US20150351780A1 - Elbow reconstruction instruments - Google Patents
Elbow reconstruction instruments Download PDFInfo
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- US20150351780A1 US20150351780A1 US14/830,414 US201514830414A US2015351780A1 US 20150351780 A1 US20150351780 A1 US 20150351780A1 US 201514830414 A US201514830414 A US 201514830414A US 2015351780 A1 US2015351780 A1 US 2015351780A1
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- drill
- tunnel
- humeral
- guide
- intersecting
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- 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
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
-
- 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
-
- 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
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1714—Guides or aligning means for drills, mills, pins or wires for applying tendons or ligaments
-
- 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
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1796—Guides or aligning means for drills, mills, pins or wires for holes for sutures or flexible wires
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8861—Apparatus for manipulating flexible wires or straps
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
Definitions
- FIG. 2A illustrates a cross-sectional view of the V-drill guide instrument of the present invention.
- FIG. 5 illustrates the skid instrument and the Suture Lasso inserted into the tunnel shown in FIG. 4 .
- FIGS. 6A-C illustrate various views (a cross-sectional view, a top view, and a left side view, respectively) of the wire skid shown in FIGS. 5 and 6 .
- FIG. 8 illustrates a humeral drill guide of the present invention for creating a tunnel in the humerus, and in position on the humerus.
- FIG. 8A illustrates a partial cross-sectional view of the humeral drill guide of FIG. 8 .
- FIG. 8B illustrates a front view of a drill used with the humeral drill guide of FIG. 8 .
- FIG. 9B illustrates a front view of the adjustable drill guide of FIG. 9A .
- FIG. 11 illustrates a suturelasso and skid extending through the humeral tunnel created by the adjustable drill guide of FIG. 9 .
- FIG. 12 illustrates the formation of two intersecting tunnels in the humerus, and according to an exemplary embodiment of the present invention.
- a method for attaching the graft includes, for example, the steps of creating a bone tunnel in the humerus, creating a bone tunnel in the ulna, placing the graft through the tunnels, and attaching at least one end of the graft to the humeral bone.
- V-drill guide 300 is provided with an elongated substantially rigid member 330 with a longitudinal axis 320 a , a proximal end 331 and a distal end 332 .
- a handle 320 is located at the proximal end 331 of the elongated member 330 .
- Two drill sleeves 310 a , 310 b having intersecting trajectories for creating an intersecting bone tunnel (a V-shaped bone tunnel) are provided at the distal end 332 of the elongated member 330 .
- the V-drill guide may have any number of trajectories but, in the preferred embodiment, angle ⁇ ( FIG. 2B ) is between 50 and 75 degrees.
- Distal end of drill sleeve 310 a , 310 b may have teeth 315 ( FIGS. 2A and 2B ) for gripping bone.
- each drill sleeve 310 a , 310 b extends in a direction non-parallel to the longitudinal axis 320 a of the handle 320 and the elongated member 330 , forming an angle ⁇ with the longitudinal axis 320 a .
- Angle ⁇ is preferably between 30 to 45 degrees, more preferably about 45 degrees.
- Each drill sleeve 310 a , 310 b is provided with a lumen 311 a , 311 b that is sized and configured to receive a surgical instrument such as a drill, a pin or an obturator, for example.
- Drill bit 350 (illustrated in FIGS. 2 and 2C ) is used to drill through the drill sleeve 310 a of the V-drill guide 300 .
- Drill bit 350 may have a stop 360 ( FIG. 2C ) to limit the depth drilled.
- skid 500 has a handle 510 and a shaft 520 .
- the shaft 520 has a u-shape channel 530 ( FIG. 6C ) for the wire loop to contact and create a smooth passageway through the tunnel.
- the position of the wire loop 650 outside the bone tunnel 380 facilitates passing sutures and the graft in the tunnel.
- FIGS. 5-6C illustrate the skid 500 and suturelasso 600 passing through the tunnel 380 .
- a through tunnel may be created using an offset guide 700 .
- Offset guide 700 is shown in FIGS. 7-7B with handle 710 .
- a cannulated tube 730 extends from handle 700 and through platform 750 .
- Cannulated tube 730 may have teeth 735 ( FIG. 7A ) at its most distal end to provide better gripping of the bony surface.
- Platform 750 ( FIG. 7B ) is generally rectangular in shape with a bore 745 for tube 730 to pass through and a prong 770 for placing against bone for stability.
- Prong 770 has a generally cylindrical shape with a distal flat side 775 contoured to approximate the bony anatomy of the ulna.
- the prong 770 is placed at the sublime tubercle of the ulna.
- the platform 750 extends away from the prong placing the cannulated tube 730 a set distance from the sublime tubercle in the desired spot for drilling the tunnel through the cannulated tube.
- Humeral socket drill guide 400 ( FIGS. 8 and 8A ) is used to drill an approximately 15 mm deep socket in the humerus with drill bit 450 .
- humeral socket drill guide 400 includes a handle 405 with a cannulated tube 407 extending from the handle.
- a drill 450 (shown in FIG. 8B ) with a depth stop 455 is placed through the cannulated tube 407 of the humeral socket drill guide 400 to create a socket 410 in humerus 100 .
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- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Biomedical Technology (AREA)
- Molecular Biology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Engineering & Computer Science (AREA)
- Dentistry (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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- Veterinary Medicine (AREA)
- Rheumatology (AREA)
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Abstract
Instrumentation for elbow reconstruction, specifically, for repairs of the ulnar collateral ligament (UCL). The instrumentation provides for precise formation of sockets and tunnels along with easy suture/graft passage while accommodating all forms of elbow UCL reconstruction techniques. A V-drill guide is provided with a handle and two drill sleeves having intersecting trajectories for creating an intersecting V-shaped bone tunnel in the ulna. An adjustable humeral guide has an adjustable arm with an arc shape, and a peg and a block extending from each end of the adjustable arm. The peg is shaped to fit within an already-formed humeral socket. The block allows a drill to pass through and form other tunnels which intersect with the originally-formed tunnel at various positions.
Description
- This is a divisional of U.S. application Ser. No. 13/028,690, filed Feb. 16, 2011, which claims the benefit of U.S. Provisional Application No. 61/306,346, filed Feb. 19, 2010, the entire disclosures of which are incorporated by reference herein.
- The present invention relates to surgical instruments and technique to reconstruct the elbow, in particular, the ulnar collateral ligament (UCL).
- When soft tissue such as a ligament or a tendon becomes detached from a bone, surgery is usually required to reattach or reconstruct the tissue. When the ligament is the ulnar collateral ligament (UCL) of the medial elbow, a graft may be used to replace the entire ligament to facilitate regrowth and permanent attachment. Instrumentation and techniques to facilitate this repair are needed.
- The present invention provides new and improved instrumentation for elbow reconstruction, specifically, for repairs of the ulnar collateral ligament (UCL). The instrumentation of the present invention provides for precise formation of sockets and tunnels along with easy suture/graft passage while accommodating all forms of elbow UCL reconstruction techniques.
- These and other features and advantages of the invention will be more apparent from the following detailed description that is provided in connection with the accompanying drawings and illustrated exemplary embodiments of the invention.
-
FIG. 1 illustrates the location of the ulnar collateral ligament between the ulna and humerus. -
FIG. 2 illustrates a V-drill guide instrument of the present invention in position on the ulna (for drilling along with a drill used to drill a bone tunnel). -
FIG. 2A illustrates a cross-sectional view of the V-drill guide instrument of the present invention. -
FIG. 2B illustrates a front view of the V-drill guide instrument of the present invention. -
FIG. 2C illustrates a front view of the drill ofFIG. 2 used with the V-drill guide instrument of the present invention. -
FIG. 3 illustrates the V-drill guide ofFIGS. 2A-B in position with an obturator inserted through the guide. -
FIG. 3A illustrates a perspective view of the obturator ofFIG. 3 . -
FIG. 4 illustrates the tunnel created using the V-drill guide ofFIGS. 2A-B . -
FIG. 5 illustrates the skid instrument and the Suture Lasso inserted into the tunnel shown inFIG. 4 . -
FIG. 6 illustrates the wire loop of the Suture Lasso ofFIG. 5 , exiting from the other end of the tunnel through the skid. -
FIGS. 6A-C illustrate various views (a cross-sectional view, a top view, and a left side view, respectively) of the wire skid shown inFIGS. 5 and 6 . -
FIG. 7 illustrates an offset guide of the present invention (an optional instrument) for creating a tunnel in the ulna, and in position on the ulna. -
FIGS. 7A and B illustrate a cross-sectional view and a perspective view, respectively, of the offset guide ofFIG. 7 . -
FIG. 8 illustrates a humeral drill guide of the present invention for creating a tunnel in the humerus, and in position on the humerus. -
FIG. 8A illustrates a partial cross-sectional view of the humeral drill guide ofFIG. 8 . -
FIG. 8B illustrates a front view of a drill used with the humeral drill guide ofFIG. 8 . -
FIG. 9 illustrates an adjustable drill guide of the present invention, for creating an intersecting tunnel in the humerus, and in position on the humerus. -
FIG. 9A illustrates an exploded perspective view of the adjustable drill guide ofFIG. 9 . -
FIG. 9B illustrates a front view of the adjustable drill guide ofFIG. 9A . -
FIG. 9C illustrates a back view of the adjustable drill guide ofFIG. 9A . -
FIG. 10 illustrates the adjustable drill guide ofFIG. 9 , in position on the humerus, and with a drill extending through the guide portion. -
FIG. 11 illustrates a suturelasso and skid extending through the humeral tunnel created by the adjustable drill guide ofFIG. 9 . -
FIG. 12 illustrates the formation of two intersecting tunnels in the humerus, and according to an exemplary embodiment of the present invention. - The present invention provides surgical systems and methods for repair of soft tissue, specifically, for reattaching or replacing the ulnar collateral ligament to the humerus and ulna. The systems of the present invention contain various instruments such as drills, guides, obturators, Suture Lassos and skids that allow precision formation of sockets and tunnels along with easy suture/graft passage, while accommodating all forms of elbow UCL reconstruction.
- A method for attaching the graft includes, for example, the steps of creating a bone tunnel in the humerus, creating a bone tunnel in the ulna, placing the graft through the tunnels, and attaching at least one end of the graft to the humeral bone.
- Referring now to the drawings, where like elements are designated by like reference numerals,
FIGS. 1-12 illustrate exemplary instruments and methods for creating elbow tunnels and passing graft through tunnels. -
FIG. 1 illustratesulnar collateral ligament 10 attached to thehumeral bone 100 on one end and to theulna bone 200 on the other end. In an exemplary method of replacing the UCL, a graft is secured within tunnels formed in thehumerus 100 and theulna 200. In one embodiment, abone tunnel 380 is formed on theulna 200 using a V-drill guide 300. -
FIG. 2 illustrates the V-drill guide 300 of the present invention positioned on theulna 200. Also shown inFIG. 2 is adrill bit 350 which is inserted through one of the sleeves of the V-drill guide 300 for drilling a bone tunnel in the ulna, as detailed below. - As shown in
FIGS. 2A and 2B , V-drill guide 300 is provided with an elongated substantiallyrigid member 330 with alongitudinal axis 320 a, aproximal end 331 and adistal end 332. Ahandle 320 is located at theproximal end 331 of theelongated member 330. Twodrill sleeves distal end 332 of theelongated member 330. The V-drill guide may have any number of trajectories but, in the preferred embodiment, angle α (FIG. 2B ) is between 50 and 75 degrees. Distal end ofdrill sleeve FIGS. 2A and 2B ) for gripping bone. - As also shown in
FIG. 2A , eachdrill sleeve longitudinal axis 320 a of thehandle 320 and theelongated member 330, forming an angle β with thelongitudinal axis 320 a. Angle β is preferably between 30 to 45 degrees, more preferably about 45 degrees. Eachdrill sleeve lumen - Drill bit 350 (illustrated in
FIGS. 2 and 2C ) is used to drill through thedrill sleeve 310 a of the V-drill guide 300.Drill bit 350 may have a stop 360 (FIG. 2C ) to limit the depth drilled. - An obturator 390 (shown in
FIGS. 3 and 3A ) may be placed indrill sleeve 310 a to hold thedrill guide 300 in position whiledrill bit 350 drills through thesecond drill sleeve 310 b. Once drilling is completed, atunnel 380 approximately 1-2 cm distal from the articulating surface of the ulna, anterior and posterior to the sublime tubercle of the ulna, is created. As illustrated inFIG. 4 , abone bridge 385 is also created betweenopenings 380 a of the tunnel 380 (i.e., the length of bone extending between the centers of the twoopenings 380 a). The V-drill guide 300 (depending on the angle) can create a bone bridge of between about 5.5 mm and 7.5 mm. This bone bridge avoids any possible fracture of the tunnel into the ulnohumeral joint. - Once
bone tunnel 380 has been created, a skid 500 (FIG. 5 ) is fully inserted into thetunnel 380. A suture/wire passing instrument 600 (for example, a retrograde suture passing instrument such as an Arthrex Suture Lasso) (FIG. 5 ) is inserted from the opposite end of the tunnel and the wire loop 650 (FIG. 6 ) is advanced until it reaches the skid within the tunnel. Theskid 500 provides a smooth path for the wire loop to follow through the tunnel. - As shown in
FIGS. 6A and 6B ,skid 500 has ahandle 510 and ashaft 520. Theshaft 520 has a u-shape channel 530 (FIG. 6C ) for the wire loop to contact and create a smooth passageway through the tunnel. The position of thewire loop 650 outside thebone tunnel 380 facilitates passing sutures and the graft in the tunnel.FIGS. 5-6C illustrate theskid 500 and suturelasso 600 passing through thetunnel 380. - In an alternate embodiment, instead of creating an intersecting bone tunnel in the ulna (such as the formation of intersecting V-shaped
bone tunnel 380 detailed above), a through tunnel may be created using an offsetguide 700. - Offset
guide 700 is shown inFIGS. 7-7B withhandle 710. A cannulatedtube 730 extends fromhandle 700 and throughplatform 750.Cannulated tube 730 may have teeth 735 (FIG. 7A ) at its most distal end to provide better gripping of the bony surface. Platform 750 (FIG. 7B ) is generally rectangular in shape with abore 745 fortube 730 to pass through and aprong 770 for placing against bone for stability.Prong 770 has a generally cylindrical shape with a distalflat side 775 contoured to approximate the bony anatomy of the ulna. Theprong 770 is placed at the sublime tubercle of the ulna. Theplatform 750 extends away from the prong placing the cannulated tube 730 a set distance from the sublime tubercle in the desired spot for drilling the tunnel through the cannulated tube. - A pin 800 (
FIG. 7 ) is placed through the cannulatedtube 730 of the offsetguide 700 and drilled through the bone. A reamer 900 is placed over thepin 800 and used to ream out a partial length of the tunnel to accommodate an end of the graft. A button could be used to attach the graft to the ulna. Alternately, if a screw is to be used for fixing the graft, the reamer would be used to ream the entire tunnel. - To complete the UCL reconstruction surgery, a second bone tunnel is formed in the
humerus bone 100. Humeral socket drill guide 400 (FIGS. 8 and 8A ) is used to drill an approximately 15 mm deep socket in the humerus withdrill bit 450. As shown inFIGS. 8 and 8A , humeralsocket drill guide 400 includes ahandle 405 with a cannulatedtube 407 extending from the handle. A drill 450 (shown inFIG. 8B ) with adepth stop 455 is placed through the cannulatedtube 407 of the humeralsocket drill guide 400 to create asocket 410 inhumerus 100. - Adjustable
humeral guide 470 is designed to fit into thesocket 410 as shown inFIG. 9 . Various views of the adjustablehumeral guide 470 are illustrated inFIGS. 9A-C . Adjustablehumeral guide 470 has anadjustable arm 474 with aproximal end 471 and adistal end 473 having an arc shape. Apeg 472 extends from thedistal end 473 of theadjustable arm 474.Peg 472 is shaped to fit within thesocket 410 created using thehumeral drill guide 400.Block 478 extends from theproximal end 471 of the adjustable arm and has apassageway 477 extending through, and sized for a drill to pass through. Adjustablehumeral guide 470 allows for at least onehole 411 to be drilled which intersects with theoriginal socket 410 at various positions. The guide may pivot and slide covering various angles in reference to thepeg 472 situated within theoriginal socket 410 which allows the surgeon to choose the best position for situating the graft. Theblock 478 slides on theadjustable arm 474 and may be securely fixed relative to thepeg 472 by a securingdevice 450, such as a knob for example (FIG. 9A ). Thesame drill 350 used to create the intersecting tunnel in the ulna is used with the adjustablehumeral guide 470 to create anintersecting tunnel 411 in the humerus, as illustrated inFIG. 10 . -
Skid 500 is used with thewire loop 650 ofsuturelasso 600 in a similar manner as in the ulna, to pass sutures and the graft through the tunnel as illustrated inFIG. 11 . -
FIG. 12 illustrates another embodiment of the present invention according to which at least two intersecting tunnels are formed in the humerus, each formed with the adjustablehumeral guide 470 of the present invention. The design of the adjustablehumeral guide 470 allows for a plurality of holes/tunnels to be drilled, each of the plurality of the holes/tunnels intersecting with theoriginal socket 410 at various positions and angles. -
FIG. 12 illustrates an exemplary embodiment only, according to which a thirdhumeral tunnel 413 is also drilled using the adjustablehumeral guide 470, in addition to the secondhumeral tunnel 411. The result is having two holes/tunnels original tunnel 410. If desired, and depending on the patient's anatomy, more than three tunnels (i.e., more than two intersecting tunnels) can be formed.FIG. 12 shows a simulation ofgraft 800 being pulled through thefirst tunnel 410, with the attachedsutures humeral tunnels sutures - Once the tunnels are created in both the ulna and the humerus, various known methods such as the Tommy Jones method, the modified Tommy Jones method, the Docking method, the Interference Screw method, or the Hybrid-Interference Screw method may be used to place and attach the graft.
- Although the present invention has been described in relation to particular embodiments thereof, many other variations and modifications and other uses will become apparent to those skilled in the art. Therefore, the present invention is to be limited not by the specific disclosure herein, but only by the appended claims.
Claims (17)
1. A surgical instrument for ulnar collateral ligament reconstruction, comprising:
an elongated substantially rigid member with a longitudinal axis, a proximal end and a distal end;
a handle located at the proximal end of the elongated member; and
two drill sleeves located at the distal end of the elongated member, the drill sleeves being symmetrically disposed relative to the longitudinal axis of the member and a mirror image of each other, the drill sleeves being non-parallel to the longitudinal axis of the elongated member and forming a structure with a V shaped configuration so that trajectories of the two drill sleeves form an angle of about 50 to about 75 degrees, a distal end of each of the drill sleeves being provided with teeth for gripping bone, and each drill sleeve having a lumen for receiving a drill, obturator, or a pin.
2. The surgical instrument of claim 1 , wherein the drill sleeves are positioned on the ulna and a drill is inserted through each sleeve to each drill a tunnel through ulna and form a resulting intersecting bone tunnel.
3. The surgical instrument of claim 2 , wherein the drill has a drill stop to limit the depth drilled.
4. The surgical instrument of claim 2 , wherein the resulting intersecting bone tunnel has a V-shaped configuration.
5. The surgical instrument of claim 4 , wherein openings of the resulting intersecting bone tunnel define a bone bridge on the bone cortex, the bone bridge having a length between the openings of about 5.5 mm to about 7.5 mm.
6. A V-drill guide for ulnar collateral ligament reconstruction, comprising:
a handle having a longitudinal axis, a proximal end and a distal; and
two drill sleeves located at the distal end of the handle, wherein the drill sleeves are symmetrically disposed relative to the longitudinal axis of the handle and a mirror image of each other, the drill sleeves being non-parallel to the longitudinal axis of the handle so that each of the drill sleeves forms a first angle with the longitudinal axis of the handle, and wherein the drill sleeves are non-parallel relative to each other and are oriented so that they form a second angle between them.
7. The V-drill guide of claim 6 , wherein the first angle is of about 30 to about 45 degrees.
8. The V-drill guide of claim 6 , wherein the second angle is of about 50 to about 75 degrees.
9. An offset guide for forming a through tunnel through the ulna, comprising:
a cannulated tube extending from a handle, the cannulated tube forming an angle of about ninety degrees with the handle; and
a platform extending from the cannulated tube, the platform forming an angle of about ninety degrees with the cannulated tube, the platform having a generally rectangular configuration and being provided with a bore to allow the cannulated tube to pass therethrough, the platform further including a prong for placement against bone cortex and on the sublime tubercle of the ulna, the prong being about parallel to the cannulated tube.
10. The offset guide of claim 9 , wherein the platform extends away from the prong to place the cannulated tube a set distance from the articulating surface of ulna/humerus joint, over the sublime tubercle of the ulna.
11. The offset guide of claim 10 , wherein the cannulated tube is sized to allow a drill pin to pass therethrough and drill a tunnel in the ulna at the set distance from the sublime tubercle of the ulna.
12. An adjustable humeral guide for forming at least one intersecting tunnel through the humerus, comprising:
an adjustable arm having a proximal end and a distal end, and an arc-shaped configuration;
a peg extending from the distal end of the adjustable arm, the peg being configured and sized to fit within a first humeral tunnel; and
a block extending from the proximal end of the adjustable arm, the block being provided with a bore to allow a drill to pass therethrough and to form at least one second humeral tunnel within the humerus, the at least one second humeral tunnel intersecting the first humeral tunnel at different angles.
13. The adjustable humeral guide of claim 12 , wherein the block is configured to pivot and slide relative to the peg, covering various angles relative to the peg.
14. The adjustable humeral guide of claim 12 , wherein the block is configured to form a plurality of humeral tunnels within the humerus, each of the plurality of humeral tunnels intersecting the first humeral tunnel at an angle.
15. The adjustable humeral guide of claim 12 , wherein the block is configured to form a second humeral tunnel within the humerus, the second humeral tunnel intersecting the first humeral tunnel at a first angle, and a third humeral tunnel, the third humeral tunnel intersecting the first humeral tunnel at a second angle.
16. A kit for ulnar collateral ligament reconstruction, comprising:
a V-drill guide for forming an intersecting V-shaped bone tunnel in the ulna, the V-drill guide comprising a handle having a longitudinal axis, a proximal end and a distal end; and two drill sleeves located at the distal end of the handle, wherein the drill sleeves are symmetrically disposed relative to the longitudinal axis of the handle and a mirror image of each other and having intersecting trajectories, the drill sleeves being non-parallel relative to each other and forming an angle of about 50 to about 75 degrees between them;
an adjustable humeral guide for forming a socket or tunnel through the humerus, the adjustable humeral guide comprising an adjustable arm having a proximal end and a distal end, and an arc-shaped configuration; a peg extending from the distal end of the adjustable arm, the peg being configured and sized to fit within a previously-formed socket or tunnel; and a block extending from the proximal end of the adjustable arm, the block being provided with a bore to allow a drill to pass therethrough and to form at least one second socket or tunnel within the humerus, the at least one second socket or tunnel intersecting the previously-formed socket or tunnel at different angles; and
a drill sized to pass through both the two drill sleeves of the V-drill guide and through the bore of the block of the adjustable humeral guide, to form the intersecting V-shaped bone tunnel in the ulna and the at least one second socket or tunnel in the humerus.
17. The kit of claim 16 , further comprising an obturator, a reamer, a skid, a wire loop and a suture passing instrument.
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US14/830,414 US20150351780A1 (en) | 2010-02-19 | 2015-08-19 | Elbow reconstruction instruments |
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US30634610P | 2010-02-19 | 2010-02-19 | |
US13/028,690 US9138246B2 (en) | 2010-02-19 | 2011-02-16 | Elbow reconstruction instruments and techniques |
US14/830,414 US20150351780A1 (en) | 2010-02-19 | 2015-08-19 | Elbow reconstruction instruments |
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US13/028,690 Division US9138246B2 (en) | 2010-02-19 | 2011-02-16 | Elbow reconstruction instruments and techniques |
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US14/830,414 Abandoned US20150351780A1 (en) | 2010-02-19 | 2015-08-19 | Elbow reconstruction instruments |
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CN105919660A (en) * | 2016-05-30 | 2016-09-07 | 袁振 | Fracture block fixing device and method for fixing fracture block |
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US6520964B2 (en) | 2000-05-01 | 2003-02-18 | Std Manufacturing, Inc. | System and method for joint resurface repair |
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