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 method of wrist fusion surgery, comprising the steps of:
exposing the radius, carpals and a metacarpal bone of a wrist of a patient
flexing the wrist of the patient;
using a unitary implant having a distal intramedullary metacarpal portion and a proximal radial plate portion by placing the distal intramedullary portion of the implant into the metacarpal bone, wherein the proximal radial plate portion includes an aperture;
straightening the wrist of the patient;
placing the proximal radial plate portion onto the radius; and
fixing the proximal radial plate portion to the radius by attaching a fastener through the aperture in the proximal radial plate portion into the radius,
wherein the distal intramedullary metacarpal portion of the implant is offset from and joined to the proximal radial plate portion of the implant by an intermediate carpal portion, and
wherein a distal end of the distal intramedullary metacarpal portion extends toward a plane defined along a longitudinal axis of the proximal radial plate portion, the distal end of the distal intramedullary metacarpal portion not coincident with the plane of the proximal radial plate portion.
2. A method of wrist fusion surgery as set forth in claim 1 , wherein flexing the wrist comprises flexing the wrist downward to expose a proximal end of the metacarpal bone.
3. A method of wrist fusion surgery as set forth in claim 1 , wherein the proximal radial plate portion is fixed to a dorsal aspect of the patient radius.
4. A method of wrist fusion surgery as set forth in claim 1 , wherein the aperture in the proximal radial plate portion includes at least one compression slot and the fastener is a screw that extends through the at least one compression slot into the radius and the method further includes the step of applying compression to the wrist by screwing the screw through the at least one compression slot.
5. A method of wrist fusion surgery as set forth in claim 1 , wherein the implant further includes an anti-rotational feature.
6. A method of wrist fusion surgery as set forth in claim 5 , wherein the anti-rotational feature is a rib on the distal intramedullary metacarpal portion.
7. A method of wrist fusion surgery as set forth in claim 1 , wherein the metacarpal is the third metacarpal.
8. A method of wrist fusion surgery as set forth in claim 1 , wherein the intermediate carpal portion includes at least one aperture and the intermediate carpal portion is fixed to the wrist by screwing a screw through the at least one aperture of the intermediate carpal portion into a carpal bone of the wrist.
9. A method of wrist fusion surgery as set forth in claim 1 , wherein a distal end of the distal intramedullary metacarpal portion extends toward and terminates prior to a plane of the proximal radial plate portion.
10. A method of wrist fusion surgery, comprising the steps of:
exposing the radius, carpals and a metacarpal bone of a wrist of a patient toward a plane
using an implant having a distal intramedullary metacarpal portion and a proximal radial plate portion including an aperture, wherein the distal intramedullary metacarpal portion and the proximal radial plate portion are joined to an intermediate carpal portion such that the distal intramedullary metacarpal portion is offset from the proximal radial plate portion, by placing the distal intramedullary metacarpal portion of the implant into the metacarpal bone, wherein a distal end of the distal intramedullary metacarpal portion extends defined along a longitudinal axis of the proximal radial plate portion, the distal end of the distal intramedullary metacarpal portion not coincident with the plane of the proximal radial plate portion;
placing the proximal radial plate portion onto a dorsal aspect of the radius; and
fixing the proximal radial plate portion to the radius by attaching a fastener through the aperture in the proximal radial plate portion into the radius.
11. A method of wrist fusion surgery as set forth in claim 10 , further comprising the step of flexing the wrist downward in a position to expose a proximal end of the metacarpal bone.
12. A method of wrist fusion surgery as set forth in claim 11 , further comprising the step of straightening the wrist prior to placing the proximal radial plate portion onto the dorsal aspect of the radius.
13. A method of wrist fusion surgery as set forth in claim 10 , wherein the proximal radial plate portion includes at least one compression slot and the fastener is a screw that extends through the at least one compression slot into the radius and the method further includes the step of applying compression to the wrist by screwing the screw through the at least one compression slot.
14. A method of wrist fusion surgery as set forth in claim 10 , wherein the distal intramedullary metacarpal portion includes an aperture to receive a fixator and further comprising the step of using a drill guide associated with the implant to drive the fixator through the aperture in the distal intramedullary metacarpal portion.