WO2020227261A1 - Outil et procédé chirurgicaux - Google Patents

Outil et procédé chirurgicaux Download PDF

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Publication number
WO2020227261A1
WO2020227261A1 PCT/US2020/031427 US2020031427W WO2020227261A1 WO 2020227261 A1 WO2020227261 A1 WO 2020227261A1 US 2020031427 W US2020031427 W US 2020031427W WO 2020227261 A1 WO2020227261 A1 WO 2020227261A1
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WO
WIPO (PCT)
Prior art keywords
tool
surgical tool
main body
surgical
bone
Prior art date
Application number
PCT/US2020/031427
Other languages
English (en)
Inventor
Daniel J. Olson
Original Assignee
Olson Daniel J
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
Priority claimed from US29/733,468 external-priority patent/USD964565S1/en
Application filed by Olson Daniel J filed Critical Olson Daniel J
Priority to US17/607,894 priority Critical patent/US20220226006A1/en
Priority to EP20802712.8A priority patent/EP3965672A4/fr
Priority to CA3139115A priority patent/CA3139115A1/fr
Priority to CN202080048971.7A priority patent/CN114554986A/zh
Publication of WO2020227261A1 publication Critical patent/WO2020227261A1/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
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8866—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices for gripping or pushing bones, e.g. approximators
    • 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
    • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A61B17/1775—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body for the foot or ankle
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B2017/564—Methods for bone or joint treatment
    • A61B2017/565—Methods for bone or joint treatment for surgical correction of axial deviation, e.g. hallux valgus or genu valgus
    • 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

Definitions

  • FIG. 3 depicts the left foot 10 of FIG. 2 after the foot 10 has developed a bunion condition.
  • an increased spacing 18 develops between the first metatarsal bone 20 and second metatarsal bone 22. This is partially due to counterclockwise rotation of the first metatarsal bone 20 and its associated pair of sesamoids 24.
  • FIG. 3 An objective in performing corrective surgery for the bunion condition depicted in FIG. 3 is best understood by comparing FIGS. 1-3 with the desired corrections best understood with reference to FIGS. 4A-C.
  • FIG. 2 taken along an approximately frontal plane at the first metatarsal head 26 is depicted in FIG.
  • FIG. 4A depicts the first metatarsal bone 20 and its first metatarsal head 26 correctly positioned with the associated sesamoids 24 also correctly positioned just beneath the first metatarsal head 26.
  • FIG. 4B a similar front cross sectional view of the skeletal arrangement 10 is depicted after development of the bunion condition of FIG. 3.
  • FIG. 4B depicts the first metatarsal bone 20 and its first metatarsal head 26 rotated in a counterclockwise direction, along with the sesamoids 24 which have rotated along with the first metatarsal head 26 toward the increased spacing 18 that has developed between the first and second metatarsal bones 20 and 22.
  • FIG. 4Q is a further front cross sectional view of the skeletal arrangement 10 of FIGS. 2 and 3, a desired objective of corrective bunion surgery is depicted with clockwise swivel or rotation 28 of the first metatarsal bead 26 and sesamoids 24 from the bunion condition positions depicted in FIG. 4B hack to positions similar to the normal positions depicted in FIG. 4A.
  • a surgical tool and method for engaging and manipulating a bone includes a tool body having a main body axis, a threaded end, and a handling end, the threaded end having threads and a tool stop.
  • the handling end is positioned to allow a user to grasp, manipulate, and rotate the tool body around the main body axis.
  • the threads are positioned to allow the surgical tool to bore into and engage the bone when the tool body is rotated in a boring direction around the main body axis, the threads allowing for tightening engagement with the bone as the tool body is rotated in the boring direction around the main body axis.
  • the tool stop is positioned to prevent the tool from being further rotated around the main body axis to prevent further boring into the bone when the tool stop contacts the bone.
  • the surgical tool thereby allows for manipulation, movement, and rotation of the bone with the surgical tool when the tool is in tightened engagement with the bone.
  • a guide hole extends through the tool body substantially along the main body axis.
  • the guide hole allows a positioning guide to extend at least partially through the tool body and into a bone at a bone boring position to align and guide the threads of the surgical tool to the bone boring position.
  • FIG. 1 depicts defined cardinal planes of a left human foot
  • FIG. 2 depicts a front perspective view of a normal skeletal arrangement of a left human foot:
  • FIG. 3 depicts a front perspective view of the skeletal arrangement of the left human foot of FIG. 2 after development of a bunion condition
  • FIG. 4A front depicts a cross sectional view of the normal skeletal arrangement of FIG. 2 taken along an approximately frontal plane at the first metatarsal head;
  • FIG. 4B depicts a cross sectional view of the skeletal arrangement of FIG. 2 after development of a bunion condition
  • FIG. 4C depicts a cross sectional view of the skeletal arrangement of FIG. 2 during correction of a bunion condition
  • FIG. 5 A depicts a front perspective view of a surgical tool according to one embodiment of the invention.
  • FIG 5B depicts a front cross sectional view of the surgical tool of FIG. 5 A taken along line 5B— 5B ofFIG. 5 A;
  • FIG. 6A depicts a magnified front view of the threaded end of the surgical tool of FIG. 5A.
  • FIG. 6B depicts a magnified front view of the threaded end of a surgical tool according to one embodiment of the invention.
  • FIG. 7 depicts a front perspective view and magnification of the skeletal arrangement of FIG. 3 after the insertion of a guide wire in the first metatarsal head;
  • FIG. 8 depicts a perspective view of the skeletal arrangement of FIG. 4 with the addition of a surgical tool of the invention to the guide wire;
  • FIG. 9 depicts a perspective view and magnification of the skeletal arrangement of FIG. 8 with the surgical tool positioned at a boring position;
  • FIG. 10 depicts a perspective view and inset view of the skeletal arrangement of FIG. 10 with the tool bored into and in threaded engagement with the first metatarsal head;
  • FIG. 13 A depicts a front perspective view of a surgical tool according to one embodiment of the invention.
  • FIG. 1 IB depicts a front cross sectional view of the surgical tool of FIG. 11 A taken along line 11 B— 1 I B of FIG. 11 A;
  • FIG. 12A depicts a front view of a surgical tool according to one embodiment of the invention.
  • FIG. I2B depicts a front perspective view of the surgical tool of FIG. 12 A;
  • FIG. 17 A depicts a front view of a surgical tool according to one embodiment of the invention.
  • FIG ⁇ 13B depicts a front perspective view of the surgical tool of FIG. 13A;
  • FIG. 14 depicts a front perspective view of a surgical tool according to one embodiment of the invention.
  • FIG. 15 depicts a front perspective View of a surgical tool according to one embodiment of the invention.
  • FIG. 16 depicts a front perspective view of a surgical tool according to one embodiment of the invention
  • FIG. 17 depicts a front perspective view of a surgical tool according to one embodiment of the invention
  • FIG. 18 depicts a front perspective view of a surgical tool according to one embodiment of the invention.
  • FIG. 19 depicts a front perspective view of a surgical tool according to one embodiment of the invention.
  • FIG. 20 depicts a front perspective view of a surgical tool according to one embodiment of the invention.
  • FIG. 21 depicts a front perspective view of a surgical tool according to one embodiment of the invention.
  • FIG. 22 depicts a front perspective view of a surgical tool according to one embodiment of the invention.
  • FIG. 23 A depicts a front view of a surgical tool according to one embodiment of the invention.
  • FIG. 23B depicts a front cross sectional exploded view of a surgical tool according to one embodiment of the invention.
  • FIG. 24 A depicts a front perspective view of a surgical tool according to one embodiment of the Invention
  • FIG. 24B depicts a front view of a surgical fool according to one embodiment of the invention.
  • FIG. 25 A depicts a perspective view of a wire angulation tool according to one embodiment of the invention.
  • FIG. 25B depicts a side view of the wire angulation tool of FIG. 25 A positioned on a left foot to align a guide wire into a first metatarsal head according to one embodiment of the invention.
  • FIG. 5A depicts a perspective view of a surgical tool 30a of the invention comprising a tool body 32a having a main body axis 34a, a threaded end 36a, and a handling end 38a.
  • Conically shaped, clockwise boring threads 40a are positioned at the threaded end 36a and are oriented to drill or bore into bone material when the surgical tool 30a is rotated around the main body axis 34a in a right and clockwise boring direction 42a.
  • the threaded end 36a also includes a tool stop 44a comprising two small tabular legs extending outwardly from the tool body 32a and just slightly above the threads 40a.
  • two handles 46a also extend outwardly from the tool body 32a.
  • the handles 46a allow the user to grasp, manipulate, and rotate the tool body 32a around the main body axis 34a.
  • the two handles 46a, the tool body 32a, and the outward extending dimensions of both legs of the tool stop 44a all lie substantially within a plane shared with the main body axis 34a wherein the surgical tool 30a remains substantially flat when placed on a flat surface (not shown).
  • the surgical tool 30a would typically be 4 to 5 inches in length, it is further contemplated this would vary greatly and ultimately depend cm the specific application or surgical circumstances.
  • FIG. 5B A front cross sectional view of the surgical tool 30a taken along line 5B— 5B of FIG. 5 A is depicted in FIG. 5B.
  • the surgical tool 30a is cannulated with the inclusion of a guide hole 48a extending substantially along the main body axis 34a, the guide hole 48a opening at the threaded end 36a at the tip 50a of the threads 40a and extending to the handling end 38a, opening at a position between the handles 46a.
  • a guide hole 48a extending substantially along the main body axis 34a
  • the guide hole 48a opening at the threaded end 36a at the tip 50a of the threads 40a and extending to the handling end 38a, opening at a position between the handles 46a.
  • FIG. 6B depicts a magnified view of a threaded end 36b of a contemplated surgical tool having a tool body 32b, tool stop 44b and clockwise boring threads 40b similar to the 1 surgical tool of 30a of FIG. 6A.
  • the surgical tool of FIG. 6B lacks a guide hole and therefore includes a pointed tip 50b at bottom of the threads 40b, possibly enhancing the bone boring capability of threads 40b in some applications.
  • the guide hole 48a allows for the accommodation of a positioning guide that is a guide wire 52a. Since the guide hole 48a is open at both the tip 50a of the threads 48a and also between the two handles 46a, the surgical tool 30a allows the guide wire 52a to extend completely though the Surgical tool 30a along the complete length of the main body axis 34a as shown in FIGS. 5A and B.
  • FIGS. 7-10 For a better understanding of the contemplated utilization of the depicted surgical tool 30a according to the invention, an example minimum incision bunion correction surgery is depicted in FIGS. 7-10. The surgery shown and described in FIGS, 7-10 is performed with the objective of achieving the bunion correction discussed supra with respect to FIGS. 4A-C.
  • the depicted foot 10 is shown with a magnification 54 of the skeletal features near the first metatarsal head 26.
  • a surgeon employing a minimum incision technique will make a small skin incision (not shown) near the first metatarsal ⁇ head 26.
  • the positioning guide that is in this example the guide wire 52a is then inserted into the skin incision and driven with a wire insertion apparatus (not shown) at an approximately 45 degree angle from the dorsal aspect of the hallux 58 into the first metatarsal head 20 as shown in FIG. 7.
  • the guide wire 52a is typically a length of a 0.45 mm diameter k-wire that is sufficiently long enough to extend the entire length of the guide hole 48a of the surgical tool 30a and to also allow an additional remaining length for further guide manipulation.
  • a wire positioning guide is shown and described in this example, it will be appreciated that other types of positioning guides such as long pins, rods, stiffened strings, rods. dowels, or any structure allowing for tool alignment can be similarly used within the contemplated scope of the invention.
  • the positioning guide or guide wire 52a is inserted through the guide hole 48a.
  • FIG. 8 With FIG. 9 and its magnification 62, as the surgical tool 36a is moved along the guide wire 52a toward the foot 10, the shaping and reduced size of the tool stop 44a enables the surgeon to maneuver or“tease” the surgical tool 36a into the incision and around surrounding skin and muscle (not shown).
  • the point of wire insertion into the first metatarsal head 26 defines a boring position 60 for the surgical tool 30a and threads 40a.
  • the clockwise threads 40a are positioned to allow the surgical tool 30a to bore into and engage the first metatarsal head when rotated in a right, clockwise boring direction 42a around the main body axis 34a.
  • the surgical tool 30a and its clockwise threads 40a aligned in correct orientation by the guide wire 52a, continue to bore into the bone material of the first metatarsal head 26 as the surgeon applies pressure from the handling end 38a while rotating the surgical tool 30a in the clockwise boring direction 42a using handles 46a.
  • the threads 40a create an increasingly tightened threaded engagement with the bone material of the first metatarsal head 26 as the surgical tool 30a continues to rotate in the clockwise boring direction 42a.
  • the required amount of rotation may vary depending of several factors such as thread density and individual bone characteristics, at least three to four threads 40a may typically be required to be fully rotatably inserted for the tool 30a to stay securely seated Into the metatarsal head 26. This tightening engagement continues until at least one leg of the tool stop 44a comes into contact with the first metatarsal head 26 to prevent further tool rotation. Once the tool stop 44a contacts bone material, the tool stop 44a is positioned to prevent the tool 30a from being further rotated around the main body axis 34a to prevent further boring.
  • the osteotomy creates a free capital fragment that includes the first metatarsal head 26, which is pushed laterally for transverse plane correction.
  • frontal plane correction is normally still necessary in order to attain proper cartilaginous alignment with the proximal phalanx of the hallux 58.
  • the frontal plane correction can be achieved by further rotating the surgical tool 30a in the right, clockwise boring direction 42a.
  • the osteotomy 56 allows the free capital fragment/first metatarsal head 26 to move independently from the remainder of the first metatarsal bone 20.
  • the tool stop 44a prevents further boring by the tool 30a while providing rotational leverage.
  • the tightened, clockwise engagement of the boring threads 40a with the capital fragment/first metatarsal head 26 causes bone rotation 68 of the metatarsal head 26 along with the clockwise rotation 42a of the surgical tool 30a.
  • the clockwise rotation 42a of the surgical tool 30a nevertheless serves to maintain and tighten the clockwise engagement between the threads 40a and capital fragment/first metatarsal head 26, further securing the desired tool-bone engagement.
  • the surgical tool 30a As the surgical tool 30a is rotated in the right, clockwise direction 42a, the resulting bone rotation 68 of the capital fragment/first metatarsal head 26 allows for the desired corrective bone repositioning along the frontal plane as depicted in FIG. 4C.
  • the frontal plane correction also allows the sesamoid bones 24 to rotate back into proper alignment. This causes the flexor hallucis longos tendon (not shown) to have a more straight line effect on the hallux 58 after the surgical correction.
  • the right, clockwise rotation tightened, clockwise engagement of the boring threads 40a with the capital fragment/first metatarsal head 26 also allows for fixed linear movement of the capital fragment by the surgical tool 30a in any of the frontal, saggital, or transverse planes.
  • the surgical tool 30a allows for substantial manipulation, movement, and rotation of bone while the tool 30a and bone are in tightened engagement
  • the guide wire 52a can be advanced across the osteotomy 56 to hold the corrected relative positioning until the surgical tool 30a is removed and permanent fixation is inserted. Once the osteotomy 56 is adequately fixated in its corrected position, the guide wire 52a can be removed.
  • the invention has been shown and described for use in performing bunion correction surgery on the human foot, it is contemplated the invention can also be used for other types of surgery and/or in other parts of both human and animal bodies wherever tight engagement is desired for bone rotation or linear bone movement or displacement Selection of a tool using either clockwise or counterclockwise threads will normally depend on the anticipated need for rotation. For most applications, it would be desirable to select a tool with threads matching the anticipated direction of rotational repositioning
  • FIG. HA depicts a front perspective view of a surgical tool 30c of the invention similar to the surgical tool 30a of FIGS. 5A and B.
  • a front cross sectional view of the surgical tool 30c taken along line 1 IB— I IB of FIG. 11 A is depicted in FIG. PB.
  • the surgical tool 30c of FIGS. HA and B has a guide hole 48c for accommodating a guide wire 52c, an elongated tool body 32c and tool axis 34c with handles 46c at the handling end 38c and a tool stop 44c at the threaded end 36c.
  • Conically shaped, counterclockwise boring threads 70c extend along the tool axis 34c below the tool stop 70c.
  • the counter clockwise threads 70c allow the surgical tool 30c to be used for left, counterclockwise boring when rotated around the tool axis 34c in the boring direction 72c. This configuration would make the surgical tool 30c suitable for performing the depicted bunion correction surgery of FIGS. 7-10 on a right foot.
  • FIGS. 12 A and B depict a surgical tool
  • the tool body 30d of the invention lacking a guide hole and optimized for use without a guide wire.
  • the surgical tool 30d lacks a guide hole, the conically shaped, counterclockwise boring threads 70d end at a pointed tip 50d similar to that depicted in FIG, 6B.
  • the pointed tip 50d could be advantageous for enhanced bone penetration when conducting a free-handed rotation of the surgical tool 30d.
  • FIGS. 13A and B depicts a surgical tool 30e of the invention having a guide hole 48e along the tool axis 34e for accommodating the guide wire 52e notwithstanding a reduced girth tool body 32e.
  • the conically shaped, counterclockwise boring threads 70e extend along the tool axis 34c below the tool stop 70c and. despite the reduced girth of the tool body 32e, allow the guide hole 48e to open at the tip 50e to eliminate the need for free-handed positioning and rotation of the surgical tool 30e.
  • FIG. 14 depicts a surgical tool 30f having a guide hole 48f for accommodating a guide wire 52f, an elongated tool body 32f and tool axis 34f with handles 46f at the handling end 38f,
  • the tool stop 44f at the threaded end 36f comprises a flange 44f extending completely around the main body axis 34f.
  • FIG. 15 depicts a surgical tool 30g of the invention having handles 46g, a tool body 32g, and tool stop 44g where the two handles 46g extend outwardly from the tool body 34g at the handling end 38g along a plane that is approximately 90 degrees from the plane in which the two legs of the tool stop 44g extend outwardly from the threaded end 44g, Since the handles 46g and tool stop 44g each share a different plane with the tool body 32g, the surgical tool 30g will not lie flat on a flattened surface. Such configurations could be desirable in applications or surgical environments where it is considered more difficult to grasp or retrieve the surgical tool 30g from an instrument table.
  • FIG. 16 depicts a surgical tool 30b of the invention having peg-shaped guide holes 46h extending from the handling end 38h of a tool body 32h having an enlarged girth and guide hole 48h.
  • the legs of the tool stop 44h extending from the threaded end 36h are also peg-shaped mid extend outwardly along the same plane as the tool body 32 h and handles 46h.
  • the enlarged girth of the tool body 32h would allow the counterclockwise boring threads 70h to create a larger threaded engagement with the first metatarsal head 26 during a right foot bunion correction surgery similar to that shown and described in FIGS. 7-10.
  • FIG. 17 depicts a surgical tool 30i of the inventi on having finger grooves 72 positioned around the perimeter of a grooved handle 74 at the handling end 38i.
  • the guide hole 48i of the surgical tool 30i extends along the main body axis 34i and through the grooved handle 74 to the tip 50 ⁇ of the counterclockwise threads 70i.
  • the finger grooves 72 facilitate single-handed manipulati on of the surgical tool 30i as the surgeon rotates the tool 301 and its counterclockwise threads 701 around its main body axis 34i.
  • FIG. 18 One variation of the grooved handle surgical tool 30i of FIG. 17 is the surgical tool 30 j depicted in FIG. 18 having a domed handle 76 that includes dome notches 78 around its outer circumference.
  • the surgical tool 30] also includes a guide hole 48] extending through the top of the domed handle 76 and along the main body axis 34] through the tip 50j of the counterclockwise threads 70j.
  • the finger grooves 72 and domes handle 76 also facilitate single-handed manipulation of the surgical tool 30] as the surgeon rotates the tool 30] and its counterclockwise threads 70] around its main body axis 34].
  • FIGS. 17 and 18 are potentially advantageous in preserving the single-handed utility of the invention while reducing the outward extending dimensions from the tool bodies 321 and 32] .
  • Other configurations having similar advantages are also possible within the contemplated invention scope.
  • FIG. 19 depicts a surgical tool 30k of the invention having a square handle 80 with four straight edges 82k to enhance single-handed manipulation during surgery while still allowing for a guide hole 48k to extend into the tool body 32k while the dimensions of the surgical tool 30k extending outward from the tool body 32 k are similarly reduced.
  • FIG. 20 A slight variation is depicted in the surgical tool 30m of FIG. 20 having a triangle handle 84m with three straight edges 82m.
  • the three straight edges 82m also allow for single-handed manipulation and include a guide hole 48m extending into the tool body 32m and opening through the tip 50m of the counterclockwise threads 70m at the threaded end 36m of the tool 30m.
  • a further variation is depicted in the surgical tool 30n of FIG. 21 having a circular handle 86 with a gnarled outer surface 88.
  • the gnarled outer surface 88 is roughened to allow enhanced tool manipulation despite the rolled shape of the outer surface 88.
  • the circular handle 86 also includes a guide hole 48n extending into the tool body 32n and opening through the tip 500 of the counterclockwise threads 70n at the threaded end 36n of the tool 30n.
  • FIG. 22 depicts a surgical tool 30p of the invention having a proud T-handle 90 positioned at the handling end 38p and having two wings 91 extending outwardly from the tool body 32p substantially along a plane shared with the tool body 32p and legs of the tool stop 44p.
  • the proud T-handle 90 also Includes flattened tool engagement surfaces 92 that enable machine or external tool engagement with the surgical tool 30p for additional tool manipulation.
  • the proud T-handle 90 also includes a guide hole 48p extending into the tool body 32p and opening through the tip 50p of the counterclockwi se threads 70p at the threaded end 36p of the tool 30p.
  • FIG. 23A depicts a front view of a surgical tool 30q of the invention having a detachable extension 94 attached to the handling end 38q of the tool body 32q.
  • An exploded cross sectional view of the surgical tool 30q is depicted in FIG. 23B.
  • the extension 94 includes handles 46q and an extension body 96 having male extension threads 98.
  • the male extension threads 98 are positioned to screw into female handling threads 100 of the guide hole 48q at the handling end 38q of the tool body 32q.
  • the extension body 96 extends along the main body axis 34q.
  • the guide hole 48q also extends along the main body axis 34q folly through the extension body 96, opening at the top of the extension 94 between foe handles 46q.
  • a length of guide wire 52q has been selected and extends entirely though the tool body 32q, with a substantial length of exposed wire extending past the handling end 38q and out of the guide hole 52q. This would typically be considered advantageous after driving the guide wire 52q into bone and as foe tool body 32q is positioned over the guide wire 52q itself. However, it would normally be considered problematic during the rotational boring of the counterclockwise threads 70q into foe bone as the wire 52q could be considered an obstruction to the surgeon as the tool 30q is rotated.
  • FIGS. 24A and B depict a surgical tool 30r of the invention having wire loops 102 positioned at locations along the outside surface of the tool body 32r,
  • one loop 102 is positioned at a location closer to the handling end 38r of the tool 30r and the other loop 102 is positioned closer to the threaded end 36r.
  • the loops 102 extend outwardly in opposite directions from the tool body 32 r along a plane shared by the tool body 32r, handles 46r, and legs of the tool stop 44r.
  • other number of loops and loop positioning would also be within the contemplated scope of the invention.
  • the loops 102 would be particularly useful in performing a surgery such as the bunion correction surgery shown and described in FIGS. 7-10, with the loops 102 allowing for the direction of additional wires (not shown) used to hold the severed capital fragment/metatarsal head 26 in position relative the remainder of the first metatarsal bone 20 after the creation of the osteotomy 56 and after the guide Wire 52a and tool have been used to complete bone repositioning.
  • additional wires not shown
  • the loops would enable the additional wires to provide temporary fixation of the correction capital fragment/metatarsal head 26.
  • a drill (not shown) can be used over the guide wire prior to the insertion of the tool.
  • a soft tissue protector (not shown) would be used.
  • the angulation tool 104 includes a flattened bottom surface 106, angulated top surface 108, and side handle 110.
  • the angulated top surface 108 is angled at 45 degrees from the flattened bottom surface 106 and includes a cannulated wire tube 112 extending on top of and along the length of the angulated top surface 108.
  • the wire tube 112 is dimensioned to accommodate a length of k-wire and allows for po sitioning of the k-wire at 45 degrees to the flattened bottom surface 106.
  • FIG. 25B depicts a surgical technique utilizing the angulation tool 104 of FIG. 25A that is a modification of the bunion correction surgical technique depicted in FIGS. 7-10 for a left foot 10.
  • a side view is depicted of a big toe nail 113 with skin and non-bone tissue 114 surrounding the first metatarsal bone 20, sesamoid bone 24, and hallux 58.
  • a small incision 116 is made near the first metatarsal head 26.
  • the angulation tool 104 is then positioned with its flattened bottom surface 106 placed over the hallux 58 so the wire tube 1.12 is oriented directly at 45 degrees with respect to the hallux 58 and first metatarsal head 26 as depicted.
  • the guide wire 52s typically a length of k-wire
  • the guide wire 52s is fed into the wire tube 112 and then guided into and through the incision 116 until it is proximate or in contact with the first metatarsal head 26 at the boring position 60s and at the correct 45 degree angle provided by the angulation tool 104.
  • a k-wire driver (not shown) is then used, while the guide wire 52s remains positioned by angulation tool 104, to drive the end of the guide wire 52s into the first metatarsal head 26 as depicted.
  • the angulation tool 104 can then be removed, with the guide wire 52s remaining in position, and a tool of the invention such as the surgical tool 30a of FIGS 5 A and B then used to complete the repositioning of the metatarsal head 26.
  • FIGS. 25 A and B depict the use of a angulation tool for optimally positioning a guide wire at 45 degrees from the hallux 58 and First metatarsal head 26, it will be appreciated that is some contemplated embodiments of the described surgical method and angulation tool, the preferred optimal angle of wire insertion may be predetermined to be 25-35 degrees or another degree of angulation with an appropriately angulated tool employed within the anticipated scope of the invention.

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  • Life Sciences & Earth Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
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  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
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  • Surgical Instruments (AREA)

Abstract

L'invention concerne un outil et un procédé chirurgicaux de mise en prise et de manipulation d'un os, comprenant un corps d'outil présentant un axe de corps principal, une extrémité filetée et une extrémité de manipulation, l'extrémité filetée présentant des filetages et une butée d'outil. L'extrémité de manipulation est positionnée pour permettre à un utilisateur de saisir, de manipuler et de faire tourner le corps d'outil autour de l'axe de corps principal. Les filetages sont positionnés pour permettre à l'outil chirurgical de forer dans l'os et d'entrer en prise avec celui-ci lorsque le corps d'outil tourne dans le sens de forage autour de l'axe de corps principal, les filetages permettant une mise en prise de serrage avec l'os lorsque le corps d'outil tourne dans le sens de forage autour de l'axe de corps principal. La butée d'outil est positionnée pour empêcher l'outil de tourner davantage autour de l'axe de corps principal pour empêcher un forage supplémentaire dans l'os lorsque la butée d'outil entre en contact avec l'os.
PCT/US2020/031427 2019-05-05 2020-05-05 Outil et procédé chirurgicaux WO2020227261A1 (fr)

Priority Applications (4)

Application Number Priority Date Filing Date Title
US17/607,894 US20220226006A1 (en) 2019-05-05 2020-05-05 Surgical Tool and Method
EP20802712.8A EP3965672A4 (fr) 2019-05-05 2020-05-05 Outil et procédé chirurgicaux
CA3139115A CA3139115A1 (fr) 2019-05-05 2020-05-05 Outil et procede chirurgicaux
CN202080048971.7A CN114554986A (zh) 2019-05-05 2020-05-05 手术工具及方法

Applications Claiming Priority (6)

Application Number Priority Date Filing Date Title
US201962843453P 2019-05-05 2019-05-05
US62/843,453 2019-05-05
US201962908562P 2019-09-30 2019-09-30
US62/908,562 2019-09-30
US29/733,468 USD964565S1 (en) 2020-05-02 2020-05-02 Boring surgical tool
US29/733,468 2020-05-02

Publications (1)

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WO2020227261A1 true WO2020227261A1 (fr) 2020-11-12

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CN (1) CN114554986A (fr)
CA (1) CA3139115A1 (fr)
WO (1) WO2020227261A1 (fr)

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CN114554986A (zh) 2022-05-27

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