Proximal humeral stabilization system
Devices, systems, and methods for bone stabilization, especially proximal humeral stabilization. The stabilization system may include a bone plate having an elongated portion extending along a longitudinal axis and an enlarged head portion extending from the elongated portion. The stabilization system may include an intramedullary nail having an upper portion and a lower portion extending from the upper portion, the upper portion and the lower portion including a plurality of holes. A plurality of fasteners may be configured to extend through one or more of the plurality of through holes in the bone plate and/or one or more of the plurality of holes in the intramedullary nail and into the bone. The plate and nail may each be used alone or in combination together to stabilize a fracture in a long bone, such as a humerus.
1. A stabilization system for stabilizing a bone, the system comprising:
a bone plate, the bone plate comprising an elongated portion extending along a longitudinal axis and an enlarged head portion extending from the elongated portion, the bone plate comprising a plurality of through holes;
an intramedullary nail, the intramedullary nail comprising an upper portion and a lower portion extending from the upper portion, the upper portion and the lower portion including a plurality of holes; and
a plurality of fasteners configured to extend through the plurality of through holes in the bone plate and through the plurality of holes in the intramedullary nail and into the bone such that the plurality of fasteners are oriented obliquely with respect to each other,
wherein the enlarged head portion extends at a lateral angle relative to the longitudinal axis,
wherein the plurality of through holes have an upper portion and a lower portion, the upper portion is tapered with a conical straight tapered surface cut through a top surface of the bone plate, and the lower portion is tapered with a conical surface, wherein the upper portion and the lower portion have different conical sections having different degrees of taper.
2. The stabilization system of claim 1 , wherein the plurality of through holes comprise first and second polyaxial openings, and the plurality of fasteners comprise polyaxial calcar screws configured to be received in the first and second polyaxial openings and configured to be aimed at a calcar region of a proximal humerus.
3. The stabilization system of claim 1 , wherein the plurality of through holes comprise a plurality of fixed angle openings positioned on the enlarged head portion of the plate, and the plurality of fasteners comprise fixed angle, locking screws configured to be received in the respective fixed angle openings and the upper portion of the intramedullary nail and configured to be aimed at a humeral head.
4. The stabilization system of claim 1 , wherein the plurality of through holes comprise a plurality of elongated slots positioned on the elongated portion of the plate, and the plurality of fasteners comprise at least one polyaxial screw configured to be received in at least one of the plurality of elongated slots and within one of the plurality of holes in the lower portion of the intramedullary nail to permit dynamic compression of the bone.
5. The stabilization system of claim 1 , wherein the plurality of fasteners include fasteners having self-forming threads on a head portion of the fasteners, which are configured to lock to at least one of the plurality of through holes on the plate.
6. The stabilization system of claim 1 , wherein the lower portion of the intramedullary nail is configured to be positioned in an intramedullary canal and the upper portion of the intramedullary nail is configured to be positioned in a humeral head.
7. The stabilization system of claim 1 , wherein the plate further comprises a second plurality of openings configured as suture holes to receive sutures configured to secure the plate to surrounding tissue.
8. The stabilization system of claim 1 , wherein the lower portion is fixed in position relative to the upper portion of the intramedullary nail.
9. The stabilization system of claim 1 , wherein the plate has a length greater than a length of the intramedullary nail.
10. A stabilization system for stabilizing a bone, the system comprising:
a bone plate, the bone plate comprising an elongated portion extending along a longitudinal axis and an enlarged head portion extending from the elongated portion, the bone plate comprising a plurality of through holes through the enlarged head portion and the elongated portion;
an intramedullary nail, the intramedullary nail comprising an upper portion and a lower portion extending from the upper portion, the upper portion and the lower portion including a plurality of holes;
a first plurality of fasteners positioned through the plurality of through holes in the enlarged head portion of the bone plate and through the plurality of holes in the upper portion of the intramedullary nail and into the bone such that the plurality of fasteners are oriented obliquely with respect to each other;
a second plurality of fasteners positioned through the plurality of through holes in the elongated portion of the bone plate and through the plurality of holes in the lower portion of the intramedullary nail and into the bone;
a third plurality of fasteners positioned through the plurality of through holes in the bone plate and directly into bone without passing through the intramedullary nail,
wherein the enlarged head portion extends at a lateral angle relative to the longitudinal axis,
wherein the plurality of through holes have an upper portion and a lower portion, the upper portion is tapered with a conical straight tapered surface cut through a top surface of the bone plate, and the lower portion is tapered with a conical surface, wherein the upper portion and the lower portion have different conical sections having different degrees of taper.
11. The stabilization system of claim 10 , further comprising a single fastener positioned through one of the plurality of through holes in the elongated portion of the bone plate and directly into bone without passing through the intramedullary nail.
12. The stabilization system of claim 10 , wherein the plurality of through holes comprise first and second polyaxial openings, and the first plurality of fasteners comprise polyaxial calcar screws configured to be received in the first and second polyaxial openings and configured to be aimed at a calcar region of a proximal humerus.
13. The stabilization system of claim 10 , wherein the plurality of through holes comprise a plurality of fixed angle openings positioned on the enlarged head portion of the plate, and the first plurality of fasteners comprise fixed angle, locking screws configured to be received in the respective fixed angle openings and the upper portion of the intramedullary nail and configured to be aimed at a humeral head.
14. The stabilization system of claim 10 , wherein the plurality of through holes comprise a plurality of elongated slots positioned on the elongated portion of the plate, and the second plurality of fasteners comprise at least one polyaxial screw configured to be received in at least one of the plurality of elongated slots and within one of the plurality of holes in the lower portion of the intramedullary nail to permit dynamic compression of the bone.
15. The stabilization system of claim 10 , wherein the first, second, or third plurality of fasteners include fasteners having self-forming threads on a head portion of the fasteners, which are configured to lock to at least one of the plurality of through holes on the plate.
16. The stabilization system of claim 10 , wherein the lower portion of the intramedullary nail is configured to be positioned in an intramedullary canal and the upper portion of the intramedullary nail is configured to be positioned in a humeral head.
17. The stabilization system of claim 10 , wherein the plate further comprises a second plurality of openings configured as suture holes to receive sutures configured to secure the plate to surrounding tissue.