Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
  • A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
  • A61B17/1664—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the hip
  • A61B17/1666—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the hip for the acetabulum
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
  • A61B17/1613—Component parts
  • A61B17/1615—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material
  • A61B17/1617—Drill bits, i.e. rotating tools extending from a handpiece to contact the worked material with mobile or detachable parts
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B2017/00477—Coupling

Definitions

• the object of the present invention is a surgical bur, and in particular an acetabular bur, also called “acetabular” reamer, that is to say, intended to dig the hip bone to place a prosthesis.
• hemispherical bolsters In the medical field, and particularly in the field of acetabulum burs, hemispherical bolsters are known, having openings and cutting edges, similar to those of cheese graters, and which are formed by stamping, cutting and cutting. spinning. Examples of such hemispherical head mills are found in documents CH 692600, CH 690021, FR 2281095, US 4811632, or US 5100267.
• Strawberries of the aforementioned type are relatively expensive to manufacture, particularly because of the various operations involved in this manufacture.
• US 5100267 discloses a single-use hemispherical cap cup milling cutter.
• the acetabulum described in this document is provided with a polymer fitting, easy to manufacture and inexpensive.
• the hemispherical cap made of stainless steel, must be manufactured according to conventional methods. It is to say that it remains expensive.
• the presence of plastics often presents risks because Materials of this type, very soft, can easily leave particles in the body, which is often poorly tolerated by the patient.
• cutters have cutting edges, arranged radially, in a star, from the axis of rotation, and which radiate outwards.
• Such examples are found in patents FR1041311, FR1031888, US3, 702, 611 or US4,621637.
• the blades are reported, that is to say, manufactured independently, and fixed in the head, which has for this purpose housing. Fixing means are necessary (such as screws or tenons), which complicates the device.
• This kind of strawberry has the same drawbacks mentioned above, and in particular the difficulty encountered by the surgeon to see the bottom of the cavity that digs the strawberry. Moreover, such strawberries remain expensive to manufacture.
• PCT application published under WO98 / 31291 shows a relatively simple acetabulum cutter in which flat blades are cut in the form of an arc of a circle in a metal foil and are joined together by slots in the blades. themselves.
• the blades intersect at right angles and fit into a half-sphere. To fix them on a tool and hold them together, the blades are inserted by pins placed at the two ends of each blade in holes made in a base plate. This plate itself has a central opening which allows to fix it on a rotary tool.
• the device covered by this PCT application WO02 / 49516 relates mainly to a fastening system of the cutter, consisting of cut blades, on a strawberry holder of known type, with bayonet.
• bayonet cutter holders are described in particular in patents EP 0 704 191, EP 0 947 170 and EP 1 129 667. They consist essentially of a handle surmounted by a cylindrical head having four notches open upwards, and which extend laterally in the wall of the cylindrical head, and a locking member sliding along the handle and provided with vertical fingers that close the notches once the mill in place.
• the cutter described in this PCT application WO 02/49516 can not however be fixed directly in the strawberry holder in question.
• the PCT application WO 02/49516 describes an intermediate tool, in which the cutter is fixed by a ball device and which itself has, at the bottom, a cross formed of two cylindrical cross-shaped pieces. , placed horizontally, and each branch is adapted to be inserted into one of the four notches of the strawberry holder.
• the advantage of such a device is to allow the attachment of a cutter consisting of blades cut in a metal sheet to a tool holder of a known type and widespread, the advantage of this type of strawberries being a cost low enough and the possibility that it gives the surgeon to see the cavity dug during the operation.
• the aim of the invention is to allow a direct attachment of a milling cutter of this type to a "bayonet" type tool, as described for example in patents EP 0 704 191 and EP 1 129 667, without need an intermediate tool.
• the present invention further proposes to provide a milling cutter, allowing such a fastener, and which is composed of blades assembled together by slots, whose longitudinal axis of symmetry preferably coincides with the axis of rotation, these blades being in contact with each other. more than two (to provide better rigidity) and preferably at least four.
• a mill easy to manufacture, will be more rigid and more efficient in cutting than known reamers, while ensuring optimum visibility during operation. It is also inexpensive to manufacture, the blades being all cut in metal sheets.
• the invention also aims to provide blades for such a construction.
• the surgical drill object of the invention is formed of several flat blades assembled together by means of slots.
• the longitudinal axis of symmetry coincides with the axis of rotation of the cutter;
• the cutter preferably comprises at least four blades; in the preferred embodiment of the invention, one or more slots of said blades, or one or more sectors of said slots, have a width different from that of other slots and / or slit sectors.
• At least one of the blades has at least one lateral extension cut into the blade itself and able to fit into a notch of a bayonet cutter holder, in particular a bayonet cutter holder of the type of those described in patents EP 0 704 191 and EP 1 129 667.
• the surgical bur according to the invention is formed of several flat blades assembled together by means of slots, and at least one of the blades has at least one lateral extension cut in the blade itself and adapted to fit into a notch of a bayonet cutter holder.
• At least one of the slits and / or sectors of the slit or slots has a width different from that of at least one slit and / or slit sector.
• the longitudinal axis of symmetry of the slots coincides with the axis of rotation of the cutter.
• the lateral extension has a folded portion relative to the plane of the blade in which it is cut.
• the folded portion ends with a rounding.
• the lateral extension has a notch.
• the cutter comprises at least one stiffening element which partially encircles and holds together the blades making up the cutter.
• the stiffening element is a flat ring whose plane is perpendicular to the axis of rotation of the cutter and which has radial notches in which the blades are inserted.
• the radial notches are made on the inner edge of the flat ring.
• the cutter comprises at least four blades, at least two of which each have two lateral extensions.
• the cutter comprises four blades, of which a first blade has at least one slot extending from the lower edge of the blade. blade, a second blade has at least one slot from the top of the rounded portion of the blade, each of said slots having, at least on one sector, a width corresponding to the thickness of the blade in which is formed the other slot, the third blade has at least one upper slot from the top of said third blade and at least one lower slot from the lower edge of said third blade, the width of said upper slot being greater than the width of said lower slot , and whose fourth blade has at least one slot extending from the top of said blade, said slot comprising at least one outer sector and one inner sector, the width of said outer sector being greater than the width of said inner sector, the width of the lower slot of the third blade corresponding to the thickness of the fourth blade, the width of the inner sector of the slot of the fourth blade corresponding to the thickness of the third blade, and the width of the upper slot of the
• the slot (15) of the first blade has at least two sectors of different width, the outer sector being wider than the inner sector.
• the second blade has at least one lower slot starting from its lower edge, said lower slot being wider than the slot which starts from the top of the blade.
• the blade according to the invention As for the blade according to the invention and intended for a milling cutter according to the invention, it comprises a rounded upper part, and a narrower lower part at the bottom of which is formed the lateral extension which allows direct attachment of the milling cutter. in the notch of the bayonet cutter holder.
• the blade comprises at least one slot having sectors of different widths.
• the blade comprises at least one slot extending from the top of the rounded portion, or the lower edge of the blade.
• the blade comprises an upper slot starting from the top of the rounded upper part and / or a lower slot starting from the lower edge, the width of the upper slot being different from the width of the lower slot.
• the blade comprises an upper slot starting from the top of the rounded upper part, and / or a lower slot starting from the lower edge, at least one of said upper or lower slots comprising at least one sector. outside and an inner sector, the width of the outer sector being greater than the width of the inner sector.
• Figure 1 is an elevational view of a bayonet cutter holder with its hemispherical cap-shaped cutter, in the known technique described in patent EP 0 704 191.
• the notches of the bayonet device are here closed by the fingers of the sliding locking piece, which is pressed against the head.
• FIG. 1 is an elevational view of a bayonet cutter holder with its hemispherical cap-shaped cutter, in the known technique described in patent EP 1 129 667.
• the sliding locking part being lowered and the fingers she wears being removed from the head, the notches are left open.
• Figure 3 is a perspective view of a milling cutter according to the invention in which the cutter has four blades, two of which are each provided with two attachment extensions folded with a rounded tip.
• FIG. 4 is a perspective view in a perspective view of a milling cutter in the same embodiment as that of FIG. 3, being mounted on the milling cutter, or removed from it, in an intermediate position. , the attachment extensions of the blades not being at the bottom of the notches intended to receive them. Locking fingers are not shown here for clarity of reading.
• Figure 5 is a detail designated by A in Figure 4 and enlarged here, showing better the intermediate position of the attachment extension of the blade in the notch of the head of the bur holder.
• Figure 6 is a front view of a blade of a milling cutter in the embodiment of Figures 3 to 4, with two attachment extensions, before they are folded.
• Figure 7 is a detail designated B in Figure 6 and enlarged here to more accurately show an attachment extension with the fold in which this extension is to be folded. 58
• FIG. 8 is a perspective view of a milling cutter according to the invention in which the milling cutter has four blades, two of which are each provided with two folded attachment extensions, as in FIG. 3, but in which the fold according to which the ends of said attachment extensions are horizontal instead of vertical, the ends of the extensions are not rounded.
• Figure 9 is a perspective view of a milling cutter in the same embodiment as that of Figure 8, mounted on the cutter holder, the blade attachment extensions being at the bottom of the notches for receiving them.
• the locking fingers that lock the cutter in this position are not shown here for clarity of reading.
• Figure 10 is a detail designated by C in Figure 9 and enlarged here, showing better the position of the blade attachment extension in the notch of the cutter head, still without representation of the locking finger.
• Figure 11 is a front view of a cutter blade in the embodiment of Figures 8 to 10, with two attachment extensions, before they are folded.
• Fig. 12 is a detail denoted by D in Fig. 11 and enlarged therein to more accurately show an attachment extension with the fold in which this extension is to be folded.
• Figure 13 is a perspective view of the various components of a milling cutter in the embodiment of Figures 3 to 7, before assembly, and without stiffening element.
• Figure 14 is a front view of a flat ring for ensuring the rigidity of the assembly formed by the blades once assembled.
• Figure 15 is a three-quarter view of a bur in an embodiment similar to that of Figures 3-7 and 13, but wherein the blades are recessed in the center.
• the blades can be cut from a metal sheet.
• metal foil does not include hard metal foils of the carbide type, but only sheets of metals that can be stamped, such as stainless steel.
• the blades 1 of the cutter according to the invention are cut from a sheet of metal; in the preferred form of the invention, the blades are cut by stamping. This way of doing has the advantage of a very low price. Laser cutting or electro-erosion is also possible, but at a less favorable price.
• the stamping operation by which the blade is cut will also give, and in the same operation, its cutting edge over the blade.
• the cutting teeth in the cutting edge of the blade, and the possible inclination of said blades relative to the plane of the blade can be obtained by stamping, and in one and the same operation.
• Such an inclination is not indispensable.
• the cutter is composed of four blades la, Ib, Ic and Id.
• Each blade has a longitudinal axis of symmetry H which coincides with the axis of rotation 19 of the cutter.
• the cutting edge of the blades that is to say the wire, is rounded, and here of substantially semicircular shape. This form is particularly well suited to acetabular cutters. However, it is obvious that many other forms can be used, depending on the purposes for which the cutter is intended.
• Each blade has at least one slot 13 or 15, which is on the axis of rotation 19. This longitudinal slot allows the insertion of blades into each other.
• Each blade also has a lower portion 12, which here has the shape of a double rectangle which extends the blade towards the head of the cutter holder to which the cutter is to be fixed. It is this lower part 12 that allows this connection.
• the slot 15 is made in the first plate 1a of the edge 16 of the lower part 12 to the middle of the height of the blade.
• the slot 13 of the second blade Ib is formed from the mid-height to the top 14 of the blade. In this way, the first two blades fit into each other at right angles.
• the third blade Ic and the fourth blade Id each have a slot 13 which goes from their top 14 to their lower part 12.
• the slot 13 of the third blade Ic is wider than the upper slot 13 that the second blade Ib.
• the upper part that is to say the outer sector 17 of the slot 13 of the fourth blade Id similarly has an increased width.
• the third blade Ic has on the other hand a lower slot 15 which goes from its lower edge 16 to the quarter of said lower part; this lower slot 15 is narrower than the upper slot 13. Its width corresponds to the thickness of the fourth blade Id.
• the slot 13 of the fourth blade Id has two sectors 17 and 18; the outer sector 17, which goes from the vertex 14 of the fourth blade Id to the middle of the height of the lower portion 12, is wider than the inner sector 18.
• the width of the inner sector 18 corresponds to the thickness of the third blade Ic.
• the third and fourth blades can be nested one inside the other, the third blade Ic being inserted into the inner sector 18 of the fourth blade Id and the fourth blade Id being inserted into the lower slot 15 of the third blade Ic.
• the third blade Ic and the fourth blade Id are here joined to each other by the lower slot 15 of the third blade and by the inner sector 18 of the fourth blade Id, at right angles.
• the group formed by the first two blades la and Ib is then inserted into the upper slot 13 and the outer sector 17 of the group formed by the third and fourth blades.
• the slot 15 of the first blade has an inner sector 18 and an outer sector 17, the latter extending in the bottom 20 of the lower part 12. This outer sector 17 is wider than the inner sector 18.
• the second blade Ib has a lower slot 15 also located in the bottom 20 of the lower part 12. The increased width of this lower slot 15 of the second plate Ib and the outer sector 17 of the slot 13 of the first blade allows it to insert the assembly formed by the third and fourth blades assembled.
• the lower parts 12 have the form of a double rectangle, and all the blades are the same length. If we consider the embodiment shown in Figure 13, we see that the lower rectangles 20 of the first blade and the second blade Ib respectively bear the outer sector 17 of the slot 15 of the first blade and the lower slot 15 of the second blade Ib. As we have seen, these two openings are wide enough to receive the assembly formed by the third and fourth blades Ic and Id. It is however possible to shorten the first and second blades, removing the lower rectangle 20. The rigidity of the assembly will however be reduced.
• a precise adjustment of the widths of the slots and the blades makes it possible to prevent any relative movement of the blades relative to one another and to obtain a rigid assembly.
• the stiffening element 7 whether it is a flat ring, a cylindrical sleeve, or any other shape, can be fixed by welding, gluing or any other way. Hunting remains the simplest process.
• This assembly can be made even more rigid, if necessary, by adding a second ring 7 a second sleeve, of larger diameter, and which encloses the blades at a greater distance from the axis of rotation 19.
• the axis of symmetry 11 of the blades 1 coincides with the axis of rotation 19 of the cutter. In order to allow their sharpening, if necessary, it is advantageous to provide a hole placed on this axis of rotation, as shown in Figures 3, 4, 6, 8, 9, 11 and 13.
• the blades are largely hollowed out, which increases the visibility and decreases the weight.
• the third and fourth blades Ic and Id each have two lateral extensions 2, projecting from the lower rectangle 20 of the lower portion 12. These lateral extensions are simply cut in the same sheet as the rest of the blade.
• the lateral extension 2 has a folded portion 4, with a rounded end 5.
• the rounding 5 has a shape which corresponds to that of the bottom of the notch 3 of the cutter holder to which the cutter must be fixed.
• the end of the extension 2 is not rounded, and is folded in a fold 21 which is perpendicular and not parallel to the axis of rotation 19.
• the last folded 4 of the extension 2 is based on a point against the bottom of the notch 3 of the cutter holder, while the top of the extension 2 is based on the top of the notch 3.
• An indentation 6 is formed in the extension 2, between the lower rectangle 20 and the folded portion 4, so as to allow more easily the folding.
• the blades have a semicircular cutting edge with teeth, which may be useful to facilitate milling depending on the intended purposes. As discussed above, preferably and to the extent possible, the teeth are cut and their inclination is obtained in one and the same stamping operation. Similarly, the extensions 2 and their parts 4 can be cut and folded in this same operation.
• extensions 2 allows direct attachment of the cutter in a conventional bayonet cutter holder, without the need for an intermediate tool.
• the cutter and blades object of the invention can be used primarily in the operations for placing hip prostheses and can be used on strawberries extremely widespread.

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• Health & Medical Sciences (AREA)
• Surgery (AREA)
• Life Sciences & Earth Sciences (AREA)
• Biomedical Technology (AREA)
• Medical Informatics (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Engineering & Computer Science (AREA)
• Dentistry (AREA)
• Heart & Thoracic Surgery (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Molecular Biology (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Surgical Instruments (AREA)
• Milling Processes (AREA)
• Milling, Broaching, Filing, Reaming, And Others (AREA)

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• 2006
  • 2006-10-09 WO PCT/CH2006/000558 patent/WO2007073606A1/fr active Search and Examination
  • 2006-10-09 CA CA002629739A patent/CA2629739A1/fr not_active Abandoned
  • 2006-10-09 EP EP06790939A patent/EP1965710A1/de not_active Withdrawn
  • 2006-10-09 US US12/087,005 patent/US20100292699A1/en not_active Abandoned
  • 2006-10-09 JP JP2008547819A patent/JP2009521962A/ja active Pending
  • 2006-10-09 BR BRPI0620862-2A patent/BRPI0620862A2/pt not_active IP Right Cessation

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