Femoral nail and instrumentation system

1. An intramedullary femoral nail system ( 1 ) for antegrade or retrograde implantation with laterally inserted bone screws, the system comprising a nail stem ( 2 ) having a multi-featured proximal end ( 3 ), a distal end and a central conduit ( 22 ); and a fastener ( 4 ), wherein the central conduit is configured to accommodate the fastener ( 4 ), wherein the multi-featured proximal end ( 3 ) comprises a plurality of holes ( 12 , 12 ′, 14 , 14 ′, 15 , 15 ′, 16 , 16 ′, 18 , 18 ′, 19 , 19 ′), which align with a plurality of corresponding holes in the fastener ( 4 ), configured to accommodate at least three laterally inserted bone screws ( 50 , 52 , 54 , 56 ), wherein the first hole ( 12 ) configured to accommodate the first bone screw ( 50 ) is at an angle that is horizontal relative to the central conduit ( 22 ) and is on a coronal plane, the hole ( 14 ) configured to accommodate the second bone screw ( 52 ) is at an angle of between about 120° to about 124° relative to the central conduit ( 22 ), and the hole ( 16 ) configured to accommodate the third bone screw ( 54 ) is at an angle of 123° relative to the central conduit ( 22 ), and wherein the second and third bone screws ( 52 , 54 ) accommodated within the holes ( 14 and 16 ) are not parallel to each other.

2. The intramedullary femoral nail system ( 1 ) for antegrade or retrograde implantation with laterally inserted bone screws according to claim 1 , wherein the hole ( 14 ) configured to accommodate the second bone screw ( 52 ) is at an angle of 123° relative to the central conduit ( 22 ) and in an ascending approach relative to the hole ( 12 ) configured to accommodate the first bone screw ( 50 ).

3. The intramedullary femoral nail system ( 1 ) according to claim 1 , wherein the holes ( 14 , 16 ) configured to accommodate the second and third bone screw ( 52 , 54 ) are rotated at an angle of at least 14° in an anterior direction relative to the coronal plane.

4. The intramedullary femoral nail system ( 1 ) according to claim 1 , wherein the hole ( 18 ) configured to accommodate a fourth bone screw ( 56 ) is at an angle of 123° relative to the central conduit ( 22 ) and in a descending approach relative to the holes ( 12 , 14 ) configured to accommodate the first bone screw ( 50 ) and the second bone screw ( 52 ).

5. The intramedullary femoral nail system ( 1 ) according to claim 1 , wherein there is a medio lateral hole ( 19 ) configured to accommodate a fifth bone screw that is placed distal to all other bone screws ( 50 , 52 , 54 , 56 ).

6. The intramedullary femoral nail system ( 1 ) according to claim 1 , further comprising an end cap adapted to matingly engage with a threaded portion ( 26 ) of the proximal end ( 3 ) of the nail stem ( 2 ).

7. An instrumentation system ( 100 ) for antegrade or retrograde implantation with laterally inserted screws for use with an intramedullary femoral nail system ( 1 ), the intramedullary femoral nail system ( 1 ) comprising a nail stem ( 2 ) having a multi-featured proximal end ( 3 ), a distal end and a central conduit ( 22 ); and a fastener ( 4 ), wherein the central conduit is configured to accommodate the fastener ( 4 ); wherein the multi-featured proximal end ( 3 ) comprises a plurality of holes ( 12 , 12 ′, 14 , 14 ′, 15 , 15 ′, 16 , 16 ′, 18 , 18 ′, 19 , 19 ′), which align with a plurality of corresponding holes in the fastener ( 4 ), configured to accommodate at least three laterally inserted bone screws ( 50 , 52 , 54 , 56 ), wherein the first hole ( 12 ) configured to accommodate the first bone screw ( 50 ) is at an angle that is horizontal relative to the central conduit ( 22 ) and is on a coronal plane, the hole ( 14 ) configured to accommodate the second bone screw ( 52 ) is at an angle of between about 120° to about 124° relative to the central conduit ( 22 ), and the hole ( 16 ) configured to accommodate the third bone screw ( 54 ) is at an angle of 123° relative to the central conduit ( 22 ), and wherein the second and third bone screws ( 52 , 54 ) accommodated within the holes ( 14 and 16 ) are not parallel to each other; and wherein the instrumentation system ( 100 ) comprises an aiming arm ( 102 ), a cannulated connecting bolt ( 104 ) comprising a threaded portion that is configured to matingly engage with a nail stem ( 2 ) of the nail system ( 1 ), the fastener ( 4 ) configured to engage with the nail system ( 1 ), and a fastener camlock ( 106 ) comprising an end cam feature ( 116 ) configured to matingly engage with the fastener ( 4 ) and the cannulated connection bolt ( 104 ); wherein the fastener camlock ( 106 ) further comprises a shaft section ( 117 ) to engage the cannulated connecting bolt ( 104 ), and a distal head ( 118 ).

8. An instrumentation system ( 100 ) for antegrade or retrograde implantation with laterally inserted screws for use with an intramedullary femoral nail system ( 1 ) for antegrade or retrograde implantation with laterally inserted bone screws, the intramedullary femoral nail system comprising a nail stem ( 2 ) having a multi-featured proximal end ( 3 ), a distal end and a central conduit ( 22 ); and a fastener ( 4 ), wherein the central conduit is configured to accommodate the fastener ( 4 ); wherein the multi-featured proximal end ( 3 ) comprises a plurality of holes ( 12 , 12 ′, 14 , 14 ′, 15 , 15 ′, 16 , 16 ′, 18 , 18 ′, 19 , 19 ′), which align with a plurality of corresponding holes in the fastener ( 4 ), configured to accommodate at least three laterally inserted bone screws ( 50 , 52 , 54 , 56 ), wherein the first hole ( 12 ) configured to accommodate the first bone screw ( 50 ) is at an angle that is horizontal relative to the central conduit ( 22 ) and is on a coronal plane, the hole ( 14 ) configured to accommodate the second bone screw ( 52 ) is at an angle of between about 120° to about 124° relative to the central conduit ( 22 ), and the hole ( 16 ) configured to accommodate the third bone screw ( 54 ) is at an angle of 123° relative to the central conduit ( 22 ), and wherein the second and third bone screws ( 52 , 54 ) accommodated within the holes ( 14 and 16 ) are not parallel to each other, wherein the instrumentation system ( 100 ) comprises an aiming arm ( 102 ), a cannulated connecting bolt ( 104 ) comprising a threaded portion that is configured to matingly engage with a nail stem ( 2 ) of the nail system ( 1 ), a fastener ( 4 ) configured to engage with the nail system ( 1 ), further comprising a modular block ( 110 a , 110 b ) configured to attach to the aiming arm ( 102 ) to consistently provide lateral bone screw trajectories for either a right or a left antegrade or retrograde implantation.

9. The instrumentation system ( 100 ) and the intramedullary nail system ( 1 ) according to claim 8 in which when the modular block ( 110 a , 110 b ) is attached to the aiming arm ( 102 ) via pins ( 140 a - d , 142 a - d ) on the aiming arm ( 102 ), the modular block ( 110 a , 110 b ) presents screw trajectories ( 150 a , 150 b , 151 a , 150 b , 152 , 153 ) on block ( 110 a , 110 b ) for inserting the bone screws ( 50 , 52 , 54 , 56 ).

10. The instrumentation system ( 100 ) for antegrade or retrograde implantation with laterally inserted screws for use with an intramedullary femoral nail system ( 1 ) for antegrade or retrograde implantation with laterally inserted bone screws of claim 8 , further comprising: a fastener camlock ( 106 ) comprising an end cam feature ( 116 ) configured to matingly engage with the fastener ( 4 ) and the cannulated connection bolt ( 104 ).

11. The instrumentation system ( 100 ) for antegrade or retrograde implantation with laterally inserted screws for use with an intramedullary femoral nail system ( 1 ) for antegrade or retrograde implantation with laterally inserted bone screws of claim 10 , wherein a hole ( 18 ) configured to accommodate a fourth bone screw ( 56 ) is at an angle of 123° relative to the central conduit ( 22 ) and in a descending approach relative to the holes ( 12 , 14 ) configured to accommodate the first bone screw ( 50 ) and the second bone screw ( 52 ).

12. The instrumentation system ( 100 ) for antegrade or retrograde implantation with laterally inserted screws for use with an intramedullary femoral nail system ( 1 ) for antegrade or retrograde implantation with laterally inserted bone screws of claim 11 , further comprising a medio lateral hole ( 19 ) configured to accommodate a fifth bone screw that is placed distal to all other bone screws ( 50 , 52 , 54 , 56 ).

13. The instrumentation system ( 100 ) for antegrade or retrograde implantation with laterally inserted screws for use with an intramedullary femoral nail system ( 1 ) for antegrade or retrograde implantation with laterally inserted bone screws of claim 12 , further comprising an end cap adapted to matingly engage with a threaded portion ( 26 ) of the proximal end ( 3 ) of the nail stem ( 2 ).

14. An instrumentation system ( 100 ) and an intramedullary femoral nail system ( 1 ) for antegrade or retrograde implantation with laterally inserted bone screws, wherein the instrumentation system ( 100 ) comprises an aiming arm ( 102 ), a cannulated connecting bolt ( 104 ) comprising a threaded portion that is configured to matingly engage with a nail stem ( 2 ) of the nail system ( 1 ), a fastener ( 4 ) thereof configured to engage with the nail system ( 1 ); wherein the intramedullary femoral nail system ( 1 ) comprises a nail stem ( 2 ) having a multi-featured proximal end ( 3 ), a distal end and a central conduit ( 22 ) configured to accommodate the fastener ( 4 ), wherein the multi-featured proximal end ( 3 ) comprises a plurality of holes ( 12 , 12 ′, 14 , 14 ′, 15 , 15 ′, 16 , 16 ′, 18 , 18 ′, 19 , 19 ′), which align with a plurality of corresponding holes in the fastener ( 4 ), configured to accommodate at least three laterally inserted bone screws ( 50 , 52 , 54 , 56 ), wherein the first hole ( 12 ) configured to accommodate the first bone screw ( 50 ) is at an angle that is horizontal relative to the central conduit ( 22 ) and is on a coronal plane, the hole ( 14 ) configured to accommodate the second bone screw ( 52 ) is at an angle of between about 120° to about 124° relative to the central conduit ( 22 ), and the hole ( 16 ) configured to accommodate the third bone screw ( 54 ) is at an angle of 123° relative to the central conduit ( 22 ), and wherein the second and third bone screws ( 52 , 54 ) are accommodated within the holes ( 14 , 16 ) are not parallel to each other.

15. The instrumentation system ( 100 ) and an intramedullary femoral nail system ( 1 ) for antegrade or retrograde implantation with laterally inserted bone screws of claim 14 , further comprising: a fastener cam lock ( 106 ) comprising an end cam feature ( 116 ) configured to matingly engage with the fastener ( 4 ) and the cannulated connection bolt ( 104 ).

16. The instrumentation system ( 100 ) and an intramedullary femoral nail system ( 1 ) for antegrade or retrograde implantation with laterally inserted bone screws of claim 15 , further comprising: a modular block ( 110 a , 110 b ) configured to attach to the aiming arm ( 102 ) to consistently provide lateral bone screw trajectories for either a right or a left antegrade or retrograde implantation.

17. The instrumentation system ( 100 ) and an intramedullary femoral nail system ( 1 ) for antegrade or retrograde implantation with laterally inserted bone screws of claim 16 , further comprising: when the modular block ( 110 a , 110 b ) is attached to the aiming arm ( 102 ) via pins ( 140 a - d , 142 a - d ) on the aiming arm ( 102 ), the modular block ( 110 a , 110 b ) presents screw trajectories ( 150 a , 150 b , 151 a , 150 b , 152 , 153 ) on block ( 110 a , 110 b ) for inserting the bone screws ( 50 , 52 , 54 , 56 ).

18. The instrumentation system ( 100 ) and an intramedullary femoral nail system ( 1 ) for antegrade or retrograde implantation with laterally inserted bone screws of claim 17 , wherein the holes ( 14 , 16 ) configured to accommodate the second and third bone screw ( 52 , 54 ) are rotated at an angle of at least 14° in an anterior direction relative to the coronal plane.

19. The instrumentation system ( 100 ) and an intramedullary femoral nail system ( 1 ) for antegrade or retrograde implantation with laterally inserted bone screws of claim 18 , wherein a hole ( 18 ) configured to accommodate a fourth bone screw ( 56 ) is at an angle of 123° relative to the central conduit ( 22 ) and in a descending approach relative to the holes ( 12 , 14 ) configured to accommodate the first bone screw ( 50 ) and the second bone screw ( 52 ).

20. The instrumentation system ( 100 ) and an intramedullary femoral nail system ( 1 ) for antegrade or retrograde implantation with laterally inserted bone screws of claim 19 , further comprising a medio lateral hole ( 19 ) configured to accommodate a fifth bone screw that is placed distal to all other bone screws ( 50 , 52 , 54 , 56 ).