# US 10,499,960 B2 · Method of bone fixation > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,499,960 B2 - Document ID: US10499960B2 - Status: Granted - Kind: B2 - Application number: 15/382,357 - Filed: 2016-12-16 - Published: 2017-04-27 - Granted: 2019-12-10 - Earliest claimed: 2015-07-13 - Assignees: IntraFuse, LLC - Applicants: IntraFuse, LLC - Inventors: M. Mary Sinnott; T. Wade Fallin; Mark D. Hayes; Robert W. Hoy - Web page: https://patentgrep.com/patent/US10499960B2 ## CPC - A61B 17/7233: {with special means of locking the nail to the bone} - A61B 17/1631: {Special drive shafts, e.g. flexible shafts (A61B17/1642, A61B17/164 take precedence)} - A61B 17/1655: {for tapping} - A61B 17/1684: {for the shoulder} - A61B 17/1717: {for applying intramedullary nails or pins} - A61B 17/1725: {for applying transverse screws or pins through intramedullary nails or pins} - A61B 17/7208: {Flexible pins, e.g. ENDER pins} - A61B 17/7225: {for bone compression} - A61B 17/725: {with locking pins or screws of special form} - A61B 17/7291: {for small bones, e.g. in the foot, ankle, hand or wrist} - A61B 17/863: {with thread interrupted or changing its form along shank, other than constant taper} - A61B 17/8866: {for gripping or pushing bones, e.g. approximators (joint distractors A61B17/025)} - A61B 17/8872: {Instruments for putting said fixation devices against or away from the bone (A61B17/7074, A61B17/808 take precedence)} - A61B 17/921: {for intramedullary devices} - A61B 17/16: Instruments for performing osteoclasis; Drills or chisels for bones; Trepans {(arthroscopic bone cutters A61B17/320016)} - A61B 17/8685: {comprising multiple separate parts} - A61B 2017/00004: {(bio)absorbable, (bio)resorbable or resorptive} - A61B 2017/00526: {Methods of manufacturing} - A61B 2017/00946: {malleable} - A61B 2017/564: {Methods for bone or joint treatment} - A61B 2017/8655: {with special features for locking in the bone} - A61B 2090/062: {penetration depth} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract Disclosed are devices and methods for stabilizing first and second bone portions relative to one another. In one example, implants, instruments and methods are provided that can be used with minimal exposure of the fractured bone and along curved path. ## Claims ### Claim 1 A method of fixating a first bone portion relative to a second bone portion, the method comprising: advancing a rigid drill to form a first bone hole from an outer surface of the first bone portion to a fracture site interposed between the first and second bone portions; advancing the rigid drill across the fracture site to form a second bone hole into the second bone portion; engaging a flexible drill with the second bone hole; and advancing the flexible drill to extend the second bone hole along a curved path. ### Claim 2 (depends on 1) The method of claim 1 further comprising: advancing a flexible tap in the second bone hole to form a helical thread along the curved path. ### Claim 3 (depends on 1) The method of claim 1 further comprising: driving a flexible threaded implant through the first bone hole, across the fracture site and into the second bone hole so that the threaded portion extends along the curved path. ### Claim 4 (depends on 3) The method of claim 3 further comprising: using a driver coupled to the flexible threaded implant to compress the first and second bone portions together. ### Claim 5 (depends on 4) The method of claim 4 wherein compressing the first and second bone portions together comprises pulling on the flexible threaded implant while pressing on a bone surface adjacent the first bone hole. ### Claim 6 (depends on 4) The method of claim 4 wherein compressing the first and second bone portions together comprises coupling the flexible threaded implant to the driver in axial force and torque transmitting relationship, abutting a portion of the driver against the first bone, and rotating the flexible threaded implant. ### Claim 7 (depends on 5) The method of claim 5 further comprising: displacing a sleeve coupled to a portion of the driver so that the sleeve presses against the bone surface adjacent the first bone hole. ### Claim 8 (depends on 7) The method of claim 7 wherein the sleeve threadably engages the driver, the method further comprising: rotating the sleeve to threadably drive the sleeve in a first direction and pull the flexible threaded implant in a second opposite direction. ### Claim 9 (depends on 3) The method of claim 3 further comprising: placing a fixation element transversely through the flexible threaded implant and into at least one of the first and second bone portions. ### Claim 10 (depends on 9) The method of claim 9 wherein placing a fixation element comprises placing the fixation element through a passage formed in a non-threaded first portion of the flexible threaded implant, the first portion being positioned within the first bone hole. ### Claim 11 (depends on 9) The method of claim 9 wherein placing a fixation element comprises engaging a modular guide assembly with a driver while the driver remains engaged with the flexible threaded implant and guiding the fixation element with the guide assembly. ### Claim 12 (depends on 9) The method of claim 9 wherein placing a fixation element comprises: engaging a modular guide assembly with a driver while the driver remains engaged with the flexible threaded implant; guiding a hole forming instrument with the modular guide through a passage formed in a non-threaded first portion of the flexible threaded implant, the first portion being positioned within the first bone hole; inserting a screw through the passage while the modular guide assembly remains engaged with the driver and the driver remains engaged with the flexible threaded implant. ### Claim 13 (depends on 3) The method of claim 3 wherein the first and second bone portions are medial and lateral fragments of a fractured clavicle, the method comprising inserting the flexible threaded implant so that a distal threaded portion of the implant is engaged with the intramedullary canal of the medial fragment and an unthreaded portion of the implant spans the fracture. ### Claim 14 (depends on 3) The method of claim 3 wherein the first and second bone portions are a lateral malleolus and shaft of a fractured fibula, the method comprising inserting the flexible threaded implant so that a distal threaded portion of the implant is engaged with the intramedullary canal of the fibular shaft and an unthreaded portion of the implant spans the fracture. ### Claim 15 (depends on 14) The method of claim 14 further comprising: inserting a first fixation member into a transverse passage through a portion of the flexible threaded implant lying within the lateral malleolus, the fixation member extending into the lateral malleoulus on opposite sides of the flexible threaded implant. ### Claim 16 (depends on 15) The method of claim 15 further comprising: inserting a second fixation member into a transverse passage through a portion of the flexible threaded implant, the second fixation member extending into the fibula on a first side of the flexible threaded implant and the second fixation member extending into a tibia on a second side of the flexible threaded implant opposite the first side. ### Claim 17 (depends on 3) The method of claim 3 wherein the first and second bone portions are an olecranon and shaft of a fractured ulna, the method comprising inserting the flexible threaded implant so that a distal threaded portion of the implant is engaged with the intramedullary canal of the ulnar shaft and an unthreaded portion of the implant spans the fracture. ### Claim 18 (depends on 3) The method of claim 3 wherein the first and second bone portions are proximal and distal fragments of a fracture metatarsal bone, the method comprising inserting the flexible threaded implant so that a distal threaded portion of the implant is engaged with the intramedullary canal of the distal metatarsal shaft and an unthreaded portion of the implant spans the fracture.