Strut plate and cabling system

Abstract

A bone plate assembly and method of utilizing same are disclosed. The assembly includes at least two plates affixed to the bone in two different locations. One of the plates includes a porous bone in-growth surface, and may be entirely porous. The assembly may further include at least one bone screw and cable for affixing the plates to the bone. In the method of use, the plates may be affixed by the screws and/or cables and the plate including the porous surface may be left in place after bone is allowed to grow therein.

Claims

1. A method of fixing a fracture of a bone comprising the steps of: placing a first plate on the bone such that the first plate spans at least a portion of the fracture; inserting at least one screw through the first plate and into the bone; placing a second plate on the bone such that the second plate spans at least a portion of the fracture, wherein the second plate is constructed entirely from porous metal foam; and attaching the second plate to the bone without the use of a screw, the second plate including a bone in-growth surface, an outward facing surface opposite the bone in-growth surface, and no holes extending between the bone in-growth surface and the outward facing surface and traversing the outward facing surface, wherein the attaching of the second plate includes wrapping at least one cable around the second plate such that the at least one cable is wrapped along the outward facing surface.

2. The method of claim 1, wherein wrapping the at least one cable includes inserting the at least one cable through a cannulation in the at least one screw.

3. The method of claim 1, wherein wrapping the at least one cable includes inserting the at least one cable through at least one channel in the first plate.

4. The method of claim 1, wherein attaching the second plate includes attaching the second plate opposite the first plate.

5. The method of claim 1, further comprising: allowing bone to grow into at least a portion of the bone in-growth surface; and removing the first plate or the at least one cable subsequent to the allowing step.

6. A method of fixing a fracture of a bone, the method comprising: placing a first plate on the bone such that the first plate spans at least a portion of the fracture; placing a second plate on the bone such that the second plate spans at least a portion of the fracture, the second plate including a bone in-growth portion, an outward facing surface opposite the bone in-growth portion, and no holes extend continuously between the bone in-growth portion and the outward facing surface and traversing the outward facing surface, wherein the second plate is constructed entirely from porous metal foam; and wrapping at least one cable around the first and second plates to attach the first and second plates to the bone such that the at least one cable is wrapped along the outward facing surface of the second plate.

7. The method of claim 6, further comprising inserting at least one screw through the first plate and into the bone.

8. The method of claim 7, wherein wrapping the at least one cable includes inserting the at least one cable through a cannulation in the at least one screw.

9. The method of claim 6, wherein wrapping the at least one cable includes inserting at least one cable through at least one channel in the first plate.

10. The method of claim 6, wherein placing the second plate includes placing the second plate opposite the first plate.

11. The method of claim 6, further comprising: allowing bone to grow into a least a portion of the bone in-growth portion; and removing the first plate or the at least one cable subsequent to the allowing step.

12. A method of fixing a fracture of a bone, the method comprising: placing a first plate on the bone such that the first plate spans at least a portion of the fracture, wherein the first plate includes a throughbore extending transverse to a longitudinal axis of the first plate; inserting at least one cannulated screw through the first plate and into the bone; placing a second plate on the bone such that the second plate spans at least a portion of the fracture, wherein the second plate is constructed entirely from porous metal foam; inserting at least one cable through a cannulation in the at least one screw; and wrapping the at least one cable around an outward facing surface of the first plate and an outward facing surface of the second plate, wherein wrapping the at least one cable around the outward surface of the second plate attaches the second plate to the bone without the use of a screw, and wherein wrapping the at least one cable further includes inserting the at least one cable through the throughbore.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

(1) A more complete appreciation of the subject matter of the present invention and of the various advantages thereof can be realized by reference of the following detailed description in which references made to the accompanying drawings in which:

(2) FIG. 1 is a perspective view of a bone plate and cabling system according to one embodiment of the present invention attached to a femur.

(3) FIG. 2 is another perspective view of the bone plate and cabling construct of FIG. 1 focusing on a different plate of the construct.

(4) FIG. 3 is a cross sectional view taken along line D-D of FIG. 2.

(5) FIG. 4 is a cross sectional view taken along line B-B of FIG. 1.

DETAILED DESCRIPTION

(6) The present invention addresses both above-noted needs, by providing a bone plate and cabling system that does not rely solely upon bone screws inserted through the plate. Rather, the present invention makes use of porous plates that can be initially affixed via a novel cabling system and thereafter allow for bone ingrowth into the plates to support the construct. Although the porous bone plates disclosed herein are described as being constructed of porous metal foam, it is contemplated that the bone plates may be of many different types of materials, including, but limited, ceramics, plastics or the like. It is also contemplated to utilize the porous bone plates of the present invention in conjunction with more standard bone plates known in the art.

(7) FIGS. 1 and 2 depict a femur 1 with a bone plate and cabling system 10 attached thereto. System 10, as shown, includes a first bone plate 12 and a second bone plate 14 (best shown in FIG. 2). Bone plate 12 is standard bone with a plurality of bone plate holes 16 that are shown both as exhibiting circular and elongate forms. Of course, the holes may exhibit any shape or construct known in the art, including, without limitation, oblong compression holes, threaded holes and holes that include deformable structures. Likewise, any number of holes may be provided on plate 12 in connection with the present invention. Additionally, plate 12 includes at least one channel or slot 18 that is sized and shaped to accept and retain a cable of the type discussed more fully below. As shown, plate 12 is designed for use in connection with a distal femur, but can exhibit many different configurations depending upon the bone that requires repair.

(8) On the other hand, bone plate 14 is shown constructed of porous material, with no holes formed therethrough. The porous material is preferably designed to allow for bone to grow directly into plate 14 after implantation. Although shown as consisting largely of the porous material, plate 14 can be only partially formed of the porous material. Specifically, in other embodiments, bone plate 14 may include an underside surface that is of a porous construction, so that when placed against the bone it can facilitate bone in-growth from the affected bone into the plate. In such a case, the remainder of the plate can be of a more solid construction.

(9) As shown, the porous metallic construction of bone plate 14 was created utilizing a laser remelting process (“LRM”). In fact, it is contemplated to form the entirety of plate 14 with such a process, including any solid portions that may be included therein. Those solid portions could alternatively be formed through more conventional processes (e.g., molding, forging, etc. . . . ) and a porous lower or bone contacting surface can be later affixed thereto via a process like LRM. Without limitation, the LRM processes disclosed in U.S. Pat. Nos. 7,537,664 and 8,147,861; U.S. Patent Application Publications Nos. 2006/0147332, 2007/0142914, 2008/0004709; and U.S. patent application Ser. Nos. 13/441,154 and 13/618,218, the disclosures of which are hereby incorporated by reference herein, can be utilized. It is also contemplated to form any porous surface via a laser etching procedure.

(10) Also depicted in FIGS. 1 and 2 is a cabling system that includes plurality of cables 20a-d and at least one cannulated screw 22. As shown, the cables may be situated so as to extend through screw 22 and around plate 12 and the femur (cable 20a), around both plates 12 and 14 (cables 20b and 20d) and through channel or slot 18 and around plate 14 (cable 20c). Of course, other configurations are also contemplated depending upon the bone being repaired and the plates being utilized.

(11) Screw 22 not only allows for the fixation of plate 12 to the bone, but also its cannulation allows for passage of cable 20a therethrough so that the cable only needs to wrap around the affected bone on one side thereof. This is further shown in the cross sectional view of FIG. 3. Although screw 22 is shown as a one piece screw, it is contemplated that the screw can include a modular head or the like. In addition, it is contemplated for one or more of plate holes 16 to be designed such that they are not only sized and shaped to receive the screws, but also allow polyaxial movement of the screws with respect to the plate. Above-mentioned channel or slot 18 is sized, shaped and oriented to receive and guide a cable placed therethrough. The channel or slot 18 can be of an open or closed design, the latter of which entirely retains the cable therein. Of course, although only a single channel or slot is shown included on plate 12, any number of them may be provided on a given plate.

(12) In use, a surgeon will place plate 12 against an affected bone (such as femur 1), so that different portions of the plate span any fracture(s) in the bone. Thereafter screws, such as screws 22, may be placed through the plate and into the bone. Cables 20a-d may then be applied to the construct and plate 14 may be introduced to the opposite side of the bone from plate 12. It is also contemplated to place plate 14 in other positions than directly opposite to plate 12 (e.g., to the side of the bone). Upon tightening of the cables, plates 12 and 14 are fixed in position.

(13) In the case of a peri-prosthetic fracture, care must be taken as to the placement of any screws so as not to interfere with the already implanted prosthesis. However, it is possible through the use of the plates, screws and cables of the present invention properly stabilize the fracture without the need for screws extending into each bone fragment. Rather, less screws can be utilized when utilizing cables 26. The cables act to stabilize the fracture, much like multiple screws would in the case of a standard bone plate use. This is especially true in the context of peri-prosthetic fractures, where the amount of bone screws that can be utilized is limited.

(14) In situations in which bone plates 12 and 14 are utilized, the use of two plates allows for a stable fixation of the bone fracture via plate 12, while bone is allowed to grow into plate 14. After proper bone growth, a surgeon may elect to remove bone plate 12 from the fracture site, thereby leaving what is effectively become a continuous bone/plate 14 construct. It is, of course, contemplated that the plates may be placed on many different portions of the bone, as well as to leave both plates in place for an extended period of time. Additionally, it is contemplated to utilize only plate 14 with one or more cables at least initially holding it in place. After proper bone growth into plate 14, the cables may be removed. It is to be understood that plate 14 could also be designed to work in conjunction with screws, like screw 22, or to include one or more channels or slots like are discussed above. Any holes provided in plates 12 or 14 could also accept a cable plug, which can provide an additional mechanism for associating the plate with a cable. For instance, it is envisioned to utilize with plates 12 or 14 any of the cables plugs disclosed in U.S. Pat. No. 8,142,434, U.S. Patent Application Publication No. 2014/0107710 and U.S. Provisional Application No. 62/035,074, the disclosures of which are hereby incorporated by reference herein.

(15) Although the invention herein has been described with reference to particular embodiments, it is to be understood that these embodiments are merely illustrative of the principles and applications of the present invention. It is therefore to be understood that numerous modifications may be made to the illustrative embodiments and that other arrangements may be devised without departing from the spirit and scope of the present invention as defined by the appended claims.