Surgical instrument handle assembly

A surgical instrument handle assembly configured for rigid and releasable connection to orthopedic devices including orthopedic shaping or cutting members such as a broaches, reamers and/or osteotomes adapted to prepare the intramedullary canal of a femur in total hip arthroplasty procedures.

FIELD OF THE INVENTION

The present invention relates generally to surgical instruments for use in orthopedic surgery, and more particularly but not exclusively relates to a surgical instrument handle assembly configured for releasable connection to orthopedic devices such as orthopedic shaping or cutting members used in total hip arthroplasty.

BACKGROUND

Minimally invasive surgical techniques have become popular in total hip arthroplasty (THA) procedures. Advantages include minimizing soft tissue damage, reducing recovery and healing time, and reducing the length of the patient's hospital stay. One version of a minimally invasive THA techniques is an “anterior approach” or “direct anterior approach” which uses, for example, a portal between the tensor fascia latae muscle and the rectus femoris muscle. An anterior approach can exploit the interval between those muscles for both acetabular and femoral preparation, allow for primary exposure of the hip joint capsule with minimization of muscle damage, limit incision length, and leverage other advantages. However, exposure of the proximal femoral intramedullary canal to prepare the canal for receipt of the femoral stem of a femoral implant can be problematic in a THA procedure using an anterior approach. For example, anatomical features of some patients, such as gut or muscle tissues and/or other anatomic structures, can present problems in accessing and preparing the femoral intramedullary canal via a short surgical incision.

In order to address these concerns, special instrument handles have been developed which may, in some instances, be provided with anterior and/or lateral offsets. Additionally, offset instrument handles reduce mobilization of the targeted bone required to gain access to the femoral intramedullary canal for shaping in preparation for a joint replacement implant such as a femoral stem. This advantage extends to all surgical approaches, and is not limited to a direct anterior approach. A bone shaping or cutting member, such as a broach or rasp, may be connected to the distal end of the instrument handle. The bone shaping member and the distal portion of the instrument handle is inserted through the incision, manipulated to avoid the gut or other anatomic structures by virtue of the anterior and/or lateral offsets, and the bone shaping member is inserted into the intramedullary canal of the femur to shape the canal for subsequent receipt of the femoral stem of a femoral implant.

Current surgical instrument handles configured for connection to bone shaping members are typically large and heavy, and separate instruments may be required for each of the right and left femurs. Consequent issues include those related to, among other things, logistics, inventory requirement, and expense. Additionally, the connection between the instrument handle and the bone shaping member may lack rigidity and may permit a degree of motion therebetween, thereby reducing control of the bone shaping member and also limiting visual and tactile feedback to the surgeon as to the fit of the bone shaping member within the femoral canal which would otherwise provide the surgeon with the ability to estimate the resulting tightness of fit of the femoral stem within the canal and to allow for easier removal of the bone shaping member from the canal subsequent to shaping.

Thus, there remains a need to provide an improved surgical instrument handle assembly for releasable connection to orthopedic shaping or cutting members for use in total hip arthroplasty. The present invention satisfies this need and provides other benefits and advantages in a novel and unobvious manner.

SUMMARY

While the actual nature of the invention covered herein can only be determined with reference to the claims appended hereto, certain forms of the invention that are characteristic of the embodiments disclosed herein are described briefly as follows.

In general, a novel clamping mechanism within a surgical instrument handle assembly is provided for releasable, rotationally and axially rigid connection to orthopedic devices such as orthopedic shaping or cutting members for use in total hip arthroplasty procedures or other orthopedic procedures whereby variation of the design of mating geometry of such a mechanism allows for offset and straight configurations of the surgical instrument handle.

In one form of the invention, a surgical instrument handle assembly is provided for releasable connection to an orthopedic device. The handle assembly includes an elongate shaft including a shaft portion extending generally along a shaft axis and defining an inner chamber at least partially bound by a shaft wall, a clamp element at least partially positioned within the inner chamber and the clamp element including a distal end portion having a bearing portion and a head portion, a compression element at least partially positioned within the inner chamber and including a flexibly elastic portion and a distal engagement portion with the distal engagement portion positioned between the shaft wall and the distal end portion of the clamp element, and an actuator including an initial state and an actuated state with the actuator operatively coupled to the flexibly elastic portion of the compression element and the actuator structured to displace the compression element generally along the inner chamber and to slidably engage the distal engagement portion of the compression element against the bearing portion of the clamp element when transitioned from the initial state toward the actuated state, and an orthopedic device including a body portion and a connection portion extending from the body portion, the connection portion arranged along a connection axis, the connection portion positioned in the inner chamber of the shaft portion and compressingly engaged by the head portion of the clamp element when the actuator is transitioned to the actuated state to thereby rigidly and releasably connect the orthopedic device to the elongate shaft.

In another form of the invention, a surgical instrument handle assembly is provided for releasable connection to an orthopedic device. The handle assembly includes an elongate shaft having an axial shaft portion arranged generally along a longitudinal axis and an offset shaft portion extending from the axial shaft portion and arranged generally along an offset axis with the offset axis defining at least one angular offset relative to the longitudinal axis and the offset shaft portion defining an inner chamber at least partially bound by a shaft wall, a clamp element at least partially positioned within the inner chamber and the clamp element including a distal end portion having a bearing portion and a head portion, a compression element at least partially positioned within the inner chamber and including a flexibly elastic portion and a distal engagement portion with the distal engagement portion positioned between the shaft wall and the distal end portion of the clamp element, and an actuator including an initial state and an actuated state with the actuator operatively coupled to the flexibly elastic portion of the compression element and the actuator structured to displace the compression element generally along the inner chamber and to slidably engage the distal engagement portion of the compression element against the bearing portion of the clamp element when transitioned from the initial state toward the actuated state, and an orthopedic device including a body portion and a connection portion extending from the body portion, the connection portion arranged along a connection axis, the connection portion positioned in the inner chamber of the offset shaft portion and compressingly engaged by the head portion of the clamp element when the actuator is transitioned to the actuated state to thereby rigidly and releasably connect the orthopedic device to the elongate shaft.

It is one object of the present invention to provide an improved surgical instrument handle assembly. Further embodiments, forms, features, aspects, benefits, objects, and advantages of the present invention will become apparent from the detailed description and figures provided herewith.

DESCRIPTION OF THE ILLUSTRATED EMBODIMENTS

For the purpose of promoting an understanding of the principles of the present invention, reference will now be made to the embodiments illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is hereby intended. Any alterations and further modifications in the described embodiments, and any further applications of the principles of the invention as described herein are contemplated as would normally occur to one skilled in the art to which the invention relates.

The following descriptions and illustrations of non-limiting embodiments of the present invention are exemplary in nature, it being understood that the descriptions and illustrations related thereto are in no way intended to limit the inventions disclosed herein and/or their applications and uses. Certain features and details associated with other embodiments of devices and methods that may be used in association with the present invention are found in commonly owned U.S. Pat. No. 7,591,821 issued on Sep. 22, 2009 and commonly owned U.S. patent application Ser. No. 12/263,030 filed on Nov. 20, 2009, the contents of each document incorporated herein by reference in its entirety.

Referring toFIGS. 1-4, shown therein is a surgical instrument40according to one form of the present invention that is, in the illustrated embodiment, configured for preparation of the intramedullary canal of a femur in a total hip replacement surgery. However, it should be understood that the surgical instrument40may be used in association with other orthopedic surgeries or procedures associated with the hip, surgeries or procedures associated with other joints such as, for example, the shoulder and knee, or surgeries involving bones in addition to the femur. The surgical instrument40generally includes a surgical instrument handle assembly50that is rigidly and releasably connectable to an orthopedic device60(FIGS. 4A and 4B) such as, for example, an orthopedic shaping or cutting member. The components of the surgical instrument handle assembly50and the orthopedic device60may be formed of any suitable material having appropriate strength, manufacturability, autoclavability, and other desired performance factors. In one embodiment, the components of the handle assembly50and the orthopedic device60are formed of biocompatible stainless steel and/or titanium. However, it should be understood that other metallic materials, composite materials, and/or plastic materials may be used.

In the illustrated embodiment, the shaping/cutting member60is configured as an orthopedic broach. However, other types and configurations of shaping/cutting members are also contemplated for use in association with the present invention including, for example, a rasp, an osteotome, a reamer, a sawblade, a bit, a graft impaction member, or other orthopedic devices suitable for shaping or cutting bone. In other embodiments, instead of a shaping/cutting member60, the handle assembly50may be used to rigidly and releasably connect to other orthopedic devices such as, for example, an intramedullary implant (i.e., a femoral stem) via direct connection of the device with the handle assembly50or via the use of an intermediate adaptor.

As shown inFIGS. 4A and 4B, in the illustrated embodiment, the broach60includes a shaping body portion70and a connection post or stem portion80extending therefrom. In one embodiment of the broach60, the shaping body70has a shape that generally matches that of a femoral implant to be subsequently inserted into the femoral medullary canal subsequent to preparation of the canal via the instrument40. The shaping body70typically includes a pair of opposite surfaces arranged substantially parallel to and spaced apart from a longitudinal axis72extending through the approximate center of the shaping body70. The parallel surfaces are typically provided with a plurality of cutting teeth74or other cutting/shaping features configured to remove material from the femoral intramedullary canal to shape the canal. Although a particular type and configuration of the shaping body70has been illustrated and described herein, it should be understood that other types and configurations are also contemplated as would occur to one having ordinary skill in the art.

In the illustrated embodiment of the broach60, the connection post or stem80extends generally along a connection axis82and defines one or more connection features configured for mating engagement with corresponding connection features defined by the handle assembly50to aid in rigidly connecting the broach60to the handle assembly50, the details of which will be set forth below. In one embodiment, the connection post80is provided with two such connection features including a first notch or groove84extending transversely into a side of the post80(i.e., in a direction transverse to the connection axis82), and a second notch or groove86extending axially into an end of the post80(i.e., in a direction generally parallel with the connection axis82). However, it should be understood that the connection post80may be provided with other types and configurations of connection features and may be provided as a negative connection feature (e.g., a notch, groove or opening formed in the post80) and/or as a positive connection feature (e.g., a projection, extension or ridge extending from the post80). In one embodiment, the transverse notch84has a V-shaped configuration and the axial notch86has a semi-circular configuration. However, other shapes and configurations of the notches84,86are also contemplated. Additionally, in the illustrated embodiment, the connection axis82of the connection post80is arranged at an oblique angle relative to the longitudinal axis72of the shaping body70. However, other configurations are also contemplated wherein the connection axis82and the longitudinal axis72are arranged generally parallel with one another. Although a particular type and configuration of the connection post80has been illustrated and described herein, it should be understood that other types and configurations are also contemplated as would occur to one having ordinary skill in the art.

Referring collectively toFIGS. 1-4, the surgical instrument handle assembly50extends along a longitudinal axis L and generally includes an axial handle100and a linkage assembly150movably connected to the axial handle100and at least partially positioned within an interior region of the axial handle100. Referring toFIGS. 4 and 9, in the illustrated embodiment, the linkage assembly150generally includes a compression element200, a clamp element300, and an actuator mechanism400. In the illustrated embodiment, the actuator mechanism400is a toggle-type actuator and generally includes a toggle handle or lever arm410and a toggle link or bar450. As will be discussed in greater detail below, actuation of the actuator mechanism400serves to displace the compression element200relative to the clamp element300, which in turn compresses a distal portion of the clamp element300in a transverse direction against the connection post80of the broach60to securely capture the post80between the clamp element300and a distal portion of the axial handle100, thereby rigidly and releasably connecting the broach60to the handle assembly50.

Referring toFIGS. 5-8, shown therein are further details regarding the axial handle100. In the illustrated embodiment, the axial handle100generally includes an elongate shaft102having a proximal end portion102aand a distal end portion102b, and a strike plate or impaction platform104attached to the proximal end portion102aof the elongate shaft102. In one embodiment, the impaction platform104is formed separately from the elongate shaft102and is attached thereto by any suitable attachment technique such as, for example, welding or fastening. However, other embodiments are also contemplated where the impaction platform104and the elongate shaft102are formed as a unitary, monolithic structure.

In one embodiment, the elongate shaft102has a generally linear configuration extending axially along the longitudinal axis L. However, other configurations are also contemplated wherein the elongate shaft102may have a curved configuration, a curvi-linear configuration, and/or an offset configuration including, for example, an anterior offset, a lateral offset, or a dual-offset including both an anterior offset and a lateral offset. Other suitable configurations of the elongate shaft102are also contemplated as would occur to one of ordinary skill in the art. In a further embodiment, the impaction platform104has a square or rectangular configuration and defines a generally flat/planar proximally-facing impact or strike surface106extending along a plane arranged generally perpendicular to the longitudinal axis L. The impact surface106provides an enlarged surface area on which the surgeon may strike the handle assembly50to enhance transmission of an impaction force through the handle assembly50to the shaping/cutting member60connected to the distal end portion102bof the elongate shaft102.

Although the impaction platform104and the impact surface106have been illustrated and described as having a particular shape and configuration, it should be understood that other shapes and configurations are also contemplated. For example, in other embodiment, the impact surface106may be provided with one or more angled or tapered regions extending along planes arranged oblique to the longitudinal axis L to provide the surgeon with the ability to apply an oblique impaction force to the axial handle100in a direction that is not perpendicular to the longitudinal axis L. Additionally, the impact surface106may be provided with a non-planar configuration including curved or rounded configurations or curvi-linear configurations. As should be appreciated, the elongate shaft102provides the surgeon with a structure to grip and manipulate, while the impaction platform104provides the surgeon with a structure that may be impacted or stricken with an impaction/striking device such as a hammer, a mallet, or other suitable devices. In other embodiments, the impaction platform104may alternately be configured as an integral impact device such as a slap hammer. In still other embodiments, the axial handle100need not necessarily include an impaction platform104.

In the illustrated embodiment, the elongate shaft102has a generally rectangular outer transverse cross-section defined by a pair of opposite longitudinal side walls110a,110band a pair of opposite longitudinal edge walls112a,112b. The elongate shaft102further includes a first distal end wall114defining a first distal end surface115extending at an oblique angle relative to the longitudinal axis L, and a second distal end wall116defining a second distal end surface117extending substantially normal or perpendicular to the first distal end surface115. Additionally, the elongate shaft102generally includes a substantially solid proximal region120extending distally from the impaction platform104, and a tubular region130extending distally from the proximal region120to the distal end portion102b. The substantially solid proximal region120of the elongate shaft102provides added strength and structural integrity to absorb and transmit the impact/strike force applied to the impaction platform104. The tubular region130provides the elongate shaft102with a hollow interior to house the components of the linkage assembly150. However, it should be understood that other suitable shapes and configurations of the elongate shaft102are also contemplated.

The substantially solid proximal region120of the elongate shaft102includes a proximal stem122positioned within a corresponding opening108formed in the impaction platform104to strengthen the interconnection between the impaction platform104and the elongate shaft102. The proximal region120further includes a passage or opening124extending transversely therethrough between the longitudinal edge walls112a,112b, and a recess or indentation126defined along the longitudinal edge wall112aand extending into the longitudinal side walls110a,110b. The transverse recess126is sized and shaped to provide access to the end portion of the toggle handle410(FIGS. 1 and 2) such that the lever portion of the toggle handle410may be readily grasped and manipulated by one or more fingers and/or the thumb of the surgeon.

In the illustrated embodiment, the tubular region130of the elongate shaft102defines a hollow interior or inner chamber132(FIG. 8), a number of slotted openings134a-134dextending transversely through the longitudinal edge walls112a,112band into communication with the hollow interior132, a window136extending transversely through the longitudinal side walls110a,110badjacent a distal region of the elongate shaft102and into communication with the hollow interior132, and a distal passage138extending through the distal end wall114and into communication with the hollow interior132. The slotted openings134a-134dand the window136provide ready access to the components contained within the hollow interior132, aid in manufacturing, assembly and/or maintenance of the handle assembly50, facilitate cleaning and/or sterilization of the handle assembly50, and/or may provide direct visualization of the components contained within the hollow interior132to verify proper operation. The distal passage138is arranged generally along a connection axis C and is sized and shaped for receipt of the connection post80of the broach60therein (FIGS. 4A/4B). In one embodiment, the connection axis C of the distal passage138is arranged substantially normal or perpendicular to the distal end surface115of the distal end wall114, and is also arranged at an oblique angle α of approximately forty (40) degrees relative to the longitudinal axis L. However, other orientations of the distal passage138are also contemplated. Additionally, in the illustrated embodiment of the elongate shaft102, the slotted openings134a-134dand the visualization window136each have a generally rectangular shape, and the distal passage138has a generally circular shape. However, other shapes and configurations of the slotted openings134a-134d, the visualization window136, and the distal passage138are also contemplated.

Referring specifically toFIG. 8, in the illustrated embodiment, the elongate shaft102is provided with a number of raised lands or plateaus140a-140cextending inwardly into the hollow interior132from inner surfaces of the longitudinal edge walls112a,112b. The raised lands or plateaus140a-140cdefine generally flat/planar bearing surfaces arranged generally parallel with the longitudinal axis L which may serve to guide the compression element200and/or the clamp element300in a direction generally parallel with the longitudinal axis L upon actuation of the actuator mechanism400. Additionally, in the illustrated embodiment, a guide pin142and a pivot pin164each extend across the hollow interior132between the longitudinal side walls110a,110b. The guide pin142is positioned generally opposite the plateau140aand aids in guiding the compression element200in a direction generally parallel with the longitudinal axis L upon actuation of the actuator mechanism400. Other features or structures may also be provided to add strength and structural integrity to the compression element200and to further aid in guiding the compression element200in a direction generally parallel with the longitudinal axis L. For example, an end portion or head of the pivot pin160(FIG. 9) that pivotally connects the compression element200with the toggle handle410may be slidably displaced along an axial slot or groove formed in one or both of the shaft side walls110a,110bduring axial displacement of the compression element200. As will be discussed in greater detail below, the pivot pin164is arranged generally along a pivot axis P3and is sized and configured for receipt within an opening in a proximal portion of the toggle link450to permit the toggle link450to pivot about the pivot pin164upon actuation of the actuator mechanism400while preventing axially displacement of the toggle link450along the longitudinal axis L.

Referring toFIG. 9, shown therein are further details regarding the linkage assembly150. As indicated above, the linkage assembly150generally includes a compression element200, a clamp element300, and an actuator mechanism400comprised of a toggle handle410and a toggle link450. In the illustrated embodiment, the components of the linkage assembly150are interconnected via a series of pins or shafts. Specifically, a proximal portion of the compression element200is pivotally connected to a first portion of the toggle handle410via a first pivot pin160extending along a first pivot axis P1to permit pivotal movement of the toggle handle410relative to the compression element200about the first pivot axis P1. Additionally, a second portion of the toggle handle410is pivotally connected to a distal portion of the toggle link450via a second pivot pin162extending along a second pivot axis P2to permit pivotal movement of the toggle handle410relative to the toggle link450about the second pivot axis P2. As indicated above, a proximal portion of the toggle link450is pivotally connected to the axial handle100via a third pivot pin164extending along a third pivot axis P3to permit pivotal movement of the toggle link450relative to the axial handle100about the third pivot axis P3while preventing axially displacement of the toggle link450along the longitudinal axis L.

Furthermore, a distal portion of the compression element200is slidably attached to the clamp element300via a pair of dowel pins166a,166bto permit a degree of relative axial movement of the compression element200relative to the clamp element300along a first vector arranged generally parallel with the longitudinal axis L, as well as a degree of relative transverse movement of the clamp element300relative to the compression element200generally along a second vector arranged generally parallel with the transverse axis T, further details of which will be set forth below. It should be appreciated that in one embodiment, movement of the compression element200relative to the clamp element300along the first and second vectors may occur simultaneously as a composite movement extending at an oblique angle relative to the longitudinal axis L and the transverse axis T. However, other embodiments and other types of movement between the compression element200and the clamp element300are also contemplated, including sequential movement of the compression element200relative to the clamp element300along the first and second vectors or directions of travel.

As should be appreciated, pivotal movement of the toggle handle410about the pivot axis P1in an outward direction away from the longitudinal axis L correspondingly pivots the toggle link450about the pivot axis P3in an outward direction away from the longitudinal axis L. This outward pivotal movement of the toggle handle410and the toggle link450reduces the distance d between the pivot axes P1and P3. Since the proximal portion of the toggle link450remains in a stationary axial position (via the pivot pin164attached to the axial handle100), outward pivotal movement of the toggle handle410and the toggle link450pulls the compression element200in a proximal direction which in turn proximally displaces the compression element200in the direction of arrow A generally along the longitudinal axis L. Conversely, pivotal movement of the toggle handle410about the pivot axis P1in an inward direction toward the longitudinal axis L correspondingly pivots the toggle link450about the pivot axis P3in an inward direction toward the longitudinal axis L. This inward pivotal movement of the toggle handle410and the toggle link450increases the distance d between the pivot axes P1and P3, which in turn pushes the compression element200in a distal direction which in turn distally displaces the compression element200in the direction of arrow B generally along the longitudinal axis L. As will be discussed in greater detail below, the proximal/distal movement of the compression element200in the direction of arrows A/B serves to transition the clamp element300between unlocked and locked configurations.

Referring toFIGS. 10-12, shown therein are further details regarding the compression element200. In the illustrated embodiment, the compression element200has a rod or shaft-like configuration extending along the longitudinal axis L. Additionally, the compression element200generally includes a proximal connection portion or pivot plate member210configured for pivotal connection with the toggle handle410, a compression portion or spring-like member220having spring-like characteristics exhibiting flexibly elastic resiliency along the longitudinal axis L, and a distal engagement portion or pusher member240configured for movable/slidable engagement with the clamp element300to force the clamp element300into compressed engagement against the connection post80of the broach60to rigidly and releasably connect the broach60to the handle assembly50. In the illustrated embodiment, the proximal connection portion210, the compression portion220, and the distal engagement portion240are integral with one another to provide the compression element200as a single-piece monolithic structure. However, in other embodiments, one or more portions of the compression element200may be provided as separate members that are assembled together to form a multi-piece compression element200.

In the illustrated embodiment, the proximal connection portion or pivot plate member210of the compression element200has a plate-like configuration defining an opening212extending therethrough in a direction transverse to the longitudinal axis L. The opening212is positioned along the pivot axis P1and is sized to receive the pivot pin160therein to pivotally connect the compression element200to the toggle handle410(FIG. 9). Although a particular configuration of the proximal connection portion210has been illustrated and described herein, it should be understood that other suitable configurations are also contemplated.

In the illustrated embodiment, the compression portion or spring member220of the compression element200has a substantially rectangular outer transverse cross-section including opposite first and second longitudinal sides222a,222bdefining an overall width dimension w therebetween, and opposite first and second longitudinal edges224a,224bdefining an overall height dimension h therebetween. As indicated above, the compression portion220has spring-like characteristics exhibiting flexibly elastic resiliency along the longitudinal axis L. The spring-like characteristics are provided by a first series of slots or slits230aextending from the first longitudinal side222aand transversely across a portion of the overall width dimension w and along the entire overall height dimension h, and a second series of slots or slits230bextending from the second longitudinal side222band transversely across a portion of the overall width dimension w and along the entire overall height dimension h.

In the illustrated embodiment, the slits230a,230bare offset from one another along the length of the compression portion220in an alternating manner so as to define a relatively narrow strip of material232extending along the longitudinal axis L in an undulating or sinusoidal configuration. In one embodiment, the slits230a,230bextend across greater than one-half of the overall width dimension w, and in a further embodiment extend across approximately three-quarters of the overall width dimension w. However, other embodiments are also contemplated where the slits230a,230bextend across other portions of the overall width dimension w. Additionally, in the illustrated embodiment, the slits230a,230beach include a relatively narrow region234extending from the respective side222a,222bwhich opens into an enlarged end region236to provide additional flexibility and elasticity to the compression portion220. In one embodiment, the narrow region234of the slits230a,230bhas a substantially rectangular configuration and the enlarged end region234of the slits230a,230bhas a substantially circular or ovular/elliptical configuration. However, other suitable shapes and configurations of the slits230a,230bare also contemplated. As should be appreciated, the slits230a,230bprovide the compression portion220with spring-like characteristics including flexibly elastic resiliency along the longitudinal axis L and to a lesser degree in directions transverse to the longitudinal axis L. Although a particular configuration of the compression portion220has been illustrated and described herein, it should be understood that other suitable spring-like configurations are also contemplated.

In the illustrated embodiment, the distal engagement portion or pusher member240of the compression element200generally includes an engagement plate portion250extending along the longitudinal axis L, and a connection portion260extending substantially perpendicularly from the engagement plate portion250.

The engagement plate portion250includes a distal end portion252defining a distal engagement surface254. In one embodiment, the distal engagement surface254has a curved or semi-circular configuration. However, other suitable shapes and configurations of the distal engagement surface254are also contemplated. Additionally, in the illustrated embodiment, the engagement plate portion250defines a first outer surface portion251aarranged generally parallel with the longitudinal axis L, and a second outer surface portion251bextending from the first outer surface portion251aand defining a relatively small outward taper or incline extending toward the distal end portion252. The tapered outer surface portion251bis engagable with a corresponding angled/undercut surface portion141bformed along the raised land or plateau140cadjacent the distal end of the elongate shaft102(FIG. 8) when the linkage assembly150is positioned in a fully extended or locked state. Such engagement provides for rigid and secure engagement between the compression element200and the elongate shaft102and between the compression element200and the clamp element300when the handle assembly50is positioned in the fully extended/locked state to substantially prevent motion therebetween, which in turn provides for rigid and secure locked engagement between the handle assembly50and the connection post80of the broach60.

In the illustrated embodiment, the connection portion260is configured as a U-shaped clevis including a pair of plates or flanges264a,264bextending transversely from the engagement plate portion250and spaced apart from one another to define a yoke or gap266therebetween sized for receipt of a portion of the clamping element300therein. The flanges264a,264bin turn define a pair of generally circular openings262a,262bthat are axially offset from one another along the longitudinal axis L. The pair of openings262a,262bare sized and shaped to receive the dowel pins166a,166btherein, respectively, which are in turn positioned within corresponding slotted openings in the clamp element300to thereby movably and slidably connect the compression element200with the clamp element300with a portion of the clamp element300being guidingly displaced within the gap266between the flanges264a,264b. Positioning of a portion of the clamp element300within the gap266between the flanges264a,264bof the compression element200also serves to increase the strength and structural integrity of the slidable interconnection between the compression element200and the clamp element300. Although a particular configuration of the distal engagement portion240has been illustrated and described herein, it should be understood that other suitable configurations are also contemplated.

Referring toFIGS. 13-15, shown therein are further details regarding the clamp element300. In the illustrated embodiment, the clamp element300extends along a longitudinal axis L and generally includes a proximal connection plate portion310and a distal clamp portion330. The proximal connection plate portion310is configured for movable connection and slidable displacement within the gap266formed between the flanges264a,264bof the distal connection portion260of the compression element200. The distal clamp portion330is configured for sliding engagement with the distal end portion252of the compression element200, and is also configured for clamping or compressed engagement against the connection post80of the broach60to rigidly and releasably connect the broach60to the handle assembly50.

In the illustrated embodiment, the proximal connection plate310of the clamp element300has a flat/planar plate-like configuration and defines a pair of slotted openings312a,312bthat are axially offset from one another along the longitudinal axis L. The slotted openings312a,312bare sized and shaped to slidably receive the dowel pins166a,166btherein which are rigidly attached to the distal connection portion260of the compression element200. In the illustrated embodiment, each of the slotted openings312a,312bincludes a first slot portion320including opposite side surfaces322a,322bextending generally along the longitudinal axis L, and a second slot portion324extending from the first slot portion320at an angle and including opposite side surfaces326a,326bextending along an oblique axis O arranged at an oblique angle relative to the longitudinal axis L. In this manner, the obliquely-extending side surfaces326a,326bof the second slot portion324are ramped or angled relative to the longitudinal axis L. Additionally, the slot portions320,324each define a slot width sized slightly larger than the outer diameter of the dowel pins166a,166b. As a result, displacement of the compression element200in a direction along the longitudinal axis L will slidably displace the dowel pins166a,166bgenerally along at least one of the slot portions320,324of the slotted openings312a,312b, further details of which will be set forth below.

In the illustrated embodiment, the distal clamp330of the clamp element300includes a transverse base portion340attached to a distal end of the proximal connection plate310, an axial plate portion350extending generally along the longitudinal axis L and oriented transverse to the base portion340, and an enlarged clamp head portion360extending axially from the plate portion350. The transverse base340has an overall width sized in relatively close tolerance with the inner width dimension of the hollow interior132of the axial handle100(as measured between the inner surfaces of the longitudinal side walls110a,110b) to properly position and/or guide the clamp element300within the hollow interior132of the axial handle100. The distal corners342of the transverse base portion340may be rounded to facilitate sliding engagement with the inner surfaces of the axial handle100. Additionally, the transverse base portion340defines a pair of proximally-facing surfaces or shoulders344positioned on opposite sides thereof that are engagable with distally-facing end surfaces268of the flanges264a,264bof the compression element200to properly position the distal end portion252of the compression element200relative to the clamp head360of the clamp element300when the handle assembly50is transitioned to a locked configuration. The plate portion350extends axially from the transverse base340and has a generally flat/planar configuration. However, other suitable configurations of the transverse base340and the axially plate350are also contemplated.

In the illustrated embodiment, the enlarged clamp head360has an irregular-shaped configuration defining a wedge or bearing surface370configured for sliding engagement with the distal end portion252of the compression element200, and a clamp surface380configured for clamping/compressed engagement against the connection post80of the broach60to rigidly and releasably connect the broach60to the handle assembly50. The wedge surface370is angled relative to the longitudinal axis L so as to define a ramp or incline. In the illustrated embodiment, the wedge surface370includes multiple ramped portions372that may define different incline angles. However, in other embodiments, the wedge surface370may define a single ramped portion defining a uniform or constant incline angle. In the illustrated embodiment, the ramped portions372are each generally flat/planar. However, other embodiments are also contemplated wherein one or more of the ramped portions372may be curved or may have a curvi-linear configuration. In the illustrated embodiment, the clamp surface380includes a first clamp surface382extending in an axial direction generally along the longitudinal axis L, and a second clamp surface384extending in a transverse direction substantially normal or perpendicular to the first clamp surface382so as to define a V-shaped projection or tongue386sized and shaped for receipt with the V-shaped notch82formed in the connection post80of the broach60. The intersection or corner formed between the first and second clamp surfaces382,384may be rounded or beveled. Additionally, in the illustrated embodiment, the clamp surfaces382,384are each generally flat/planar. However, other embodiments are also contemplated wherein one or both of the clamp surfaces382,384may be provided with a curved or curvi-linear configuration. Although a particular configuration of the clamp head360has been illustrated and described herein, other suitable configurations of the clamp head360are also contemplated.

Referring toFIGS. 16 and 17, shown therein are further details regarding the toggle handle or lever arm410. In the illustrated embodiment, the toggle handle410includes a clevis portion420arranged at a distal end thereof and configured for pivotal connection with the proximal connection portion210of the compression element200, a flange portion430proximally offset from clevis portion420and configured for pivotal connection with a distal portion of the toggle link450, and an elongate lever portion440extending proximally from the flange portion430and configured to be grasped and manipulated by the surgeon.

In the illustrated embodiment, the clevis portion420of the toggle handle410includes a pair of spaced apart plates or flanges424a,424bdefining a yoke or space therebetween sized to receive the proximal connection portion210of the compression element200therein, and with the plates424a,424bdefining a pair of aligned openings426a,426barranged along the first pivot axis P1and sized to receive the pivot pin160therein to pivotally connect the toggle handle410to the compression element200(FIG. 9). The flange portion430of the toggle handle410has a plate-like configuration and defines an opening432arranged along the second pivot axis P2and sized to receive the pivot pin162therein to pivotally connect the toggle handle410to a distal portion of the toggle link450(FIG. 9). The elongate lever portion440of the toggle handle410includes a base portion442and a proximal gripping portion444extending therefrom which is positioned adjacent the transverse recess126of the axial handle100(FIGS. 1 and 2) such that the proximal gripping portion444may be readily grasped and manipulated by one or more fingers and/or the thumb of the surgeon. Although a particular configuration of the toggle handle410has been illustrated and described herein, it should be understood that other suitable configurations are also contemplated.

Referring toFIGS. 18 and 19, shown therein are further details regarding the toggle link or pivot bar450. In the illustrated embodiment, a distal end of the toggle link450includes a clevis portion460and the proximal end of the toggle link450includes a pivot connection portion470. The clevis portion460includes a pair of spaced apart plates or flanges462a,462bdefining a yoke or space therebetween sized to receive the flange portion430of the toggle handle410therein, and with the plates462a,462bdefining a pair of aligned openings464a,464barranged along the second pivot axis P2and sized to receive the pivot pin162therein to pivotally connect the toggle link450to the toggle handle410(FIG. 9). The pivot connection portion470of the toggle link450defines an opening472extending therethrough along the third pivot axis P3and sized to receive the pivot pin164therein to pivotally connect the toggle link450to the axial handle100(FIG. 9). Although a particular configuration of the toggle link450has been illustrated and described herein, it should be understood that other suitable configurations are also contemplated.

Referring once again toFIG. 9, pivotal movement of the toggle handle410about the pivot axis P1in an outward direction away from the longitudinal axis L correspondingly reduces the distance d between the pivot axes P1and P3, which in turn pulls the compression element200and proximally displaces the compression element200in the direction of arrow A to transition the handle assembly50to an unlocked configuration that permits the broach60to be engaged with and/or released from the handle assembly50(FIG. 4A). Conversely, pivotal movement of the toggle handle410about the pivot axis P1in an inward direction toward the longitudinal axis L correspondingly increases the distance d between the pivot axes P1and P3, which in turn pushes the compression element200and distally displaces the compression element200in the direction of arrow B to transition the handle assembly50to a locked configuration to rigidly engage the broach60to the handle assembly50(FIG. 4B). Although a toggle-type actuator mechanism400has been illustrated and described herein for use in association with the handle assembly50, it should be understood that other suitable actuator mechanisms are also contemplated to axially displace the compression element200in the direction of arrow A/B to transition the handle assembly50between the locked and unlocked configurations. For example, in other embodiments, a cam actuator mechanism, a screw-type actuator mechanism, a worm/thread mechanism, a rack and pinion mechanism, a piston actuator mechanism, a ratchet actuator mechanism, an electrical actuator, a pneumatic actuator (including CO2cartridge-type actuators), a hydraulic actuator, or other suitable actuator mechanisms may be used in association with the handle100to transition the handle assembly50between the locked and unlocked configurations.

Having described the components, features and functional characteristics associated with the handle assembly50, reference will now be made to engagement of the handle assembly50to the broach60according to one form of the present invention.

Referring initially toFIGS. 4 and 4A, the toggle handle410is initially pivoted about the pivot axis P1in an outward direction away from the longitudinal axis L, which in turn proximally displaces the compression element200in the direction of arrow A to transition the handle assembly50to the unlocked configuration illustrated inFIG. 4A. As the compression element200is displaced in the direction of arrow A, the dowel pins166a,166battached to the distal connection plate portion260of the compression element200are movably displaced along the oblique slot portions324defined by the slotted openings312a,312bin the clamp element300, which in turn displaces the clamp element300generally along the transverse axis T and away from the distal passage138of the axial shaft100to thereby retract the clamp head360away from the connection axis C and out of the distal passage138to permit insertion of the connection post80of the broach60into the distal passage138. As indicated above, in one embodiment, movement of the clamp element300along the first and second vectors (i.e., along the longitudinal axis L and the transverse axis T) may occur simultaneously as a composite movement extending at an oblique angle relative to the longitudinal axis L and the transverse axis T.

Referring toFIGS. 4 and 4B, once the connection post80is properly positioned within the distal passage138and the broach60is rotated to the desired orientation about the connection axis C, the toggle handle410is pivoted about the pivot axis P1in an inward direction toward from the longitudinal axis L, which correspondingly distally displaces the compression element200in the direction of arrow B to transition the handle assembly50to the locked configuration illustrated inFIG. 4B. As the compression element200is displaced in the direction of arrow B, the distal end portion252of the compression element200is slidably engaged along the inclined/angled wedge surface370defined by the clamp head360of the clamp element300. As should be appreciated, sliding engagement of the distal end portion252of the compression element200along the inclined/angled wedge surface370of the clamp head360correspondingly displaces the clamp element300along the longitudinal axis L and along the transverse axis T toward the connection post80of the broach60. However, as indicated above, movement of the clamp element300may occur simultaneously along first and second vectors (i.e., along the longitudinal axis L and the transverse axis T) to provide a composite-type movement.

The V-shaped projection386defined by the clamp head360is driven into engagement with the V-shaped notch84of the connection post80until the clamp surfaces382,384of the projection386are compressed firmly against the inner bearing surfaces of the V-shaped notch84, which in turn compresses the connection post80against the opposite side wall of the distal passage138to thereby securely and rigidly connect the broach60to the handle assembly50. Additionally, the overall strength and rigidity of the connection between the handle assembly50and the broach60is enhanced via the tight sandwiching/stacking of the distal end portion252of the compression element200between the clamp head360and the longitudinal wall112bof the axial shaft100. In this manner, the longitudinal wall112bof the axial shaft100acts as a backstop or a buttress to prevent movement and/or deflection of the distal end portion252of the compression element200and the clamp head360, thereby increasing the strength and rigidity of the connection between the handle assembly50and the broach60.

As should be appreciated, the spring-like characteristics exhibited by the compression portion220(i.e., the flexible elasticity and resiliency) of the compression element200permits the application of a maximal axial force against the wedge surface370defined by the clamp head360regardless of potential tolerance gaps, dimensional variations, or misalignments between the components of the handle assembly50, and/or potential tolerance gaps, dimensional variations, or misalignments between the handle assembly50(i.e., the clamp head360and the distal passage138) and the connection post80of the broach60. In this manner, the spring-like characteristics of the compression portion220in combination with the actuation force generated by the linkage assembly150provide the handle assembly50with a clamping action similar to that of a vice-grip tool to thereby provide a secure and rigid connection between the handle assembly50and the broach60. As should also be appreciated, the secure and rigid connection between the broach60and the handle assembly50eliminates or at least minimizes motion (e.g., micro-motion) and/or deflection therebetween, thereby providing various advantages including, for example, increased control of the broach60, increased visual and tactile feedback to the surgeon as to the fit of the broach60within the femoral canal, an increased ability of the surgeon to more precisely estimate the resulting tightness of fit of a femoral stem within the femoral canal, and/or easier removal of the broach60from the femoral canal subsequent to shaping.

Subsequent to use of the handle assembly50and the broach60to shape the femoral canal, the toggle handle410may once again be pivoted in an outward direction away from the longitudinal axis L to transition the handle assembly50back to the unlocked configuration illustrated inFIG. 4A, thereby releasing the clamping force exerted onto the connection post80to permit removal of the broach60from the handle assembly50. As should be further appreciated, various types, configurations and/or sizes of orthopedic shaping/cutting members may be used interchangeably in association with the handle assembly50, and a set or series of modular broaches or other shaping/cutting members may be provided as a kit along with the handle assembly50.

Referring toFIGS. 20-22, shown therein is a surgical instrument handle assembly500according to another form of the invention that is configured for preparation of the intramedullary canal of a femur in a total hip replacement surgery or other orthopedic surgeries. The handle assembly500has many of the same components and features as the handle assembly50illustrated and described above, and is similarly configured for rigid and releasable connection to an orthopedic device such as, for example, the broach60illustrated and described above (FIGS. 4A and 4B). In addition to the broach60, the handle assembly500may also be used in association with other configurations of broaches, other types and configurations of shaping/cutting members, other orthopedic devices, or orthopedic implants. However, unlike the handle assembly50which is provided with an axial handle100having a generally linear elongate shaft102extending along a single longitudinal axis L, the illustrated embodiment of the handle assembly500is provided with a handle600including an elongate shaft602having an axial shaft portion603a, an offset shaft portion603b, and a distal transition portion603c.

Similar to the handle assembly50illustrated and described above, the handle assembly500is likewise provided with a linkage assembly650(FIG. 21) movably connected to the handle600, and similarly includes a compression element700, a clamp element800, and an actuator mechanism900. In the illustrated embodiment, the actuator mechanism900is a toggle-type actuator and generally includes a toggle handle910and a toggle link950. As should be appreciated, the linkage assembly650of the handle assembly500(i.e., the compression element700, the clamp element800, and the actuator mechanism900) is similar in structure and function to the linkage assembly150of the handle assembly50(i.e., the compression element200, the clamp element300, and the actuator mechanism400) illustrated and described above. The handle assembly500likewise operates in a manner similar to that of the handle assembly50to provide a secure and rigid connection with the shaping member60. However, structural differences between certain components of the handle assembly500and corresponding components of the handle assembly50may be apparent. Some of these structural differences are illustrated inFIGS. 20-30in association with the following description.

As indicated above, the illustrated embodiment of the handle600includes an axial shaft portion603a, an offset shaft portion603b, and a distal transition portion603c. The axial shaft portion603ahas a linear configuration arranged generally along a longitudinal axis L. The offset shaft portion603bextends from the axial shaft portion603aand is arranged generally along an offset axis O that defines one or more angular offsets relative to the longitudinal axis L. In the illustrated embodiment, the offset axis O of the offset shaft portion603bdefines both an anterior offset and a lateral offset relative to the longitudinal axis L. However, other embodiments are also contemplated where the offset shaft portion603bis arranged such that the offset axis O defines a single offset or other types of compound offsets relative to the longitudinal axis L. As should be appreciated, providing the elongate shaft602with one or more angular offsets (via inclusion of the offset shaft portion603b) may be beneficial when inserting the shaping member60into the femoral intramedullary canal using an anterior surgical approach to minimize interference with adjacent soft tissues or other anatomic structures surrounding the hip joint of the patient. The distal transition portion603cextends from the offset shaft portion603band defines a distal post-receiving passage638(similar to the distal post-receiving passage138defined by the axial shaft100of the handle assembly50) sized and shaped for receipt of the connection post80of the broach60.

The distal post-receiving passage638is arranged along a connection axis C oriented at an oblique angle relative to the offset axis O. However, other embodiments are also contemplated wherein the elongate shaft602does not include a distal transition portion603c, with the distal post-receiving passage638defined by a distal region of the offset shaft portion603b. In the illustrated embodiment, the connection axis C is arranged generally parallel with the longitudinal axis L of the axial shaft portion603a, albeit offset from the longitudinal axis L in one or more directions (e.g., in anterior and lateral directions). However, other embodiments are also contemplated where the connection axis C may be angled relative to the longitudinal axis L of the axial shaft portion603a. Additionally, as shown inFIG. 22, the handle shaft602defines a projection639extending into the post-receiving passage638and arranged generally along the connection axis C. The projection639is sized and shaped for receipt within the axial notch or groove86formed in the end of the connection post80of the broach60(FIG. 4A). In the illustrated embodiment, the projection639and the axial notch86each have a semi-circular configuration. However, other suitable shapes and configurations are also contemplated. Receipt of the projection639within the axial notch86in the broach connection post80provides an added degree of strength and rigidity to the connection of the broach60to the handle assembly500. As should be appreciated, the shape, configuration, position and/or geometry of the post-receiving passage638may be varied to accommodate/control various aspects associated with the handle assembly500and its relation relative to the broach60(i.e., the orientation/position of the broach60relative to one or more portions of the handle assembly500).

In the illustrated embodiment, the handle600includes a strike plate or impaction platform604similar in structure and function to the impaction platform104illustrated and described above. The impaction platform604has a generally flat/planar proximally-facing impact or strike surface606and is operatively attached to a proximal end portion of the axial shaft portion603a. However, other shapes and configurations of the impaction platform604are also contemplated. As should be appreciated, the shape, configuration, position, orientation and/or geometry of the impaction platform604including the particular shape, configuration, position, orientation and/or geometry of the impact or strike surface606may be varied to accommodate/control various aspects associated with the handle assembly500and its relation to the broach60.

In the illustrated embodiment, the axial shaft portion603a, the offset shaft portion603b, and the distal transition portion603ceach have a generally linear configuration and each define a generally rectangular outer transverse cross-section. However, other shapes and configurations are also contemplated. At least the offset shaft portion603band the distal transition portion603cdefine a hollow interior or inner chamber632to house the components of the linkage assembly650. The offset shaft portion603bmay be provided with a number of slotted openings634extending transversely through one or more shaft walls and into communication with the hollow interior632. The offset shaft portion603band/or the distal transition portion603cmay also define a window636(FIG. 22) extending transversely therethrough and into communication with the hollow interior632. The slotted openings634and the window636provide ready access to the components contained within the hollow interior632, aid in manufacturing, assembly and/or maintenance of the handle assembly500, facilitate cleaning and/or sterilization of the handle assembly500, and/or may provide direct visualization of the components contained within the hollow interior632to verify proper operation. Additionally, as indicated above, the distal transition portion603cof the shaft602defines a distal post-receiving passage638arranged along the connection axis C and extending through a distal end wall and into communication with the hollow interior632.

In the illustrated embodiment, the offset shaft portion603bis also provided with a number of raised lands or plateaus640extending inwardly into the hollow interior632and defining generally flat/planar bearing surfaces configured to guide the compression element700and/or the clamp element800in a direction generally parallel with the offset axis O upon actuation of the actuator mechanism900. It should be understood that other features or structures may also be provided to further aid in guiding the compression element700and/or the clamp element800in a direction generally along the offset axis O and/or to add strength and structural integrity to the linkage assembly650. For example, one or more guide pins may be positioned at locations along the hollowing interior632to further aid in guiding the compression element700and/or the clamp element800upon actuation of the actuator mechanism900.

Referring specifically toFIG. 21, the linkage assembly650generally includes a compression element700, a clamp element800, and an actuator mechanism900comprised of a toggle handle910and a toggle link950. In the illustrated embodiment, the components of the linkage assembly650are interconnected via a series of pins or shafts. Specifically, a proximal portion of the compression element700is pivotally connected to a first portion of the toggle handle910via a first pivot pin660extending along a first pivot axis P1to permit pivotal movement of the toggle handle910relative to the compression element700about the first pivot axis P1. A second portion of the toggle handle910is pivotally connected to a distal portion of the toggle link950via a second pivot pin662extending along a second pivot axis P2to permit pivotal movement of the toggle handle910relative to the toggle link950about the second pivot axis P2. Additionally, a proximal portion of the toggle link950is pivotally connected to the offset shaft portion603bof the shaft602via a third pivot pin664extending along a third pivot axis P3to permit pivotal movement of the toggle link950relative to the handle600about the third pivot axis P3while preventing axially displacement of the toggle link950along the offset axis O.

Furthermore, a distal portion of the compression element700is slidably attached to the clamp element800via a pair of dowel pins666a,666bto permit a degree of relative axial movement of the compression element700relative to the clamp element800along a first vector arranged generally parallel with the offset axis O, as well as a degree of relative transverse movement of the clamp element700relative to the compression element800generally along a second vector arranged generally parallel with a transverse axis T oriented substantially normal to the offset axis O, further details of which will be set forth below. It should be appreciated that in one embodiment, movement of the compression element700relative to the clamp element800along the first and second vectors may occur simultaneously as a composite movement extending at an oblique angle relative to the offset axis O and the transverse axis T. However, other embodiments and other types of movement between the compression element700and the clamp element800are also contemplated, including sequential movement of the clamp element800along the first and second vectors or directions of travel.

As should be appreciated, the linkage assembly650operates in a manner similar to the linkage assembly150illustrated and described above. Specifically, pivotal movement of the toggle handle910about the pivot axis P1in an outward direction away from the offset axis O correspondingly pivots the toggle link950about the pivot axis P3in an outward direction away from the offset axis O. This outward pivotal movement of the toggle handle910and the toggle link950reduces the distance between the pivot axes P1and P3. Since the proximal portion of the toggle link950remains in a stationary axial position (via the pivot pin664attached to the handle shaft602), outward pivotal movement of the toggle handle910and the toggle link950pulls the compression element700in a proximal direction, which in turn proximally displaces the compression element700in the direction of arrow A generally along the offset axis O. Conversely, pivotal movement of the toggle handle910about the pivot axis P1in an inward direction toward the offset axis O correspondingly pivots the toggle link950about the pivot axis P3in an inward direction toward the offset axis O. This inward pivotal movement of the toggle handle910and the toggle link950increases the distance between the pivot axes P1and P3and pushes the compression element700in a distal direction, which in turn distally displaces the compression element700in the direction of arrow B generally along the offset axis O. As should be appreciated, the proximal/distal movement of the compression element700in the direction of arrows A/B serves to transition the compression element700and the clamp element800between unlocked and locked configurations. Although a toggle-type actuator mechanism900has been illustrated and described herein for use in association with the handle assembly500, it should be understood that other suitable actuator mechanisms are also contemplated to axially displace the compression element700in the direction of arrow A/B. For example, in other embodiments, a cam actuator mechanism, a screw-type actuator mechanism, a worm/thread mechanism, a rack and pinion mechanism, a piston actuator mechanism, a ratchet actuator mechanism, an electrical actuator, a pneumatic actuator (including CO2cartridge-type actuators), a hydraulic actuator, or other suitable actuator mechanisms may be used in association with the handle600to transition the handle assembly500between the locked and unlocked configurations.

Referring toFIGS. 23-25, shown therein are further details regarding the compression element700. In the illustrated embodiment, the compression element700has a rod or shaft-like configuration extending along a longitudinal axis L. Additionally, the compression element700generally includes a proximal connection portion or pivot plate member710configured for pivotal connection with the toggle handle910, a compression portion or spring-like member720having spring-like characteristics exhibiting flexibly elastic resiliency along the longitudinal axis L, and a distal engagement portion or pusher member740configured for movable/slidable engagement with the clamp element800to force the clamp element800into compressed engagement against the connection post80of the broach60to thereby rigidly and releasably connect the broach60to the handle assembly500. In the illustrated embodiment, the proximal connection portion710, the compression portion720, and the distal engagement portion740are integral with one another to provide the compression element700as a single-piece monolithic structure. However, in other embodiments, one or more portions of the compression element700may be provided as separate members that are assembled together to form a multi-piece compression element700.

In the illustrated embodiment, the proximal connection portion or pivot plate member710of the compression element700has a plate-like configuration defining an opening712extending therethrough in a direction transverse to the longitudinal axis L. The opening712is positioned along the pivot axis P1and is sized to receive the pivot pin660therein to pivotally connect the compression element700to the toggle handle910(FIG. 21). Although a particular configuration of the proximal connection portion710has been illustrated and described herein, it should be understood that other suitable configurations are also contemplated.

In the illustrated embodiment, the compression portion or spring member720of the compression element700has a substantially rectangular outer transverse cross-section including opposite first and second longitudinal sides722a,722bdefining an overall width dimension w therebetween, and opposite first and second longitudinal edges724a,724bdefining an overall height dimension h therebetween. As indicated above, the compression portion720has spring-like characteristics exhibiting flexibly elastic resiliency along the longitudinal axis L. The spring-like characteristics are provided by a first series of slots or slits730aextending from the first longitudinal side722aand transversely across a portion of the overall width dimension w and along the entire overall height dimension h, and a second series of slots or slits730bextending from the second longitudinal side722band transversely across a portion of the overall width dimension w and along the entire overall height dimension h. In the illustrated embodiment, the slits730a,730bare offset from one another along the length of the compression portion720in an alternating manner so as to define a relatively narrow strip of material732extending along the longitudinal axis L in an undulating or sinusoidal configuration. In one embodiment, the slits730a,730bextend across greater than one-half of the overall width dimension w, and in a further embodiment extend across approximately three-quarters of the overall width dimension w. However, other embodiments are also contemplated where the slits730a,730bextend across other portions of the overall width dimension w. Additionally, in the illustrated embodiment, the slits730a,730beach have a uniform slit width. However, in other embodiments, the slits730a,730bmay be provided with a non-uniform or varying slit width including, for example, an enlarged portion at the inner end of the slits730a,730bto provide additional flexibility and elasticity to the compression portion720. As should be appreciated, the slits730a,730bprovide the compression portion720with spring-like characteristics including flexibly elastic resiliency along the longitudinal axis L and to a lesser degree in directions transverse to the longitudinal axis L. Although a particular configuration of the compression portion720has been illustrated and described herein, it should be understood that other suitable spring-like configurations are also contemplated.

In the illustrated embodiment, the distal engagement portion or pusher member740of the compression element700generally includes an engagement plate portion750extending along the longitudinal axis L, and a connection portion760extending substantially perpendicularly from the engagement plate portion750.

The engagement plate portion750defines a distal end portion752defining a distal engagement surface754. In one embodiment, the distal engagement surface754has a curved or semi-circular configuration. However, other suitable shapes and configurations of the distal engagement surface754are also contemplated. Additionally, in the illustrated embodiment, the engagement plate portion750defines a first outer surface portion751aarranged generally parallel with the longitudinal axis L, and a second outer surface portion751bextending from the first outer surface portion751aand defining a relatively small outward taper or incline extending toward and intersecting the engagement surface754of the distal end portion752. The tapered outer surface portion751bis engagable with a corresponding angled/undercut surface portion741bformed along the distal end of the elongate shaft602(FIG. 21) when the linkage assembly650is positioned in a fully extended or locked state. Such engagement provides for rigid and secure engagement between the compression element700and the elongate shaft602and between the compression element700and the clamp element800when the handle assembly500is positioned in the fully extended/locked state (FIG. 21) to substantially prevent motion therebetween, which in turn provides for rigid and secure locked engagement between the handle assembly500and the connection post80of the broach60.

In the illustrated embodiment, the connection portion760is configured as a U-shaped clevis including a pair of plates or flanges764a,764bextending transversely from the engagement plate portion750and spaced apart from one another to define a yoke or gap766therebetween sized for receipt of a portion of the clamping element800therein. The flanges764a,764bin turn define a pair of generally circular openings762a,762bthat are axially offset from one another along the longitudinal axis L. The pair of openings762a,762bare sized and shaped to receive the dowel pins666a,666btherein, respectively, which are in turn positioned within corresponding slotted openings in the clamp element800to thereby movably and slidably connect the compression element700with the clamp element800with a portion of the clamp element800being guidingly displaced within the gap766between the flanges764a,764b. Positioning of a portion of the clamp element800within the gap766between the flanges764a,764bof the compression element700also serves to increase the strength and structural integrity of the slidable interconnection between the compression element700and the clamp element800. Although a particular configuration of the distal engagement portion740has been illustrated and described herein, it should be understood that other suitable configurations are also contemplated.

Referring toFIGS. 26-30, shown therein are further details regarding the clamp element800. In the illustrated embodiment, the clamp element800extends along a longitudinal axis L and generally includes a proximal connection plate portion810and a distal clamp portion830. The proximal connection plate portion810is configured for movable connection and slidable displacement within the gap766formed between the flanges764a,764bof the distal connection portion760of the compression element700. The distal clamp portion830is configured for sliding engagement with the distal end portion752of the compression element700, and is also configured for clamping or compressed engagement against the connection post80of the broach60to rigidly and releasably connect the broach60to the handle assembly500.

In the illustrated embodiment, the proximal connection plate810of the clamp element800has a flat/planar plate-like configuration and defines a pair of slotted openings812a,812bthat are axially offset from one another along the longitudinal axis L. The slotted openings812a,812bare sized and shaped to slidably receive the dowel pins666a,666bwhich are rigidly attached to the distal connection plate760of the compression element700. In the illustrated embodiment, each of the slotted openings812a,812bincludes a first slot portion820including opposite side surfaces822a,822bextending generally along a first oblique axis O1arranged at an oblique angle relative to the longitudinal axis L, and a second slot portion824extending from the first slot portion820and including opposite side surfaces826a,826bextending along a second oblique axis O2arranged at an oblique angle relative to the first oblique axis O1and the longitudinal axis L. In this manner, the obliquely-extending side surfaces of the first and second slot portions820,824are ramped or angled relative to the longitudinal axis L. Additionally, the slot portions820,824each define a slot width sized slightly larger than the outer diameter of the dowel pins666a,666b. As a result, displacement of the compression element700in a direction along the longitudinal axis L will slidably displace the dowel pins666a,666bgenerally along at least one of the slot portions820,824of the slotted openings812a,812b, further details of which will be set forth below. As indicated above, in one embodiment, movement of the clamp element800occurs along first and second vectors (i.e., along the offset axis O and the transverse axis T), which may occur simultaneously as a composite movement extending at an oblique angle relative to the offset axis O and the transverse axis T.

In the illustrated embodiment, the distal clamp830of the clamp element800includes a transverse base portion840attached to a distal end of the proximal connection plate810, an axial plate portion850extending generally along the longitudinal axis L and oriented transverse to the base portion840, and an enlarged clamp head portion860extending axially from the plate portion850. The transverse base840has an overall width sized in relatively close tolerance with the inner width dimension of the hollow interior632of the handle600to properly position and/or guide the clamp element800within the hollow interior632of the handle600. The distal corners842of the transverse base portion840may be rounded to facilitate sliding engagement with the inner surfaces of the handle600. Additionally, the transverse base portion840defines a pair of proximally-facing surfaces or shoulders844positioned on opposite sides thereof that are engagable with distally-facing end surfaces768of the flanges764a,764bof the compression element700to properly position the distal end portion752of the compression element700relative to the clamp head860of the clamp element800when the handle assembly500is transitioned to a locked configuration. The plate portion850extends axially from the transverse base840and has a generally flat/planar configuration. However, other suitable configurations of the transverse base840and the axially plate850are also contemplated.

In the illustrated embodiment, the enlarged clamp head860has an irregular-shaped configuration defining a wedge or bearing surface870configured for sliding engagement with the distal end portion752of the compression element700, and a clamp surface880configured for clamping/compressed engagement against the connection post80of the broach60to rigidly and releasably connect the broach60to the handle assembly500. The wedge surface870is angled relative to the longitudinal axis L so as to define a ramp or incline. In the illustrated embodiment, the wedge surface870includes multiple ramped portions872that may define different incline angles. However, in other embodiments, the wedge surface870may define a single ramped portion defining a uniform or constant incline angle. In the illustrated embodiment, the ramped portions872are each generally flat/planar. However, other embodiments are also contemplated wherein one or more of the ramped portions872may be curved or may have a curvi-linear configuration. In the illustrated embodiment, the clamp surface880includes first and second clamp surfaces882,884that together define a generally V-shaped projection or tongue886sized and shaped for receipt with the V-shaped notch82formed in the connection post80of the broach60. The intersection or corner formed between the first and second clamp surfaces882,884may be rounded or beveled. Additionally, in the illustrated embodiment, the clamp surfaces882,884are each generally flat/planar. However, other embodiments are also contemplated wherein one or both of the clamp surfaces882,884may be provided with a curved or curvi-linear configuration. Further, in the illustrated embodiment, the clamp surfaces882,884extend along planes that are oblique (i.e., non-perpendicular and non-parallel) relative to central longitudinal planes P of the clamp element800(FIG. 29). In other words, the planes along which the clamp surfaces382,384extend are skewed relative to central longitudinal planes P of the clamp element800. Although a particular configuration of the clamp head860has been illustrated and described herein, other suitable configurations of the clamp head860are also contemplated. As should be appreciated, the geometry of the clamp head860including the particular shape and configuration of the clamp surfaces882,884may be varied to accommodate/control various aspects associated with the handle assembly500and its relation relative to the broach60(i.e., the orientation/position of the broach60relative to one or more portions of the handle assembly500).

Referring once again toFIGS. 20 and 21, in the illustrated embodiment, the toggle handle910includes a clevis portion920arranged at a distal end thereof and configured for pivotal connection with the proximal connection portion710of the compression element700, a flange portion930proximally offset from clevis portion920and configured for pivotal connection with a distal portion of the toggle link950, and an elongate lever portion940extending proximally from the flange portion930and configured to be grasped and manipulated by the surgeon. The clevis portion920includes a pair of spaced apart plates or flanges defining a yoke or space therebetween sized to receive the proximal connection portion710of the compression element700therein, and with the plates defining aligned openings arranged along the first pivot axis P1and sized to receive the pivot pin660therein to pivotally connect the toggle handle910to the compression element700. The flange portion930has a plate-like configuration and defines an opening arranged along the second pivot axis P2and sized to receive the pivot pin662therein to pivotally connect the toggle handle910to a distal portion of the toggle link950. The elongate lever portion940of the toggle handle910includes a base portion942and a proximal gripping portion944extending therefrom and positioned adjacent the axial shaft portion603aof the handle600for grasping and manipulation by the surgeon. Although a particular configuration of the toggle handle910has been illustrated and described herein, it should be understood that other suitable configurations are also contemplated.

In the illustrated embodiment, the toggle link950includes a distal clevis portion960and a proximal pivot connection portion970. The clevis portion960includes a pair of spaced apart plates or flanges defining a yoke or space therebetween sized to receive the flange portion940of the toggle handle910therein, and with the plates defining a pair of aligned openings arranged along the second pivot axis P2and sized to receive the pivot pin662therein to pivotally connect the toggle link950to the toggle handle910. The pivot connection portion970defines an opening extending therethrough along the third pivot axis P3and sized to receive the pivot pin664therein to pivotally connect the toggle link950to the offset shaft portion603bof the handle600. Although a particular configuration of the toggle link950has been illustrated and described herein, it should be understood that other suitable configurations are also contemplated.

Having described the components, features and functional characteristics associated with the handle assembly500, reference will now be made to engagement of the handle assembly500to the broach60according to one form of the present invention. Referring once again toFIGS. 20-22, the toggle handle910is initially pivoted about the pivot axis P1in an outward direction away from the offset axis O, which in turn pulls the compression element700and proximally displaces the compression element700in the direction of arrow A to transition the handle assembly50to an unlocked configuration. As the compression element700is displaced in the direction of arrow A, the dowel pins666a,666battached to the distal connection plate portion760of the compression element700are movably displaced along one of the oblique slot portions822,824defined by the slotted openings812a,812bin the clamp element800, which in turn displaces the clamp element800in a transverse direction away from the distal passage638of the shaft600to thereby retract the clamp head860away from the connection axis C and out of the distal passage638to permit insertion of the connection post80of the broach60into the distal post-receiving passage638. As indicated above, when the connection post80of the broach60is inserted into the distal post-receiving passage638, the projection639(FIG. 22) is positioned within the axial notch86formed in the end of the connection post80(FIG. 4A) to provide an added degree of strength and rigidity to the connection of the broach60to the handle assembly500.

Once the connection post80is properly positioned within the distal passage638and the broach60is rotated to the desired orientation about the connection axis C, the toggle handle910is pivoted about the pivot axis P1in an inward direction toward from the offset axis O, which correspondingly pushes the compression element700and distally displaces the compression element700in the direction of arrow B to transition the handle assembly500to a locked configuration. As the compression element700is displaced in the direction of arrow B, the distal end portion752of the compression element700is slidably engaged along the inclined/angled wedge surface870defined by the clamp head860of the clamp element800. As should be appreciated, sliding engagement of the distal end portion752of the compression element700along the inclined/angled wedge surface870of the clamp head360correspondingly displaces the clamp element800in a direction transverse to the connection axis C toward the connection post80of the broach60. As indicated above, movement of the clamp element800may occur simultaneously along first and second vectors (i.e., along the offset axis O and the transverse axis T) to provide a composite-type movement.

The V-shaped projection886defined by the clamp head860is driven into engagement with the V-shaped notch84of the connection post80until the clamp surfaces882,884of the projection886are compressed firmly against the inner bearing surfaces of the V-shaped notch84, which in turn compresses the connection post80against the opposite side wall of the distal passage638to thereby securely and rigidly connect the broach60to the handle assembly500. Additionally, the overall strength and rigidity of the connection between the handle assembly500and the broach60is enhanced via the tight sandwiching/stacking of the distal end portion752of the compression element700between the clamp head860and an inner wall of the offset shaft portion603b. In this manner, the inner wall of the of the offset shaft portion603bacts as a backstop or a buttress to prevent movement and/or deflection of the distal end portion752of the compression element700and the clamp head860, thereby increasing the strength and rigidity of the connection between the handle assembly500and the broach60.

As should be appreciated, the spring-like characteristics exhibited by the compression portion720(i.e., the flexible elasticity and resiliency) of the compression element700permits the application of a maximal axial force against the wedge surface870defined by the clamp head860regardless of potential tolerance gaps, dimensional variations, or misalignments between the components of the handle assembly500, and/or potential tolerance gaps, dimensional variations, or misalignments between the handle assembly500(i.e., the clamp head860and the distal passage638) and the connection post80of the broach60. In this manner, the spring-like characteristics of the compression portion720in combination with the actuation force generated by the linkage assembly650provide the handle assembly500with a clamping action similar to that of a vice-grip tool to thereby provide a secure and rigid connection between the handle assembly500and the broach60. As should also be appreciated, the secure and rigid connection between the broach60and the handle assembly500eliminates or at least minimizes motion (e.g., micro-motion) and/or deflection therebetween, thereby providing various advantages including, for example, increased control of the broach60, increased visual and tactile feedback to the surgeon as to the fit of the broach60within the femoral canal, an increased ability of the surgeon to more precisely estimate the resulting tightness of fit of a femoral stem within the femoral canal, and/or easier removal of the broach60from the femoral canal subsequent to shaping.

Referring toFIGS. 31-33, shown therein is a surgical instrument handle assembly500′ according to another form of the invention configured for preparation of the intramedullary canal of a femur in a total hip replacement surgery or other orthopedic surgeries. The handle assembly500′ has many of the same components and features as the handle assembly500illustrated and described above, with like components being referred to using like reference numbers.

The handle assembly500′ is likewise configured for rigid and releasable connection to an orthopedic shaping/cutting device such as, for example, a broach60′. The broach60′ is configured similar to the broach60illustrated and described above. Similar to the broach60, the broach60′ includes a shaping body portion70′ and a connection post or stem portion80′ extending therefrom and arranged generally along a post axis82′ that is co-axial with the connection axis C′ of the distal post-receiving passage638′ defined by the handle assembly500′, and with the connection post80′ likewise defining a transverse notch or groove84′ and an axial notch or groove86′ (FIG. 33). In one embodiment, the shaping body70′ extends along a longitudinal axis72′ and has a shape that generally matches that of a femoral implant to be subsequently inserted into the femoral medullary canal subsequent to preparation of the canal, and also includes a plurality of cutting teeth or other cutting/shaping features configured to remove material from the femoral intramedullary canal to shape the canal. The post axis82′ of the connection post80′ may be arranged either parallel with or oblique to the longitudinal axis72′ of the shaping body70′. Although a particular type and configuration of the broach60′ has been illustrated and described herein, it should be understood that other types and configurations are also contemplated as would occur to one having ordinary skill in the art. In addition to the broach60′, the handle assembly500′ may also be used in association with other configurations of broaches, other types and configurations of shaping/cutting members, other orthopedic devices, or orthopedic implants.

Similar to the handle assembly500, the handle assembly500′ is likewise provided with a handle600′ including an elongate shaft602′ having an axial shaft portion603a′, an offset shaft portion603b′, and a distal transition portion603c′. Additionally, the handle assembly500′ is similarly provided with a linkage assembly650′ (FIG. 33) movably connected to the handle600′ and generally including a compression element700′, a clamp element800′, and an actuator mechanism900′, with the actuator mechanism900′ configured as a toggle-type actuator including a toggle handle910′ and a toggle link950′. As should be appreciated, the linkage assembly650′ of the handle assembly500′ is structurally and functionally similar to the linkage assembly650illustrated and described above with regard to the handle assembly500. The handle assembly500′ likewise operates in a manner similar to that of the handle assembly500to provide a secure and rigid connection of the handle assembly500′ with the shaping member60′. However, structural differences between certain components of the handle assembly500′ and corresponding components of the handle assembly500may be apparent. Some of these structural differences are illustrated inFIGS. 31-33in association with the following description.

As indicated above, the illustrated embodiment of the handle600′ includes an axial shaft portion603a′, an offset shaft portion603b′, and a distal transition portion603c′. The axial shaft portion603a′ has a linear configuration arranged generally along a longitudinal axis L′. The axial shaft portion603a′ further defines a recess or indentation626′ sized and shaped to provide access to the lever portion944′ of the toggle handle910′ such that the lever portion944′ may be readily grasped and manipulated by one or more fingers and/or the thumb of the surgeon. In the illustrated embodiment, the recess or indentation626′ extends partially into the axial shaft portion603a′ a distance sufficient to provide access to the lever portion944′. However, in other embodiments, the recess626′ may extend entirely through the thickness of the axial shaft portion603a′. The offset shaft portion603b′ extends from the axial shaft portion603a′ and is arranged generally along an offset axis O′ that defines one or more angular offsets relative to the longitudinal axis L′. In the illustrated embodiment, the offset axis O′ of the offset shaft portion603b′ defines both an anterior offset and a lateral offset relative to the longitudinal axis L′. However, other embodiments are also contemplated where the offset shaft portion603b′ is arranged such that the offset axis O′ defines a single offset or other types of compound offsets relative to the longitudinal axis L′. As should be appreciated, providing the elongate shaft602′ with one or more angular offsets (via inclusion of the offset shaft portion603b′) may be beneficial when inserting the shaping member60′ into the femoral intramedullary canal using an anterior surgical approach to minimize interference with adjacent soft tissues or other anatomic structures surrounding the hip joint of the patient.

The distal transition portion603c′ extends from the offset shaft portion603b′ and defines a distal post-receiving passage638′ (similar to the distal post-receiving passage638defined by the handle assembly500) sized and shaped for receipt of the connection post80′ of the broach60′. The distal post-receiving passage638′ is arranged along a connection axis C′ which may be oriented either parallel to or arranged at an oblique angle relative to the offset axis O′. However, other embodiments are also contemplated wherein the elongate shaft602′ does not include a distal transition portion603c′, with the distal post-receiving passage638′ defined by a distal region of the offset shaft portion603b′. In the illustrated embodiment, the connection axis C′ is arranged oblique to the longitudinal axis L′ of the axial shaft portion603a′. However, other embodiments are also contemplated where the connection axis C′ may be generally parallel with the longitudinal axis L′ of the axial shaft portion603a′. Additionally, as shown inFIG. 33, the handle shaft602′ defines a projection639′ extending into the post-receiving passage638′ and arranged generally along the connection axis C′. The projection639′ is sized and shaped for receipt within the axial notch or groove86′ formed in the end of the connection post80′ of the broach60′. Receipt of the projection639′ within the axial notch86′ in the broach connection post80′ provides an added degree of strength and rigidity to the interconnection of the broach60′ with the handle assembly500′.

In the illustrated embodiment, the handle600′ includes a strike plate or impaction platform604′ similar in structure and function to the impaction platform604illustrated and described above. The impaction platform604′ is operatively attached to a proximal end portion of the axial shaft portion603a′ and has a normal proximally-facing impact or strike surface606′, and further includes an angled proximally-facing impact or strike surface608′ arranged at an oblique angle relative to the strike surface606′. It should be understood that the impaction platform604′ may be provided with additional obliquely-oriented proximally-facing impact or strike surfaces. As should be appreciated, inclusion of the obliquely-oriented proximally-facing impact or strike surfaces608′ allows the surgeon to apply impact forces along axes that are not parallel with the longitudinal axis L′. Other shapes and configurations of the impaction platform604′ and the strike surfaces606′,608′ are also contemplated including, for example, non-rectangular shapes and configurations of the impaction platform604′ and/or impact or strike surfaces606′,608′ having a curved or curvi-linear configuration.

In the illustrated embodiment, the axial shaft portion603a′, the offset shaft portion603b′, and the distal transition portion603c′ each have a generally linear configuration and each define a generally rectangular outer transverse cross-section. However, other shapes and configurations are also contemplated. At least the offset shaft portion603b′ and the distal transition portion603c′ define a hollow interior or inner chamber632′ to house the components of the linkage assembly650′. The offset shaft portion603b′ may be provided with a number of slotted openings634′ extending transversely through one or more shaft walls and into communication with the hollow interior632′. The offset shaft portion603b′ and/or the distal transition portion603c′ may also define a window636′ extending transversely therethrough and into communication with the hollow interior632′ adjacent the interconnection of the connection post80′ of the broach60′ with the projection639′ defined by the handle shaft602′. The openings634′ and the window636′ provide ready access to the components contained within the hollow interior632′, aid in manufacturing, assembly and/or maintenance of the handle assembly500′, facilitate cleaning and/or sterilization of the handle assembly500′, and/or may provide direct visualization of the components contained within the hollow interior632′ to verify proper operation.

In the illustrated embodiment, the offset shaft portion603b′ is also provided with a number of raised lands or plateaus640′ extending inwardly into the hollow interior632′ and defining generally flat/planar bearing surfaces configured to guide the compression element700′ and/or the clamp element800′ in a direction generally parallel with the offset axis O′ upon actuation of the actuator mechanism900′. It should be understood that other features or structures may also be provided to further aid in guiding the compression element700′ and/or the clamp element800′ in a direction generally along the offset axis O′ and/or to add strength and structural integrity to the linkage assembly650′. For example, one or more guide pins may be positioned at locations along the hollowing interior632′ to further aid in guiding the compression element700′ and/or the clamp element800′ upon actuation of the actuator mechanism900′. Additionally, an end portion or head of the pivot pin660′ (FIG. 31A) that pivotally connects the compression element700′ with the toggle handle910′ may be slidably displaced along an axial slot or groove637′ formed in a side wall of the offset shaft portion603b′ to add further strength and structural integrity to the linkage assembly650′. A portion of the compression element700′ may also be slidably displaced along an axial slot or groove formed in a side wall of the offset shaft portion603b′ to add further strength and structural integrity to the linkage assembly650′.

Referring specifically toFIG. 33, the linkage assembly650′ generally includes a compression element700′, a clamp element800′, and an actuator mechanism900′ comprised of a toggle handle910′ and a toggle link950′. In the illustrated embodiment, the components of the linkage assembly650′ are interconnected via a series of pins or shafts. Specifically, a proximal portion of the compression element700′ is pivotally connected to a first portion of the toggle handle910′ via a first pivot pin660′ extending along a first pivot axis P1′ to permit pivotal movement of the toggle handle910′ relative to the compression element700′ about the first pivot axis P1′. A second portion of the toggle handle910′ is pivotally connected to a distal portion of the toggle link950′ via a second pivot pin662′ extending along a second pivot axis P2′ to permit pivotal movement of the toggle handle910′ relative to the toggle link950′ about the second pivot axis P2′. Additionally, a proximal portion of the toggle link950′ is pivotally connected to the offset shaft portion603b′ of the shaft602′ via a third pivot pin664′ extending along a third pivot axis P3′ to permit pivotal movement of the toggle link950′ relative to the handle600′ about the third pivot axis P3′ while preventing axially displacement of the toggle link950′ along the offset axis O′. Furthermore, a distal portion of the compression element700′ is slidably attached to the clamp element800′ via a pair of dowel pins666a′,666b′. As should be appreciated, the linkage assembly650′ operates in a manner similar to the linkage assembly650illustrated and described above, and therefore need not be discussed in further detail.

While the instruments and devices described herein have been described for use in association with femoral intramedullary canal preparation, it should be understood that the instruments and devices may also be used in association with other surgical procedures and/or in the preparation of other bones or bony structures. In reading the claims, words such as “a”, “an”, “at least one”, and “at least a portion” are not intended to limit the claims to only one item unless specifically stated to the contrary. Additionally, when the language “at least a portion” and/or “a portion” is used, the claims may include a portion and/or the entire item unless specifically stated to the contrary. Furthermore, when the term “distal” is used with respect to a structure, the term refers to the far end of the structure, and when the term “proximal” is used with respect to a structure, the term refers to the near end of the structure.

Various changes and modifications to the described embodiments described herein will be apparent to those skilled in the art, and such changes and modifications can be made without departing from the spirit and scope of the invention and without diminishing its intended advantages. Additionally, while the invention has been illustrated and described in detail in the drawings and foregoing description, the same is to be considered illustrative and not restrictive in character, it being understood that only selected embodiments have been shown and described and that all changes, equivalents, and modifications that come within the scope of the inventions described herein or defined by the following claims are desired to be protected.