1. A method for using an elbow prosthesis in a patient, the method comprising:
obtaining the elbow prosthesis comprising:
an ulnar component having a bearing end and a stem, wherein the stem is coupled to the bearing end and extends away from the bearing end;
a humeral component having a holder end and a stem, wherein the stem extends away from the holder end; and
at least one bearing member coupled to the holder end;
wherein the bearing end is configured to be coupled within the holder end to articulate against the at least one bearing member;
making an incision in the patient;
determining the proper size for the ulnar component and the humeral component;
preparing an ulna and a humerus of the patient;
securing the humeral component into the humerus of the patient;
attaching the ulnar component to the humeral component comprises:
rotatably coupling the ulnar component to the humeral component; and
securing the at least one bearing member to an inner surface of the holder end;
rotating the ulnar component from ninety degrees of hyperextension with respect to the humeral component into extension;
rotating the ulnar component from extension into flexion to couple the ulnar component to the humeral component;
securing the ulnar component into the ulna of the patient; and
closing the incision in the patient.
2. The method of claim 1, further comprising:
assessing the condition of the ulna and the humerus to determine the degree of hard and soft tissue resection.
3. The method of claim 1, wherein determining the proper size for the ulnar component and the humeral component comprises using at least one of diagnostic imaging and sizing trials.
4. The method of claim 1, wherein preparing the humerus of the patient comprises resecting a distal end of the humerus and removing fracture fragments to expose the distal end of the humerus.
5. The method of claim 1, further comprising:
implanting trials for the humeral component and the ulnar component; and
assessing at least one of soft tissue balance, range of motion, joint spacing, and stability.
6. A method for using an elbow prosthesis in a patient, the method comprising:
obtaining the elbow prosthesis comprising:
an ulnar component having a bearing end and a stem, wherein the stem is coupled to the bearing end and extends away from the bearing end;
a humeral component having a holder end and a stem, wherein the stem extends away from the holder end; and
at least one bearing member coupled to the holder end;
wherein the bearing end is configured to be coupled within the holder end to articulate against the at least one bearing member;
making an incision in the patient;
determining the proper size for the ulnar component and the humeral component;
preparing an ulna and a humerus of the patient;
securing the humeral component into the humerus of the patient;
attaching the ulnar component to the humeral component;
securing the ulnar component into the ulna of the patient prior to attaching the ulnar component to the humeral component, wherein the ulna with the secured ulnar component is hyper-extended to enable actuation of the bearing end relative to the holder end to couple the ulnar component to the humeral component; and
closing the incision in the patient.
7. The method of claim 1, further comprising:
using a guiding system for inserting at least one fixation device into the stem of the ulnar component.
8. The method of claim 1, further comprising:
attaching surrounding soft tissue structures to the elbow prosthesis.
9. The method of claim 8, further comprising:
balancing the soft tissue structures of the elbow of the patient.
10. The method of claim 9, further comprising:
assessing the joint and functionality of the implanted elbow prosthesis.
11. A method for implanting an elbow prosthesis in a patient, the method comprising:
obtaining an elbow prosthesis comprising:
an ulnar component having a bearing end and a stem, wherein the stem is coupled to the bearing end and extends in a distal direction from the bearing end;
a humeral component having a holder end and a stem, wherein the stem extends in a proximal direction from the holder end; and
a coupling mechanism, the coupling mechanism comprises at least one bearing member, the bearing end, and the holder end;
wherein the at least one bearing member is positioned within the holder end and the bearing end is configured to be rotatably coupled within the holder end and articulate against the at least one bearing member;
making an incision in the patient;
determining the proper size for the ulnar component and the humeral component;
preparing an ulna and a humerus of the patient;
securing the humeral component into the humerus of the patient and rotatably coupling the ulnar component to the humeral component;
securing the at least one bearing member to an inner surface of the holder end by positioning the at least one bearing member at approximately ninety degrees of hyperextension from the humeral component;
inserting the bearing end of the ulnar component into the holder end of the humeral component adjacent to the at least one bearing member;
rotating the ulnar component relative to the humeral component to lock the ulnar component to the humeral component;
securing the ulnar component in the ulna of the patient; and
closing the incision in the patient.
12. A method for inserting an elbow prosthesis in a patient, the method comprising:
obtaining the elbow prosthesis, the prosthesis comprising:
an ulnar component having a bearing end and a stem, wherein the stem is coupled to the bearing end and extends in a direction opposite the bearing end, and wherein the bearing end comprises a bearing body, the bearing body having a bearing surface and a mating surface, the bearing surface is convex and configured as one of a spherical shape, an oval shape or an elliptical shape, and the mating surface is substantially planar;
a humeral component having a holder end with at least one bearing member coupled to the holder end, a stem, and at least one arm connecting the at least one bearing member to the stem, wherein the stem extends in a direction opposite the holder end; and
a coupling mechanism, the coupling mechanism comprises the at least one bearing member, the bearing body, and the holder end, wherein the at least one bearing member is positioned within an opening disposed on a posterior aspect of the humeral component and the corresponding mating surface disposed on the bearing body;
the bearing end is configured to be coupled within the holder end and slide against the at least one bearing member;
the bearing body further comprising a means for alignment with the at least one bearing member; and
the means for alignment comprising at least one projection extending away from the bearing surface in at least one of a lateral or medial direction;
making an incision in the patient;
determining the proper size for the ulnar component and the humeral component;
preparing the ulna and the humerus of the patient;
securing the humeral component into the humerus of the patient and coupling the ulnar component to the humeral component;
securing the ulnar component in the ulna of the patient; and
closing the incision in the patient.
13. The method of claim 12, wherein attaching the ulnar component to the humeral component comprises coupling the ulnar component to the humeral component secured into the humerus of the patient.
14. The method of claim 13, wherein coupling the ulnar component to the humeral component comprises aligning the coupling mechanism.
15. The method of claim 14, wherein aligning the coupling mechanism comprises aligning the mating surface of the bearing body with at least one slot of the at least one bearing member, inserting the bearing body between the at least one arm, and positioning the bearing body adjacent to the bearing members.
16. A method of assembling an elbow prosthesis, the method comprising:
obtaining an ulnar component comprising a bearing end and a stem, wherein the stem is coupled to the bearing end and extends distally from the bearing end and the bearing end comprises at least one projection extending in at least one of a lateral or medial direction from the bearing end;
obtaining a humeral component comprising a holder end and a stem, wherein the stem extends proximally from the holder end and the holder end comprises at least one notch;
obtaining at least one bearing member with an articulating surface and a slot extending from an exterior side of the bearing member into the articulating surface;
inserting the at least one bearing member into the holder end of the humeral component;
positioning the at least one bearing member at approximately ninety degrees of hyperextension relative to the humeral component;
aligning a mating surface of the bearing end with the slot of the at least one bearing member and aligning the at least one projection with the at least one notch;
sliding the at least one projection of the bearing end into the slot of the at least one bearing member and the at least one projection into the at least one notch; and
rotating the ulnar component with respect to the humeral component to secure the ulnar component to the humeral component.
17. The method of claim 6, further comprising:
assessing the condition of the ulna and the humerus to determine the degree of hard and soft tissue resection.
18. The method of claim 6, wherein determining the proper size for the ulnar component and the humeral component comprises using at least one of diagnostic imaging and sizing trials.
19. The method of claim 6, wherein preparing the humerus of the patient comprises resecting a distal end of the humerus and removing fracture fragments to expose the distal end of the humerus.
20. The method of claim 6, further comprising:
implanting trials for the humeral component and the ulnar component; and
assessing at least one of soft tissue balance, range of motion, joint spacing, and stability.
21. The method of claim 6, further comprising:
using a guiding system for inserting at least one fixation device into the stem of the ulnar component.
22. The method of claim 6, further comprising:
attaching surrounding soft tissue structures to the elbow prosthesis.
23. The method of claim 22, further comprising:
balancing the soft tissue structures of the elbow of the patient.
24. The method of claim 23, further comprising:
assessing the joint and functionality of the implanted elbow prosthesis.
The claims below are in addition to those above.
All refrences to claim(s) which appear below refer to the numbering after this setence.
1. A shim for leveling and supporting plumbing fixtures against an installation surface, comprising:
a series of individually detachable connected members, said series comprising a flat bottom and a generally sloping top;
said connected members each comprising a support having a concave portion adapted to engage the bottom of a plumbing fixture; and
said connected members connected by a detachable portion adapted to break away from said support, whereby said detachable portion separates from said connected member under said plumbing fixture.
2. The shim of claim 1 wherein said connected members are arc shaped along their length and arranged in a nested configuration.
3. The shim of claim 2 wherein said arc shape comprises a radius of substantially 4.25 inches.
4. The shim of claim 1 wherein said connected members comprise sides and a top, and wherein said concave portions extend along said top, whereby a channel is formed in said top.
5. The shim of claim 4 wherein said channel comprises an arc, the radius of which is substantially 0.75 inches.
6. The shim of claim 4 wherein the difference in height from the base of said channel to the lip of said channel is substantially 0.028 inches.
7. The shim of claim 4 wherein said channel is of lesser width than said top, said top also comprising flat portion extending from an edge of said channel to an edge of said connected member.
8. The shim of claim 7 wherein said detachable portion is adapted to detach from said channel, and remain connected to said flat portion.
9. The shim of claim 8 wherein said detachable portion is substantially 0.052 inches between connected members.
10. The shim of claim 4 wherein said connected members comprise only four sides and a top, and further comprise a concave hollow bottom.
11. The shim of claim 1 wherein said shim is substantially 4.793 inches long.
12. The shim of claim 1 wherein said shim is substantially 0.401 inches at its thickest extreme, and substantially 0.089 inches at its thinnest extreme.
13. The shim of claim 1 wherein said shim is substantially 0.998 inches across at its thinnest extreme and substantially 1.248 inches across at its thickest extreme.
14. The shim of claim 1 wherein said connected members are individually substantially 0.342 inches wide.
15. The shim of claim 1 wherein the connected members vary in height by substantially 132 inch increments from one connected member to the next.
16. The shim of claim 15 wherein said connected members range in height from substantially 116 inch thick to 1332 inches thick.
17. The shim of claim 1 wherein the shim is made of a plastic material.
18. The shim of claim 17 wherein the shim is made of high impact polystyrene.
19. A shim for leveling and supporting plumbing fixtures against an installation surface, comprising:
a series of nested individually detachable connected arced members, said series comprising a flat bottom and a stepped sloping top;
said connected arced members each having a top surface comprising a concave support adapted to engage the bottom surface of a plumbing fixture; and
said connected arced members connected by detachable tabs, each of said tabs adapted to break away from the smaller of the two arced members to which it is connected, while remaining connected to the larger of the two arced members to which it is connected.
20. A method of shimming a plumbing fixture, such as a toilet, sink or tub, comprising the steps of:
placing a fixture on an installation surface so as to locate areas needing shimming;
obtaining a shim, comprising a series of connected members, each member comprising an arc shape and further comprising a top surface with a channel disposed there in, and wherein said connecting members are detachable in a manner leaving a clean edge along the portion of the connected member facing outward from the fixture;
placing the shim under the fixture so that the bottom of the fixture comes to rest in the channel of one connected member, and so that the connected member supports and stabilizes the fixture; and
separating the connected members extending from the fixture from the connected member under the fixture by forcing the connected members apart, wherein connecting material between the connected members separates cleanly from the connected member under the fixture.