WO2022077004A1

WO2022077004A1 - Arthroscopic surgical tool for manipulating bony tissue

Info

Publication number: WO2022077004A1
Application number: PCT/US2021/071748
Authority: WO
Inventors: Robert A. Kelly
Original assignee: Kelly Robert A
Priority date: 2020-10-07
Filing date: 2021-10-06
Publication date: 2022-04-14

Abstract

Systems and methods for manipulating bony tissue such as a bone fragment are described. For example, a surgical tool includes a handle assembly that is operatively coupled to a grasping assembly. The grasping assembly includes jaw members which are sized and shaped to selectively grasp a bone fragment. The described examples include a surgical tool that includes a guide assembly selectively coupled thereto. The guide assembly includes a channel therethrough which is sized and shaped to guide a supplemental tool, such as a drill, fastener, guide wire, or suture, toward the bone fragment. In some implementations, the guide assembly includes one or more sleeves that are sized and shaped to be selectively translatable through the channel. The sleeves may be positioned concentrically or at an acute angle relative to the channel.

Description

ARTHROSCOPIC SURGICAL TOOL FOR MANIPULATING BONY TISSUE

CROSS REFERENCE TO RELATED APPLICATIONS

[0001] The present application claims the benefit of and priority to U.S. Provisional Application 63/088,603, filed October 7, 2020, and entitled, “Arthroscopic Surgical Tool for Manipulating Bony Tissue,” which is incorporated herein by reference in its entirety.

TECHNICAL FIELD

[0002] Examples set forth in the present disclosure relate to medical devices. More particularly, but not by way of limitation, the present disclosure describes an arthroscopic surgical tool for manipulating bony tissue.

BACKGROUND

[0003] Surgical repair of the tissues near a joint, such as the shoulder or knee, are often performed using arthroscopy, which is preferable to open procedures for a variety of reasons. Arthroscopic surgery is typically performed by inserting instruments through one or more small incisions near the joint. A tubular cannula may be inserted through an incision and into the body, providing a secure and semi-rigid pathway for the arthroscopic instruments. An endoscope may be inserted to provide illumination and real-time images of the surgical field during the procedure.

BRIEF DESCRIPTION OF THE DRAWINGS

[0004] Features of the various examples described will be readily understood from the following detailed description, in which reference is made to the figures. A reference numeral is used with each element in the description and throughout the several views of the drawing. When a plurality of similar elements is present, a single reference numeral may be assigned to like elements, with an added lower-case letter referring to a specific element.

[0005] The various elements shown in the figures are not drawn to scale unless otherwise indicated. The dimensions of the various elements may be enlarged or reduced in the interest of clarity. The several figures depict one or more implementations and are presented by way of example only and should not be construed as limiting. Included in the drawing are the following figures:

[0006] FIG. 1 is a perspective illustration of a surgical tool, according to an example implementation;

[0007] FIG. 2 is a schematic side view of the example surgical tool of FIG. 1 grasping bony tissue, such as a bone fragment;

[0008] FIG. 3 is a schematic end view which corresponds to the side view shown in FIG. 2;

[0009] FIG. 4 is a schematic side view of the example surgical tool of FIG. 1, showing a guide assembly and one or more sleeves; and

[0010] FIG. 5 is a schematic side view of an alternate sleeve with the guide assembly. DETAILED DESCRIPTION

[0011] Various implementations and details are described with reference to examples, including a surgical tool comprising a handle assembly that is operatively coupled to a grasping assembly. The grasping assembly includes opposing jaw members which are sized and shaped to selectively grasp bony tissue, such as a bone fragment. The described examples include a surgical tool that includes a guide assembly selectively coupled to the elongate tool body. The guide assembly includes a channel therethrough which is sized and shaped to guide a supplemental tool, such as a drill, fastener, guide wire, or suture, toward the bone fragment. In some implementations, the guide assembly includes one or more sleeves that are sized and shaped to be selectively translatable through the channel. The sleeves may be positioned concentrically or at an acute angle relative to the channel.

[0012] The following detailed description includes systems, methods, techniques, instruction sequences, and computing machine program products illustrative of examples set forth in the disclosure. Numerous details and examples are included for the purpose of providing a thorough understanding of the disclosed subject matter and its relevant teachings. Those skilled in the relevant art, however, may understand how to apply the relevant teachings without such details. Aspects of the disclosed subject matter are not limited to the specific devices, systems, and method described because the relevant teachings can be applied or practice in a variety of ways. The terminology and nomenclature used herein is for the purpose of describing particular aspects only and is not intended to be limiting. In general, well-known instruction instances, protocols, structures, and techniques are not necessarily shown in detail.

[0013] The terms “coupled” or “connected” as used herein refer to any logical, optical, physical, or electrical connection, including a link or the like by which the electrical or magnetic signals produced or supplied by one system element are imparted to another coupled or connected system element. Unless described otherwise, coupled or connected elements or devices are not necessarily directly connected to one another and may be separated by intermediate components, elements, or communication media, one or more of which may modify, manipulate, or carry the electrical signals. The term “on” means directly supported by an element or indirectly supported by the element through another element that is integrated into or supported by the element.

[0014] The term “proximal” is used to describe an item or part of an item that is situated near, adjacent, or next to an object or person, whereas “distal” describes an item or part that is distant. For example, the end of an item nearest the hand may be referred to as the proximal end, whereas the distant and generally opposing end may be referred to as the distal end.

[0015] Additional objects, advantages and novel features of the examples will be set forth in part in the following description, and in part will become apparent to those skilled in the art upon examination of the following and the accompanying drawings or may be learned by production or operation of the examples. The objects and advantages of the present subject matter may be realized and attained by means of the methodologies, instrumentalities and combinations particularly pointed out in the appended claims.

[0016] Aspects of the present disclosure relate to surgical tools for grasping and manipulating tissue inside the body. Without limiting the scope of the disclosure, various aspects are described through a discussion of various examples, including systems, tools, and methods related to arthroscopic shoulder surgery.

[0017] Reference now is made in detail to the examples illustrated in the accompanying drawings and discussed below.

[0018] FIG. 1 is a perspective illustration of an example surgical tool 100 that includes a generally elongate tool body 150 extending from a proximal end 120 to a distal end 110. The surgical tool 100, as shown, includes a handle assembly 300 at the proximal end 120 and a grasping assembly 200 at the distal end 110. In some implementations, the surgical tool 100 includes a guide assembly 400 that is selectively attached to the elongate tool body 150, as shown. [0019] The grasping assembly 200 in some implementations includes a lower jaw member 210 and an upper jaw member 220, at least one of which is movable relative to the other. The jaw members 210, 220 are selectively movable between a fully closed position, one or more intermediate or partly closed positions, and a fully open position. The jaw members 210, 220 may be used to grasp an object such as bony tissue. In some cases, a bone fragment 10 has separated from one of the bones of the shoulder joint and, if clinically indicated, may be selected for re-attachment. The handle assembly 300 in some implementations controls the movement of the jaw members 210, 220.

[0020] The surgical tool 100 may be constructed of medical-grade stainless steel or any other material suitable for use in surgery.

[0021] The surgical tool 100 including the grasping assembly 200, in some implementations, is about twenty-four centimeters in length and has an effective diameter of about nine millimeters, so that the tool 100 can be slidably received through a surgical cannula, such as ten-millimeter shoulder cannula.

[0022] When the jaw members 210, 220 are in the fully closed position, the surgical tool 100 in some implementations is sized and shaped to be readily inserted and moved through a surgical cannula. The jaw members 210, 220 in some implementations are about twenty millimeters in length. Beyond the open end of the surgical cannula, the closed jaw members 210, 220 in some implementations are sized and shaped to facilitate the penetration of soft tissues as the tool 100 advances into the body and toward the surgical field. In some implementations, the closed jaw members 210, 220 meet and form a composite blade at the distal end 110 which is sized and shaped to cut through soft tissue. [0023] FIG. 2 is a schematic side view of the example surgical tool 100 grasping bony tissue such as a bone fragment 10. In some implementations, the lower jaw 210 is fixed relative to the tool body 150 and includes a pair of tines (spaced apart as shown in FIG. 1 and FIG. 3). In some example implementations, the tine ends are blade sharp, to facilitate the penetration of soft tissues as the tool 100 advances into the body.

[0024] The upper jaw 220 in some implementations is movable about a hinge 215 and includes a single blade or flat scoop, as shown. In this example, the handle assembly 300 controls the movement of the upper jaw member 220.

[0025] Referring again to FIG. 1, the handle assembly 300 in some implementations includes a grip 310, a trigger 320, a safety bar 330, and a locking bar 340. The handle assembly 300 is sized and shaped to facilitate grasping and manipulation by a human hand. The grip 310 is sized and shaped to facilitate grasping by a hand, especially a gloved hand. The grip 310 may extend about ten or eleven centimeters in length, as measured orthogonally relative to the tool body 150.

[0026] The trigger 320, in some implementations, is pivotably coupled to the grip 310 about a hinge near the proximal end 120 of the elongate tool body 150. The trigger 320 extends to a distal trigger end 325. Manipulation of the trigger 320 controls the movement of one or both jaw members 210, 220.

[0027] The safety bar 330 in some implementations is pivotably coupled to the trigger 320. When the safety bar 330 is extended and positioned between the grip 310 and the trigger 320, as shown, the trigger 320 is prevented from rotating further toward the grip 310. When the safety bar 330 is retracted against the trigger 320, rotation of the trigger 320 is not limited.

[0028] The locking bar 340 in this example is pivotably coupled to an intermediate location near the distal end of the grip 310, as shown. The locking bar 340 includes one or more blocking elements 345, each of which is sized and shaped to engage with the distal end 325 of the trigger 320. The blocking elements 345, as shown, may be arranged in a row along the inwardly facing surface of the locking bar 340. When the distal end 325 of the trigger 320 is engaged with any one of the blocking elements 345, the locking bar 340 holds the trigger 320 in a stable position; in turn, the stabilized trigger 320 holds one or both jaw members 210, 220 in a stable position, thereby securing the hold of the gasping assembly 220 on the bone fragment 10 being held between the jaws 210, 220.

[0029] Release of the locking bar 340 releases the trigger 320 and, in turn, releases the hold of the jaw members 210, 220 on the bone fragment 10.

[0030] In some implementations, the trigger 320 is biased in an opening direction, away from the grip 310, such that the trigger 320 remains open unless manipulated by a hand in a closing direction toward the grip 310. An open position of the trigger 320 corresponds to an open position for the jaw members 210, 220. [0031] The safety bar 330, in some implementations, is biased in a direction toward the trigger 320, such that the safety bar 330 remains retracted against the trigger 320 unless manipulated by a hand. In this aspect, the safety bar 330 may include a notch, a slot, or some other feature that facilitates grasping of the bar 330 by a finger.

[0032] The locking bar 340, in some implementations, is biased in a direction toward the grip 310, such that the safety bar 330 remains retracted against the grip 310 until ready for use - and such that the locking bar 340 is biased toward the distal end 325 of the trigger 320, thereby maintaining the engagement between the blocking elements 345 and the trigger 320 unless the locking bar 340 is released by a hand.

[0033] The surgical tool 100 includes a guide assembly 400, as shown in FIG. 1. In some implementations, the guide assembly 400 is permanently coupled, attached, or otherwise integrated into the elongate tool body 150. In other implementations, the guide assembly 400 is a separate and discrete unit, which is only selectively coupled or attached to an outer surface of the elongate tool body 150. In this example, the elongate tool body 150 and the guide assembly 400 include one or more mating elements (e.g., pins and slots) which are sized and shaped to mutually engage with one another and thereby selectively attach or release the guide assembly 400 from the tool body 150.

[0034] The guide assembly 400 includes a tubular body 410 that defines a channel 420 therethrough. The channel 420 in some implementations extends along and through the entire length of the tubular body 410. The guide assembly 400 in some implementations extends to a location near the distal end 110 of the elongate tool body 150, as shown in FIG. 2.

[0035] FIG. 3 is a schematic view of the distal end 110 of the tool 100, which corresponds to the side view shown in FIG. 2. In some implementations, as shown, the guide assembly 400 is sized and shaped so that its open end is located between the tines of the lower jaw 210.

[0036] In some implementations, the guide assembly 400 includes one or more sleeves 450, shown in FIG. 4. Each sleeve 450 is sized and shaped to be selectively and slidably inserted and moved in translation through the channel 420. In this aspect, the channel 420 supports at least a portion of each sleeve 450 that is positioned within the channel 420.

[0037] Each sleeve 450 may be selectively moved through the channel 420 from a withdrawn or retracted position to an inserted or engaged position, in which the sleeve 450 is located near the bone fragment 10 being held between the jaws 210, 220. In the engaged position, the distal end of the one or more sleeves 450 may be located immediately adjacent or touching the bone fragment 10 being held between the jaws 210, 220, as shown in FIG. 4. In this aspect, the guide assembly 400 is configured to guide or direct a supplemental tool (e.g., a drill, a cannulated drill, a drill bit, a fastener, a cannulated fastener, a fastening tool, a guide wire, a pin, a surgical suture assembly) or other instrument toward the surface of the bone fragment 10. [0038] Referring briefly to the example lower jaw 210 illustrated in FIG. 1 and FIG. 3, the tines are spaced apart, defining a gap between the tines that is sized and shaped to facilitate passage of the one or more sleeves 450 between the tines and toward the surface of the bone fragment 10. In this aspect, the geometry of the open spaces defined by the lower jaw 210 is coordinated with the geometry of the sliding sleeves 450.

[0039] In the engaged position, the distal end of the one or more sleeves 450 may extend beyond the distal end of the tubular body 410; in other words, beyond the distal opening of the channel 420, as shown in FIG. 4. Accordingly, in order to facilitate the ability to grasp the proximal end of the one or more sleeves 450, the sleeves 450 may be sized in length such that the proximal end is not drawn into the channel 420.

[0040] In some implementations, the one or more sleeves 450 includes an inner sleeve 460 concentrically positioned within an outer sleeve 470, as shown in FIG. 4. The sleeves 460, 470 are selectively translatable relative to each other, and relative to the supporting channel 420.

[0041] The inner sleeve 460 defines an inner lumen 465 therethrough which, in some implementations, is sized and shaped to slidably receive a supplemental tool, such as a guide wire, a Kirschner wire (K-wire), a pin, or other pin-shaped device. For example, a K-wire may have a diameter of 0.062 millimeters. The inner lumen 465 of the inner sleeve 460 is sized and shaped to facilitate easy insertion, manipulation, and removal of a guide wire or pin. When the inner sleeve 460 is positioned near the bone fragment 10, the guide wire may be inserted through the inner lumen 465 until it contacts the bone fragment 10. As shown in FIG. 4, a guide wire or pin (not shown) as it exits the inner lumen 465 will emerge near the bone fragment 10. Some guide wires have a threaded distal end or another element for releasably attaching the guide wire to the bone fragment 10. Alternatively, the guide wire may rest against the surface of the bone fragment 10. [0042] The outer sleeve 470 defines an outer lumen 475 therethrough. The outer sleeve 470 and its lumen 475 in some implementations are sized and shaped to slidably receive one or more supplemental tools or instruments (e.g., an inner sleeve 460, as shown), serially or one at a time, such as a cannulated drill, a fastener, and a suture assembly. In some implementations, a cannulated drill is configured to drive a cannulated drill bit along a guide wire. For example, a cannulated drill bit may be 2.5 millimeters in diameter with a central opening sized to fit over a 0.062-mm guide wire. As shown in FIG. 4, the proximal end of one or sleeves 450 (e.g., outer sleeve 470, as shown) in some implementations includes a graspable portion that is sized and shaped to facilitate grasping by the fingers or by an instrument.

[0043] When the outer sleeve 470 is positioned near the bone fragment 10, the cannulated drill bit may be inserted through the outer lumen until it contacts the bone fragment 10 and the drill may be operated to rotate the drill bit and drill a hole into or through bone fragment 10. [0044] The outer lumen 475 is sized and shaped to slidably receive and direct toward the bone fragment 10 one or more supplemental tools or instruments, such as a cannulated screw or other fastener, a surgical suture assembly (e.g., a needle holder grasping a needle swaged to a suture). In this aspect, the outer sleeve 470 provides a guide from outside the body to the bone fragment 10 for any of a variety of devices and instruments which may be useful in securing, affixing, or otherwise manipulating an internal object such as a bone fragment 10. For example, a cannulated screw (and/or one or more sutures) may be inserted into the hole in the bone fragment 10 produced by the drill and used to affix the bone fragment 10 to a nearby bony surface or structure. [0045] In some implementations, the channel 420 through the tubular body 410 of the guide assembly 400 extends along a direction that is parallel with or colinear relative to a central axis 152 of the elongate tool body 150. The lumens 465, 475 defined by each of the one or more sleeves 450, when inserted into the channel 420, in some implementations, are concentric with the channel 420. In this example, the lumens, sleeves 450, channel 420, and tool body 150 are all aligned with and directed toward a center of the bone fragment 10, where the center is defined relative to the geometric center of the grasping jaws 210, 220.

[0046] FIG. 5 is a schematic side view of an alternate sleeve 480 positioned within the channel 420 of the guide assembly. The alternate sleeve 480 defines an alternate lumen 485 therethrough, extending along an alternate sleeve axis 482. As shown, the central, longitudinal sleeve axis 482 through the alternate sleeve 480 is not parallel to the tubular body axis 412 of the guide assembly 400 - nor is the alternate sleeve axis 482 parallel to the tool body axis 152 of the elongate tool body 150. For example, as shown, the alternate sleeve axis 482 may be oriented at an acute angle 490 (e.g., five degrees) relative to the axis 152 of the elongate tool body 150.

[0047] In use, the alternate sleeve 480 directs a guide wire or tool toward a selected surface of the bone fragment 10. With this configuration, the alternative sleeve 480 may be selectively rotated within the channel 420 such that the alternate lumen 485 directs a guide wire or tool toward any surface of the bone fragment 10 including, for example, any point on a circular arc defined by the acute angle 490 (e.g., five degrees). Other alternate sleeves and lumens of any size and shape may be designed to direct a supplemental tool or guide wire toward a desired point on a bone fragment 10.

[0048] In an alternative example implementation, an alternate sleeve is generally parallel to the tool body 150, but it defines an angled lumen therethrough which is not parallel to the body of the alternate sleeve.

[0049] In some implementations, the guide assembly channel 420 alone (e.g., without any sleeves 450 inserted therethrough) is used to direct a supplemental tool or guide wire toward the bone fragment 10. [0050] One or more of the steps described below may be performed simultaneously, in a series, in an order other than shown and described, or in conjunction with additional steps. Some steps may be omitted or, in some applications, repeated. The various processes of inserting, withdrawing, advancing and retracting, or pushing, as described herein, may be accomplished with the hand or fingers, or with a specialized device or tool.

[0051] In accordance with an example method of using the apparatus described herein, a surgeon or operator may set the jaw members 210, 220 at least partly closed and insert the grasping assembly 200 into a cannula toward a surgical field. The jaw members 210, 220 are sized and shaped to facilitate the penetration of soft tissues which may be present beyond the distal end of the surgical cannula. The jaws 210, 220 are closed, in some implementations, by fully closing the trigger 320 toward the grip 310.

[0052] The jaws 210, 220 are opened, in some implementations, by opening the trigger 320 on the handle assembly 300 relative to the grip 310. The jaws 210, 220 are partially closed (e.g., in order to grasp an object such as a bone fragment 10) by partially closing the trigger 320 toward the grip 310. The locking bar 340 may be engaged to hold the trigger 320 in place and thereby secure the bone fragment 10 in the grip of the jaw members 210, 220. The safety bar 330 may be engaged to further secure the trigger 320 in place.

[0053] With the bone fragment 10 secured in a stable position relative to the surgical tool 100, the outer sleeve 470 together with the inner sleeve 460 may be inserted into the guide assembly 400 using the hand or a tool. A guide wire may be inserted through the inner lumen of the inner sleeve 460, using the hand or a tool, until the guide wire emerges near the bone fragment 10. The guide wire may be positioned against the outer surface of the bone fragment 10 or, in some cases, inserted or screwed into the bone fragment 10.

[0054] With the guide wire in place adjacent the bone fragment 10, the inner sleeve 460 may be retracted and removed, using the hand or a tool, leaving only the outer sleeve 470 inside the channel 420 of the guide assembly 400. A cannulated drill bit may be positioned around the guide wire, and a drill coupled to the drill bit may be inserted into the outer lumen of the outer sleeve 470 until the drill bit emerges near the bone fragment 10. The drill may be used to drill a hole into and/or through the bone fragment 10.

[0055] The guide assembly 400 may also be repositioned and inserted adjacent a secondary location on the bone fragment 10 for the purpose of drilling an additional hold and/or installing a secondary fastener to the bone fragment 10.

[0056] After drilling, the drill may be retracted and removed from the outer sleeve 470. A cannulated fastener, such as a bone screw, may be positioned around the guide wire and pushed with a fastening tool, such as a screwdriver, into the outer lumen of the outer sleeve 470 until the fastener emerges near the bone fragment 10. In other examples, the fastener is one or more surgical sutures arranged through the hole and around the bone fragment 10. The fastener may be attached to the bone fragment 10 such that the distal end of the fastener extends beyond the opposing or rear surface of the bone fragment 10, such that the distal end may be driven into or otherwise attached to a nearby bone, bony surface, or other structure. After fastening, the tool and then the surgical tool 100 may be removed from the arthroscopic cannula.

[0057] Except as stated immediately above, nothing that has been stated or illustrated is intended or should be interpreted to cause a dedication of any component, step, feature, object, benefit, advantage, or equivalent to the public, regardless of whether it is or is not recited in the claims. [0058] It will be understood that the terms and expressions used herein have the ordinary meaning as is accorded to such terms and expressions with respect to their corresponding respective areas of inquiry and study except where specific meanings have otherwise been set forth herein. Relational terms such as first and second and the like may be used solely to distinguish one entity or action from another without necessarily requiring or implying any actual such relationship or order between such entities or actions. The terms “comprises,” “comprising,” “includes,” “including,” or any other variation thereof, are intended to cover a non-exclusive inclusion, such that a process, method, article, or apparatus that comprises or includes a list of elements or steps does not include only those elements or steps but may include other elements or steps not expressly listed or inherent to such process, method, article, or apparatus. An element preceded by “a” or “an” does not, without further constraints, preclude the existence of additional identical elements in the process, method, article, or apparatus that comprises the element.

[0059] Unless otherwise stated, any and all measurements, values, ratings, positions, magnitudes, sizes, and other specifications that are set forth in this specification, including in the claims that follow, are approximate, not exact. Such amounts are intended to have a reasonable range that is consistent with the functions to which they relate and with what is customary in the art to which they pertain. For example, unless expressly stated otherwise, a parameter value or the like may vary by as much as plus or minus ten percent from the stated amount or range.

[0060] In addition, in the foregoing Detailed Description, it can be seen that various features are grouped together in various examples for the purpose of streamlining the disclosure. This method of disclosure is not to be interpreted as reflecting an intention that the claimed examples require more features than are expressly recited in each claim. Rather, as the following claims reflect, the subject matter to be protected lies in less than all features of any single disclosed example. Thus, the following claims are hereby incorporated into the Detailed Description, with each claim standing on its own as a separately claimed subject matter.

[0061] While the foregoing has described what are considered to be the best mode and other examples, it is understood that various modifications may be made therein and that the subject matter disclosed herein may be implemented in various forms and examples, and that they may be applied in numerous applications, only some of which have been described herein. It is intended by the following claims to claim any and all modifications and variations that fall within the true scope of the present claims.

Claims

CLAIMS What is claimed is:

1. A surgical tool (100) comprising: an elongate tool body (150) extending from a handle assembly (300) to a grasping assembly (200) comprising at least one lower jaw member (210) and at least one upper jaw member (220), wherein the jaw members are sized and shaped to selectively grasp a bone fragment (10) therebetween, and wherein the handle assembly (300) is operatively coupled to the grasping assembly (200); and a guide assembly (400) selectively coupled to the elongate tool body (1 0) and comprising a tubular body (410) defining a channel (420) therethrough, wherein the channel (420) is sized and shaped to guide a supplemental tool toward the grasping assembly (200).

2. The surgical tool (100) of claim 1, wherein the handle assembly (300) is operatively coupled to selectively rotate the at least one upper jaw member (220) about a hinge (215), and wherein the at least one lower jaw member (210) comprises a pair of tines spaced apart and fixed relative to the elongate tool body (150).

3. The surgical tool (100) of claim 1, wherein the channel (420) is sized and shaped to guide a supplemental tool toward and between the pair of tines of the lower jaw member (210).

4. The surgical tool (100) of claim 1, wherein the handle assembly (300) comprises: a grip (310); a trigger (320) pivotably coupled to the grip (310) and extending to a distal trigger end (325), wherein the trigger (320) is operatively configured to close the upper jaw member (220) toward the lower jaw member (210) when the trigger (320) rotates toward the grip (310); and a locking bar (340) pivotably coupled to the grip (310) and comprising one or more blocking elements (345) sized and shaped to releasably engage with the distal trigger end (325), thereby securing the trigger (320) in a stable position until released.

5. The surgical tool (100) of claim 4, wherein the handle assembly (300) further comprises a safety bar (330) that is pivotably coupled to the trigger (320) and sized and shaped to releasably engage with the grip (310), thereby preventing unintended rotation of the trigger (320) relative to the grip (310) until released.

6. The surgical tool (100) of claim 1, wherein the guide assembly (400) further comprises: one or more sleeves (450) concentrically positioned within and selectively translatable through the channel (420).

7. The surgical tool (100) of claim 6, wherein the one or more sleeves (450) comprises: an outer sleeve (470) defining an outer lumen (475) therethrough; and an inner sleeve (460) concentrically positioned within and selectively translatable through the outer lumen (475), the inner sleeve (460) defining an inner lumen (465) therethrough which is sized and shaped to slidably receive a guide wire.

8. The surgical tool (100) of claim 7, wherein the supplemental tool comprises one or more of a drill, a cannulated drill, a drill bit, a fastener, a cannulated fastener, a fastening tool, a guide wire, a pin, a surgical suture assembly, and wherein the outer lumen (475) is sized and shaped, when the inner sleeve (460) is withdrawn, to slidably receive the supplemental tool.

9. The surgical tool (100) of claim 6, wherein the channel (420) extends along a channel axis (412) that is substantially parallel to a body axis (152) extending through the elongate tool body (150), and wherein the one or more sleeves (450) comprises an alternate sleeve (480) defining an alternate lumen (485) therethrough and extending along an alternate central axis (482), wherein the alternate sleeve (480) is sized and shaped to be positioned within and selectively translated through the channel (420) at an acute angle (490) relative to the channel axis (412).