Internal joint distraction method
View Patent ↗An internal joint distraction device provides articulation to an articulating bone joint between an upper bone structure and a lower bone structure. The device includes a medial plate shaped to at least partially conform to a medial side of a bone structure of a limb and includes a lateral plate shaped to at least partially conform to a lateral side of a bone structure of a limb. Each of the medial and lateral plates may include a longitudinal length sufficient to extend from the upper bone structure to the lower bone structure thereby spanning at least a portion of the joint. Each plates includes at least one proximal connection feature formed therein for connecting to the upper bone structure and at least one distal connection feature formed therein for connecting to the lower bone structure. An axle extends from one of the connection features on the medial plate to one of the connection features on the lateral plate. The axle extends through one of the upper and lower bone structures in a manner that said one of the upper and lower bone structures pivots about the axle relative to the other of the upper and lower bone structures.
1. A treatment method for maintaining a first bone structure in a distracted state, comprising:
creating a first passage through a talus substantially along a pivot axis of the ankle joint;
inserting an axle through the first passage, the axle including structural features that prevent relative rotation of the axle relative to the talus;
implanting a fibula bone plate in contact with and adjacent to the lateral side of the fibula such that a connection feature in the fibula bone plate aligns with the axis of the axle;
connecting the axle to the fibula bone plate to provide articulating movement of the talus with the axle relative to the fibula;
implanting a tibia bone plate in contact with and adjacent to the medial side of the tibia such that a connection feature in the tibia bone plate aligns with the axis of the axle;
connecting the axle to the tibia bone plate to provide articulating movement of the talus with the axle relative to the tibia;
creating a second passage through both the tibia and fibula that aligns with a connection feature on each of the fibula and tibia plates;
implanting a pin through the second passage that connects to both the fibular fibula and tibia bone plates.
2. The method of claim 1 , wherein implanting the fibula and tibia bone plates is accomplished percutaneously.
3. The method of claim 1 , wherein implanting the pin comprises:
passing a K wire through the second most distal connection features on the first and second bone plates; and
drilling the second passage over the K wire; and
passing the pin through the second passage and connecting the pin to the first and second plates.
4. The method of claim 1 , further comprising driving spherically headed bone screws though the plates so that spherical heads rest in spherical countersinks formed in the plates.
5. The method of claim 1 , wherein implanting the tibia plate includes orienting a distal end of the tibia into a recessed shoulder portion shaped to receive a portion of the end of the tibia.
6. The method of claim 1 , comprising drilling a passage in the fibula using a drill guide in the axle.
7. The method of claim 1 , wherein implanting includes percutaneously sliding one of the fibula bone plate and the tibia bone plate along the respective fibula or tibia under the epidermis.
8. The method of claim 1 , further comprising forming a bore in the tibia and wherein implanting a tibia bone plate comprises inserting a boss formed on the inner surface of the tibia bone plate into the bore such that the boss carries loading applied by the tibia.
9. The method of claim 1 , including distracting the tibia and the talus using a self-contained, fully implantable distraction system.
10. The method of claim 9 , wherein distracting includes rotating a non-concentric bushing.