CA2026781A1 - Screw and driver - Google Patents
Screw and driverInfo
- Publication number
- CA2026781A1 CA2026781A1 CA002026781A CA2026781A CA2026781A1 CA 2026781 A1 CA2026781 A1 CA 2026781A1 CA 002026781 A CA002026781 A CA 002026781A CA 2026781 A CA2026781 A CA 2026781A CA 2026781 A1 CA2026781 A1 CA 2026781A1
- Authority
- CA
- Canada
- Prior art keywords
- screw
- front portion
- counterbore
- driver
- axial
- Prior art date
- Legal status (The legal status 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 status listed.)
- Abandoned
Links
Classifications
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B25—HAND TOOLS; PORTABLE POWER-DRIVEN TOOLS; MANIPULATORS
- B25B—TOOLS OR BENCH DEVICES NOT OTHERWISE PROVIDED FOR, FOR FASTENING, CONNECTING, DISENGAGING OR HOLDING
- B25B23/00—Details of, or accessories for, spanners, wrenches, screwdrivers
- B25B23/02—Arrangements for handling screws or nuts
- B25B23/08—Arrangements for handling screws or nuts for holding or positioning screw or nut prior to or during its rotation
- B25B23/10—Arrangements for handling screws or nuts for holding or positioning screw or nut prior to or during its rotation using mechanical gripping means
- B25B23/105—Arrangements for handling screws or nuts for holding or positioning screw or nut prior to or during its rotation using mechanical gripping means the gripping device being an integral part of the driving bit
- B25B23/108—Arrangements for handling screws or nuts for holding or positioning screw or nut prior to or during its rotation using mechanical gripping means the gripping device being an integral part of the driving bit the driving bit being a Philips type bit, an Allen type bit or a socket
-
- 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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/864—Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated
-
- 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
- A61B17/8875—Screwdrivers, spanners or wrenches
- A61B17/8886—Screwdrivers, spanners or wrenches holding the screw head
- A61B17/8888—Screwdrivers, spanners or wrenches holding the screw head at its central region
Abstract
A screw (20) and driver (50) combination designed so that the screw (20) is releasably axially couplable with the driver (50) and so that the screw (20) is positively rotatably engageable with the driver (50). The screw (20) comprises an axial bore (26) of circular cross section and a counterbore (28) of polygonal cross section. The driver (50) comprises a radially-compressible front portion (66) sized to engage the axial bore (26) of the screw with a minor spring interference fit and an intermediate portion (56) sized to positively rotatably engage the counterbore (28) of the screw (20). The screw (120) and driver (150) may be adapted for use with a guide wire insertion system by providing axial bores (125, 185) extending through the entire lengths of the screw (20) and driver (50). The driver (250) may include a mechanical expansion assembly (297) for causing said front portion to expand radially.
Description
WO90/08S10 P~T/US90/00651 2~
SCREW and DRIVER
' ' : '.:
FIELD OF _HE INVENTION
The present invention relates to screw and driver assemblies, and more particularly to surgical screw :;
and driver assemblies designed so t~la~ the driver is releasab1y couplable to the screw.
BACKGROUND OF_THE INVENTION
In certain situations, it is desirable that a ` :~
screw be both rotationall~ as well as axially releasably coupla~le with a drivex. For instance, in limited-access work applications, e.g., in arthroscopic or other "closed" surgeries~,~where a scxew is to b~ insarted into a ho}e which is~not readily accessible, i~ is advantageous to aXially coup~e the screw with the driver be~ore inserting the screw into the surgical sit~ Such~axial coupling is 15~ beneficial where the screw implantation site is ~: :
accessiblei e.g. where the screw is inserted:in;a downwardly:facing hole.
With:such screw:and driver combinations, the screw is ~Sirst attached to the driver and~then the driver is manipulated until the~screw ~ontacts the implan~ation site, wher~upon thQ:driYer is rotated until the screw is:~ul~y implant~ed.~ Than~ the dri~er is ~isengaged fr~m~the sarew~by~pulling it axially away from the ~ r ', uch~screw~:;and~dri~er:~combinati~ons:~are~known:in :~
th~ art~ s illustrated by U.S.~:~Pat~nt:Nos. 2,32~,3~8, 2,511~,05~ 2,775,913,~3~:,463,~209, 3~,695j321, and WO 9iD~O~10 PCr/US90/006$1 ,( !''''''' ~`` ~
SCREW and DRIVER
' ' : '.:
FIELD OF _HE INVENTION
The present invention relates to screw and driver assemblies, and more particularly to surgical screw :;
and driver assemblies designed so t~la~ the driver is releasab1y couplable to the screw.
BACKGROUND OF_THE INVENTION
In certain situations, it is desirable that a ` :~
screw be both rotationall~ as well as axially releasably coupla~le with a drivex. For instance, in limited-access work applications, e.g., in arthroscopic or other "closed" surgeries~,~where a scxew is to b~ insarted into a ho}e which is~not readily accessible, i~ is advantageous to aXially coup~e the screw with the driver be~ore inserting the screw into the surgical sit~ Such~axial coupling is 15~ beneficial where the screw implantation site is ~: :
accessiblei e.g. where the screw is inserted:in;a downwardly:facing hole.
With:such screw:and driver combinations, the screw is ~Sirst attached to the driver and~then the driver is manipulated until the~screw ~ontacts the implan~ation site, wher~upon thQ:driYer is rotated until the screw is:~ul~y implant~ed.~ Than~ the dri~er is ~isengaged fr~m~the sarew~by~pulling it axially away from the ~ r ', uch~screw~:;and~dri~er:~combinati~ons:~are~known:in :~
th~ art~ s illustrated by U.S.~:~Pat~nt:Nos. 2,32~,3~8, 2,511~,05~ 2,775,913,~3~:,463,~209, 3~,695j321, and WO 9iD~O~10 PCr/US90/006$1 ,( !''''''' ~`` ~
3, 88g, ~44 . Known screw and driver combinations typically ~;uf~r from one or more problems which limit their utility and acceptance in certain situations.
For instance, known screw and drivex assemblies when designed to provide sufficient axially locking engagement can be difficult to operate, inasmuch as the driver must be inserted with an un~cceptably large axial ~orce to overcome the frictional interference between screw and driver. With some screw and driver combinations, the rotational enyagement between the screw and driver is not sufficiently positive, i.e., there often is an unacceptably large ~mount o~ play between the screw and driver. Other screw and driver combinations (1) tend to be relatively expensive to produce due to the relatively compIex shapes of the screw and driver and (~) can permit ~ome axial wobble between screw and drivert i.eO, the:combination is not designed to ensure the driver is always perfectly co-axially aligned with the screw.
ARY OF THE INVENTION
An object of the present invention is to provide a screw and driver co~ ination dasign~d la) to provide positiY~ rotational engagement between screw and ~ ;
driv~r, (b) to parmit ~he driver to be securely atta~hable to the screw so that the driver is restrained ~rom moving axially relati~e to the screw ~ i while at the same time permitting ~he driver to be ,~
relative~y easily attachable to and~de~chable from th~ screw, and (c)~ to ensurs ~he screw and driver when engag~d remain co-axially aligned with~one another.
:
.: ' WO90J08510 2~ ~s ~ PCT/~S90/00651 r; j i' -3- 1 .
:
~.;
Another object of the present invention is to provide a screw and driver combination achieving the foregoin~ objects which is adapted for use with a ~:
"K-wire" or other guide wire insertion system.
These and other objects are achieved by a screw and driver combination comprising a screw and a driver designed to rotatably drive the screw. The latter is preferably, although not necessarily, threaded along its entire length, comprises an axial bore of circular cross section which is open to the top~end of the screw and a counterbore of polygonal, preferably hexagonal, cross-section which is also open to the top end of the screw.
The driver comprises an elongate shaft ~erminating in a radially-compressible cylindrical front portion.
The latter is sized and configured s~ ~ha~ when the front portion is inserted through the~counterbore into .
the axial bore of the screwr:the front~portion will : ;
;compress radially. When the front~portion is fully i.nserted, it snugly engages the wall of the axial bore with a minor spring-biased~in~erference, whereby the ~ ;
driv~r is re~easably~coupled in an~axial sense, to the scr~iw.
:The driver also comprises an elongate intermediate~
portion having a polygonal, pref~rably~hexagonal,~
crvss-section with the cross-sectional configuration and dimension:of the intermediate~;portion being:
subs~antially equal ~o the cross-s~e~tional :
con~iguration and dimension:o~ ~he:~counter~ore of the ;.
screw. The inter~ediate por~ion is attached to the ~ ~ .
rear~end of`the front portion and the front end of ~he ~:
WOg~/08~10 PCT/US90/00~5~
, ~
c~ `j 9 -4~
1, '.'~ .
shaft, Thus, when the front portion is inserted in the axial bore of the screw and the intermediate ,`
portion is inserted in the counterbore, by rotating the shaft rotational drive is transmitted, via the engagement of the intermediate portion and the counterbore, to the screw.
.
BRIEF DESCRIPTIC)N OF THE DRAWINGS
For a fuller understanding of the nature and objects of the preæent invention, reference should be made to the following detailed description which is to be considered together~with the accompanying drawing~
Fig, 1 is a sid~ elevation view, partially broken away, of the screw o~ the present invention;
Fig. 2 is an end view of the screw taken alony line 2-2 in Fig. 1; .
Fig. 3 is a side elevation of the~dri~er of the pre~sent invention;
~ ig. 4 is an enlarged view of the ~ront portion of the driver illustrated in Fig. 3;
Fig. 5 is an enlarged cross-sectional view:taken ..
alon~ line 5-5 in Fig. 4;~
Fig~ 6 is a cro~s-sectional view of the driver taken along line 6-6 in Fig. 5, Fig! 7 is an~enI~arged side elevation view nf an . .
alternativa version~of the front portion~of~the drit~er;
Fig~ 8 is an enlarged cross-sécti~onal view o~ the:~ro~t por~ion illustrated~in~Fig. 7 taken along line 8~8 in Fig~ 7; ~
:
:
W~90/08510 PCT/US90/00651 2 r f r~
-5- ~
~ .
-., .
Fig. 9 is a cross~sectional view of the front portion illustrated in Fig. 8 taken along line 9-9 in Fig. 8;
Fig 10 is a plan view showing the screw of the present invention inserted into a gap between a bone plug and the wall of the hole in the bone in which th~
bone plug is inserted;
Fig. 11 is a side elevation, partially broken away, of the screw of the f irst alternative embodiment of the present invention;
Fig. 12 i~ a side elevatlon of the driver of the first alternative embodiment of the present invention;
Flg. 13 is a schematic side elevation view showing th~ screw and drivex of the first alternative embodiment, the material in which ~he screw of the first alternative embodiment is to be implanted, and the guide wire used with the screw and driver of the first alternative embodiment;
Fig. 14 is a side elevation, taken in cross seation, of the front portion o~ one version of the driver of the second alternative embodime~t;
Fig.~ 15 is a side elevation of~he driver o~ the second alternative embodiment; and Fig. 16 is a ~ide elevation, taken in cross s~ction, of the front portion of anoth r ~ersion of th~drlver of the second alternative embodiment..
:In:tha drawing~., lik~ referen~e numerals refer to : ~.
ike~parts.
~ ~ .
~ eferring to Fiqs.~ 3,~the present inve~tion is a :
.
WO90/~510 P~TJUS90/00~51 ~:
!'~,'`' ' screw and driver oombination consisting o~ screw 20 and driver 50.
Screw 20 comprises an elongate shaft having a flat back end 22 and a pointed front end 24. Screw 20 is preferably cylindrical along the majority of its length, with the front portion of the screw tapering down to pointed front end 24. Thus, screw 20 preferably does not comprise a distinct head having a diameter which is greater than the diameter of the ~haft of the screw. Alternatively, where the application so requires, a head (not shown) may be attached to back end 22.
Screw 20 is threaded along the entire length of its outside surface. The`specific thread pitch will, of course, vary with application and screw size, although for a screw designed ~or use i~ arthroscopic or other cIo~ed surgeries and having a length of about one~inch (l") a thread pitch of about O.llO
inches/thread is satis~actory.
Screw 20 comprises a blind axial bore 26 which is open to back end 22.: Axial bore 26 has a ciraular :~
cross-section, wi~h:the diameter o~ the axial bore pre~erably being equal to roughly one-third the outside diameter ~f screw 20. The length of axial bore 7 ' '' ~6 is preferably egual to about two-thirds the:overall lengthlo~ screw~20.
Grew 20 also comprises~a blind c~unterbore 2~
which ls co-axia1~with axial ~ore 26 and i5 open to }
back end~22. Counter~ore 28~has a polygonal, , ~-pre~erably hexagonal~ cro~s-section wi~h the result that the:~sounterbor~:~comprises~a plura1ity o~ ~lat :~
WO90/08510 PCT/US9~/00651 1 ~
7 ~
-7- 1 `
.` ~. .
'~,"'`''''' ,' elongate adjoining faces 28'. Counterbore 2~ is dimensioned so that the diame~er of a circle contacting simultaneously all of the flat faces ~8' of the counterbore is at least as large as the diameter of '~
axial bore 26, and in mosk ~ases is larger than the diameter of axial bore 26. As a result of this dimensioning, a seat 30 is fo~med at~the base of counterbore 2a. The;length of counterbore 28 relative to the portion of axial bore 26 having a circular cross section may vary based on known design parameters,~ i although in an exemplary screw 20 the~portion of bore 26 having a circular cross section is~approximately one-and-a-half times as long as counter~ore~28.~A
tapered reoesses 29 is~preferably provi~ed at the mouth of counterbQre 28.
As used~hereina~fter, bore 26 shall;refer~to the portlon o~bore 2& having a~circular cross section, iOe. th~ portion o~ bore;26;~be~ween sea~t 30 and the '' ',' blind~end of~the bore,~unless~speci~ically mentioned otherwise.
Turning now to~Figs~ 3~-5, drxver 50~comprises~a ~ r handle 52~and~an elongate~shaft 54~attached to the'~
front;~end~of the handl~e.~ Where screw~20~nd driver 50 ar~ ~intended to'be~ùsed;in~closed~surgeries,~the outside~diame~er o~ shaft 54' must~be ~elected,so t,hat~
thè ~lat~er' can ~e ~reely inserted~into and removed rQm a; con~entiona~}~cannula. ~The~length~of shaft 54 wil~,~-,o~ourse;~ var~,w~ith~,~appl~ication.~
` ' The~front~end~ ~ shaft~54~tap~rs~ a~reduoed dia~eter~ nte ~ediaté~partion~56.~ ~The~latter~has~a polygona~ cross-section, the spe~ polygonal :shape~
W090/0~;10 Pcr/lJsso/
of which corresponds to the polygonal configuration of the cross-section of counterbore 2~ in the screw 20 with which the driver 50 is adapted for use. For instance, if counterbore 28 has a hexagonal cross-sectiona~ con~iguration, then intermediate poxtion 56 also has a hexagonal cross-section.
Furthermore, intermediate portion 56 is-dimensioned to be freely slidably insertable into and ~emovable from counterbore 28. At the same time~ intermediate port.ion 56 is dimensioned so that when it is inserted in counterbore 28 it positively engages the sidewall of the counter~ore so t~at rotational dr.ive can be tran~mitted from intermediate portion 56 to screw 20 with minimal lost motion.
As noted above, intermediate portion 56 has a reduced outside diameter relative to~sha*t 54.
Intermediate poxtion 5~ joins shaft:54 with a smoothly tapering radius portion 580 Preferably, although not n~c~ssarily, the polygonal cross-~ction~of in~rmediate portion 56 is carxied through tapering radius poxtion 58 and terminates at the :junction of the radius portion with shaft 54. The len~gth vf intermediata portlon 56r as measured~between the fron~ s end:60 of the intermediate~portion and:front end of radius portion 58, is roughly equàl to;the length, of couhterbore 28.;~
Driver 50 further comprises~an~elongate, radial:ly compressible ~ront portion~66~having a central portion ~$~and a radial~ly-project~ing tip portioin 70,~ Central p~rtion 68~is cylindrical in ex~erior configuratioll when not~: in ~ the t::Qmpressed `:: :
WOg~/0~510 PCT/US90/00651 ~.
~., ,r~ "~", ~
` J `. ~
_9_ .~.
;~., state, and is attached at its rear end 72 to front end 60 of intermediate portion 56 so that the axes of ' ..
elongation of front portion 66 and intermediate .
portion 56 are co-axial. The diameter of the central portion 68 is l~ss than the diameter of a circle ,:
circumscribin~ intermediate portion 56, with the result that a shoulder 69 tFig. ~) is for~ed at the junction of the central portion and:the interme~iAte portio~. Preferably, front portion 66 is slightly, e.g. 0.05", shorter than bore 2fi. , .`' Tip portion 70 is co-axial and integral with central portion 68, and is positioned~adjacent front : ;.
end~74 o~ front portion 66. Tip portio~ 70 has a generally cylindrical exterior configuration, with the :
outside diameter o~ the:tip portion~being slightly .', greater than (i.e.~ o.noos - O.OOlS inches) the diame~er o~:axial bore ~ in screw~20~wh:en the tip portion is not ln the compressed sta:te.~ Tip portion 70 tapers radially inwardly (a)~at~its front :end~to intersect front~;en~'74~ and (b)~at'its rear:end to:intersect '~
cen~ral: pcrtion 68.
"
Front portion 66~further~comprises an axial~ bore ~0 which~xtands:along~the entire:length of th~ront ~ port~ion.~The inside diameter ~f~axial bore 80 is ,~' : roughly half the outside diameter o central port~on Front portion~66~al~s~in~1udes three slots 82 : ':~
xte~ding~along`the~length~o~;;the~front~portion~and:~
ing~axia~l bore~8~o~wit~h~i ou~side~surfa~e o~ the nt~portion~ :Ea¢h~slot~8~2;~;ls a~ularIy space~about :~
the~circumference~'ot front~end:~74~so ~s to~be spaSed WOgO/08510 PCT/US90/006~
, ~, ,-. . .
7 ~ 7~ 0-120 from the two adjacent slots, whereby front portion 66 is divided into three equally-sized elongate segments 84a, 84b and 84c.
. Preferably, although not necessarily, as best seen in Fig. 6, the length of the radially-outermost portion of each slot 82 is about equal to the length of axial bore 80, while the length of the radially-innermost por~ion of each slot 8~ is about equal to two-thirds the length of axial bore 80. The wall of front portion 66 in which slots 82 are provided tapers along a gradual radius be~ween the radially~innermost and radially-outermost portions of the~ slots, as illustrated at 85 in Fig.~ 6.
Alternatively, the radially-innermost and radially-~utermost portions of each slot 82 may be the same length or may be related in length by a ralationship of other than two-thirds to one. The width of slots 82~ is approximately equal to one quarter the diameter :of axial bore 80.
As described in greater detail hereina~ter, axial bore 8p and slo~s 82 are provided:to allow front portion 66 to be compressed radially inwardly. When a radia1ly compressive~force~is applied to front portion 66, segments 84a, 84b and 84c will move toward one 7 another. The diam~ter! of axial bore ~O,~jthe o;utside diameter of tip portion 70 when in~the uncompressed state, and the:width and~number o~slots::8~i are selected:~so:~hat tip.por~io~ 70:wil1 snugly engage the wall;~o~ axial~bore 2~6~with a~minor:spring interference ~ ~ :
it~when~insert~d~i~ bore 26. In this:compre~sed state,:the front ends of.se~ments:84a~, 84b and 84c are WOgO/0851~ PCT/US90/0~651 ~ ~ 2 ~ 3~
3:
driven toward one another so that the width of the fror~t ends of slots 82 is reduced somewhat.
Front portion 66 is made from a materiaI which can .
readily accommodate, without fatigue;o:r shear, ~epeated compression and release of segments 84a, 84b and 84c. This material is also sufficiently:resilient and has sufficient spring memory so that when segments 84a, 84b and 8:4c are radially compressed,~the segments attain a radially-outwardly acting spring bias.~
Suitable materials having these properties include I ::.
stainless steel and titanium. ~ ::
Re~erring now to~Fi~s. 7-s,:in~an alternative embodiment of front portion 66j four slots 82 are ~ ~
provided in the front portion. ~ach of:the slots 82 ~ r' :is s`paced~Q from adjacent:~slots, a~s:~measured around ~ .` the~ciraumference of front end 74. ~ As such, front portion:66 is divided:into four equally-sized, ; ~ , ,j qlongate ~segments 84a,~84b~,:8~c and 8;4d, and each~slot ~82:~is::~diametri~all~ opposite a:twin~slot 82.~ Th~
radial~ly~innermost~as~well~-as~the radially:outermost .
portions: of slots 8~2~of~`the~alternative embodiment:o~
front~portion 66 extend substantially the entire Iength ~f~:~ront~p0rtiOn~;6~6~unl~ike the~510ts of~ he ;~
mb~diment illustrated:in~Figs.:4~-6`~(where the ` : :~
radially-outermost:.portion o~ the~sIot~is :: ~
prefe~ably l:onger than th~ radially-innermost`portion : ::
o~ the~s}ot,~as~;indica~ed.~at`~5~in~Fi~ 6). ~
Fr~ p~rtion~66~comp~ises-a~air of~transverse borès~9o~and~92~éxté~di`ng;~èn*irely~through the~
hickness~of~:cen~ral~portion:~;~6~ .Bc~re 90;~and~:92 extend n~mally~to~the~long axis:of:~ront~portion 66, WO90/085tO PCT~US90/006 intersect the axial bore 80 at the inner end thereof and are perpendicularly aligned with respe~t ~o one another. Bore 90 is positioned so that its long axis extends through one of the pairs of diametrically opposed slots 82, and bore 92 is positioned so that its long axis extends through the other of the pairs of diametrically opposed slots 82~: T~e diameters of bore 90 and 9? are identical and are somewhat greater than the width of slots 82. Bores~90 and 92 are provided to prevent the formation of stress fractures ~.
at the base o~ slots 82 which might reduce the resiliency and spring memory of elongate portions 8~a, 84b, ~4c,~and 84d.
The outside diameter of tip portion 7 0 of the four-slot version o~ front portion 66:is about 0.002-0.00~: inches, preferably 0.003 inches, greater than the inside diameter of bore 26 of screw 20. Thus, the outside diamater o~ tip portion 70 of the four-slot version of front portion:~66 is slightly greater than ~th~ outside diameter o~ the tip portion 70 of the thr~e-slot version of fxont portion~:66. Tip portion ~ ;
of the four-slot version of front portion 66 has his slightly larger diameter~because the provision of our~slots 82, as:opposèd to:three::slots 82, permits the four slot ve~sion~of front portion 66 to be~more ea:sily~radially~compressed. As such, to achieve the desired minor spring interference~fit between front : ' 1.
:portion 66;and counterbora~26, the outside~diameter of tip~portion 70~of~:the~;four ~lot~version~of front ; ;
portion 66 ~is slightly enlarged. ~
WO~0/0~510 PCT/US90/00651 . ` " ' ' `' I ,.
-13~
i' .' EXAMPLE
An ~emplary screw and driver combination of the .:
present invention, designed for use in arthroscopic or other closed surgeries, possesses the foll~wing ~pecific dimensions: :
Scréw 20 . _ _ overall length: l.18"
outside diameter (measured at radially outermos~
portion of threads): 0.276"
angle of pointed front portion: 30 with respect 1 :
to longitudinal axis (included angle of 60) diameter of axial bore 26: '~Q.094S"
polygonal configuration of counterbore:
~hexagonal,: with di~metric distance between para}lel~opposing faoes equal to 110.0945 thread pitch:~ .llO:inches/thread length of counterbore 2~: 0.20' length of axial bore 26: 0,4511 :
Drlver 50 overall length: 9.25"
length o~ shaft 54: 4.00" ~
diam~eter of shaft 54: .l87" :~ ;
ength o~ intermediate:portion::56~(excluding ~ .
radius por~ion ~8): 0.20'~
pbl~gonal configùration of intermediàte portion 56: hexagonal,~with diametric distancP between ~ .
any two~pa~alIel~opposing faces~equa} to: O.Og28 : 5 ngth of~ront portion:~6:6: O.:~o"
length of cen~ral:portion~8: 0~40"
diameter-of cen~ral portian ~:(in un~ompressed ~ .
~, , WO90/08510 PCT/US90/00651 ~
2 ~ l4 state): 0.088"
diamet~r of tip portion (in uncompressed state):
0.0955"
length of slots 82 radially innermbst edge: 0.l20"
radially outermost edge: 0.200"
width o~ slots 82: O.OlO1' number of slots 82: 3 The above-listed dimensions are onIy exemplary, and may, of course, be varied depending upon the `~
desired application of the pres~nt screw and:driver com~ination.
:
OPER~T~
Referring to Figs. l-lO, the screw and driver ~ `~
c~mbination of the present invention may be a~5factQrily used, for example, in a surgical context :to secure a bone plug lO0 (Fig. lO) in a hole 102 drilled:in a bone 104. As is:well known,~the diametar o~ hole 102 is selected so that the co~ners of bone plug lOO will contact:the wall of hole lO2. Typically, : :
a tendon~(not shown) or other tissue is attached~to bone plug lOO before it~is inserted~:in hole 102.
~ter the bone plug lOO has been inserted i~nto hole ~
lO~,. driver SO is manipulated relative to screw 20 so : :
that front portion 66 passes through~counterbore:28 into axia~:bore:26:o~scr~ew 20. Because ~h~ diameter of tip po~tion 70 in~the~uncompresscd~state is~slightly gr~ater than:the diame~er::of axial bore 26:of screw:20, ~ :
frcnt~:partion 66 must~bé~radially compressed somewhat ~;
:
W~90/08510 P~T/US90/00651 ;
-15- 1 :
,;
.
so t.hat the tip portion can be slidingly inserted into bore 26. To this end, tip portion 70 is provided with an inwar,dly tapering front end which coacts in cam-like fashion with either (a~ tapering recess 29 at.the mouth of counterbore 28 when bore 26 and counterbore 28 have similar inside diameters or (b) the mouth of bore 26 (adjacent seat 30) when the inside diameter of bore 26 is greater than the inside diameter of bore 26. Thus, when front portion 66 is urged into bore 26 this cam-like coaction forces segments 84a, 84b and 84c or, 84a-84d in the case of the alternative embodiment illustrated ln Figs. 7-9, ra~ially inwardly. This radially inward compressio~ of front portion 66 ~.
penmits the latter to be inserted through counterbore 28 and into axial bore 26 with a sliding ~it. Because front portion 66 is campres`sed slightly~when received in axial bore 26, tip portion 7~ engages the axial bore with a minor spring interference fit.
When front portion 66 i~ fully inserted in axial bore 26 in screw 20, and the length of the straight, non-tapering section o~ intermediate portion ~6 is greater than or equal to the length of counterbore 28 in screw 20, driver shoulder 69 will engage screw seat `
30. When the length of :the straight, non-tapering section of intermediate portion 5~ is less than the length l of counterbore 28 j bac:k ` end 22 of screw 20 adj acent recess 2~ :will engage radially tapering .. -portion SB of intermediate portion~56 when fro~t portion 66 is:fulIy inserted in axial bore 26. In ).
either~ case, this engagement provides feedback tc, the u~e~ :as to when the~ fron~ portion is fully inser~ed.
.
:
. .
WO90/08~10 PCT/US90/00651 7 ~
During the insertion of front portion 66, shaft 54 must be rotated so that ~he ~lat faces of intermediate piortion 56 are parallel to respective flat faces of counterbore 28 in screw 20. The oross-sectional dimensions of intermediate portion 56 are slightly less than the cross-sectional dimensions o~ screw counterbore 28 so the intermediate portion oa~ be inserted into the counterbore with an easy sliding fit. The dimensions of intermediate portion 56 relative to the dimensions of counterbore 28 are also selected so that rotational drive can be transmitted from driver 50 to screw 20 with minimal loss of energy.
The pointed ~ront end of screw 20 is then inserted into one of the gaps 106 (Fig. 10) between ~one plug lO0 and the wall of hole 102. Because screw 20 is coupled with driver 50 as a result of th~ minor spring interference fit between tip 70 and axial bore 26, the scr~w may be directed to the opening of the gap 10 solely by appropriate manipulation of driver 50.
Whe~re screw 20 is being used in a closed surgery, the screw and driver sha~t 54:may~be inserted as a unit into an appropriately-positioned cannula, with the ~driver being manipulated based on informiation pro~ided by th~ fiber optic or other viewing system used in i ~
conjun~tion wit~ the clos~d surgery until ~he pointed ~ :
~ront end of the screw is receiv~d in the opening of ' ~:
the gap 106.
Next, driver handle 52 is rotated, causing shaft -54 and intermediate portion 56 to:rotate. The latter has th~ 6ame polygonal conf iguration as and ~s :: : :
::
, ~ :
~: , . . .
2~ ; L~:
.
approximately the same size as counterbore 28 so that when intermediate portion 56 is rotated i~ trànsmits rotational drive to the wall of ~he counterbore and hence to screw 20. As screw 20 is rotated, its outer threaded surface engages bone plug 100 and the adjacent portion of bone 104 and thereby pulls the screw into the bone and bone plug. When screw 20 is fully implanted it ac~s as a wedge~forcing bone plug 100 into tight frictional engagement with ~he wall of hole 102. ~ :
After screw 20 has been fully inserted, driver 50 is separated from the screw by pulling the driver axially away from the screw. Tip portion 70 resists this axial pulling to some extent so as~to ensure the screw and driver do not lnadvertently become:separa~ed prior to completion of the implantation of the screw.
However, when a moderately forceful axial pulI is ~`
app1ied, the minor spring interference between tip ~ ~;
portion 70 and axial bore 26 is overcome and the .:
d~iver can be detached~ from the screw.
':
FIRST ~LTERNATIVE EMBODIMENT
: In arthroscopi~ and other closed surgeries, so called "K" wire or other guide wire systems are used . t`
to deliver a surgical ~asten~r to an implantatlon site. As is known, these ~ystems comprise a long wire~ , :
typically having a pointed end, which is inserted in~o ~-;
selecte~ tissue in the~surg~ical site. ~Surgical tools, ': -:
fasteners and other~devices:adapted~for use~with guide wire-systems (and hence:compris;ing~an:axial bore ex~ending entirely through~the device) are deIivered WO9~/0~S10 PCT/US90/0~651 ~.
`; - . ,.;
.
~ ~i ' ` 7 18 ,~
to the site in the tissue where the wire has heen inserted by placing the device on the wire so the latter extends thxough the axial bore of the device.
The device is then moved down the wire until it reaches the tissue.
Referring now to Figs. 11-13, screw I20 and driver 150 of the alternative embodiment o~ the present invention are virtually identical to screw 20 and driver 50 of the first embodiment of the present invention, except that axial bores are~provided extending through the entire length of both the screw 120 and driver 1i50. By providing these axial bores, screw 120 and driver lSO are adapted for use with a guide wire:s~stem o~ the type described above.
:~De~cribing screw 120 in greater detail, the latter i has a cylindrical configuration, wi:th the pointed ~ront end of the screw terminating in a~lunt tip 123.
The exterior sur~ace:is threaded,~as described above with~reference to screw 2:0. Screw 120 comprises an axial bore 125 which~extends through the èntir~ length of the~screw. :The:pointed front end of screw 120 is blunted`~as a result~o~ the passage of bore 125~
therethrough,~ with the:area of blunt;~ip;123 being equàl ~o the: area of th~::cross-sec~ion of bore 125.
5crcw 120 includes a:count~rbore~1~6 which is ;
co-axial with akial`bore~l25 and is open to rear end ~122 o~ the~ screw.~ Screw 120 further inclùd~s a aounterbo~e 1:28:which is ~al60 co-axial;~with axial bore~
125~:and is open to rear end 122:o~ the:screw. A ~ :
tapered~r~cess 129~is provided in~rear end~122 at the mouth:;of counterbore 1~8~
~, WO90/08510 PCT/US90/00651 ~
~` P
-19- . '~
. ~.
The length, diameter and cross-sectional con-figuxation of counterbores 126 and 1~ are equal to the length and diameter of bore 26 and counterbore 28, respectively, of screw 20. The diame~er of axial bore ~.
125 is somewhat greater than the diameter of the guide wire with which screw 120 and drivPr 150 are to be ~.
used, so that the screw can slide freely along the wire. Thus, for example, for a guide wire having a diameter of 0.035", axial bore 125 should have a diameter of about 0.045'l. In any event, the diameter o~ axial bore 125 is always less than or equal to the diameter of counterbore 126.
Thus, in every detaill except for the provision of axial bore 125 and the resultant blunt tip ~23, screw 120 is identical to screw 20. t Referring to Fig. 12, driver 1~0 comprises a :-ha~dle 152, an elongate shaft 154 attached to the handle, an intermediate portion ~56 attached to the ~ont en~ of the el~ngate shaft, and a front portion ,-166 attached to the front end of the in~ermediate portion. An axial bore 1~0 extends through the entire length of front portion 166. Elements 152-156, 166 and 180 are identical in length, diameter and cross-sectional configuration to corresponding I .:
elements 52-56, 66 and B0 of driver 50. ! ~-Drlver 150 differs from driver 50 only in tha~ ~he ~' f~rm~r comprises a c~ntral axial bore lB5 extending through the entire length o~ driver 150. Thus, central bore 185 ex~ends through handle 152, shaft 154, intermediate porti~n 156 and front portion 16 Although axial bore 180~can be regarded às a ~.
.
WO90~8S10 PCT/US9~/00651 i. ... .
~"~ y~ -20-.~ :
counterbore with respect to axial bore 185, in most cases central ~ore 18~ and axial bore 180 will be coextensive inasmuch as the diameter of central bore 1~5 is preferably identical to the diameter of axial bore 180. The diameters of axial bore 1~0 and central bore 185 are, of course, somewhat greater than the diameter of the guide wire with which screw 120 and driver 150 are to be used.
Thus, in every detail, except for the provision of central bore 185, driver 150 is identical to driver 180.
Referring now to Figs. 10-13, screw 120 and driver 150 axe used in substantially the same:manner as screw 20 and driver 50 of the first embodiment, the only difference being screw 120 and driver:150 are delivered to the implantation site using a guide wire system. Thus, prior to inserting screw 120 using dri~er lS0, a long thin guide wire 200 i5 inserted into th~ material 300, e.~., tiSsuQ such as bone, l~gament, or tendon, into which screw 120 is to be implanted. Thus, referring to Fig. 10, if screw 120 i5 to be implanted in gap 106 between~:bone plug 100 and the wall ~f hole:102, then guide wire ~00 is inserted into~the bone~at the bottom of gap 106. If screw 120 is to be inserted into the material 300 ~
surxounding a pil'ot hole~400 formed in material 300, as il~lustrated in Fig. 13, then guide wir~ 200 is ~ ~ t~
nsertèd into pilot hole 400 so that it~penetrates ~`
into~the material a~ the base of the pilot:hole and is -substantially coaxial with~respect~to the pilot hole.
;Guide wire 200 has~a diameter of~approximately , ~ , W~gOJ08~10 PCT/US9~/0065~
~.
3 .
0.035 inches and its leading tip 202 preferably :
penetrates tissue 300 to a depth of at least 0.75 inches. It is to be appreciated that the guide wire's leading tip 202 is substantially pointed so that it can more easily penetrate through into material 300. :~
Guide wire 20Q may be implanted simply by pushing it into the tissue, or it may be mounted in a drilling device (not shown) t~ facilitate entry~
In the event the ~uide wire 200 is inkended to be simply pushed into material 300, a supporting cannula ~ -of the sort well known in the art (not shown) may be concentrically mounted around at least a portion of -~
the guid~ wire during insertion;so as to help maintain the linear shape o~ the guide wire during penetration.
If such a supporting cannula i~ used, it is removed ~rom around the guide wire as soon as th~ guide wire ha~ been properly positioned as shown in Fig. 13.
~lternatively, in the event guide wire 200 is intended to be drilled into material 300, the guide wire's l~ading tip 202 may also include a helical drilling thread (not shown~ to facilitat~ penetration. If a -drilling device is used to deploy guide wire 200, the drilling device is de~ached from the guide wire as soon as the guide wire has been properly positioned in the manner shown in Fig. 13~
eerence shou1d be made to Fig~ 13 in c:o~nectiorl with the following descrip~ion of-~he f manner in whic:h sc:rew 12 0 and driver 1~0 are used with , ~uide wire ~00. First, driver 150 i5 urged toward scraw 120 so that driver ~ront portion 766 en~ers cou~terbore 128 of screw 120. DriYe~ 150 is urged ~' ~
'.
W090/08S10 PCT/~S~0/006~1 .,~``'` ~ ^~ ;
toward screw 120 until the driver's intermediate .
portion 156 reaches the mouth oP counterbore 128. At this juncture, driver 150 i5 rotated so that the flat ~aces o~ intermediate portion 156 line up with the corresponding respective flat faces o~ counterbore 128 -~of screw 120. Th~reafter; driver 150 is urged toward screw 120 causing interme~iate portion 156 of driver 150 to enter screw counterbore 12~ and driver front portion 166 to enter screw counterbore 126. As di~cussed above with respect to driver 50, when front portion 166 is inserted into counterbore 1:26, front portion 16~ is radially compressed slightly so that ~;
the ~ront portion 166 engages the wall of the counterbore 126 with a minor spring:interference fit.
When front portion 166 of driver 150 is inserted in screw 120 in this manner, by rotating driver 150, :typically via handle 15~, rotational drive is transmitted from driver I50 to the screw as a result of :
the positive rotational engagement beb~ween intermediate portion 156 of driver 150 and~the wall o~
counterbore 128 of screw 1200 Additionally, screw 120 and driver 150 are releasably coupl~d in an~axial :~
sènse as ~ result of the minor spring inter~erence ~:::~ `~ :
~etWeen ~river fron~ p~rtion 166 and the wall of :
coun~erbore 126 of screw 12~
Nex~, screw i20~and driver 150 are l~oaded ::
oncentrically~onto~guide wire~200, with the ~crew9~
ront~tip 123:leading., s:o that the guide wixe passes ~ ?
through~the screw/s~axial bore 125 and~the driver's cen~àl b~re 185. ~Screw 12~0 is then deIivered to p:~lot h~le ~00 l:y mov:ing th~: c:oupl:~d~:æcrew and driYer ~ ~ ;
WO90/08S10 PCT/US9~/006 -2~,- , combination down guide wire 200 until tip 123 of screw 120 çontacts th~ portion~ o~ material 300 surrounding the opening of the pilot hole, as illustrated in Fig.
13. Driver 150 is ~hen rotated, which in turn causes screw 120 to rotate, whereby the screw thread on the exterior of screw 1~0 engages material 300 and pulls the screw into the material. Driver 150 is rotated until the screw is eith~r partially or fully implanted in material 300, as desired. Driver 150 is then separated from screw 120 by pulling the driver away from the screw with a force sufficient to overcome the minor spring interference between driver front portion 166 and screw counterbore 126. After removing dri~er 150 f~om guide wire 200, the latter is withdrawn from pilot hole 400 le~ving screw 120 firmly implanted in material 300. This compl~tes the screw implantation .:
procedure usiny t~e screw and driver combination of the alternativ~ embodiment.
Referring to Fi~. 10, a similar implantation procedure is followed when æcrew l~O~is to be implanted into gap 106 between bone plug lO0 and the wall of hole 102 in bone 104~ the only differencP
being guide wire 200 i~ positioned in gap~106 instead o~:in pilot hole 400. ~ :
SEC'OND ~ sTgRNA I!`t7E EMBOt:)IME~
Under certain circumstances it may ba desirable to ~i ~: f~rc~ elon~a~e ~sections:`:84a-84c or 84a~84d, as~:the case may be; o~ front~portion 66~adially outwardly.
~ To achieve this function~,~a second~alternati~e : : :e~bodiment of th~ pr~sent~invention is:provided :: , :
W~90/08510 PCT/US9~/~0651 ~ ;
.... ~ "
..
--24-- `
consistin~ of drivi~r 250 illustrated in Figs. 14-16.
Driver 250 com~ris~s a handle 2~2`, an elongate shaft 254, an intermediate portion 256, and a front portion 266. The latter comprises a central portion 268, a tip portion 270, and terminates at ~ront end 274.
Three or four slots 282 are provided extending along the length of front portion 266 and coupling the exterior surface of ~ront portion ~66 with axial bore 280 which runs the entire length of ~ront portion 266.
Elements 2S2, 254, 256, 266, ~68, 270, 274, 280, and 282 are identical in siæe, configuration and number~
as the case may be, respectively, to elements 52,:54, 56, 6~6,~ 68, 70, 74, 80, and 82 of driver 50 il`lust~ated in Figs. 3-9 and described above.
: Driver ~50 dif~ers from driver 50 in several :
respects. First, axial bore 280 is extended ` ~ :
rearwardly through intermediate portion 266,~shaft 254 ~: and into at least the front portion;o~ handle;2520 ` : Second,:an:elonga~e shaft 293 is disposed in axial bore:28~0. ;The outside diameter of sha~t~293 is~
selectéd so that:th~e latter slides frèely inside axial bore~280.~ Sha~t::293 termlnates in a blun~ end 294.
: Third:, the front;end:of:axial bore:~280 tapers:;
radially inwardly adjacent~ront~end 274 as indicated : a~ 295.
F~urth~, à transverse~lot 296 is~provided in handle 252~couplin~ axial~ bore 280 with the outside sur~ace~of:~hè~:handl~
Fl~th,:a l~er:~297::~is~pivo~ally;mounted~in slot 2g6~Q~:~as~bè::tio~rotatabl~about~an axis~extending~
per~è~d:icular~to~:th~long~axis~of~shaft~254.~ one end ;~
WO90/08510 PCT~US90/00651 ~ .
; 5 ~
. .
, of lever 2g7 is flexibly attached to the rear end of sh~ft 293 and the other end of the lever projects out of slot 2g6 away from the exterior surface of handle ~.
252. Lever 297 is mounted and attached in this fashion so that by moving the protruding portion of lever 297 l:oward front portion 266, shaft 293 is c~used to move rearwardly in axial bore 280 away ~rom front end 274 o~ front portion 266. Similarly, ~y moving the protruding portion of lever 297 away from front portion 266, shaft 293 is caused to mo~e forwardly in axial bore 280:toward front end 274.
Shaft 293 is sixed so that when the protruding~portion of lever 297 is mo~ed rearward of the vertical~
position, as seen in Fig~` I5, blunt end 2~4 of shaft 293 will cont~c~ the radially-inwardl~y tapering portion 295 of: axial bore: 280. Further:rearward mov~ment of lever 2~7 caus~s blunt end 294 to move forward relative to tapering portion 295, whereby the ;~ blunt end coacts with the tapering~portion`in cam-like fashion causing~front portion 2~6 to~expand r~dially.
Shaf~ 293 is also sized so that when lever 297 is ~ `
moved forward of the~vertical position, as seen in ~ig 15t blunt end 2g4~ o~ shaft 293 will not contact ` t ., tapèring portion 295.~
These di~erences~between driver 2~50 and driv~r $0 exist for both ~he ~our~slo~ v~rsion (Fig. 14) and the ~ `
three sil:ot ver~,ion ~ ig~. 16:) of ~ront portion 266. . t;-J' Optional~y,~axial~bore ~0:may be~xtended~ to the rear~end o~`~handle 252~and::a ~ore~may b~ provided in ;shaft 293 so ~hat dr;iver ~50~can~be~used~with ~ guid~
wire:200 o~ the~ype:~described above~ and~illustrated ~ .
WO90/08510 . PCT/US90/00651 `~
!`
-26- , ~ r~
in Fig. 13.
Driver 250'is adapted for use with screw ~O
described above, and functions in a similar manner to :
driver 50. The only difference in operation between driver 250 and:driver 50 is that the ~or~er, after being rotationally and axially:coupled to screw:20, is ~'`
actuated to cause front portion 2~6 to expand radially and thereby securely axially couple the front portion ;~ ,, with the wall of bore 2~ o~ screw~20. This'actuation is effected by moving tha protruding portion of lever ; .. :
297 rearwardly so as to cause blunt end~29~ of sha~t 29~ to~muve forwardly and coact in cam-like fashion with;tap;ering portion,295~ This aoaction causes front portion~266 to :expand radially~
An:important advantage of the ~screw and driver combination~of the~:~present-~invention~is th~at front: ;: :~
: : portion 66~(166,~2~66)~ is~de6igned~to~engage bore 26(~126)~
of screw 2~0(120) with~both;:~an~interference a~s well as a~
spring'~it. ~This mode~o~engageme~t is advantageous in that~it~provides~ a s~ecùre~axial coùplin~:between s~rew and~driver~and~ye~permits~the:driver~to:be withdrawn from~the~,screw withoùt~the~neéd`;~to:~apply an una~ceptably-~large~axial,;~f;orce:to the::~drivcr.
Addit~io~nally,~by~sizing~the~front~portion 66(166, 2~6) :~
and~bore ~26(126)~ so~that~they~engage~one anoth:er~with, an~ln~irf~rence':~fi~ 'the:'ilim1tations associated~:with~a :~
solely~spring-biased engagemen~ e.g.~ loss of,~
res`il~iency'~ th use',~ e oid e~ irst~àlter~at:lve~embodiment o~the present :
invention~hich is~desig~èd r~use~w a~guide wire s~stem:is a~an~ag~ous'~ln that it ~facilita~is:quick WO90/~851~ PCr/US90/00~51 ~ `: 2 i ~ 7~
-27~
and easy axial alignment of the screw with the pilot hol. This ease o~ alignment i-~ especially impor~ant where the screw is to be inserted in a pilot hole which is relatively inaccessible, e.g. a pilot hole located deep in a arthroscopy site.
The second alternative embodiment of the present in~ention is advantageous in that axially coupling between ~crew and driver is achieved by interference fit, spring bias and positive mechanical locking. By -designing ths driver 250 to include these three means for axially coupling the screw thereto,~ the material ;, characteristic~ for driver ~50 become less critical inasmuch as the spring memory characteristics of the material are less important.
Since certain changes may be made in the above-described screw and~driver without departing from the scope of the invention hersin involved, it is intended th~t all matter con~ained in the above descripti~n or shown~in the~accompanying drawings shall be interpreted in an illustrative and not in a limiting sense~
.
?
: - : : ?`
For instance, known screw and drivex assemblies when designed to provide sufficient axially locking engagement can be difficult to operate, inasmuch as the driver must be inserted with an un~cceptably large axial ~orce to overcome the frictional interference between screw and driver. With some screw and driver combinations, the rotational enyagement between the screw and driver is not sufficiently positive, i.e., there often is an unacceptably large ~mount o~ play between the screw and driver. Other screw and driver combinations (1) tend to be relatively expensive to produce due to the relatively compIex shapes of the screw and driver and (~) can permit ~ome axial wobble between screw and drivert i.eO, the:combination is not designed to ensure the driver is always perfectly co-axially aligned with the screw.
ARY OF THE INVENTION
An object of the present invention is to provide a screw and driver co~ ination dasign~d la) to provide positiY~ rotational engagement between screw and ~ ;
driv~r, (b) to parmit ~he driver to be securely atta~hable to the screw so that the driver is restrained ~rom moving axially relati~e to the screw ~ i while at the same time permitting ~he driver to be ,~
relative~y easily attachable to and~de~chable from th~ screw, and (c)~ to ensurs ~he screw and driver when engag~d remain co-axially aligned with~one another.
:
.: ' WO90J08510 2~ ~s ~ PCT/~S90/00651 r; j i' -3- 1 .
:
~.;
Another object of the present invention is to provide a screw and driver combination achieving the foregoin~ objects which is adapted for use with a ~:
"K-wire" or other guide wire insertion system.
These and other objects are achieved by a screw and driver combination comprising a screw and a driver designed to rotatably drive the screw. The latter is preferably, although not necessarily, threaded along its entire length, comprises an axial bore of circular cross section which is open to the top~end of the screw and a counterbore of polygonal, preferably hexagonal, cross-section which is also open to the top end of the screw.
The driver comprises an elongate shaft ~erminating in a radially-compressible cylindrical front portion.
The latter is sized and configured s~ ~ha~ when the front portion is inserted through the~counterbore into .
the axial bore of the screwr:the front~portion will : ;
;compress radially. When the front~portion is fully i.nserted, it snugly engages the wall of the axial bore with a minor spring-biased~in~erference, whereby the ~ ;
driv~r is re~easably~coupled in an~axial sense, to the scr~iw.
:The driver also comprises an elongate intermediate~
portion having a polygonal, pref~rably~hexagonal,~
crvss-section with the cross-sectional configuration and dimension:of the intermediate~;portion being:
subs~antially equal ~o the cross-s~e~tional :
con~iguration and dimension:o~ ~he:~counter~ore of the ;.
screw. The inter~ediate por~ion is attached to the ~ ~ .
rear~end of`the front portion and the front end of ~he ~:
WOg~/08~10 PCT/US90/00~5~
, ~
c~ `j 9 -4~
1, '.'~ .
shaft, Thus, when the front portion is inserted in the axial bore of the screw and the intermediate ,`
portion is inserted in the counterbore, by rotating the shaft rotational drive is transmitted, via the engagement of the intermediate portion and the counterbore, to the screw.
.
BRIEF DESCRIPTIC)N OF THE DRAWINGS
For a fuller understanding of the nature and objects of the preæent invention, reference should be made to the following detailed description which is to be considered together~with the accompanying drawing~
Fig, 1 is a sid~ elevation view, partially broken away, of the screw o~ the present invention;
Fig. 2 is an end view of the screw taken alony line 2-2 in Fig. 1; .
Fig. 3 is a side elevation of the~dri~er of the pre~sent invention;
~ ig. 4 is an enlarged view of the ~ront portion of the driver illustrated in Fig. 3;
Fig. 5 is an enlarged cross-sectional view:taken ..
alon~ line 5-5 in Fig. 4;~
Fig~ 6 is a cro~s-sectional view of the driver taken along line 6-6 in Fig. 5, Fig! 7 is an~enI~arged side elevation view nf an . .
alternativa version~of the front portion~of~the drit~er;
Fig~ 8 is an enlarged cross-sécti~onal view o~ the:~ro~t por~ion illustrated~in~Fig. 7 taken along line 8~8 in Fig~ 7; ~
:
:
W~90/08510 PCT/US90/00651 2 r f r~
-5- ~
~ .
-., .
Fig. 9 is a cross~sectional view of the front portion illustrated in Fig. 8 taken along line 9-9 in Fig. 8;
Fig 10 is a plan view showing the screw of the present invention inserted into a gap between a bone plug and the wall of the hole in the bone in which th~
bone plug is inserted;
Fig. 11 is a side elevation, partially broken away, of the screw of the f irst alternative embodiment of the present invention;
Fig. 12 i~ a side elevatlon of the driver of the first alternative embodiment of the present invention;
Flg. 13 is a schematic side elevation view showing th~ screw and drivex of the first alternative embodiment, the material in which ~he screw of the first alternative embodiment is to be implanted, and the guide wire used with the screw and driver of the first alternative embodiment;
Fig. 14 is a side elevation, taken in cross seation, of the front portion o~ one version of the driver of the second alternative embodime~t;
Fig.~ 15 is a side elevation of~he driver o~ the second alternative embodiment; and Fig. 16 is a ~ide elevation, taken in cross s~ction, of the front portion of anoth r ~ersion of th~drlver of the second alternative embodiment..
:In:tha drawing~., lik~ referen~e numerals refer to : ~.
ike~parts.
~ ~ .
~ eferring to Fiqs.~ 3,~the present inve~tion is a :
.
WO90/~510 P~TJUS90/00~51 ~:
!'~,'`' ' screw and driver oombination consisting o~ screw 20 and driver 50.
Screw 20 comprises an elongate shaft having a flat back end 22 and a pointed front end 24. Screw 20 is preferably cylindrical along the majority of its length, with the front portion of the screw tapering down to pointed front end 24. Thus, screw 20 preferably does not comprise a distinct head having a diameter which is greater than the diameter of the ~haft of the screw. Alternatively, where the application so requires, a head (not shown) may be attached to back end 22.
Screw 20 is threaded along the entire length of its outside surface. The`specific thread pitch will, of course, vary with application and screw size, although for a screw designed ~or use i~ arthroscopic or other cIo~ed surgeries and having a length of about one~inch (l") a thread pitch of about O.llO
inches/thread is satis~actory.
Screw 20 comprises a blind axial bore 26 which is open to back end 22.: Axial bore 26 has a ciraular :~
cross-section, wi~h:the diameter o~ the axial bore pre~erably being equal to roughly one-third the outside diameter ~f screw 20. The length of axial bore 7 ' '' ~6 is preferably egual to about two-thirds the:overall lengthlo~ screw~20.
Grew 20 also comprises~a blind c~unterbore 2~
which ls co-axia1~with axial ~ore 26 and i5 open to }
back end~22. Counter~ore 28~has a polygonal, , ~-pre~erably hexagonal~ cro~s-section wi~h the result that the:~sounterbor~:~comprises~a plura1ity o~ ~lat :~
WO90/08510 PCT/US9~/00651 1 ~
7 ~
-7- 1 `
.` ~. .
'~,"'`''''' ,' elongate adjoining faces 28'. Counterbore 2~ is dimensioned so that the diame~er of a circle contacting simultaneously all of the flat faces ~8' of the counterbore is at least as large as the diameter of '~
axial bore 26, and in mosk ~ases is larger than the diameter of axial bore 26. As a result of this dimensioning, a seat 30 is fo~med at~the base of counterbore 2a. The;length of counterbore 28 relative to the portion of axial bore 26 having a circular cross section may vary based on known design parameters,~ i although in an exemplary screw 20 the~portion of bore 26 having a circular cross section is~approximately one-and-a-half times as long as counter~ore~28.~A
tapered reoesses 29 is~preferably provi~ed at the mouth of counterbQre 28.
As used~hereina~fter, bore 26 shall;refer~to the portlon o~bore 2& having a~circular cross section, iOe. th~ portion o~ bore;26;~be~ween sea~t 30 and the '' ',' blind~end of~the bore,~unless~speci~ically mentioned otherwise.
Turning now to~Figs~ 3~-5, drxver 50~comprises~a ~ r handle 52~and~an elongate~shaft 54~attached to the'~
front;~end~of the handl~e.~ Where screw~20~nd driver 50 ar~ ~intended to'be~ùsed;in~closed~surgeries,~the outside~diame~er o~ shaft 54' must~be ~elected,so t,hat~
thè ~lat~er' can ~e ~reely inserted~into and removed rQm a; con~entiona~}~cannula. ~The~length~of shaft 54 wil~,~-,o~ourse;~ var~,w~ith~,~appl~ication.~
` ' The~front~end~ ~ shaft~54~tap~rs~ a~reduoed dia~eter~ nte ~ediaté~partion~56.~ ~The~latter~has~a polygona~ cross-section, the spe~ polygonal :shape~
W090/0~;10 Pcr/lJsso/
of which corresponds to the polygonal configuration of the cross-section of counterbore 2~ in the screw 20 with which the driver 50 is adapted for use. For instance, if counterbore 28 has a hexagonal cross-sectiona~ con~iguration, then intermediate poxtion 56 also has a hexagonal cross-section.
Furthermore, intermediate portion 56 is-dimensioned to be freely slidably insertable into and ~emovable from counterbore 28. At the same time~ intermediate port.ion 56 is dimensioned so that when it is inserted in counterbore 28 it positively engages the sidewall of the counter~ore so t~at rotational dr.ive can be tran~mitted from intermediate portion 56 to screw 20 with minimal lost motion.
As noted above, intermediate portion 56 has a reduced outside diameter relative to~sha*t 54.
Intermediate poxtion 5~ joins shaft:54 with a smoothly tapering radius portion 580 Preferably, although not n~c~ssarily, the polygonal cross-~ction~of in~rmediate portion 56 is carxied through tapering radius poxtion 58 and terminates at the :junction of the radius portion with shaft 54. The len~gth vf intermediata portlon 56r as measured~between the fron~ s end:60 of the intermediate~portion and:front end of radius portion 58, is roughly equàl to;the length, of couhterbore 28.;~
Driver 50 further comprises~an~elongate, radial:ly compressible ~ront portion~66~having a central portion ~$~and a radial~ly-project~ing tip portioin 70,~ Central p~rtion 68~is cylindrical in ex~erior configuratioll when not~: in ~ the t::Qmpressed `:: :
WOg~/0~510 PCT/US90/00651 ~.
~., ,r~ "~", ~
` J `. ~
_9_ .~.
;~., state, and is attached at its rear end 72 to front end 60 of intermediate portion 56 so that the axes of ' ..
elongation of front portion 66 and intermediate .
portion 56 are co-axial. The diameter of the central portion 68 is l~ss than the diameter of a circle ,:
circumscribin~ intermediate portion 56, with the result that a shoulder 69 tFig. ~) is for~ed at the junction of the central portion and:the interme~iAte portio~. Preferably, front portion 66 is slightly, e.g. 0.05", shorter than bore 2fi. , .`' Tip portion 70 is co-axial and integral with central portion 68, and is positioned~adjacent front : ;.
end~74 o~ front portion 66. Tip portio~ 70 has a generally cylindrical exterior configuration, with the :
outside diameter o~ the:tip portion~being slightly .', greater than (i.e.~ o.noos - O.OOlS inches) the diame~er o~:axial bore ~ in screw~20~wh:en the tip portion is not ln the compressed sta:te.~ Tip portion 70 tapers radially inwardly (a)~at~its front :end~to intersect front~;en~'74~ and (b)~at'its rear:end to:intersect '~
cen~ral: pcrtion 68.
"
Front portion 66~further~comprises an axial~ bore ~0 which~xtands:along~the entire:length of th~ront ~ port~ion.~The inside diameter ~f~axial bore 80 is ,~' : roughly half the outside diameter o central port~on Front portion~66~al~s~in~1udes three slots 82 : ':~
xte~ding~along`the~length~o~;;the~front~portion~and:~
ing~axia~l bore~8~o~wit~h~i ou~side~surfa~e o~ the nt~portion~ :Ea¢h~slot~8~2;~;ls a~ularIy space~about :~
the~circumference~'ot front~end:~74~so ~s to~be spaSed WOgO/08510 PCT/US90/006~
, ~, ,-. . .
7 ~ 7~ 0-120 from the two adjacent slots, whereby front portion 66 is divided into three equally-sized elongate segments 84a, 84b and 84c.
. Preferably, although not necessarily, as best seen in Fig. 6, the length of the radially-outermost portion of each slot 82 is about equal to the length of axial bore 80, while the length of the radially-innermost por~ion of each slot 8~ is about equal to two-thirds the length of axial bore 80. The wall of front portion 66 in which slots 82 are provided tapers along a gradual radius be~ween the radially~innermost and radially-outermost portions of the~ slots, as illustrated at 85 in Fig.~ 6.
Alternatively, the radially-innermost and radially-~utermost portions of each slot 82 may be the same length or may be related in length by a ralationship of other than two-thirds to one. The width of slots 82~ is approximately equal to one quarter the diameter :of axial bore 80.
As described in greater detail hereina~ter, axial bore 8p and slo~s 82 are provided:to allow front portion 66 to be compressed radially inwardly. When a radia1ly compressive~force~is applied to front portion 66, segments 84a, 84b and 84c will move toward one 7 another. The diam~ter! of axial bore ~O,~jthe o;utside diameter of tip portion 70 when in~the uncompressed state, and the:width and~number o~slots::8~i are selected:~so:~hat tip.por~io~ 70:wil1 snugly engage the wall;~o~ axial~bore 2~6~with a~minor:spring interference ~ ~ :
it~when~insert~d~i~ bore 26. In this:compre~sed state,:the front ends of.se~ments:84a~, 84b and 84c are WOgO/0851~ PCT/US90/0~651 ~ ~ 2 ~ 3~
3:
driven toward one another so that the width of the fror~t ends of slots 82 is reduced somewhat.
Front portion 66 is made from a materiaI which can .
readily accommodate, without fatigue;o:r shear, ~epeated compression and release of segments 84a, 84b and 84c. This material is also sufficiently:resilient and has sufficient spring memory so that when segments 84a, 84b and 8:4c are radially compressed,~the segments attain a radially-outwardly acting spring bias.~
Suitable materials having these properties include I ::.
stainless steel and titanium. ~ ::
Re~erring now to~Fi~s. 7-s,:in~an alternative embodiment of front portion 66j four slots 82 are ~ ~
provided in the front portion. ~ach of:the slots 82 ~ r' :is s`paced~Q from adjacent:~slots, a~s:~measured around ~ .` the~ciraumference of front end 74. ~ As such, front portion:66 is divided:into four equally-sized, ; ~ , ,j qlongate ~segments 84a,~84b~,:8~c and 8;4d, and each~slot ~82:~is::~diametri~all~ opposite a:twin~slot 82.~ Th~
radial~ly~innermost~as~well~-as~the radially:outermost .
portions: of slots 8~2~of~`the~alternative embodiment:o~
front~portion 66 extend substantially the entire Iength ~f~:~ront~p0rtiOn~;6~6~unl~ike the~510ts of~ he ;~
mb~diment illustrated:in~Figs.:4~-6`~(where the ` : :~
radially-outermost:.portion o~ the~sIot~is :: ~
prefe~ably l:onger than th~ radially-innermost`portion : ::
o~ the~s}ot,~as~;indica~ed.~at`~5~in~Fi~ 6). ~
Fr~ p~rtion~66~comp~ises-a~air of~transverse borès~9o~and~92~éxté~di`ng;~èn*irely~through the~
hickness~of~:cen~ral~portion:~;~6~ .Bc~re 90;~and~:92 extend n~mally~to~the~long axis:of:~ront~portion 66, WO90/085tO PCT~US90/006 intersect the axial bore 80 at the inner end thereof and are perpendicularly aligned with respe~t ~o one another. Bore 90 is positioned so that its long axis extends through one of the pairs of diametrically opposed slots 82, and bore 92 is positioned so that its long axis extends through the other of the pairs of diametrically opposed slots 82~: T~e diameters of bore 90 and 9? are identical and are somewhat greater than the width of slots 82. Bores~90 and 92 are provided to prevent the formation of stress fractures ~.
at the base o~ slots 82 which might reduce the resiliency and spring memory of elongate portions 8~a, 84b, ~4c,~and 84d.
The outside diameter of tip portion 7 0 of the four-slot version o~ front portion 66:is about 0.002-0.00~: inches, preferably 0.003 inches, greater than the inside diameter of bore 26 of screw 20. Thus, the outside diamater o~ tip portion 70 of the four-slot version of front portion:~66 is slightly greater than ~th~ outside diameter o~ the tip portion 70 of the thr~e-slot version of fxont portion~:66. Tip portion ~ ;
of the four-slot version of front portion 66 has his slightly larger diameter~because the provision of our~slots 82, as:opposèd to:three::slots 82, permits the four slot ve~sion~of front portion 66 to be~more ea:sily~radially~compressed. As such, to achieve the desired minor spring interference~fit between front : ' 1.
:portion 66;and counterbora~26, the outside~diameter of tip~portion 70~of~:the~;four ~lot~version~of front ; ;
portion 66 ~is slightly enlarged. ~
WO~0/0~510 PCT/US90/00651 . ` " ' ' `' I ,.
-13~
i' .' EXAMPLE
An ~emplary screw and driver combination of the .:
present invention, designed for use in arthroscopic or other closed surgeries, possesses the foll~wing ~pecific dimensions: :
Scréw 20 . _ _ overall length: l.18"
outside diameter (measured at radially outermos~
portion of threads): 0.276"
angle of pointed front portion: 30 with respect 1 :
to longitudinal axis (included angle of 60) diameter of axial bore 26: '~Q.094S"
polygonal configuration of counterbore:
~hexagonal,: with di~metric distance between para}lel~opposing faoes equal to 110.0945 thread pitch:~ .llO:inches/thread length of counterbore 2~: 0.20' length of axial bore 26: 0,4511 :
Drlver 50 overall length: 9.25"
length o~ shaft 54: 4.00" ~
diam~eter of shaft 54: .l87" :~ ;
ength o~ intermediate:portion::56~(excluding ~ .
radius por~ion ~8): 0.20'~
pbl~gonal configùration of intermediàte portion 56: hexagonal,~with diametric distancP between ~ .
any two~pa~alIel~opposing faces~equa} to: O.Og28 : 5 ngth of~ront portion:~6:6: O.:~o"
length of cen~ral:portion~8: 0~40"
diameter-of cen~ral portian ~:(in un~ompressed ~ .
~, , WO90/08510 PCT/US90/00651 ~
2 ~ l4 state): 0.088"
diamet~r of tip portion (in uncompressed state):
0.0955"
length of slots 82 radially innermbst edge: 0.l20"
radially outermost edge: 0.200"
width o~ slots 82: O.OlO1' number of slots 82: 3 The above-listed dimensions are onIy exemplary, and may, of course, be varied depending upon the `~
desired application of the pres~nt screw and:driver com~ination.
:
OPER~T~
Referring to Figs. l-lO, the screw and driver ~ `~
c~mbination of the present invention may be a~5factQrily used, for example, in a surgical context :to secure a bone plug lO0 (Fig. lO) in a hole 102 drilled:in a bone 104. As is:well known,~the diametar o~ hole 102 is selected so that the co~ners of bone plug lOO will contact:the wall of hole lO2. Typically, : :
a tendon~(not shown) or other tissue is attached~to bone plug lOO before it~is inserted~:in hole 102.
~ter the bone plug lOO has been inserted i~nto hole ~
lO~,. driver SO is manipulated relative to screw 20 so : :
that front portion 66 passes through~counterbore:28 into axia~:bore:26:o~scr~ew 20. Because ~h~ diameter of tip po~tion 70 in~the~uncompresscd~state is~slightly gr~ater than:the diame~er::of axial bore 26:of screw:20, ~ :
frcnt~:partion 66 must~bé~radially compressed somewhat ~;
:
W~90/08510 P~T/US90/00651 ;
-15- 1 :
,;
.
so t.hat the tip portion can be slidingly inserted into bore 26. To this end, tip portion 70 is provided with an inwar,dly tapering front end which coacts in cam-like fashion with either (a~ tapering recess 29 at.the mouth of counterbore 28 when bore 26 and counterbore 28 have similar inside diameters or (b) the mouth of bore 26 (adjacent seat 30) when the inside diameter of bore 26 is greater than the inside diameter of bore 26. Thus, when front portion 66 is urged into bore 26 this cam-like coaction forces segments 84a, 84b and 84c or, 84a-84d in the case of the alternative embodiment illustrated ln Figs. 7-9, ra~ially inwardly. This radially inward compressio~ of front portion 66 ~.
penmits the latter to be inserted through counterbore 28 and into axial bore 26 with a sliding ~it. Because front portion 66 is campres`sed slightly~when received in axial bore 26, tip portion 7~ engages the axial bore with a minor spring interference fit.
When front portion 66 i~ fully inserted in axial bore 26 in screw 20, and the length of the straight, non-tapering section o~ intermediate portion ~6 is greater than or equal to the length of counterbore 28 in screw 20, driver shoulder 69 will engage screw seat `
30. When the length of :the straight, non-tapering section of intermediate portion 5~ is less than the length l of counterbore 28 j bac:k ` end 22 of screw 20 adj acent recess 2~ :will engage radially tapering .. -portion SB of intermediate portion~56 when fro~t portion 66 is:fulIy inserted in axial bore 26. In ).
either~ case, this engagement provides feedback tc, the u~e~ :as to when the~ fron~ portion is fully inser~ed.
.
:
. .
WO90/08~10 PCT/US90/00651 7 ~
During the insertion of front portion 66, shaft 54 must be rotated so that ~he ~lat faces of intermediate piortion 56 are parallel to respective flat faces of counterbore 28 in screw 20. The oross-sectional dimensions of intermediate portion 56 are slightly less than the cross-sectional dimensions o~ screw counterbore 28 so the intermediate portion oa~ be inserted into the counterbore with an easy sliding fit. The dimensions of intermediate portion 56 relative to the dimensions of counterbore 28 are also selected so that rotational drive can be transmitted from driver 50 to screw 20 with minimal loss of energy.
The pointed ~ront end of screw 20 is then inserted into one of the gaps 106 (Fig. 10) between ~one plug lO0 and the wall of hole 102. Because screw 20 is coupled with driver 50 as a result of th~ minor spring interference fit between tip 70 and axial bore 26, the scr~w may be directed to the opening of the gap 10 solely by appropriate manipulation of driver 50.
Whe~re screw 20 is being used in a closed surgery, the screw and driver sha~t 54:may~be inserted as a unit into an appropriately-positioned cannula, with the ~driver being manipulated based on informiation pro~ided by th~ fiber optic or other viewing system used in i ~
conjun~tion wit~ the clos~d surgery until ~he pointed ~ :
~ront end of the screw is receiv~d in the opening of ' ~:
the gap 106.
Next, driver handle 52 is rotated, causing shaft -54 and intermediate portion 56 to:rotate. The latter has th~ 6ame polygonal conf iguration as and ~s :: : :
::
, ~ :
~: , . . .
2~ ; L~:
.
approximately the same size as counterbore 28 so that when intermediate portion 56 is rotated i~ trànsmits rotational drive to the wall of ~he counterbore and hence to screw 20. As screw 20 is rotated, its outer threaded surface engages bone plug 100 and the adjacent portion of bone 104 and thereby pulls the screw into the bone and bone plug. When screw 20 is fully implanted it ac~s as a wedge~forcing bone plug 100 into tight frictional engagement with ~he wall of hole 102. ~ :
After screw 20 has been fully inserted, driver 50 is separated from the screw by pulling the driver axially away from the screw. Tip portion 70 resists this axial pulling to some extent so as~to ensure the screw and driver do not lnadvertently become:separa~ed prior to completion of the implantation of the screw.
However, when a moderately forceful axial pulI is ~`
app1ied, the minor spring interference between tip ~ ~;
portion 70 and axial bore 26 is overcome and the .:
d~iver can be detached~ from the screw.
':
FIRST ~LTERNATIVE EMBODIMENT
: In arthroscopi~ and other closed surgeries, so called "K" wire or other guide wire systems are used . t`
to deliver a surgical ~asten~r to an implantatlon site. As is known, these ~ystems comprise a long wire~ , :
typically having a pointed end, which is inserted in~o ~-;
selecte~ tissue in the~surg~ical site. ~Surgical tools, ': -:
fasteners and other~devices:adapted~for use~with guide wire-systems (and hence:compris;ing~an:axial bore ex~ending entirely through~the device) are deIivered WO9~/0~S10 PCT/US90/0~651 ~.
`; - . ,.;
.
~ ~i ' ` 7 18 ,~
to the site in the tissue where the wire has heen inserted by placing the device on the wire so the latter extends thxough the axial bore of the device.
The device is then moved down the wire until it reaches the tissue.
Referring now to Figs. 11-13, screw I20 and driver 150 of the alternative embodiment o~ the present invention are virtually identical to screw 20 and driver 50 of the first embodiment of the present invention, except that axial bores are~provided extending through the entire length of both the screw 120 and driver 1i50. By providing these axial bores, screw 120 and driver lSO are adapted for use with a guide wire:s~stem o~ the type described above.
:~De~cribing screw 120 in greater detail, the latter i has a cylindrical configuration, wi:th the pointed ~ront end of the screw terminating in a~lunt tip 123.
The exterior sur~ace:is threaded,~as described above with~reference to screw 2:0. Screw 120 comprises an axial bore 125 which~extends through the èntir~ length of the~screw. :The:pointed front end of screw 120 is blunted`~as a result~o~ the passage of bore 125~
therethrough,~ with the:area of blunt;~ip;123 being equàl ~o the: area of th~::cross-sec~ion of bore 125.
5crcw 120 includes a:count~rbore~1~6 which is ;
co-axial with akial`bore~l25 and is open to rear end ~122 o~ the~ screw.~ Screw 120 further inclùd~s a aounterbo~e 1:28:which is ~al60 co-axial;~with axial bore~
125~:and is open to rear end 122:o~ the:screw. A ~ :
tapered~r~cess 129~is provided in~rear end~122 at the mouth:;of counterbore 1~8~
~, WO90/08510 PCT/US90/00651 ~
~` P
-19- . '~
. ~.
The length, diameter and cross-sectional con-figuxation of counterbores 126 and 1~ are equal to the length and diameter of bore 26 and counterbore 28, respectively, of screw 20. The diame~er of axial bore ~.
125 is somewhat greater than the diameter of the guide wire with which screw 120 and drivPr 150 are to be ~.
used, so that the screw can slide freely along the wire. Thus, for example, for a guide wire having a diameter of 0.035", axial bore 125 should have a diameter of about 0.045'l. In any event, the diameter o~ axial bore 125 is always less than or equal to the diameter of counterbore 126.
Thus, in every detaill except for the provision of axial bore 125 and the resultant blunt tip ~23, screw 120 is identical to screw 20. t Referring to Fig. 12, driver 1~0 comprises a :-ha~dle 152, an elongate shaft 154 attached to the handle, an intermediate portion ~56 attached to the ~ont en~ of the el~ngate shaft, and a front portion ,-166 attached to the front end of the in~ermediate portion. An axial bore 1~0 extends through the entire length of front portion 166. Elements 152-156, 166 and 180 are identical in length, diameter and cross-sectional configuration to corresponding I .:
elements 52-56, 66 and B0 of driver 50. ! ~-Drlver 150 differs from driver 50 only in tha~ ~he ~' f~rm~r comprises a c~ntral axial bore lB5 extending through the entire length o~ driver 150. Thus, central bore 185 ex~ends through handle 152, shaft 154, intermediate porti~n 156 and front portion 16 Although axial bore 180~can be regarded às a ~.
.
WO90~8S10 PCT/US9~/00651 i. ... .
~"~ y~ -20-.~ :
counterbore with respect to axial bore 185, in most cases central ~ore 18~ and axial bore 180 will be coextensive inasmuch as the diameter of central bore 1~5 is preferably identical to the diameter of axial bore 180. The diameters of axial bore 1~0 and central bore 185 are, of course, somewhat greater than the diameter of the guide wire with which screw 120 and driver 150 are to be used.
Thus, in every detail, except for the provision of central bore 185, driver 150 is identical to driver 180.
Referring now to Figs. 10-13, screw 120 and driver 150 axe used in substantially the same:manner as screw 20 and driver 50 of the first embodiment, the only difference being screw 120 and driver:150 are delivered to the implantation site using a guide wire system. Thus, prior to inserting screw 120 using dri~er lS0, a long thin guide wire 200 i5 inserted into th~ material 300, e.~., tiSsuQ such as bone, l~gament, or tendon, into which screw 120 is to be implanted. Thus, referring to Fig. 10, if screw 120 i5 to be implanted in gap 106 between~:bone plug 100 and the wall ~f hole:102, then guide wire ~00 is inserted into~the bone~at the bottom of gap 106. If screw 120 is to be inserted into the material 300 ~
surxounding a pil'ot hole~400 formed in material 300, as il~lustrated in Fig. 13, then guide wir~ 200 is ~ ~ t~
nsertèd into pilot hole 400 so that it~penetrates ~`
into~the material a~ the base of the pilot:hole and is -substantially coaxial with~respect~to the pilot hole.
;Guide wire 200 has~a diameter of~approximately , ~ , W~gOJ08~10 PCT/US9~/0065~
~.
3 .
0.035 inches and its leading tip 202 preferably :
penetrates tissue 300 to a depth of at least 0.75 inches. It is to be appreciated that the guide wire's leading tip 202 is substantially pointed so that it can more easily penetrate through into material 300. :~
Guide wire 20Q may be implanted simply by pushing it into the tissue, or it may be mounted in a drilling device (not shown) t~ facilitate entry~
In the event the ~uide wire 200 is inkended to be simply pushed into material 300, a supporting cannula ~ -of the sort well known in the art (not shown) may be concentrically mounted around at least a portion of -~
the guid~ wire during insertion;so as to help maintain the linear shape o~ the guide wire during penetration.
If such a supporting cannula i~ used, it is removed ~rom around the guide wire as soon as th~ guide wire ha~ been properly positioned as shown in Fig. 13.
~lternatively, in the event guide wire 200 is intended to be drilled into material 300, the guide wire's l~ading tip 202 may also include a helical drilling thread (not shown~ to facilitat~ penetration. If a -drilling device is used to deploy guide wire 200, the drilling device is de~ached from the guide wire as soon as the guide wire has been properly positioned in the manner shown in Fig. 13~
eerence shou1d be made to Fig~ 13 in c:o~nectiorl with the following descrip~ion of-~he f manner in whic:h sc:rew 12 0 and driver 1~0 are used with , ~uide wire ~00. First, driver 150 i5 urged toward scraw 120 so that driver ~ront portion 766 en~ers cou~terbore 128 of screw 120. DriYe~ 150 is urged ~' ~
'.
W090/08S10 PCT/~S~0/006~1 .,~``'` ~ ^~ ;
toward screw 120 until the driver's intermediate .
portion 156 reaches the mouth oP counterbore 128. At this juncture, driver 150 i5 rotated so that the flat ~aces o~ intermediate portion 156 line up with the corresponding respective flat faces o~ counterbore 128 -~of screw 120. Th~reafter; driver 150 is urged toward screw 120 causing interme~iate portion 156 of driver 150 to enter screw counterbore 12~ and driver front portion 166 to enter screw counterbore 126. As di~cussed above with respect to driver 50, when front portion 166 is inserted into counterbore 1:26, front portion 16~ is radially compressed slightly so that ~;
the ~ront portion 166 engages the wall of the counterbore 126 with a minor spring:interference fit.
When front portion 166 of driver 150 is inserted in screw 120 in this manner, by rotating driver 150, :typically via handle 15~, rotational drive is transmitted from driver I50 to the screw as a result of :
the positive rotational engagement beb~ween intermediate portion 156 of driver 150 and~the wall o~
counterbore 128 of screw 1200 Additionally, screw 120 and driver 150 are releasably coupl~d in an~axial :~
sènse as ~ result of the minor spring inter~erence ~:::~ `~ :
~etWeen ~river fron~ p~rtion 166 and the wall of :
coun~erbore 126 of screw 12~
Nex~, screw i20~and driver 150 are l~oaded ::
oncentrically~onto~guide wire~200, with the ~crew9~
ront~tip 123:leading., s:o that the guide wixe passes ~ ?
through~the screw/s~axial bore 125 and~the driver's cen~àl b~re 185. ~Screw 12~0 is then deIivered to p:~lot h~le ~00 l:y mov:ing th~: c:oupl:~d~:æcrew and driYer ~ ~ ;
WO90/08S10 PCT/US9~/006 -2~,- , combination down guide wire 200 until tip 123 of screw 120 çontacts th~ portion~ o~ material 300 surrounding the opening of the pilot hole, as illustrated in Fig.
13. Driver 150 is ~hen rotated, which in turn causes screw 120 to rotate, whereby the screw thread on the exterior of screw 1~0 engages material 300 and pulls the screw into the material. Driver 150 is rotated until the screw is eith~r partially or fully implanted in material 300, as desired. Driver 150 is then separated from screw 120 by pulling the driver away from the screw with a force sufficient to overcome the minor spring interference between driver front portion 166 and screw counterbore 126. After removing dri~er 150 f~om guide wire 200, the latter is withdrawn from pilot hole 400 le~ving screw 120 firmly implanted in material 300. This compl~tes the screw implantation .:
procedure usiny t~e screw and driver combination of the alternativ~ embodiment.
Referring to Fi~. 10, a similar implantation procedure is followed when æcrew l~O~is to be implanted into gap 106 between bone plug lO0 and the wall of hole 102 in bone 104~ the only differencP
being guide wire 200 i~ positioned in gap~106 instead o~:in pilot hole 400. ~ :
SEC'OND ~ sTgRNA I!`t7E EMBOt:)IME~
Under certain circumstances it may ba desirable to ~i ~: f~rc~ elon~a~e ~sections:`:84a-84c or 84a~84d, as~:the case may be; o~ front~portion 66~adially outwardly.
~ To achieve this function~,~a second~alternati~e : : :e~bodiment of th~ pr~sent~invention is:provided :: , :
W~90/08510 PCT/US9~/~0651 ~ ;
.... ~ "
..
--24-- `
consistin~ of drivi~r 250 illustrated in Figs. 14-16.
Driver 250 com~ris~s a handle 2~2`, an elongate shaft 254, an intermediate portion 256, and a front portion 266. The latter comprises a central portion 268, a tip portion 270, and terminates at ~ront end 274.
Three or four slots 282 are provided extending along the length of front portion 266 and coupling the exterior surface of ~ront portion ~66 with axial bore 280 which runs the entire length of ~ront portion 266.
Elements 2S2, 254, 256, 266, ~68, 270, 274, 280, and 282 are identical in siæe, configuration and number~
as the case may be, respectively, to elements 52,:54, 56, 6~6,~ 68, 70, 74, 80, and 82 of driver 50 il`lust~ated in Figs. 3-9 and described above.
: Driver ~50 dif~ers from driver 50 in several :
respects. First, axial bore 280 is extended ` ~ :
rearwardly through intermediate portion 266,~shaft 254 ~: and into at least the front portion;o~ handle;2520 ` : Second,:an:elonga~e shaft 293 is disposed in axial bore:28~0. ;The outside diameter of sha~t~293 is~
selectéd so that:th~e latter slides frèely inside axial bore~280.~ Sha~t::293 termlnates in a blun~ end 294.
: Third:, the front;end:of:axial bore:~280 tapers:;
radially inwardly adjacent~ront~end 274 as indicated : a~ 295.
F~urth~, à transverse~lot 296 is~provided in handle 252~couplin~ axial~ bore 280 with the outside sur~ace~of:~hè~:handl~
Fl~th,:a l~er:~297::~is~pivo~ally;mounted~in slot 2g6~Q~:~as~bè::tio~rotatabl~about~an axis~extending~
per~è~d:icular~to~:th~long~axis~of~shaft~254.~ one end ;~
WO90/08510 PCT~US90/00651 ~ .
; 5 ~
. .
, of lever 2g7 is flexibly attached to the rear end of sh~ft 293 and the other end of the lever projects out of slot 2g6 away from the exterior surface of handle ~.
252. Lever 297 is mounted and attached in this fashion so that by moving the protruding portion of lever 297 l:oward front portion 266, shaft 293 is c~used to move rearwardly in axial bore 280 away ~rom front end 274 o~ front portion 266. Similarly, ~y moving the protruding portion of lever 297 away from front portion 266, shaft 293 is caused to mo~e forwardly in axial bore 280:toward front end 274.
Shaft 293 is sixed so that when the protruding~portion of lever 297 is mo~ed rearward of the vertical~
position, as seen in Fig~` I5, blunt end 2~4 of shaft 293 will cont~c~ the radially-inwardl~y tapering portion 295 of: axial bore: 280. Further:rearward mov~ment of lever 2~7 caus~s blunt end 294 to move forward relative to tapering portion 295, whereby the ;~ blunt end coacts with the tapering~portion`in cam-like fashion causing~front portion 2~6 to~expand r~dially.
Shaf~ 293 is also sized so that when lever 297 is ~ `
moved forward of the~vertical position, as seen in ~ig 15t blunt end 2g4~ o~ shaft 293 will not contact ` t ., tapèring portion 295.~
These di~erences~between driver 2~50 and driv~r $0 exist for both ~he ~our~slo~ v~rsion (Fig. 14) and the ~ `
three sil:ot ver~,ion ~ ig~. 16:) of ~ront portion 266. . t;-J' Optional~y,~axial~bore ~0:may be~xtended~ to the rear~end o~`~handle 252~and::a ~ore~may b~ provided in ;shaft 293 so ~hat dr;iver ~50~can~be~used~with ~ guid~
wire:200 o~ the~ype:~described above~ and~illustrated ~ .
WO90/08510 . PCT/US90/00651 `~
!`
-26- , ~ r~
in Fig. 13.
Driver 250'is adapted for use with screw ~O
described above, and functions in a similar manner to :
driver 50. The only difference in operation between driver 250 and:driver 50 is that the ~or~er, after being rotationally and axially:coupled to screw:20, is ~'`
actuated to cause front portion 2~6 to expand radially and thereby securely axially couple the front portion ;~ ,, with the wall of bore 2~ o~ screw~20. This'actuation is effected by moving tha protruding portion of lever ; .. :
297 rearwardly so as to cause blunt end~29~ of sha~t 29~ to~muve forwardly and coact in cam-like fashion with;tap;ering portion,295~ This aoaction causes front portion~266 to :expand radially~
An:important advantage of the ~screw and driver combination~of the~:~present-~invention~is th~at front: ;: :~
: : portion 66~(166,~2~66)~ is~de6igned~to~engage bore 26(~126)~
of screw 2~0(120) with~both;:~an~interference a~s well as a~
spring'~it. ~This mode~o~engageme~t is advantageous in that~it~provides~ a s~ecùre~axial coùplin~:between s~rew and~driver~and~ye~permits~the:driver~to:be withdrawn from~the~,screw withoùt~the~neéd`;~to:~apply an una~ceptably-~large~axial,;~f;orce:to the::~drivcr.
Addit~io~nally,~by~sizing~the~front~portion 66(166, 2~6) :~
and~bore ~26(126)~ so~that~they~engage~one anoth:er~with, an~ln~irf~rence':~fi~ 'the:'ilim1tations associated~:with~a :~
solely~spring-biased engagemen~ e.g.~ loss of,~
res`il~iency'~ th use',~ e oid e~ irst~àlter~at:lve~embodiment o~the present :
invention~hich is~desig~èd r~use~w a~guide wire s~stem:is a~an~ag~ous'~ln that it ~facilita~is:quick WO90/~851~ PCr/US90/00~51 ~ `: 2 i ~ 7~
-27~
and easy axial alignment of the screw with the pilot hol. This ease o~ alignment i-~ especially impor~ant where the screw is to be inserted in a pilot hole which is relatively inaccessible, e.g. a pilot hole located deep in a arthroscopy site.
The second alternative embodiment of the present in~ention is advantageous in that axially coupling between ~crew and driver is achieved by interference fit, spring bias and positive mechanical locking. By -designing ths driver 250 to include these three means for axially coupling the screw thereto,~ the material ;, characteristic~ for driver ~50 become less critical inasmuch as the spring memory characteristics of the material are less important.
Since certain changes may be made in the above-described screw and~driver without departing from the scope of the invention hersin involved, it is intended th~t all matter con~ained in the above descripti~n or shown~in the~accompanying drawings shall be interpreted in an illustrative and not in a limiting sense~
.
?
: - : : ?`
Claims (19)
1. A screw and driver combination comprising:
an elongate screw including (a) first and second ends, (b) an axial bore coupled with said first end, said axial bore having a circular cross section of selected diameter, and (c) a counterbore coupled with said first end and coaxial with said axial bore, said counterbore having a selected length and a polygonal cross section of selected configuration and dimension;
and a driver including (a) an elongate shaft having a front end, (b) an elongate intermediate portion having first and second ends, said second end of said intermediate portion being attached to said front end of shaft, said intermediate portion having a polygonal cross section configured and dimensioned (i) so that said intermediate portion can be inserted into said counterbore of said screw with a sliding fit and (ii) so that when said intermediate portion is inserted in said counterbore said intermediate portion drivingly engages said counterbore so that rotational drive can be transmitted from said driver to said screw, and (c) a cylindrical front portion having a back end and a front end, said back end of said front portion being attached to said first end of said intermediate portion, said front portion comprising compression means for permitting said front portion to be compressed radially into a compressed state, the design and diameter of said cylindrical front portion being chosen (i) so that insertion of said front portion into said bore of said screw causes said front portion to be compressed into said compressed state, and (ii) so that when said front portion is inserted in said bore said front portion engages said bore with a spring interference fit, whereby said front portion cannot be removed from said bore except when a selected axial force is applied to said front portion.
an elongate screw including (a) first and second ends, (b) an axial bore coupled with said first end, said axial bore having a circular cross section of selected diameter, and (c) a counterbore coupled with said first end and coaxial with said axial bore, said counterbore having a selected length and a polygonal cross section of selected configuration and dimension;
and a driver including (a) an elongate shaft having a front end, (b) an elongate intermediate portion having first and second ends, said second end of said intermediate portion being attached to said front end of shaft, said intermediate portion having a polygonal cross section configured and dimensioned (i) so that said intermediate portion can be inserted into said counterbore of said screw with a sliding fit and (ii) so that when said intermediate portion is inserted in said counterbore said intermediate portion drivingly engages said counterbore so that rotational drive can be transmitted from said driver to said screw, and (c) a cylindrical front portion having a back end and a front end, said back end of said front portion being attached to said first end of said intermediate portion, said front portion comprising compression means for permitting said front portion to be compressed radially into a compressed state, the design and diameter of said cylindrical front portion being chosen (i) so that insertion of said front portion into said bore of said screw causes said front portion to be compressed into said compressed state, and (ii) so that when said front portion is inserted in said bore said front portion engages said bore with a spring interference fit, whereby said front portion cannot be removed from said bore except when a selected axial force is applied to said front portion.
2. A combination according to claim 1 wherein said compression means comprises:
an axial bore in said front portion coupled with said front end of said front portion and extending substantially the entire length of said front portion;
and a plurality of axially-extending slots in said front portion coupling said axial bore of said front portion with the exterior surface of said front portion.
an axial bore in said front portion coupled with said front end of said front portion and extending substantially the entire length of said front portion;
and a plurality of axially-extending slots in said front portion coupling said axial bore of said front portion with the exterior surface of said front portion.
3. A combination according to claim 2 wherein:
said plurality of slots comprises three slots.
said plurality of slots comprises three slots.
4. A combination according to claim 2 wherein said plurality of slots comprises four slots.
5. A combination according to claim 1 wherein the length of said intermediate portion is greater than the length of said counterbore and the length of said front portion is less than the length of said axial bore minus the length of said counterbore.
6. A combination according to claim 1 wherein said intermediate portion is attached to said shaft and said front portion is attached to said intermediate portion so that the axes of elongation of said shaft, said intermediate portion and said front portion are coaxial.
7. A combination according to claim 1 wherein said second end of said screw is pointed.
8. A combination according to claim 1 wherein said cylindrical front portion comprises a central portion and a tip portion, the outside diameter of said tip portion being slightly greater than the inside diameter of the portion of said axial bore of said screw having a circular cross section when said front portion is not in said compressed state, and the outside diameter of said central portion being less than the outside diameter of said tip portion.
9. A combination according to claim 1 wherein the outside diameter of said front portion is slightly greater than the inside diameter of the portion of said axial bore of said screw having a circular cross section when said front portion is not in said compressed state.
10. A combination according to claim 1 wherein a screw thread is disposed on the exterior surface of said screw extending along the entire length of said screw.
11. A combination according to claim 1 wherein the configuration of the cross section of said intermediate portion of said driver and said counterbore of said screw is hexagonal.
12. A combination according to claim 1 wherein said screw comprises a central bore extending through the entire length of said screw, and said driver comprises a central bore extending through the entire length of said driver.
13. A screw and driver combination designed for use with an elongate guide wire, the combination comprising:
an elongate screw including (a) first and second ends, (b) an axial bore extending through the entire length of said screw, with the diameter of said axial bore being greater than the diameter of a guide wire adapted for insertion into the material into which the screw is to be implanted, (c) a counterbore coupled with said first end and coaxial with said axial bore, said counterbore having an inner axial portion with a circular cross section of selected diameter, and an outer axial portion coupled with said first end and having a polygonal cross section of selected configuration and dimension; and a driver including (a) an elongate shaft having a front end, (b) an elongate intermediate portion having first and second ends, said second end of said intermediate portion being attached to said front end of shaft, said intermediate portion having a polygonal cross section configured and dimensioned (i) so that said intermediate portion can be inserted into said outer axial portion of said counterbore of said screw with a sliding fit and (ii) so that when said intermediate portion is inserted in said outer axial portion of said counterbore said intermediate portion drivingly engages said outer axial portion of said counterbore so that rotational drive can be transmitted from said driver to said screw, (c) a cylindrical front portion having a back end and a front end, said back end of said front portion being attached to said first end of said intermediate portion, aid front portion comprising compression means for permitting said front portion to be compressed radially into a compressed state, the design and diameter of said cylindrical front portion being chosen (i) so that insertion of said front portion into said inner axial portion of said counterbore of said screw causes said front portion to be compressed into said compressed state, and (ii) so that when said front portion is inserted in said inner axial portion of said counterbore said front portion engages said inner axial portion of said counterbore with a spring interference fit, whereby said front portion cannot be removed from said inner axial portion of said counterbore except when a selected axial force is applied to said front portion, and (d) an axial bore extending through the entire length of said drive, said axial bore having a diameter greater than the diameter of said guide wire.
an elongate screw including (a) first and second ends, (b) an axial bore extending through the entire length of said screw, with the diameter of said axial bore being greater than the diameter of a guide wire adapted for insertion into the material into which the screw is to be implanted, (c) a counterbore coupled with said first end and coaxial with said axial bore, said counterbore having an inner axial portion with a circular cross section of selected diameter, and an outer axial portion coupled with said first end and having a polygonal cross section of selected configuration and dimension; and a driver including (a) an elongate shaft having a front end, (b) an elongate intermediate portion having first and second ends, said second end of said intermediate portion being attached to said front end of shaft, said intermediate portion having a polygonal cross section configured and dimensioned (i) so that said intermediate portion can be inserted into said outer axial portion of said counterbore of said screw with a sliding fit and (ii) so that when said intermediate portion is inserted in said outer axial portion of said counterbore said intermediate portion drivingly engages said outer axial portion of said counterbore so that rotational drive can be transmitted from said driver to said screw, (c) a cylindrical front portion having a back end and a front end, said back end of said front portion being attached to said first end of said intermediate portion, aid front portion comprising compression means for permitting said front portion to be compressed radially into a compressed state, the design and diameter of said cylindrical front portion being chosen (i) so that insertion of said front portion into said inner axial portion of said counterbore of said screw causes said front portion to be compressed into said compressed state, and (ii) so that when said front portion is inserted in said inner axial portion of said counterbore said front portion engages said inner axial portion of said counterbore with a spring interference fit, whereby said front portion cannot be removed from said inner axial portion of said counterbore except when a selected axial force is applied to said front portion, and (d) an axial bore extending through the entire length of said drive, said axial bore having a diameter greater than the diameter of said guide wire.
14. A system for use in implanting a screw into selected material, the system comprising:
an elongate guide wire adapted to be inserted into selected material in which said screw is to be implanted;
an elongate screw including (a) first and second ends, (b) an axial bore extending through the entire length of said screw, with the diameter of said axial bore being greater than the diameter of said guide wire, (c) a counterbore coupled with said first end and coaxial with said axial bore, said counterbore having an inner axial portion with a circular cross section of selected diameter, and an outer axial portion coupled with said first end and having a polygonal cross section of selected configuration and dimension; and a driver including (a) an elongate shaft having a front end, (b) an elongate intermediate portion having first and second ends, said second end of said intermediate portion being attached to said front end of shaft, said intermediate portion having a polygonal cross section configured and dimensioned (i) so that said intermediate portion can be inserted into said outer axial portion of said counterbore of said screw with a sliding fit and (ii) so that when said intermediate portion is inserted in said outer axial portion of said counterbore said intermediate portion drivingly engages said outer axial portion of said counterbore so that rotational drive can be transmitted from said driver to said screw, (c) a cylindrical front portion having a back end and a front end, said back end of said front portion being attached to said first end of said intermediate portion, said front portion comprising compression means for permitting said front portion to be compressed radially into a compressed state, the design and diameter of said cylindrical front portion being chosen (i) so that insertion of said front portion into said inner axial portion of said counterbore of said screw causes said front portion to be compressed into said compressed state, and (ii) so that when said front portion is inserted in said inner axial portion of said counterbore said front portion engages said inner axial portion of said counterbore with a spring interference fit, whereby said front portion cannot be removed from said inner axial portion of said counterbore except when a selected axial force is applied to said front portion, and (d) an axial bore extending through the entire length of said driver, said axial bore having a diameter greater than the diameter of said guide wire.
an elongate guide wire adapted to be inserted into selected material in which said screw is to be implanted;
an elongate screw including (a) first and second ends, (b) an axial bore extending through the entire length of said screw, with the diameter of said axial bore being greater than the diameter of said guide wire, (c) a counterbore coupled with said first end and coaxial with said axial bore, said counterbore having an inner axial portion with a circular cross section of selected diameter, and an outer axial portion coupled with said first end and having a polygonal cross section of selected configuration and dimension; and a driver including (a) an elongate shaft having a front end, (b) an elongate intermediate portion having first and second ends, said second end of said intermediate portion being attached to said front end of shaft, said intermediate portion having a polygonal cross section configured and dimensioned (i) so that said intermediate portion can be inserted into said outer axial portion of said counterbore of said screw with a sliding fit and (ii) so that when said intermediate portion is inserted in said outer axial portion of said counterbore said intermediate portion drivingly engages said outer axial portion of said counterbore so that rotational drive can be transmitted from said driver to said screw, (c) a cylindrical front portion having a back end and a front end, said back end of said front portion being attached to said first end of said intermediate portion, said front portion comprising compression means for permitting said front portion to be compressed radially into a compressed state, the design and diameter of said cylindrical front portion being chosen (i) so that insertion of said front portion into said inner axial portion of said counterbore of said screw causes said front portion to be compressed into said compressed state, and (ii) so that when said front portion is inserted in said inner axial portion of said counterbore said front portion engages said inner axial portion of said counterbore with a spring interference fit, whereby said front portion cannot be removed from said inner axial portion of said counterbore except when a selected axial force is applied to said front portion, and (d) an axial bore extending through the entire length of said driver, said axial bore having a diameter greater than the diameter of said guide wire.
15. A screw and driver combination comprising:
an elongate screw including (a) a first end and a pointed second end, (b) an axial bore coupled with said first end, said axial bore having a circular cross section of selected diameter, and (c) a counterbore coupled with said first end and coaxial with said axial bore; said counterbore having a selected length and a hexagonal cross section of selected dimension wherein a screw thread is disposed on the exterior surface of said screw extending along the entire length of said screw; and a driver including (a) an elongate shaft having a front end, (b) an elongate intermediate portion having first and second ends, said second end of said intermediate portion being attached to said front end of said shaft so that said shaft and said intermediate portion are coaxially aligned, said intermediate portion having a hexagonal cross section configured and dimensioned (i) so that said intermediate portion can be inserted into said counterbore of said screw with a sliding fit and (ii) so that when said intermediate portion is inserted in said counterbore said intermediate portion drivingly engages said counterbore so that rotational drive can be transmitted from said driver to said screw, and (c) a cylindrical front portion having a back end and a front end, said back end of said front portion being attached to said first end of said intermediate portion so that said intermediate portion and said front portion are coaxially aligned, said front portion comprising compression means for permitting said front portion to be compressed radially into a compressed state, the design and diameter of said cylindrical front portion being chosen (i) so that insertion of said front portion into the section of said bore of said screw having a circular cross section causes said front portion to be compressed into said compressed state, and (ii) so that when said front portion is inserted in said section of said bore having a circular cross section said front portion engages said section with a spring interference fit whereby said front portion cannot be removed from said section except when a selected axial force is applied to said front portion, said compression means comprising (a) an axial bore in said front portion coupled with said front end of said front portion and extending substantially the entire length of said front portion and (b) a plurality of axially-extending slots in said front portion coupling said axial bore of said front portion with the exterior surface of said front portion, further wherein said front portion comprises a central portion and a tip portion, the outside diameter of said tip portion being slightly greater than the inside diameter of said section of said axial bore of said screw having a circular cross section when said front portion is not in said compressed state; and the outside diameter of said central portion being somewhat less than the outside diameter of said tip portion.
an elongate screw including (a) a first end and a pointed second end, (b) an axial bore coupled with said first end, said axial bore having a circular cross section of selected diameter, and (c) a counterbore coupled with said first end and coaxial with said axial bore; said counterbore having a selected length and a hexagonal cross section of selected dimension wherein a screw thread is disposed on the exterior surface of said screw extending along the entire length of said screw; and a driver including (a) an elongate shaft having a front end, (b) an elongate intermediate portion having first and second ends, said second end of said intermediate portion being attached to said front end of said shaft so that said shaft and said intermediate portion are coaxially aligned, said intermediate portion having a hexagonal cross section configured and dimensioned (i) so that said intermediate portion can be inserted into said counterbore of said screw with a sliding fit and (ii) so that when said intermediate portion is inserted in said counterbore said intermediate portion drivingly engages said counterbore so that rotational drive can be transmitted from said driver to said screw, and (c) a cylindrical front portion having a back end and a front end, said back end of said front portion being attached to said first end of said intermediate portion so that said intermediate portion and said front portion are coaxially aligned, said front portion comprising compression means for permitting said front portion to be compressed radially into a compressed state, the design and diameter of said cylindrical front portion being chosen (i) so that insertion of said front portion into the section of said bore of said screw having a circular cross section causes said front portion to be compressed into said compressed state, and (ii) so that when said front portion is inserted in said section of said bore having a circular cross section said front portion engages said section with a spring interference fit whereby said front portion cannot be removed from said section except when a selected axial force is applied to said front portion, said compression means comprising (a) an axial bore in said front portion coupled with said front end of said front portion and extending substantially the entire length of said front portion and (b) a plurality of axially-extending slots in said front portion coupling said axial bore of said front portion with the exterior surface of said front portion, further wherein said front portion comprises a central portion and a tip portion, the outside diameter of said tip portion being slightly greater than the inside diameter of said section of said axial bore of said screw having a circular cross section when said front portion is not in said compressed state; and the outside diameter of said central portion being somewhat less than the outside diameter of said tip portion.
16. A combination according to claim 1 wherein said driver further comprises:
expansion means movable between a first position and a second position for causing said front portion of said driver to expand radially when said expansion means is moved toward said second position; and actuation means coupled to said expansion means for causing said expansion means to move between said first position and said second position.
expansion means movable between a first position and a second position for causing said front portion of said driver to expand radially when said expansion means is moved toward said second position; and actuation means coupled to said expansion means for causing said expansion means to move between said first position and said second position.
17. A combination according to claim 16 wherein said actuation means comprises:
an axial bore in said driver extending through said front portion, said intermediate portion, and at least a front section of said handle, said bore being open to said front end of said front portion, said bore comprising a radially-inwardly tapering section adjacent said front end of said front portion;
a shaft disposed in said axial bore and sized to be freely slidable along the entire length of said axial bore except for within said radially-inwardly tapering section of said axial bore, said shaft having a front end, said shaft being additionally sized so that when said front end of said shaft is urged into said radially-inwardly tapering section of said axial bore said shaft coacts with said radially-inwardly tapering section in cam-like fashion so as to cause said front portion to expand radially.
an axial bore in said driver extending through said front portion, said intermediate portion, and at least a front section of said handle, said bore being open to said front end of said front portion, said bore comprising a radially-inwardly tapering section adjacent said front end of said front portion;
a shaft disposed in said axial bore and sized to be freely slidable along the entire length of said axial bore except for within said radially-inwardly tapering section of said axial bore, said shaft having a front end, said shaft being additionally sized so that when said front end of said shaft is urged into said radially-inwardly tapering section of said axial bore said shaft coacts with said radially-inwardly tapering section in cam-like fashion so as to cause said front portion to expand radially.
18. A combination according to claim 17 wherein said actuation means comprises lever means mounted adjacent said front section of said handle and coupled to said shaft for causing said shaft to move axially between a first position wherein said front end of said shaft is not disposed within said radially-inwardly tapering section of said axial bore and a second position wherein said front end of said shaft is disposed within the portion of said radially-inwardly tapering portion having the smallest inside diameter.
19. A combination according to claim 17 wherein said axial bore extends through the entire length of said handle and is open to a rear end of said handle, and said shaft comprises a central axial bore extending through the entire length of said shaft.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US30734389A | 1989-02-06 | 1989-02-06 | |
| US307,343 | 1989-02-06 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2026781A1 true CA2026781A1 (en) | 1990-08-07 |
Family
ID=23189317
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002026781A Abandoned CA2026781A1 (en) | 1989-02-06 | 1990-02-02 | Screw and driver |
Country Status (5)
| Country | Link |
|---|---|
| EP (1) | EP0411109A4 (en) |
| AU (1) | AU5166790A (en) |
| CA (1) | CA2026781A1 (en) |
| FI (1) | FI904905A0 (en) |
| WO (1) | WO1990008510A1 (en) |
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| AUPP000797A0 (en) * | 1997-10-24 | 1997-11-20 | Cryptych Pty Ltd | Fixation of cruciate ligament grafts |
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Family Cites Families (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US1410088A (en) * | 1921-03-25 | 1922-03-21 | American Telephone & Telegraph | Screw driver |
| US2593622A (en) * | 1949-02-04 | 1952-04-22 | Albert L Stanelle | Screw holding screw driver |
| US2686447A (en) * | 1953-05-11 | 1954-08-17 | Vernon L Vock | Stud extractor structure |
| US2775913A (en) * | 1955-07-20 | 1957-01-01 | Deliso John | Self-gripping tool with resilient wires for turning socket head fasteners |
| US4325153A (en) * | 1979-10-22 | 1982-04-20 | Charles Finnegan | Combined screwdriver and boring apparatus |
| SU940376A1 (en) * | 1980-06-05 | 1985-02-07 | Научно-Исследовательская Лаборатория Металлоостеосинтеза С Клиникой Им.Арнольда Сеппо | Screw driver for osteosynthesis |
| SU940375A1 (en) * | 1980-06-17 | 1985-02-07 | Таллинский Политехнический Институт | Screw driver for osteosynthesis |
| SU1097307A1 (en) * | 1983-02-24 | 1984-06-15 | Центральный научно-исследовательский институт травматологии и ортопедии им.Н.Н.Приорова | Screw driver and holder for osteosynthesis |
-
1990
- 1990-02-02 CA CA002026781A patent/CA2026781A1/en not_active Abandoned
- 1990-02-02 AU AU51667/90A patent/AU5166790A/en not_active Abandoned
- 1990-02-02 WO PCT/US1990/000651 patent/WO1990008510A1/en not_active Application Discontinuation
- 1990-02-02 EP EP19900904053 patent/EP0411109A4/en not_active Withdrawn
- 1990-10-05 FI FI904905A patent/FI904905A0/en not_active IP Right Cessation
Also Published As
| Publication number | Publication date |
|---|---|
| EP0411109A4 (en) | 1991-07-24 |
| AU5166790A (en) | 1990-08-24 |
| EP0411109A1 (en) | 1991-02-06 |
| WO1990008510A1 (en) | 1990-08-09 |
| FI904905A0 (en) | 1990-10-05 |
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| Date | Code | Title | Description |
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| FZDE | Dead |