Source: https://patents.google.com/patent/US20050137606A1/en
Timestamp: 2019-06-27 08:55:40
Document Index: 799259131

Matched Legal Cases: ['Application No. 10', 'art 14', 'art 16', 'art 14', 'art 16', 'art 14', 'art 16', 'art 14', 'art 16', 'art 14', 'art 16', 'art 14']

US20050137606A1 - Quick-release drill guide assembly for bone plate - Google Patents
Quick-release drill guide assembly for bone plate Download PDF
US20050137606A1
US20050137606A1 US10/979,915 US97991504A US2005137606A1 US 20050137606 A1 US20050137606 A1 US 20050137606A1 US 97991504 A US97991504 A US 97991504A US 2005137606 A1 US2005137606 A1 US 2005137606A1
US10/979,915
2004-11-01 Application filed by Synthes USA LLC filed Critical Synthes USA LLC
2004-11-01 Priority to US10/979,915 priority patent/US20050137606A1/en
2005-06-23 Publication of US20050137606A1 publication Critical patent/US20050137606A1/en
2008-03-04 Assigned to HFSC COMPANY reassignment HFSC COMPANY ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: SYNTHES (USA)
2008-03-04 Assigned to SYNTHES (USA) reassignment SYNTHES (USA) ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: RYAN, CHRISTOPHER, STIHL, PASCAL
2008-05-08 Assigned to SYNTHES (U.S.A.) reassignment SYNTHES (U.S.A.) ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: HFSC COMPANY
This is a continuation of International Application No. PCT/US04/026399, filed Aug. 13, 2004, and is a continuation-in-part of U.S. Non-Provisional Patent Application No. 10/639,515, filed Aug. 13, 2003, the entirety of which applications are expressly incorporated herein by reference thereto.
When the tail of the Y-shaped ratchet-gear mechanism is pressed by a finger of a user in a rotary motion in a direction toward the handle member, the distal end of the alignment drill-barrel is urged into the bushing which in turn, expands the forward-end of the bushing, thus locking the bushing within a hole or recess of the bone-plate. The bushing is configured and dimensioned to expand within a bone-plate hole or recess such that it is releasably locked to the bone-plate.
When the release knob is further pressed, the pawls are disengaged from the serrations, and the Y-shaped ratchet-gear mechanism returns to an unactuated position, preferably by action of a biasing member such as a spring. The Y-shaped ratchet-gear mechanism, in turn, through its C-shaped vice-grip moves the alignment drill-barrel in a longitudinal direction along its axis, away from the fingers. As a result, the bushing assumes a retracted position thereby disengaging the hole or recess.
Another embodiment of a drill-guide assembly is described, comprising an alignment barrel having a proximal end and a distal end; a bushing configured to slidably receive the alignment barrel, the bushing having a radially expandable forward-end and a proximal end, the forward-end configured to be insertable within a hole or recess in a bone plate; a release knob having serrations; and a movable ratchet gear mechanism having a first leg, a second leg and a tail, the first leg of the ratchet-gear mechanism connected to the alignment barrel, the second leg of the ratchet-gear mechanism having pawls configured and adapted to engage the serrations to hold the alignment barrel in position, the tail of the ratchet gear mechanism operable by a user to selectively move the ratchet-gear mechanism, wherein, movement of the ratchet-gear mechanism slides the alignment barrel relative to the bushing to radially expand the forward end to releasably lock the bushing to the plate, and a first drill guide coupled to the bushing, wherein the first drill guide is configured to receive and guide a drill-bit.
The first drill guide may be coupled to the bushing by a first connecting element. The first connecting element may have at least two bores for respectively receiving at least a portion a bushing therethrough and at least a portion of a drill guide therethrough. The first drill guide may also be further coupled to the bushing by a second connecting element, and the second connecting element may have at least two bores for respectively receiving at least a portion of a bushing therethrough and at least a portion of a drill guide therethrough.
At least two bores of the first connecting element may be separated by a first distance, and the at least two bores of the second connecting element may be separated by a second distance, wherein the first distance may be greater than the second distance, and wherein the second connecting element may be closer to the distal end of the forward end of the bushing than the first connecting element. Alternatively, the first connecting element may be closer to the distal end of the forward end of the bushing than the second connecting element.
The first connecting element may further comprise a fin bore configured to receive at least a portion of fin therethrough, wherein at least a portion of the fin in configured to engage at least a portion of a hole or recess when the bushing engages a bone-plate.
The drill-guide assembly may further comprise a second guide coupled to the bushing, wherein the second drill guide is configured to receive and guide a drill-bit. The second drill guide may be coupled to the first drill guide. The first and second drill guide may be coupled to the bushing by a first connecting element. The first connecting element may have at least three bores for respectively receiving at least a portion of the first drill guide therethrough, at least a portion of the second drill guide therethrough, and a least a portion of the bushing therethrough.
The first connecting element may further include a fin bore configured to receive at least a portion of fin therethrough, wherein at least a portion of the fin in configured to engage at least a portion of a hole or recess when the bushing engages a bone-plate.
The first drill guide and second drill guide may further be coupled to the bushing by a second connecting element.
The second connecting element may also have at least three bores for respectively receiving at least a portion of the first drill guide therethrough, at least a portion of the second drill guide therethrough, and a least a portion of the bushing therethrough.
The bores of the first connecting element receiving first and second drill guides are separated by a first distance, and the bores of the second connecting element receiving first and second drill guides are separated by a second distance, wherein the first distance is greater than the second distance, and wherein the second connecting element may be closer to the distal end of the forward end of the bushing than the first connecting element. Alternatively, the first connecting element may be closer to the distal end of the forward end of the bushing than the second connecting element.
The first drill guide may have a longitudinal axis, and when the bushing is locked to a bone-plate, the longitudinal axis of the first drill guide may generally be aligned with a first bone-fastener hole of the bone-plate. The drill-guide assembly may further comprise a second drill guide configured to receive and guide a drill-bit and coupled to the bushing, the second drill guide having a longitudinal axis, and when the bushing is locked to a bone-plate, the longitudinal axis of the second drill guide may be generally aligned with a second bone-fastener hole of the bone-plate. The recess of the bone-plate includes at least one shaped area and a slot.
An alternative method for drilling holes in bone is also described, comprising the steps of: (a) providing a drill-guide assembly, comprising an alignment barrel having a proximal end and a distal end; a bushing configured to slidably receive the alignment barrel, the bushing having a radially expandable forward-end and a proximal end, the forward-end configured to be insertable within a hole or recess in a bone plate; a release knob having serrations; and a movable ratchet gear mechanism having a first leg, a second leg and a tail, the first leg of the ratchet-gear mechanism connected to the alignment barrel, the second leg of the ratchet-gear mechanism having pawls configured and adapted to engage the serrations to hold the alignment barrel in position, the tail of the ratchet gear mechanism operable by a user to selectively move the ratchet-gear mechanism, wherein, movement of the ratchet-gear mechanism slides the alignment barrel relative to the bushing to radially expand the forward end to releasably lock the bushing to the plate, and at least a first guide coupled to the bushing, wherein the first drill guide is configured to receive and guide a drill-bit; (b) inserting the bushing into a recess of a bone plate; (c) aligning at least the first drill guide with a first bone fastener hole in the bone-plate; (d) expanding the bushing in the recess; (e) locking the bushing to the plate; (f) inserting a drill-bit into the first drill guide; and (g) drilling a first hole.
At least a portion of the forward end of the bushing may be configured to fit in at least a portion of the recess. The bushing may be locked to the plate by locking the alignment barrel and bushing in fixed relation to each other. The drill guide assembly may further comprise a second drill guide coupled to the bushing, wherein the second drill guide is configured to receive and guide a drill-bit.
The method may further comprise the steps of inserting a drill-bit guide into the second drill guide, and drilling a second hole.
A kit for use with drilling bones is also described, comprising: (a) a drill-guide assembly, comprising an alignment barrel having a proximal end and a distal end; a bushing configured to slidably receive the alignment barrel, the bushing having a radially expandable forward-end and a proximal end, the forward-end configured to be insertable within a hole or recess in a bone plate; a release knob having serrations; and a movable ratchet gear mechanism having a first leg, a second leg and a tail, the first leg of the ratchet-gear mechanism connected to the alignment barrel, the second leg of the ratchet-gear mechanism having pawls configured and adapted to engage the serrations to hold the alignment barrel in position, the tail of the ratchet gear mechanism operable by a user to selectively move the ratchet-gear mechanism, wherein, movement of the ratchet-gear mechanism slides the alignment barrel relative to the bushing to radially expand the forward end to releasably lock the bushing to the plate; (b) at least first and second drill guides able to be coupled to the bushing; and (c) at least first and second connecting elements for coupling at least one drill guide to the bushing.
At least the first and second drill guides may have different lengths, and at least the first and second drill guides may have different diameters. At least the first and second connecting elements may each have a bore for receiving at least one drill guide therethrough and a bore for receiving a bushing therethrough, wherein the bores of the first connecting element have a first arrangement, and the bores of the second connecting element have a second arrangement, and wherein the first arrangement may be substantially different than the second arrangement.
FIG. 1 is a perspective view of a first embodiment of a drill-guide assembly;
FIG. 2 is a cross-sectional view of an embodiment of an alignment drill-barrel that may be used with the assembly of FIG. 1;
FIG. 3 is a partial cross-sectional view of another embodiment of an alignment drill-barrel that may be used with the assembly of FIG. 1;
FIG. 6A is a side view of the Y-shaped ratchet-gear mechanism;
FIG. 6B is a perspective view of the drill-guide assembly showing the ratchet-gear mechanism connected to the dual-arm support;
FIG. 7A is a perspective view of the ratchet-gear mechanism engaging the release knob;
FIG. 11 is a perspective view of the drill-guide assembly of FIG. 1 engaged to a bone-plate.
FIG. 12A is a perspective view of another embodiment of a drill-guide assembly with drill guides;
FIG. 12B is another perspective view of the assembly of FIG. 12A;
FIG. 12C is a partial top view of an exemplary bone plate that can be used with the assemblies of FIGS. 1 and 12A;
FIG. 13A is a top view of a proximal connecting element for use with the assembly of FIG. 12A; and
FIG. 13B is a top view of a distal connecting element for use with the assembly of FIG. 12A.
This embodiment of a drill-guide assembly 5 can be secured or locked into a fastener hole in a bone plate. A related embodiment of a drill-guide assembly 500 that can be secured or locked into a drill recess 354 is shown infra in FIGS. 12A-13B. Locking or securing may facilitate precision in the surgical procedure, for example, drilling or fastening screws or other similar fasteners. Moreover, the drill-guide can be quickly detached and released from the bone-plate improving the speed of surgical procedures involving drilling or similar procedures.
Drill-guide assembly 5 may include an alignment assembly 15, a release knob 100, a handle member 250, a ratchet-gear mechanism 50, and a dual-arm support 10.
The alignment assembly 15 may comprise an alignment drill-barrel 150 and a bushing 200. A surgeon or a user can releasably attach the alignment assembly 15 in the fastener hole 352 of a bone-plate 350. Other attachment options are discussed infra, particularly in relation to FIGS. 12A-13B. A drill-bit or other such instrument can be inserted into and through the alignment assembly 15.
Referring to FIG. 2, an embodiment of the alignment drill-barrel 150 is shown. The alignment drill-barrel 150 may have a through bore 185 from its proximal end 174 to its distal end 172. A drill-bit or other instrument may be inserted through the bore 185. In the embodiment of FIG. 2, the drill-barrel comprises a first hollow cylindrical section 156 with an annular diameter of x12, a second hollow cylindrical section 158 with an inside annular diameter of x18, and a third hollow cylindrical section 160 with an inside annular diameter of x24, wherein x24 is smaller than x18, and x18 is smaller than x2. The outside surface of the alignment drill-barrel 150 comprises a shoulder 162 and a shoulder 164 wherein the outside diameter of the first section 166 is x14 which is greater than the outside diameter x20 of the second section 168. x14has an exemplary diameter of 3 mm to 10 mm, preferably about 8 mm. The third section 170 is a conical section that tapers from an outside diameter x22 at shoulder 164 to a diameter x26 at the distal end 172. The proximal end 174 of the alignment drill-barrel 150 preferably has first circular ridge 152 and second circular ridge 154. The first and the second circular ridges 152 and 154 respectively, have an outside diameter x16.
In this embodiment, the first circular ridge 152 is flush with the proximal end 174 of the alignment drill-barrel 150. The conical section 170 tapers from an outside diameter x22 at the transition 164 to an outside diameter x26 at end 172. Preferably, inner diameter x24 is constant along the length of conical section 170 of alignment drill-barrel 150 as defined along center line 180.
Referring to FIG. 3, an alignment drill-barrel 150 according to another embodiment is shown. In FIG. 3, alignment drill-barrel 150 is hollow with a cylindrical section 182 and a tapered, conical section 184 to facilitate movement of alignment drill-barrel 150 within bushing 200. Cylindrical section 182 has outside diameter x5, while conical section 184 tapers from an outside diameter x5 at the transition 186 to an outside diameter x6 at the distal end 188. Preferably, inner diameter x7 may be constant along the length of alignment drill-barrel 150 as defined along center line 190.
Referring to FIG. 4, a bushing is shown. Bushing 200 may coaxially receive alignment drill-barrel 150 about a central line 240. Bushing 200 may be substantially symmetrical about line 240. The forward end 222 of bushing 200 may preferably be comprised of longitudinally extending fingers 210. Individual fingers 210 may be separated by slits 204 extending longitudinally between adjacent fingers 210. Slits 204 as shown, for example, in FIG. 4, may include a circular portion 206 that serves to minimize stress concentration when fingers 210 are flexed. Fingers 210 may be resiliently biased inwardly and naturally assume an inward disposition when in a relaxed state. At a front portion of the expandable forward end 202 of bushing 200, the fingers 210 may form a radially expandable circumferential neck 208. At the back end of and adjacent to neck 208 may preferably be a shoulder 212.
Neck 208 may span a length that is slightly longer than the thickness of the fastener hole wall from the bone-side surface to the top surface of a bone-plate. Thus, neck 208 can be inserted into the bone-plate fastener hole 352 and the fingers 210 expanded to secure the bushing 200 to the plate. More particularly, movement of alignment drill-barrel 150 within bushing 200 may expand fingers 210 to secure the bushing 200 to the bone plate. In this manner, the drill-guide assembly can be secured to the plate, restricting relative movement. In a preferred embodiment, fingers 210 forming a radially expandable rim 214 may be provided at the front end of and adjacent to neck 208.
In another embodiment, the distal end 222 of the bushing 200 may not contain the rim 214, the neck 208 or the shoulder 212, but instead has a tapered end with the inner and the outer diameter of the tapered end decreasing from point 220 shown in FIG. 4. In such an embodiment, the taper is such that it may fit freely through a fastener hole in a bone plate.
In alternate embodiments, no rim may be used. The several portions of bushing 200, i.e., the neck 208, the shoulder 212, and the rim 214, may preferably be a single piece of material of unitary construction.
In other alternate embodiments, fingers 210 need not include a shoulder, neck, and/or a rim. Instead, for example, a small pin may be used to secure the bushing to the plate. In an alternatively preferred embodiment, the inward bias of fingers 210 is selected to produce the desired friction with the bone-plate 350 so that the fingers 210 fit snugly within the bone-plate fastener hole 352 (or drill recess 354, as discussed infra in relation to FIGS. 12A-13B), preferably allowing operation of handle member 250 with only one hand. Alternative resiliency for fingers 210 may be varied to suit the purpose of the design.
The dual-arm support 10 is preferably fixed with the bushing 200 by welding. In an alternative embodiment, friction fitting, press fitting, and such can be used. Outer diameter x3 of ridge 218 is about the same size as inner diameter x1 of the clamp 12 of the dual-arm support 10. Bushing 200 may also be fixed to dual-arm support 10 by releasable fastener means. First part 14 is generally perpendicular to the axial direction of the alignment assembly 15 or the bushing 200. The second part 16 of the dual-arm support 10 preferably forms an obtuse angle θd1 with the first part 14 of the dual-arm support 10. θd1 may range from about 90
to about 180
, and more preferably from about 105
to about 135
. Dual-arm support 10 and handle member 250 are fixedly connected by a dowel pin 20 at the front end of the handle member 250, so that they are immovable with respect to each other. In the preferred embodiment, handle member 250 is located remotely from the drilling site, thereby increasing visibility near the locking bone plate 350.
As shown in FIG. 5, the second part 16 of the dual-arm support 10 may be attached to the first part 14 by a dowel pin 18, or the dual-arm support 10 may be an integral, monolithic construction. The second part 16 of the dual-arm support 10 also forms an obtuse angle θd2 with the handle member 250. θd2 may range from about 90
. The handle member 250 and the dual-arm support 10 generally form an “S” shape or a zigzag shape, and in a preferred embodiment, the longitudinal axis 24 of the first part 14 and the longitudinal axis 26 of the second part 16 lie in the same plane. The longitudinal axis 280 of the handle member 250 also preferably lies in the same plane as the longitudinal axis 24 of the first part 14 and the longitudinal axis 26 of the second part 16 of the dual-arm support 10. Preferably the longitudinal axis 24 of the first-part 14 of the dual-arm support 10 is generally parallel with the longitudinal axis 280 of the handle member 250.
The first leg 52 of the ratchet-gear mechanism comprises a generally C-shaped vice-grip 60 at its end, and a pivot hole 62 for insertion of a pivot screw 64. The C-shaped vice-grip 60 grips the alignment drill-barrel 150 in between the first ridge 152 and second ridge 154 (see also FIG. 2) located at the end 174 of the drill-barrel 150. As shown in FIG. 6A, in a preferred embodiment, the plane of the C-shaped vice-grip 60 that forms an anterior portion of the first leg 52 of the Y-shaped ratchet-gear mechanism 50 makes an acute angle θd with the longitudinal axis 64 of the first leg 52 of the Y-shaped ratchet-gear mechanism 50. At the point of inflexion between the longitudinal first leg 52 and the C-shaped vice grip 60, pivot screw 64 and hole 62 are located. This pivot mechanism 62 helps the movement of the alignment drill-barrel 150. In a preferred embodiment, the acute angle is from about 25
. In a further preferred embodiment the acute angle θd is such that when the ratchet-gear mechanism 50 is completely disengaged from the serrations 102 of the release knob 100, the alignment drill-barrel 150 can be removed from the bushing 200 in a longitudinal direction away from the fingers 210 by moving the ratchet-gear mechanism 50 in a direction away from the handle member 250, about the pivot screw 64. θd may be 0
, with an exemplary dimension of 60
Alignment drill-barrel 150 may be configured and dimensioned to be slidably received within bushing 200. The alignment drill-barrel 150 and bushing 200 may cooperate to permit drill-guide assembly 5 to lock to a bone plate 350. The conical section 184 of the alignment drill-barrel 150 may cooperate with fingers 210 of bushing 200 to expand fingers 210 when the alignment drill-barrel 150 is moved into a locked position. The conical section 184 of alignment drill-barrel 150 may push outwardly against the inner surface of the bushing 200 as alignment drill-barrel 150 is moved forward to expand the forward end 214 of the bushing 200. In this embodiment, the conical section mates with and pushes against the inner surface of the bushing 200 forward of circular portion 206 of slits 204 in fingers 210, to push the fingers 210 radially outward (see FIG. 4).
Alignment drill-barrel 150 may be aligned within bushing 200, such that center line 240 or 190 may be collinear with line 180. When bushing 200 is placed in a fastener hole of a bone plate, and ratchet-gear mechanism 50 is actuated such that the almost fully actuated position is reached (i.e. when trigger 56 is substantially parallel to handle member 250), end 172 of alignment drill-barrel 150 may be substantially coplanar with rim 214 of bushing 200. It should be noted that alignment drill-barrel 150 may be coaxially received in bushing 200 which may also be the path of surgical drill-bit 400 inserted in cannula 182 of the alignment drill-barrel 150.
Generally, a surgeon or user should continue to depress the trigger 56 and handle member 250 toward each other to maintain an actuated position of Y-shaped ratchet-gear mechanism. Depending on the size of the fastener hole 352 (or drill recess 354, see FIGS. 12A-13B) and the firmness of the locking desired, the pawls 58 located on the second leg 54 of the Y-shaped ratchet-gear mechanism 50 may engage with the serrations 102 on the release knob 100 holding the ratchet-gear mechanism 50 in place. The release knob 100 preferably may be held firm in its position by the compression force of the spring mechanism 272, which may be located at the front end 254 inside the cavity 256 of the handle member 250. With the ratchet-gear mechanism 50 provided in this drill-guide assembly 5, the serrations 102 on the release knob 100 can be used to releasably lock Y-shaped ratchet-gear mechanism 50 at the desired level of actuation. This may obviate the need for a surgeon or user to continue to depress the trigger 56 relative to handle member 250 after desired actuation has occurred. The pawls 58 on the second leg 54 of the Y-shaped ratchet-gear mechanism 50 may engage the serrations 102 on the release knob 100 when the trigger 56 is pressed sufficiently. The release knob 100 may be held in a fixed position as a result of the compression force exerted by the compressed spring 272.
When the release knob 100 is pressed in the direction of the front end 254 of the handle member 250, the spring member 272 may be compressed, the pawls 58 may be disengaged from the serrations 102, and the Y-shaped ratchet-gear mechanism 50 may become unactuated. When the Y-shaped ratchet-gear mechanism 50 is unactuated, the force that is keeping the alignment drill-barrel 150 in a position toward fingers 210 may be released. As a result, the alignment drill-barrel 100 may no longer be pushing the fingers 210 on the bushing 200 in an outward direction toward the bone-plate 350. The alignment drill-barrel 150 can be then moved in a longitudinal direction away from the fingers 210 on the bushing 200. As a result, the bushing 200 may assume a retracted position as demonstrated in FIG. 9. Once the fingers 210 retract, the drill-assembly 5 may unlock from the fastener hole 352 or drill recess 354 of the bone-plate 350 and the user or surgeon can withdraw it.
When the release knob 100 is pressed to further compress the spring, the pawls 58 may disengage from serrations 102, thereby de-actuating the Y-shaped ratchet-gear mechanism 50, which in turn, through the pivot action at the pivot screw 64 may result in the movement of the alignment drill-barrel 150 in a direction away from the bone-plate 350.
Before and during bone plate implantation, the surgeon or user may insert the expandable distal end 222 of bushing 200 in particular neck 208 and rim 214, into fastener hole 352 or drill recess 354 in a bone plate 350. By pressing trigger 56 of the Y-shaped ratchet-gear mechanism 50 relative to the handle member 250, the surgeon or user may grasp and manipulate the plate 350 without an additional plate holder if so desired. Friction between the forward conical section 184 of the alignment drill-barrel 150 and the inner surface of fingers 210 especially at neck 208 and rim 214 may retain the expandable distal end 222 of bushing 200 in an expanded, locked position. Thus, when bushing 200 is in the expanded, locked position in a fastener hole of a plate placed in position for implantation, movement of the plate during the drilling operation can be minimized.
Drill-barrel 150 may preferably be sized so that once the bone plate 350 is properly positioned over the implantation site and bushing 206 is locked to the plate, the insertion point of a surgical drill-bit 400 at the proximal end of drill-barrel 150, is located at a distance beyond the patient's body such that a spinning surgical drill-bit 400 will not laterally reach or harm surrounding tissues that the surgeon or user does not intend to drill.
Another embodiment of a drill-guide assembly 500 is shown in FIGS. 12A-13B. As with drill-guide assembly 5 (see FIG. 1, supra), assembly 500 may include an alignment assembly 515, release knob 600, handle member 650, ratchet-gear mechanism 550, bushing 450 with fingers 570 and slits 572, and a dual-arm support 610, the components of which may exhibit some or all of the characteristics of the corresponding components described above in relation to assembly 5.
Drill-guide assembly 500 may also include first and second drill guides 502, 504 for use with surgical drill (e.g., 400). Drill guides 502, 504 may be connected to bushing 450 by proximal and distal connecting elements 510, 512, which are discussed in more detail below in relation to FIGS. 13A-13B. Drill guides 502, 504 may also have proximal ends 506, 508 and distal ends 516, 518, with a bores 507, 509 extending therebetween. The bores 507, 509 should be sized to receive at least a portion of a surgical drill, and should preferably align with a bone fastener hole 352 during use. Drill guides 502, 504 may have a length L1, L2 (see FIGS. 12A-12B) from about 150 mm to about 350 mm, and more preferably, a length of about 260 mm. Generally, drill guides 502, 504 have a greater length than bushing 450. Drill guide lengths L1, L2 may or may not be approximately equal.
Bores 507, 509 may have a variable diameter B1, B2 along the length L1, L2 of drill guides 502, 504. Bore diameter B1, B2 may have a diameter of about 5 mm to about 15 mm at proximal ends 506, 508 and/or distal ends 516, 518.
Drill-guide assembly 500 may be used with the plate shown in FIG. 12C. Plate 350 may have a plurality of fastener holes 352 and at least one drill recess 354 in body 351. Recess 354 may have shaped areas 356 a, 356 b with midpoint 358 a, 358 b, with a distance MPD between midpoints. Recess 354 may also have a slot area 360 extending between shaped areas 356 a, 356 b.
Alternatively, recess 354 may at least partially comprise a polygonal shape, such as a hexagon, rectangle, or square. The recess 354 may also take the shape of a plurality of polygonal shapes, for example, two overlapping hexagons may comprise the shape of the recess 354 to form a combination-polygonal recess. These embodiments may be particularly useful in bone-plates with a reduced area in which to place a recess 354 for purposes of aligning assembly 500.
In use, the fingers 570 of bushing 450 of assembly 500 may be inserted into drill recess 354, instead of fastener hole 352. The engagement and/or locking of the bushing 450 within a drill recess 354 may take some or all of the characteristics of the engagement and/or locking of bushing 200 with a fastener hole 352, as described above. Generally, it may be preferable for the bushing 450 to engage the drill recess 354 at shaped area 356 a, 356 b. The placement and locking of bushing 450 at shaped area 356 a may align drill guides 502, 504 with fastener holes 352 a, 352 b, respectively. Similarly, the placement and locking of bushing 450 at shaped area 356 b may align drill guides 502, 504 with fastener holes 352 c, 352 d, respectively.
Assembly 500 may also have a fin 514 to assist the insertion, locking, and/or alignment of the assembly in a drill recess 354. Fin 514 may generally be an elongated component, with at least a portion of the fin 514 secured in the distal connecting element 512 at fin bore 536 (see FIG. 13B). In use, when the bushing engages a shaped area 356 a, 356 b, the fin concurrently engages slot 360. The fin 514 may or may not touch the sides of the slot 360 when the bushing 450 is fully inserted into a shaped area 356 a, 356 b.
FIG. 13A is a top view of a proximal connecting element 510, and FIG. 13B is a top view of a distal connecting element 512. Proximal connecting element 510 may have a bushing bore 530 a, and first and second drill guide bores 532 a, 534 a. First and second drill guide bores 532 a, 534 a may have respective midpoints 537 a, 539 a, wherein a distance D, extends between midpoints 537 a, 539 a. Distal connecting element 512 similarly may have a bushing bore 530 b, and first and second drill guide bores 532 b, 534 b with respective midpoints 537 b, 539 b. Midpoints 537 b, 539 b may have a distance D2 between them. Distal connecting element 512 may also have a fin bore 536 located near the bushing bore 530 b. Fin bore 536 may receive at least a portion of a fin 514, as discussed above.
Bushing bores 530 a, 530 b may receive at least a portion of a bushing 450. Likewise, first and second drill guide bores 532 a, 534 a, 532 b, 534 b may receive at least a portion of a first and second drill guide 502, 504, respectively. Generally, the proximal connecting element 510 may be situated near the proximal ends 506, 508 of first and second drill guide 502, 504, and the distal connecting element 512 may be situated near the distal ends 516, 518 of the first and second drill guides 502, 504. While the embodiment in FIGS. 12A-12B show two connecting elements, 502, 504, it contemplated that only one connecting element could be used, or that more than two connecting elements could be utilized with a single assembly 500.
The placement of the bores in the connecting elements 510, 512 may determine the angles and arrangements of which the bushing 450 and first and second drill guides 502, 504 are situated in relation to one another. For instance, the embodiment shown in FIGS. 12A-13B utilizes proximal connecting element 510 with distance D1 larger than the distance D2 of the distal connecting element 512. The result of this arrangement is, as bushing 450 and first and second drill guides 502, 504 are generally linear, that the bushing and drill guides are generally convergent from the proximal end of the assembly to the distal end of the assembly 500. However, it is contemplated that D1 and D2 could be substantially equal, thereby creating an arrangement where the bushing and drill guides would be substantially parallel. Moreover, D2 may be greater than D1, thereby creating a divergent relationship between the bushing and/or drill guides from the proximal to the distal end of the assembly 500. Generally, both D1 and D2 may be from about 5 mm to about 35 mm. The sizes of the bores of each connecting element 510, 512 may generally fit a desired engagement portion of a bushing and/or drill guide.
Those skilled in the art will recognize that bushing 200, 450 may be configured and dimensioned to fit bone plate fastener holes and/or drill recesses with shapes other than circular. For example, bushing 200, 450 may be adapted to fit elliptical, hexagonal, star-shaped, or square fastener holes and/or drill recesses.
Preferably, the components of surgical drill-guide assembly 5, 500 are metallic, passivated, and electropolished. Most preferably, the components are formed of stainless steel, except for the springs which are formed of spring steel, although other materials may be used. Preferably, at least the handle member is forged, while the other components may be machined, and the surgical drill-guide assembly preferably has a matte finish so that the surfaces of the components do not reflect operating room light in such a manner as to distract the surgeon or user. Some components may be subjected to heat treatments so that the surfaces are work hardened. The surfaces are preferably burr-free. Preferably, the surface finish allows individual components to move with respect to each other in a smooth and non-binding fashion through each component's entire range of motion. Additionally, all pins and fasteners are preferably flush with the surfaces into which they are fixed.
The present invention also involves several methods of drilling holes. In one embodiment, a surgeon or user may insert the bushing of a surgical drill-guide assembly into a fastener hole of a bone-plate and may depress the ratchet-gear mechanism to slide the alignment drill-barrel forward, expanding the bushing preferably by the conical portions of the alignment drill-barrel radially spreading the fingers in the bushing. The surgeon or user may then lock the bushing to the plate by locking the alignment drill-barrel and the bushing in fixed relation to each other, which thereby may relieve the surgeon or user of the need to squeeze the ratchet-gear mechanism toward the handle (see FIG. 11). The surgeon or user may align the surgical drill-bit along the drilling axis defined through the center of the bore in the alignment drill-barrel and inserts the drill-bit in the barrel. The surgeon or user then may drill a first hole coaxial with the central axis of a first fastener hole in the plate. The drill-bit may be stopped at a predetermined distance to provide a hole of predetermined depth. The drill-bit may be removed from the alignment drill-barrel. The bushing may thereafter be unlocked from the plate by pressing the release knob, which may release the bushing from the fastener hole so that the user can then freely and unfetteredly remove the drill-guide assembly from the plate.
In another embodiment of use, a surgeon or user may insert the bushing of a surgical drill-guide assembly into a shaped area drill recess of a bone-plate and may depress the ratchet-gear mechanism to slide the alignment drill-barrel forward, expanding the bushing preferably by the conical portions of the alignment drill-barrel radially spreading the fingers in the bushing. The fin of the assembly may concurrently engage the slot of the recess. The surgeon or user may then lock the bushing to the plate by locking the alignment drill-barrel and the bushing in fixed relation to each other, which thereby may relieve the surgeon or user of the need to squeeze the ratchet-gear mechanism toward the handle (see FIG. 11). The surgeon or user may align the surgical drill-bit along the drilling axis defined through the centers of the bores of the first and/or second drill guides and may insert the drill-bit into the bores as desired.
an alignment barrel having a proximal end and a distal end;
a bushing configured to slidably receive the alignment barrel, the bushing having a radially expandable forward-end and a proximal end, the forward-end configured to be insertable within a hole or recess in a bone plate;
the first leg of the ratchet-gear mechanism connected to the alignment barrel,
the second leg of the ratchet-gear mechanism having pawls configured and adapted to engage the serrations to hold the alignment barrel in position,
wherein, movement of the ratchet-gear mechanism slides the alignment barrel relative to the bushing to radially expand the forward end to releasably lock the bushing to the plate, and
a first drill guide coupled to the bushing, wherein the first drill guide is configured to receive and guide a drill-bit.
2. The drill-guide assembly of claim 1, wherein the first drill guide is coupled to the bushing by a first connecting element.
3. The drill-guide assembly of claim 2, wherein the first connecting element has at least two bores for respectively receiving at least a portion a bushing therethrough and at least a portion of a drill guide therethrough.
4. The drill-guide assembly of claim 3, wherein the first drill guide is further coupled to the bushing by a second connecting element.
5. The drill-guide assembly of claim 4, wherein the second connecting element has at least two bores for respectively receiving at least a portion of a bushing therethrough and at least a portion of a drill guide therethrough.
6. The drill-guide assembly of claim 5, wherein the at least two bores of the first connecting element are separated by a first distance, and the at least two bores of the second connecting element are separated by a second distance, wherein the first distance is greater than the second distance, and wherein the second connecting element is closer to the distal end of the forward end of the bushing than the first connecting element.
7. The drill-guide assembly of claim 5, wherein the at least two bores of the first connecting element are separated by a first distance, and the at least two bores of the second connecting element are separated by a second distance, wherein the first distance is greater than the second distance, and wherein the first connecting element is closer to the distal end of the forward end of the bushing than the second connecting element.
8. The drill-guide assembly of claim 3, wherein the first connecting element further comprises a fin bore configured to receive at least a portion of fin therethrough, wherein at least a portion of the fin in configured to engage at least a portion of a hole or recess when the bushing engages a bone-plate.
9. The drill-guide assembly of claim 1, further comprising a second guide coupled to the bushing, wherein the second drill guide is configured to receive and guide a drill-bit.
10. The drill-guide assembly of claim 9, wherein the second drill guide is coupled to the first drill guide.
11. The drill-guide assembly of claim 10, wherein the first and second drill guide are coupled to the bushing by a first connecting element.
12. The drill-guide assembly of claim 11, wherein the first connecting element has at least three bores for respectively receiving at least a portion of the first drill guide therethrough, at least a portion of the second drill guide therethrough, and a least a portion of the bushing therethrough.
13. The drill-guide assembly of claim 12, wherein the first connecting element further comprises a fin bore configured to receive at least a portion of fin therethrough, wherein at least a portion of the fin in configured to engage at least a portion of a hole or recess when the bushing engages a bone-plate.
14. The drill-guide assembly of claim 12, wherein the first drill guide and second drill guide are further coupled to the bushing by a second connecting element.
15. The drill-guide assembly of claim 14, wherein the second connecting element has at least three bores for respectively receiving at least a portion of the first drill guide therethrough, at least a portion of the second drill guide therethrough, and a least a portion of the bushing therethrough.
16. The drill-guide assembly of claim 15, wherein the bores of the first connecting element receiving first and second drill guides are separated by a first distance, and the bores of the second connecting element receiving first and second drill guides are separated by a second distance, wherein the first distance is greater than the second distance, and wherein the second connecting element is closer to the distal end of the forward end of the bushing than the first connecting element.
17. The drill-guide assembly of claim 15, wherein the bores of the first connecting element receiving first and second drill guides are separated by a first distance, and the bores of the second connecting element receiving first and second drill guides are separated by a second distance, wherein the first distance is greater than the second distance, and wherein the first connecting element is closer to the distal end of the forward end of the bushing than the second connecting element.
18. The drill-guide assembly of claim 1, the first drill guide having a longitudinal axis, and wherein when the bushing is locked to a bone-plate, the longitudinal axis of the first drill guide is generally aligned with a first bone-fastener hole of the bone-plate.
19. The drill-guide assembly of claim 18, further comprising a second drill guide configured to receive and guide a drill-bit and coupled to the bushing, the second drill guide having a longitudinal axis, and wherein when the bushing is locked to a bone-plate, the longitudinal axis of the second drill guide is generally aligned with a second bone-fastener hole of the bone-plate.
20. The drill-guide assembly of claim 1, wherein the recess of the bone-plate includes at least one shaped area and a slot.
21. A method for drilling holes in bone, comprising the steps of:
(a) providing a drill-guide assembly, comprising an alignment barrel having a proximal end and a distal end; a bushing configured to slidably receive the alignment barrel, the bushing having a radially expandable forward-end and a proximal end, the forward-end configured to be insertable within a hole or recess in a bone plate; a release knob having serrations; and a movable ratchet gear mechanism having a first leg, a second leg and a tail, the first leg of the ratchet-gear mechanism connected to the alignment barrel, the second leg of the ratchet-gear mechanism having pawls configured and adapted to engage the serrations to hold the alignment barrel in position, the tail of the ratchet gear mechanism operable by a user to selectively move the ratchet-gear mechanism, wherein, movement of the ratchet-gear mechanism slides the alignment barrel relative to the bushing to radially expand the forward end to releasably lock the bushing to the plate, and at least a first guide coupled to the bushing, wherein the first drill guide is configured to receive and guide a drill-bit;
(b) inserting the bushing into a recess of a bone plate;
(c) aligning at least the first drill guide with a first bone fastener hole in the bone-plate;
(d) expanding the bushing in the recess;
(e) locking the bushing to the plate;
(f) inserting a drill-bit into the first drill guide; and
(g) drilling a first hole.
22. The method of claim 21, wherein at least a portion of the forward end of the bushing is configured to fit in at least a portion of the recess.
23. The method of claim 21, wherein the bushing is locked to the plate by locking the alignment barrel and bushing in fixed relation to each other.
24. The method of claim 21, wherein the drill guide assembly further comprising a second drill guide coupled to the bushing, wherein the second drill guide is configured to receive and guide a drill-bit.
25. The method of claim 24, further comprising the steps of inserting a drill-bit guide into the second drill guide, and drilling a second hole.
26. A kit for use with drilling bones, comprising:
(a) a drill-guide assembly, comprising an alignment barrel having a proximal end and a distal end; a bushing configured to slidably receive the alignment barrel, the bushing having a radially expandable forward-end and a proximal end, the forward-end configured to be insertable within a hole or recess in a bone plate; a release knob having serrations; and a movable ratchet gear mechanism having a first leg, a second leg and a tail, the first leg of the ratchet-gear mechanism connected to the alignment barrel, the second leg of the ratchet-gear mechanism having pawls configured and adapted to engage the serrations to hold the alignment barrel in position, the tail of the ratchet gear mechanism operable by a user to selectively move the ratchet-gear mechanism, wherein, movement of the ratchet-gear mechanism slides the alignment barrel relative to the bushing to radially expand the forward end to releasably lock the bushing to the plate;
(b) at least first and second drill guides able to be coupled to the bushing; and
(c) at least first and second connecting elements for coupling at least one drill guide to the bushing.
27. The kit of claim 26, wherein at least the first and second drill guides have different lengths.
28. The kit of claim 26, wherein at least the first and second drill guides have different diameters.
29. The kit of claim 26, wherein at least the first and second connecting elements each have a bore for receiving at least one drill guide therethrough and a bore for receiving a bushing therethrough, wherein the bores of the first connecting element have a first arrangement, and the bores of the second connecting element have a second arrangement, and wherein the first arrangement is substantially different than the second arrangement.
US10/979,915 2003-08-13 2004-11-01 Quick-release drill guide assembly for bone plate Abandoned US20050137606A1 (en)
US10/639,515 Continuation-In-Part US7357804B2 (en) 2003-08-13 2003-08-13 Quick-release drill-guide assembly for bone-plate
US20050137606A1 true US20050137606A1 (en) 2005-06-23
US20130338675A1 (en) * 2012-06-19 2013-12-19 Howmedica Osteonics Corp. Glenoid baseplate insertion tool
US7357804B2 (en) 2008-04-15
EP1449484A1 (en) 2004-08-25 Surgical drill guide
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