Methods for treating fractures of the femur and femoral fracture devices

Abstract

The present invention relates to methods and devices for treating femoral fractures, wherein a polyaxial cross member is employed to accommodate a wide range of angles and anteversions/retroversions in the femur, and different securing mechanisms can also be employed to hold and retain such polyaxial cross member in place at the desired orientation.

1 . An apparatus for treating fractures of the femur comprising: 
 a first plate configured to secure to an exterior of a femur, the first plate providing a first opening;    an extended portion having a polyaxial joint affixed at one end, the extended portion configured to extend through the first opening.    a cross member configured for insertion into the extended portion to permit sliding compression of a fracture of the femur and rotation about a plurality of axes as provided by the polyaxial joint; and    a securing mechanism configured to hold the polyaxial joint at a predetermined orientation in the first opening.    
   
   
       2 . The apparatus of  claim 1 , wherein the first plate includes the first opening; and 
 the securing mechanism comprises:    a second plate arranged to secure the polyaxial joint in the first opening; and    at least one fastening element configured to fasten the second plate to the first plate to hold the polyaxial joint at the predetermined orientation.    
   
   
       3 . The apparatus of  claim 2 , wherein an area of the first plate surrounding the first opening is depressed in a shape of the second plate to urge the second plate to an outer surface of the first plate when the second plate is fastened to the first.  
   
   
       4 . The apparatus of  claim 1 , wherein the first plate and the second plate are arranged on different planes when the second plate is fastened to the first plate.  
   
   
       5 . The apparatus of  claim 1 , wherein the securing mechanism comprises: 
 a securing element arranged to form the first opening with the first plate and secure the polyaxial joint in the first opening; and    at least one fastening element configured to fasten the securing element to the first plate to hold the polyaxial joint at the predetermined orientation in the first opening.    
   
   
       6 . The apparatus of  claim 5 , wherein the securing element has a first shape that complements a second shape at one end of the first plate to form a curved shape for the opening.  
   
   
       7 . The apparatus of  claim 1 , wherein the first plate includes the first opening; and 
 the securing mechanism comprises:    a second plate configured to be threaded to the first plate to secure the polyaxial joint in the first opening and holds the polyaxial joint at the predetermined orientation.    
   
   
       8 . The apparatus of  claim 1 , wherein: 
 the securing mechanism comprises an expandable collet arranged inside the first opening; and    the extended portion is tapered along its long axis and insertable into the expandable collet to lock the polyaxial joint at the predetermined orientation in the first opening.    
   
   
       9 . The apparatus of  claim 8 , wherein the polyaxial joint comprises a member having at least a curved surface and one or more expansion slots.  
   
   
       10 . The apparatus of  claim 9 , wherein the tapered extended portion is threaded at one end, and the member is threaded for affixing to the threaded end of the tapered extended portion.  
   
   
       11 . The apparatus of  claim 8 , wherein the expandable collet comprises a plurality of separate sections.  
   
   
       12 . The apparatus of  claim 1 , wherein the polyaxial joint comprises a member having at least one spherical surface.  
   
   
       13 . The apparatus of  claim 1 , wherein the member comprises a surface having one or more surface features, and the opening includes an inner surface having one or more surface features which physically cooperate with the member surface features.  
   
   
       14 . The apparatus of  claim 12  wherein the opening includes a curved inner surface.  
   
   
       15 . The apparatus of  claim 12 , wherein the opening includes a tapered inner surface.  
   
   
       16 . The apparatus of  claim 5 , wherein the securing element is configured to have one end integral with the first plate and another end separated from first plate by a gap; and 
 the at least one fastening element is configured to fasten the securing element to the first plate at the gap.    
   
   
       17 . The apparatus of  claim 16 , wherein the at least one fastening element is configured to fasten the securing element to the first plate at an outside perimeter of the first plate.  
   
   
       18 . The apparatus of  claim 12 , wherein the spherical member comprises a plurality of separate sections.  
   
   
       19 . The apparatus of  claim 7 , wherein the second plate includes one or more ball bearings that make contact with the polyaxial joint as the second plate is threaded to the first plate to further hold the polyaxial joint at the predetermined orientation.  
   
   
       20 . The apparatus of  claim 1 , wherein the securing mechanism includes: 
 an interference element arranged for insertion between an inner surface of the first opening and the polyaxial joint to prevent movement of the polyaxial joint and lock the polyaxial joint at a predetermined orientation in the first opening.    
   
   
       21 . The apparatus of  claim 1 , wherein the securing mechanism includes: 
 an interference element arranged to protrude from a position at a perimeter of the opening to exert pressure on the polyaxial joint to prevent movement of the polyaxial joint and lock the polyaxial joint at the predetermined orientation in the first opening.    
   
   
       22 . The apparatus of  claim 1 , wherein the securing mechanism includes: 
 a spring-loaded member and a fastening element;    the fastening element is configured to exert pressure on the spring-loaded member to extend a length of the spring-loaded member; and    the spring-loaded member is configured to protrude from a position at a perimeter of the first opening in response to the exerted pressure to lock the polyaxial joint at the predetermined orientation in the first opening.    
   
   
       23 . The apparatus of  claim 1 , wherein the securing mechanism includes: 
 a cam lock having a rotating member and a pressure member, wherein the pressure member is configured to protrude from a position at a perimeter of the opening to exert pressure on the polyaxial joint, based on a rotation of the rotating member, to prevent movement of the polyaxial joint.    
   
   
       24 . An apparatus for treating fractures of the femur comprising: 
 a first plate configured to secure to an exterior of a femur, the first plate providing a first opening;    an extended portion having a polyaxial joint affixed at one end, the extended portion is configured to extend through the first opening; and    a cross member configured for insertion into the extended portion to permit sliding compression of a fracture of the femur and rotation about a plurality of axes as provided by the polyaxial joint;    wherein the polyaxial joint comprises two sections arranged on each side of the first opening to compress the first plate therebetween and lock the extended portion in place at a predetermined orientation.    
   
   
       25 . An apparatus for treating fractures of the femur comprising: 
 a first plate configured to secure to an exterior of a femur, the first plate providing a first opening;    an extended portion having a cylindrical-shape joint affixed at one end, the extended portion is configured to extend through the first opening;    a cross member configured for insertion into the extended portion to permit sliding compression of a fracture of the femur and rotation about an axis as provided by the cylindrical-shape joint; and    a securing mechanism configured to lock the polyaxial joint at a predetermined orientation in the first opening.    
   
   
       26 . An apparatus for treating fractures of the femur comprising: 
 An intramedullary rod having a proximal end and a distal end and configured for insertion into the marrow canal of the femur, the intramedullary rod includes a proximal pair of openings closer to the proximal end than to the distal end;    a spherical joint inserted internal to the intramedullary rod near the proximal pair of openings in the intramedullary rod;    a cross member configured for insertion through the proximal pair of openings and the spherical joint to permit sliding compression of a fracture of the femur and rotation about a plurality of axes as provided by the spherical joint; and    a securing mechanism internal to the intramedullary rod and configured to lock the polyaxial joint at a predetermined orientation in the first opening.    
   
   
       27 . The apparatus of  claim 26 , wherein the securing mechanism comprises: 
 a setting element configured to exert pressure on the spherical joint to lock the spherical joint at the predetermined orientation.    
   
   
       28 . The apparatus of  claim 27 , wherein the setting element comprises a screw.  
   
   
       29 . The apparatus of  claim 6 , wherein the securing mechanism comprises: 
 a cam lock having a rotating member and a pressure member, wherein the pressure member is configured to exert pressure on the spherical joint, based on a rotation of the rotating member, to prevent movement of the polyaxial joint.    
   
   
       30 . The apparatus of  claim 26 , wherein the spherical joint includes a first through bore configured to receive the cross member therethrough.  
   
   
       31 . The apparatus of  claim 26 , wherein the spherical joint includes at least two through bores, one of which is configured to receive the cross member therethrough.  
   
   
       32 . The apparatus of  claim 31 , wherein the other through bore in the spherical joint is configured to receive another cross member.  
   
   
       33 . The apparatus of  claim 31 , wherein the other through bore in the spherical joint is configured to receive a guiding mechanism that is used to guide the cross member.  
   
   
       34 . The apparatus of  claim 26 , further comprising: 
 an extended portion that engages the spherical joint and extends out of the intramedullary rod through at least one of the proximal pair of openings.    
   
   
       35 . The apparatus of  claim 26 , further comprising: 
 another spherical joint inserted internal to the intramedullary rod near the proximal pair of openings in the intramedullary rod;    
   
   
       36 . A method for treating fractures of the femur, comprising: 
 inserting a cross member into a head of a femur at a desired angle;    placing an extended portion through a first opening in a first plate to enclose a part of the cross member;    permitting a sliding compression of a fracture of the femur through the cross member enclosing in the extended portion; and    arranging the first plate to touch a lateral side of the femur, while maintaining the extended portion through the first opening and the enclosure of the cross member at the desired angle, by rotating a polyaxial joint that is affixed at one end of the extended portion; and    once the first plate is arranged at a desired position at the lateral side of the femur, engaging a securing mechanism to lock the polyaxial joint at an orientation that corresponds to the desired angle of the cross member.    
   
   
       37 . A method for treating fractures of the femur comprising: 
 inserting an intramedullary rod having a proximal end and a distal end into a femur, the intramedullary rod further having a proximal pair of openings closer to the proximal end than to the distal end and a spherical joint internal to the intramedullary rod and near the proximal pair of openings;    determining a proper angle for insertion of a cross member to engage a head of the femur;    rotating the spherical joint to an orientation that corresponds with the proper angle for the cross member to engage the femoral head;    engaging a secure mechanism to lock the spherical joint at the corresponding orientation; and    inserting the cross member through the pair of proximal openings and the spherical joint to engage the femoral head, the cross member permitting a sliding compression of a fracture of the femur.