IE83815B1 - Surgical instrumentation - Google Patents
Surgical instrumentation Download PDFInfo
- Publication number
- IE83815B1 IE83815B1 IE1998/0128A IE980128A IE83815B1 IE 83815 B1 IE83815 B1 IE 83815B1 IE 1998/0128 A IE1998/0128 A IE 1998/0128A IE 980128 A IE980128 A IE 980128A IE 83815 B1 IE83815 B1 IE 83815B1
- Authority
- IE
- Ireland
- Prior art keywords
- instrumentation
- bone
- bone engaging
- tool guide
- tool
- Prior art date
Links
- 210000000988 Bone and Bones Anatomy 0.000 claims description 76
- 210000002758 Humerus Anatomy 0.000 claims description 20
- 210000001699 lower leg Anatomy 0.000 description 4
- 210000002310 Elbow Joint Anatomy 0.000 description 3
- 238000002271 resection Methods 0.000 description 3
- 238000003780 insertion Methods 0.000 description 2
- 241000763859 Dyckia brevifolia Species 0.000 description 1
- 210000003127 Knee Anatomy 0.000 description 1
- 210000002303 Tibia Anatomy 0.000 description 1
- 239000007943 implant Substances 0.000 description 1
- 238000009434 installation Methods 0.000 description 1
- 239000000463 material Substances 0.000 description 1
- 239000000203 mixture Substances 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- 239000010935 stainless steel Substances 0.000 description 1
- RTAQQCXQSZGOHL-UHFFFAOYSA-N titanium Chemical compound [Ti] RTAQQCXQSZGOHL-UHFFFAOYSA-N 0.000 description 1
- 229910052719 titanium Inorganic materials 0.000 description 1
- 239000010936 titanium Substances 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/14—Surgical saws ; Accessories therefor
- A61B17/15—Guides therefor
Description
SURGICAL INSTRUMENTATION
This invention relates to instrumentation for
aligning a surgical tool and primarily although not
exclusively relates to instrumentation for use in
resecting the distal end of a humerus.
When implanting a total joint prosthesis, it is
necessary to resect the ends of the bones which meet at
the joint. In the past, resecting has been carried out
by eye and relied almost exclusively on the skill of
the surgeon. More recently, instrumentation has been
produced for resecting the fiemur or tibia for
installation of a total knee prosthesis. Such
instrumentation comprises a jig to which is fitted a
rod. The rod is inserted into a bore drilled into the
intramedullary canal and provides alignment of the jig
with the longitudinal axis of the bone. One or more
openings are provided in the jig for insertion of a
drill bit or saw blade. Although this conventional
instrumentation provides reasonable alignment with the
longitudinal axis of the bone, it does not provide
rotational alignment of the jig about the longitudinal
axis of the bone, so that the surgeon must have
considerable skill and experience before he can carry
out an accurate bone resection.
According to the present invention there is
provided instrumentation for aligning a surgical tool
during the resecting of an end of a bone, the
instrumentation comprising a tool guide in which is
provided an opening for receiving and guiding a portion
of the surgical tool and a pair of clamping members
which are adapted to engage opposite sides of the bone,
at least one of the clamping members being provided
with a bone engaging element which is adapted to engage
a particular region of the bone and has a bone engaging
surface which has a known orientation relative to the
opening in the tool guide, such that when the clamping
elements are tightened onto the bone, the opening in
the tool guide is at a predetermined rotational
orientation with respect to the longitudinal axis of
the bone.
Preferably the tool guide is provided with a bone
engaging surface which engages the end of the bone
during a resecting operation.
Preferably the distance between the bone engaging
surface of the bone engaging element and the bone
engaging surface of the tool guide is set prior to
attachment of the instrumentation to the bone. This
distance may be fixed at the time the instrumentation
is manufactured or may be adjustable.
In one embodiment of instrumentation in which the
said distance is adjustable, the bone engaging element
is releasably slidable along an arm connected to the
tool guide. Preferably the arm is integrally formed
with the tool guide.
The tool guide may be provided with a rod which is
inserted into a bore in the intramedullary canal during
resection.
The guide opening in the tool guide may comprise a
slot for receiving the blade of a saw or may comprise a
bore for receiving the shank of a drill. A plurality
of guide openings may be provided in the tool guide and
may comprise a combination of slots and bores.
The bone engaging element is preferably elongate
and when engaging a bone extends substantially
transverse to the longitudinal axis of the bone.
Preferably, the instrumentation is used for
aligning a surgical tool for the resecting of an end of
a bone. In an embodiment adapted for resecting the
distal end of a humerus, the bone engaging element
engages the posterior cortex of the distal humerus and
the distance between the bone engaging surface of the
bone engaging element and the bone engaging surface of
the tool guide is adjustable between 30 and 40mm.
Preferably, the distance is fixed at 35mm.
For a better understanding of the present
invention and to show how it may be carried into
effect, reference will now be made, by way of example,
to the accompanying drawings, in which:
Figure 1 is a perspective View of instrumentation
for aligning a bone saw during resecting of the distal
end of a humerus;
Figure 2 is a rear View of the instrumentation of
Figure 1;
Figure 3 is a view on one side of the
instrumentation of Figure 1 when fitted to the distal
end of a humerus; and
Figure 4 is a View from above of the
instrumentation of Figure 1 when fitted to the distal
end of a humerus.
Referring to the drawings, Figure 1 and 2 are
views of instrumentation for aligning a bone saw with
the distal end of a humerus. The instrumentation
comprises a tool guide 2 integrally formed with an
opposing pair of clamping members 4, 6. Slots 8 which
are rectangular in cross—section and are adapted to
receive the blade of a bone saw extend through the
width of the tool guide 2.
Between the slots 8 is provided a bore 10 which
slidably receives an intramedullary rod 12. The rod 12
extends from the bone engaging face 11 of the tool
guide 2 between the clamping members 4, 6.
The free ends 14, 16 of the clamping members 4, 6
are provided with openings (not shown) which receive
the shanks 18, 20 of respective bone engaging elements
22, 24.
The shanks 18, 20 are slidable along a common axis
so that the bone engaging elements 20, 24 can be
brought closer together or moved further apart, and are
fixed in position by means of respective collets
operated by finger wheels 26, 28.
The bone engaging elements 22, 24 are of elongate
form and taper from a broad base portion to a narrow
bone engaging edge 30, 32.
Referring to Figures 3 and 4, in use of the
instrumentation a bore 32 is drilled along the
intramedullary canal from the distal end 34 of a
humerus 36 which is to resected. The finger wheels 26,
28 of the instrumentation are then unscrewed, so that
the bone engaging elements can be moved apart
sufficiently to accommodate the humerus 36 and the
instrumentation is placed onto the humerus with the
intramedullary rod 12 removed, such that the face 11 of
the tool guide 2 engages the distal end 34 of the
humerus 36. The rod 12 is then pushed through the bore
in the instrumentation and into the bore 32 in the
intramedullary canal of the humerus. The bone engaging
elements 22, 24 are then brought together so that the
edges 30, 32 of the bone engaging elements 22, 24 are
brought into contact with the cortex of the distal
humerus 36.
Anatomical studies have established a relationship
between the posterior cortex of the distal humerus and
the axis of movement of the elbow joint with reference
to the coronal plane. Referring to Figure 4, with the
distance d1 between the bone engaging face 11 of the
tool guide 2 and the bone engaging edge 30 of the upper
bone engaging element 22 set at 35mm, the axis of
movement of the elbow joint with reference to the
coronal plane will be parallel to the posterior cortex
of the distal humerus 36 and consequently the bone
engaging edge 30 of the upper bone engaging element 22
will itself be parallel to the axis of movement of the
elbow joint with reference to the coronal plane. By
arranging the slots 8 in the tool guide 2 such that
they extend in planes parallel to the bone engaging
edge 30 of the upper bone engaging element 22,
insertion of a bone saw (not shown) through the slots 8
will result in extremely accurate resection of the
distal end of the humerus, so that when a prosthetic
implant is attached to the resected bone the axis of
the movement of the artificial joint with reference to
the coronal plane will coincide exactly or
substantially exactly with the axis of movement of the
natural joint prior to the operation.
In an alternative embodiment (not illustrated) at
least the upper bone engaging element 22 is slidably
mounted to the clamping element 4, so that the upper
bone engaging element 22 can be slid along a line
substantially parallel to the intramedullary rod 12 and
the distance dl between the bone engaging edge 30 of the
bone engaging element 22 and the bone engaging surface
of the tool guide 2 can be adjusted to accommodate
variations in the dimensions of the humerus from
patient to patient. However it has been found that in
most cases if the distance dl in Figure 4 is set at 35mm
this is appropriate for most patients.
The adjustability of the position of the upper
bone engaging element may be provided by forming a
track in the upper clamping member 4 along which the
shank 18 of the upper bone engaging element 22 can
slide. In such an embodiment, tightening of the finger
wheels 26, 28 would not only set the relative
separation of the bone engaging elements 22, 24, but
would also set the distance between one or more of
these elements and the bone engaging face 11 of the
tool guide 2.
Instead of a single bore 10 through the tool guide
2, a pair of offset bores (not shown) may be provided
such that the instrumentation could be used on either a
left or right humerus, simply by inserting the
intramedullary rod 12 in the appropriate opening.
The instrumentation is preferably made of
stainless steel or titanium, but any appropriate
material with sufficient stiffness and strength and
which is suitable for autoclaving may also be used.
Claims (13)
1. Instrumentation for aligning a surgical tool during the resecting of an end of a bone, the instrumentation comprising a tool guide in which is provided an opening for receiving and guiding a portion of the surgical tool and a pair of clamping members which are adapted to engage opposite sides of the bone, at least one of the clamping members being provided with a bone engaging element which is adapted to engage a particular region of the bone and has a bone engaging surface which has a known orientation relative to the opening in the tool guide, such that when the clamping elements are tightened onto the bone, the opening in the tool guide is at a predetermined rotational orientation with respect to the longitudinal axis of the bone.
2. Instrumentation as claimed in claim 1, in which the tool guide is provided with a bone engaging surface which engages the end of the bone.
3. Instrumentation as claimed in claim 2, in which the distance between the bone engaging surface of the bone engaging element and the bone engaging surface of the tool guide is adjustable.
4. Instrumentation as claimed in claim 3, in which the tool guide is provided with an arm and the bone engaging element is releasably slidable along the arm to adjust the said distance.
5. Instrumentation as claimed in claim 4, in which the arm is integrally formed with the tool guide.
6. Instrumentation as claimed in any one of the preceding claims, in which the tool guide is provided with an intramedullary rod.
7. Instrumentation as claimed in any one of the preceding claims, in which the guide opening in the tool guide comprises a slot for receiving the blade of a saw.
8. Instrumentation as claimed in any one of the preceding claims, in which a plurality of guide openings are provided.
9. Instrumentation as claimed in any one of the preceding claims, in which the bone engaging element is elongate and when engaging the bone extends substantially transverse to the longitudinal axis of the bone.
10. Instrumentation as claimed in any one of the preceding claims, when appendant to claim 2, for aligning a surgical tool for resecting the distal end of a humerus, in which the distance between the bone engaging surface of the bone engaging element and the bone engaging surface of the tool guide is between 30 and 40mm.
11. Instrumentation as claimed in claim 10, in which the said distance is 35mm.
12. Instrumentation as claimed in claim 10 or 11, in which the bone engaging element engages the posterior cortex of the distal humerus.
13. Instrumentation substantially as described herein with reference to and as shown in the accompanying drawings. MACLACHLAN & DONALDSON Applicants’ Agents 47 Merrion Square DUBLIN 2
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
GBUNITEDKINGDOM21/02/19979703637.0 | |||
GB9703637A GB2322304B (en) | 1997-02-21 | 1997-02-21 | Surgical Tool Aligning Device |
Publications (2)
Publication Number | Publication Date |
---|---|
IE980128A1 IE980128A1 (en) | 1998-08-26 |
IE83815B1 true IE83815B1 (en) | 2005-02-23 |
Family
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