sonoma Orthopedic Products, Inc. Surgical station for orthopedic reconstruction surgery
US8974540B2 (en) 2006-12-07 2015-03-10 Ihip Surgical, Llc Method and apparatus for attachment in a modular hip replacement or fracture fixation device
US8029573B2 (en) * 2006-12-07 2011-10-04 Ihip Surgical, Llc Method and apparatus for total hip replacement
US8579985B2 (en) 2006-12-07 2013-11-12 Ihip Surgical, Llc Method and apparatus for hip replacement
US7909882B2 (en) * 2007-01-19 2011-03-22 Albert Stinnette Socket and prosthesis for joint replacement
US8317845B2 (en) * 2007-01-19 2012-11-27 Alexa Medical, Llc Screw and method of use
US7918853B2 (en) 2007-03-20 2011-04-05 Smith & Nephew, Inc. Orthopaedic plate and screw assembly
JP2010522046A (en) 2007-03-22 2010-07-01 ノヴァリン・オルソペディクス・インコーポレーテッド Segmented intramedullary structure
US20080262626A1 (en) * 2007-04-18 2008-10-23 Howmedica Osteonics Corp. Femoral sleeve for hip resurfacing
US8882816B2 (en) 2007-08-02 2014-11-11 Proactive Orthopedics, Llc Fixation and alignment device and method used in orthopaedic surgery
EP2200540A4 (en) * 2007-08-02 2011-03-02 Proactive Orthopedic Llc Fixation and alignment device and method used in orthopaedic surgery
US20090105840A1 (en) * 2007-10-18 2009-04-23 Inbone Technologies, Inc. Fibular stiffener and bony defect replacer
US20090216273A1 (en) * 2008-02-19 2009-08-27 U. S. Spinal Technologies, L.L.C. Curved facet joint fixation assembly and associated implantation tool and method
SE532211C2 (en) * 2008-03-27 2009-11-17 Swemac Innovation Ab Device for fixing bone fragments in case of bone fracture
US20090275993A1 (en) * 2008-04-30 2009-11-05 Phan Christopher U Apparatus and methods for inserting facet screws
US8858565B1 (en) 2008-05-08 2014-10-14 Cayenne Medical, Inc. Inserter for soft tissue or bone-to-bone fixation device and methods
US8123806B1 (en) 2008-05-09 2012-02-28 Cayenne Medical, Inc Method of tensioning a tissue graft having suture bundles using a cleated bar
WO2009152273A1 (en) 2008-06-10 2009-12-17 Sonoma Orthopedic Products, Inc. Fracture fixation device, tools and methods
US8303589B2 (en) * 2008-06-24 2012-11-06 Extremity Medical Llc Fixation system, an intramedullary fixation assembly and method of use
US8328806B2 (en) 2008-06-24 2012-12-11 Extremity Medical, Llc Fixation system, an intramedullary fixation assembly and method of use
US9289220B2 (en) 2008-06-24 2016-03-22 Extremity Medical Llc Intramedullary fixation assembly and method of use
US8313487B2 (en) 2008-06-24 2012-11-20 Extremity Medical Llc Fixation system, an intramedullary fixation assembly and method of use
US8343199B2 (en) 2008-06-24 2013-01-01 Extremity Medical, Llc Intramedullary fixation screw, a fixation system, and method of fixation of the subtalar joint
US9017329B2 (en) 2008-06-24 2015-04-28 Extremity Medical, Llc Intramedullary fixation assembly and method of use
US9044282B2 (en) 2008-06-24 2015-06-02 Extremity Medical Llc Intraosseous intramedullary fixation assembly and method of use
EP2339976B1 (en) 2008-07-09 2016-03-16 Icon Orthopaedic Concepts, LLC Ankle arthrodesis nail and outrigger assembly
US8414584B2 (en) 2008-07-09 2013-04-09 Icon Orthopaedic Concepts, Llc Ankle arthrodesis nail and outrigger assembly
EP2326271A4 (en) * 2008-08-15 2013-11-20 Kinetic Spine Technologies Inc Dynamic pedicle screw
US20140012322A1 (en) * 2008-10-10 2014-01-09 Brian Gayvey Bone Screw
BRPI0920111B8 (en) 2008-11-06 2021-06-22 Synthes Gmbh unidirectional sliding device for intramedullary and intertrochanteric fixation implants.
US20100168799A1 (en) * 2008-12-29 2010-07-01 Schumer Evan D Ulnar osteotomy plate including increased compression
WO2010091242A1 (en) * 2009-02-05 2010-08-12 Novalign Orthopaedics, Inc. Proximal femur fixation apparatus, systems and methods with angled elongate elements
US8870876B2 (en) 2009-02-13 2014-10-28 Tarsus Medical Inc. Methods and devices for treating hallux valgus
TW201031381A (en) * 2009-02-24 2010-09-01 Univ Nat Yang Ming The anti-subsidence dynamic coupling fixation plate for proximal femoral fracture
US8206446B1 (en) 2009-03-10 2012-06-26 Cayenne Medical, Inc. Method for surgically repairing a damaged ligament
JP5805624B2 (en) 2009-04-24 2015-11-04 シンセス ゲゼルシャフト ミット ベシュレンクテル ハフツングSynthes Gmbh Multiple screw
US20100331891A1 (en) * 2009-06-24 2010-12-30 Interventional Spine, Inc. System and method for spinal fixation
US8449544B2 (en) 2009-06-30 2013-05-28 Smith & Nephew, Inc. Orthopaedic implant and fastener assembly
KR101743051B1 (en) 2009-06-30 2017-06-02 스미스 앤드 네퓨, 인크. Orthopaedic implant and fastener assembly
IN2012DN00983A (en) 2009-09-14 2015-04-10 Synthes Gmbh
US8277459B2 (en) 2009-09-25 2012-10-02 Tarsus Medical Inc. Methods and devices for treating a structural bone and joint deformity
US20110160772A1 (en) * 2009-12-28 2011-06-30 Arcenio Gregory B Systems and methods for performing spinal fusion
US20110160728A1 (en) * 2009-12-31 2011-06-30 Amei Technologies, Inc. Intramedullary Compression Nail and Related Method for Jones Fractures
US9381045B2 (en) 2010-01-13 2016-07-05 Jcbd, Llc Sacroiliac joint implant and sacroiliac joint instrument for fusing a sacroiliac joint
US9333090B2 (en) 2010-01-13 2016-05-10 Jcbd, Llc Systems for and methods of fusing a sacroiliac joint
SG182463A1 (en) 2010-01-13 2012-08-30 Jcbd Llc Sacroiliac joint fixation fusion system
US9554909B2 (en) 2012-07-20 2017-01-31 Jcbd, Llc Orthopedic anchoring system and methods
US9421109B2 (en) 2010-01-13 2016-08-23 Jcbd, Llc Systems and methods of fusing a sacroiliac joint
US8652141B2 (en) 2010-01-21 2014-02-18 Tarsus Medical Inc. Methods and devices for treating hallux valgus
WO2011112619A1 (en) * 2010-03-08 2011-09-15 Krinke Todd A Apparatus and methods for bone repair
US9204910B2 (en) * 2010-03-10 2015-12-08 Advanced Orthopaedic Solutions, Inc. Telescoping bone screw
US9308080B2 (en) 2010-03-10 2016-04-12 Smith & Nephew Inc. Composite interference screws and drivers
US9579188B2 (en) 2010-03-10 2017-02-28 Smith & Nephew, Inc. Anchor having a controlled driver orientation
US9775702B2 (en) 2010-03-10 2017-10-03 Smith & Nephew, Inc. Composite interference screws and drivers
US20130041414A1 (en) * 2010-03-10 2013-02-14 Advanced Orthopaedic Solutions, Inc. Telescoping Bone Screw
US8979865B2 (en) 2010-03-10 2015-03-17 Smith & Nephew, Inc. Composite interference screws and drivers
US20110288588A1 (en) * 2010-05-20 2011-11-24 Spinefrontier Inc System and method for facet fixation and fusion
US8696719B2 (en) 2010-06-03 2014-04-15 Tarsus Medical Inc. Methods and devices for treating hallux valgus
ITPI20100081A1 (en) * 2010-07-01 2012-01-02 Prete Ferdinando Del A DEVICE TO FACILITATE THE APPLICATION OF A FIXING PLATE TO THE RELATED SCREW FOR THE MINIMALLY INVASIVE STABILIZATION OF PERTROCANTERIC FEMORAL FRACTURES WITH SCREW SYSTEMS - SLIPPER PLAQUE.
ES2552254T3 (en) 2010-11-17 2015-11-26 Hyprevention Implantable device for the preventive or curative treatment of fractures of the femur, associated ancillary
WO2012074991A1 (en) * 2010-11-30 2012-06-07 Amit Sinha Bone compression and fixation devices
US9138219B2 (en) 2010-12-29 2015-09-22 Tarsus Medical Inc. Methods and devices for treating a syndesmosis injury
US9039765B2 (en) 2011-01-21 2015-05-26 Warsaw Orhtopedic, Inc. Implant system and method for stabilization of a sacro-iliac joint
WO2012099944A1 (en) * 2011-01-21 2012-07-26 Synthes Usa, Llc Trochanteric femoral nail augmentable
US20120215263A1 (en) * 2011-02-23 2012-08-23 Choon Sung Lee Extensible pedicle screw coupling device
US8518087B2 (en) 2011-03-10 2013-08-27 Interventional Spine, Inc. Method and apparatus for minimally invasive insertion of intervertebral implants
US8394129B2 (en) 2011-03-10 2013-03-12 Interventional Spine, Inc. Method and apparatus for minimally invasive insertion of intervertebral implants
EP2683327B1 (en) 2011-03-11 2017-11-29 Smith & Nephew, Inc. Trephine
CA2830505A1 (en) * 2011-03-21 2012-09-27 Ronald Childs Sleeve for bone fixation device
EP2717784B1 (en) 2011-06-07 2020-08-05 Smith & Nephew, Inc. Surgical anchor delivery system
EP2720628B1 (en) 2011-06-17 2021-08-11 Jcbd, Llc Sacroiliac joint implant system
US9101399B2 (en) 2011-12-29 2015-08-11 Proactive Orthopedics, Llc Anchoring systems and methods for surgery
US9078673B2 (en) * 2012-01-18 2015-07-14 Ortho Innovations, Inc. Method of humeral head resurfacing and/or replacement and system for accomplishing the method
WO2013134682A1 (en) 2012-03-09 2013-09-12 Si-Bone Inc. Artificial si joint
US10363140B2 (en) 2012-03-09 2019-07-30 Si-Bone Inc. Systems, device, and methods for joint fusion
IN2014DN06946A (en) 2012-03-09 2015-04-10 Si Bone Inc
ES2828357T3 (en) 2012-05-04 2021-05-26 Si Bone Inc Fenestrated implant
US9554836B2 (en) * 2012-06-29 2017-01-31 The Cleveland Clinic Foundation Intramedullary bone stent
US20140031934A1 (en) * 2012-07-26 2014-01-30 Warsaw Orthopedic, Inc. Sacro-iliac joint implant system and method
US9198657B2 (en) * 2012-09-13 2015-12-01 Basil Anthony Kocur Anchor unit implant
US9398928B2 (en) * 2012-09-28 2016-07-26 DePuy Synthes Products, Inc. Adjustable height arthroplasty plate
US10631994B2 (en) 2012-10-12 2020-04-28 Smith & Nephew, Inc. Fusion Implant
WO2014078321A1 (en) * 2012-11-13 2014-05-22 Greenberg Louis E Orthopedic implant having non-circular cross section and method of use thereof
US9277928B2 (en) 2013-03-11 2016-03-08 Interventional Spine, Inc. Method and apparatus for minimally invasive insertion of intervertebral implants
US9993353B2 (en) 2013-03-14 2018-06-12 DePuy Synthes Products, Inc. Method and apparatus for minimally invasive insertion of intervertebral implants
US9936983B2 (en) 2013-03-15 2018-04-10 Si-Bone Inc. Implants for spinal fixation or fusion
US9700356B2 (en) 2013-07-30 2017-07-11 Jcbd, Llc Systems for and methods of fusing a sacroiliac joint
US9155531B2 (en) 2013-03-15 2015-10-13 Smith & Nephew, Inc. Miniaturized dual drive open architecture suture anchor
US10245087B2 (en) 2013-03-15 2019-04-02 Jcbd, Llc Systems and methods for fusing a sacroiliac joint and anchoring an orthopedic appliance
US9510872B2 (en) 2013-03-15 2016-12-06 Jcbd, Llc Spinal stabilization system
US9826986B2 (en) 2013-07-30 2017-11-28 Jcbd, Llc Systems for and methods of preparing a sacroiliac joint for fusion
US9717539B2 (en) 2013-07-30 2017-08-01 Jcbd, Llc Implants, systems, and methods for fusing a sacroiliac joint
KR20150140738A (en) 2013-04-09 2015-12-16 스미스 앤드 네퓨, 인크. Open-architecture interference screw
US9517098B2 (en) * 2013-07-03 2016-12-13 Biomet Manufacturing, Llc Bone fusion device
WO2015057866A1 (en) 2013-10-15 2015-04-23 Si-Bone Inc. Implant placement
US11147688B2 (en) 2013-10-15 2021-10-19 Si-Bone Inc. Implant placement
US9770278B2 (en) 2014-01-17 2017-09-26 Arthrex, Inc. Dual tip guide wire
EP3111099B1 (en) 2014-02-24 2020-04-01 Curtin University Of Technology A fastener
US10166055B2 (en) * 2014-05-16 2019-01-01 Biomet C.V. Method and apparatus for bone fixation
US9801546B2 (en) 2014-05-27 2017-10-31 Jcbd, Llc Systems for and methods of diagnosing and treating a sacroiliac joint disorder
AU2015267025A1 (en) * 2014-05-27 2017-01-12 Interventional Spine, Inc. Method and apparatus for spondylolysis repair
US20160015426A1 (en) 2014-07-15 2016-01-21 Treace Medical Concepts, Inc. Bone positioning and cutting system and method
WO2016044731A1 (en) 2014-09-18 2016-03-24 Si-Bone Inc. Implants for bone fixation or fusion
US9662157B2 (en) 2014-09-18 2017-05-30 Si-Bone Inc. Matrix implant
US9814499B2 (en) 2014-09-30 2017-11-14 Arthrex, Inc. Intramedullary fracture fixation devices and methods
US10575883B2 (en) 2014-12-15 2020-03-03 Smith & Nephew, Inc. Active fracture compression implants
US9687250B2 (en) 2015-01-07 2017-06-27 Treace Medical Concepts, Inc. Bone cutting guide systems and methods
US10849631B2 (en) * 2015-02-18 2020-12-01 Treace Medical Concepts, Inc. Pivotable bone cutting guide useful for bone realignment and compression techniques
US10980617B2 (en) * 2015-02-23 2021-04-20 Maurice Valen Implantable surgical screw for bone reconstruction
US10376206B2 (en) 2015-04-01 2019-08-13 Si-Bone Inc. Neuromonitoring systems and methods for bone fixation or fusion procedures
US10085736B2 (en) 2015-05-01 2018-10-02 L. Pearce McCarty, III Hollow body anchor
US9833338B2 (en) * 2015-06-30 2017-12-05 Expanding Orthopedics Inc. Tool for intervertebral cage
US10357314B2 (en) 2015-07-08 2019-07-23 Stryker European Holdings I, Llc Instrumentation and method for repair of a bone fracture
US10154863B2 (en) * 2015-07-13 2018-12-18 IntraFuse, LLC Flexible bone screw
US10136929B2 (en) * 2015-07-13 2018-11-27 IntraFuse, LLC Flexible bone implant
US10485595B2 (en) * 2015-07-13 2019-11-26 IntraFuse, LLC Flexible bone screw
US10499960B2 (en) 2015-07-13 2019-12-10 IntraFuse, LLC Method of bone fixation
US9622805B2 (en) 2015-08-14 2017-04-18 Treace Medical Concepts, Inc. Bone positioning and preparing guide systems and methods
US10849663B2 (en) 2015-07-14 2020-12-01 Treace Medical Concepts, Inc. Bone cutting guide systems and methods
CA2991424A1 (en) 2015-07-14 2017-01-19 Treace Medical Concepts, Inc. Bone positioning guide
CA2998727A1 (en) 2015-08-14 2017-02-23 Treace Medical Concepts, Inc. Tarsal-metatarsal joint procedure utilizing fulcrum
US11278337B2 (en) 2015-08-14 2022-03-22 Treace Medical Concepts, Inc. Tarsal-metatarsal joint procedure utilizing fulcrum
CA2998481A1 (en) 2015-09-18 2017-03-23 Treace Medical Concepts, Inc. Joint spacer systems and methods
EP3150153B1 (en) * 2015-09-29 2019-10-30 Orthofix S.r.l. Endosseous screw assembly and internal fixation system comprising said endosseous screw assembly
US10952866B2 (en) 2015-10-13 2021-03-23 DePuy Synthes Products, Inc. Intervertebral implant and bone graft inserter
AU2017233553B2 (en) 2016-03-18 2022-02-03 Curtin University An expandable fastener for orthopaedic applications
US10512470B1 (en) 2016-08-26 2019-12-24 Treace Medical Concepts, Inc. Osteotomy procedure for correcting bone misalignment
US11083503B2 (en) 2016-09-22 2021-08-10 Globus Medical, Inc. Systems and methods for intramedullary nail implantation
US10492803B2 (en) 2016-09-22 2019-12-03 Globus Medical, Inc. Systems and methods for intramedullary nail implantation
US10524808B1 (en) 2016-11-11 2020-01-07 Treace Medical Concepts, Inc. Devices and techniques for performing an osteotomy procedure on a first metatarsal to correct a bone misalignment
US10939939B1 (en) 2017-02-26 2021-03-09 Treace Medical Concepts, Inc. Fulcrum for tarsal-metatarsal joint procedure
US10631881B2 (en) 2017-03-09 2020-04-28 Flower Orthopedics Corporation Plating depth gauge and countersink instrument
US10603055B2 (en) 2017-09-15 2020-03-31 Jcbd, Llc Systems for and methods of preparing and fusing a sacroiliac joint
US11179234B2 (en) 2017-09-15 2021-11-23 Paragon 28, Inc. Ligament fixation system, implants, devices, and methods of use
EP3687422A4 (en) 2017-09-26 2021-09-22 SI-Bone, Inc. Systems and methods for decorticating the sacroiliac joint
WO2019071273A1 (en) 2017-10-06 2019-04-11 Paragon 28, Inc. Ligament fixation system, implants, devices, and methods of use
EP3700447B1 (en) * 2017-10-25 2023-09-06 Paragon 28, Inc. Ligament fixation system, implants, and devices with a compression cap
US10966834B2 (en) * 2018-01-25 2021-04-06 DePuy Synthes Products, Inc. Break off spacer clip for trochanteric femoral nail telescoping head element
IL276785B1 (en) * 2018-02-21 2024-03-01 Southern Implants Pty Ltd Asymmetric zygomatic dental implant with partial micro thread/groove
WO2020014457A1 (en) 2018-07-11 2020-01-16 Treace Medical Concepts, Inc. Compressor-distractor for angularly realigning bone portions
US11583323B2 (en) 2018-07-12 2023-02-21 Treace Medical Concepts, Inc. Multi-diameter bone pin for installing and aligning bone fixation plate while minimizing bone damage
US11607250B2 (en) 2019-02-13 2023-03-21 Treace Medical Concepts, Inc. Tarsal-metatarsal joint procedure utilizing compressor-distractor and instrument providing sliding surface
US11369419B2 (en) 2019-02-14 2022-06-28 Si-Bone Inc. Implants for spinal fixation and or fusion
AU2020223180A1 (en) 2019-02-14 2021-07-22 Si-Bone Inc. Implants for spinal fixation and or fusion
US11633219B2 (en) 2019-06-26 2023-04-25 Globus Medical, Inc. Fenestrated pedicle nail
WO2021026448A1 (en) 2019-08-07 2021-02-11 Treace Medical Concepts, Inc. Bi-planar instrument for bone cutting and joint realignment procedure
US11889998B1 (en) 2019-09-12 2024-02-06 Treace Medical Concepts, Inc. Surgical pin positioning lock
US11890039B1 (en) 2019-09-13 2024-02-06 Treace Medical Concepts, Inc. Multi-diameter K-wire for orthopedic applications
KR102276643B1 (en) 2019-11-11 2021-07-13 주식회사 제일메디칼코퍼레이션 Leg screw for bone fixation having separate structure
EP4065015A4 (en) 2019-11-27 2024-01-03 Si Bone Inc Bone stabilizing implants and methods of placement across si joints
AU2021200320A1 (en) * 2020-01-22 2021-08-05 Howmedica Osteonics Corp. Femoral implant
AU2021212261A1 (en) 2020-01-31 2022-08-18 Treace Medical Concepts, Inc. Metatarsophalangeal joint preparation and metatarsal realignment for fusion
KR102159904B1 (en) 2020-04-24 2020-09-24 강경원 Menstrual Cup with a Drug-releasing Ring
EP4259015A1 (en) 2020-12-09 2023-10-18 SI-Bone, Inc. Sacro-iliac joint stabilizing implants and methods of implantation
USD1011524S1 (en) 2022-02-23 2024-01-16 Treace Medical Concepts, Inc. Compressor-distractor for the foot

Citations (90)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1802560A (en) * 1923-04-04 1931-04-28 Arthur C Kerwin Masonry bolt
US2077804A (en) * 1936-05-19 1937-04-20 Morrison Gordon Monroe Device for treating fractures of the neck of the femur
US2485531A (en) * 1948-01-13 1949-10-18 Dzus William Surgical toggle bolt
US2570465A (en) * 1949-08-01 1951-10-09 Joseph S Lundholm Means for fixation of hip fractures
US3489143A (en) * 1967-12-15 1970-01-13 William X Halloran Convertible hip pin
US4052988A (en) * 1976-01-12 1977-10-11 Ethicon, Inc. Synthetic absorbable surgical devices of poly-dioxanone
US4275717A (en) * 1979-07-27 1981-06-30 Zimmer Usa, Inc. Intramedullary fixation device for fractured tubular bones
US4463753A (en) * 1980-01-04 1984-08-07 Gustilo Ramon B Compression bone screw
US4640271A (en) * 1985-11-07 1987-02-03 Zimmer, Inc. Bone screw
US4667663A (en) * 1983-07-13 1987-05-26 Keizo Miyata Intramedullary nail used to unite separated fragments of fractured long bone
US4688561A (en) * 1985-09-17 1987-08-25 Reese H William Bone handling apparatus and method
US4721103A (en) * 1985-01-31 1988-01-26 Yosef Freedland Orthopedic device
US4743257A (en) * 1985-05-08 1988-05-10 Materials Consultants Oy Material for osteosynthesis devices
US4760843A (en) * 1985-07-12 1988-08-02 Artur Fischer Connector for fractured bones
US4796612A (en) * 1986-08-06 1989-01-10 Reese Hewitt W Bone clamp and method
US4815909A (en) * 1986-11-19 1989-03-28 Leon Simons Wood screw and method for making same
US4827917A (en) * 1986-12-30 1989-05-09 Richards Medical Company Fermoral fracture device
US4873976A (en) * 1984-02-28 1989-10-17 Schreiber Saul N Surgical fasteners and method
US4898186A (en) * 1986-09-11 1990-02-06 Gunze Limited Osteosynthetic pin
US4903692A (en) * 1989-05-08 1990-02-27 Reese Hewitt W Bone clamp installation tool
US4917554A (en) * 1988-04-09 1990-04-17 Cryotherm Limited Screw unit to join semi-rigid mats together
US4940467A (en) * 1988-02-03 1990-07-10 Tronzo Raymond G Variable length fixation device
US5059193A (en) * 1989-11-20 1991-10-22 Spine-Tech, Inc. Expandable spinal implant and surgical method
US5092891A (en) * 1990-03-08 1992-03-03 Kummer Frederick J Cement plug for the medullary canal of a bone and coacting tool for installing same
US5098433A (en) * 1989-04-12 1992-03-24 Yosef Freedland Winged compression bolt orthopedic fastener
US5116336A (en) * 1990-03-19 1992-05-26 Synthes (U.S.A.) Osteosynthetic anchor bolt
US5122141A (en) * 1990-08-30 1992-06-16 Zimmer, Inc. Modular intramedullary nail
US5122133A (en) * 1990-10-26 1992-06-16 Smith & Nephew Richards Inc. Compression screw for a joint endoprosthesis
US5217462A (en) * 1991-03-05 1993-06-08 Pfizer Hospital Products Group, Inc. Screw and driver
US5242447A (en) * 1992-02-06 1993-09-07 Howmedica Inc. Pin with tapered root diameter
US5246441A (en) * 1989-09-08 1993-09-21 Linvatec Corporation Bioabsorbable tack for joining bodily tissue
US5250049A (en) * 1992-01-10 1993-10-05 Michael Roger H Bone and tissue connectors
US5300074A (en) * 1990-12-17 1994-04-05 Synthes (U.S.A.) Two-part angle plate
US5452748A (en) * 1994-01-07 1995-09-26 Simmons; John M. Synchronized dual thread connector
US5498265A (en) * 1991-03-05 1996-03-12 Howmedica Inc. Screw and driver
US5501695A (en) * 1992-05-27 1996-03-26 The Anspach Effort, Inc. Fastener for attaching objects to bones
US5536127A (en) * 1994-10-13 1996-07-16 Pennig; Dietmar Headed screw construction for use in fixing the position of an intramedullary nail
US5549610A (en) * 1994-10-31 1996-08-27 Smith & Nephew Richards Inc. Femoral intramedullary nail
US5626613A (en) * 1995-05-04 1997-05-06 Arthrex, Inc. Corkscrew suture anchor and driver
US5628751A (en) * 1993-06-21 1997-05-13 United States Surgical Corporation Orthopedic fastener applicator with rotational or longitudinal driver
US5646359A (en) * 1994-05-31 1997-07-08 Kabushiki Kaisha Kawai Gakki Seisakusho Silencing method and apparatus for pianos
US5662683A (en) * 1995-08-22 1997-09-02 Ortho Helix Limited Open helical organic tissue anchor and method of facilitating healing
US5669915A (en) * 1995-03-22 1997-09-23 Aesculap Ag Drilling jig for surgical drilling tools
US5713903A (en) * 1991-03-22 1998-02-03 United States Surgical Corporation Orthopedic fastener
US5720753A (en) * 1991-03-22 1998-02-24 United States Surgical Corporation Orthopedic fastener
US5725541A (en) * 1996-01-22 1998-03-10 The Anspach Effort, Inc. Soft tissue fastener device
US5728097A (en) * 1992-03-17 1998-03-17 Sdgi Holding, Inc. Method for subcutaneous suprafascial internal fixation
US5728116A (en) * 1994-01-13 1998-03-17 Ethicon, Inc. Spiral surgical tack
US5741282A (en) * 1996-01-22 1998-04-21 The Anspach Effort, Inc. Soft tissue fastener device
US5743914A (en) * 1996-06-06 1998-04-28 Skiba; Jeffry B. Bone screw
US5772662A (en) * 1986-06-23 1998-06-30 Howmedica Inc. Femoral fixation system
US5782865A (en) * 1995-08-25 1998-07-21 Grotz; Robert Thomas Stabilizer for human joints
US5871485A (en) * 1998-03-18 1999-02-16 Rao; G.V. Subba Device for internal fixation of femoral neck fractures
US5893850A (en) * 1996-11-12 1999-04-13 Cachia; Victor V. Bone fixation device
US5908422A (en) * 1997-01-13 1999-06-01 Synthes (U.S.A) Helical osteosynthetic implant
US5928235A (en) * 1993-06-01 1999-07-27 Endocare Ag Osteosynthesis auxiliary for the treatment of subtrochanteric, peritrochanteric, and femoral-neck fractures
US5928244A (en) * 1996-10-04 1999-07-27 United States Surgical Corporation Tissue fastener implantation apparatus and method
US5931870A (en) * 1996-10-09 1999-08-03 Smith & Nephew, Inc. Acetabular ring prosthesis with reinforcement buttress
US5935129A (en) * 1997-03-07 1999-08-10 Innovasive Devices, Inc. Methods and apparatus for anchoring objects to bone
US5947999A (en) * 1996-12-03 1999-09-07 Groiso; Jorge A. Surgical clip and method
US5948000A (en) * 1996-10-03 1999-09-07 United States Surgical Corporation System for suture anchor placement
US5954747A (en) * 1997-11-20 1999-09-21 Clark; Ron Meniscus repair anchor system
US5957924A (en) * 1997-05-22 1999-09-28 Bionx Implants Oy Installation tool for suture anchor
US6010513A (en) * 1997-11-26 2000-01-04 Bionx Implants Oy Device for installing a tissue fastener
US6015410A (en) * 1997-12-23 2000-01-18 Bionx Implants Oy Bioabsorbable surgical implants for endoscopic soft tissue suspension procedure
US6019762A (en) * 1998-04-30 2000-02-01 Orthodyne, Inc. Adjustable length orthopedic fixation device
US6068648A (en) * 1998-01-26 2000-05-30 Orthodyne, Inc. Tissue anchoring system and method
US6083244A (en) * 1996-09-13 2000-07-04 Tendon Technology, Ltd. Apparatus and method for tendon or ligament repair
US6168595B1 (en) * 1997-02-11 2001-01-02 Orthomatrix, Inc. Modular intramedullary fixation system and insertion instrumentation
US6183472B1 (en) * 1998-04-09 2001-02-06 Howmedica Gmbh Pedicle screw and an assembly aid therefor
US6183474B1 (en) * 1996-03-13 2001-02-06 Dale G. Bramlet Surgical fastener assembly
US6371989B1 (en) * 1996-09-13 2002-04-16 Jean-Luc Chauvin Method of providing proper vertebral spacing
US20020055740A1 (en) * 2000-11-08 2002-05-09 The Cleveland Clinic Foundation Method and apparatus for correcting spinal deformity
US6511481B2 (en) * 2001-03-30 2003-01-28 Triage Medical, Inc. Method and apparatus for fixation of proximal femoral fractures
US6517543B1 (en) * 1999-08-17 2003-02-11 Pioneer Laboratories, Inc. Bone connector system with anti-rotational feature
US6527774B2 (en) * 2000-11-08 2003-03-04 The Cleveland Clinic Foundation Apparatus for attaching fractured sections of bone
US6544265B2 (en) * 2000-11-08 2003-04-08 The Cleveland Clinic Foundation Apparatus for implantation into bone related applications
US6551322B1 (en) * 2000-10-05 2003-04-22 The Cleveland Clinic Foundation Apparatus for implantation into bone
US6558389B2 (en) * 1999-11-30 2003-05-06 Ron Clark Endosteal tibial ligament fixation with adjustable tensioning
US6579293B1 (en) * 2000-08-02 2003-06-17 Rama E. Chandran Intramedullary rod with interlocking oblique screw for tibio-calcaneal arthrodesis
US6582453B1 (en) * 2000-07-14 2003-06-24 Opus Medical, Inc. Method and apparatus for attaching connective tissues to bone using a suture anchoring device
US6585740B2 (en) * 1998-11-26 2003-07-01 Synthes (U.S.A.) Bone screw
US6585730B1 (en) * 2000-08-30 2003-07-01 Opus Medical, Inc. Method and apparatus for attaching connective tissues to bone using a knotless suture anchoring device
US6589249B2 (en) * 1998-05-12 2003-07-08 Scimed Life Systems, Inc. Manual bone anchor placement devices
US6599297B1 (en) * 1996-09-02 2003-07-29 Nobel Biocare Ab Device for ventilating the middle ear
US20040127906A1 (en) * 2002-07-19 2004-07-01 Culbert Brad S. Method and apparatus for spinal fixation
US6887243B2 (en) * 2001-03-30 2005-05-03 Triage Medical, Inc. Method and apparatus for bone fixation with secondary compression
US6942668B2 (en) * 2001-11-19 2005-09-13 Triage Medical, Inc. Proximal anchors for bone fixation system
US20060122609A1 (en) * 2004-12-08 2006-06-08 Srdjan Mirkovic Method and apparatus for spinal stabilization
US20060122610A1 (en) * 2004-12-08 2006-06-08 Culbert Brad S Method and apparatus for spinal stabilization

Family Cites Families (222)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2121193A (en) * 1932-12-21 1938-06-21 Hanicke Paul Gustav Erich Fracture clamping apparatus
US2173655A (en) 1936-11-27 1939-09-19 Chrysler Corp Power transmission
US2388056A (en) 1943-07-17 1945-10-30 Nathan V Hendricks Adjustable support
US2489870A (en) 1946-03-02 1949-11-29 Dzus William Bone fastening device
US2745709A (en) * 1950-11-22 1956-05-15 Vasshaug Jorgen Alfred Working table
US2800601A (en) * 1952-09-05 1957-07-23 Light Products Inc Electron discharge device
US2801189A (en) * 1952-10-08 1957-07-30 Owens Corning Fiberglass Corp Glass fiber article and process of plural coated fiber and process of preparation
US2808182A (en) * 1954-11-15 1957-10-01 Leonard Altman Pouring stopper
US3115804A (en) 1959-11-16 1963-12-31 Wisconsin Alumni Res Found Snap bolt having resiliently flexible shank portion
US3842825A (en) 1973-11-12 1974-10-22 R Wagner Hip fixation device
GB1565178A (en) 1977-02-24 1980-04-16 Interfix Ltd Bone screw
US4341206A (en) 1978-12-19 1982-07-27 Synthes Ag Device for producing a hole in a bone
US4262665A (en) 1979-06-27 1981-04-21 Roalstad W L Intramedullary compression device
US4965825A (en) * 1981-11-03 1990-10-23 The Personalized Mass Media Corporation Signal processing apparatus and methods
US4641640A (en) 1982-01-18 1987-02-10 Calvin Griggs Compression screw assembly
FR2519857A1 (en) 1982-01-19 1983-07-22 Butel Jean DEVICE FOR OSTEOSYNTHESIS OF THE FRACTURES OF THE END OF THE FEMUR
IE55242B1 (en) 1982-05-17 1990-07-18 Nat Res Dev Endoprosthetic bone joint devices
US4456005A (en) * 1982-09-30 1984-06-26 Lichty Terry K External compression bone fixation device
US4537185A (en) 1983-06-10 1985-08-27 Denis P. Stednitz Cannulated fixation screw
US4655777A (en) 1983-12-19 1987-04-07 Southern Research Institute Method of producing biodegradable prosthesis and products therefrom
IL70736A (en) 1984-01-20 1988-05-31 Rosenberg Lior Self-locking pin device particularly useful for internally fixing bone fractures
GB2157788B (en) 1984-04-11 1988-02-10 Anthony John Nield Anchoring devices
US4646741A (en) 1984-11-09 1987-03-03 Ethicon, Inc. Surgical fastener made from polymeric blends
US4632101A (en) 1985-01-31 1986-12-30 Yosef Freedland Orthopedic fastener
GB8508710D0 (en) 1985-04-03 1985-05-09 Himoud H Screw for surgical use
US5013315A (en) 1985-07-12 1991-05-07 Minnesota Mining And Manufacturing Company Semiabsorbable bone plate spacer
US4889119A (en) 1985-07-17 1989-12-26 Ethicon, Inc. Surgical fastener made from glycolide-rich polymer blends
AT383820B (en) * 1985-09-25 1987-08-25 Vianova Kunstharz Ag METHOD FOR PRODUCING SELF-CROSS-LINKING CATHIONIC LACQUER BINDERS AND THE USE THEREOF
US6005161A (en) 1986-01-28 1999-12-21 Thm Biomedical, Inc. Method and device for reconstruction of articular cartilage
US5167663A (en) 1986-12-30 1992-12-01 Smith & Nephew Richards Inc. Femoral fracture device
FI81498C (en) 1987-01-13 1990-11-12 Biocon Oy SURGICAL MATERIAL OCH INSTRUMENT.
JPS6452439A (en) 1987-08-25 1989-02-28 Fujitsu Ltd Ultrasonic diagnostic apparatus
JP2548953B2 (en) 1987-09-26 1996-10-30 大日本印刷株式会社 Method for producing plastic molded article having scratch-resistant matte surface
JPH01189854A (en) 1988-01-25 1989-07-31 Fuji Elelctrochem Co Ltd Flat type nonaqueous electrolytic cell
US4858601A (en) 1988-05-27 1989-08-22 Glisson Richard R Adjustable compression bone screw
US4959064A (en) 1988-10-07 1990-09-25 Boehringer Mannheim Corporation Dynamic tension bone screw
US4988351A (en) 1989-01-06 1991-01-29 Concept, Inc. Washer for use with cancellous screw for attaching soft tissue to bone
US4963144A (en) 1989-03-17 1990-10-16 Huene Donald R Bone screw fixation assembly, bone screw therefor and method of fixation
DE3909182C1 (en) 1989-03-21 1990-08-09 Orthoplant Endoprothetik Gmbh, 2800 Bremen, De
US4927421A (en) 1989-05-15 1990-05-22 Marlowe Goble E Process of endosteal fixation of a ligament
US4978349A (en) 1989-08-03 1990-12-18 Synthes (U.S.A.) Fixation plate
WO1991009572A1 (en) 1989-12-21 1991-07-11 Bakinsky Nauchno-Issledovatelsky Institut Travmatologii I Ortopedii Compressing screw for osteosynthesis
US5013316A (en) 1990-03-26 1991-05-07 Marlowe Goble E Soft tissue anchor system
US5120171A (en) * 1990-11-27 1992-06-09 Stuart Surgical Bone screw with improved threads
US5725529A (en) 1990-09-25 1998-03-10 Innovasive Devices, Inc. Bone fastener
US7074203B1 (en) 1990-09-25 2006-07-11 Depuy Mitek, Inc. Bone anchor and deployment device therefor
US5372146A (en) 1990-11-06 1994-12-13 Branch; Thomas P. Method and apparatus for re-approximating tissue
US5098435A (en) * 1990-11-21 1992-03-24 Alphatec Manufacturing Inc. Cannula
FR2672202B1 (en) * 1991-02-05 1993-07-30 Safir BONE SURGICAL IMPLANT, ESPECIALLY FOR INTERVERTEBRAL STABILIZER.
US5098241A (en) * 1991-02-05 1992-03-24 Xyzyx International Corp. Variable length telescopic connector and method for use
DE9104025U1 (en) * 1991-04-03 1992-07-30 Waldemar Link Gmbh & Co, 2000 Hamburg, De
AR244071A1 (en) 1991-09-05 1993-10-29 Groiso Jorge Abel An elastic staple for osteosynthesis and a tool for placing it.
FR2676911B1 (en) * 1991-05-30 1998-03-06 Psi Ste Civile Particuliere INTERVERTEBRAL STABILIZATION DEVICE WITH SHOCK ABSORBERS.
US5236431A (en) 1991-07-22 1993-08-17 Synthes Resorbable fixation device with controlled stiffness for treating bodily material in vivo and introducer therefor
US5167664A (en) 1991-08-26 1992-12-01 Zimmer, Inc. Ratcheting bone screw
US5334184A (en) 1992-06-30 1994-08-02 Bimman Lev A Apparatus for intramedullary fixation broken bones
FR2693364B1 (en) * 1992-07-07 1995-06-30 Erpios Snc INTERVERTEBRAL PROSTHESIS FOR STABILIZING ROTATORY AND FLEXIBLE-EXTENSION CONSTRAINTS.
US5334204A (en) 1992-08-03 1994-08-02 Ace Medical Company Fixation screw
US5382248A (en) * 1992-09-10 1995-01-17 H. D. Medical, Inc. System and method for stabilizing bone segments
US5370646A (en) 1992-11-16 1994-12-06 Reese; H. William Bone clamp and installation tool
US5312410A (en) 1992-12-07 1994-05-17 Danek Medical, Inc. Surgical cable tensioner
FR2699065B1 (en) 1992-12-10 1995-03-10 Hardy Jean Marie Self-compressing screw for the treatment of epiphyseal and / or osteochondral fractures.
US5545164A (en) 1992-12-28 1996-08-13 Advanced Spine Fixation Systems, Incorporated Occipital clamp assembly for cervical spine rod fixation
US5496318A (en) * 1993-01-08 1996-03-05 Advanced Spine Fixation Systems, Inc. Interspinous segmental spine fixation device
US6030162A (en) * 1998-12-18 2000-02-29 Acumed, Inc. Axial tension screw
US5470333A (en) 1993-03-11 1995-11-28 Danek Medical, Inc. System for stabilizing the cervical and the lumbar region of the spine
US6162234A (en) 1993-03-23 2000-12-19 Freedland; Yosef Adjustable button cinch anchor orthopedic fastener
US5563127A (en) * 1993-03-24 1996-10-08 The Dupont Merck Pharmaceutical Company Boronic acid and ester inhibitors of thrombin
US5415661A (en) * 1993-03-24 1995-05-16 University Of Miami Implantable spinal assist device
US5540698A (en) 1993-04-21 1996-07-30 Amei Technologies Inc. System and method for securing a medical cable
US5449361A (en) 1993-04-21 1995-09-12 Amei Technologies Inc. Orthopedic cable tensioner
SE509192C2 (en) 1993-06-16 1998-12-14 Lindab Ab Self-drilling pop rivets as well as ways to provide a rivet joint by means of this
CA2167293A1 (en) 1993-07-16 1995-01-26 Gregg Stuart Baker Implant device and method of installing
US6004327A (en) 1993-08-03 1999-12-21 Stryker Technologies Corporation Ratcheting compression device
JP3085043B2 (en) 1993-08-05 2000-09-04 株式会社村田製作所 Zinc oxide piezoelectric crystal film on sapphire surface
FR2711505B1 (en) * 1993-10-25 1995-12-29 Tornier Sa Device for synthesizing fractures of the upper end of the femur.
US5618314A (en) 1993-12-13 1997-04-08 Harwin; Steven F. Suture anchor device
US5558674A (en) 1993-12-17 1996-09-24 Smith & Nephew Richards, Inc. Devices and methods for posterior spinal fixation
SE9402130D0 (en) 1994-06-17 1994-06-17 Sven Olerud Device and method for plate fixation of legs
US6001101A (en) 1994-07-05 1999-12-14 Depuy France Screw device with threaded head for permitting the coaptation of two bone fragments
FR2722980B1 (en) * 1994-07-26 1996-09-27 Samani Jacques INTERTEPINOUS VERTEBRAL IMPLANT
US5527312A (en) * 1994-08-19 1996-06-18 Salut, Ltd. Facet screw anchor
US5464427A (en) 1994-10-04 1995-11-07 Synthes (U.S.A.) Expanding suture anchor
FR2728778B1 (en) 1994-12-30 1998-08-21 Diebold Patrice Francois TRANS- OR INTRA-BONE IMPLANT FOR THE APPROXIMATION AND PRESSURIZATION OF BONE AND ANCILLARY FRAGMENTS FOR THE IMPLEMENTATION OF THIS IMPLANT
FI101129B (en) 1995-01-13 1998-04-30 Vivoxid Oy New bioactive glasses and their use
US5643320A (en) 1995-03-13 1997-07-01 Depuy Inc. Soft tissue anchor and method
US5520690A (en) * 1995-04-13 1996-05-28 Errico; Joseph P. Anterior spinal polyaxial locking screw plate assembly
FI101933B (en) 1995-06-13 1998-09-30 Biocon Oy Joint prosthesis
US6146384A (en) 1995-10-13 2000-11-14 Sdgi Holdings, Inc. Orthopedic fixation device and method of implantation
USD374287S (en) 1995-12-12 1996-10-01 Zimmer, Inc. Orthopadeic washer
US5649931A (en) 1996-01-16 1997-07-22 Zimmer, Inc. Orthopaedic apparatus for driving and/or removing a bone screw
US5899906A (en) 1996-01-18 1999-05-04 Synthes (U.S.A.) Threaded washer
CN1177918A (en) 1996-02-28 1998-04-01 卢茨·比德尔曼 Bone screw
DE19607517C1 (en) 1996-02-28 1997-04-10 Lutz Biedermann Bone screw for osteosynthesis
FR2745709B1 (en) 1996-03-08 1998-08-14 Caffiniere Jean Yves De COMPRESSION RECOVERY SCREW FOR PERCUTANEOUS OSTEOSYNTHESIS
US5792044A (en) 1996-03-22 1998-08-11 Danek Medical, Inc. Devices and methods for percutaneous surgery
US5667508A (en) 1996-05-01 1997-09-16 Fastenetix, Llc Unitary locking cap for use with a pedicle screw
US6491714B1 (en) 1996-05-03 2002-12-10 William F. Bennett Surgical tissue repair and attachment apparatus and method
US5849004A (en) 1996-07-17 1998-12-15 Bramlet; Dale G. Surgical anchor
EP0820736A1 (en) 1996-07-23 1998-01-28 Biomat B.V. Detachably connecting cap for a screw used in orthopaedic surgery
JP3223346B2 (en) 1996-09-19 2001-10-29 タキロン株式会社 Osteosynthesis screw washers
CA2217406C (en) 1996-10-04 2006-05-30 United States Surgical Corporation Suture anchor installation system with disposable loading unit
WO1998017188A1 (en) 1996-10-24 1998-04-30 Spinal Concepts, Inc. Method and apparatus for spinal fixation
CA2269065A1 (en) 1996-11-04 1998-05-14 Thomas M. Espinosa A fastener assembly serving as a product, or combined with other components as a product, allows automatic controlled movements in one direction and prevents movements in the opposite direction when forces are applied
US6648890B2 (en) 1996-11-12 2003-11-18 Triage Medical, Inc. Bone fixation system with radially extendable anchor
US20050143734A1 (en) * 1996-11-12 2005-06-30 Cachia Victor V. Bone fixation system with radially extendable anchor
US6632224B2 (en) 1996-11-12 2003-10-14 Triage Medical, Inc. Bone fixation system
US6027504A (en) 1996-12-06 2000-02-22 Mcguire; David A. Device and method for producing osteotomies
US6796983B1 (en) 1997-01-02 2004-09-28 St. Francis Medical Technologies, Inc. Spine distraction implant and method
US20020143331A1 (en) 1998-10-20 2002-10-03 Zucherman James F. Inter-spinous process implant and method with deformable spacer
US5836948A (en) * 1997-01-02 1998-11-17 Saint Francis Medical Technologies, Llc Spine distraction implant and method
US5941911A (en) 1997-01-16 1999-08-24 Buechel; Frederick F. Orthopedic prosthesis employing bone screws and cement
IT1293934B1 (en) 1997-01-21 1999-03-11 Orthofix Srl ENDOMIDOLLAR NAIL FOR THE TREATMENT OF HIP FRACTURES
US5782866A (en) 1997-03-25 1998-07-21 Ethicon, Inc. System for anchoring tissue to bone
US5810821A (en) 1997-03-28 1998-09-22 Biomet Inc. Bone fixation screw system
IES77331B2 (en) 1997-06-03 1997-12-03 Tecos Holdings Inc Pluridirectional and modulable vertebral osteosynthesis device of small overall size
US6692499B2 (en) 1997-07-02 2004-02-17 Linvatec Biomaterials Oy Surgical fastener for tissue treatment
US5890333A (en) * 1997-07-11 1999-04-06 Boroviak; Richard Concrete form
FR2766353B1 (en) 1997-07-28 1999-11-26 Dimso Sa IMPLANT, ESPECIALLY ANTERIOR CERVICAL PLATE
US5954722A (en) 1997-07-29 1999-09-21 Depuy Acromed, Inc. Polyaxial locking plate
US6001100A (en) 1997-08-19 1999-12-14 Bionx Implants Oy Bone block fixation implant
JPH1189854A (en) 1997-09-16 1999-04-06 Kobe Steel Ltd Cervical vertebra correcting holder
WO1999021501A1 (en) * 1997-10-27 1999-05-06 Saint Francis Medical Technologies, Llc Spine distraction implant
US6036071A (en) * 1997-11-03 2000-03-14 Cobbs Manufacturing Company Bracket for attachment of a vehicle accessory to a vehicle structure
FR2774581B1 (en) 1998-02-10 2000-08-11 Dimso Sa INTEREPINOUS STABILIZER TO BE ATTACHED TO SPINOUS APOPHYSIS OF TWO VERTEBRES
FR2775183B1 (en) 1998-02-20 2000-08-04 Jean Taylor INTER-SPINOUS PROSTHESIS
US5984966A (en) 1998-03-02 1999-11-16 Bionx Implants Oy Bioabsorbable bone block fixation implant
US5984927A (en) 1998-03-03 1999-11-16 Ethicon, Inc. Device for sutureless attachment of soft tissue to bone
US5997538A (en) 1998-03-23 1999-12-07 New York Society For The Ruptured And Crippled Maintaining The Hospital For Special Surgery Rotationally ratcheting bone screw
WO1999062417A1 (en) 1998-06-04 1999-12-09 Synthes Ag Chur Surgical blind rivet with closing element
DE19831336C2 (en) 1998-07-13 2003-06-18 Sepitec Foundation Vaduz Bone screw, especially for use with translaminar vertebrae
DE19832798C1 (en) 1998-07-21 1999-11-04 Aesculap Ag & Co Kg Instrument for installation of surgical bone plates
US5989255A (en) 1998-08-06 1999-11-23 Smith & Nephew Orthopaedic done screw apparatus
US6248108B1 (en) * 1998-09-30 2001-06-19 Bionx Implants Oy Bioabsorbable surgical screw and washer system
US7029473B2 (en) * 1998-10-20 2006-04-18 St. Francis Medical Technologies, Inc. Deflectable spacer for use as an interspinous process implant and method
US6066142A (en) 1998-10-22 2000-05-23 Depuy Orthopaedics, Inc. Variable position bone drilling alignment guide
US6099529A (en) 1998-10-26 2000-08-08 Musculoskeletal Transplant Foundation Allograft bone fixation screw method and apparatus
DE19851152A1 (en) 1998-11-06 2000-05-11 Storz Karl Gmbh & Co Kg Instruments for implanting a cruciate ligament replacement in a knee joint
CA2291349A1 (en) * 1998-12-23 2000-06-23 Nortel Networks Corporation A wireless communication system in which a base station controller routes packet data between roaming mobile units and a coupled packet data network
US6355043B1 (en) * 1999-03-01 2002-03-12 Sulzer Orthopedics Ltd. Bone screw for anchoring a marrow nail
PT1042989E (en) 1999-04-08 2004-05-31 Orthofix Int Bv IMPROVED BOLT TO BE APPLIED IN BONES IN ORTHOPEDIC SURGERY
US6126663A (en) 1999-04-15 2000-10-03 Hair; John Hunter Expandable bone connector
US6478805B1 (en) * 1999-04-16 2002-11-12 Nuvasive, Inc. System for removing cut tissue from the inner bore of a surgical instrument
FR2792521B1 (en) 1999-04-22 2001-08-31 New Deal COMPRESSION OSTEOSYNTHESIS SCREWS AND IMPLEMENTATION ANCILLARY
US6423067B1 (en) 1999-04-29 2002-07-23 Theken Surgical Llc Nonlinear lag screw with captive driving device
US6328739B1 (en) * 1999-05-04 2001-12-11 Industrial Technology Research Institute Enhanced spine fixation apparatus
US7094239B1 (en) 1999-05-05 2006-08-22 Sdgi Holdings, Inc. Screws of cortical bone and method of manufacture thereof
DE29908360U1 (en) * 1999-05-11 2000-09-21 Hehl Gerhard Slide screw for the operative supply of e.g. Fractures of the femoral neck
US6123711A (en) * 1999-06-10 2000-09-26 Winters; Thomas F. Tissue fixation device and method
US6458134B1 (en) * 1999-08-17 2002-10-01 Pioneer Laboratories, Inc. Bone connector system with anti-rotational feature
US6379363B1 (en) 1999-09-24 2002-04-30 Walter Lorenz Surgical, Inc. Method and apparatus for reattachment of a cranial flap using a cranial clamp
FR2799640B1 (en) 1999-10-15 2002-01-25 Spine Next Sa IMPLANT INTERVETEBRAL
US6251111B1 (en) 1999-10-20 2001-06-26 Sdgi Holdings, Inc. Jack for pulling a vertebral anchor
CA2386504C (en) * 1999-10-22 2008-07-15 Mark A. Reiley Facet arthroplasty devices and methods
US6974478B2 (en) * 1999-10-22 2005-12-13 Archus Orthopedics, Inc. Prostheses, systems and methods for replacement of natural facet joints with artificial facet joint surfaces
FR2800601B1 (en) 1999-11-05 2002-01-04 Europ Foot Platform ANKLE PROSTHESIS
US6287313B1 (en) 1999-11-23 2001-09-11 Sdgi Holdings, Inc. Screw delivery system and method
FR2801189B1 (en) 1999-11-24 2002-10-25 Newdeal IMPLANT FOR BONE SHORTENING, AND PARTICULARLY, METATARSIAN
AU2726701A (en) 1999-12-10 2001-06-18 Nuvasive, Inc. Facet screw and bone allograft intervertebral support and fusion system
US6290701B1 (en) 2000-01-11 2001-09-18 Albert Enayati Bioabsorbable rivet bone fastener
BR0104246A (en) 2000-01-26 2002-05-21 Heartport Inc Vascular incisor and method
US6228087B1 (en) * 2000-01-31 2001-05-08 Depuy Orthopaedics, Inc. Fixation member for treating orthopedic fractures
US6899716B2 (en) 2000-02-16 2005-05-31 Trans1, Inc. Method and apparatus for spinal augmentation
US6423061B1 (en) 2000-03-14 2002-07-23 Amei Technologies Inc. High tibial osteotomy method and apparatus
US6468277B1 (en) 2000-04-04 2002-10-22 Ethicon, Inc. Orthopedic screw and method
US6402750B1 (en) 2000-04-04 2002-06-11 Spinlabs, Llc Devices and methods for the treatment of spinal disorders
AU2001259154A1 (en) 2000-04-26 2001-11-07 Anchor Medical Technologies, Inc. Bone fixation system
FR2808182B1 (en) 2000-04-28 2002-10-31 Newdeal Sa COMPRESSION SPINDLE FOR THE SOLIDARIZATION OF PHALANGES
US6559389B1 (en) * 2000-08-25 2003-05-06 General Electric Company High-density cable and method therefor
US6554831B1 (en) * 2000-09-01 2003-04-29 Hopital Sainte-Justine Mobile dynamic system for treating spinal disorder
US6485491B1 (en) 2000-09-15 2002-11-26 Sdgi Holdings, Inc. Posterior fixation system
US6468309B1 (en) 2000-10-05 2002-10-22 Cleveland Clinic Foundation Method and apparatus for stabilizing adjacent bones
US6669698B1 (en) 2000-10-24 2003-12-30 Sdgi Holdings, Inc. Vertebrae fastener placement guide
US6648893B2 (en) 2000-10-27 2003-11-18 Blackstone Medical, Inc. Facet fixation devices
US6551319B2 (en) * 2000-11-08 2003-04-22 The Cleveland Clinic Foundation Apparatus for implantation into bone
RS49794B (en) 2000-11-22 2008-06-05 Milorad Mitković Internal fixator of bones
US6752831B2 (en) * 2000-12-08 2004-06-22 Osteotech, Inc. Biocompatible osteogenic band for repair of spinal disorders
US6635059B2 (en) 2001-01-03 2003-10-21 Bernard L. Randall Cannulated locking screw system especially for transiliac implant
US6929606B2 (en) 2001-01-29 2005-08-16 Depuy Spine, Inc. Retractor and method for spinal pedicle screw placement
DE20101793U1 (en) 2001-02-02 2001-05-03 Aesculap Ag & Co Kg Surgical implant for fixing adjacent bone plates
US7686807B2 (en) 2001-03-22 2010-03-30 Interventional Spine, Inc. Tool for bone fixation device
EP1379186B1 (en) 2001-03-30 2009-05-27 Interventional Spine, Inc. Distal bone anchors for bone fixation with secondary compression
US6452439B1 (en) * 2001-05-07 2002-09-17 International Business Machines Corporation Inductive voltage spike generator with diode shunt
US6770075B2 (en) 2001-05-17 2004-08-03 Robert S. Howland Spinal fixation apparatus with enhanced axial support and methods for use
US6361537B1 (en) * 2001-05-18 2002-03-26 Cinci M. Anderson Surgical plate with pawl and process for repair of a broken bone
US6673074B2 (en) 2001-08-02 2004-01-06 Endius Incorporated Apparatus for retaining bone portions in a desired spatial relationship
US6547795B2 (en) * 2001-08-13 2003-04-15 Depuy Acromed, Inc. Surgical guide system for stabilization of the spine
US6916323B2 (en) 2001-08-21 2005-07-12 Depuy Products, Inc. Method and apparatus for percutaneously securing a bone screw and a bone plate to a bone of a patient
US6733534B2 (en) * 2002-01-29 2004-05-11 Sdgi Holdings, Inc. System and method for spine spacing
US6875215B2 (en) 2002-02-15 2005-04-05 John Stanley Taras Distraction pin for fracture fixation
US6669729B2 (en) 2002-03-08 2003-12-30 Kingsley Richard Chin Apparatus and method for the replacement of posterior vertebral elements
US20030220643A1 (en) 2002-05-24 2003-11-27 Ferree Bret A. Devices to prevent spinal extension
US20040008949A1 (en) * 2002-06-21 2004-01-15 Gang Liu Fiber optic connection system and method of using the same
FR2841764B1 (en) 2002-07-05 2005-05-20 Newdeal Sa SCREW OF OSTEOSYNTHESIS AND SELF-TAPPING AND SELF-FORWARD COMPRESSION
DE10236691B4 (en) * 2002-08-09 2005-12-01 Biedermann Motech Gmbh Dynamic stabilization device for bones, in particular for vertebrae
US7641677B2 (en) * 2002-11-20 2010-01-05 Orthopediatrics Corp. Compression bone fragment wire
US7587587B2 (en) 2002-12-05 2009-09-08 Broadcom Corporation Data path security processing
US7070601B2 (en) 2003-01-16 2006-07-04 Triage Medical, Inc. Locking plate for bone anchors
WO2004078221A2 (en) 2003-02-28 2004-09-16 Triage Medical Inc. Deployment tool for distal bone anchors with secondary compression
JP2006519087A (en) 2003-02-28 2006-08-24 トリアージ メディカル、 インコーポレイテッド Tools for bone fixation devices
US7354442B2 (en) 2003-05-05 2008-04-08 Warsaw Orthopedic, Inc. Bone anchor and methods of using the same
US6951561B2 (en) 2003-05-06 2005-10-04 Triage Medical, Inc. Spinal stabilization device
US7749251B2 (en) 2003-06-13 2010-07-06 Aeolin, Llc Method and apparatus for stabilization of facet joint
US6945975B2 (en) 2003-07-07 2005-09-20 Aesculap, Inc. Bone fixation assembly and method of securement
US7074238B2 (en) * 2003-07-08 2006-07-11 Archus Orthopedics, Inc. Prostheses, tools and methods for replacement of natural facet joints with artificial facet joint surfaces
US7377942B2 (en) * 2003-08-06 2008-05-27 Warsaw Orthopedic, Inc. Posterior elements motion restoring device
ITMO20030232A1 (en) 2003-08-07 2005-02-08 Sacmi MEANS OF CAPSULE
US7731737B2 (en) * 2003-10-24 2010-06-08 Zimmer Spine, Inc. Methods and apparatuses for fixation of the spine through an access device
US7591837B2 (en) * 2003-10-28 2009-09-22 Pyramid Spine, Llc Facet triangle spinal fixation device and method of use
US20050149030A1 (en) 2003-12-19 2005-07-07 Depuy Spine, Inc. Facet joint fixation system
US20050216026A1 (en) 2004-01-14 2005-09-29 Culbert Brad S Guidance system for spinal stabilization
US7846183B2 (en) 2004-02-06 2010-12-07 Spinal Elements, Inc. Vertebral facet joint prosthesis and method of fixation
WO2006017641A2 (en) * 2004-08-03 2006-02-16 Vertech Innovations, L.L.C. Spinous process reinforcement device and method
US20060036259A1 (en) * 2004-08-03 2006-02-16 Carl Allen L Spine treatment devices and methods
US7658753B2 (en) * 2004-08-03 2010-02-09 K Spine, Inc. Device and method for correcting a spinal deformity
US20060036323A1 (en) * 2004-08-03 2006-02-16 Carl Alan L Facet device and method
US20060085010A1 (en) * 2004-09-29 2006-04-20 The Cleveland Clinic Foundation Minimally invasive method and apparatus for placing facet screws and fusing adjacent vertebrae
US7396360B2 (en) * 2004-09-29 2008-07-08 The Cleveland Clinic Foundation Minimally invasive method and apparatus for fusing adjacent vertebrae
WO2007048038A2 (en) 2005-10-21 2007-04-26 Acumed Llc Orthopedic rod with locking aperture
EP2010073A4 (en) 2006-04-21 2011-05-25 Interventional Spine Inc Method and apparatus for spinal fixation
US7998176B2 (en) 2007-06-08 2011-08-16 Interventional Spine, Inc. Method and apparatus for spinal stabilization
KR20100023541A (en) 2008-08-22 2010-03-04 삼성전자주식회사 Connector unit and display device having the same

Patent Citations (100)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1802560A (en) * 1923-04-04 1931-04-28 Arthur C Kerwin Masonry bolt
US2077804A (en) * 1936-05-19 1937-04-20 Morrison Gordon Monroe Device for treating fractures of the neck of the femur
US2485531A (en) * 1948-01-13 1949-10-18 Dzus William Surgical toggle bolt
US2570465A (en) * 1949-08-01 1951-10-09 Joseph S Lundholm Means for fixation of hip fractures
US3489143A (en) * 1967-12-15 1970-01-13 William X Halloran Convertible hip pin
US4052988A (en) * 1976-01-12 1977-10-11 Ethicon, Inc. Synthetic absorbable surgical devices of poly-dioxanone
US4275717A (en) * 1979-07-27 1981-06-30 Zimmer Usa, Inc. Intramedullary fixation device for fractured tubular bones
US4463753A (en) * 1980-01-04 1984-08-07 Gustilo Ramon B Compression bone screw
US4667663A (en) * 1983-07-13 1987-05-26 Keizo Miyata Intramedullary nail used to unite separated fragments of fractured long bone
US4873976A (en) * 1984-02-28 1989-10-17 Schreiber Saul N Surgical fasteners and method
US4721103A (en) * 1985-01-31 1988-01-26 Yosef Freedland Orthopedic device
US4743257A (en) * 1985-05-08 1988-05-10 Materials Consultants Oy Material for osteosynthesis devices
US4743257C1 (en) * 1985-05-08 2002-05-28 Materials Consultants Oy Material for osteosynthesis devices
US4760843A (en) * 1985-07-12 1988-08-02 Artur Fischer Connector for fractured bones
US4688561A (en) * 1985-09-17 1987-08-25 Reese H William Bone handling apparatus and method
US4640271A (en) * 1985-11-07 1987-02-03 Zimmer, Inc. Bone screw
US5772662A (en) * 1986-06-23 1998-06-30 Howmedica Inc. Femoral fixation system
US4796612A (en) * 1986-08-06 1989-01-10 Reese Hewitt W Bone clamp and method
US4898186A (en) * 1986-09-11 1990-02-06 Gunze Limited Osteosynthetic pin
US4815909A (en) * 1986-11-19 1989-03-28 Leon Simons Wood screw and method for making same
US4827917A (en) * 1986-12-30 1989-05-09 Richards Medical Company Fermoral fracture device
US4940467A (en) * 1988-02-03 1990-07-10 Tronzo Raymond G Variable length fixation device
US4917554A (en) * 1988-04-09 1990-04-17 Cryotherm Limited Screw unit to join semi-rigid mats together
US5098433A (en) * 1989-04-12 1992-03-24 Yosef Freedland Winged compression bolt orthopedic fastener
US4903692A (en) * 1989-05-08 1990-02-27 Reese Hewitt W Bone clamp installation tool
US5246441A (en) * 1989-09-08 1993-09-21 Linvatec Corporation Bioabsorbable tack for joining bodily tissue
US5059193A (en) * 1989-11-20 1991-10-22 Spine-Tech, Inc. Expandable spinal implant and surgical method
US5092891A (en) * 1990-03-08 1992-03-03 Kummer Frederick J Cement plug for the medullary canal of a bone and coacting tool for installing same
US5116336A (en) * 1990-03-19 1992-05-26 Synthes (U.S.A.) Osteosynthetic anchor bolt
US5122141A (en) * 1990-08-30 1992-06-16 Zimmer, Inc. Modular intramedullary nail
US5122133A (en) * 1990-10-26 1992-06-16 Smith & Nephew Richards Inc. Compression screw for a joint endoprosthesis
US5300074A (en) * 1990-12-17 1994-04-05 Synthes (U.S.A.) Two-part angle plate
US5498265A (en) * 1991-03-05 1996-03-12 Howmedica Inc. Screw and driver
US5217462A (en) * 1991-03-05 1993-06-08 Pfizer Hospital Products Group, Inc. Screw and driver
US5713903A (en) * 1991-03-22 1998-02-03 United States Surgical Corporation Orthopedic fastener
US5720753A (en) * 1991-03-22 1998-02-24 United States Surgical Corporation Orthopedic fastener
US5250049A (en) * 1992-01-10 1993-10-05 Michael Roger H Bone and tissue connectors
US5242447A (en) * 1992-02-06 1993-09-07 Howmedica Inc. Pin with tapered root diameter
US5728097A (en) * 1992-03-17 1998-03-17 Sdgi Holding, Inc. Method for subcutaneous suprafascial internal fixation
US5501695A (en) * 1992-05-27 1996-03-26 The Anspach Effort, Inc. Fastener for attaching objects to bones
US5928235A (en) * 1993-06-01 1999-07-27 Endocare Ag Osteosynthesis auxiliary for the treatment of subtrochanteric, peritrochanteric, and femoral-neck fractures
US5628751A (en) * 1993-06-21 1997-05-13 United States Surgical Corporation Orthopedic fastener applicator with rotational or longitudinal driver
US5452748A (en) * 1994-01-07 1995-09-26 Simmons; John M. Synchronized dual thread connector
US5728116A (en) * 1994-01-13 1998-03-17 Ethicon, Inc. Spiral surgical tack
US6036701A (en) * 1994-01-13 2000-03-14 Ethicon, Inc. Spiral surgical tack
US5904696A (en) * 1994-01-13 1999-05-18 Ethicon, Inc. Spiral surgical tack
US5646359A (en) * 1994-05-31 1997-07-08 Kabushiki Kaisha Kawai Gakki Seisakusho Silencing method and apparatus for pianos
US5536127A (en) * 1994-10-13 1996-07-16 Pennig; Dietmar Headed screw construction for use in fixing the position of an intramedullary nail
US5549610A (en) * 1994-10-31 1996-08-27 Smith & Nephew Richards Inc. Femoral intramedullary nail
US5669915A (en) * 1995-03-22 1997-09-23 Aesculap Ag Drilling jig for surgical drilling tools
US5626613A (en) * 1995-05-04 1997-05-06 Arthrex, Inc. Corkscrew suture anchor and driver
US5662683A (en) * 1995-08-22 1997-09-02 Ortho Helix Limited Open helical organic tissue anchor and method of facilitating healing
US5782865A (en) * 1995-08-25 1998-07-21 Grotz; Robert Thomas Stabilizer for human joints
US5725541A (en) * 1996-01-22 1998-03-10 The Anspach Effort, Inc. Soft tissue fastener device
US5741282A (en) * 1996-01-22 1998-04-21 The Anspach Effort, Inc. Soft tissue fastener device
US6183474B1 (en) * 1996-03-13 2001-02-06 Dale G. Bramlet Surgical fastener assembly
US5743914A (en) * 1996-06-06 1998-04-28 Skiba; Jeffry B. Bone screw
US6599297B1 (en) * 1996-09-02 2003-07-29 Nobel Biocare Ab Device for ventilating the middle ear
US6083244A (en) * 1996-09-13 2000-07-04 Tendon Technology, Ltd. Apparatus and method for tendon or ligament repair
US6371989B1 (en) * 1996-09-13 2002-04-16 Jean-Luc Chauvin Method of providing proper vertebral spacing
US5948000A (en) * 1996-10-03 1999-09-07 United States Surgical Corporation System for suture anchor placement
US5928244A (en) * 1996-10-04 1999-07-27 United States Surgical Corporation Tissue fastener implantation apparatus and method
US5931870A (en) * 1996-10-09 1999-08-03 Smith & Nephew, Inc. Acetabular ring prosthesis with reinforcement buttress
US5893850A (en) * 1996-11-12 1999-04-13 Cachia; Victor V. Bone fixation device
US5947999A (en) * 1996-12-03 1999-09-07 Groiso; Jorge A. Surgical clip and method
US5908422A (en) * 1997-01-13 1999-06-01 Synthes (U.S.A) Helical osteosynthetic implant
US6168595B1 (en) * 1997-02-11 2001-01-02 Orthomatrix, Inc. Modular intramedullary fixation system and insertion instrumentation
US5935129A (en) * 1997-03-07 1999-08-10 Innovasive Devices, Inc. Methods and apparatus for anchoring objects to bone
US5957924A (en) * 1997-05-22 1999-09-28 Bionx Implants Oy Installation tool for suture anchor
US5954747A (en) * 1997-11-20 1999-09-21 Clark; Ron Meniscus repair anchor system
US6010513A (en) * 1997-11-26 2000-01-04 Bionx Implants Oy Device for installing a tissue fastener
US6015410A (en) * 1997-12-23 2000-01-18 Bionx Implants Oy Bioabsorbable surgical implants for endoscopic soft tissue suspension procedure
US6068648A (en) * 1998-01-26 2000-05-30 Orthodyne, Inc. Tissue anchoring system and method
US5871485A (en) * 1998-03-18 1999-02-16 Rao; G.V. Subba Device for internal fixation of femoral neck fractures
US6183472B1 (en) * 1998-04-09 2001-02-06 Howmedica Gmbh Pedicle screw and an assembly aid therefor
US6019762A (en) * 1998-04-30 2000-02-01 Orthodyne, Inc. Adjustable length orthopedic fixation device
US6589249B2 (en) * 1998-05-12 2003-07-08 Scimed Life Systems, Inc. Manual bone anchor placement devices
US6585740B2 (en) * 1998-11-26 2003-07-01 Synthes (U.S.A.) Bone screw
US6517543B1 (en) * 1999-08-17 2003-02-11 Pioneer Laboratories, Inc. Bone connector system with anti-rotational feature
US6558389B2 (en) * 1999-11-30 2003-05-06 Ron Clark Endosteal tibial ligament fixation with adjustable tensioning
US6582453B1 (en) * 2000-07-14 2003-06-24 Opus Medical, Inc. Method and apparatus for attaching connective tissues to bone using a suture anchoring device
US6579293B1 (en) * 2000-08-02 2003-06-17 Rama E. Chandran Intramedullary rod with interlocking oblique screw for tibio-calcaneal arthrodesis
US6585730B1 (en) * 2000-08-30 2003-07-01 Opus Medical, Inc. Method and apparatus for attaching connective tissues to bone using a knotless suture anchoring device
US6551322B1 (en) * 2000-10-05 2003-04-22 The Cleveland Clinic Foundation Apparatus for implantation into bone
US6527774B2 (en) * 2000-11-08 2003-03-04 The Cleveland Clinic Foundation Apparatus for attaching fractured sections of bone
US20020055740A1 (en) * 2000-11-08 2002-05-09 The Cleveland Clinic Foundation Method and apparatus for correcting spinal deformity
US6544265B2 (en) * 2000-11-08 2003-04-08 The Cleveland Clinic Foundation Apparatus for implantation into bone related applications
US6511481B2 (en) * 2001-03-30 2003-01-28 Triage Medical, Inc. Method and apparatus for fixation of proximal femoral fractures
US6887243B2 (en) * 2001-03-30 2005-05-03 Triage Medical, Inc. Method and apparatus for bone fixation with secondary compression
US6890333B2 (en) * 2001-03-30 2005-05-10 Triage Medical, Inc. Method and apparatus for bone fixation with secondary compression
US20050131411A1 (en) * 2001-03-30 2005-06-16 Culbert Brad S. Method and apparatus for bone fixation with secondary compression
US6908465B2 (en) * 2001-03-30 2005-06-21 Triage Medical, Inc. Distal bone anchors for bone fixation with secondary compression
US20060195103A1 (en) * 2001-11-19 2006-08-31 Marty Padget Proximal anchors for bone fixation system
US6942668B2 (en) * 2001-11-19 2005-09-13 Triage Medical, Inc. Proximal anchors for bone fixation system
US20040127906A1 (en) * 2002-07-19 2004-07-01 Culbert Brad S. Method and apparatus for spinal fixation
US20070118132A1 (en) * 2002-07-19 2007-05-24 Triage Medical, Inc. Method and apparatus for spinal fixation
US20070123868A1 (en) * 2002-07-19 2007-05-31 Culbert Brad S Method and apparatus for spinal fixation
US20060122610A1 (en) * 2004-12-08 2006-06-08 Culbert Brad S Method and apparatus for spinal stabilization
US20060122609A1 (en) * 2004-12-08 2006-06-08 Srdjan Mirkovic Method and apparatus for spinal stabilization
US20070016191A1 (en) * 2004-12-08 2007-01-18 Culbert Brad S Method and apparatus for spinal stabilization

Cited By (104)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10349991B2 (en) 2001-03-30 2019-07-16 DePuy Synthes Products, Inc. Method and apparatus for bone fixation with secondary compression
US10111695B2 (en) 2001-03-30 2018-10-30 DePuy Synthes Products, Inc. Distal bone anchors for bone fixation with secondary compression
US8715284B2 (en) 2001-03-30 2014-05-06 Interventional Spine, Inc. Method and apparatus for bone fixation with secondary compression
US9408648B2 (en) 2001-03-30 2016-08-09 Interventional Spine, Inc. Method and apparatus for bone fixation with secondary compression
US20080108996A1 (en) * 2001-08-23 2008-05-08 Interventional Spine, Inc. Deployment tool for distal bone anchors with secondary compression
US9993349B2 (en) 2002-06-27 2018-06-12 DePuy Synthes Products, Inc. Intervertebral disc
US7824429B2 (en) 2002-07-19 2010-11-02 Interventional Spine, Inc. Method and apparatus for spinal fixation
US8109977B2 (en) 2002-07-19 2012-02-07 Interventional Spine, Inc. Method and apparatus for spinal fixation
US9713486B2 (en) 2002-07-19 2017-07-25 DePuy Synthes Products, Inc. Method and apparatus for spinal fixation
US7993377B2 (en) 2002-07-19 2011-08-09 Interventional Spine, Inc. Method and apparatus for spinal fixation
US8945190B2 (en) 2002-07-19 2015-02-03 Interventional Spine, Inc. Method and apparatus for spinal fixation
US20060039772A1 (en) * 2003-02-12 2006-02-23 Romano Matthys-Mark Screw with integrated screwdriver
US7316532B2 (en) * 2003-02-12 2008-01-08 Synthes (U.S.A.) Screw with integrated screwdriver
US10639074B2 (en) 2004-12-08 2020-05-05 Decima Spine, Inc. Method and apparatus for spinal stabilization
US10667844B2 (en) 2004-12-08 2020-06-02 Decima Spine, Inc. Method and apparatus for spinal stabilization
US20060122610A1 (en) * 2004-12-08 2006-06-08 Culbert Brad S Method and apparatus for spinal stabilization
US10070893B2 (en) 2004-12-08 2018-09-11 Decima Spine, Inc. Method and apparatus for spinal stabilization
US20060122609A1 (en) * 2004-12-08 2006-06-08 Srdjan Mirkovic Method and apparatus for spinal stabilization
US7648523B2 (en) 2004-12-08 2010-01-19 Interventional Spine, Inc. Method and apparatus for spinal stabilization
US9962189B2 (en) 2004-12-08 2018-05-08 Decima Spine, Inc. Method and apparatus for spinal stabilization
US7857832B2 (en) 2004-12-08 2010-12-28 Interventional Spine, Inc. Method and apparatus for spinal stabilization
US7901438B2 (en) 2004-12-08 2011-03-08 Interventional Spine, Inc. Method and apparatus for spinal stabilization
US9226758B2 (en) 2004-12-08 2016-01-05 Decima Spine, Inc. Method and apparatus for spinal stabilization
US9445826B2 (en) 2004-12-08 2016-09-20 Decima Spine, Inc. Method and apparatus for spinal stabilization
US10398566B2 (en) 2006-12-07 2019-09-03 DePuy Synthes Products, Inc. Intervertebral implant
US11497618B2 (en) 2006-12-07 2022-11-15 DePuy Synthes Products, Inc. Intervertebral implant
US11432942B2 (en) 2006-12-07 2022-09-06 DePuy Synthes Products, Inc. Intervertebral implant
US11642229B2 (en) 2006-12-07 2023-05-09 DePuy Synthes Products, Inc. Intervertebral implant
US11712345B2 (en) 2006-12-07 2023-08-01 DePuy Synthes Products, Inc. Intervertebral implant
US10583015B2 (en) 2006-12-07 2020-03-10 DePuy Synthes Products, Inc. Intervertebral implant
US11273050B2 (en) 2006-12-07 2022-03-15 DePuy Synthes Products, Inc. Intervertebral implant
US10390963B2 (en) 2006-12-07 2019-08-27 DePuy Synthes Products, Inc. Intervertebral implant
US11660206B2 (en) 2006-12-07 2023-05-30 DePuy Synthes Products, Inc. Intervertebral implant
US9254153B2 (en) 2007-04-19 2016-02-09 Stryker Trauma Gmbh Hip fracture device with static locking mechanism allowing compression
US8734494B2 (en) 2007-04-19 2014-05-27 Stryker Trauma Gmbh Hip fracture device with static locking mechanism allowing compression
US8398636B2 (en) 2007-04-19 2013-03-19 Stryker Trauma Gmbh Hip fracture device with barrel and end cap for load control
US7998176B2 (en) 2007-06-08 2011-08-16 Interventional Spine, Inc. Method and apparatus for spinal stabilization
US10973652B2 (en) 2007-06-26 2021-04-13 DePuy Synthes Products, Inc. Highly lordosed fusion cage
US9839530B2 (en) 2007-06-26 2017-12-12 DePuy Synthes Products, Inc. Highly lordosed fusion cage
US11622868B2 (en) 2007-06-26 2023-04-11 DePuy Synthes Products, Inc. Highly lordosed fusion cage
US10603087B2 (en) 2008-01-14 2020-03-31 Conventus Orthopaedics, Inc. Apparatus and methods for fracture repair
US9788870B2 (en) 2008-01-14 2017-10-17 Conventus Orthopaedics, Inc. Apparatus and methods for fracture repair
US11399878B2 (en) 2008-01-14 2022-08-02 Conventus Orthopaedics, Inc. Apparatus and methods for fracture repair
US9517093B2 (en) 2008-01-14 2016-12-13 Conventus Orthopaedics, Inc. Apparatus and methods for fracture repair
US10433977B2 (en) 2008-01-17 2019-10-08 DePuy Synthes Products, Inc. Expandable intervertebral implant and associated method of manufacturing the same
US10449058B2 (en) 2008-01-17 2019-10-22 DePuy Synthes Products, Inc. Expandable intervertebral implant and associated method of manufacturing the same
US11737881B2 (en) 2008-01-17 2023-08-29 DePuy Synthes Products, Inc. Expandable intervertebral implant and associated method of manufacturing the same
US9931223B2 (en) 2008-04-05 2018-04-03 DePuy Synthes Products, Inc. Expandable intervertebral implant
US9993350B2 (en) 2008-04-05 2018-06-12 DePuy Synthes Products, Inc. Expandable intervertebral implant
US11712342B2 (en) 2008-04-05 2023-08-01 DePuy Synthes Products, Inc. Expandable intervertebral implant
US11712341B2 (en) 2008-04-05 2023-08-01 DePuy Synthes Products, Inc. Expandable intervertebral implant
US11707359B2 (en) 2008-04-05 2023-07-25 DePuy Synthes Products, Inc. Expandable intervertebral implant
US11602438B2 (en) 2008-04-05 2023-03-14 DePuy Synthes Products, Inc. Expandable intervertebral implant
US11617655B2 (en) 2008-04-05 2023-04-04 DePuy Synthes Products, Inc. Expandable intervertebral implant
US11701234B2 (en) 2008-04-05 2023-07-18 DePuy Synthes Products, Inc. Expandable intervertebral implant
US10449056B2 (en) 2008-04-05 2019-10-22 DePuy Synthes Products, Inc. Expandable intervertebral implant
US11612491B2 (en) 2009-03-30 2023-03-28 DePuy Synthes Products, Inc. Zero profile spinal fusion cage
CN102686177A (en) * 2009-11-10 2012-09-19 史密夫和内修有限公司 Controlling bone compression
WO2011060082A3 (en) * 2009-11-10 2011-09-29 Smith & Nephew, Inc. Controlling bone compression
US10172654B2 (en) 2009-11-10 2019-01-08 Smith & Nephew, Inc. Controlling bone compression
US11607321B2 (en) 2009-12-10 2023-03-21 DePuy Synthes Products, Inc. Bellows-like expandable interbody fusion cage
US10500062B2 (en) 2009-12-10 2019-12-10 DePuy Synthes Products, Inc. Bellows-like expandable interbody fusion cage
US9730739B2 (en) 2010-01-15 2017-08-15 Conventus Orthopaedics, Inc. Rotary-rigid orthopaedic rod
US9848889B2 (en) 2010-01-20 2017-12-26 Conventus Orthopaedics, Inc. Apparatus and methods for bone access and cavity preparation
US8961518B2 (en) 2010-01-20 2015-02-24 Conventus Orthopaedics, Inc. Apparatus and methods for bone access and cavity preparation
US20110184471A1 (en) * 2010-01-28 2011-07-28 Warsaw Orthopedic, Inc. Bone anchor with predetermined break point and removal features
US8523914B2 (en) * 2010-01-28 2013-09-03 Warsaw Orthopedic, Inc. Bone anchor with predetermined break point and removal features
US8906022B2 (en) 2010-03-08 2014-12-09 Conventus Orthopaedics, Inc. Apparatus and methods for securing a bone implant
US9993277B2 (en) 2010-03-08 2018-06-12 Conventus Orthopaedics, Inc. Apparatus and methods for securing a bone implant
US10966840B2 (en) 2010-06-24 2021-04-06 DePuy Synthes Products, Inc. Enhanced cage insertion assembly
US11872139B2 (en) 2010-06-24 2024-01-16 DePuy Synthes Products, Inc. Enhanced cage insertion assembly
US9895236B2 (en) 2010-06-24 2018-02-20 DePuy Synthes Products, Inc. Enhanced cage insertion assembly
US11911287B2 (en) 2010-06-24 2024-02-27 DePuy Synthes Products, Inc. Lateral spondylolisthesis reduction cage
US10548741B2 (en) 2010-06-29 2020-02-04 DePuy Synthes Products, Inc. Distractible intervertebral implant
US11654033B2 (en) 2010-06-29 2023-05-23 DePuy Synthes Products, Inc. Distractible intervertebral implant
US11452607B2 (en) 2010-10-11 2022-09-27 DePuy Synthes Products, Inc. Expandable interspinous process spacer implant
US10058433B2 (en) 2012-07-26 2018-08-28 DePuy Synthes Products, Inc. Expandable implant
US9883951B2 (en) 2012-08-30 2018-02-06 Interventional Spine, Inc. Artificial disc
US10413422B2 (en) 2013-03-07 2019-09-17 DePuy Synthes Products, Inc. Intervertebral implant
US9522070B2 (en) 2013-03-07 2016-12-20 Interventional Spine, Inc. Intervertebral implant
US11497619B2 (en) 2013-03-07 2022-11-15 DePuy Synthes Products, Inc. Intervertebral implant
US11850164B2 (en) 2013-03-07 2023-12-26 DePuy Synthes Products, Inc. Intervertebral implant
US11006991B2 (en) 2013-07-03 2021-05-18 DePuy Synthes Products, Inc. Method and apparatus for sacroiliac joint fixation
US10166056B2 (en) 2013-07-03 2019-01-01 DePuy Synthes Products, Inc. Method and apparatus for sacroiliac joint fixation
US9522028B2 (en) 2013-07-03 2016-12-20 Interventional Spine, Inc. Method and apparatus for sacroiliac joint fixation
US10022132B2 (en) 2013-12-12 2018-07-17 Conventus Orthopaedics, Inc. Tissue displacement tools and methods
US10076342B2 (en) 2013-12-12 2018-09-18 Conventus Orthopaedics, Inc. Tissue displacement tools and methods
US11426290B2 (en) 2015-03-06 2022-08-30 DePuy Synthes Products, Inc. Expandable intervertebral implant, system, kit and method
US9913727B2 (en) 2015-07-02 2018-03-13 Medos International Sarl Expandable implant
US11596522B2 (en) 2016-06-28 2023-03-07 Eit Emerging Implant Technologies Gmbh Expandable and angularly adjustable intervertebral cages with articulating joint
US11596523B2 (en) 2016-06-28 2023-03-07 Eit Emerging Implant Technologies Gmbh Expandable and angularly adjustable articulating intervertebral cages
US11510788B2 (en) 2016-06-28 2022-11-29 Eit Emerging Implant Technologies Gmbh Expandable, angularly adjustable intervertebral cages
US10537436B2 (en) 2016-11-01 2020-01-21 DePuy Synthes Products, Inc. Curved expandable cage
US10888433B2 (en) 2016-12-14 2021-01-12 DePuy Synthes Products, Inc. Intervertebral implant inserter and related methods
US10398563B2 (en) 2017-05-08 2019-09-03 Medos International Sarl Expandable cage
US11446155B2 (en) 2017-05-08 2022-09-20 Medos International Sarl Expandable cage
US11344424B2 (en) 2017-06-14 2022-05-31 Medos International Sarl Expandable intervertebral implant and related methods
US10918426B2 (en) 2017-07-04 2021-02-16 Conventus Orthopaedics, Inc. Apparatus and methods for treatment of a bone
US10940016B2 (en) 2017-07-05 2021-03-09 Medos International Sarl Expandable intervertebral fusion cage
US11446156B2 (en) 2018-10-25 2022-09-20 Medos International Sarl Expandable intervertebral implant, inserter instrument, and related methods
US11806245B2 (en) 2020-03-06 2023-11-07 Eit Emerging Implant Technologies Gmbh Expandable intervertebral implant
US11426286B2 (en) 2020-03-06 2022-08-30 Eit Emerging Implant Technologies Gmbh Expandable intervertebral implant
US11850160B2 (en) 2021-03-26 2023-12-26 Medos International Sarl Expandable lordotic intervertebral fusion cage
US11752009B2 (en) 2021-04-06 2023-09-12 Medos International Sarl Expandable intervertebral fusion cage

Also Published As

Publication number Publication date
US20020143333A1 (en) 2002-10-03
US20120277795A1 (en) 2012-11-01
ATE432051T1 (en) 2009-06-15
US20090069813A1 (en) 2009-03-12
US6890333B2 (en) 2005-05-10
US20020143335A1 (en) 2002-10-03
US8551094B2 (en) 2013-10-08
US7556629B2 (en) 2009-07-07
ES2324524T3 (en) 2009-08-10
EP2055252A1 (en) 2009-05-06
US20140142629A1 (en) 2014-05-22
DE60232440D1 (en) 2009-07-09
KR100876815B1 (en) 2009-01-07
KR20040002891A (en) 2004-01-07
US20020143334A1 (en) 2002-10-03
US6908465B2 (en) 2005-06-21
US6511481B2 (en) 2003-01-28
US10111695B2 (en) 2018-10-30
US20050137595A1 (en) 2005-06-23
US20040199162A1 (en) 2004-10-07

Similar Documents

Publication Publication Date Title
US10111695B2 (en) Distal bone anchors for bone fixation with secondary compression
US10349991B2 (en) Method and apparatus for bone fixation with secondary compression
US7070601B2 (en) Locking plate for bone anchors
US7326211B2 (en) Deployment tool for distal bone anchors with secondary compression
CA2442334C (en) Distal bone anchors for bone fixation with secondary compression
US20060089647A1 (en) Method and apparatus for delivering an agent
US20040138665A1 (en) Proximal anchors for bone fixation system
AU2002250488A1 (en) Distal bone anchors for bone fixation with secondary compression

Legal Events

Date Code Title Description
AS Assignment

Owner name: INTERVENTIONAL SPINE, INC., CALIFORNIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:TRIAGE MEDICAL INC.;REEL/FRAME:020206/0327

Effective date: 20061128

Owner name: INTERVENTIONAL SPINE, INC.,CALIFORNIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:TRIAGE MEDICAL INC.;REEL/FRAME:020206/0327

Effective date: 20061128

STCB Information on status: application discontinuation

Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION