Abstract:
Disclosed is a driven surgical driver for wire guide surgical components. The driver has a rotatable drive shaft which is configured to apply driving and rotational forces to a medical device. A wire clamp is provided which is configured to hold the guide wire at a fixed distance from the tissue while the medical device is being driven distally away from the wire clamp. A process provides for grasping a point on the guide wire at a fixed distance from the tissue with the wire clamp. This grasping point on the guide wire is maintained at the fixed distance from the tissue while a force is applied to the driver to affix the medical device relative to the tissue.

Description:
TECHNICAL FIELD 
     The present invention pertains generally to a guide wire capturing surgical instrument and, more particularly, to a cannulated guide wire surgical instrument used for driving bone screws, resurfacing and drilling instruments or other surgical devices. 
     BACKGROUND OF THE INVENTION 
     The use of orthopedic fastening devices, such as bone screws, has greatly aided the medical field in the treatment of bone fractures, as well as enabling the ever increasing use of orthopedic implants and orthopedic appliances. With respect to the treatment of bone fractures, it is sometimes generally necessary to surgically reposition the fragmented bone members in an atomically acceptable orientation, and then fasten the bone members together in order to facilitate the healing process. Bone screws are typically employed in stabilization procedures used to treat bone fractures. 
     When a bone screw is employed, either to fasten two or more members together or to secure an orthopedic appliance (e.g. bone plate) to a bone, alignment and proper orientation is critical. To ensure proper alignment, a guide wire is often installed along the desired trajectory for the bone screw. The cannulated bone screw is then disposed over the guide wire. The guide wire functions to guide the cannulated bone screw in its proper direction. After the insertion of the bone screw, the guide wire is removed from the joined components. 
     Typically, a cannulated drive is used to drive the cannulated screw over the guide wire. After the cannulated screw has been deposited over the guide wire, the guide wire is typically threaded through a cannulated driver. As the driver rotates the screw, it is intended that the guide wire will rotate within the driver. Unfortunately, occasionally the guide wire will get caught or hung up on the driven screw. As a result, the wire which has been deposited through the cannulated screw is likewise rotated, thus allowing the guide wire to further insert itself into the patient. This creates a situation where it is possible that the moving guide wire could pierce some part of the patient, resulting in unnecessary pain or soft tissue damage. 
     Other uses of guide wires are also known for other surgical procedures. For example, natural joints may undergo degenerative changes due to a variety of etiologies. When these degenerative changes become so far advanced and irreversible, it may ultimately become necessary to replace a natural joint with a prosthetic joint. During the orthopedic procedure, it is generally known in the art to prepare either side of the joints natural material using guide wire guided cutting devices such cannulated drill bits and driven cannulated reamers. However, here again, the current prior art cannulated drill bits and reamers and associated surgical components may suffer from many disadvantages associated with the inadvertent driving of the guide wire as discussed above. What is needed then is a capturing guide wire surgical instrument that does not suffer from the above-mentioned disadvantages. 
     SUMMARY OF THE INVENTION 
     The present invention provides in one embodiment a driven surgical driver for driving a cannulated bone screw into the bone. This screw is disposed over a guide wire. The driven surgical driver is cannulated and is coupled to a driver which has an actuatable clamp capable of clamping the guide wire to prevent undesirable further insertion of the guide wire into the bone. 
     In one embodiment, a driven surgical driver is disclosed that has an internal clamp which clamps a guide wire. The wire clamp is configured to hold the guide wire a fixed distance from the tissue while a medical device is driven distally away from the wire clamp by a driven shaft. 
     In another embodiment, an apparatus for driving a medical device having a guide wire clasping driven member which maintains the length of a guide wire coupled to a tissue. The apparatus for driving a medical device has a rotatable shaft configured to be coupled to the medical device and a wire clamp which clamps the wire at a fixed distance from the tissue. A driver is coupled to the rotatable drive shaft. 
     In another embodiment of the invention, a driven member is provided. The driven member has a proximal end which is configured to drive a fastener. On its proximal end, the member has a quick connect member which allows the driven member to be quickly coupled to a driver. Disposed between the proximal and distal ends is a clamp which is configured to fixedly couple a surgical guide wire. 
     Further disclosed is a method for rotating a medical device with respect to a biological tissue having a guide wire. The method includes providing a medical device and a guide wire clasping member having a driven shaft and a wire clamp. The wire clamp is configured to hold the guide wire at a fixed distance from the tissue. The method further includes positioning the guide wire clamping member relative to the medical device, and clamping the guide wire at a fixed distance from the tissue. Forces are applied to the draft shaft which applies forces to the medical device. 
     Further areas of applicability of the present invention will become apparent from the detailed description provided hereinafter. It should be understood that the detailed description and specific examples, while indicating the preferred embodiment of the invention, are intended for purposes of illustration only and are not intended to limit the scope of the invention. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     The present invention will become more fully understood from the detailed description and the accompanying drawings, wherein: 
     FIG. 1 is a exploded perspective view of a wire capturing driver of a first embodiment of the present invention; 
     FIG. 2 is an assembled view of the wire capturing driver shown in FIG. 1; 
     FIGS. 3 a - 3   c  are cross-sectional views of the wire capturing driver of the present invention; 
     FIG. 4 is a cross-sectional view the wire capturing driver of the present invention driving a cannulated bone screw; 
     FIG. 5 is an exploded view of a second embodiment of the present invention; 
     FIG. 6 is an assembled view of the second embodiment of the present invention; 
     FIGS. 7 a - 7   b  represent cross-sectional view of a coupling mechanism of the second embodiment of the present invention; 
     FIG. 8 is a cross-sectional view of the second embodiment of the present invention driving a cannulated screw into bone material; and 
     FIGS. 9-12 illustrate a method of using the first embodiment of the present invention to drive a cannulated bone fastener during a surgical procedure. 
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     The following description of the preferred embodiments is merely exemplary in nature and is in no way intended to limit the invention, its application, or uses. Moreover, while the present invention is discussed below in relation to driving a bone screw, those skilled in the art will recognize that the cannulated segmented devices such as drills and reamers may be used. 
     FIGS. 1 and 2 depict a perspective view of a driven member  20  according to a first embodiment of the present invention. The driven member  20  is formed generally of three components, an outer sleeve  22 , a wire fastener or retaining member  24  and a central shaft  26 . 
     The outer sleeve  22  defines a first central through bore  28  which slidably accepts the central shaft  26 . The outer sleeve  22  defines an axial threaded bore  30  which accepts a threaded exterior surface  32  on the wire fastener  24 . The outer sleeve  22  further defines a slot  31  disposed on an exterior surface  33 . The slot  31  assists in the proper orientation of a fastener with the driver member  20 , further discussed herein. 
     The wire fastener  24  is an annular member which defines a through bore  34 . The through bore  34  is configured to slidably accept the central shaft  26 . Disposed on the proximal surface  36  of the wire fastener  24  is a pair of wire clasping jaws  38  (see FIG. 3 a ). The wire clasping jaws  38  are coupled to the proximal surface  36  by a pair of generally parallel flanges  40 . The flanges  40  are configured to deformably or resiliently allow the wire clasping jaws  38  to move from a first non-engaged position  42  to an engaged position  44  (see FIGS. 3 a  and  3   c ). 
     As best shown in FIG. 1, the central shaft  26  defines a guide wire accepting through bore  46 . The proximal end  48  of the central shaft  26  defines a cannulated screw engaging portion. Alternatively, the proximal end  48  can define a quick coupler which allows for varying styles of fastener driving heads to be coupled to the central shaft  26 . Examples of these include Phillips, straight, or star heads. 
     The distal end  52  of the central shaft  26  defines a cannulated quick coupling member  50 . The quick coupling member  50  facilitates the coupling of the driven member  20  with a driver (not shown). It is envisioned that the driver can be a standard screw driver handle, an electric or pneumatic powered driver such as a drill, or any other type of driver. Disposed between the proximal and distal ends  48  and  52  is a pair of slots  56  defined on an exterior surface  57  of the central shaft  26 . The slots  56  are configured to slidably accept the pair of wire capturing jaws  38  of the wire fastener  24 . 
     As best shown in FIGS. 3 a - 3   c , the central shaft  26  is disposed within the through bore  34  of the wire fastener  24  such that the wire clasping jaws  38  are disposed through the slots  56  into the wire accepting through bore  46 . As can be seen, the central shaft  26  is slidable within both the wire fastener  24  and the first through bore  28  of the outer sleeve  22 . 
     The guide wire  58  is threaded through an aperture  60  in the proximal end  48  of the central shaft  26  into the wire accepting through bore  46 . The guide wire  58  is then threaded between the wire clasping jaws  38 . The threaded exterior surface  32  of the wire fastener  24  is then inserted into the axially threaded bore  30  of the outer sleeve  22 . Further defined within the outer sleeve  22  is an angled shoulder  62  which functions to engage an angled surface  63  on the wire clasping jaws  38 . As the wire fastener  24  is rotatably inserted into the axially threaded bore  30 , the angled shoulder  62  engages the angled surface  63  of the wire clasping jaws  38 . As the wire fastener  24  is inserted further, the angled surface  63  functions to force the wire clasping jaws  38  together and engage them with the guide wire  58 . It does so by bending or flexing of the flanges  40 . 
     FIG. 4 depicts a cross-sectional view of the driven member  20  of the first embodiment of the invention engaging a cannulated bone fastener or screw  66 . The drive member  20  is shown with the guide wire  58  clasped between the wire clasping jaws  38 . The proximal end  64  of the outer sleeve  22  is shown engaged with the surface of the bone being joined. As can be seen, the cannulated bone fastener  66  is shown disposed within the central through bore  28  of the outer sleeve  22  and engaged with the driver head  68  found on the proximal end  48  of the central shaft  26 . The driver head  68  may be of any shape including Phillips, hex, regular, etc. 
     When the central shaft  26  is rotated by a driver (not shown), the driver head  68  rotates the cannulated bone fastener  66  into the bone. The rotation of the central shaft  26  also rotates the outer sleeve  22 . Rotational forces from the central shaft  26  are transmitted to the outer sleeve  22  through the side surfaces  70  of the wire clasping jaws  38 . Because the guide wire  58  is fixed with respect to the outer sleeve  22  and the central shaft  26  is slidable within the outer sleeve  22 , the cannulated bone fastener  66  can be driven while the depth of the threaded guide wire  58  is held in a substantially predetermined and fixed position. The wire clasping jaws  38  can be disengaged from the guide wire  58  by lifting the driver head  68  off the cannulated bone fastener  66 , holding the outer sleeve  22  to prevent its rotation, and rotating the central shaft  26  in a reverse direction. 
     While the figures show the use of the driven member  20  to drive a cannulated bone screw, it should be understood that the driven member is equally usable for use with tissue cutting devices such as drill bits and reamers. Furthermore, while the components are depicted as being coaxial, there is no requirement that the wire clamp be coaxial with the driven shaft or the driver or that the driven member be cannulated. 
     With reference to FIGS. 5 and 6 which depict a fastener driver  72  according to a second preferred embodiment of the invention, shown is an outer sleeve  74 , a central shaft  76 , spacer bars  78  and  80 , a handle  82 , and a wire locking member or mechanism  84 . 
     The outer sleeve  74  defines a first axial through bore  86 . The proximal end  88  of the outer sleeve  74  defines a bone engaging surface  90 , and the distal end  91  of the outer sleeve  74  defines a pair of apertures  92  and  94  which engage the spacer bars  78  and  80 . Defined within the exterior surface  96  of the outer sleeve  74  is shown at least one slot  98  and a pair of through threaded holes  100  which define a bore into the pair of apertures  92  and  94 . The slot  98  allows the surgeon to ensure the control shaft  76  is properly seated prior to locking the guide wire  58  (as further described below). 
     The central shaft  76  is a cannulated rod which defines an interior guide wire accepting bore  102 . The central shaft proximal end  104  defines either a cannulated screw engaging member  106  or a quick coupler (not shown) which will accept a cannulated screw engaging member  106 . 
     The handle  82  defines an axial through bore  114 . Disposed on the proximal end  116  of the handle  82  is a first aperture  118 . The first aperture  118  accepts the distal end  108  of the central shaft  76 . The proximal end  116  of the handle  82  further defines a pair of holes  122  and  124  which slidably accept the spacer bars  78  and  80 . 
     Defined within the distal end  126  of the handle  82  is a bore  127 . The bore  127  is configured to slidably accept the wire locking member  84 . Disposed between the proximal and distal ends  116  and  126  is a through slot  128 . The through slot  128  allows access to a threaded through bore  130  formed in an exterior surface  132  of the wire locking member  84 . 
     The wire locking member  84  is an annular member defining three bores therethrough. The first axial bore  134  is configured to accept the guide wire  58 . A pair of through bores  136  and  138  are configured to slidably accept the spacer bars  78  and  80 . The threaded through bore  130  is configured to accept a threaded knob  140 . The threaded knob  140  is configured to clamp the guide wire  58  within the first axial bore  134 . 
     As is shown in FIGS. 7 a - 7   b , the guide wire  58  is disposed through the first axial bore  134  of the wire locking member  84 . The threaded knob  140  is disposed through the slot  128  of handle  82  and functions to clamp the guide wire  58  within the first axial bore  134 . The threaded knob  140  is further configured to allow the handle  82  to slide with relationship to the wire locking member  84 . 
     FIG. 8 is a cross-sectional view of the fastener driver  72  according to the second embodiment of the present invention engaging the cannulated bone fastener  66 . The fastener driver  72  is shown with the guide wire  58  clasped within the wire locking member  84 . The bone engaging surface  90  of the outer sleeve  74  is shown engaging the bone to be coupled. The cannulated bone fastener  66  is shown disposed within the first axial through bore  86  and engaged with the cannulated screw engaging member  106 . 
     The spacer bars  78  and  80  are shown fixed to the outer sleeve  74  by a set screw  142 . One skilled in the art would recognize that spacer bars  78  and  80  can be welded to the outer sleeve  74 . The spacer bars  78  and  80  function to fix the distance between the outer sleeve  74  and the locking member  84 . The central shaft  76  is operable to slide within the outer sleeve  74  and is fixed to the handle  82 . When the central shaft  76  is rotated, the screw engaging member  106  rotates the cannulated bone coupling fastener  66 . Rotational forces applied to the handle  82  are also transmitted to the outer sleeve  74 . As the central shaft  76  is operable to slide within the outer sleeve  74 , the cannulated bone fastener  66  can be driven while the guide wire  58  is prevented from being driven further into the tissue. 
     FIGS. 9-12 represent the use of the first and second embodiments of the present invention in a surgical procedure. FIG. 9 shows a guide wire  58  being inserted into the outer maleolas of the tibula as is known in the art. The guide wire  58  will function to provide directional and spatial stability to the cannulated bone fastener  66  while it is being inserted. FIG. 10 depicts the cannulated bone fastener  66  being threaded onto the guide wire  58 . 
     FIG. 11 depicts the use of the first embodiment of the invention. After the cannulated bone fastener  66  is threaded onto the guide wire  58 , the guide wire  58  is threaded through the drive member  20 . The proximal end  64  of the outer sleeve  22  is seated onto the bone. The cannulated bone fastener  66  is now disposed within the central bore  28  of the outer sleeve  22 . The wire fastener  24  is rotated within the axially threaded bore  30 , causing the wire clasping jaws  38  to lock onto the guide wire  58 . A driver in the form of a handle is used to apply rotational forces to the cannulated bone fastener  66 . Once the cannulated bone fastener  66  is inserted, the wire clasping jaws  38  can be disengaged by reverse rotation or the driven member  20  can be used to assist in the removal of the guide wire  58 . 
     FIG. 12 depicts the use of the second embodiment of the present invention. After the cannulated bone fastener  66  is threaded onto the guide wire  58 , the guide wire  58  is threaded through the fastener driver  72 . Most importantly, the guide wire  58  is threaded through the wire locking member  84 . The bone engaging surface  90  is brought down upon the bone surface, and the threaded knob  140  is rotated to clamp the guide wire  58  within the first axial bore  134 . The handle  82  is rotated to cause the cannulated bone fastener  66  to be inserted. 
     The description of the invention is merely exemplary in nature and, thus, variations that do not depart from the gist of the invention are intended to be within the scope of the invention. Such variations are not to be regarded as a departure from the spirit and scope of the invention.