A humeral fracture fixation system is provided and includes a nail-plate fixation device having a plate-like head portion, an intramedullary nail portion, and a bent neck portion therebetween which creates an angle between the plate and nail portions. The upper surface of the nail portion is substantially straight for contact with the endosteum and the nail portion includes threaded holes for machine screws. The head portion includes locking holes for receiving fixed-angle bone support elements, and K-wire alignment holes. The front of the head portion includes suture holes while presenting a smooth profile. A specific implantation jig and screw guide cannula are also provided.
1. An implant for fixation of a bone fracture, the bone having a diaphysis with a medullary canal, an endosteum within the medullary canal, and a metaphysis with an articular surface at its end, comprising:
a) an intramedullary nail portion having a substantially straight endosteal surface for contacting the endosteum and a plurality of threaded screw holes longitudinally displaced along the nail portion;
b) a plate-like head portion at an angle relative to said endosteal surface, said head portion including five locking holes at which bone support elements may be locked relative to the head portion, each of said five locking holes defining a respective and discrete axis, with one of the locking holes being a central locking hole,
wherein when the head portion is seated on the metaphysis the central locking hole defines an axis directed toward the center of the articular surface of the bone, and
the remaining locking holes have axes spatially distributed and diverging from the axis of the central locking hole; and
c) a neck portion between the head and nail portions longitudinally and vertically offsetting said head and nail potions, wherein said central locking hole extends through both said head portion and said neck portion.
2. An implant according to claim 1 , wherein:
the angle between the head and nail portions is approximately 10°-25°.
3. An implant according to claim 1 , wherein:
the head portion includes at least one K-wire alignment hole which is sized to stably receive a K-wire at a fixed angle.
4. An implant according to claim 1 , wherein:
the head portion includes at least one non-threaded suture hole at which suture may be coupled to said head portion.
5. An implant according to claim 4 , wherein:
said head portion has a thickness, and
said at least one suture hole includes three suture tunnels, each of which includes a side which is longer than the thickness of the head portion.
6. An implant according to claim 4 , wherein:
the head portion has a proximal-distal axis and a central plane, and
the at least one suture hole includes three suture tunnels including a first central tunnel perpendicular to the proximal-distal axis and extending through the central plane, and second and third tunnels on either side of the first tunnel and which are at angle of about 45°±15° degrees with respect to the first tunnel.
7. An implant according to claim 1 , wherein:
the head portion includes
(i) a catch at an end opposite the nail portion, and
(ii) a screw hole, both for coupling an implantation jig thereto.
8. An implant for fixation of a bone fracture, the bone having a diaphysis with a medullary canal, an endosteum within the medullary canal, and a metaphysis with an articular surface at its end, comprising:
a) an intramedullary nail portion having a substantially straight endosteal surface for contacting the endosteum and a plurality of threaded screw holes longitudinally displaced along the nail portion;
b) a plate-like head portion at an angle relative to said endosteal surface, said head portion including a proximal first locking hole, a distal second locking hole, and a third locking hole longitudinally displaced in a proximal-distal direction along said head portion between said first and second locking holes; and
c) a neck portion between the head and nail portions longitudinally and vertically offsetting said head and nail potions, wherein said third locking hole extends through both said head portion and said neck portion.
9. An implant according to claim 8 , wherein:
when said head portion is seated on the metaphysis, said third locking hole defines an axis directed toward the center of the articular surface of the bone.
10. An implant according to claim 8 , wherein:
the first and second locking holes have axes spatially distributed and diverging from the axis of the third locking hole.
11. An implant according to claim 8 , wherein:
said head portion has a lower surface, said lower surface extends along an axis in said proximal-distal direction, and said third locking hole is oriented at an oblique angle relative to said proximal-distal axis of said lower surface.
12. An implant according to claim 8 , wherein:
said head portion include a lower surface, and said neck portion is coupled at a center of said lower surface.
13. An implant according to claim 12 , wherein:
said head portion has a lower surface, said lower surface extends along an axis in said proximal-distal direction, and said third locking hole is oriented at an oblique angle relative to said proximal-distal axis of said lower surface.