System and method for bone fixation using a nail locked to an encircling anchor
Systems and methods for fixing bone using an intramedullary nail locked to an encircling anchor including a bushing and a locking member. An exemplary system may include any combination of the nail, one or more bushings, one or more locking members, an instrument to guide installation of the bushing, at least one drill, and a driver that attaches to the bushing. The instrument may define a guide axis and be configured to be coupled to a bone such that the guide axis extends across the bone. The instrument may be used to guide a drill, the bushing, and/or the locking member along the guide axis into the bone. The nail may be configured to be placed along the medullary canal of the bone such that the nail extends through the bushing, and the locking member may be configured to lock the nail to the bushing.
1 . A system for bone fixation, comprising:
a nail configured to be placed longitudinally in a medullary canal of a bone;
a bushing having a trailing portion and a leading portion, the trailing portion forming a shoulder adjacent the leading portion and defining a transverse aperture through which the nail is configured to extend, the leading portion being elongated and substantially cylindrical, wherein the trailing portion of the busing comprises one or more lateral protrusions configured to attach the bushing to a near cortex of the bone, the one or more lateral protrusions forming an external thread; and
a locker configured to lock the nail to the bushing.
2 . The system of claim 1 , wherein the trailing portion of the bushing tapers or ends abruptly to form the shoulder.
3 . The system of claim 1 , wherein at least one of the lateral protrusions forms at least part of an inlet of the transverse aperture.
4 . The system of claim 1 , wherein the one or more lateral protrusions comprise a plurality of teeth or define a plurality of axial columns of teeth.
5 . The system of claim 4 , wherein the one or more lateral protrusions form two or more sets of teeth that are circumferentially spaced from one another on the trailing portion, and wherein each set of teeth of the two or more sets are arranged on a same helical path as one another.
6 . The system of claim 4 , wherein the plurality of teeth comprises an axial column of teeth arranged parallel to a long axis of the bushing.
7 . The system of claim 1 , wherein the shoulder is spherical or planar.
8 . The system of claim 1 , wherein the trailing portion of the bushing further defines an axial aperture intersecting the transverse aperture and having an internal thread, and wherein the locker has an external thread that is complementary to the internal thread.
9 . The system of claim 1 , wherein the bushing defines a long axis, and wherein the transverse aperture is elongated parallel to the long axis and has a tapered inlet.
10 . The system of claim 1 , wherein the transverse aperture comprises opposite ends that are spaced from one another parallel to a through-axis of the transverse aperture, and wherein each opposite end is beveled circumferentially to form a widened inlet.
11 . The system of claim 1 , wherein the transverse aperture comprises an inlet, and wherein the inlet has a length measured parallel to a long axis of the bushing that is at least one-half a length of the trailing portion measured parallel to the long axis.
12 . The system of claim 1 , wherein the transverse aperture comprises an inlet, wherein the inlet has a maximum width measured parallel to a diametrical axis of the bushing that is orthogonal to a long axis of the bushing and orthogonal to a through-axis of the aperture, and wherein the maximum width is at least one-half an average diameter of the trailing portion.
13 . The system of claim 1 , wherein a leading region of the nail comprises a main portion defining a long axis and a tip that is offset from the long axis.
14 . The system of claim 13 , wherein the tip is elongated substantially parallel to the long axis of the main portion.
15 . The system of claim 13 , wherein the main portion has a uniform diameter, and wherein the tip is tapered.
16 . The system of any claim 13 , wherein a trailing region of the nail is curved in a plane, and wherein the tip is offset from the main portion in the plane.
17 . The system of claim 13 , wherein the tip is less than one-half the length of the main portion.
18 . A system for bone fixation, comprising:
a nail configured to be placed longitudinally in a medullary canal of a bone;
a bushing having a trailing portion and a leading portion, the trailing portion forming a shoulder adjacent the leading portion and defining a transverse aperture through which the nail is configured to extend, the leading portion being elongated and substantially cylindrical, wherein the trailing portion of the busing comprises one or more lateral protrusions configured to attach the bushing to a near cortex of the bone, the one or more lateral protrusions comprise a plurality of teeth or define a plurality of axial columns of teeth; and
a locker configured to lock the nail to the bushing.
19 . The system of claim 18 , wherein the trailing portion of the bushing tapers or ends abruptly to form the shoulder.
20 . The system of claim 18 , wherein at least one of the lateral protrusions forms at least part of an inlet of the transverse aperture.
21 . The system of claim 18 , wherein the one or more lateral protrusions form two or more sets of teeth that are circumferentially spaced from one another on the trailing portion, and wherein each set of teeth of the two or more sets are arranged on a same helical path as one another.
22 . The system of claim 18 , wherein the plurality of teeth comprises an axial column of teeth arranged parallel to a long axis of the bushing.
23 . The system of claim 18 , wherein the shoulder is spherical or planar.
24 . The system of claim 18 , wherein the trailing portion of the bushing further defines an axial aperture intersecting the transverse aperture and having an internal thread, and wherein the locker has an external thread that is complementary to the internal thread.
25 . The system of claim 18 , wherein the bushing defines a long axis, and wherein the transverse aperture is elongated parallel to the long axis and has a tapered inlet.
26 . The system of claim 18 , wherein the transverse aperture comprises opposite ends that are spaced from one another parallel to a through-axis of the transverse aperture, and wherein each opposite end is beveled circumferentially to form a widened inlet.
27 . The system of claim 18 , wherein the transverse aperture comprises an inlet, and wherein the inlet has a length measured parallel to a long axis of the bushing that is at least one- half a length of the trailing portion measured parallel to the long axis.
28 . The system of claim 18 , wherein the transverse aperture comprises an inlet, wherein the inlet has a maximum width measured parallel to a diametrical axis of the bushing that is orthogonal to a long axis of the bushing and orthogonal to a through-axis of the aperture, and wherein the maximum width is at least one-half an average diameter of the trailing portion.
29 . The system of claim 18 , wherein a leading region of the nail comprises a main portion defining a long axis and a tip that is offset from the long axis.
30 . The system of claim 29 , wherein the tip is elongated substantially parallel to the long axis of the main portion.
31 . The system of claim 29 , wherein the main portion has a uniform diameter, and wherein the tip is tapered.
32 . The system of any claim 29 , wherein a trailing region of the nail is curved in a plane, and wherein the tip is offset from the main portion in the plane.
33 . The system of claim 29 , wherein the tip is less than one-half the length of the main portion.