BACKGROUND

Field

Embodiments of the present application relate to repair systems, tools, and methods for providing reinforcement of bones. More specifically, the present application relates to repair systems, tools, and methods for providing reconstruction and reinforcement of the fifth metatarsal.

Description of the Related Art

Bone fractures are a common medical condition both in the young and old segments of the population. As one example, sports and work-related accidents account for a significant number of bone fractures seen in emergency rooms among all age groups. Further, the acceptance and ubiquitous application of passive restraint systems in automobiles has created greater numbers of non-life threatening fractures. In the past, a person that might expire from a serious automobile accident now survives with multiple traumas and resultant fractures. With an increasingly aging population, osteoporotic fractures have increased. Osteoporosis and osteoarthritis are among the most common conditions to affect the musculoskeletal system, as well as frequent causes of locomotor pain and disability. The National Osteoporosis Foundation estimates that as many as 44 million Americans are affected by osteoporosis and low bone mass, leading to fractures in more than 300,000 people over the age of 65.

One current treatment of bone fractures includes surgically resetting the fractured bone. After the surgical procedure, the fractured area of the body (i.e., where the fractured bone is located) is often placed in an external cast for an extended period of time to ensure that the fractured bone heals properly. This can take several months for the bone to heal and for the patient to remove the cast before resuming normal activities.

In some instances, an intramedullary (LM) rod or nail is used to align and stabilize the fracture. In that instance, a metal rod is placed inside a canal of a bone and fixed in place, typically at both ends. See, for example, Fixion™ IM (Nail), www.disc-o-tech.com. Placement of conventional IM rods are typically a “line of sight” and require access collinear with the center line of the IM canal. Invariably, this line of sight access violates, disrupts, and causes damage to important soft tissue structures such as ligaments, tendons, cartilage, fascia, and epidermis. This approach requires incision, access to the canal, and placement of the IM nail. The nail can be subsequently removed or left in place. A conventional IM nail procedure requires a similar, but possibly larger, opening to the space, a long metallic nail being placed across the fracture, and either subsequent removal, or when the nail is not removed, a long term implant of the IM nail. The outer diameter of the IM nail must be selected for the minimum inside diameter of the space. Therefore, portions of the IM nail may not be in contact with the canal. Further, micro-motion between the bone and the IM nail may cause pain or necrosis of the bone. In still other cases, infection can occur. The LM nail may be removed after the fracture has healed. This requires a subsequent surgery with all of the complications and risks of a later intrusive procedure. In general, rigid IM rods or nails are difficult to insert, can damage the bone and require additional incisions for cross-screws to attach the rods or nails to the bone.

SUMMARY

The repair systems, tools, and methods have several features, no single one of which is solely responsible for its desirable attributes. Without limiting the scope as expressed by the claims that follow, the more prominent features of the systems and methods will now be discussed briefly. After considering this discussion, and particularly after reading the section entitled “Detailed Description” one will understand how the features of the systems and methods provide several advantages over other devices.

One of the advantages of embodiments of the repair systems described herein include that the repair systems are simple, intuitive systems. The repair systems advantageously have few parts, making the repair systems robust and cost-effective to manufacture.

The repair systems can be used in a variety of surgeries, such as minimally invasive surgery. For instance, in various embodiments, the repair systems can be used in all surgeries, and in particular embodiments, the repair systems are favorable in the repair of the fifth metatarsal, including fractures of the fifth metatarsal.

In some embodiments, a repair system is provided. The repair system can include a fixation device. The fixation device can include an elongate body configured to be inserted within a fifth metatarsal, the elongate body comprising a threaded section. The fixation device can include one or more grippers configured to be deflected outward to grip the sidewalls of a canal of the fifth metatarsal. The repair system can include an end cap. The end cap can include a fastener comprising thread configured to engage the threaded section of the fixation device. The end cap can include a cap, wherein the cap is configured to move relative to the fastener.

In some embodiments, the elongate body comprises a bend. In some embodiments, the end cap is configured for intra-operative compression. In some embodiments, the fastener head is captive within the cap. In some embodiments, the cap is configured for polyaxial movement relative to the fastener. In some embodiments, the cap is configured to rotate relative to the fastener. In some embodiments, the cap comprises a tapered external surface. In some embodiments, the cap comprises a cylindrical boss. In some embodiments, the thread of the fastener is configured to extend distally from the cap when the fastener is disposed within the cap, further comprising a projection extending distally from the cap. In some embodiments, the cap comprises one or more grooves configured to self-tap into the fifth metatarsal. In some embodiments, the thread of the fastener is configured to extend distally from the cap when the fastener is disposed within the cap, the cap further comprising one or more hooks extending proximally.

In some embodiments, a method of using a repair system is provided. The method can include the step of inserting a fixation device within a canal of a fifth metatarsal. The method can include the step of selecting an end cap comprising a cap and a fastener. The method can include the step of coupling the end cap to the fixation device by engaging the fastener with a lumen of the fixation device. The method can include the step of adjusting the position of the end cap relative to the fixation device to apply intra-operative compression to one or more segments of the fifth metatarsal.

The method can include the step of limiting a depth of a counter bore based on the end cap. In some embodiments, limiting the depth of the counter bore comprises abutting a stop of a reamer with a portion of a drill guide. The method can include the step of limiting a depth of insertion of the fixation device based on the end cap. In some embodiments, limiting the depth of insertion of the fixation device comprises abutting a sleeve of an insertion tool with the anatomy of a patient. In some embodiments, limiting the depth of insertion of the fixation device comprises pulling and rotating a sleeve of an insertion tool to select the depth of insertion. The method can include the step of actuating a gripper to secure the fixation device within the intramedullary canal of the fifth metatarsal. The method can include the step of rotating the cap relative to the fastener after coupling the end cap to the fixation device. The method can include the step of angling the cap relative to the fastener after coupling the end cap to the fixation device.

