JP2009524473A - Fracture fixation device and implantation jig therefor - Google Patents

Abstract

A fixing device and a jig for assisting implantation of the fixing device into a fractured bone are provided.
A fracture fixation device includes a plate portion and an intramedullary nail portion that is offset from the plate portion by a neck portion. The plate portion includes a peg hole portion displaced in the longitudinal direction, and the peg hole portion directs the peg along a virtual plane parallel to the subchondral bone of the joint surface. The top surface of the plate portion includes a recess that defines the position of the jig. The nail portion has a threaded screw hole oriented perpendicular to the endosteal surface and a K-wire alignment hole parallel to and smaller than the screw hole. The jig has a first portion associated with the recess and a second portion aligned over the threaded hole of the nail portion. The rear side of the first part of the jig is curved upward in order to facilitate the operation of the jig. The first and second portions of the jig include a K wire guide hole that defines the orientation of the K-wire relative to the hole in the device.
[Selection] Figure 1

Description

Disclosure details

BACKGROUND OF THE INVENTION
1. The present invention relates generally to surgical devices. More particularly, the present invention relates to a surgical apparatus and tool for implanting a fracture fixation device.

2. State of the art Serious long bone fractures are often treated by plating. In plating, a relatively wide incision is made at the fracture site, and the muscle fibers and tendons are displaced from the bone to expose the surface of the bone, ideally to support and fix the fracture to heal. Securely attach the bone plate to one or more bone fragments. Because the procedure required to implant the plate is relatively invasive, plating is generally intended for fractures that cannot be treated with less invasive fixation methods.

  Less complex fractures are often treated with casting or wire. However, such traditional therapies do not provide the fixation and support necessary to recover as desired. On the other hand, plating surgical methods are often too invasive for less severe fractures. In addition, conventional plating can cause tendon irritation and skin necrosis and may require extensive removal of the periosteum to attach the plate to the surface of the bone. For this reason, many fractures that are not very misaligned, especially metaphyseal fractures (fractures at the ends of the long bones) remain under-treated.

  For example, a coreless fracture is caused by a compressive force applied to the distal radius, where the distal fracture fragment is displaced backwards and the hand is deflected to the heel side at the wrist, but the degree of displacement is large. Is treated with a backplate. However, coreless fractures that are not so displaced are generally not sufficiently treated because doctors ask for invasive treatment by surgery. If not properly treated, such a fracture can permanently deform the wrist. Therefore, it is important to align the fractures and fix the bones relative to each other for proper healing.

  More recently, relatively less invasive fixation devices have become available for the treatment of wrist fractures. For example, US Pat. No. 6,379,359 issued to Dahners teaches an intrafocal fixation device having an intramedullary portion and a plate portion for placement at the metaphysis. However, devices such as those described in Dahners are unlikely to be accepted by the surgeon or likely to be useful unless some important issues are addressed. First, the subchondral bone must be properly supported. Second, the support must be properly aligned on the bone. Thirdly, the support for the subchondral bone needs to be attached so as not to violate the structure of the implant with low invasiveness. Fourth, the implant should not require excessive bone removal that can further weaken the fracture site. Therefore, there is a need to provide the surgeon with a fracture fixation implant and a jig that allows it to be easily implanted.

[Summary of the Invention]
Accordingly, an object of the present invention is to provide a fixation device and a jig for assisting in embedding the fixation device in a fractured bone.

  Another object of the present invention is to provide a fixation device designed to treat metaphyseal fractures.

  A further object of the present invention is to insert a fastener into the hole and the opening in the bone, the longitudinally misaligned hole and the corresponding opening in the intramedullary portion of the fixation device. It is to provide a jig assembly that is properly aligned as possible.

  Yet another object of the present invention is to provide a jig assembly that facilitates drilling axially aligned holes through peg holes and metaphyseal bones in the plate of the fixation device.

  According to these objects described in detail below, a fracture fixation device and a jig therefor are provided.

  The fracture fixation device according to the present invention has an upper metaphyseal plate portion and an intramedullary nail portion that is offset horizontally and vertically with respect to the plate portion by a neck portion. The plate portion includes angle fixing holes that are displaced in the longitudinal direction. Each angle fixing hole includes a peg so that the peg that passes through the hole substantially corresponds to the joint surface of the subchondral bone. (Or fixing screws, together called “pegs”) are oriented in different angular directions. The nail portion includes a threaded screw hole oriented normal to the endosteal surface and a smaller K-wire alignment hole parallel to the screw hole. Yes.

  The anchoring jig for the anchoring device comprises a first part with a concave surface that can be placed on the plate part of the anchoring device and a second part that is relatively high, the screw of the intramedullary nail part of the anchoring device And a second portion aligned over the hole.

  The first portion includes an opening aligned with the angle fixing hole. A cannulated locking drill guide is used to lock the jig to the implant and guide the drill in alignment with one of the angled locking holes. The rear part of the first part of the jig is curved upward so that the nail part of the fixation device can be easily operated in the intrafocal space, and during the implantation process, the first part is the shaft of the fracture. It can be placed on the side. The first portion of the jig includes two K-wire guide holes that extend on opposite sides of the front end of the plate portion when the jig is connected to the plate portion. The K-wire guide hole holds the approximate sized K-wire in close contact and directs the K-wire at a constant angle parallel to the screw hole at the extreme end of the plate portion. Designed to. Two such guide holes are provided. This is because the holes at the extreme ends of the left fixation device (for the left hand) and the right fixation device (for the right hand) have opposite angles, respectively, and the jig is used in each of the left and right devices. Can be used. For specific applications, a K-wire guide hole located on the side of the limb (left hand or right hand) performing the operation is used. Each of the K-wire guide hole portions is substantially parallel to the axis of the screw hole portion at the end of the end, and defines an axis disposed close to and spaced from the axis. For this reason, this axis predicts the trajectory of the peg passed through the screw hole at the end. In use, before drilling any holes in the bone for a peg for a threaded hole, the K-wire is pierced through the appropriate K-wire guide hole to see through the bone within the bone. Observe below to confirm that the placement of the K-wire relative to the articular surface of the subchondral bone and subsequent placement of the peg through the endmost screw hole is appropriate.

  The second part of the jig includes a longitudinally displaced hole or slot for the drill guide. The second portion also includes a K-wire guide hole configured to direct the K-wire at a fixed angle into the K-wire alignment hole in the nail portion of the fixation device. As before, before drilling any hole in the diaphysis for a screw for the nail part, a K-wire is pierced through the K-wire guide hole in the second part and the K-wire placement is seen through. Observing below, it can be confirmed that the placement of the K-wire relative to the shaft is appropriate.

  Still other objects and advantages of the present invention will become apparent to those of ordinary skill in the art by reference to the detailed description when taken in conjunction with the accompanying drawings.

Detailed Description of Preferred Embodiments
Referring now to FIGS. 1-4, a fracture fixation device 10 according to the present invention includes an epiphyseal plate portion 12 and an intramedullary nail portion 14 that is plate-shaped by a neck portion 16. Offset horizontally and vertically with respect to the part. The plate portion 12 has a narrow outline, and the vicinity of the upper surface 20 is slightly rounded. The plate portion 12 includes four angle fixing holes 22, 24, 26, 28 that are displaced in the longitudinal direction, each angle fixing hole being preferably threaded and smooth. Or, it is configured to lock a fastener, such as a threaded peg 30, in a different orientation than the other fasteners (i.e., the axes are at an angle to each other). When viewed from the plate end of the apparatus, the peg 30 is laterally offset to define a virtual plane (the virtual plane is substantially transverse to the longitudinal axis A of the plate portion). The virtual surface substantially corresponds to the articular surface of the subchondral bone (ie, extends in parallel). The plate portion 12 includes a recess 32 for reference to the position of the embedded jig, as will be described later. The nail portion 14 is preferably oriented normal to a flattened endosteal surface 40 and three threaded screw holes 34, 36, 38 parallel to these screw holes. And a smaller K-wire alignment hole 42 sized to allow the K-wire to enter closely at a fixed angle. At the distal end 44 of the nail portion 14, there is a portion 46 that curves downward and then curves upward. This portion 46 facilitates the manipulation of the distal end of the nail portion through the intrafocal space and into the medullary canal.

  With reference now to FIG. 5 with the fixation device 10 in mind, an embedded jig 100 for the fixation device includes a first portion 102 that can be placed on the plate portion 12 of the fixation device and a screw in the intramedullary nail portion 14 of the fixation device 10. The second portion 104 is positioned on the holes 34, 36, and 38 and is relatively high.

  The first portion 102 includes a lower hump (not shown), which is to be placed in the recess 32 (FIG. 2) of the plate portion 12 of the fixation device. In addition, the first part is not shown, although it is on the left and right sides, access openings 106 (at the front), axially aligned with the fixed angle screw holes 22, 24, 26, 28. ), 108 (in the rear). These openings are preferably initially positioned over a drill guide tip (not shown) that is inserted into all angle-fixed holes except the hole below the access opening 110. A drill guide tip that functions as a small drill guide is described in detail in US patent application Ser. No. 11 / 011,917 filed on Dec. 14, 2004, both owned by the present applicant, The entire contents of which are incorporated herein by reference. As another option, drill guide tips are not required and each drill guide can be inserted into the angle-fixed hole just prior to drilling a hole in the bone aligned with the angle-fixed hole.

  In accordance with one aspect of the present invention, a cannulated locking drill guide 116 having a threaded end 118 is provided through the opening 110 to provide a hole in the plate portion 12. 26 so that a part of the guide 116 applies a force to the jig 100 described above. The fixing drill guide 116 simultaneously engages the hump in the recess 32 to immobilize the jig 100 relative to the fixing device 10 so that the two are fixed relative to each other.

  According to another aspect of the present invention, the rear portion 120 of the first portion 102 of the jig 100 is curved upward so that the nail portion 14 of the fixation device can be easily operated inside the intrafocal space and the embedding step. In the meantime, the first portion can be placed on the diaphysis side of the fracture (eg, the proximal cortex of the distal radius).

  The plate portion 12 of the fixing device 10 is too narrow to support what is contained in the K-wire guide hole. Thus, according to a further aspect of the invention, the first portion 102 of the jig 100 includes two K-wire guide holes 122, 124 that are connected to the jig 100. Extends to both sides of the front portion of the plate portion so that the K-wire is offset and guided relative to the plate portion when secured to the securing device 10. The K-wire guide holes 122, 124 closely hold the approximately sized K-wire 126 and are the most distal (ie, the most distal when the fixation device is used on the distal radius). Designed to direct the K-wire 126 at a constant angle parallel to the threaded hole 22). Two such guide holes are provided, because the holes at the extreme ends of the left and right fixation devices (for left hand and right hand) each have opposite angles and the same jig is And can be used with each of the left and right fixation devices. In certain applications, K-wire guide holes are used that are located on the opposite side of the fixed drill guide from where it is positioned. That is, as shown in FIG. 5, when the fixing drill guide is on the left side of the plate, the right K wire guide hole 122 is used. Each K-wire guide hole 122 defines an axis that is laterally offset from the axis of the extreme end screw hole 22, is substantially parallel, and the screw hole It is spaced apart from and close to the 22 axes (preferably within about 5 mm), and therefore predicts the trajectory of the peg passed through the screw hole 22 at the extreme end. In use, before making any holes in the bone for the peg 30 for screw holes, the K-wire 126 pierces the bone through the appropriate K wire guide hole 122 and sees its placement within the bone. Observe below to confirm proper placement of the K-wire 126 relative to the articular surface of the subchondral bone. If accurate, the screw hole can be drilled with confidence that the screw will not enter the articular space. If it is not correctly positioned as shown by fluoroscopic visualization of the K-wire, the plate can be repositioned, pierced with the K-wire again and inspected again until properly positioned.

  The jig second portion 104 is positioned longitudinally in the threaded holes 34, 36, 38 of the intramedullary portion 14 of the fixation device 10 as described in detail in US Pat. No. 6,926,720. To align, it includes holes or slots 130, 132, 134 that are displaced in the longitudinal direction. According to yet another aspect of the present invention, the second portion 104 also includes a K-wire guide hole 136, which is used to secure the K-wire 138 at a fixed angle. The nail portion is configured to be directed into the K-wire alignment hole 142. As before, before making any hole in the diaphysis for the screw for the nail part, the K-wire is stabbed into the second part through the K-wire guide hole and the arrangement of the K wire is seen through. Observation below can confirm that the placement of the K wire relative to the diaphysis is appropriate. If correct, the screw hole can be drilled with confidence that the screw is properly aligned with the shaft of the shaft. If it is not correctly aligned when visualized and shown under fluoroscopy, the nail portion can be repositioned, the K-wire pierced again, and reinspected until the placement is correct.

  The jig can be used in combination with drill guides, bits, and gauges as described in previously incorporated US Pat. No. 6,926,720.

  Embodiments of an anchoring device and an embedded jig for the anchoring device have been described and illustrated herein. While specific embodiments of the present invention have been described, it is not intended to limit the invention to this, but the invention is intended to be as broad as the technology allows, and the specification is to be construed as such. Is intended. For example, although the peg has been described as being used in a fixation device, other angle fixation bone fixation devices can be used as well. Thus, those skilled in the art will appreciate that the provided invention can be modified without departing from the spirit and scope of the invention as defined in the claims.

Embodiment
(1) In the fracture fixing device,
An upper metaphyseal plate portion having a top surface with a recess for locating the implantation jig and a plurality of angular fixation holes for receiving bone anchors;
An intramedullary nail portion offset horizontally and vertically with respect to the plate portion by a neck portion;
A fracture fixing device comprising:
(2) In the fracture fixing device according to Embodiment 1,
The fracture fixation device, wherein the plate portion is longer than the width and the longitudinal axis is substantially parallel to the nail portion.
(3) In the fracture fixing device according to Embodiment 1,
The fracture fixation device, wherein the plate portion has a substantially rounded upper surface.
(4) In the fractured part fixing device according to Embodiment 1,
The angle fixing hole is a fracture fixing device in which a screw is cut.
(5) In the fracture fixing device according to Embodiment 1,
The fracture fixing device, wherein at least two of the angle fixing holes have axes inclined with respect to each other.
(6) In the fracture fixing device according to Embodiment 1,
The fracture fixing device, wherein the nail portion includes a plurality of screw holes.
(7) In the fractured part fixing device according to Embodiment 6,
The fracture fixing device, wherein the screw holes are parallel to each other and are threaded.

(8) In the fracture fixing device,
A metaphyseal plate portion with a plurality of angular fixation holes for receiving bone anchors;
An intramedullary nail portion offset horizontally and vertically with respect to the plate portion by a neck portion, the nail portion including a plurality of screw holes and a K-wire alignment hole; The intramedullary nail wherein the K-wire alignment hole is smaller than the screw hole, parallel to the screw hole, and sized to closely receive the K-wire at a fixed angle Part,
A fracture fixing device comprising:
(9) In the fractured part fixing device according to the eighth embodiment,
The screw hole portion is a fracture fixing device in which a screw is cut.
(10) In the fractured part fixing device according to Embodiment 8,
The fracture fixation device, wherein the nail portion includes a substantially flat endosteal surface, the endosteal surface being on the same side as the plate portion of the device.
(11) In the fracture fixing device according to the eighth embodiment,
The fracture fixing device, wherein the nail portion includes an end portion having a curved portion.
(12) In the fractured part fixing device according to Embodiment 8,
The fracture fixation device, wherein the plate portion is longer than the width and the longitudinal axis is substantially parallel to the nail portion.
(13) In the fractured part fixing device according to the eighth embodiment,
The angle fixing hole is a fracture fixing device in which a screw is cut.
(14) In the fractured part fixing device according to Embodiment 8,
The fracture fixing device, wherein at least two of the angle fixing holes have axes inclined with respect to each other.

(15) In the fracture fixing device,
An epiphyseal plate portion including an upper surface with a plurality of angular fixation holes for receiving a bone anchor, the plate portion defining a longitudinal axis substantially parallel to the intramedullary portion of the device The epiphyseal plate portion, wherein the intramedullary nail portion is offset horizontally and vertically with respect to the plate portion by a neck portion;
With
Each of the angle fixing holes has an axis extending in a direction different from the other angle fixing holes, and the axis has an imaginary plane extending transversely to the longitudinal axis. The fracture fixing device that is defined.
(16) In the fracture fixing device according to embodiment 15,
The fracture surface fixing device, wherein the virtual surface substantially corresponds to the joint surface of the subchondral bone at the distal end of the radius.
(17) In the fracture fixing device according to Embodiment 15,
The angle fixing hole is a fracture fixing device in which a screw is cut.
(18) In the fracture fixing device according to embodiment 15,
The fracture fixing device, wherein the nail portion includes a plurality of screw holes.
(19) In the fracture fixing device according to Embodiment 18,
The screw hole portion is a fracture fixing device in which a screw is cut.
(20) In the fracture fixing device according to Embodiment 18,
The fracture fixation device, wherein the nail portion includes a K-wire alignment hole that is parallel to the screw hole and sized to closely receive the K-wire at a fixed angle.

(21) In an embedded jig used in a fracture fixing device,
a) a first portion having a front portion, a rear portion, and a lower surface including a structure for determining a position of the jig relative to the fracture fixing device, and having a plurality of access openings; A first K-wire guide hole for allowing a hole to be drilled through the access opening, wherein the rear portion includes an upward curve with respect to the lower surface and the front portion guides the K-wire at a constant angle. Including a first part,
b) a plurality of parallel, longitudinally misaligned openings for receiving the drill guide, and a second K-wire guide hole oriented parallel to the misaligned openings; A second part provided, wherein the second part is offset in a direction perpendicular to the first part; and
An embedded jig.
(22) In the embedding jig according to embodiment 21,
The embedded jig, wherein the front portion includes another K-wire guide hole oriented at an angle substantially opposite to the first K-wire guide hole.
(23) An improvement regarding an embedded jig for use in a fracture fixation device having an angle fixing hole for a fastener, the device including a device contact surface removably connectable to the fixation device. ,
The embedded jig includes at least one K-wire guide hole, and the at least one K-wire guide hole is sized to closely receive a K-wire, whereby the K-wire Improved at a substantially constant angle and guided substantially offset from the device contact surface while being substantially parallel to the angle-fixing hole of the fixing device.

(24) In the improvement described in Embodiment 23,
The K-wire guide hole portion is an improvement in which the K-wire is positioned within about 5 mm from the axis of the angle fixing hole portion.
(25) In the improvement described in Embodiment 23,
The jig comprises two K-wire guide holes oriented at opposite angles in the transverse direction.
(26) In the improvement described in embodiment 23,
The jig includes at least two K-wire guide holes, wherein at least one of the K-wire guide holes is oriented perpendicular to the endosteal surface of the fixation device.
(27) In the improvement described in Embodiment 23,
Implant contact surface is connected to the upward curved surface, improved.
(28) In the assembly of the fixing device and the embedded jig,
a) an orthopedic implant comprising a plate portion and an intramedullary portion that is offset longitudinally and perpendicularly to the plate portion, wherein the plate portion is angularly fixed to receive a bone anchor An orthopedic implant comprising a hole, the angle-fixed hole having an axis;
b) an embedded jig including a first portion with a first K-wire guide hole, wherein the first K-wire guide hole offsets the K-wire at a fixed angle from the plate portion of the implant. However, an embedded jig that guides, in close proximity to and spaced from the axis, substantially parallel to the axis of the angle fixing hole,
c) means for connecting the jig to the implant;
An assembly comprising:

(29) In the assembly according to embodiment 28,
The intramedullary portion includes an endosteal surface and at least one angle fixing hole having an axis oriented parallel to the endosteal surface, and a constant angle with respect to the at least one angle fixing hole A K-wire alignment hole for directing the K-wire to the K-wire alignment hole, the K-wire alignment hole being substantially parallel to and spaced from the axis of the angle fixing hole in the nail portion In close proximity,
The implantation jig includes a second portion that is offset and parallel to the intramedullary portion, the second portion being a second K oriented parallel to a second K-wire hole. An assembly including a wire guide hole, wherein the second part is offset in a direction perpendicular to the first part;
(30) In the assembly according to embodiment 28,
The first portion of the embedded jig includes a front portion and a rear portion, the K-wire guide hole is provided in the front portion, and the rear portion is curved upward with respect to the lower surface of the first portion. An assembly including a portion.
(31) In the assembly according to embodiment 28,
The first part of the embedding jig includes a front part and a rear part, and the K-wire guide hole is provided in the front part, and the rear part is formed on an implant contact surface of the first part. An assembly that is curved upwards.

(32) In the assembly according to embodiment 31,
The assembly includes an anterior portion including first and second K-wire guide holes.
(33) In the assembly according to embodiment 28,
The means for coupling includes a cannulated drill guide that engages the implant and applies a force to the jig.
(34) In the assembly according to embodiment 28,
The assembly wherein the means for coupling includes one of a recess and a hump on the implant contact surface of the jig and the other of the recess and the hump on the jig contact surface of the implant.

1 is a side view of a fixing device according to the present invention. 1 is a plan view of a fixing device according to the present invention. It is a bottom view of the plate part edge part of the fixing device of this invention. It is a plate partial end view of the fixing device of the present invention. FIG. 3 is a perspective view of an embedded jig according to the present invention connected to a fixation device of the present invention.

Claims (34)

In the fracture fixing device,
An upper metaphyseal plate portion having a top surface with a recess for locating the implantation jig and a plurality of angular fixation holes for receiving bone anchors;
An intramedullary nail portion offset horizontally and vertically with respect to the plate portion by a neck portion;
A fracture fixing device comprising: In the fracture fixing device according to claim 1,
The fracture fixation device, wherein the plate portion is longer than the width and the longitudinal axis is substantially parallel to the nail portion. In the fracture fixing device according to claim 1,
The fracture fixation device, wherein the plate portion has a substantially rounded upper surface. In the fracture fixing device according to claim 1,
The angle fixing hole is a fracture fixing device in which a screw is cut. In the fracture fixing device according to claim 1,
The fracture fixing device, wherein at least two of the angle fixing holes have axes inclined with respect to each other. In the fracture fixing device according to claim 1,
The fracture fixing device, wherein the nail portion includes a plurality of screw holes. The fracture fixing device according to claim 6, wherein
The fracture fixing device, wherein the screw holes are parallel to each other and are threaded. In the fracture fixing device,
A metaphyseal plate portion with a plurality of angular fixation holes for receiving bone anchors;
An intramedullary nail portion offset horizontally and vertically with respect to the plate portion by a neck portion, the nail portion including a plurality of screw holes and a K-wire alignment hole; The intramedullary nail wherein the K-wire alignment hole is smaller than the screw hole, parallel to the screw hole, and sized to closely receive the K-wire at a fixed angle Part,
A fracture fixing device comprising: The fracture fixing device according to claim 8,
The screw hole portion is a fracture fixing device in which a screw is cut. The fracture fixing device according to claim 8,
The fracture fixation device, wherein the nail portion includes a substantially flat endosteal surface, the endosteal surface being on the same side as the plate portion of the device. The fracture fixing device according to claim 8,
The fracture fixing device, wherein the nail portion includes an end portion having a curved portion. The fracture fixing device according to claim 8,
The fracture fixation device, wherein the plate portion is longer than the width and the longitudinal axis is substantially parallel to the nail portion. The fracture fixing device according to claim 8,
The angle fixing hole is a fracture fixing device in which a screw is cut. The fracture fixing device according to claim 8,
The fracture fixing device, wherein at least two of the angle fixing holes have axes inclined with respect to each other. In the fracture fixing device,
An epiphyseal plate portion including an upper surface with a plurality of angular fixation holes for receiving a bone anchor, the plate portion defining a longitudinal axis substantially parallel to the intramedullary portion of the device The epiphyseal plate portion, wherein the intramedullary nail portion is offset horizontally and vertically with respect to the plate portion by a neck portion;
With
Each of the angle fixing hole portions has an axis extending in a direction different from the other angle fixing hole portions, and the axis defines an imaginary plane extending transversely with respect to the longitudinal axis. Fracture fixation device. The fracture fixing device according to claim 15,
The fracture surface fixing device, wherein the virtual surface substantially corresponds to the joint surface of the subchondral bone at the distal end of the radius. The fracture fixing device according to claim 15,
The angle fixing hole is a fracture fixing device in which a screw is cut. The fracture fixing device according to claim 15,
The fracture fixing device, wherein the nail portion includes a plurality of screw holes. The fracture fixing device according to claim 18,
The screw hole portion is a fracture fixing device in which a screw is cut. The fracture fixing device according to claim 18,
The fracture fixation device, wherein the nail portion includes a K-wire alignment hole that is parallel to the screw hole and sized to closely receive the K-wire at a fixed angle. In the embedded jig used in the fracture fixation device,
a) a first portion having a front portion, a rear portion, and a lower surface including a structure for determining a position of the jig relative to the fracture fixing device, and having a plurality of access openings; A first K-wire guide hole for allowing a hole to be drilled through the access opening, wherein the rear portion includes an upward curve with respect to the lower surface and the front portion guides the K-wire at a constant angle. Including a first part,
b) a plurality of parallel, longitudinally misaligned openings for receiving the drill guide, and a second K-wire guide hole oriented parallel to the misaligned openings; A second part provided, wherein the second part is offset in a direction perpendicular to the first part; and
An embedded jig. The embedded jig according to claim 21, wherein
The embedded jig, wherein the front portion includes another K-wire guide hole oriented at an angle substantially opposite to the first K-wire guide hole. In an improvement with respect to an embedded jig for use in a fracture fixation device having an angle fixing hole for a fastener, the device including a device contact surface removably connectable to the fixation device.
The embedded jig includes at least one K-wire guide hole, and the at least one K-wire guide hole is sized to closely receive a K-wire, whereby the K-wire Improved at a substantially constant angle and guided substantially offset from the device contact surface while being substantially parallel to the angle-fixing hole of the fixing device. In the improvement of claim 23,
The K-wire guide hole portion is an improvement in which the K-wire is positioned within about 5 mm from the axis of the angle fixing hole portion. In the improvement of claim 23,
The jig comprises two K-wire guide holes oriented at opposite angles in the transverse direction. In the improvement of claim 23,
The jig includes at least two K-wire guide holes, wherein at least one of the K-wire guide holes is oriented perpendicular to the endosteal surface of the fixation device. In the improvement of claim 23,
Implant contact surface is connected to the upward curved surface, improved. In the assembly of the fixing device and the embedded jig,
a) an orthopedic implant comprising a plate portion and an intramedullary portion that is offset longitudinally and perpendicularly to the plate portion, wherein the plate portion is angularly fixed to receive a bone anchor An orthopedic implant comprising a hole, the angle-fixed hole having an axis;
b) an embedded jig including a first portion with a first K-wire guide hole, wherein the first K-wire guide hole offsets the K-wire at a fixed angle from the plate portion of the implant. However, an embedded jig that guides, in close proximity to and spaced from the axis, substantially parallel to the axis of the angle fixing hole,
c) means for connecting the jig to the implant;
An assembly comprising: The assembly of claim 28.
The intramedullary portion includes an endosteal surface and at least one angle fixing hole having an axis oriented parallel to the endosteal surface, and a constant angle with respect to the at least one angle fixing hole A K-wire alignment hole for directing the K-wire to the K-wire alignment hole, the K-wire alignment hole being substantially parallel to and spaced from the axis of the angle fixing hole in the nail portion In close proximity,
The implantation jig includes a second portion that is offset and parallel to the intramedullary portion, the second portion being a second K oriented parallel to a second K-wire hole. An assembly including a wire guide hole, wherein the second part is offset in a direction perpendicular to the first part; The assembly of claim 28.
The first portion of the embedded jig includes a front portion and a rear portion, the K-wire guide hole is provided in the front portion, and the rear portion is curved upward with respect to the lower surface of the first portion. An assembly including a portion. The assembly of claim 28.
The first part of the embedding jig includes a front part and a rear part, and the K-wire guide hole is provided in the front part, and the rear part is formed on an implant contact surface of the first part. An assembly that is curved upwards. 32. The assembly of claim 31, wherein
The assembly includes an anterior portion including first and second K-wire guide holes. The assembly of claim 28.
The means for coupling includes a cannulated drill guide that engages the implant and applies a force to the jig. The assembly of claim 28.
The assembly wherein the means for coupling includes one of a recess and a hump on the implant contact surface of the jig and the other of the recess and the hump on the jig contact surface of the implant.

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