CN114554986A - Surgical tool and method - Google Patents

Abstract

A surgical tool and method for engaging and manipulating a bone includes a tool body having a body axis, a threaded end having threads and a tool stop, and an operative end. The operating end is positioned to allow a user to grasp, manipulate and rotate the tool body about the body axis. The threads are positioned to allow the surgical tool to drill into and engage the bone when the tool body is rotated in a drilling direction about the body axis, the threads allowing tightening of the engagement with the bone when the tool body is rotated in the drilling direction about the body axis. The tool stop is positioned to prevent the tool from being rotated further about the body axis to prevent further drilling into the bone when the tool stop contacts the bone.

Description

Surgical tool and method

Background

With the less invasive nature of modern surgical techniques, surgeons must often deal with the tight spaces created by the smallest surgical incision and surrounding anatomy. In procedures involving bone manipulation, anatomical structures such as tendons, muscles, skin, and adjacent bone are often tightly packed within and around the bone, requiring the surgeon to apply significant linear or rotational forces to the bone during the procedure to move, align, or rotate the bone.

For example, in the case of foot surgery, the surgeon must often move, adjust or rotate the bones of the foot along one or more defined planes. These defined planes include a sagittal plane 4, a transverse plane 6, and a frontal plane 8, as shown in the environment of the human left foot 2 in fig. 1. Comparing fig. 1 to fig. 2, fig. 2 depicts the normal skeletal arrangement of the left foot 10, with each metatarsal 12, proximal 14 and distal 16 bones lying in the sagittal 4, transverse 6 and frontal 8 planes.

In the particular case of bunion correction surgery, the need for linear and rotational bone motion across a vertical plane is apparent. Fig. 3 depicts the left foot 10 of fig. 2 after the left foot 10 has developed a bunion symptom. As can best be appreciated by comparing the normal bone alignment in fig. 2 with the bone alignment after the symptoms of bunion have developed in fig. 3, the spacing 18 between the first metatarsal 20 and the second metatarsal head 22 is increased. This is due in part to the counterclockwise rotation of the first metatarsal 20 and its associated pair of sessile bones 24.

The purpose of performing a corrective procedure on the symptoms of bunion depicted in fig. 3 can best be understood by comparing fig. 1-3 with the desired correction best understood with reference to fig. 4A-4C. A front cross-sectional view of the normal skeletal arrangement 10 of the left foot of fig. 2 taken along the approximate frontal plane at the first metatarsal head 26 is depicted in fig. 4A. In this view, fig. 4A depicts the first metatarsal 20 and its first metatarsal head 26 correctly positioned, with the associated sessile bone 24 also correctly positioned directly beneath the first metatarsal head 26.

Referring now to fig. 4B, a similar front cross-sectional view of the bone arrangement 10 is depicted after the bunion symptoms of fig. 3 have developed. In this view, fig. 4B depicts the first metatarsal 20 and its first metatarsal head 26 rotating in a counterclockwise direction, and the seed bone 24 rotating with the first metatarsal head 26 toward the increased spacing 18 formed between the first metatarsal 20 and the second metatarsal 22.

Referring now to fig. 4C, fig. 4C is a further front cross-sectional view of the bone arrangement 10 of fig. 2 and 3, depicting a desired goal of a procedure to correct bunions by rotating or spinning 28 the first metatarsal head 26 and the sessile bone 24 clockwise from the bunions-symptomatic position depicted in fig. 4B to a position similar to the normal position depicted in fig. 4A.

Although bunion correction surgery is used as an example herein, surgeons must also address similar surgical constraints when operating on bones in other parts of the human and animal anatomy, requiring similar bone rotation, adjustment and manipulation within and across defined anatomical planes.

Disclosure of Invention

A surgical tool and method for engaging and manipulating a bone includes a tool body having a body axis, a threaded end having threads and a tool stop, and an operative end. The operative end is positioned to allow a user to grasp, manipulate and rotate the tool body about the body axis. The threads are positioned to allow the surgical tool to drill into and engage the bone when the tool body is rotated in a drilling direction about the body axis, the threads allowing tightening of the engagement with the bone as the tool body is rotated in the drilling direction about the body axis. The tool stop is positioned to prevent the tool from being rotated further about the body axis to prevent further drilling into the bone when the tool stop contacts the bone. The surgical tool thus allows manipulation, movement and rotation of the bone with the surgical tool while the tool is in close engagement with the bone.

In some embodiments, the guide hole extends through the tool body substantially along the body axis. The guide hole allows the positioning guide to extend at least partially through the tool body and into the bone at the bone drilling location to align with the threads of the surgical tool and guide to the bone drilling location.

Drawings

For a fuller understanding and appreciation of the present invention and many of its advantages, reference should be made to the following detailed description taken in conjunction with the accompanying drawings.

FIG. 1 depicts a defined principal plane of a human left foot;

FIG. 2 depicts a front perspective view of a normal skeletal arrangement of a human left foot;

FIG. 3 depicts a front perspective view of the arrangement of bones of the left human foot of FIG. 2 after the development of symptoms of bunion;

FIG. 4A depicts a cross-sectional view, taken along the approximate frontal plane at the first metatarsal head, of the normal bone arrangement of FIG. 2 at a front view angle;

FIG. 4B depicts a cross-sectional view of the bone arrangement of FIG. 2 after the development of symptoms of bunion;

FIG. 4C depicts a cross-sectional view of the bone arrangement of FIG. 2 during correction of a bunion symptom;

FIG. 5A depicts a front perspective view of a surgical tool according to one embodiment of the present invention;

FIG. 5B depicts a front cross-sectional view of the surgical tool of FIG. 5A taken along line 5B-5B of FIG. 5A;

fig. 6A depicts an enlarged front view of the threaded end of the surgical tool of fig. 5A.

FIG. 6B depicts an enlarged front view of the threaded end of a surgical tool according to one embodiment of the present invention;

FIG. 7 depicts a front perspective view and an enlarged view of the skeletal arrangement of FIG. 3 after insertion of a guidewire into the first metatarsal head;

FIG. 8 depicts a perspective view of the bone arrangement of FIG. 4 with the surgical tool of the present invention applied to a guide wire;

FIG. 9 depicts a perspective and enlarged view of the bone arrangement of FIG. 8 with a surgical tool positioned at a drilling location;

fig. 10 depicts a perspective view and inset of the skeletal arrangement of fig. 10, with the tool drilled into and threadedly engaged with the first metatarsal head;

FIG. 11A depicts a front perspective view of a surgical tool according to one embodiment of the present invention;

FIG. 11B depicts a front cross-sectional view of the surgical tool of FIG. 11A taken along line 11B-11B of FIG. 11A;

FIG. 12A depicts a front view of a surgical tool according to one embodiment of the present invention;

FIG. 12B depicts a front perspective view of the surgical tool of FIG. 12A;

FIG. 13A depicts a front view of a surgical tool according to one embodiment of the present invention;

FIG. 13B depicts a front perspective view of the surgical tool of FIG. 13A;

FIG. 14 depicts a front perspective view of a surgical tool according to one embodiment of the present invention;

FIG. 15 depicts a front perspective view of a surgical tool according to one embodiment of the present invention;

FIG. 16 depicts a front perspective view of a surgical tool according to one embodiment of the present invention;

FIG. 17 depicts a front perspective view of a surgical tool according to one embodiment of the present invention;

FIG. 18 depicts a front perspective view of a surgical tool according to one embodiment of the present invention;

FIG. 19 depicts a front perspective view of a surgical tool according to one embodiment of the present invention;

FIG. 20 depicts a front perspective view of a surgical tool according to one embodiment of the present invention;

FIG. 21 depicts a front perspective view of a surgical tool according to one embodiment of the present invention;

FIG. 22 depicts a front perspective view of a surgical tool according to one embodiment of the present invention;

FIG. 23A depicts a front view of a surgical tool according to one embodiment of the present invention;

FIG. 23B depicts a front cross-sectional exploded view of a surgical tool according to one embodiment of the present invention;

FIG. 24A depicts a front perspective view of a surgical tool according to one embodiment of the present invention;

FIG. 24B depicts a front view of a surgical tool according to one embodiment of the present invention;

FIG. 25A depicts a perspective view of a wire angle tool according to an embodiment of the invention; and

fig. 25B depicts a side view of the wire angulation tool of fig. 25A positioned on the left foot to align a guidewire into the first metatarsal head, according to one embodiment of the present invention.

Detailed Description

Referring to the drawings, like reference numerals are used to designate identical or corresponding parts throughout the several embodiments and the accompanying drawings. In some of the drawings, some specific embodiment variations in corresponding parts are denoted by adding lowercase letters to reference numerals.

Fig. 5A depicts a perspective view of a surgical tool 30a of the present invention, the surgical tool 30a including a tool body 32a having a body axis 34a, a threaded end 36a, and a manipulation end 38 a. A conically shaped clockwise drilling thread 40a is positioned at the threaded end 36a and is oriented to drill or bore a hole in bone material as the surgical tool 30a is rotated about the body axis 34a in a rightward and clockwise drilling direction 42 a. The threaded end 36a further includes: a tool stop portion 44a comprising two platelet-shaped legs extending outwardly from the tool body 32a and slightly above the threads 40 a. At the operating end 38a, two handles 46a also extend outwardly from the tool body 32 a. The handle 46a allows a user to grasp the tool body 32a, manipulate the tool body 32a, and rotate the tool body 32a about the body axis 34 a. The outward extensions of the two handles 46a, tool body 32a, and the two legs of tool stop 44a all lie substantially in a common plane with the body axis 34a, wherein the surgical tool 30a remains substantially flat when placed on a flat surface (not shown). While it is contemplated that the surgical tool 30a will typically be 4 to 5 inches in length, it is further contemplated that this will vary greatly and ultimately depend on the particular application or surgical environment.

A front cross-sectional view of the surgical tool 30a is depicted in fig. 5B, taken along line 5B-5B of fig. 5A. As best understood by comparing fig. 5A and 5B, the surgical tool 30a is hollow and includes a guide bore 48a extending substantially along the body axis 34a, the guide bore 48a opening at the threaded end 36a at the head 50a of the threads 40a and extending to the operative end 38a, opening at a location between the handles 46 a. As best understood by brief reference to the enlarged view of the threaded end 36A of the surgical tool 30a in fig. 6A, positioning the guide hole 48a at the tip 50a of the thread 48a results in the tip 50a becoming slightly dull as shown.

While the invention has been shown and described as including a blunt threaded tip, it is understood that other tip configurations are possible within the intended scope of the invention. For example, fig. 6B depicts an enlarged view of the threaded end 36B of a contemplated surgical tool having a tool body 32B, a tool stop 44B, and clockwise drill threads 40B, similar to the surgical tool 30a of fig. 6A. However, since it is non-hollow, the surgical tool of fig. 6B has no pilot hole, and therefore includes a pointed tip 50B at the bottom of the thread 40B, which may enhance the bone drilling capabilities of the thread 40B in some applications.

Referring again to the embodiment surgical tool 30a of fig. 5A-6A, guide hole 48a allows for the accommodation of a positioning guide, which is a guide wire 52 a. As shown in fig. 5A and 5B, because the guide hole 48a is open both at the tip 50a of the thread 48a and between the two handles 46a, the surgical tool 30a allows the guide wire 52a to extend completely through the surgical tool 30a along the entire length of the body axis 34 a.

To better understand the intended use of the depicted surgical tool 30a according to the present invention, an exemplary minimal incision bursitis correction procedure is depicted in fig. 7-10. The procedure shown and described in fig. 7-10 is performed with the goal of achieving the bunion correction discussed above with respect to fig. 4A-C.

Referring to fig. 7, the depicted foot 10 is shown with an enlargement 54 of the bony feature near the first metatarsal head 26. A surgeon employing the minimal incision technique will make a small skin incision (not shown) near the first metatarsal head 26. The positioning guide (in this example, guide wire 52a) is then inserted into the skin incision and driven into the first metatarsal head 20 at an approximately 45 degree angle from the dorsal aspect of the big toe 58 with a wire insertion device (not shown) as shown in fig. 7. Guidewire 52a is typically a 0.45mm diameter k-wire of sufficient length to extend the entire length of guide hole 48a of surgical tool 30a and also allow additional remaining length for further guiding operations. Although a wire positioning guide is shown and described in this example, it should be understood that other types of positioning guides, such as long pins, rods, reinforced cords, rods, pins, or any structure that allows for tool alignment, can be similarly used within the intended scope of the present invention.

Comparing fig. 7 with fig. 8, a positioning guide or guidewire 52a is inserted through guide hole 48 a. Comparing fig. 8 with fig. 9 and its enlargement 62, the profile and reduced size of tool stop 44a enables the surgeon to manipulate or "tease" surgical tool 36a into the incision and surrounding skin and muscles (not shown) as surgical tool 36a is moved along guide wire 52a toward foot 10. As shown in fig. 9, the point of insertion of the wire into the first metatarsal head 26 defines a drilling location 60 for the surgical tool 30a and threads 40 a. The clockwise threads 40a are positioned to allow the surgical tool 30a to drill into and engage a first metatarsal head when rotated about the body axis 34a in a rightward, clockwise drilling direction 42 a.

Referring to fig. 10 and its inset 64, the surgical tool 30a and its clockwise threads 40a are aligned in the correct orientation by the guide wire 52a, and as the surgeon applies pressure from the operative end 38a and rotates the surgical tool 30a in the clockwise drilling direction 42a using the handle 46a, the surgical tool 30a and its clockwise threads 40a continue drilling into the bone material of the first metatarsal head 26. As shown in the bone section 66 of inset 64, as the surgical tool 30a continues to rotate in the clockwise drilling direction 42a, the threads 40a form increasingly tight threaded engagement with the bone material of the first metatarsal head 26. While the amount of rotation required may vary depending on several factors such as thread density and individual bone characteristics, it may generally be desirable that at least three to four turns of thread 40a be able to fully rotate insertion tool 30a to remain securely seated in metatarsal head 26. This secure engagement continues until at least one leg of the tool stop 44a contacts the first metatarsal head 26 to prevent further rotation of the tool. Once tool stop 44a contacts the bone material, tool stop 44a is positioned to prevent further rotation of tool 30a about body axis 34a, thereby preventing further drilling.

The surgeon using this technique will next make a resection transverse incision or osteotomy 56 at the neck (diaphyseal-metaphyseal junction) of the first metatarsal 20. Comparing fig. 10 with fig. 1, the osteotomy produces free skull fragments, including the first metatarsal head 26, which are pushed laterally to make a transverse plane correction. However, frontal plane correction is still typically required in order to properly align the cartilage with the proximal phalanx of the big toe 58.

Once the free skull fragment/first metatarsal head 26 has been severed from the remainder of the first metatarsal 20 at the osteotomy 56, frontal plane correction can be achieved by further rotating the surgical tool 30a in the rightward clockwise drilling direction 42 a. The osteotomy 56 allows the free skull fragment/first metatarsal head 26 to move independently of the remainder of the first metatarsal 20. When the surgical tool 30a is rotated further in the clockwise drilling direction to the right 42a, the tool stop 44a prevents further drilling by the tool 30a while providing a rotational lever. As a result, the tight clockwise engagement of the drilling threads 40a with the skull fragment/first metatarsal head 26 causes a bone rotation 68 of the metatarsal head 26 and a clockwise rotation 42a of the surgical tool 30 a. While the tool stop 44a prevents further drilling of the thread 40a, the clockwise rotation 42a of the surgical tool 30a serves to maintain and tighten the clockwise engagement between the thread 40a and the skull fragment/first metatarsal head 26, further ensuring the desired tool-bone engagement.

When the surgical tool 30a is rotated in the clockwise rightward direction 42a, the resulting bone rotation 68 of the skull fragment/first metatarsal head 26 allows for the desired corrective bone repositioning along the frontal plane as shown in fig. 4C. Frontal plane correction also allows the seed bones 24 to rotate back into proper alignment. This results in the flexor hallucis longus tendon (not shown) having a more linear effect on the big toe 58 after surgical correction. The tight, clockwise engagement of the drilling threads 40a with the rightward clockwise rotation of the skull fragment/first metatarsal head 26 also allows for the fixed linear movement of the skull fragment in any of the frontal, sagittal, or transverse planes by the surgical tool 30 a. Thus, the surgical tool 30a allows for a large amount of manipulation, movement and rotation of the bone while the tool 30a is in close engagement with the bone.

Referring again to fig. 7-10, once the frontal plane correction and any other manipulation of the head fragment/first metatarsal head 26 have been completed, the guide wire 52a may be advanced through osteotomy 56 to maintain the relative positioning of the correction until the surgical tool 30a is removed and a permanent fixation device is inserted. Once osteotomy 56 is sufficiently fixed in its corrected position, guidewire 52a may be removed.

Although the invention has been shown and described as being used for performing bunion correction surgery on a human foot, it is contemplated that the invention may be used in other types of surgery and/or other parts of the human and animal body where tight engagement is required to achieve bone rotation or linear bone movement or displacement. The choice of tool to use either clockwise or counterclockwise threads is generally dependent on the desired rotation requirements. For most applications, it is desirable to select a tool with threads that match the desired rotational repositioning direction.

For example, fig. 11A depicts a front perspective view of a surgical tool 30c of the present invention that is similar to the surgical tool 30a of fig. 5A and 5B. For comparison, a front cross-sectional view of the surgical tool 30c is depicted in FIG. 11B, taken along line 11B-11B of FIG. 11A. The surgical tool 30c of fig. 11A and 11B has a guide bore 48c for receiving a guide wire 52c, an elongate tool body 32c and a tool axis 34c, a handle 46c at an operative end 38c, and a tool stop 44c at a threaded end 36 c. The conical counterclockwise drilling thread 70c extends along the tool axis 34c below the tool stop 70 c. The counterclockwise threads 70c allow the surgical tool 30c to be used for counterclockwise drilling to the left when the surgical tool 30c is rotated about the tool axis 34c in the drilling direction 72 c. This configuration would adapt the surgical tool 30c to perform the bunion correction procedure shown in fig. 7-10 on the right foot.

Although the present invention has been shown and described using a positioning guide such as guide wire 52a in fig. 5A and B and 7-10, it should be understood that freehand drill tool design and surgical techniques are also included within the intended scope of the present invention, as are variations in tool size and features. For example, fig. 12A and 12B depict a surgical tool 30d of the present invention that has no guide hole and is optimized for use without a guide wire. The tool body 32d has a reduced circumference along the tool axis 34d, as does the handle 46 d. The peg-shaped leg forms a tool stop 44d at the threaded end 36 d. Since the surgical tool 30d has no pilot hole, the conical counter-clockwise drilling thread 70d terminates at a tip 50d similar to that shown in fig. 6B. In the embodiment shown in fig. 12A and 12B, the prongs 50d may be beneficial in enhancing bone penetration when freehand rotation of the surgical tool 30d is performed.

It should also be understood that some contemplated embodiments may utilize guide holes and positioning guides even if the tool body has a reduced circumference. For example, fig. 13A and 13B depict a surgical tool 30e of the present invention having a guide hole 48e along the tool axis 34e for receiving a guide wire 52e despite the reduced circumference of the tool body 32 e. The conical counter-clockwise drilling thread 70e extends along the tool axis 34c below the tool stop 70c and allows the guide hole 48e to open at the tip 50e despite the reduced circumference of the tool body 32e to eliminate the need for freehand positioning and rotation of the surgical tool 30 e.

Other variations of the tool stop are possible within the intended scope of the invention. For example, fig. 14 depicts a surgical tool 30f having a guide bore 48f for receiving a guide wire 52f, an elongated tool body 32f, and a tool axis 34f, with a handle 46f at an operative end 38f, however, a tool stop 44f at a threaded end 36f includes a flange 44f extending completely around the body axis 34 f.

Although the invention has been shown and described using a tool in which the handle, tool body and legs all lie substantially in a common plane, it will be appreciated that the invention may also include tools in which such elements occupy different planes. For example, fig. 15 depicts a surgical tool 30g of the present invention having a handle 46g, a tool body 32g, and a tool stop 44g, wherein two handles 46g extend outwardly from the tool body 34g at the operative end 38g along a plane that is approximately 90 ° from the plane along which the two legs of the tool stop 44g extend outwardly from the threaded end 44 g. Since the handle 46g and the tool stop 44g each share a different plane with the tool body 32g, the surgical tool 30g will not lie flat on an upper flat surface. Such a configuration may be desirable in applications or surgical environments where it is considered more difficult to grasp or retrieve the surgical tool 30g from the instrument table.

Other variations in the shape and size of the handle, tool stop or tool body are also possible and within the intended scope of the invention. For example, fig. 16 depicts a surgical tool 30h of the present invention having a nail-shaped guide hole 46h extending from the operative end 38h of the tool body 32h, the tool body 32h having an enlarged perimeter and a guide hole 48 h. The leg of the tool stop 44h extending from the threaded end 36h is also a spike-shaped intermediate portion that extends outwardly along the same plane as the tool body 32h and the handle 46 h. During a right bunion capsulitis correction procedure similar to that shown and described in fig. 7-10, the enlarged circumference of the tool body 32h will allow the counter-clockwise drilled thread 70h to engage the larger thread that created the first metatarsal head 26.

It should also be understood that the present invention may incorporate various other alternative configurations of handles and/or knobs at the operative end of the surgical tool within the intended scope of the present invention. For example, fig. 17 depicts a surgical tool 30i of the present invention having a finger groove 72 positioned around the periphery of a slotted handle 74 at the operative end 38 i. In this configuration, the guide hole 48i of the surgical tool 30i extends along the body axis 34i and through the slotted handle 74 to the tip 50j of the counterclockwise thread 70 i. The finger groove 72 facilitates one-handed operation of the surgical tool 30i as the surgeon rotates the tool 30i and its counter-clockwise thread 701 about the body axis 34i of the surgical tool 30 i.

One variation of the slotted handle surgical tool 30i of fig. 17 is the surgical tool 30j depicted in fig. 18 having a dome-shaped handle 76, the dome-shaped handle 76 including a dome-shaped notch 78 around its periphery. The surgical tool 30j also includes a guide hole 48j extending through the top of the dome handle 76 and through the tip 50j of the counterclockwise thread 70j along the body axis 34 j. The finger groove 72 and the domed handle 76 also facilitate one-handed operation of the surgical tool 30j as the surgeon rotates the tool 30j and its counterclockwise thread 70j about the body axis 34j of the surgical tool 30 i.

The surgical tools 30i and 30j of fig. 17 and 18 have potential advantages in maintaining the one-handed utility of the present invention while reducing the size extending outwardly from the tool bodies 32i and 32 j. Other configurations with similar advantages are possible within the scope of the contemplated invention. For example, fig. 19 depicts a surgical tool 30k of the present invention having a square handle 80 with four straight sides 82k to enhance one-handed operation during surgery while still allowing the guide hole 48k to extend into the tool body 32k, and the size of the surgical tool 30k extending outwardly from the tool body 32k is similarly reduced.

A slight variation is depicted in the surgical tool 30m of fig. 20, the surgical tool 30m having a triangular handle 84m with three straight sides 82 m. The three straight sides 82m also allow for one-handed operation and include a guide hole 48m extending into the tool body 32m and opening through the tip 50m of the counterclockwise thread 70m at the threaded end 36m of the tool 30 m.

A further variation is depicted in the surgical tool 30n of fig. 21, the surgical tool 30n having a circular handle 86 with a rough outer surface 88. The rough outer surface 88 is roughened to allow enhanced tool operation despite the curled shape of the outer surface 88. The circular handle 86 also includes a guide hole 48n, the guide hole 48n extending into the tool body 32n and opening through a head 500 of the counterclockwise thread 70n at the threaded end 36n of the tool 30 n.

A double wing handle configuration may also be used to reduce the size of the surgical tool and/or configure the surgical tool of the present invention to allow additional manipulation using external tools or devices. For example, fig. 22 depicts a surgical tool 30p of the present invention having a protruding T-shaped handle 90 at the operative end 38p and having two wings 91 extending outwardly from the tool body 32p substantially along a common plane with the legs of the tool body 32p and tool stop 44 p. The protruding tee handle 90 also includes a flat tool engagement surface 92 that enables a machine or external tool to engage the surgical tool 30p for additional tool manipulation. The protruding tee handle 90 also includes a guide bore 48p, the guide bore 48p extending into the tool body 32p and opening at the threaded end 36p of the tool 30p by the tip 50p of the counterclockwise thread 70 p.

It is further contemplated that some embodiments may incorporate an extension structure or a multi-part body structure, particularly where it would be advantageous to conceal all or a portion of the positioning guide or to increase the distance between the drilling location and the handle or other steering structure. For example, fig. 23A depicts a front view of a surgical tool 30q of the present invention, the surgical tool 30q having a detachable extension 94 attached to the operative end 38q of the tool body 32 q. Fig. 23B depicts an exploded cross-sectional view of the surgical tool 30 q. As best understood by comparing fig. 23A and 23B, extension 94 includes handle 46q and extension body 96 having male extension threads 98. Male extension threads 98 are positioned at the operative end 38q of the tool body 32q to be threaded into female operating threads 100 of the guide bore 48 q. When the extension 94 has been fully threaded into place at the operative end 38q of the tool body 32q, the extension body 96 extends along the body axis 34C. In this position, the guide hole 48q also extends along the body axis 34C, completely through the extension body 96, opening at the top of the extension body 94 between the handles 46 q.

As shown in fig. 23A and 23B, a length of guidewire 52q has been selected and extends completely through tool body 32q, with a majority of the exposed wire extending past working end 38q and out guide opening 52 q. This is generally considered advantageous after driving guidewire 52q into the bone and when tool body 32q is positioned over guidewire 52q itself. However, it is generally considered problematic in the process of rotationally drilling counter-clockwise threads 70q into bone, because guidewire 52q may be considered an obstruction to the surgeon as tool 30q is rotated.

Further comparing fig. 23A and 23B, the extension 94 is attached to the operative end 38q of the tool body 32q and over the remaining exposed length of the guidewire 52q such that the remaining exposed length of the guidewire 52q can be fully contained within the combined guide bore 48q of the tool body 32q and the extension body 96. In the embodiment of fig. 23A and 23B, the male extension threads 98 of the extension 94 and the female operating threads 100 of the tool body 32a are generally tightened counter-clockwise to allow the engagement between the threads 98 and 100 to tighten as the surgeon rotates the surgical tool 30q about the body axis 34C to drill a hole into bone with the counter-clockwise threads 70 q. However, it should be understood that in other contemplated embodiments, similar male extension threads and female operating threads will be clockwise tightened in position to allow for tightening engagement of a tool having clockwise positioned threads.

It should also be understood that in some contemplated embodiments, additional attachments may be added at different locations on the surgical tool for specific surgical purposes within the intended scope of the present invention. For example, fig. 24A and 24B depict a surgical tool 30r of the present invention having a wire loop 102 positioned at a location along the outer surface of the tool body 32 r. In the embodiment shown in fig. 24A and 24B, one ring 102 is positioned at a location closer to the operative end 38r of the tool 30r and the other ring 102 is positioned closer to the threaded end 36 r. In this configuration, the ring 102 extends outwardly from the tool body 32r in opposite directions along a plane common to the legs of the tool body 32r, the handle 46r, and the tool stop 44 r. However, it should be understood that other numbers of rings and ring orientations are also within the intended scope of the present invention.

As shown in fig. 24A and 24B, the loop 102 will be particularly useful in performing procedures such as the bunion correction procedure shown and described in fig. 7-10, wherein the loop 102 allows for the guidance of additional wires (not shown) for holding the severed skull fragment/metatarsal head 26 in place relative to the remainder of the first metatarsal 20 after the osteotomy 56 is formed and after the guide wire 52a and tool have been used to complete the bone repositioning. Thus, the loops will enable the additional wires to provide temporary fixation of the corrective skull fragment/metatarsal head 26.

It should also be understood that additional tools and techniques may also be used to perform the bone surgery technique within the intended scope of the present invention. For example, in some contemplated surgical methods, a drill bit (not shown) may be used on the guidewire prior to insertion of the tool. In such an embodiment, a soft tissue protector (not shown) would be used.

Referring now to fig. 25A, another contemplated surgical technique of the present invention will involve aligning a guidewire using an angle tool 104. The angle tool 104 includes a flat bottom surface 106, an angled top surface 108, and a side handle 110. The angled top surface 108 is at a 45 degree angle to the flat bottom surface 106 and includes a hollow conduit 112 on top of the angled top surface 108 and extending along the length of the angled top surface 108. The conduit 112 is sized to receive a length of k-wire and allows the k-wire to be positioned at 45 degrees to the flat bottom surface 106.

Fig. 25B depicts a surgical technique using the angle tool 104 of fig. 25A that is a modification of the bunions correction surgical technique depicted in fig. 7-10 for the left foot 10. Referring to fig. 25B, a side view of the big toenail 113 is depicted with skin and non-bone tissue 114 surrounding the first metatarsal 20, the sessile bone 24 and the big toe 58. A small incision 116 is made near the first metatarsal head 26. The angle tool 104 is then placed with its flat bottom surface 106 on the big toe 58 so that the conduit 112 is oriented at 45 degrees directly to the big toe 58 and the first metatarsal head 26 as shown.

Once the angle tool 104 is in this position as shown in fig. 25B, the guidewire 52s, which is typically a length of k-wire, is fed into the guidewire tube 112 and then guided into and through the cut 116 until it is at the drilling location 60s and approaches or contacts the first metatarsal head 26 at the correct 45 degree angle provided by the angle tool 104. A k-wire driver (not shown) is then used while the guidewire 52s remains positioned by the angle tool 104 to drive the end of the guidewire 52s into the first metatarsal head 26 as shown. The angle tool 104 may then be removed, leaving the guidewire 52s held in place, and repositioning of the metatarsal head 26 is then accomplished using a tool of the present invention, such as the surgical tool 30a of fig. 5A and 5B.

While the surgical technique depicted in fig. 25A and 25B depicts the use of an angle tool to optimally position the guidewire at 45 degrees to the big toe 58 and first metatarsal head 26, it should be understood that in some contemplated embodiments of the described surgical methods and angle tools, the optimal angle for the preferred wire insertion may be predetermined to be 25-35 degrees or another angle using an appropriately angled tool within the intended scope of the present invention.

Those skilled in the art will recognize that the present invention is capable of embodiments other than those illustrated and described. It is to be understood that the details of the structure of the disclosed apparatus and method may be varied in various ways without departing from the invention itself. Accordingly, the drawings and detailed description are to be regarded as including equivalents thereof without departing from the spirit and scope of the invention.

Claims (124)

1. A surgical tool for engaging and manipulating a bone, comprising:

a tool body having a body axis, a threaded end, and an operative end;

the threaded end having threads and a tool stop;

the operative end is positioned to allow a user to grasp, manipulate and rotate the tool body about the body axis;

the threads being positioned to allow the surgical tool to drill into and engage the bone when the tool body is rotated in a drilling direction about the body axis, the threads allowing tightening of the engagement with the bone when the tool body is rotated in the drilling direction about the body axis;

the tool stop is positioned to prevent the surgical tool from being further rotated about the body axis and from drilling further into the bone when the tool stop contacts the bone; and

the surgical tool allows manipulation, movement and rotation of the bone with the surgical tool when the surgical tool is in intimate contact with the bone.

2. A surgical tool as claimed in claim 1, wherein the thread is positioned to drill into and engage the bone by rotation of the tool body in a clockwise direction to the right about the body axis.

3. A surgical tool as in claim 1, wherein the threads are positioned to drill into and engage the bone by rotation of the tool body in a counterclockwise direction to the left about the body axis.

4. The surgical tool of claim 1, further comprising:

the tool stop has at least one leg extending outwardly from the tool body;

the operating end having at least one handle extending outwardly from the tool body; and

the at least one leg of the tool stop and the at least one handle of the operative end lie substantially in a common plane with the body axis, the surgical tool remaining substantially flat when placed on a flat surface.

5. The surgical tool of claim 1, further comprising:

the tool stop has two legs extending outwardly from the tool body;

the operating end has two handles extending outwardly from the tool body; and

the two legs of the tool stop and the two handles of the operating end lie substantially in a common plane with the body axis, the surgical tool remaining substantially flat when placed on a flat surface.

6. A surgical tool as in claim 1, wherein the tool stop comprises a flange.

7. A surgical tool as claimed in claim 1, wherein the tool stop comprises at least one plate-like leg.

8. A surgical tool as claimed in claim 1, wherein the tool stop comprises at least one peg-like leg.

9. A surgical tool as claimed in claim 1, wherein the tool stop extends completely around the body axis.

10. The surgical tool of claim 1, further comprising:

the tool body having an operative thread positioned at the operative end;

an extension having an extension axis and an extension thread;

the extension thread of the extension is threadably connectable to the operating thread of the tool body, the extension axis of the extension being substantially collinear with the body axis of the tool body; and

the extension threads of the extension are positioned to screw onto the operating threads of the tool body as the extension and the tool body are rotated about the body axis and the extension axis in the drilling direction.

11. A surgical tool as recited in claim 1, wherein said operative end is positioned to connect to an external drill for rotation of said surgical tool about said body axis.

12. A surgical tool as recited in claim 1, further comprising a knob at said operative end to allow rotation of said surgical tool about said body axis.

13. A surgical tool as recited in claim 1, further comprising a slotted handle at the operative end to allow rotation of the surgical tool about the body axis.

14. A surgical tool as recited in claim 1, further comprising a dome handle at said operative end to allow rotation of said surgical tool about said body axis.

15. A surgical tool as recited in claim 1, further comprising a square handle at said operative end to allow rotation of said surgical tool about said body axis.

16. A surgical tool as recited in claim 1, further comprising a triangular handle at said operative end to allow rotation of said surgical tool about said body axis.

17. A surgical tool as recited in claim 1, further comprising a circular handle at said operative end to allow rotation of said surgical tool about said body axis.

18. A surgical tool as recited in claim 1, further comprising a protruding T-handle at said operative end to allow rotation of said surgical tool about said body axis.

19. A surgical tool as claimed in claim 1, further comprising an engagement surface for attachment of an external tool for rotation of the tool body about the body axis.

20. The surgical tool of claim 1, further comprising a loop at a location along the tool body to guide an additional wire to provide temporary fixation of bone material.

21. A surgical tool for engaging and manipulating a bone, comprising:

a tool body having a body axis, a threaded end, an operative end, and a guide bore extending through the tool body substantially along the body axis;

the threaded end having threads and a tool stop;

the operative end is positioned to allow a user to grasp, manipulate and rotate the tool body about the body axis;

the guide hole allows a positioning guide to extend at least partially through the tool body and into bone at a bone drilling location to align and guide the threads of the surgical tool to the bone drilling location;

the threads positioned to allow the surgical tool to drill into the bone at the bone drilling location and engage the bone when the tool body is rotated in a drilling direction about the body axis, the threads allowing tightening of engagement with the bone when the tool body is rotated in the drilling direction about the body axis;

the tool stop is positioned to prevent the surgical tool from being further rotated about the body axis and from drilling further into the bone when the tool stop contacts the bone; and

the surgical tool allows manipulation, movement and rotation of the bone with the surgical tool when the surgical tool is in intimate contact with the bone.

22. A surgical tool as claimed in claim 21, wherein the thread is positioned to drill into and engage the bone by rotation of the tool body in a clockwise direction to the right about the body axis.

23. A surgical tool as in claim 21, wherein the threads are positioned to drill into and engage the bone by rotation of the tool body in a counterclockwise direction to the left about the body axis.

24. A surgical tool as in claim 21, wherein the positioning guide is a guide wire.

25. An surgical tool as recited in claim 21, wherein the positioning guide is a guide wire pre-embedded in the bone at the bone drilling location.

26. A surgical tool as claimed in claim 21, wherein the positioning guide is a k-wire having a diameter of 0.45 mm.

27. A surgical tool as recited in claim 21, further comprising:

the tool stop has at least one leg extending outwardly from the tool body;

the operating end having at least one handle extending outwardly from the tool body; and

the at least one leg of the tool stop and the at least one handle of the operative end lie substantially in a common plane with the body axis, the surgical tool remaining substantially flat when placed on a flat surface.

28. A surgical tool as recited in claim 21, further comprising:

the tool stop has two legs extending outwardly from the tool body;

the operating end has two handles extending outwardly from the tool body; and

the two legs of the tool stop and the two handles of the operating end lie substantially in a common plane with the body axis, the surgical tool remaining substantially flat when placed on a flat surface.

29. A surgical tool as claimed in claim 21, wherein the tool stop comprises a flange.

30. A surgical tool as claimed in claim 21, wherein the tool stop comprises at least one plate-like leg.

31. A surgical tool as claimed in claim 21, wherein the tool stop comprises at least one peg-like leg.

32. A surgical tool as claimed in claim 21, wherein the tool stop extends completely around the body axis.

33. A surgical tool as recited in claim 21, further comprising:

the tool body having an operative thread positioned at the operative end;

an extension having an extension axis, an extension bore extending substantially along the extension axis, and an extension thread;

the extension threads of the extension are threadably connectable to the operating threads of the tool body, the extension axis of the extension is substantially collinear with the body axis of the tool body, and the guide hole is substantially collinear with the extension bore;

the guide hole and the extension hole are positioned to allow the positioning guide to extend at least partially through the tool body and the extension; and

the extension threads of the extension are positioned to thread onto the operating threads of the tool body as the extension and the tool body are rotated in the drilling direction about the body axis and the extension axis.

34. A surgical tool as in claim 21, wherein the manipulation end is positioned to connect to an external drill for rotation of the surgical tool about the body axis.

35. A surgical tool as in claim 21, further comprising a knob at the operative end to allow rotation of the surgical tool about the body axis.

36. A surgical tool as in claim 21, further comprising a slotted handle at the operative end to allow rotation of the surgical tool about the body axis.

37. A surgical tool as in claim 21, further comprising a dome handle at the operative end to allow rotation of the surgical tool about the body axis.

38. A surgical tool as claimed in claim 21, further comprising a square handle at the operative end to allow rotation of the surgical tool about the body axis.

39. A surgical tool as in claim 21, further comprising a triangular handle at the operative end to allow rotation of the surgical tool about the body axis.

40. A surgical tool as recited in claim 21, further comprising a circular handle at said operative end to allow rotation of said surgical tool about said body axis.

41. A surgical tool as in claim 21, further comprising a protruding T-handle at the operative end to allow rotation of the surgical tool about the body axis.

42. A surgical tool as claimed in claim 21, further comprising an engagement surface for attachment of an external tool for rotation of the tool body about the body axis.

43. A surgical tool as claimed in claim 21, further comprising an engagement surface for attachment of an external tool for rotation of the tool body about the body axis.

44. A surgical tool as claimed in claim 21, further comprising a loop at a location along the tool body to allow for the guidance of additional wires to provide temporary fixation of bone material.

45. A surgical tool for performing bunions surgery on the left foot, comprising:

a tool body having a body axis, a threaded end, an operative end, and a guide bore extending through the tool body substantially along the body axis;

the threaded end having threads and a tool stop;

the operative end is positioned to allow a user to grasp, manipulate and rotate the tool body about the body axis;

the guide hole allowing a positioning guide to extend at least partially through the tool body and into a first metatarsal head of the left foot at a bone drilling location to align and guide the threads of the surgical tool to the bone drilling location;

the threads positioned to allow the surgical tool to drill into and engage the first metatarsal head at the bone drilling location when the tool body is rotated in a clockwise drilling direction to the right about the body axis, the threads allowing tightening of engagement with the first metatarsal head when the tool body is rotated in the clockwise drilling direction to the right about the body axis;

the tool stop is positioned to prevent the surgical tool from being further rotated in the clockwise rightward direction about the body axis and from further drilling into the first metatarsal head when the tool stop contacts a bone; and

the surgical tool allows manipulation and movement of the first metatarsal head in the frontal, sagittal and transverse planes of the left foot and clockwise rotation of the first metatarsal head to the right when the surgical tool is in close engagement with the first metatarsal head.

46. A surgical tool as claimed in claim 45, wherein the positioning guide is a guide wire.

47. An operative tool according to claim 45, wherein the positioning guide is a guide wire pre-embedded in the bone at the bone drilling location.

48. A surgical tool as claimed in claim 45, wherein the positioning guide is a K-wire having a diameter of 0.45 mm.

49. A surgical tool as claimed in claim 45, further comprising:

the tool stop has at least one leg extending outwardly from the tool body;

the operating end having at least one handle extending outwardly from the tool body; and

the at least one leg of the tool stop and the at least one handle of the operative end lie substantially in a common plane with the body axis, the surgical tool remaining substantially flat when placed on a flat surface.

50. A surgical tool as claimed in claim 45, further comprising:

the tool stop has two legs extending outwardly from the tool body;

the operating end has two handles extending outwardly from the tool body; and

the two legs of the tool stop and the two handles of the operating end lie substantially in a common plane with the body axis, the surgical tool remaining substantially flat when placed on a flat surface.

51. A surgical tool as claimed in claim 45, wherein the tool stop comprises a flange.

52. A surgical tool as claimed in claim 45, wherein the tool stop comprises at least one plate-like leg.

53. A surgical tool as claimed in claim 45, wherein the tool stop comprises at least one peg-like leg.

54. A surgical tool as claimed in claim 45, wherein the tool stop extends completely around the body axis.

55. A surgical tool as claimed in claim 45, further comprising:

the tool body having an operating thread positioned at the operating end;

an extension having an extension axis, an extension bore extending substantially along the extension axis, and an extension thread;

the extension threads of the extension are threadably connectable to the operating threads of the tool body, the extension axis of the extension is substantially collinear with the body axis of the tool body, and the guide hole is substantially collinear with the extension bore;

the guide hole and the extension hole are positioned to allow the positioning guide to extend at least partially through the tool body and the extension; and

the extension threads of the extension are positioned to screw onto the operating threads of the tool body as the extension and the tool body are rotated about the body axis and the extension axis in the drilling direction.

56. A surgical tool as claimed in claim 45, wherein the operative end is positioned to connect to an external drill for rotation of the surgical tool about the body axis.

57. A surgical tool as claimed in claim 45, further comprising a knob at the operative end to allow rotation of the surgical tool about the body axis.

58. A surgical tool as claimed in claim 45, further comprising a slotted handle at the operative end to allow rotation of the surgical tool about the body axis.

59. A surgical tool as claimed in claim 45, further comprising a domed handle at the operative end to allow rotation of the surgical tool about the body axis.

60. A surgical tool as claimed in claim 45, further comprising a square handle at the operative end to allow rotation of the surgical tool about the body axis.

61. A surgical tool as claimed in claim 45, further comprising a triangular handle at the operative end to allow rotation of the surgical tool about the body axis.

62. A surgical tool as claimed in claim 45, further comprising a circular handle at the operative end to allow rotation of the surgical tool about the body axis.

63. A surgical tool as claimed in claim 45, further comprising a protruding T-handle at the operative end to allow rotation of the surgical tool about the body axis.

64. A surgical tool as claimed in claim 45, further comprising an engagement surface for attachment of an external tool for rotation of the tool body about the body axis.

65. A surgical tool as claimed in claim 45, further comprising an engagement surface for attachment of an external tool for rotation of the tool body about the body axis.

66. A surgical tool as claimed in claim 45, further comprising a loop at a location along the tool body to allow for the guidance of additional wires to provide temporary fixation of bone material.

67. A surgical tool for performing bunions surgery on the right foot, comprising:

a tool body having a body axis, a threaded end, an operative end, and a guide bore extending through the tool body substantially along the body axis;

the threaded end having threads and a tool stop;

the operative end is positioned to allow a user to grasp, manipulate and rotate the tool body about the body axis;

the guide hole allows a positioning guide to extend at least partially through the tool body and into a first metatarsal head of the right foot at a bone drilling location to align and guide the threads of the surgical tool to the bone drilling location;

the threads positioned to allow the surgical tool to drill into and engage the first metatarsal head at the bone drilling location when the tool body is rotated in a left counterclockwise drilling direction about the body axis, the threads allowing tightening of engagement with the first metatarsal head when the tool body is rotated in the left counterclockwise drilling direction about the body axis;

the tool stop is positioned to prevent the surgical tool from being further rotated in the left counterclockwise direction about the body axis and from further drilling into the first metatarsal head when the tool stop contacts a bone; and

the surgical tool allows manipulation and movement of the first metatarsal head in the frontal, sagittal and transverse planes of the right foot and rotation of the first metatarsal head left and counterclockwise when the surgical tool is in close engagement with the first metatarsal head.

68. A surgical tool as claimed in claim 67, wherein the positioning guide is a guide wire.

69. An operative tool according to claim 67 wherein said positioning guide is a guide wire pre-embedded in said bone at said bone drilling location.

70. A surgical tool as claimed in claim 67, wherein the positioning guide is a K-wire having a diameter of 0.45 mm.

71. A surgical tool as claimed in claim 67, further comprising:

the tool stop has at least one leg extending outwardly from the tool body;

the operating end having at least one handle extending outwardly from the tool body; and

the at least one leg of the tool stop and the at least one handle of the operative end lie substantially in a common plane with the body axis, the surgical tool remaining substantially flat when placed on a flat surface.

72. A surgical tool as claimed in claim 67, further comprising:

the tool stop has two legs extending outwardly from the tool body;

the operating end has two handles extending outwardly from the tool body; and

the two legs of the tool stop and the two handles of the operating end lie substantially in a common plane with the body axis, the surgical tool remaining substantially flat when placed on a flat surface.

73. A surgical tool as claimed in claim 67, wherein the tool stop comprises a flange.

74. A surgical tool as claimed in claim 67, wherein the tool stop comprises at least one plate-like leg.

75. A surgical tool as claimed in claim 67, wherein the tool stop comprises at least one peg-like leg.

76. A surgical tool as claimed in claim 67, wherein the tool stop extends completely around the body axis.

77. A surgical tool as claimed in claim 67, further comprising:

the tool body having an operative thread positioned at the operative end;

an extension having an extension axis, an extension bore extending substantially along the extension axis, and an extension thread;

the extension threads of the extension are threadably connectable to the operating threads of the tool body, the extension axis of the extension is substantially collinear with the body axis of the tool body, and the guide hole is substantially collinear with the extension bore;

the guide hole and the extension hole are positioned to allow the positioning guide to extend at least partially through the tool body and the extension; and

the extension threads of the extension are positioned to screw onto the operating threads of the tool body as the extension and the tool body are rotated about the body axis and the extension axis in the drilling direction.

78. A surgical tool as claimed in claim 67, wherein the operative end is positioned to connect to an external drill for rotation of the surgical tool about the body axis.

79. A surgical tool as claimed in claim 67, further comprising a knob at the operative end to allow rotation of the surgical tool about the body axis.

80. A surgical tool as claimed in claim 67, further comprising a slotted handle at the operative end to allow rotation of the surgical tool about the body axis.

81. A surgical tool as claimed in claim 67, further comprising a domed handle at the operative end to allow rotation of the surgical tool about the body axis.

82. A surgical tool as claimed in claim 67, further comprising a square handle at the operative end to allow rotation of the surgical tool about the body axis.

83. A surgical tool as claimed in claim 67, further comprising a triangular handle at the operative end to allow rotation of the surgical tool about the body axis.

84. A surgical tool as claimed in claim 67, further comprising a circular handle at the operative end to allow rotation of the surgical tool about the body axis.

85. A surgical tool as claimed in claim 67, further comprising a protruding T-handle at the operative end to allow rotation of the surgical tool about the body axis.

86. A surgical tool as claimed in claim 67, further comprising an engagement surface for attachment of an external tool for rotation of the tool body about the body axis.

87. A surgical tool as claimed in claim 67, further comprising an engagement surface for attachment of an external tool for rotation of the tool body about the body axis.

88. A surgical tool as claimed in claim 67, further comprising a loop at a location along the tool body to allow an additional wire to be guided to provide temporary fixation of bone material.

89. A surgical method, comprising:

providing a surgical tool having a tool body having a body axis, a threaded end having threads and a tool stop, and an operative end positioned to allow a user to grasp, manipulate, and rotate the tool body about the body axis;

rotating the surgical tool in a drilling direction about the body axis to drill into a bone and engage the bone with the thread, further tightening the engagement with the bone as the surgical tool continues to rotate in the drilling direction about the body axis;

continuing to rotate the surgical tool until the tool stop contacts the bone to prevent the surgical tool from being further rotated about the body axis and from further drilling into the bone; and

manipulating, moving and rotating the bone with the surgical tool while the surgical tool is in close engagement with the bone.

90. The surgical method of claim 89, wherein the threads of the tool body are rotated in a clockwise direction to the right about a main tool body axis to drill into and engage the bone.

91. The surgical method of claim 89, wherein the threads of the tool body are rotated in a counterclockwise direction to the left about the main tool body axis to drill into and engage the bone.

92. The surgical method of claim 89, wherein an external drill is connected to the operative end of the tool body, the drill being subsequently used to rotate the surgical tool about the body axis.

93. The surgical method of claim 89, further comprising:

providing a ring at a location along the tool body; and

additional wires are directed through the loop and used to provide temporary fixation of the bone material.

94. A surgical method, comprising:

providing a surgical tool having a tool body having a body axis, a threaded end, an operative end, and a guide hole extending through the tool body substantially along the body axis, the threaded end having threads and a tool stop, the operative end positioned to allow a user to grasp, manipulate, and rotate the tool body about the body axis;

providing a positioning guide and inserting the positioning guide into the bone at a bone drilling location;

extending the positioning guide at least partially through the tool body through the guide hole;

aligning the positioning guide with the thread of the surgical tool and to the bone drilling location;

rotating the surgical tool in a drilling direction about the body axis to drill into the bone and engage the bone with the threads at the bone drilling location, the threads further tightening engagement with the bone as the tool body continues to rotate in the drilling direction about the body axis;

continuing to rotate the surgical tool until the tool stop contacts the bone to prevent further rotation of the tool about the body axis and further drilling into the bone; and

manipulating, moving and rotating the bone while the surgical tool is in close engagement with the bone.

95. The surgical method of claim 94, wherein the threads of the tool body are rotated in a clockwise direction to the right about the main tool body axis to drill into and engage the bone.

96. The surgical method of claim 94, wherein the threads of the tool body are rotated in a counterclockwise direction to the left about the main tool body axis to drill into and engage the bone.

97. The surgical method of claim 94, wherein the positioning guide is a guidewire.

98. The surgical method of claim 94, wherein the positioning guide is a guide wire pre-embedded in the bone at the bone drilling location.

99. The surgical method of claim 94, wherein the positioning guide is a k-wire having a diameter of 0.45 mm.

100. The surgical method of claim 94, wherein an external drill is connected to the operative end of the tool body, the drill being subsequently used to rotate the surgical tool about the body axis.

101. The surgical method of claim 94, further comprising:

providing a ring at a location along the tool body; and

additional wires are directed through the loop and used to provide temporary fixation of the bone material.

102. The surgical method of claim 94, further comprising:

providing an angle tool guide having a positioning angle;

positioning the angle tool relative to the borehole location; and

aligning the positioning guide with the angulation tool at the positioning angle, and inserting the positioning guide into bone at the drilling location.

103. A method of performing bunion surgery on a left foot comprising:

providing a surgical tool having a tool body having a body axis, a threaded end, an operative end, and a guide hole extending through the tool body substantially along the body axis, the threaded end having threads and a tool stop, the operative end positioned to allow a user to grasp, manipulate, and rotate the tool body about the body axis;

providing a positioning guide and inserting the positioning guide into a first metatarsal head of the left foot at a bone drilling location;

extending the positioning guide at least partially through the tool body through the guide hole;

aligning the positioning guide with the thread of the surgical tool and to the bone drilling location;

rotating the surgical tool in a clockwise rightward drilling direction about the body axis to drill into the first metatarsal head and engage the first metatarsal head with the threads at the bone drilling location, the threads further tightening engagement with the first metatarsal head as the tool body continues to rotate in the clockwise rightward direction about the body axis;

continuing to rotate the surgical tool in the clockwise rightward direction until the tool stop contacts the first metatarsal head to prevent the surgical tool from being further rotated in the clockwise rightward direction about the body axis and from further drilling into the first metatarsal head; and

manipulating and moving the first metatarsal head on the frontal, sagittal and transverse planes of the left foot, and effecting clockwise rightward rotation of the first metatarsal head with the surgical tool as the surgical tool is brought into close engagement with the first metatarsal head.

104. A method of performing a bunions procedure according to claim 103, wherein said positioning guide is a guide wire.

105. A method of performing a bunions procedure according to claim 103, wherein said positioning guide is a guide wire pre-embedded in said first metatarsal head at said bone drilling location.

106. A method of performing a bunion procedure according to claim 103, wherein the positioning guide is a k-wire of 0.45mm diameter.

107. A method of performing a bunions procedure according to claim 103, wherein an external drill is connected to the operative end of the tool body, the drill being subsequently used to rotate the surgical tool about the body axis.

108. A method of performing a bunion procedure according to claim 103, further comprising:

providing a ring at a location along the tool body; and

additional wires are directed through the loop and used to provide temporary fixation of the bone material.

109. A method of performing a bunion procedure according to claim 103, further comprising:

providing an angle tool guide having a positioning angle;

positioning the angle tool relative to the borehole location; and

aligning the positioning guide with the angulation tool at the positioning angle, and inserting the positioning guide into the first metatarsal head at the drilling location.

110. A method of performing bunion surgery on the right foot, comprising:

providing a surgical tool having a tool body having a body axis, a threaded end, an operative end, and a guide hole extending through the tool body substantially along the body axis, the threaded end having threads and a tool stop, the operative end positioned to allow a user to grasp, manipulate, and rotate the tool body about the body axis;

providing a positioning guide and inserting the positioning guide into a first metatarsal head of the right foot at a bone drilling location;

extending the positioning guide at least partially through the tool body through the guide hole;

aligning the positioning guide with the thread of the surgical tool and to the bone drilling location;

rotating the surgical tool in a left counterclockwise drilling direction about the body axis to drill into the first metatarsal head and engage the first metatarsal head with the threads at the bone drilling location, the threads further tightening engagement with the first metatarsal head as the tool body continues to rotate in the left counterclockwise direction about the body axis;

continuing to rotate the surgical tool in the left counterclockwise direction until the tool stop contacts the first metatarsal head to prevent the surgical tool from being further rotated in the left counterclockwise direction about the body axis and from further drilling into the first metatarsal head; and

manipulating and moving the first metatarsal head on the frontal, sagittal and transverse planes of the right foot, and effecting left-counterclockwise rotation of the first metatarsal head with the surgical tool as the surgical tool is brought into close engagement with the first metatarsal head.

111. A method of performing a bunions procedure as claimed in claim 110, wherein said positioning guide is a guide wire.

112. A method of performing a bunions procedure as claimed in claim 110, wherein said positioning guide is a guide wire pre-embedded in said first metatarsal head at said bone drilling location.

113. A method of performing a bunions procedure as claimed in claim 110, wherein said positioning guide is a k-wire of 0.45mm diameter.

114. A method of performing a bunions procedure as claimed in claim 110, wherein an external drill is connected to the operative end of the tool body, the drill being subsequently used to rotate the surgical tool about the body axis.

115. A method of performing a bunion procedure as recited in claim 110, further comprising:

providing a ring at a location along the tool body; and

additional wires are directed through the loop and used to provide temporary fixation of the bone material.

116. A method of performing a bunion procedure as recited in claim 110, further comprising:

providing an angle tool guide having a positioning angle;

positioning the angle tool relative to the borehole location; and

aligning the positioning guide with the angulation tool at the positioning angle, and inserting the positioning guide into the first metatarsal head at the drilling location.

117. A surgical method, comprising:

providing a surgical tool having a tool body having a body axis, a threaded end, an operative end, and a guide hole extending through the tool body substantially along the body axis, the threaded end having threads and a tool stop, the operative end positioned to allow a user to grasp, manipulate, and rotate the tool body about the body axis;

providing an angle tool guide having a positioning angle and positioning the angle tool guide proximate the bone drilling location;

providing a positioning guide and aligning the positioning guide with the angle tool at the positioning angle;

inserting the positioning guide into a bone at the bone drilling location;

extending the positioning guide at least partially through the tool body through the guide hole;

aligning the positioning guide with the thread of the surgical tool and to the bone drilling location;

rotating a surgical tool in a drilling direction about the body axis to drill into the bone and engage the bone with the threads at the bone drilling location, the threads further tightening engagement with the bone as the tool body continues to rotate in the drilling direction about the body axis;

continuing to rotate the surgical tool until the tool stop contacts the bone to prevent the tool from being further rotated about the body axis and from further drilling into the bone; and

manipulating, moving and rotating the bone while the surgical tool is in close engagement with the bone.

118. The surgical method of claim 117, wherein the threads of the tool body are rotated in a clockwise direction to the right about the main tool body axis to drill into and engage the bone.

119. The surgical method of claim 117, wherein the threads of the tool body are rotated in a counterclockwise direction to the left about the main tool body axis to drill into and engage the bone.

120. The surgical method of claim 117, wherein the positioning guide is a guidewire.

121. The surgical method of claim 117, wherein the positioning guide is a guide wire pre-embedded in the bone at the bone drilling location.

122. The surgical method of claim 117, wherein the positioning guide is a k-wire with a diameter of 0.45 mm.

123. The surgical method of claim 117, wherein an external drill is connected to the operative end of the tool body, the drill being subsequently used to rotate the surgical tool about the body axis.

124. The surgical method of claim 117, further comprising:

providing a ring at a location along the tool body; and

additional wires are directed through the loop and used to provide temporary fixation of the bone material.

Images