Bone fixation system
A bone fixation system includes an intramedullary nail and a lag screw. A proximal portion of the intramedullary nail includes a first proximal bore configured to accept the lag screw and a second proximal bore configured to accept a portion of an antirotation screw insertion tool. A distal portion of the intramedullary nail defines at least one opening configured to accept a distal locking screw. The lag screw includes a sheath and a rod mounted for sliding movement within the sheath. The rod has a threaded distal end defining a diagonal bore configured to accept an antirotation screw.
1. A bone fixation system comprising:
an intramedullary nail including a proximal portion defining
a first proximal bore configured to accept a lag screw, and
a second proximal bore configured to accept a portion of an antirotation screw insertion tool, the second proximal bore having a predetermined diameter;
a lag screw configured to extend through the first proximal bore in the proximal portion of the intramedullary nail, the lag screw including
a sheath, and
a rod mounted for sliding movement within the sheath, the rod including a threaded distal end defining an internally threaded diagonal bore having a predetermined diameter; and
an antirotation screw configured to be mounted at the end of the antirotation screw insertion tool and inserted through the second proximal bore, the antirotation screw including
a screw head having a predetermined diameter less than the predetermined diameter of the second proximal bore and greater than the predetermined diameter of the diagonal bore,
a shank having a threaded distal portion configured to achieve good purchase in bone and a threaded proximal portion configured to engage the internally threaded bore of the rod.
2. The bone fixation system according to claim 1 , wherein;
the intramedullary nail has a distal portion of the intramedullary nail having a longitudinal axis;
the first proximal bore extends at an angle in the range of about 120° to about 140° with respect to the longitudinal axis of the distal portion of the intramedullary nail; and
the second proximal bore extends at an angle in the range of about 90° and about 105° with respect to the longitudinal axis of the distal portion of the intramedullary nail.
3. The bone fixation system according to claim 2 , wherein:
the rod has a longitudinal axis; and
the diagonal bore extends at an angle in the range of about 25° to about 55° with respect to the longitudinal axis of the rod.
4. The bone fixation system according to claim 1 , wherein:
the sheath of the lag screw has a predetermined outer diameter; and
the antirotation screw has a predetermined diameter not more than half the predetermined outer diameter of the sheath of the lag screw.
5. The bone fixation system according to claim 1 , wherein:
the lag screw has a predetermined length when fully extended; and
the antirotation screw has a predetermined length no more than ¾ths of the predetermined length of the lag screw.
6. The bone fixation system according to claim 1 , wherein:
the intramedullary nail has a proximal end, a distal portion, and a predetermined length; and
the distal portion of the intramedullary nail defines a targeted screw hole located a predetermined distance from the proximal end of the intramedullary nail, wherein the predetermined distance is between about 44% and about 67% of the predetermined length of the nail.
7. The bone fixation system according to claim 1 , wherein:
the intramedullary nail has a proximal end, a distal portion having a distal tip, and a predetermined length; and
the distal portion of the intramedullary nail defines
a first targeted screw hole located a first predetermined distance away from the proximal end of the intramedullary nail, wherein the first predetermined distance is between about 34% and about 52% of the predetermined length of the intramedullary nail;
a distal locking hole located near the distal tip of the intramedullary nail;
a distal locking slot located in close proximity to the distal locking hole; and
a second targeted screw hole located between the first targeted screw hole and the distal locking hole.
8. A method of repairing a fracture in a femur, the method comprising;
implanting an intramedullary nail in the femur, the intramedullary nail including
a proximal portion defining
a first proximal bore configured to accept a lag screw, and
a second proximal bore configured to accept a portion of an antirotation screw insertion tool, the second proximal bore having a predetermined diameter,
a lag screw configured to extend through the first proximal bore in the proximal portion of the intramedullary nail, the lag screw including
a sheath, and
a rod mounted for sliding movement within the sheath, the rod including a threaded distal end defining an internally threaded diagonal having a predetermined diameter, and
an antirotation screw configured to be mounted at the end of the antirotation screw insertion tool and inserted through the second proximal bore, the antirotation screw including
a screw head,
a shank, and
a locking mechanism configured to lock the antirotation screw within the diagonal bore;
inserting the lag screw through the first proximal bore in the proximal portion of the intramedullary nail;
mounting the antirotation screw on the portion of the antirotation screw insertion tool;
inserting the antirotation screw insertion tool through the second proximal bore in the proximal portion of the intramedullary nail until the screw head abuts the intramedullary nail;
manipulating the antirotation screw insertion tool to lock the antirotation screw within the diagonal bore of the lag screw; and
removing the antirotation screw insertion tool.
9. The bone fixation system according to claim, 8 wherein:
the antirotation screw comprises
a threaded distal end configured to achieve good purchase in bone; and
a threaded proximal end; and
the diagonal bore has an internally threaded end configured to mate with the threaded proximal end of the antirotation screw; and
the locking mechanism comprises the threaded proximal end of the antirotation screw and the internally threaded end of the diagonal bore.
10. The method according to claim 9 , wherein manipulating the antirotation screw insertion tool comprises rotating the antirotation screw until the threaded proximal end of the antirotation screw engages the internally threaded end of the diagonal bore.