US-12622731-B2 - Hinged dorsal spanning plate

Abstract

In one aspect, the disclosure relates to a dorsal spanning plate assembly comprising a first plate member that can be fixed to a bone or bone fragment distal to a distal radius fracture and a second plate member that can be fixed to a bone or bone fragment proximal to the distal radius fracture. In an aspect, the dorsal spanning plate assembly includes a joint such as, for example, a hinge joint or a ball-and-socket joint, wherein the joint is not fixed during placement of the dorsal spanning plate assembly. In still another aspect, a subject in whom the dorsal spanning plate assembly is implanted retains some range of motion in the fractured joint, thereby reducing muscle atrophy and retaining joint flexion during recovery. Also disclosed are methods of setting bone fractures using the dorsal spanning plate assembly.

Inventors

• Panambur Laxminarayan Bhandari

Assignees

• VANDERBILT UNIVERSITY

Dates

Publication Date

20260512

Application Date

20241028

Claims (19)

1. 1 . A dorsal spanning plate assembly comprising: a first plate member, wherein the first plate member comprises an elongated body defining a first longitudinal axis and including a first proximal end, a first distal end, a first bone contacting surface, and an opposite surface; a second plate member, wherein the second plate member comprises an elongated body defining a second longitudinal axis and including a second proximal end, a second distal end, a second bone contacting surface, and an opposite surface and a movable joint connecting the first proximal end to the second distal end, wherein the movable joint is configured to allow subject-directed movement of a radio carpal joint following implantation in a subject; and wherein the dorsal spanning plate assembly does not include a setting fastener.
2. 2 . The dorsal spanning plate assembly of claim 1 , wherein the first plate member and the second plate member each comprise one or more holes.
3. 3 . The dorsal spanning plate assembly of claim 2 , further comprising one or more first screws extending through one of the one or more holes in the first plate member, wherein the one or more first screws are suitable for securing into a bone or bone fragment.
4. 4 . The dorsal spanning plate assembly of claim 2 , further comprising one or more second screws extending through one of the one or more holes in the second plate member, wherein the one or more second screws are suitable for securing into a bone or bone fragment.
5. 5 . The dorsal spanning plate assembly of claim 1 , wherein the movable joint comprises a hinge joint or a ball-and-socket joint.
6. 6 . The dorsal spanning plate assembly of claim 5 , wherein the movable joint is a hinge joint and allows flexion and extension of the radio carpal joint in a subject.
7. 7 . The dorsal spanning plate assembly of claim 5 , wherein the movable joint is a ball-and-socket joint and allows three-dimensional motion of the radio carpal joint in a subject.
8. 8 . The dorsal spanning plate assembly of claim 1 , wherein the subject has a distal radius fracture.
9. 9 . The dorsal spanning plate assembly of claim 1 , further comprising one or more additional stabilizing wires, pins, or connectors.
10. 10 . The dorsal spanning plate assembly of claim 1 , further comprising a pistoning mechanism, wherein in the pistoning mechanism, the first plate member is configured to move in and out of an opening in the second plate member, or the second plate member is configured to move in and out of the first plate member.
11. 11 . The dorsal spanning plate assembly of claim 10 , wherein a center of rotation of the pistoning mechanism is at a center point of the radio carpal joint.
12. 12 . The dorsal spanning plate assembly of claim 11 , wherein the first plate member or the second plate member configured to move in and out of an opening is dorsal to a center of rotation of the dorsal spanning plate assembly.
13. 13 . The dorsal spanning plate assembly of claim 10 , wherein the first plate member or the second plate member configured to move in and out of an opening has a greater length when the radio carpal joint is in flexion and a shorter length when the radio carpal joint is extended.
14. 14 . A method for setting a distal radius fracture, the method comprising: placing the dorsal spanning plate assembly of claim 1 in close proximity to the distal radius fracture such that the first bone contacting surface is adjacent to at least one first bone of the subject and the second bone contacting surface is adjacent to a second bone in the subject; attaching the first bone contacting surface to the at least one first bone using at least a first anchoring fastener; and attaching the second bone contacting surface to the second bone using at least a second anchoring fastener.
15. 15 . The method of claim 14 , wherein the first bone comprises at least one metacarpal bone.
16. 16 . The method of claim 15 , wherein the at least one metacarpal bone is metacarpal III.
17. 17 . The method of claim 14 , wherein the second bone comprises a radius bone.
18. 18 . The method of claim 14 , wherein the first anchoring fastener, the second anchoring fastener, or both, comprise a bone screw.
19. 19 . The method of claim 14 , further comprising removing the dorsal spanning plate assembly after a period of from about 8 weeks to about 12 weeks.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to, and the benefit of, U.S. provisional application Ser. No. 63/595,019 filed Nov. 1, 2023, which is hereby incorporated by reference in its entirety. BACKGROUND Distal radius fractures are common. A dorsal spanning plate is often used to treat such fractures. Typical dorsal spanning plates work by maintaining distraction at the radio carpal joint, which helps in keeping the fracture in reduction. These plates are often used along with volar plates; and are usually removed after 8-12 weeks. One drawback of using conventional dorsal spanning plates plate is that the wrist joint is completely immobilized for 8-12 weeks. This is not only inconvenient for the patient when the plate is in place, but also may limit future range of motion of the wrist as well as contribute to overall muscle weakness around the fracture site. In particular, muscle atrophy can occur when a joint is held immobile for a period of weeks or months, requiring months of physical therapy. Although some dorsal spanning plates currently in use are equipped with hinges, these hinges merely aid the surgeon in positioning the fractured joint and are fixed or immobilized during implantation surgery once proper positioning of the joint or proper reduction of the fracture is achieved, these are not intended or designed for continued motion of affected joints during fracture healing and will fail if the joint is left unfixed. In fact, in many cases, continued motion after installation would endanger the fracture reduction. Thus, muscle atrophy and decreased range of motion are still risks for patients equipped with these devices. Despite advances in distal radius fracture heling research, there is still a scarcity of devices that are capable of keeping the fracture in reduction while also allowing for retention of range of motion and providing for decreases in muscle atrophy typically seen with dorsal spanning plates that are fixed in place. These needs and other needs are satisfied by the present disclosure. SUMMARY In accordance with the purpose(s) of the present disclosure, as embodied and broadly described herein, the disclosure, in one aspect, relates to a dorsal spanning plate assembly comprising a first plate member that can be fixed to a bone or bone fragment distal to a distal radius fracture and a second plate member that can be fixed to a bone or bone fragment proximal to the distal radius fracture. In an aspect, the dorsal spanning plate assembly includes a joint such as, for example, a hinge joint or a ball-and-socket joint, wherein the joint is not fixed during placement of the dorsal spanning plate assembly. In still another aspect, a subject in whom the dorsal spanning plate assembly is implanted retains some range of motion in the fractured joint, thereby reducing muscle atrophy and retaining joint flexion during recovery. Also disclosed are methods of setting bone fractures using the dorsal spanning plate assembly. Other systems, methods, features, and advantages of the present disclosure will be or become apparent to one with skill in the art upon examination of the following drawings and detailed description. It is intended that all such additional systems, methods, features, and advantages be included within this description, be within the scope of the present disclosure, and be protected by the accompanying claims. In addition, all optional and preferred features and modifications of the described embodiments are usable in all aspects of the disclosure taught herein. Furthermore, the individual features of the dependent claims, as well as all optional and preferred features and modifications of the described embodiments are combinable and interchangeable with one another. BRIEF DESCRIPTION OF THE DRAWINGS Many aspects of the present disclosure can be better understood with reference to the following drawings. The components in the drawings are not necessarily to scale, emphasis instead being placed upon clearly illustrating the principles of the present disclosure. Moreover, in the drawings, like reference numerals designate corresponding parts throughout the several views. FIG. 1 is a photograph of a side view of a hinged dorsal spanning plate according to the present disclosure, fixed onto a model radio carpal joint, wherein the joint is held in a neutral position. FIG. 2 is a photograph of a top view of a hinged dorsal spanning plate according to the present disclosure, fixed onto a model radio carpal joint. In this view, the joint is in a neutral position and the pistoning mechanism from one piece of the plate is in a shortened or inserted configuration relative to the other piece. FIG. 3 is a photograph of a side view of a hinged dorsal spanning plate according to the present disclosure, fixed onto a model radio carpal joint, wherein the joint is held in a flexed position. In this view, the pistoning mechanism from one piece of the plate is in a len