• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
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  • 优先权
    • 专利摘要:
    multi-hole drill sleeve with protective sleeve. The present invention relates to a guiding device for bone fixation which includes (a) a cable extending from a first end to a second end along a longitudinal axis, (b) a guide arm connected to the second end of the cable and having an opening extending through it, where the guide arm is attached to a protective sleeve; and (c) a drill sleeve configured and sized for insertion through the guide arm opening. the drill sleeve has a first and second guideway extending therethrough to guide an insertion of a guidewire into a bone. the drill sleeve is movable between a first position in which the drill sleeve is rotatable axially and rotatably with respect to the guide arm to a second position in which the drill sleeve is axially and rotatably locked with respect to the arm -guide.
    公开号:BR112015005634B1
    申请号:R112015005634-2
    申请日:2013-09-10
    公开日:2021-07-20
    发明作者:Martin Felder
    申请人:Synthes Gmbh；
    IPC主号:
    专利说明:

    BACKGROUND OF THE INVENTION
    [001] Systems and methods for bone fixation sometimes require the insertion of a bone fixation device to, for example, clamp fragments of a bone in a corrected alignment and/or to increase a bone strength. For example, a bone fixation device can be inserted into a medullary cavity of a bone and aligned to a target portion of the medullary cavity via a guidewire that marks a prescribed trajectory for insertion of the bone fixation device. Proper positioning of the guidewire is very important as even a small misalignment can cause the bone fixation element to follow an incorrect trajectory through the bone. In worst cases, this can cause the bone fixation member to extend laterally off an axis of the bone. In many other cases, misalignment can lead to insertion of the bone fixation device into the medullary cavity in a laterally displaced position which can lead to additional fracture, prevent the medullary cavity from widening and/or can inhibit insertion of the bone fixation device. bone at the desired depth in the bone. SUMMARY OF THE INVENTION
    [002] The present invention relates to a guiding device for bone fixation comprising a cable extending from a first end to a second end along a longitudinal axis and a first guide arm connected to the second end of the cable and having a first opening extending therethrough, wherein the first guide arm is connected to a protective sleeve in combination with a second guide arm connected to the first guide arm and having a second guide arm opening extending therethrough and a drill sleeve configured and sized for insertion through the second opening of the second guide arm, wherein the drill sleeve has a first guide channel extending therethrough to guide an insert from a guidewire into a bone, in which the drill sleeve is movable between a first configuration in which the drill sleeve is axially movable relative to the second guidearm to a second configuration in which the drill sleeve is drill is not axially movable with respect to the second guide arm. BRIEF DESCRIPTION OF THE DRAWINGS
    [003] Various embodiments of the invention will be described below by way of example and with reference to the attached drawings in which:
    [004] Figure 1 illustrates a first perspective of a bone fixation device according to an exemplary embodiment of the invention;
    [005] Figure 2 illustrates a first partial cross-sectional view of the bone fixation device of Figure 1;
    [006] Figure 3 illustrates a second partial cross-sectional view of the bone fixation device of Figure 1;
    [007] Figure 4 illustrates a second perspective view of the bone fixation device of Figure 1;
    [008] Figure 5 illustrates a perspective view of an extension arm of the device of Figure 1;
    [009] Figure 6 illustrates a partial cross-sectional view of the extension of Figure 5;
    [0010] Figure 7 illustrates a perspective view of a housing of the device of Figure 1;
    [0011] Figure 8 illustrates a partial cross-sectional view of the housing of Figure 8;
    [0012] Figure 9 illustrates a first perspective view of a locking element of the device of Figure 1;
    [0013] Figure 10 illustrates a second perspective view of the locking element of Figure 9;
    [0014] Figure 11 illustrates a third perspective view of the locking element of Figure 9;
    [0015] Figure 12 illustrates a side view in partial cross section of the locking element of Figure 9;
    [0016] Figure 13 illustrates a perspective view of a protective glove of the device of Figure 1;
    [0017] Figure 14 illustrates a partial cross section of the cylindrical protective fitting of Figure 13;
    [0018] Figure 15 illustrates a first perspective view of a drill sleeve of the device of Figure 1;
    [0019] Figure 16 illustrates a second perspective view of the drill sleeve of Figure 15;
    [0020] Figure 17 illustrates a partial cross-sectional view of the drill sleeve of Figure 15;
    [0021] Figure 18 illustrates a third perspective view of the drill sleeve of Figure 15;
    [0022] Figure 19 illustrates the device of Figure 1 in a first operational configuration;
    [0023] Figure 20 illustrates the device of Figure 1 in a second operational configuration;
    [0024] Figure 21 illustrates a device according to an alternative embodiment of the invention;
    [0025] Figure 22 illustrates the device of Figure 21 in a first operational configuration;
    [0026] Figure 23 illustrates the device of Figure 21 in a second operational configuration;
    [0027] Figure 24 illustrates a first perspective view of the device of Figure 21 in operation;
    [0028] Figure 25 illustrates a second perspective view of the device of Figure 21 in operation;
    [0029] Figure 26 illustrates a third perspective view of the device of Figure 21 in operation;
    [0030] Figure 27 illustrates a first perspective view of a device according to another embodiment of the invention;
    [0031] Figure 28 illustrates a partial view through the device of Figure 27;
    [0032] Figure 29 illustrates a partial cross-sectional view of the device of Figure 27 in an axially and pivotally locked position;
    [0033] Figure 30 illustrates a partial cross-sectional view of the device of Figure 27 in a locked position;
    [0034] Figure 31 illustrates a partial view through the device of Figure 27 in the axially locked position and pivotally;
    [0035] Figure 32 illustrates a partial view through the device of Figure 27 in a locked position;
    [0036] Figure 33 illustrates the device of Figure 27 in a first operational configuration;
    [0037] Figure 34 illustrates the device of Figure 27 in a second operational configuration;
    [0038] Figure 35 illustrates the device of Figure 27 in a third operational configuration;
    [0039] Figure 36 illustrates the device of Figure 27 in a fourth operational configuration; and
    [0040] Figure 37 illustrates the device of Figure 27 in a fifth operational configuration. DETAILED DESCRIPTION
    [0041] The present invention is directed to a system and method for bone fixation comprising a guiding device configured to assist in an insertion of a guidewire into a bone (e.g., in a medullary cavity) at a target position (eg in alignment with the medullary cavity). Specifically, the directing device according to the invention is formed as a multi-hole trocar configured for removable attachment to a protective sleeve and movable thereto in an insertion configuration with a pointed distal tip of the trocar extending into position. distal end of the protective cylindrical fitting and an operational configuration in which the protective cylindrical fitting is moved distal to the distal tip of the trocar, as will be described in more detail later. The trocar further comprises a drill sleeve including a plurality of channels extending longitudinally therethrough, each of the channels being configured to receive a guidewire. The drill sleeve can be rotated relative to the trocar to change the positions of the channels to obtain an optimal position of a channel selected from among the channels so that a guidewire inserted through them will pass through the bone along a desired trajectory. Once this desired position is reached, a locking mechanism is activated to prevent the drill sleeve from rotating in the opposite direction to the desired position and to prevent axial movement of the drill bit in relation to the trocar. Where devices need to be removed from the body to reposition a drill sleeve frequently, an exemplary device in accordance with the invention allows rotation and axial movement of the drill sleeve after the device has been inserted over a target portion of a bone while the device remains in place inside the body. The exemplary device according to the invention can be used to guide a guidewire or other device through any bone in the body. It is noted that, although the exemplary modality is presented with respect to a device configured for insertion into a medullary canal of a long bone, the exemplary system and method according to the invention can be employed on any other bone without deviating from the scope of the invention. As used herein, the term "proximal" refers to a direction approaching a physician or other user and the term "distal" refers to a direction approaching a target treatment site on the body.
    [0042] Figures 1 to 20 show an exemplary device 100 according to the present invention. The device comprises a cable 102 operatively connected to a housing 104 through an extension arm 106. The housing 104 comprises an opening 108 extending therethrough, configured and sized to receive a protective sleeve 110 thereon. In an exemplary embodiment, the protective cylindrical fitting 110 is permanently attached to the housing 104 by, for example, welding. Housing 104 is also permanently secured to extension arm 102 and cable 102. A locking element 112 is provided on a proximal face of extension 106, wherein locking element 112 has an opening 114 extending through the same to allow insertion of a cylindrical drill insert 116 therethrough. Locking element 112 is removable from housing 104 for cleaning. the cylindrical drill fitting 116 is configured to extend through the protective cylindrical fitting 110 and distally beyond a distal end thereof, as will be described in more detail later. A distal end of the cylindrical drill housing 116 comprises a locking mechanism configured to engage the opening 114 (e.g., with a threaded or ratchet engagement), as will be described in more detail later. In a first operational configuration, the locking mechanism is disengaged from the opening 114 to allow longitudinal movement and rotation of the cylindrical drill bit 116 relative to the opening 114 of the locking element 112. In a second operational configuration, the locking mechanism engages opening 114 preventing axial movement of cylindrical drill insert 116 relative to locking element 112 while still allowing rotation thereof relative to locking element 112, as will be described in greater detail in connection with the exemplary method of the invention . In an exemplary embodiment, the locking mechanism remains in the second operational configuration until a user applies a force to the locking element 112 to cause movement thereof to the first configuration. The exemplary device according to the invention allows a physician or other user to rotate the cylindrical drill insert 116 to a desired orientation without having to apply a constant distal force to drill the cylindrical drill insert 116 against bone, as will also be described. in more detail later.
    [0043] Figures 3 to 8 show a detailed view of the cable 102, the extension 106 and the housing 104 exemplifying according to the invention. Cable 102 extends from a first end 120 to a second end 122 and comprises an elongated channel 124 extending longitudinally therethrough. Channel 124 is configured to receive a first portion of extension 106 therein. Handle 102 can be formed in any ergonomic configuration, as those skilled in the art will comprise, for example, applying a silicone overmould on an outer wall of handle 102. Extension 106 extends from a first end 126 having an opening 128 through a second end 130 configured to engage housing 104. Opening 128 is configured to retain extension 106 within a mold during silicone injection, as those skilled in the art will understand. The first end 126 comprises a widened diameter portion 132 extending the length of the opening 128, the widened diameter portion 132 providing added resistance at the location of the opening 128, as those skilled in the art will understand. An elongated shaft 134 extends away from the enlarged diameter portion 132 to the second end 130 of the head 102. In an exemplary embodiment, the shaft 134 has a substantially circular cross-sectional shape, although any other shape may be employed without deviate from the scope of the invention. Extension 106 further comprises a tapered portion 136 extending outwardly of head 102, wherein tapered portion 136 is angled such that when handle 102 is positioned at a desired angle to the bone (not shown), the The housing 104 attached to the second end 130 is situated in a plane extending substantially orthogonal to a longitudinal geometric axis of the bone, as will be described in more detail later. Second end 130 is permanently attached to housing 104 by, for example, laser welding. It is noted, however, that any other fastening mechanism can be used without departing from the scope of the invention.
    [0044] The housing 104 is formed with a substantially flat body having an opening 138 extending laterally therein to receive the second end 130 of the extension 106. The opening 108 extends substantially perpendicularly through the housing 104 of one face proximal 140 to a distal face 142. A pair of grooved arms 144, 146 is provided on the proximal face 142, wherein each of the grooved arms 144, 146 has a slot 148 formed therein substantially parallel to a plane of the housing 104 of so that the locking element 112 is slidably receivable therein in parallel alignment with the housing 104. In an exemplary embodiment, the arms 144, 146 are positioned at opposite ends of the proximal face 140 so that the locking element 112 can be inserted from one direction of cable 102 and extension 106 as shown in Figure 2.
    [0045] The locking element 112 extends from a first end having a tab 150 and along a side arm 152 to a substantially flat body portion 154 configured for placement adjacent to the housing 104. lock 112 comprise mounts 156 extending outwardly therefrom and configured to engage slots 148 of housing 104. In an operational configuration, a physician or other user slides mounts 156 along slots 148 until opening 114 is provisionally aligned with opening 108. A spring rail 162 provided on the lower surface of the locking member 112 prevents the locking member 112 from sliding beyond a configuration in alignment with the housing 104. Specifically, the spring rail 162 engages with the socket cylindrical drill 116 inserted through locking element 112 and housing 104 to prevent further sliding movement thereof in relation to each other. themselves.
    [0046] The opening 114 of the locking element also comprises a protrusion 158 extending outwardly from a side wall thereof and into the channel at a predetermined distance. In an exemplary embodiment, protrusion 158 is provided in a side wall located opposite side arm 152. Protrusion 158 has a substantially flat wall 160 configured to interface with cylindrical drill insert 116 inserted therethrough. Specifically, a width of opening 114 in protrusion 158 is sufficient to allow insertion of cylindrical drill insert 116 therethrough. As will be described in greater detail below, the locking element 112 is movable relative to the housing 104 so that, in a first position, the protrusion 158 frictionally engages the cylindrical drill bit 116 to prevent axial movement of the same and , in a second position, the boss 158 does not contact the cylindrical drill insert 116. Specifically, in the first position, the boss 158 frictionally engages one of the first to second threaded portions 184, 188.
    [0047] Figures 13 and 14 illustrate an exemplary protective glove 110 according to the invention. the protective cylindrical fitting 110 extends along a central longitudinal axis from a distal end 164 to a distal end 166 and has a substantially circular cross-sectional shape. In an exemplary embodiment, a proximal portion 168 of protective cylindrical fitting 110 has a reduced diameter selected to engage opening 108. A distal portion 170 of protective cylindrical fitting 110 has an enlarged diameter selected to prevent insertion thereof into opening 108. , thereby preventing the protective cylindrical fitting 110 from retracting proximally away from the bone in an operational configuration. Distal end 166 is formed with an angled wall configured to conform to an angle of a head of a target bone. Distal end 166 may also comprise a tapered portion 172 that has a narrow angle of approximately 45°, although any other angle may be used without departing from the scope of the invention. As those skilled in the art will understand, the tapered portion 172 aids in the insertion of the protective cylindrical socket 110 into a target portion adjacent to the bone. A pointed tip 174 provided at distal end 166 is configured to securely engage the bone to lock a position of the protective cylindrical socket 110 against the same.
    [0048] Figures 15 to 18 illustrate a cylindrical fitting of an exemplary drill 116 according to the invention. the cylindrical drill socket 116 extends from a distal end 176 comprising a head 177 to a distal end 180 comprising an axis 178 and a longitudinal axis 182. An outer diameter of the head 177 is greater than a diameter of the opening 114 of the locking element to prevent axial movement of head 177 distally in locking element 112. A first threaded portion 184 may extend distally of head 177 and may be configured to threadably engage a threaded portion of opening 114. unthreaded portion 186 extends distally from first threaded portion 180. A second threaded portion 188 may be provided distally from unthreaded portion 182 and may be configured to threadably engage opening 114 in an axially locked configuration, as will be further described. details later. A distal portion of the shaft 178 is provided with a taper 190 configured to aid insertion of the same into the target location on the body, as those skilled in the art will understand. the cylindrical drill socket 116 comprises a plurality of elongated channels 192 extending longitudinally therethrough and open at the openings 194 at the distal end 176 and at the openings 196 at the distal end 180. The channels 192 may be provided in any configuration through the socket drill cylindrical 116. Additionally, any number of flutes 192 may be used without departing from the scope of the invention. In an exemplary embodiment, a first trough 192 may extend through a central longitudinal axis of the cylindrical drill bit 116. Four additional troughs 192 may be provided around the first trough and may be separated from each other by approximately 90°.
    [0049] As shown in Figures 19 and 20, in an exemplary method in accordance with the present invention, a physician or other user forms an incision at a target entry point adjacent, for example, to a head of a target bone. Proximal portion 168 of cylindrical protective housing 110 is then positioned in opening 108 of the housing. Cylindrical drill fitting 116 is then inserted through opening 114 and opening 104. Distal end 166 is then inserted into the body until contact is made with the head of the bone. The physician then applies distally directed pressure to the device 100 to maintain a position of the protective cylindrical socket 110 over the bone. In a first insertion configuration, the physician moves the locking member 112 medially toward the body to release an axial locking force on the cylindrical drill socket 116. In this configuration, the boss 158 is moved in the opposite direction to the cylindrical socket of drill 116 and out of alignment with opening 108. In this configuration, the cylindrical drill insert 116 is allowed to move axially with respect to device 100 to assist in proper positioning of the drill. Once the distal end 180 of the cylindrical drill socket 116 is in a desired position in contact with the bone, the physician moves the locking element 112 into a locked configuration by moving the locking element laterally away from the body. In the locked configuration, the protrusion 158 moves into the groove axis of the opening 108 to apply a radially compressive pressure to the cylindrical drill bit 116 sufficient to prevent axial movement thereof. The pressure applied by protrusion 158 can be selected to further allow rotation of the cylindrical drill insert 116 about its longitudinal axis 182, thereby allowing a physician to rotate the channels 190 to a desired position on the bone. The locking element 112 can be moved from the insertion configuration to the locking configuration as many times as necessary to properly position the channels 190 over the bone. The exemplary device according to the invention is configured so that the physician does not need to apply constant pressure to the cylindrical drill insert 116 to maintain its position in the bone. Additionally, the ergonomic design of the invention is easier to handle, thus reducing the time required to perform a guidewire insertion procedure and reducing radiation exposure, as those skilled in the art will understand. After proper positioning of the cylindrical drill socket 116, the clinician can insert a guidewire (not shown) into a channel selected from channels 190 and perform the remainder of the bone fixation procedure in accordance with systems and methods known in the art .
    [0050] As shown in Figures 21 to 26, a device 200 according to another alternative embodiment of the invention is substantially similar to device 100, except as noted below, with like elements referenced with like reference numerals. Device 200 comprises a cable 202 operatively connected to a housing 204 through an extension 206. In an exemplary embodiment, the extension 206 may extend in longitudinal alignment with a longitudinal axis of the cable 202, although any other configuration may also be used. without deviating from the scope of the invention. Housing 204 is formed substantially similar to housing 104 and comprises opening 108 extending therethrough to receive cylindrical protective housing 110 therethrough. A locking element 212 of device 200 comprises opening 114 configured to allow insertion of the cylindrical drill insert 116 therethrough. The locking element 212 also comprises a lever 213 connected to a base portion 214. The lever 213 is pivotally connected to the housing 104 through, for example, a pivot pin 215. As will be described in more detail later, the lever 213 can be pivoted relative to the housing from a first operational configuration as shown in Figure 22 to a second operational configuration as shown in Figure 23. In a first configuration, lever 213 is positioned so that base 214 extends substantially parallel to a longitudinal geometric axis of the cable 202, as will be described hereinafter.
    [0051] According to an exemplary method according to the invention, the device 200 is inserted into the body in an insertion configuration in which the head 177 of the cylindrical drill insert 116 is placed against the locking element 212, as shown in Figure 21. During insertion, a physician or other user applies a distally directed force to lever 213, where the force causes lever 213 to rotate as shown in Figure 23. As those skilled in the art will understand, base engagement 214 with the extension 206 limits the pivotal movement of the lever 213. The pivotal movement of the lever 213 causes the opening 114 of the locking member 212 to come out of longitudinal alignment with the opening 108 of the housing 204. As with the device 100, this configuration causes the cylindrical drill insert 116 to friction lock and prevent rotation or axial movement. Once the distal end 180 of the cylindrical drill fitting 116 has made contact with an outer surface of a target bone, the clinician releases lever 213 and allows lever 213 to return to the polarized configuration of Figure 22, where opening 114 of locking element 212 returns to longitudinal alignment with opening 108 of housing 204. In this configuration, cylindrical drill insert 116 is capable of moving axially and rotatably relative to protective cylindrical insert 110. of lever 213 causes the protective cylindrical fitting to move distally towards the bone so that the distal end 166 of the protective cylindrical fitting 110 is in contact with the outer surface of the bone. In this configuration, the cylindrical drill fitting 116 and the protective cylindrical fitting 110 are in direct contact with the target portion of the bone. The physician may then optionally rotate the cylindrical drill insert 116 relative to the protective cylindrical insert 110 to provisionally align the channels to a target insertion orientation. A guidewire 20 can then be inserted into a selected channel 190 of the cylindrical drill insert 116. If the clinician determines that a position of the guidewire 20 is not accurate, an additional guidewire 20 can be inserted through the one of the channels 190 without removing the device 200 and reinserting it into the body, as is generally done in conventional devices. If the clinician has determined that a position of the additional guidewire 20 is correct, the first guidewire 20 can be removed from the body.
    [0052] Figures 27 and 37 reveal a device 300 according to another embodiment of the invention. Device 300 is substantially similar to device 100 except as noted below, with like elements referenced with like reference numerals. Device 300 comprises a cable 302 operatively connected to a housing 304 through an extension 306. Similar to extension 106, extension 306 includes a tapered portion 136 extending outwardly of cable 302, wherein tapered portion 136 is angled from so that when the cable 302 is positioned at a desired angle to the bone (not shown), the housing 304 attached to the second end 130 is situated in a plane substantially orthogonal to a longitudinal geometric axis of the bone, as will be further described. details later. However, it should be noted that extension 306 may extend from cable 302 at any other angle without departing from the scope of the invention. Housing 304 is formed substantially similar to housing 104 and is operatively connected to a protective sleeve 310 formed substantially similar to cylindrical protective housing 110. As with cylindrical protective housing 110, cylindrical protective housing 310 is also integrally formed with (e.g., welded to) housing 304.
    [0053] A cylindrical drill fitting 312 is insertable into an opening 308 that extends through the housing 304 and the protective cylindrical fitting 310. The cylindrical drill fitting 312 is formed substantially similar to the cylindrical drill fitting 116 and if extends from a distal end 320 comprising a head 322 to a distal end 324 along an axis 326. A longitudinal axis of the cylindrical drill housing 312 is aligned with a longitudinal axis of the protective cylindrical housing 310. An outer diameter of head 322 is greater than a diameter of housing opening 308 to prevent axial movement of head 322 distally into housing 304. Axial movement of cylindrical drill housing 312 relative to housing 304 is limited by a first stop mechanism. axial movement as described here. Specifically, the cylindrical drill socket 312 comprises one or more radial mounts 330 distributed on an outer wall thereof distally from the head 322. The radial mounts 330 may comprise a first angled wall 332 and a second wall 334 extending substantially perpendicular to the axis. longitudinal geometry of the cylindrical drill insert 312. As those skilled in the art will understand, this configuration allows sliding insertion of the first angled wall 332 beyond opening 308 and into housing 304 to lockably engage a radial groove 336 extending into an inner wall of it. Specifically, since radial mounts 330 have been slidably received within radial groove 336, engagement of second wall 334 with a distal end of radial groove 336 prevents removal of cylindrical drill insert 312 from the housing. To remove cylindrical drill insert 312 from housing 304, a user manually constrains the first and second partitions 338, 340 of the head 377 defined by a transverse slot 342. Specifically, constriction of the first and second partitions 338, 340 causes the constriction of a proximal region of the cylindrical drill socket 312, thereby releasing the radial bearings 330 from the radial groove 336. The radial bearings 330 may be provided at opposite locations of the cylindrical drill socket 312 that correspond to the positions of the first and second partitions 338 , 340.
    [0054] The rotary movement of the cylindrical drill insert 312 relative to the housing 304 can be controlled by a separate rotation control mechanism. Specifically, the cylindrical drill insert may additionally comprise one or more knobs 344 formed on an outer wall thereof adjacent to a distal end of the head 322. In an exemplary embodiment, knob 344 is hemispherical, although other shapes are provided within scope. of the invention. In an exemplary embodiment, two knobs 344 may be provided on opposing walls of the cylindrical drill socket 312, as shown in Figure 28. The opening 308 may include a plurality of correspondingly shaped recesses 346 extending therein to allow for insertion. of the button in it. In an exemplary embodiment, opening 308 may include four recesses 346 distributed therein and spaced approximately 90 degrees apart. In an operational configuration, a user may select a desired rotational orientation of the cylindrical drill housing 312 with respect to the housing 304 and insert buttons 344 distally into the desired recesses 346 to lock the cylindrical drill housing 312 in the desired orientation. Distal movement of knobs 344 in recesses 346 also causes radial bearings 330 to engage groove 336, thus allowing simultaneous locking of cylindrical drill bit 312 against axial movement and rotation relative to housing 304.
    [0055] A distal portion of shaft 322 may be provided with a taper formed substantially similar to tapered portion 190 and configured to aid insertion thereof at the target location in the body, as those skilled in the art will understand.
    [0056] The cylindrical drill fitting 312 comprises the first, second and third elongated troughs 350, 352, 354 extending longitudinally therethrough and open to the proximal and distal ends 320, 324. In an exemplary embodiment, the first trough 350 extends through a central longitudinal axis of cylindrical drill bit 312. A width of transverse slot 342 is less than a diameter of first opening 350 to aid in proper positioning of a guidewire therethrough, as will be described in greater detail below in relation to the exemplary method according to the invention. The second and third channels 352, 354 are equidistant with respect to the first channel 350 on opposite lateral sides thereof. However, it is noted that the second and third flutes 352, 354 can be provided in any configuration through the cylindrical drill socket 312. Additionally, any number of additional flutes can be used without departing from the scope of the invention. Placement of the first, second, and third channels 350, 352, 354 allows a user to insert multiple guidewires into bone without removing the cylindrical drill fitting 312 or removing a previously placed guidewire, as described in more detail in with respect to the exemplary method below.
    [0057] According to an exemplary method according to the invention, device 300 is inserted into the body in an insertion configuration with the cylindrical drill fitting 312 locked in a first orientation with respect to housing 304, as shown in Figure 27 In this position, the cylindrical drill fitting 312 is held within the protective cylindrical fitting 310 and the housing 304 through a friction fit and locked against axial movement and rotation using mechanisms previously described in this document. Once the distal end 324 of the cylindrical drill fitting 312 has made contact with an outer surface of a target bone (eg, a proximal portion of the femur), a physician can optionally adjust the cylindrical drill fitting 312 to an orientation. desired in relation to the bone. Once the cylindrical drill fitting 312 is locked relative to the protective cylindrical fitting 310 and the housing 304, a first guidewire 30 can then be inserted into the first channel 350, as shown in Figure 33. If the physician determining that a position of guidewire 30 is not accurate, a second guidewire 40 can be inserted through one of the second and third channels 352, 354 without removing the first guidewire 30. Specifically, after insertion of the first guidewire 30, the physician may determine that the cylindrical drill fitting 312 requires rotation relative to the housing 304. To accomplish this, the first guidewire 30 can remain in place while a constrictive force is applied to the first and second. partitions 338, 340, followed by a proximal withdrawal of the cylindrical drill insert 312 a sufficient distance to separate the radial bearing 330 from the head 322. such as inside housing 304 to again lock a position thereof. The clinician can then insert the second guidewire 40 through, for example, the third channel 354, as shown in Figures 34 and 35. If the position of the second guidewire 40 is determined to be correct, the first guidewire. guide 30 can be removed, as shown in Figure 36. the cylindrical drill insert 312 can then be removed from housing 304 while leaving guide wire 40 in place, as shown in Figure 37. As those skilled in the art will understand, this allows the insertion of other devices (eg reamer, drill, etc.) through the protective cylindrical fitting 310 to complete the designated procedure.
    [0058] It will be evident to those skilled in the art that various modifications and variations may be made in the structure and methodology of the present invention, without departing from the spirit or scope of the invention. Accordingly, it is intended that the present invention encompass modifications and variations of the present invention, provided they are within the scope of the appended claims and their equivalents.
    权利要求:
    Claims (15)
    [0001]
    1. A targeting device (300) for fixing bone, comprising: a cable (302) extending from a first end to a second end along a longitudinal axis; a guide arm (304, 306) connected to the second end of the cable (302) and having an opening (308) extending therethrough, wherein the guide arm (304, 306) is connected to a sleeve. protection (310); and a drill sleeve (312) configured and sized for insertion through the opening (308) of the guide arm (304, 306), wherein the drill sleeve (312) has a first guide channel (350) extending therefrom. is therethrough to guide an insertion of a guidewire into a bone, characterized in that the drill sleeve (312) is movable between a first position in which the drill sleeve (312) is movable axially and shapely. rotatable with respect to the guide arm (304, 306) and a second position in which the drill sleeve (312) is axially and rotatably locked with respect to the guide arm (304, 306); The drill (312) further has a second guide channel (352) extending therethrough to guide an insertion of a guide wire into the bone.
    [0002]
    2. Directing device according to claim 1, characterized in that an outer wall of the drill sleeve (312) comprises a radial bearing (330) configured to lockably engage a radial groove (336) provided in the opening (308) to lock the drill sleeve (312) in the second position.
    [0003]
    3. Directing device according to claim 2, characterized in that the radial support (330) includes a first angled wall (332) and a second wall (334) extending perpendicular to a longitudinal axis of the sleeve. drill (312), wherein engagement of the second wall (334) with a proximal wall of the radial groove (336) prevents an axial movement of the drill sleeve (312) in the second position.
    [0004]
    4. Directing device according to claim 3, characterized in that at least two radial supports (330) are distributed on an outer wall of the drill sleeve (312) distally from a head (322) of the drill sleeve ( 312).
    [0005]
    5. Directing device according to claim 3 or 4, characterized in that a head (322) of the drill sleeve (312) includes a transverse slot (342) defining the first and second portions (338, 340 ) on lateral sides thereof, wherein a radial compression of the first and second portions (338, 340) allows a withdrawal of the radial bearing (330) from the radial groove (336).
    [0006]
    6. Directing device according to claim 5, characterized in that the radial supports (330) are provided at opposite locations of the drill sleeve (312) corresponding to the positions of the first and second portions (338, 340).
    [0007]
    7. Directing device according to any one of claims 4 to 6, characterized in that an outer diameter of the head (322) is greater than a diameter of the opening (308) to prevent axial movement of the head (322) distally on the guide arm (304, 306).
    [0008]
    8. Directing device according to any one of claims 1 to 7, characterized in that an outer wall of the drill sleeve (312) includes a button (344) extending outwardly from it a predetermined distance, at that the knob (344) engages one of a plurality of recesses (346) formed in the opening (308) to allow insertion of the drill sleeve (312) into the guide arm (304, 306) in a selected angular orientation.
    [0009]
    9. Directing device according to claim 8, characterized in that two buttons (344) are provided on the opposite walls of the drill sleeve (312).
    [0010]
    10. Directing device according to claim 8 or 9, characterized in that the opening (308) includes four recesses (346) distributed there and separated from each other by 90 degrees.
    [0011]
    11. Directing device according to any one of claims 2 to 10, characterized in that the distal movement of the buttons (344) in the recesses (346) causes the radial supports (330) to engage in the grooves (336), thus allowing a simultaneous locking of the drill sleeve (312) against axial movement and rotation relative to the guide arm (304, 306).
    [0012]
    12. Directing device according to any one of claims 1 to 11, characterized in that the first guide channel (350) extends through a central longitudinal axis of the drill sleeve (312).
    [0013]
    13. Directing device according to claim 12 and claim 5, characterized in that a width of the transverse slit (342) is smaller than the diameter of the first channel (350).
    [0014]
    14. Directing device according to any one of claims 1 to 13, characterized in that it further comprises a third guide channel (354) that extends through the drill sleeve (312).
    [0015]
    15. Directing device according to claim 14, characterized in that the second and third channels (352, 354) are equidistant from the first channel (350) on the opposite side sides thereof.
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    同族专利:
    公开号 | 公开日
    CA2885034C|2021-07-27|
    EP2895084B1|2020-10-28|
    CA2885034A1|2014-03-20|
    KR20200091501A|2020-07-30|
    EP3158952A1|2017-04-26|
    WO2014043093A1|2014-03-20|
    JP6339080B2|2018-06-06|
    KR102263818B1|2021-06-15|
    BR112015005634A2|2017-07-04|
    JP2015531654A|2015-11-05|
    EP2895084A1|2015-07-22|
    CN104619270B|2017-10-20|
    US20140081281A1|2014-03-20|
    CN104619270A|2015-05-13|
    IN2015DN01581A|2015-07-03|
    EP3158952B1|2019-10-23|
    KR102193250B1|2020-12-23|
    KR20150058297A|2015-05-28|
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    法律状态:
    2018-11-21| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|
    2019-12-03| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|
    2021-05-11| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|
    2021-07-20| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 10/09/2013, OBSERVADAS AS CONDICOES LEGAIS. |
    优先权:
    申请号 | 申请日 | 专利标题
    US201261701070P| true| 2012-09-14|2012-09-14|
    US61/701,070|2012-09-14|
    PCT/US2013/058960|WO2014043093A1|2012-09-14|2013-09-10|Multihole drill sleeve with protection sleeve|
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