Intra-osseous plate system and method
An intra-osseous support structure can be used to fixate opposed portions of bone. In some examples, the intra-osseous support structure is positioned in openings formed in adjacent portions of bones. Fasteners are inserted through the bone portions to secure the intra-osseous support structure in the bones. Depending on the application, one or more external bone plates may also be applied to the bone portions. The external bone plate may be in compression while the intra-osseous support structure is in tension under load in situ.
1. A method comprising:
performing an osteotomy on a metatarsal to separate the metatarsal into a first metatarsal portion and a second metatarsal portion;
forming an opening in the first metatarsal portion and an opening in the second metatarsal portion;
placing an intra-osseous support structure in the opening in the first metatarsal portion and in the opening in the second metatarsal portion, the intra-osseous support structure bridging between the first metatarsal portion and the second metatarsal portion;
inserting a first fastener through the first metatarsal portion and into the intra-osseous support structure; and
inserting a second fastener through the second metatarsal portion and into the intra-osseous support structure.
2. The method of claim 1 , further comprising:
forming a first hole in the first metatarsal portion, the first hole and the opening in the first metatarsal portion intersecting; and
forming a second hole in the second metatarsal portion, the second hole and the opening in the second metatarsal portion intersecting,
wherein the first fastener is inserted through the first hole and the second fastener is inserted through the second hole.
3. The method of claim 1 , further comprising:
engaging the first fastener with the intra-osseous support structure; and
engaging the second fastener with the intra-osseous support structure.
4. The method of claim 1 , wherein:
inserting the first fastener through the first metatarsal portion and into the intra-osseous support structure comprises inserting the first fastener through a dorsal surface of the first metatarsal portion and into the intra-osseous support structure; and
inserting the second fastener through the second metatarsal portion and into the intra-osseous support structure comprises inserting the second fastener through the dorsal surface of the second metatarsal portion and into the intra-osseous support structure.
5. The method of claim 1 , wherein forming the opening in the first metatarsal portion and the opening in the second metatarsal portion comprises forming the opening in the first metatarsal portion at a location between a dorsal surface and a plantar surface of the first metatarsal portion and forming the opening in the second metatarsal portion at the location between the dorsal surface and the plantar surface.
6. The method of claim 1 , wherein forming the opening in the first metatarsal portion and the opening in the second metatarsal portion comprises forming the opening in a longitudinal side of the first metatarsal portion and forming the opening in the longitudinal side of the second metatarsal portion.
7. The method of claim 6 , wherein the longitudinal side of the first metatarsal portion comprises a medial side of the first metatarsal portion and the longitudinal side of the second metatarsal portion comprises the medial side of the second metatarsal portion.
8. The method of claim 6 , wherein placing the intra-osseous support structure in the opening in the first metatarsal portion and the opening in the second metatarsal portion comprises placing the intra-osseous support structure in the opening in the longitudinal side of the first metatarsal portion and in the opening in the longitudinal side of the second metatarsal portion.
9. The method of claim 8 , wherein the intra-osseous support structure comprises a stop on a perimeter edge, and placing the intra-osseous support structure in opening in the longitudinal side of the first metatarsal portion and in the opening in the longitudinal side of the second metatarsal portion comprises placing the intra-osseous support structure in opening in the longitudinal side of the first metatarsal portion and in the opening in the longitudinal side of the second metatarsal portion until the stop contacts a bone surface.
10. The method of claim 1 , further comprising attaching an additional support structure that does not engage the intra-osseous support structure to the first metatarsal portion and the second metatarsal portion, wherein the additional support structure comprises at least one of a staple and a pin.
11. The method of claim 1 , wherein:
the intra-osseous support structure comprises a tab extending beyond a perimeter edge of the intra-osseous support structure;
placing the intra-osseous support structure in the opening in the first metatarsal portion and the opening in the second metatarsal portion comprises placing the intra-osseous support structure using the tab; and
after placing the intra-osseous support structure in the opening in the first metatarsal portion and the opening in the second metatarsal portion, removing the tab.
12. The method of claim 1 , wherein:
the intra-osseous support structure comprises a first threaded opening and a second threaded opening;
inserting the first fastener through the first metatarsal portion and into the intra-osseous support structure comprises screwing the first fastener into the first threaded opening; and
inserting the second fastener through the second metatarsal portion and into the intra-osseous support structure comprises screwing the second fastener into the second threaded opening.
13. The method of claim 1 , further comprising:
inserting a third fastener through the first metatarsal portion and into the intra-osseous support structure; and
inserting a fourth fastener through the second metatarsal portion and into the intra-osseous support structure.
14. The method of claim 1 , wherein:
the intra-osseous support structure comprises a first major surface, a second major surface, and a perimeter edge extending between the first major surface and the second major surface; and
the first major surface and the second major surface are each devoid of any protrusions.
15. The method of claim 14 , wherein at least one of the first major surface and the second major surface comprises a surface texture.
16. The method of claim 1 , further comprising adjusting an alignment of the first metatarsal portion relative to the second metatarsal portion.
17. The method of claim 16 , wherein:
the metatarsal is a first metatarsal; and
placing the intra-osseous support structure in the opening in the first metatarsal portion and the opening in the second metatarsal portion comprises placing the intra-osseous support structure in cancellous bone of the first metatarsal portion and in cancellous bone of the second metatarsal portion.
18. The method of claim 1 , further comprising positioning a plate on an outer surface of the first metatarsal portion and the second metatarsal portion, wherein:
inserting the first fastener through the first metatarsal portion and into the intra-osseous support structure comprises inserting the first fastener through a first aperture of the plate, into the underlying first metatarsal portion, and into the intra-osseous support structure positioned in the first metatarsal portion; and
inserting the second fastener through the second metatarsal portion and into the intra-osseous support structure comprises inserting the second fastener through a second aperture of the plate, into the underlying second metatarsal portion, and into the intra-osseous support structure positioned in the second metatarsal portion.
19. The method of claim 1 , wherein:
inserting the first fastener through the first metatarsal portion comprises inserting the first fastener through a thickness of the first metatarsal portion less than an entire thickness of the first metatarsal portion; and
inserting the second fastener through the second metatarsal portion comprises inserting the second fastener through a thickness of the second metatarsal portion less than an entire thickness of the second metatarsal portion.
20. The method of claim 19 , wherein:
the thickness of the first metatarsal portion is within a range from one-half to two-thirds of the entire thickness of the first metatarsal portion; and
the thickness of the second metatarsal portion is within a range from one-half to two-thirds of the entire thickness of the second metatarsal portion.