Bone fracture fixation systems with both multidirectional and unidirectional fixation devices

Abstract

A fixation system includes a device having a plurality of like threaded peg holes. Two types of pegs are couplable within the peg holes. One type is multidirectional, and the shaft can be oriented at various angles relative to an axis extending through the peg hole. Another peg is directionally-fixed and limited to extension through the peg hole in a single direction; i.e., coaxial with the peg hole axis. The peg holes and both types of pegs are adapted such that either of the pegs can be received within any of the peg holes of the device.

1 - 9 . (canceled)  
     
     
         10 . A fracture fixation system, comprising: 
 a) a fracture fixation device defining at least one hole, said hole having an upper portion provided with an internal thread, and a lower portion having a substantially spherically concave surface;    b) a first fixation element having a head and a shaft, said head including a first portion having an external thread adapted to thread with said internal thread, a second portion having a substantially spherically convex surface corresponding to said substantially spherically concave surface, and an engagement portion for a rotational driver;    c) a second fixation element having a head and a shaft, said head including a first portion defining a cup and having a substantially spherically convex surface corresponding to said substantially spherically concave surface; and    d) a cap having an external thread adapted to thread with said internal thread, an engagement portion for a rotational driver, and a lower portion sized to be received within said cup of said second fixation element.    
     
     
         11 . A fracture fixation system according to  claim 10 , wherein: 
 at least one of said substantially spherically concave surface of said device, said substantially spherically convex surface of said first fixation element and said substantially spherically convex surface of said second fixation element is provided with a relatively high coefficient of friction.    
     
     
         12 . A fracture fixation system according to  claim 10 , wherein: 
 one of said shaft of said first fixation element and said shaft of said second fixation element is non-threaded.    
     
     
         13 . A fracture fixation system according to  claim 10 , wherein: 
 said fixation device is a plate device.    
     
     
         14 . A fracture fixation system according to  claim 13 , wherein: 
 said plate device is a volar plate.    
     
     
         15 . A fracture fixation system according to  claim 10 , wherein: 
 said fixation device is a nail-plate device.    
     
     
         16 . A fracture fixation system according to  claim 10 , wherein: 
 said fixation device includes a plurality of threaded holes.    
     
     
         17 . A fracture fixation system according to  claim 10 , wherein: 
 said cup of said second fixation element includes a surface area, and said lower portion of said cap includes a protuberance adapted to define a substantially small contact area relative to said surface area of said cup.    
     
     
         18 . A fracture fixation system according to  claim 10 , wherein: 
 said a cap comprises a base and a set screw,    said base includes said external thread adapted to thread with said internal thread of said at least one hole, an internal thread, and said engagement portion for a rotational driver, and    said set screw includes an external thread adapted to thread with said internal thread of said base, a second engagement portion for a rotational driver, and said lower portion of said cap.    
     
     
         19 . A fracture fixation system according to  claim 18 , wherein: 
 said external thread of said base has a first pitch, said external thread of said set screw has a second pitch, and said first pitch is greater than said second pitch.    
     
     
         20 . A fracture fixation system according to  claim 10 , wherein: 
 said cup of said second fixation element defines an engagement portion for a rotational driver.    
     
     
         21 . A fracture fixation system according to  claim 10 , wherein: 
 said at least one hole includes first and second holes, said first hole defines a first axis and said second hole defines a second axis,    wherein said first fixation element is coupled within said first hole in alignment with said first axis, and said second fixation element is coupled within said second hole at an angle relative to said second axis.    
     
     
         22 . A fracture fixation system according to  claim 21 , wherein: 
 said first and second axes are parallel.    
     
     
         23 . A fracture fixation system according to  claim 21 , wherein: 
 said angle is within a range of +15′ relative to said second axis.    
     
     
         24 . A kit for a fracture fixation system, comprising: 
 a) a fracture fixation device defining at least first and second like holes, each said hole having an upper portion provided with an internal thread;    b) a first fixation element couplable within at least said first hole, said first fixation element having a head and a shaft, said head having an external thread engageable with said internal thread and an engagement portion for a rotational driver;    c) a second fixation element couplable within at least said second hole, said second fixation element having a head and a shaft; and    d) a cap having an external thread that is engageable with said internal thread of said second hole and an engagement portion for a rotational driver.    
     
     
         25 . A kit according to  claim 24 , wherein: 
 said cap includes a lower portion that engages with said head of said second fixation element to angularly fix said head of said second fixation element within said second hole.    
     
     
         26 . A kit according to  claim 25 , wherein: 
 said lower portion of said cap clamps against said head of said second fixation element to provide said angular fixation.    
     
     
         27 . A kit according to  claim 25 , wherein: 
 said head of said second fixation element includes a cup having a surface area, and said lower portion of said cap includes a protuberance adapted to define a substantially small contact area relative to said surface area of said cup.    
     
     
         28 . A kit according to  claim 25 , wherein: 
 said cap comprises a base and a set screw,    said base includes said external thread adapted to thread with said internal thread of said first and second holes, an internal thread, and said engagement portion for a rotational driver, and    said set screw includes an external thread adapted to thread with said internal thread of said base, a second engagement portion for a rotational driver, and said lower portion of said cap.    
     
     
         29 . A kit according to  claim 28 , wherein: 
 said external thread of said base has a first pitch, said external thread of said set screw has a second pitch, and said first pitch is greater than said second pitch.    
     
     
         30 . A kit according to  claim 24 , wherein: 
 said head of said second fixation element defines a cup having an engagement portion for a rotational driver.    
     
     
         31 . A kit according to  claim 25 , wherein: 
 said head of said second fixation element defines a concave surface, and said lower portion of said cap has a spherically-curved convex surface corresponding to said concave surface.    
     
     
         32 . A kit according to  claim 24 , wherein: 
 said first hole includes a lower portion having a substantially spherically concave surface, said first fixation element includes a portion having a substantially spherically convex surface corresponding to said spherically concave surface, said substantially spherically concave surface and said substantially spherically convex portion intended for contact with each other.    
     
     
         33 . A kit according to  claim 24 , wherein: 
 said shaft of said first peg is non-threaded.    
     
     
         34 . A kit according to  claim 24 , wherein: 
 said shaft of said second peg is non-threaded.    
     
     
         35 . A kit according to  claim 34 , wherein: 
 said second fixation element includes an engagement portion for a rotational driver.    
     
     
         36 . A kit according to  claim 24 , wherein: 
 said fixation device is a plate.    
     
     
         37 . A kit according to  claim 24 , wherein: 
 said fixation device is nail-plate.    
     
     
         38 . A kit according to  claim 24 , wherein: 
 when said first and second fixation element are fixed within said at least first and second holes, said first and second fixation elements define a plurality of non-parallel axes collectively oriented to provide a framework for supporting fractured bone fragments.    
     
     
         39 . A kit according to  claim 24 , wherein: 
 said at least first and second holes includes at least three holes closely spaced in a linear or curvilinear arrangement.    
     
     
         40 . A kit according to  claim 24 , wherein: 
 said fixation device includes a plate portion defining said at least first and second holes.    
     
     
         41 . A kit according to  claim 40 , wherein: 
 said plate portion has a body portion and a head portion angled relative said body portion, said head portion defining said at least first and second holes.    
     
     
         42 . A kit according to  claim 40 , wherein: 
 said fixation device also includes a nail portion extending from said plate portion.    
     
     
         43 . A kit according to  claim 24 , wherein: 
 said fixation device includes at least one non-threaded screw hole.    
     
     
         46 . A method of treating a bone fracture, comprising: 
 a) providing a fixation device having a plurality of like threaded holes, each of said holes defining an axis, said holes having an upper portion provided with an internal thread and a lower portion having a substantially spherically concave surface;    b) positioning the fixation device over the bone fracture;    c) drilling holes through the holes into the bone, wherein a first of the drilled holes is drilled substantially coaxial with the axis through a peg hole, and a second of the drilled holes is drilled at an angle relative to the axis through a peg hole;    d) providing a first fixation element having a head and a shaft, said head including an external thread adapted to thread with said internal thread, a portion having a substantially spherically convex surface corresponding to said substantially spherically concave surface, and an engagement portion for a rotational driver;    e) inserting said first fixation element through one of the holes such that the shaft of the first fixation element extends into the first drilled hole;    f) providing a second fixation element and a discrete cap, said second fixation element having a head and a shaft, said head of said second fixation element including a portion defining a cup and having a substantially spherically convex surface corresponding to said substantially spherically concave surface, and said cap having an external thread, an engagement portion for a rotational driver, and lower portion sized to be received within said cup of said second peg;    g) inserting the second fixation element through another of the holes such that the shaft of the second fixation element extends through the second drilled hole; and    h) threadably engaging the cap in the other of the holes until a portion of the cap engages the head of the second fixation element.    
     
     
         47 . A method according to  claim 46 , wherein: 
 said threadably engaging the cap causes clamping of the head of the second fixation element between the cap and the fixation device.    
     
     
         48 . A method according to  claim 46 , wherein: 
 said providing said second fixation element and a discrete cap includes providing said second fixation element with a non-threaded shaft.