EXTRA-MEDULLARY PLATE FOR FRACTURE STABLIZATION WITH INTRA-MEDULLARY NAIL AND ALIGNING ARM
A device provides a variety of fracture fixation options should a fracture occur after total hip arthroplasty or total knee arthroplasty, and provides associated methods and apparatus for application of provided fixation. The ability to pre-engineer fracture fixation contingent solutions into femoral or tibial components provides for a distinct clinical advantage in the planning and execution for periprosthetic fracture fixation. Said methods and apparatus include targeting devices which allow for intimate association of fixed angle locking screws in pre-drilled holes in an existing prosthetic, femoral nail, or other components including additional fixation components. Such apparatus and methods further include the use of alignment devices and other components to allow for ease of repair of fractures utilizing the pre-engineered solutions.
1 . An extramedullary plate for securing at least one fracture between a plurality of bone segments, wherein the extramedullary plate comprises:
a plurality of extramedullary plate clearance holes for accepting one or more extramedullary plate interlocking screws;
a first interface adapted to engage an intramedullary nail, the intramedullary nail comprising a plurality of intramedullary nail clearance holes, the plurality of intramedullary nail clearance holes for accepting one or more intramedullary nail interlocking screws for further securing the plurality of bone segments;
a second interface adapted to engage an aligning arm, the aligning arm having one or more first alignment features, the second interface for further aligning the intramedullary nail with respect to the extramedullary plate; and
such that the one or more first alignment features are further adapted for providing mechanical alignment of at least one additional screw with both at least one of the extramedullary plate clearance holes and with at least one of the intramedullary nail clearance holes, so as to allow for insertion of the at least one additional screw within at least one respective extramedullary plate clearance hole and at least one respective intramedullary nail clearance hole in registration.
2 . The apparatus of claim 1 wherein the aligning arm further comprises one or more second alignment features, such that the one or more second alignment features are further adapted for providing alignment of at least one of the intramedullary nail interlocking screws with respective ones of the intramedullary nail clearance holes, and so as to allow for the insertion of the at least one intramedullary nail interlocking screws within the respective ones of the intramedullary nail clearance holes in alignment.
3 . The apparatus of claim 2 wherein the aligning arm further comprises one or more third alignment features, such that the one or more third alignment features are further adapted for providing mechanical alignment of at least one of the extramedullary plate interlocking screws with respective ones of the extramedullary plate clearance holes, and so as to allow for the insertion of the at least one extramedullary plate interlocking screws within the respective ones of the extramedullary plate clearance holes in alignment.
4 . The apparatus of claim 1 wherein at least one intermedullary nail interlocking screw also acts as the extramedullary plate locking screw.
5 . The apparatus of claim 1 wherein the one or more first alignment features comprises respective one or more cannula.
6 . The apparatus of claim 1 wherein the one or more second alignment features comprises respective one or more cannula.
7 . The apparatus of claim 1 wherein the one or more third alignment features comprises respective one or more cannula.
8 . The apparatus of claim 1 wherein the intramedullary nail is further configured to provide a) access to an intramedullary canal and b) clearance associated with at least one feature of an in situ prothesis.
9 . The apparatus of claim 8 wherein the clearance associated with the at least one feature of the in situ prothesis comprises an intercondylar notch of a distal femoral component of a knee prothesis.
10 . The apparatus of claim 9 wherein the prothesis is the distal femur prothesis and is associated with an arthroplasty.
11 . The apparatus of claim 1 further comprising:
the intramedullary nail having an intramedullary nail feature;
the extramedullary plate having an extramedullary plate feature; and
wherein the intramedullary nail feature and the extramedullary plate feature further enable use of the intramedullary nail together with the extramedullary plate.
12 . The apparatus of claim 1 wherein:
the intramedullary nail is one of a plurality of intramedullary nails,
wherein the extramedullary plate is one of a plurality of extrameduallary plates each comprising a plurality of extramedullary plate clearance holes for accepting one or more of the extramedullary plate interlocking screws; and
wherein the aligning arm is further for aligning the plurality of intramedullary nails with the plurality of extramedullary plates.