WO2017067768A1 - Dispositif auxiliaire de guidage chirurgical et ensemble de perçage chirurgical - Google Patents

Dispositif auxiliaire de guidage chirurgical et ensemble de perçage chirurgical Download PDF

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Publication number
WO2017067768A1
WO2017067768A1 PCT/EP2016/073165 EP2016073165W WO2017067768A1 WO 2017067768 A1 WO2017067768 A1 WO 2017067768A1 EP 2016073165 W EP2016073165 W EP 2016073165W WO 2017067768 A1 WO2017067768 A1 WO 2017067768A1
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WO
WIPO (PCT)
Prior art keywords
guide
sleeve
aid
guide sleeve
surgical
Prior art date
Application number
PCT/EP2016/073165
Other languages
German (de)
English (en)
Inventor
Urs Hulliger
Horst Lindner
Frank Orschler
Original Assignee
Königsee Implantate GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Königsee Implantate GmbH filed Critical Königsee Implantate GmbH
Publication of WO2017067768A1 publication Critical patent/WO2017067768A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1728—Guides or aligning means for drills, mills, pins or wires for holes for bone plates or plate screws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
    • A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/062—Measuring instruments not otherwise provided for penetration depth
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06—Measuring instruments not otherwise provided for
    • A61B2090/067—Measuring instruments not otherwise provided for for measuring angles

Definitions

  • the invention relates to a surgical guide, in particular for surgical instruments and / or osteosynthesis aids, according to the preamble of claim 1. Furthermore, the invention relates to a surgical drill set comprising a surgical guide according to the invention and a surgical drill according to claim 21.
  • angle-stable screws are also often used.
  • Such angle-stable screws have a head thread and are anchored in an internal thread in the osteosynthesis or bone plate.
  • a stable locking with regard to the osteosynthesis plate to be anchored can not be achieved.
  • variable angle locking screws can be anchored in the bone plate in a fixed angular range (for example +/- 15 °).
  • angular range for example +/- 15 °.
  • care must be taken to ensure that the maximum angular range that is permissible for the variable angle-stable locking is not exceeded.
  • the object of the present invention is to provide a further developed surgical guide, in particular for surgical instruments and / or osteosynthesis aids, which allows guidance of a surgical instrument and / or an osteosynthesis adjuvant in a defined angle range, wherein with the same surgical guide and an exact vertical guidance of a surgical instrument and / or an osteosynthesis adjuvant to be made possible.
  • a surgical guide aid in particular for surgical instruments and / or osteosynthesis aids, is assumed, wherein the surgical guide aid comprises a guide sleeve and a fixing sleeve.
  • the guide sleeve includes a Gelenkabsehnitt.
  • the guide sleeve on a hinge portion.
  • the fixing sleeve and the guide sleeve are displaceable relative to one another such that the joint portion is at least partially blocked or blocked.
  • the surgical guide therefore comprises at least two sleeves, namely a guide sleeve and a fixing sleeve.
  • the guide sleeve is due to their
  • the fixing sleeve serves the joint portion of the Füh to block. Furthermore, the Ftxierhülse act as an extension of the guide sleeve.
  • the surgical instrument may be, for example, a drill or a screwdriver or an endoscope or. to act a similar surgical instrument.
  • the osteosynthetic adjuvant may be, for example, a wire and / or a surgical screw.
  • the fixing sleeve is slid longitudinally displaceable on the guide sleeve.
  • the inner diameter of the fixing sleeve is preferably slightly larger than the outer diameter of the guide sleeve. If a fixing sleeve is pushed over the joint portion of the guide sleeve at least in sections, the joint portion may be at least partially blocked or is partially blocked.
  • the Ftxierhülse is mounted longitudinally displaceable within the guide sleeve.
  • a hollow connecting portion for connection to a bone plate and / or for connection to a surgical implant. If the guide sleeve is connected to a bone plate and / or a surgical implant by means of a connecting section, the surgical guide aid can be used in the state connected to the bone plate and / or the surgical implant. This is to facilitate delivery of surgical instruments and / or osteosynthetic adjuvant.
  • the connecting portion may have an external thread. In this embodiment, it is therefore possible that the guide aid in a threaded portion. » Which is formed in a bone plate and / or a surgical implant, is screwed.
  • connection portion is formed such that, viewed in the insertion direction, longitudinal elements, in particular longitudinal reinforcements having.
  • the connection section can at
  • the connecting section comprises a latching element which can be snapped into a bone plate and / or into a medical implant,
  • a innenkonusförmi- ges guide element may be formed at one / the first end portion of the guide sleeve.
  • a innenkonusförmiges guide element and the connecting portion is formed at the first end portion of the guide sleeve.
  • An inner cone-shaped guide element is to be understood as meaning an element which is hollow, wherein the surface delimiting the cavity is conical or frusto-conical in shape.
  • the limiting surface may also be referred to as an inner wall.
  • the inner cone-shaped guide element serves for a surgical instrument introduced into the surgical guide aid and / or an osteosynthesis aid introduced into the surgical guide aid along the surface section formed along the cavity or along the inner wall in the direction of a bone plate and / or or in the direction of a medical implant.
  • the inner cone-shaped guide element is at least partially formed inside the guide aid. Due to the formation of an inner cone or because of the funnel-shaped formation, the surgical instrument and / or the osteosynthesis aid are guided in a targeted manner in the direction of a bone plate and / or in the direction of a medical implant.
  • the inner cone or the funnel is designed such that the cross section in the direction of an exit opening of the surgical guide aid becomes smaller and smaller.
  • the outlet opening is understood to mean the opening of the surgical guide aid which, in the use state, points in the direction of a bone plate and / or in the direction of a medical implant and / or in the direction of the patient.
  • the inner cone-shaped guide element and the connecting portion form a one-piece component.
  • the inner cone-shaped guide element and the connecting portion form a one-piece component.
  • Connecting portion formed, for example, monolithic. It is also conceivable that the inner cone-shaped guide element and the connecting portion but initially separate components are firmly connected to each other, in particular welded and / or glued » be.
  • the hollow connecting portion may have an inner cone which is opposite to the inner cone-shaped guide member such that a portion of the connecting portion with the smallest inner diameter corresponds to a portion of the guide member with the smallest inner diameter or structurally merges into this portion of the foundedsseiements While the inner cone of the effetsseiements in the direction of the exit opening surgical guiding aid having a smaller and smaller inner diameter, the inner cone of the connecting portion is preferably designed such that the inner diameter in the direction of the outlet opening of the surgical guide aid becomes larger.
  • cross-section in the longitudinal direction of the guide aid is in this respect a double-cone shape, wherein the tips of the two cones rest against each other or merge into one another.
  • this does not mean that the two cones of the double cone must have matching volumes. Rather, the two cones of the double cone can have different sizes.
  • the inner cone-shaped guide element and / or the connecting portion is formed integrally with the guide sleeve.
  • the guide sleeve with the inner cone-shaped guide element and / or with the connecting portion may be formed, for example, monolithic.
  • the guide sleeve is firmly connected to the inner cone-shaped guide element and / or fixed to the connecting portion. If the guide aid according to the invention consists of as few individual parts as possible, this can on the one hand be assembled more simply and, on the other hand, the guide aid is made more robust in this case.
  • the inner cone-shaped guide element and / or the connecting section may form or form the joint section.
  • no separate joint portion is formed. This in Nenkonusförmige guide element and / or the connecting portion at the same time have the function of a joint portion.
  • the inner cone-shaped guide element and / or can
  • the inner cone-shaped guide element is simultaneously formed as a ball joint.
  • a one-piece member comprising the inner cone-shaped guide member and the connecting portion is formed as a ball joint a.
  • the articulated section of the guide aid can be designed as a hinge joint, in particular as a double hinge joint, or as a guide sleeve section, which has in particular laser-cut recesses.
  • the joint portion of the guide sleeve is in particular designed such that a defined angular range, which can be adjusted with respect to a portion to be bent of the guide sleeve to another portion, in particular the portion of the guide sleeve, which includes the connecting portion, is limited by the hinge portion.
  • an angle range in particular the maximum angular range
  • the joint portion may also be formed as a ball joint or as a spring, in particular as a spiral spring.
  • the joint section is designed as a guide sleeve section which has recesses
  • this guide sleeve section to consist of a plurality of individual segments arranged one behind the other in the longitudinal direction of the guide sleeve. Recesses are formed between the individual segments so that the individual segments can be displaced relative to each other.
  • the guide sleeve portion has a continuous hollow-shaped recess.
  • the described recesses are introduced by means of a laser in the guide sleeve.
  • the joint portion is provided in the formation of the joint portion as a guide sleeve portion with recesses that the joint portion in 360 ° about the longitudinal axis of the guide aid can cause angling of a portion of the guide sleeve.
  • the guide sleeve may have a recess extending in the longitudinal direction, wherein a measuring scale may be formed on the outer surface of the guide sleeve in the region of the recess.
  • a recess extending in the longitudinal direction is to be understood such a recess . whose extent in the longitudinal direction is greater than in the radial direction.
  • the measuring scale can be formed on the outer surface, in particular around the recess.
  • the measuring scale is printed or engraved in the outer surface of the guide sleeve.
  • a surgical instrument guided in the guide sleeve and / or a guided osteosynthesis aid can be assessed as to whether it is inserted sufficiently deeply into a patient.
  • the fixing sleeve has a first, the connecting portion of the guide sleeve facing the end portion, and a second, facing away from the connecting portion of the guide sleeve end portion, wherein the hinge portion by at least partially positioning the first end portion of the fixing sleeve at the level of the first end portion the guide sleeve is at least partially blocked.
  • blocking or disabling of the blocking of the joint portion is caused by positioning the fixing sleeve in relation to the guide sleeve that includes the hinge portion.
  • the joint portion is completely blocked.
  • the joint portion is either completely covered by the fixing sleeve or the fixing sleeve extends within the guide sleeve such that the joint portion can not be actuated due to the blocking positioning of the fixing sleeve.
  • a gripping element may be formed. This gripping element is preferably formed completely on the outer surface of the second end portion of the fixing sleeve. This can be a corrugation. It is also possible to form at least one element enlarging the outer surface of the guide sleeve.
  • the gripping element can i be designed in particular ring-shaped.
  • a Verrastungs- or locking element is formed at the second end portion of the fixing sleeve. This allows a fixing of the fixing sleeve on the guide sleeve. It is possible to form locking elements and / or screw clamp connections. By fixing the fixing sleeve to the guide sleeve, in particular in the state blocking the hinge section, a pushing off of the fixing sleeve from the guide sleeve can be avoided.
  • an end wall forming an opening of the guide sleeve may be formed.
  • the opening is an insertion opening for surgical instruments to be used and / or osteosynthesis aids to be used, which are positioned by means of the surgical guide aid in relation to a bone plate and / or in relation to a medical implant.
  • the surgical instrument and / or the osteosynthetic adjuvant when inserted can be used with angled use of the surgical guide, i. in such a condition that the hinge portion causes angling of a first portion of the guide sleeve relative to a second portion of the guide sleeve.
  • a surgical instrument inserted into the surgical guide aid and / or an introduced osteosynthetic adjuvant is preferably guided at two points of the guide aid.
  • the entry point is preferably located at the opening edge of the end wall.
  • the exit point is located at the peripheral edge of the exit opening, which is preferably formed at the connecting portion.
  • An imaginary connecting line between the entry point and the exit point takes in relation to the longitudinal axis of the Ranshil Fe such an angle " corresponds, for example, a drilling angle or an angle of a wire to be inserted,
  • the guide according to the invention is a drilling jig.
  • the surgical instrument is therefore preferably a surgical drill
  • the guide aid With the help of the guide aid according to the invention, it is possible to guide the drill in a defined angular range, which is defined by the joint portion and / or by the inner cone-shaped guide element.
  • the 0 ° angle can be set separately and fixed with the help of the fixing sleeve.
  • the vertical embodiment is defined as a 0 ° angle in relation to a bone plate and / or in relation to a medical implant. This is especially true when the corresponding hole of the bone plate has been inserted perpendicular to the plate.
  • Embodiments are also conceivable in which the hole is inclined relative to the plate and a bone screw in this predetermined course is to be screwed into the plate and into the bone of a patient.
  • the screw is not deflected or angled in relation to the borehole, so that there is also a 0 ° angle here.
  • a common feature encompassing the two mentioned embodiments is that the fixation due to the fixation sleeve takes place in such a way that the surgical instrument and / or the osteosynthesis aid (eg screw, bone wire) is aligned parallel to the opening of the bone plate and is preferably aligned along the opening axis of the bone plate ,
  • the drilling jig can be securely connected to a bone plate and / or to a medical implant. This represents a considerable safety advantage.
  • the fixing sleeve can be pushed by axial displacement over the joint portion, so that a drilling angle of 0 ° can be adjusted.
  • the surgical guide aid may comprise a lever handle, so that the guide aid can be more easily inserted into an opening of a bone plate and / or a medical implant.
  • the lever handle may comprise a passage opening for a connecting portion of a guide.
  • the lever handle itself Having connecting portion for insertion into an opening of a bone plate and / or a medical implant.
  • the fixing sleeve and the guide sleeve are fixable to one another in the position.
  • the fixing sleeve and the guide sleeve are preferably fixed in their positions or positions taken with respect to the longitudinal extension of the guide aid. This makes it possible, for example, in a complete blocking of the Geienkabitess that accidental displacement of the Fixierhütse and thus unintentional unlocking of the joint portion is prevented and thus slipping during the performance of a drilling operation is prevented.
  • a fixation of the fixing sleeve with the guide sleeve allows, for example, a blockage of sections of the joint portion, so that the degree of blocking of the joint portion is adjustable by means of fixing the fixing sleeve with the guide sleeve,
  • the smaller the distance between the first end portion of the fixing sleeve and the first end portion of the guide sleeve the greater the degree of locking of the Geienkabitess. If the first end section of the fixing sleeve bears against and / or against the first end section of the guide sleeve, the highest degree of blocking, namely complete blocking, of the joint section is achieved. The greater the distance between the first end portion of the fixing sleeve and the first end portion of the guide sleeve, the lower the degree of locking of the joint portion. The lowest degree of blocking corresponds to a complete release of the Geienkabitess.
  • fixation of the fixing sleeve with the guide sleeve in the position relative to one another can be carried out, for example, by means of a thread and / or a latching mechanism.
  • the thread can be formed, for example, in that an external thread section is formed on the outer surface of the guide sleeve and an internal thread section is formed on the inner surface of the fixing sleeve. This is a preferred embodiment of the thread.
  • an in nengewindeabêt is formed and on the inner surface of the Fix erhülse an external thread portion is formed.
  • latching elements can be formed on the outer surface of the guide sleeve and / or on the inner surface of the fixing sleeve.
  • a subsidiary aspect of the invention relates to a surgical drilling set comprising a surgical guide according to the invention and a surgical drill.
  • the drill of the surgical drill set can have a marking, preferably such that the marking is visible through a recess extending in the longitudinal direction of the guide sleeve of the guide aid during a drilling operation.
  • the mark may be, for example, a color mark. With the help of this marking or color marking can be measured on the basis of a measuring scale formed in the region of how far the drill is already inserted into a bone and if possibly already reached an end position of the drill.
  • Figures la - lc The guide sleeve and the fixing sleeve of a guide according to the invention in several positions to each other;
  • Figures 2a and 2b trained as a drilling guide guide in
  • FIGS. 3a-3c show various embodiments and states of differently shaped joint sections
  • Figures 4a and 4b a drilling jig with measuring scale in a side view and in a sectional view;
  • FIGS. 5a and 5b show various connecting sections of a guide aid and the bone plate to be connected . ;
  • Figure 6 an inner cone-shaped guide element with
  • Figures 7a + 7b schematic representations of various embodiments of fixing possibilities of the fixing sleeve and guide sleeve in the position to each other.
  • the surgical guide 10 comprises a guide sleeve 11 and a fixing sleeve 12.
  • the fixing sleeve 12 is pushed onto the guide sleeve 11, the guide sleeve 11 has a first end portion 21 and a second end portion 22.
  • the Fixierhulse has a first end portion 23 and a second end portion 24.
  • the fixing sleeve 12 is pushed onto the guide sleeve 11 such that the first end portion 23 of the fixing sleeve 12 is pushed in the direction of the first end portion 21 of the guide sleeve 11.
  • a joint portion (not shown here) can be blocked or released.
  • FIGS. 1a-1c the fixing sleeve 12 is pushed or displaced longitudinally displaceably on the guide sleeve 11.
  • an inventive surgical drilling set 40 is shown, this comprises a surgical assistance 10, and a drill 50, the basis of these diagrams is illustrated »that the surgical guide sleeve 10 in a locked state (Fig. 2a) and respectively in a deblocked released state (Fig. 2b) can be brought.
  • FIG. 2a an inserted into the surgical guide 10 drill 50 is shown.
  • the fixing sleeve 12 is displaced on the guide sleeve 11, that the first end portion 23 of the fixing sleeve 12 is located at the level of the first end portion 21 of the guide sleeve 11.
  • the joint portion 30 shown in Fig. 2b is blocked.
  • the first end portion 23 of the fixing sleeve 12 is positioned at the level of the first end portion 21 of the guide sleeve 11.
  • the first end section 23 of the fixing sleeve 12 is displaced in the direction of the second end section 22 of the guide sleeve 11.
  • a gripping portion 35 is formed at the two end portion 24 of the fixing ⁇ th 12th
  • the gripping portion 35 is formed as a thickening of the fixing sleeve 12 in the second end portion 24 of the fixing sleeve 12. This allows a surgeon with gloves and liquids located thereon, the fixing sleeve 12 easy to use.
  • a drill 50 with the drill bit 51 is first introduced into the inlet opening 25.
  • the fixing sleeve 12 is preferably positioned upon insertion of the drill bit 50 into the guide aid 10 such that the hinge portion 30 is released and allows easy insertion of the drill bit 50 in the preferred angular position.
  • the drill 50 is introduced into the guide aid 10 so far that the drill 50 with the drill tip 51 emerges from the outlet opening 26.
  • FIGS. 2 a and 2 b also show that a hollow connecting section 27 is formed on the first end section 21 of the guide sleeve 11.
  • the connecting portion 27 has an external thread 28.
  • the connecting portion 27 serves in the present case to connect the guide aid 10 with a bone plate.
  • the connecting portion 27 is inserted by means of the external thread 28 in a threaded portion of a bone plate.
  • the threaded portion of the bone plate is formed in an opening of the bone plate into which, for example, a screw is to be introduced later.
  • the guide sleeve 10 is connected in a first step with a bone plate and / or a medical implant, wherein in this method step, the fixing sleeve 12 should cause blocking of the joint portion 30.
  • the hinge portion 30 is released by retracting the fixing sleeve 12, so that then the drill 50 can be inserted into the guide aid 10.
  • a first embodiment of a hinge portion 30 is shown.
  • the illustrated hinge portion 30 is not blocked and is already in an angled state.
  • the hinge portion 30 is formed as a guide sleeve portion 31, which has, in particular laser-cut, recesses 32.
  • the recesses 32 are formed such that webs 33 are formed.
  • the webs 33 can be positioned relative to one another in such a way that webs 33 abut one another on the upper edge 34, whereby the recesses 32 or the distances between the webs 33 at the lower edge 36 of the guide sleeve section 31 are widened.
  • an angling of the guide sleeve 11 can be effected with the illustrated guide sleeve section 21.
  • the recesses 32 and webs 33 are formed such that only angling of the guide sleeve 11 in a defined angular range, for example, +/- 15 °, can take place. From a certain angle, the webs 33 can not be positioned further to each other or pushed towards each other at the upper edge 34 shown here.
  • the Getenkabites 30 shown in Figures 3b and 3c is formed as a hinge joint 37.
  • pins 38 are formed, which are rotatable with
  • Indentations 39 cooperate.
  • the hinge portion 30 is shown in the locked state.
  • Fig. 3c shows the hinge joint 37 in the actuated state.
  • a guide sleeve 10 is shown in a connected to a bone plate 60 state.
  • the connecting portion 27, in particular the associated external thread 28 in a (not shown) opening of the Bone plate 60 introduced and screwed in there.
  • the guide sleeve 11 has a recess 13 running in the longitudinal direction of the guide sleeve II.
  • the recess 13 is formed as a slot.
  • An inserted into the guide sleeve 11 surgical tool, such as a drill 50 is visible through the recess 13. If there is a marking on the drill 50, it can be read through the recess 13,
  • the guide aid 10 according to FIG. 4a is shown in section.
  • a drill 50 is inserted into the guide sleeve 11 of the guide 10.
  • the guide sleeve 11 has at the second end portion 22 of the guide sleeve 11 an end wall 41 which forms an opening 16 of the guide sleeve 11.
  • the opening 16 is the entrance opening of the guide sleeve 11.
  • the connecting portion 27 is formed with the external thread 28.
  • the connecting portion 27 is hollow, so that a drill 50 or a surgical instrument from the output port 26 can be performed.
  • an inner cone-shaped guide element 42 is formed on the first end section 21 of the guide sleeve 11.
  • This inner cone-shaped guide element 42 has a funnel-shaped inner wall 43.
  • the inner cone-shaped form or the inner cone-shaped guide element 42 is designed such that the inner cross section of the guide element 42 in the direction of the exit opening 26 becomes smaller.
  • the connecting section 27 and the inner cone-shaped guide element 42 form a one-piece component 44.
  • the hollow connecting portion 27 has an inner cone 45, which is formed opposite to the inner cone-shaped guide member 42.
  • a portion 29 of the connecting portion 27 with the smallest inner diameter corresponds to the portion of the guide member 42 with the smallest inner diameter.
  • the inner cone 45 and the inner wall 43 of the inner cone-shaped guide element 42 form a double-cone shape, wherein the two cones have different sizes.
  • the two cones meet at section 29 on each other.
  • the illustrated drill 50 can in the angled mode of the guide sleeve 11 along the inner wall 43 of the inner cone-shaped Füh guiding element 42 are guided in the direction of the outlet opening 26.
  • the drill 50 is located at a point of the opening 16 delimiting end wall 41 at.
  • the drill 50 abuts a point of the portion 29.
  • the drill 50 is therefore guided at only two points of the guide sleeve 11.
  • the guide sleeve 11 comprises a first portion 17 and a second portion 18, wherein the second portion 18 can be angled in relation to the first portion 17 due to the hinge portion 30.
  • the first portion 17 is formed in the state connected to the bone plate 60 perpendicular thereto.
  • a bone plate 60 is shown.
  • the guide aid 10, in particular the guide sleeve 11 is inserted by means of the connecting portion 27 in the opening 61 of the bone plate 60 and connected to the opening 61.
  • the opening 61 has an internal thread 62.
  • the external thread 28 is screwed into the internal thread 62. This allows a drill 50 inserted into the guide aid 10 to be stably guided. Slippage of the drill 50 is thus avoided.
  • FIG. 5b likewise shows a bone plate 60 with an opening 61.
  • the connecting portion 27 has longitudinal members 52 which are formed as longitudinal reinforcements on. Thus, there is no screwing of the connecting portion 27. Rather, the connecting portion 27 is engaged in the opening 61.
  • a lever handle 70 serve. This has a portion 71 with passage opening. Through this section 71, the connecting portion 27 can be guided.
  • FIG. 6 shows a further embodiment with regard to a joint section 30.
  • a one-part component 44 according to FIG. 4b is formed, this having rounded side surfaces 53, so that the one-piece component 44 at the same time forms the joint section 30.
  • the component 44 is rotatably mounted in the guide sleeve 11.
  • the inner cone-shaped guide element 42, the connecting portion 27 and the hinge portion 30 are combined in this embodiment in a single component. i?
  • FIG. 7 a shows a further embodiment of a guide aid 10, wherein the hinge section 30 is designed as a guide sleeve section 31, which has recesses 32, in particular laser-cut.
  • the joint portion 30 corresponds for example to the Geienkabêt 30 shown in Fig. 3a.
  • a thread 80 is shown that is formed by the fact that on the outer surface of the guide sleeve 11, a male threaded portion 81 is formed and on the inner surface of the fixing sleeve 12, an internally threaded portion 82 is formed. This is a preferred embodiment of the thread 80.
  • the thread 80 serves to fix the fixing sleeve 12 with the guide sleeve 11.
  • a fixation of the fixing sleeve 12 with the guide sleeve 11 allows a blockage of the joint portion 30 so that the degree of blocking of the joint portion 30 by means of fixing the fixing sleeve 12 with the guide sleeve 11 is adjustable.
  • the abutment of the first end portion 23 of the fixing sleeve 12 on and / or on the first end portion 21 of the guide sleeve 11 can also be realized as a spaced covering the first end portion 21 of the guide sleeve 11.
  • the complete blockage is marked 0 ° in the sketched scale.
  • the lowest degree of blocking corresponds to a complete release of the joint portion 30. This is in the outlined scale as 15th ° marked. This corresponds to the maximum possible deflection of the joint portion 30. It is possible that the scale on the guide sleeve 11 and / or the fixing sleeve 12, in particular on the guide sleeve 11, formed, in particular imprinted and / or engraved, is, This allows an exact adjustment of the degree of locking of the hinge portion 30th
  • the fixation of the fixing sleeve 12 with the guide sleeve 11 causes an accidental displacement of the fixing sleeve 12 and thus an unintentional cancellation of the blocking of the joint portion 30 and thus slipping during the execution of a drilling operation is prevented.
  • Fig. 7b Also in Fig. 7b is shown a way to fix the fixing sleeve 12 with the guide sleeve 11.
  • a latching mechanism 85 is formed on the inner surface of the fixing sleeve 12 and / on the outer surface of the guide sleeve 11 locking elements 86 are formed
  • On the guide sleeve 11 may also be formed a scale. Accordingly, it is possible to form the scale both in the region of the first end portion 21 and in a central portion of the guide sleeve 11.
  • the hinge portion 30 is formed as a ball joint-shaped joint (see Fig. 6).
  • a flange member 87 is formed. The flange member 87 is in the blocked state completely against the end face 88 of the fixing sleeve 12. With at least partial release of the hinge portion 30, the flange
  • the joint portion 30 may be formed, for example, as a combination of a hinge joint (see FIGS. 3b and 3c) and a ball joint-shaped joint (see FIG. 6).

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  • Surgical Instruments (AREA)

Abstract

L'invention concerne un dispositif auxiliaire de guidage chirurgical (10) conçu en particulier pour des instruments chirurgicaux et/ou des moyens auxiliaires d'ostéosynthèse. Selon l'invention, ce dispositif auxiliaire de guidage chirurgical (10) comprend une douille de guidage (11) comportant une partie articulée (30), ainsi qu'une douille de fixation (12), cette douille de fixation (12) et la douille de guidage (11) pouvant être déplacées l'une par rapport à l'autre, de manière que la partie articulée (30) soit ou puisse être bloquée au moins dans certaines régions.
PCT/EP2016/073165 2015-10-19 2016-09-29 Dispositif auxiliaire de guidage chirurgical et ensemble de perçage chirurgical WO2017067768A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
DE202015105524.2 2015-10-19
DE202015105524 2015-10-19
DE202016100245.1 2016-01-20
DE202016100245.1U DE202016100245U1 (de) 2015-10-19 2016-01-20 Chirurgische Führungshilfe und chirurgisches Bohrset

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WO2017067768A1 true WO2017067768A1 (fr) 2017-04-27

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WO (1) WO2017067768A1 (fr)

Cited By (1)

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Publication number Priority date Publication date Assignee Title
US20220183702A1 (en) * 2018-01-30 2022-06-16 Conmed Corporation Drill guide assembly

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11974899B2 (en) * 2018-04-23 2024-05-07 Panthera Dental Inc. Subperiosteal dental implant device, subperiosteal securement kit and method for securing a subperiosteal dental implant device to an exposed jawbone
DE102019105685A1 (de) * 2019-03-06 2020-09-10 Otto-Von-Guericke-Universität Magdeburg Flexible Führungsvorrichtung

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030040752A1 (en) * 2001-08-21 2003-02-27 Kitchens David Gregory Method and apparatus for percutaneously securing a bone screw and a bone plate to a bone of a patient
US20080140130A1 (en) * 2004-01-26 2008-06-12 Chan Jason S Highly-versatile variable-angle bone plate system
US20090228047A1 (en) * 2008-03-07 2009-09-10 Guillaume Derouet Device for reducing a fracture, in particular a distal radius fracture
US20100130983A1 (en) * 2008-11-26 2010-05-27 Osteomed L.P. Drill Guide for Angled Trajectories
EP2543328A1 (fr) * 2006-11-21 2013-01-09 Smith & Nephew, Inc. Guide de foret à angle variable

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8172854B2 (en) * 2007-07-19 2012-05-08 Spinal Elements, Inc. Attachable instrument guide with detachable handle
US9113970B2 (en) * 2010-03-10 2015-08-25 Orthohelix Surgical Designs, Inc. System for achieving selectable fixation in an orthopedic plate
US20140243828A1 (en) * 2011-08-11 2014-08-28 Jake P. Heiney Orthopaedic Device

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20030040752A1 (en) * 2001-08-21 2003-02-27 Kitchens David Gregory Method and apparatus for percutaneously securing a bone screw and a bone plate to a bone of a patient
US20080140130A1 (en) * 2004-01-26 2008-06-12 Chan Jason S Highly-versatile variable-angle bone plate system
EP2543328A1 (fr) * 2006-11-21 2013-01-09 Smith & Nephew, Inc. Guide de foret à angle variable
US20090228047A1 (en) * 2008-03-07 2009-09-10 Guillaume Derouet Device for reducing a fracture, in particular a distal radius fracture
US20100130983A1 (en) * 2008-11-26 2010-05-27 Osteomed L.P. Drill Guide for Angled Trajectories

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20220183702A1 (en) * 2018-01-30 2022-06-16 Conmed Corporation Drill guide assembly

Also Published As

Publication number Publication date
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