Full wrist fusion device
Disclosed is a device for total wrist fusion that includes (a) a first section, which is preferably a plate, that is positioned under the skin on top of the forearm, wrist and potentially part of the hand and connected to one or more of the radius or carpal bones, (b) a second section, which is preferably in the shape of an awl and is received in the cannula of the third metacarpal bone. Optionally, an anti-rotational third section may be included, which can connect to the top of the third metacarpal bone.
1. A wrist fusion implant having a length along an implant longitudinal axis, the implant comprising:
a distal intramedullary metacarpal portion that has a thickness, a length, a width, and a first longitudinal axis along the length of the distal intramedullary metacarpal portion:
a proximal dorsal radial plate portion that has a thickness, a length, and a second longitudinal axis along the length of the proximal dorsal radial plate portion, the proximal dorsal radial plate portion comprising a bone-facing surface that is configured to overlay a dorsal aspect of a radius and an opposing surface, wherein a plurality of apertures extend from the bone-facing surface to the opposing surface; and
an intermediate carpal portion that links the distal intramedullary metacarpal portion with the proximal dorsal radial plate portion along the implant longitudinal axis, the intermediate carpal portion defining a third longitudinal axis along a length of the intermediate carpal portion, the third longitudinal axis at a first angle with the second longitudinal,
wherein the distal intramedullary metacarpal portion is pre-shaped such that, when at rest, the first longitudinal axis extends at a second angle relative to the second longitudinal axis, a distal end of the distal intramedullary metacarpal portion extending toward the second longitudinal axis and spaced apart from the second longitudinal axis.
2. A wrist fusion implant as set forth in claim 1 , wherein the intermediate carpal portion is at from 10° to 20° relative to the proximal dorsal radial plate portion.
3. A wrist fusion implant as set forth in claim 1 , wherein the distal intramedullary metacarpal portion has a tapered end.
4. A wrist fusion implant as set forth in claim 3 , wherein the distal intramedullary metacarpal portion has a cross-section which is circular.
5. A wrist fusion implant as set forth in claim 1 , wherein the distal intramedullary metacarpal portion further includes a non-rotational feature.
6. A wrist fusion implant as set forth in claim 5 , wherein the distal intramedullary metacarpal portion further includes one or more apertures and the non-rotational feature comprises one or more fasteners that are received in the one or more apertures.
7. A wrist fusion implant as set forth in claim 1 , wherein the plurality of the apertures of the proximal dorsal radial portion comprise a compression slot.
8. A wrist fusion implant as set forth in claim 1 , wherein the proximal dorsal radial plate portion has a width of 9 to 15 mm.
9. A wrist fusion implant as set forth in claim 1 , further comprising an anti-rotational section extending from a location on the distal intramedullary metacarpal portion, the intermediate carpal portion, or the proximal dorsal radial plate portion and extending over the distal intramedullary metacarpal portion along the length of the distal intramedullary metacarpal portion.
10. A wrist fusion implant as set forth in claim 9 , wherein the anti-rotational section comprises a plurality of openings configured to receive fasteners that are configured to connect the implant to a metacarpal bone via an outer surface of the metacarpal bone.
11. A wrist fusion implant as set forth in claim 1 , wherein the distal intramedullary metacarpal portion comprises a plurality of ribs that are spaced apart along the length of the distal intramedullary metacarpal portion.
12. A wrist fusion implant as set forth in claim 1 , wherein the distal intramedullary metacarpal portion extends upward at an angle of from 10° to 20° from a position where the distal intramedullary metacarpal portion meets the intermediate carpal portion.
13. A wrist fusion implant system comprising:
an implant; and
at least one fixator;
wherein the implant comprises a stepped profile along an implant longitudinal axis with a first section and a second section,
the second section comprising a distal intramedullary metacarpal spike portion configured to reside within at least a portion of a metacarpal bone, the second section having a cross-section that is rounded and defining a thickness, a length, a width, and a first longitudinal axis along the length of the second section, the first section joined along the implant longitudinal axis to the second section;
the first section comprising:
a proximal plate portion off-set from the distal intramedullary metacarpal spike portion, the proximal plate portion having a length, a thickness, and a second longitudinal axis along the length of the proximal plate portion, the proximal plate portion comprising a bone-facing surface that is configured to overlay and be connected to a cortical aspect of a radius and an opposing surface, wherein a plurality of apertures extend from the bone-facing surface to the opposing surface such that each aperture is capable of receiving the at least one fixator to connect the proximal plate portion to the radius, and
an intermediate carpal portion that extends obliquely relative to the implant longitudinal axis to link the distal intramedullary metacarpal spike portion with the proximal plate portion along the implant longitudinal axis,
wherein the distal intramedullary metacarpal spike portion is pre-shaped such that, when at rest, the first longitudinal axis extends at an angle relative to the second longitudinal, a distal end of the distal intramedullary metacarpal spike portion extending toward the second longitudinal axis and spaced apart from the second longitudinal axis.
14. A wrist fusion implant system as set forth in claim 13 , wherein the proximal plate portion has a width of 9 to 15 mm.
15. A wrist fusion implant system as set forth in claim 13 , wherein the intermediate carpal portion is at from 10° to 20° relative to the proximal plate portion.
16. A wrist fusion implant system as set forth in claim 13 , comprising a third section that comprises an anti-rotational section extending from a location of the first or second section and extending over the second section along the length of the second section.
17. A wrist fusion implant system as set forth in claim 16 , wherein the third section comprises a plurality of openings, the at least one fixator configured to be received in at least one of the plurality of openings to couple the implant to the metacarpal bone via an outer surface of the metacarpal bone.
18. A wrist fusion implant system as set forth in claim 13 , wherein the second section comprises a plurality of ribs.
19. A wrist fusion implant as set forth in claim 13 , wherein the second section extends upward at an angle of from 10° to 20° from a position where the second section meets the first section.