Patent ID: 12232785

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

Turning now to the Figures, where the purpose is to describe preferred embodiments according to the invention and not limit same,FIG.1shows a perspective side view of a device10according to aspects of the invention. Device10has a first section20and a second section50. In one preferred embodiment device10has an overall length of between 90 and 150 mm, and is most preferably about 120 mm in length, and is comprised of stainless steel although any suitable material for permanent placement in the body would suffice.

First section20is configured to fit under the skin of the forearm and wrist and connect to the radius bone and one or more carpal bones in the forearm and/or wrist in order to secure section20.FIGS.6and7illustrate a device10according to the invention fully inserted and attached.

First section20is preferably an elongated plate having a length of 45 mm-75 mm, and most preferably about 60 mm, a thickness of between 3 and 4 mm, and most preferably about 3.5 mm, and a width of 9-15 mm, and most preferably about 11 mm. First section20includes a first end22, apertures24, a top surface26and a bottom surface28. Apertures24pass from top surface26through bottom surface28to enable bone screws (which means any device suitable to connect first section20to one or more bones in the forearm and/or wrist)30, which are shown inFIGS.6and7, to pass through and connect to a bone, such as the radius and/or a carpal bone. Screws30are preferably standard bone screws known in the art. As shown inFIG.5, drill guides40may be associated with each aperture26to assist in quickly positioning and drilling screws30.

As shown inFIG.7, openings24may be formed as compression slots24A capable of accepting either one or two screws30. If formed as compression slots, the ends of each slot farthest from the hand are sloped inward so that a screw30positioned at that location will push against the sloped surface and press section20A away from the hand to create compression along the bone. If the slot24A is long enough another screw30may be positioned, tor example, in slotted retainer24B, to secure device10.

First section20also preferably includes a bended portion, or bend, 32. Bend32is at a preferred angle of about 10°-20°, is positioned at the wrist and marks the transition from the portion of device10on the forearm to the portion on the top of the hand. In a preferred embodiment, the bend has a drop D of between 0.5 and 1.5, and most preferably about 1.0 cm, and a length of between 15 and 25 mm, and most preferably 20 mm. Alternatively, first section20may be straight.

There are preferably three or more apertures24(or24A) on first section20, and most preferably five with one located at about the center of the wrist.

Second section50is either connected to or (most preferably) integrally formed with first section20. As shown, after or during the bend32, device10narrows and conforms in shape to form second end50, although it could conform in shape to form second end50at any suitable location, whether or not device10has a bend32. In this embodiment, second end50has an end52and a cylindrical body54. Depending on the overall shape of device10, second section50may extend upward at a 10°-20° angle, and most preferably about 15°, from the position at which it meets first portion20, or extend straight from that position, or extend at any suitable angle. As shown, second section50is between 30 and 50 mm, and most preferably about 40 mm in length. The portion that extends into the cannula of the third metacarpal is preferably 3-4 mm, and most preferably about 3.5 mm in diameter. Second section50may include either longitudinal ribs, latitudinal ribs, or both.

An optional third section100is an anti-rotational section that helps prevent device10from rotating. Preferably third section100is a separate piece attached to device10immediately after bend32or at any suitable location. Third section100extends upward and outward so that it extends generally above second section50. It has an attachment portion102with one or more screw holes104(shown inFIG.7) that receive fasteners106to attach it to device100. Upward and outward extending portion or rib108has an extension108A that includes one or more screw holes110. Fasteners112(which are preferably bone screws) can pass through screw holes110and connect to the top of the third metacarpal bone to help prevent device10from rotating.

Optionally, second portion50has one or more receiving apertures60(shown inFIG.7) that are positioned in the cannula of the third metacarpal when the second portion50is properly positioned in the hand. Each of the receiving apertures60is configured to receive the end of a fastener that is fastened to both the top bone of the third metacarpal and a receiving aperture60of the second portion50to further help prevent rotation. Another option to provide an anti-rotational structure is to eliminate the third section100and just insert one or more fasteners into the top bone of the third metacarpal and have each of the fasteners received in a receiving aperture60of the second section, as described above.

FIG.4shows a third section100A with a right angle, instead of the generally S-sloped, shape of third section100. A third section according to the invention could be integrally formed with device10instead of being connected thereto.

In use, an appropriate incision is made preferably lengthwise along the hand, across the wrist and along part of the forearm so that device10may be received under the skin. The wrist is then flexed downward and second section50is pressed into the cannula of the third metacarpal bone. If the third section100is used, and if not integrally formed with device10, it will preferably have already been connected to device10prior to the placement of second section50into the third metacarpal bone. Third section100(if used) is secured to the top of the third metacarpal bone by positing screws106through the screw holes and securing them to the top of the third metacarpal bone, as previously described. Alternatively, screws106may also be received into receiving apertures formed in second portion50that are positioned inside the third metacarpal bone. Or, no third section100is used and one or more screws are positioned through the top of the third metacarpal bone and into one or more receiving apertures of the second portion50to help prevent rotation.

Then wrist is straightened and section20is positioned o the forearm and wrist. Screws30are then placed through the apertures24into the radius and/or one or more carpal bones to secure device10.

Some specific examples of the invention are as follows:

1. A device for fusion of the wrist, the device comprising:

(a) a first substantially rigid section configured to be positioned under the skin of the forearm and wrist, and to be secured to at least one or more bones in the forearm; and(b) a second section connected to or integrally formed with the first section, the second section configured to be received in the cannula of the third metacarpal bone.
2. The device of example 1 wherein the first section is an elongated plate.
3. The device of example 1 or example 2 wherein the first section has a downward bend between the wrist and the hand.
4. The device of example 3 wherein the downward bend is at an angle of 10°-20°.
5. The device of any of examples 1˜4 wherein the first section has apertures that permit screws to pass through.
6. The device of any of examples 1-5 that further includes drill guides associated with each aperture in the first section.
7. The device of any of examples 1-6 wherein the first section is between 3.0 and 4.0 mm thick.
8. The device of any of examples 1-3 or 5-7 wherein the bend has a drop of between 0.5 and 1.5 cm and extends along the device for a length between 15 and 25 mm.
9. The device of any of examples 1-8 wherein the first section is between 9 mm and 15 mm wide.
10. The device of any of examples 1-9 wherein the first section has three or more apertures.
11. The device of any of examples 1-10 wherein the first section has five apertures.
12. The device of any of examples 5, 10 or 11 that has an aperture above the wrist to enable a screw to be inserted into a bone at the wrist.
13. The device of any of examples 1 and 2 wherein the second section is integrally formed with the first section.
14. The device of any of examples 1-13 wherein the second section extends at an upward angle of between 10° and 20° from the point at where it meets the first section.
15. The device of any of examples 1-13 wherein the second section extends at an upward angle of between 15° from the point at where it meets the first section.
16. The device of any of examples 1 and 15 wherein the second section is between 30 and 50 mm in length.
17. The device of any of examples 1 and 15 wherein the second section is 40 mm in length.
18. The device of any of examples 1-17 wherein the portion of the second section that extends into the cannula of the third metacarpal bone is between 2 mm and 4 mm in diameter.
19. The device of any of examples 1-17 wherein the portion of the second section that extends into the cannula of the third metacarpal bone is 3 mm in diameter.
20. The device of any of examples 1-19 that further includes an anti-rotational section.
21. The device of example 20 wherein the anti-rotational section is connected to the first section.
22. The device of any of examples 3, 4 or 8 that further includes an anti-rotational section connected to the device past the bend and on the part of the device which is to be positioned on the hand.
23. The device of any of examples 20-22 wherein the anti-rotational section is connected to the device by screws.
24. The device of any of examples 20-23 wherein the anti-rotational section extends upward and outward from the device and extends above the second section so that it can be connected to the top of the third metacarpal bone.
25. The device of any of examples 20-24 wherein the anti-rotational device includes one or more screw holes to allow a screw to pass through it and connect to the top of the third metacarpal bone.
26. The device of example 1 that includes an anti-rotational device integrally formed therewith.
27. The device of any of examples 1-26 that is comprised of stainless steel.
28. The device of any of examples 1-27 wherein the first section has a length of 45-75 mm.
29. The device of any of examples wherein the first section has a length of 60 mm.
30. The device of any of examples 1-29 wherein the device has a length of 105-135 mm.
31. The device of any of examples 1-29 that has a length of 120 mm.
32. The device of example 1 or example 2 wherein the first section is straight.
33. The device of any of examples 1-2 wherein the second section extends straight from the point at which it meets the first section.
34. The device of example 26 wherein the anti-rotational section extends above and outward from the device and extends above the second section so that it can be connected to the top of the third metacarpal bone.
35. The device of example 26 or example 34 wherein the anti-rotational device includes one or more screw holes to allow a screw to pass through it and connect to the top of the third metacarpal bone.
36. The device of any of examples 1-35 wherein the second section has one or more receiving apertures that is positioned in the cannula of the third metacarpal when the second section is properly positioned in the hand, each of the one or more receiving apertures for receiving a fastener positioned through the top of the third metacarpal bone in order to secure the top of the third metacarpal bone to the second portion, in order to help prevent rotation of the device.
37. The device of example 36 wherein each of the fasteners is a screw.
38. The device of example 36 wherein each of the one or more receiving apertures is threaded to threadingly receive a screw.

Having thus described some embodiments of the invention, other variations and embodiments that do not depart from the spirit of the invention will become apparent to those skilled in the art. The scope of the present invention is thus not limited to any particular embodiment, but is instead set forth in the appended claims and the legal equivalents thereof. Unless expressly stated in the written description or claims, the steps of any method recited in the claims may be performed in any order capable of yielding the desired result.