Apparatus and methods for bone repair preparation

Abstract

Apparatus and methods for preparing a fractured bone for repair. Preparing the bone may include fracture reduction. Preparing the bone may include holding a fracture in reduction. Preparing the bone may include identifying locations for obtaining access to an interior region of the bone. The apparatus may include structures outside the bone that interact with fragments of the bone. The structures may participate in the reduction. The structures may participate in holding the reduction. The structures may participate in identifying the locations.

1 - 30 . (canceled) 
     
     
         31 . Apparatus for reducing a fracture, the apparatus comprising:
 a base configured to be secured to a first bone segment; and   a bone fragment manipulator that is in mechanical communication with the base and is configured to:
 engage a second bone segment; 
 displace the second bone segment along one or more of three orthogonal axes; and 
 rotate the bone second bone segment about one or more of the three orthogonal axes. 
   
     
     
         32 . The apparatus of  claim 31  wherein the bone fragment manipulator comprises:
 an elongated bone penetrating member; and 
 a collar configured to receive the elongated bone penetrating member. 
 
     
     
         33 . The apparatus of  claim 31 , the bone fragment manipulator comprising:
 an elongated bone penetrating member;   a cannulated body configured to receive the elongated bone penetrating member, the cannulated body comprising:
 outer threads; and 
 retention fingers; 
   a tapered form configured to compress the retention fingers; and   a female threaded member configured to engage the outer threads and thereby cause compression to be applied to, or to be relieved from, the retention fingers.   
     
     
         34 . The apparatus of  claim 31  further comprising a support that is configured to translate in:
 a first direction; and 
 a second direction that is orthogonal to the first direction. 
 
     
     
         35 . The apparatus of  claim 34  the support comprising an upper plate and a lower plate;
 wherein displacement of the female threaded member from the tapered form is configured to displace the upper plate from the lower plate. 
 
     
     
         36 . The apparatus of  claim 35  wherein the base comprises a frame that is configured to limit displacement of the upper plate from the lower plate. 
     
     
         37 . The apparatus of  claim 36  wherein the bone fragment manipulator is locked about and along one or more of the three orthogonal axes by pressure applied:
 (a) through the female threaded member and the tapered form to the support; and 
 (b) through the support to the frame. 
 
     
     
         38 . The apparatus of  claim 33  wherein the tapered form is configured to compress the retention fingers against the elongated bone penetrating member when the cannulated body threadedly engages the female threaded member. 
     
     
         39 . The apparatus of  claim 33  wherein:
 the female threaded member includes a first curved articulating surface for articulating against the support; and 
 the tapered form includes a second curved articulating surface for articulating against the support. 
 
     
     
         40 . The apparatus of  claim 31  further comprising, when the bone fragment manipulator is a first bone-fragment manipulator, a second bone fragment manipulator that is in mechanical communication with the base and is configured to:
 engage a third bone segment; 
 displace the third bone segment along one or more of three orthogonal axes; and 
 rotate the third bone segment about one or more of three orthogonal axes. 
 
     
     
         41 . Apparatus for reducing a fracture, the apparatus comprising:
 a base configured to be secured to a first bone segment;   an elongated bone penetrating member in mechanical communication with the base and is configured to:
 engage a second bone segment; 
 displace the second bone segment along one or more of three orthogonal axes; and 
 rotate the second bone segment about one or more of the three orthogonal axes; and 
   a pressure source configured to fix the elongated bone penetrating member to substantially prevent:
 displacement of the second bone segment along one or more of the three orthogonal axes; and 
 rotation of the second bone segment about one or more of the three orthogonal axes. 
   
     
     
         42 . The apparatus of  claim 41  wherein the pressure source is configured to lock the elongated bone penetrating member relative to the base. 
     
     
         43 . The apparatus of  claim 41  further comprising a support that is configured to translate in:
 a first direction; and 
 a second direction that is orthogonal to the first direction. 
 
     
     
         44 . The apparatus of  claim 43  wherein the pressure source is configured to lock the support relative to the base. 
     
     
         45 . The apparatus of  claim 41  wherein the pressure source comprises:
 a cannulated body for receiving the elongated bone penetrating member, the cannulated body comprising:
 outer threads; and 
 retention fingers; 
 
 a tapered form configured to compress the retention fingers against the elongated bone penetrating member; and 
 a female threaded member configured to engage the outer threads and thereby cause compression to be applied to, or to be relieved from, the retention fingers. 
 
     
     
         46 . The apparatus of  claim 41  wherein the pressure source comprises:
 an upper plate; 
 a lower plate; 
 a cannulated body; 
 a female threaded member; 
 a tapered form; and 
 a frame; 
 wherein: 
 threaded engagement of the cannulated body and the female threaded member is configured to displace the female threaded member from the tapered form; 
 displacement of the female threaded member from the tapered form is configured to displace the upper plate from the lower plate; and 
 the frame is configured to limit displacement of the upper plate from the lower plate. 
 
     
     
         47 . Apparatus for reducing a fracture, the apparatus comprising:
 a base configured to be secured to a first bone segment;   a cannulated body comprising outer threads, the cannulated body configured to receive an elongated bone penetrating member;   a female threaded member configured to threadedly engage the outer threads of the cannulated body;   a tapered form configured to compress the cannulated body against the elongated bone penetrating member; and   a support configured to receive the tapered form.   
     
     
         48 . The apparatus of  claim 47  further comprising a detent that limits rotational displacement of the tapered form relative to the support. 
     
     
         49 . The apparatus of  claim 47  comprising a pressure source that is configured to fix:
 a position of the elongated bone penetrating member relative to the cannulated body; and 
 a position of the tapered form relative to the support. 
 
     
     
         50 . The apparatus of  claim 47  wherein the tapered form includes expansion members that are configured to press against the support in response to threaded engagement of the cannulated body and the female threaded member. 
     
     
         51 . The apparatus of claim  55 , wherein, when the bone engaging member is positioned in the cannulated body, threaded engagement of the cannulated body and the female threaded member is configured to fix a position of the bone engaging member:
 relative to the cannulated body; and   relative to the support.