CN114554986B

CN114554986B - Surgical tool and method

Info

Publication number: CN114554986B
Application number: CN202080048971.7A
Authority: CN
Inventors: D·J·奥尔森
Original assignee: Individual
Current assignee: Individual
Priority date: 2019-05-05
Filing date: 2020-05-05
Publication date: 2024-08-23
Anticipated expiration: 2040-05-05
Also published as: CN114554986A; CA3139115A1; WO2020227261A1

Abstract

A surgical tool and method for engaging and manipulating bone includes a tool body having a main axis, a threaded end and an operative end, the threaded end having threads and a tool stop. The operating end is positioned to allow a user to grasp, manipulate and rotate the tool body about the main body axis. The threads are positioned to allow the surgical tool to drill into and engage bone when the tool body is rotated about the main body axis in a drilling direction, and the threads allow tightening engagement with bone when the tool body is rotated about the main body axis in the drilling direction. The tool stop is positioned to prevent the tool from being rotated further about the body axis to prevent further drilling into the bone when the tool stop contacts the bone.

Description

Surgical tool and method

Background

With the less invasive of modern surgical techniques, surgeons must often deal with the small space created by the smallest surgical incision and surrounding anatomy. In procedures involving bone manipulation, anatomical structures such as tendons, muscles, skin, and adjacent bones are often tightly packed within and around the bone, requiring the surgeon to apply significant linear or rotational forces to the bone to move, adjust, or rotate the bone during the procedure.

For example, in the case of a foot surgery, a surgeon must often move, adjust or rotate the bones of the foot along one or more defined planes. As shown in the context of the human left foot 2 in fig. 1, these defined planes include the sagittal plane 4, the transverse plane 6, and the frontal plane 8. Comparing fig. 1 and 2, fig. 2 depicts the normal skeletal arrangement of the left foot 10, with each of the metatarsal bones 12, proximal bones 14, and distal bones 16 lying in the sagittal plane 4, transverse plane 6, and frontal plane 8.

In the particular case of a bunion correction surgery, the need for linear and rotational bone movement across a vertical plane is apparent. Fig. 3 depicts the left foot 10 after the left foot 10 of fig. 2 has formed a buna inflammatory shape. As can be best appreciated by comparing the normal skeletal arrangement of fig. 2 with the skeletal arrangement of fig. 3 following the inflammatory progression of the hallux capsule, the spacing 18 between the first metatarsal head 20 and the second metatarsal head 22 increases. This is due in part to the counterclockwise rotation of the first metatarsal 20 and its associated pair of seed bones 24.

The purpose of performing corrective surgery on the inflammation of the hallux depicted in fig. 3 can be best understood by comparing fig. 1-3 with the desired correction best understood with reference to fig. 4A-4C. A front cross-sectional view of the normal skeletal arrangement 10 of the left foot of fig. 2 is depicted in fig. 4A, taken along an approximately frontal plane at the first metatarsal head 26. In this view, fig. 4A depicts the first metatarsal 20 and its first metatarsal 26 correctly positioned, with the associated seed 24 also correctly positioned directly below the first metatarsal 26.

Referring now to fig. 4B, a similar front cross-sectional view of the bone arrangement 10 is depicted after inflammatory progression of the bunion of fig. 3. In this view, fig. 4B depicts the first metatarsal 20 and its first metatarsal head 26 rotated in a counter-clockwise direction, and the seed 24 rotated with the first metatarsal head 26 toward the increased spacing 18 formed between the first metatarsal 20 and the second metatarsal 22.

Referring now to fig. 4C, fig. 4C is a further front cross-sectional view of the skeletal arrangement 10 of fig. 2 and 3, depicting a desired goal of a bunion correction procedure by rotating or rotating 28 the first metatarsal head 26 and the seed 24 clockwise from the bunion inflammatory position depicted in fig. 4B to a position similar to the normal position depicted in fig. 4A.

Although a bunion correction procedure is used herein as an example, surgeons must also deal with similar surgical constraints in operating on bones in other parts of the human and animal anatomy, requiring similar bone rotation, adjustment and manipulation within and across defined anatomical planes.

Disclosure of Invention

A surgical tool and method for engaging and manipulating bone includes a tool body having a main axis, a threaded end having threads and a tool stop, and an operative end. The operating end is positioned to allow a user to grasp, manipulate and rotate the tool body about the main body axis. The threads are positioned to allow the surgical tool to drill into and engage bone when the tool body is rotated about the main body axis in a drilling direction, the threads allowing tightening engagement with the bone as the tool body is rotated about the main body axis in the drilling direction. The tool stop is positioned to prevent the tool from being rotated further about the body axis to prevent further drilling into the bone when the tool stop contacts the bone. The surgical tool thus allows manipulation, movement and rotation of the bone with the surgical tool while the tool is in tight engagement with the bone.

In some embodiments, the pilot hole extends through the tool body substantially along the main axis. The guide hole allows the positioning guide to extend at least partially through the tool body and into the bone at the bone drilling location to align with the threads of the surgical tool and guide to the bone drilling location.

Drawings

For a more complete appreciation and understanding of the invention, and many of the advantages thereof, reference is made to the following detailed description taken in conjunction with the accompanying drawings.

FIG. 1 depicts a defined principal plane of the left human foot;

FIG. 2 depicts a front perspective view of a normal skeletal arrangement of a human left foot;

FIG. 3 depicts a front perspective view of the skeletal arrangement of the human left foot of FIG. 2 after inflammatory progression of the hallux capsule;

FIG. 4A depicts a cross-sectional view of the normal skeletal arrangement of FIG. 2 taken along an approximately frontal plane at the first metatarsal head at a forward viewing angle;

FIG. 4B depicts a cross-sectional view of the bone arrangement of FIG. 2 after inflammatory progression of the bunions;

FIG. 4C depicts a cross-sectional view of the skeletal arrangement of FIG. 2 during correction of a bunion symptom;

FIG. 5A depicts a front perspective view of a surgical tool according to one embodiment of the invention;

FIG. 5B depicts a front cross-sectional view of the surgical tool of FIG. 5A taken along line 5B-5B of FIG. 5A;

fig. 6A depicts an enlarged front view of the threaded end of the surgical tool of fig. 5A.

FIG. 6B depicts an enlarged front view of a threaded end of a surgical tool according to one embodiment of the present invention;

FIG. 7 depicts a front perspective view and an enlarged view of the skeletal arrangement of FIG. 3 after insertion of a guide wire into a first metatarsal head;

FIG. 8 depicts a perspective view of the bone arrangement of FIG. 4, wherein the surgical tool of the present invention is applied to a guidewire;

FIG. 9 depicts a perspective view and an enlarged view of the bone arrangement of FIG. 8 with the surgical tool positioned at a drilling location;

FIG. 10 depicts a perspective view and an illustration of the skeletal arrangement of FIG. 10, with a tool drilled into and threadedly engaged with the first metatarsal head;

FIG. 11A depicts a front perspective view of a surgical tool according to one embodiment of the invention;

FIG. 11B depicts a front cross-sectional view of the surgical tool of FIG. 11A taken along line 11B-11B of FIG. 11A;

FIG. 12A depicts a front view of a surgical tool according to one embodiment of the invention;

FIG. 12B depicts a front perspective view of the surgical tool of FIG. 12A;

FIG. 13A depicts a front view of a surgical tool according to one embodiment of the invention;

FIG. 13B depicts a front perspective view of the surgical tool of FIG. 13A;

FIG. 14 depicts a front perspective view of a surgical tool according to one embodiment of the invention;

FIG. 15 depicts a front perspective view of a surgical tool according to one embodiment of the invention;

FIG. 16 depicts a front perspective view of a surgical tool according to one embodiment of the invention;

FIG. 17 depicts a front perspective view of a surgical tool according to one embodiment of the invention;

FIG. 18 depicts a front perspective view of a surgical tool according to one embodiment of the invention;

FIG. 19 depicts a front perspective view of a surgical tool according to one embodiment of the invention;

FIG. 20 depicts a front perspective view of a surgical tool according to one embodiment of the invention;

FIG. 21 depicts a front perspective view of a surgical tool according to one embodiment of the invention;

FIG. 22 depicts a front perspective view of a surgical tool according to one embodiment of the invention;

FIG. 23A depicts a front view of a surgical tool according to one embodiment of the invention;

FIG. 23B depicts a front cross-sectional exploded view of a surgical tool according to one embodiment of the invention;

FIG. 24A depicts a front perspective view of a surgical tool according to one embodiment of the invention;

FIG. 24B depicts a front view of a surgical tool according to one embodiment of the invention;

FIG. 25A depicts a perspective view of a wire angle tool according to one embodiment of the invention; and

Fig. 25B depicts a side view of the wire angulation tool of fig. 25A positioned on the left foot to align the guidewire into the first metatarsal head, according to one embodiment of the invention.

Detailed Description

Referring to the drawings, like numerals are used to indicate identical or corresponding parts throughout the several embodiments and the drawings. In some of the drawings, some particular embodiment variations in the corresponding parts are indicated by adding lower case letters to the reference numerals.

Fig. 5A depicts a perspective view of a surgical tool 30a of the present invention, the surgical tool 30a including a tool body 32a having a main axis 34a, a threaded end 36a, and an operative end 38 a. A conically shaped clockwise drilling thread 40a is positioned at threaded end 36a and is oriented to drill or bore holes in bone material as surgical tool 30a is rotated about body axis 34a in a rightward and clockwise drilling direction 42 a. Threaded end 36a further includes: a tool stop 44a comprising two platelet-shaped legs extending outwardly from the tool body 32a and slightly above the threads 40 a. At the operative end 38a, two handles 46a also extend outwardly from the tool body 32a. The handle 46a allows a user to grasp the tool body 32a, manipulate the tool body 32a, and rotate the tool body 32a about the main axis 34 a. The outwardly extending dimensions of the two handles 46a, tool body 32a, and the two legs of tool stop 44a all lie substantially in a common plane with main body axis 34a, wherein surgical tool 30a remains substantially flat when placed on a flat surface (not shown). While it is contemplated that surgical tool 30a will typically be 4 to 5 inches in length, it is further contemplated that this will vary greatly and ultimately depend on the particular application or surgical environment.

A front cross-sectional view of surgical tool 30a is depicted in FIG. 5B, taken along line 5B-5B of FIG. 5A. As best understood by comparing fig. 5A and 5B, surgical tool 30a is hollow, including a guide hole 48a extending substantially along body axis 34a, the guide hole 48a opening at threaded end 36a at head 50a of thread 40a and extending to operative end 38a, opening at a location between handles 46 a. As can be best appreciated by briefly referring to the enlarged view of threaded end 36A of surgical tool 30a in fig. 6A, positioning pilot hole 48a at tip 50a of thread 48a results in tip 50a being slightly blunted as shown.

While the invention has been shown and described as including a blunt threaded tip, it should be understood that other tip configurations are possible within the intended scope of the invention. For example, fig. 6B depicts an enlarged view of the threaded end 36B of a desired surgical tool similar to the surgical tool 30a of fig. 6A having a tool body 32B, a tool stop 44B, and clockwise drilling threads 40B. However, because it is non-hollow, the surgical tool of fig. 6B does not have a pilot hole, and thus includes a pointed tip 50B at the bottom of the thread 40B, which may enhance the bone drilling capabilities of the thread 40B in some applications.

Referring again to the embodiment surgical tool 30a of fig. 5A-6A, guide hole 48a allows for receiving a positioning guide, which is guide wire 52a. As shown in fig. 5A and 5B, since guide hole 48a is open at tip 50a of thread 48a and between handles 46a, surgical tool 30a allows guide wire 52a to extend completely through surgical tool 30a along the entire length of body axis 34 a.

For a better understanding of the intended use of the depicted surgical tool 30a according to the present invention, an exemplary minimally invasive bunion correction procedure is depicted in fig. 7-10. The purpose of performing the procedure shown and described in fig. 7-10 is to achieve the bunion correction discussed above with respect to fig. 4A-C.

Referring to fig. 7, the depicted foot 10 is shown with an enlargement 54 of the bone features near the first metatarsal head 26. A surgeon using a minimal incision technique will make a small skin incision (not shown) near the first metatarsal head 26. The positioning guide (in this example, guide wire 52 a) is then inserted into the skin incision and driven into the first metatarsal head 20 at an angle of about 45 degrees from the back of the big toe 58 with a wire insertion device (not shown) as shown in fig. 7. The guide wire 52a is typically a 0.45mm diameter k-wire long enough to extend the entire length of the guide hole 48a of the surgical tool 30a and also allow additional remaining length for further guiding operations. Although a wire positioning guide is shown and described in this example, it should be understood that other types of positioning guides, such as long pins, rods, reinforced ropes, rods, pins, or any structure that allows for tool alignment, can similarly be used within the intended scope of the present invention.

Comparing fig. 7 to fig. 8, a positioning guide or wire 52a is inserted through guide hole 48 a. Comparing now fig. 8 with fig. 9 and its enlargement 62, the profile and reduced size of tool stop 44a enable a surgeon to manipulate or "pick" surgical tool 36a into an incision and surrounding skin and muscles (not shown) as surgical tool 36a is moved along guidewire 52a toward foot 10. As shown in fig. 9, the point at which the wire is inserted into the first metatarsal head 26 defines a drilling location 60 for the surgical tool 30a and the threads 40 a. The clockwise threads 40a are positioned to allow the surgical tool 30a to drill into and engage the first metatarsal head when rotated about the body axis 34a in a rightward, clockwise drilling direction 42 a.

Referring to fig. 10 and its illustration 64, the surgical tool 30a and its clockwise threads 40a are aligned in the correct direction by the guide wire 52a, and as the surgeon applies pressure from the operative end 38a and rotates the surgical tool 30a in the clockwise drilling direction 42a using the handle 46a, the surgical tool 30a and its clockwise threads 40a continue to drill into the bone material of the first metatarsal head 26. As shown in the bone cross-sectional view 66 of the insert 64, the threads 40a form an increasingly tighter threaded engagement with the bone material of the first metatarsal head 26 as the surgical tool 30a continues to rotate in the clockwise drilling direction 42 a. Although the amount of rotation required may vary depending on several factors such as thread density and individual bone characteristics, at least three to four turns of threads 40a may generally be required to fully rotate the insertion tool 30a to remain securely seated in the metatarsal head 26. This secure engagement continues until at least one leg of the tool stop 44a contacts the first metatarsal head 26 to prevent further rotation of the tool. Once the tool stop 44a contacts the bone material, the tool stop 44a is positioned to prevent further rotation of the tool 30a about the body axis 34a, thereby preventing further drilling.

The surgeon employing this technique will then make a lateral incision or osteotomy 56 at the neck of the first metatarsal 20 (diaphyseal-metaphyseal junction). Comparing fig. 10 to fig. 1, the osteotomy produces free fragments of skull, including the first metatarsal heads 26, which are pushed laterally for lateral plane correction. However, in order to properly align the cartilage with the proximal phalanx of the thumb 58, frontal plane correction is still generally required.

Once the free skull fragments/first metatarsal heads 26 have been severed from the remainder of the first metatarsal 20 at the osteotomy 56, frontal plane correction may be achieved by further rotating the surgical tool 30a in the rightward clockwise drilling direction 42a. The osteotomy 56 allows the free skull fragments/first metatarsal head 26 to move independently of the remainder of the first metatarsal 20. When surgical tool 30a is rotated further in a clockwise drilling direction 42a to the right, tool stop 44a prevents further drilling by tool 30a while providing a rotating lever. As a result, the tight clockwise engagement of the drill threads 40a with the skull fragments/first metatarsal heads 26 causes bone rotation 68 of the metatarsal heads 26 and clockwise rotation 42a of the surgical tool 30 a. While the tool stop 44a prevents further drilling of the threads 40a, the clockwise rotation 42a of the surgical tool 30a serves to maintain and tighten the clockwise engagement between the threads 40a and the skull fragments/first metatarsal heads 26, further ensuring the desired tool-bone engagement.

When the surgical tool 30a is rotated in the right clockwise direction 42a, the resulting bone rotation 68 of the skull fragments/first metatarsal heads 26 allows for the desired corrective bone repositioning along the frontal plane as shown in fig. 4C. Frontal plane correction also allows the seed 24 to rotate back into proper alignment. This results in a longer flexor tendons of the thumb (not shown) having a more linear effect on the thumb 58 after surgical correction. The tight, clockwise engagement of the drill threads 40a with the clockwise rotation of the skull fragments/first metatarsal heads 26 to the right also allows for the fixation of the linearly moving skull fragments on any of the frontal, sagittal or transverse planes by the surgical tool 30 a. Thus, surgical tool 30a allows for a large amount of manipulation, movement, and rotation of bone while tool 30a and bone are in intimate engagement.

Referring again to fig. 7-10, once frontal plane correction and any other manipulation of the head fragments/first metatarsal heads 26 has been completed, the guide wire 52a may be advanced through the osteotomy 56 to maintain the corrected relative positioning until the surgical tool 30a is removed and a permanent fixture is inserted. Once the osteotomy 56 is sufficiently fixed in its corrected position, the guide wire 52a can be removed.

Although the invention has been shown and described as being used in connection with a bunion correction procedure on a human foot, it is contemplated that the invention may be used in connection with other types of procedures and/or other parts of the human and animal body, as long as tight engagement is required to achieve bone rotation or linear bone movement or displacement. The choice of tool to use either clockwise or counter-clockwise threads is generally dependent on the desired rotation requirements. For most applications, it is desirable to select a tool with threads that match the intended rotational repositioning direction.

For example, fig. 11A depicts a front perspective view of a surgical tool 30c of the present invention that is similar to the surgical tool 30a of fig. 5A and 5B. For comparison, a front cross-sectional view of surgical tool 30c is depicted in FIG. 11B, taken along line 11B-11B of FIG. 11A. The surgical tool 30c of fig. 11A and 11B has a guide hole 48c for receiving a guide wire 52c, an elongated tool body 32c and a tool axis 34c, a handle 46c at the operative end 38c, and a tool stop 44c at the threaded end 36 c. A conical counter-clockwise drilling thread 70c extends along the tool axis 34c below the tool stop 70 c. The counterclockwise threads 70c allow the surgical tool 30c to be used for counterclockwise drilling to the left as the surgical tool 30c is rotated about the tool axis 34c in the drilling direction 72 c. This configuration would adapt surgical tool 30c to perform the bunion correction procedure shown in fig. 7-10 on the right foot.

While the invention has been shown and described using positioning guides such as guide wires 52a in fig. 5A and B and 7-10, it should be understood that freehand drilling tool designs and surgical techniques are also included within the intended scope of the invention, as are variations in tool size and features. For example, fig. 12A and 12B depict a surgical tool 30d of the present invention, the surgical tool 30d having no guide holes and being optimized for use without a guide wire. The tool body 32d has a reduced circumference along the tool axis 34d, as does the handle 46 d. The pin leg forms a tool stop 44d at the threaded end 36 d. Since surgical tool 30d has no pilot hole, conical counter-clockwise drilling threads 70d terminate at a tip 50d similar to that shown in fig. 6B. In the embodiment shown in fig. 12A and 12B, the prongs 50d may facilitate enhanced bone penetration when performing freehand rotation of the surgical tool 30 d.

It should also be appreciated that even though the tool body has a reduced circumference, some contemplated embodiments may utilize guide holes and positioning guides. For example, fig. 13A and 13B depict a surgical tool 30e of the present invention having a guide hole 48e along the tool axis 34e for receiving a guide wire 52e despite the reduced circumference of the tool body 32 e. The conical counter-clockwise bore thread 70e extends along the tool axis 34c below the tool stop 70c and allows the pilot hole 48e to open at the tip 50e despite the reduced circumference of the tool body 32e to eliminate the need for freehand positioning and rotation of the surgical tool 30 e.

Other variations of the tool stop are possible within the intended scope of the invention. For example, fig. 14 depicts a surgical tool 30f having a guide hole 48f for receiving a guide wire 52f, an elongated tool body 32f, and a tool axis 34f, with a handle 46f at the operative end 38f, however, a tool stop 44f at the threaded end 36f includes a flange 44f extending completely around the body axis 34 f.

While the invention has been shown and described using a tool in which the handle, tool body and legs all lie substantially in a common plane, it will be appreciated that the invention may also include tools in which such elements occupy different planes. For example, fig. 15 depicts a surgical tool 30g of the present invention having a handle 46g, a tool body 32g, and a tool stop 44g, wherein the two handles 46g extend outwardly from the tool body 34g at the operative end 38g along a plane that is approximately 90 ° from the plane along which the two legs of the tool stop 44g extend outwardly from the threaded end 44 g. Since the handle 46g and tool stop 44g each share a different plane with the tool body 32g, the surgical tool 30g will not lie on a flat surface. Such a configuration may be desirable in applications or surgical environments where it is considered more difficult to grasp or retrieve surgical tool 30g from an instrument table.

Other variations in the shape and size of the handle, tool stop, or tool body are possible and are within the intended scope of the invention. For example, fig. 16 depicts a surgical tool 30h of the present invention having a pin-shaped guide hole 46h extending from the operative end 38h of the tool body 32h, the tool body 32h having an enlarged perimeter and a guide hole 48h. The leg of the tool stop 44h extending from the threaded end 36h is also a spike-shaped intermediate portion that extends outwardly along the same plane as the tool body 32h and the handle 46 h. During a right foot bunion correction procedure similar to that shown and described in fig. 7-10, the enlarged perimeter of the tool body 32h will allow the counter-clockwise bore threads 70h to engage with the larger threads that create the first metatarsal head 26.

It should also be understood that the present invention may incorporate various other alternative configurations of handles and/or knobs at the operative end of the surgical tool within the intended scope of the present invention. For example, fig. 17 depicts a surgical tool 30i of the present invention having a finger groove 72 positioned around the perimeter of a slotted handle 74 at the operative end 38 i. In this configuration, guide bore 48i of surgical tool 30i extends along body axis 34i and through slotted handle 74 to head 50j of counter-clockwise thread 70 i. The finger groove 72 facilitates one-handed operation of the surgical tool 30i as the surgeon rotates the tool 30i and its counter-clockwise threads 701 about the body axis 34i of the surgical tool 30i.

One variation of slotted handle surgical tool 30i of fig. 17 is surgical tool 30j depicted in fig. 18, which has a dome-shaped handle 76, the dome-shaped handle 76 including a dome notch 78 around its periphery. Surgical tool 30j also includes a guide hole 48j extending through the top of dome handle 76 and through the tip 50j of counter-clockwise thread 70j along body axis 34 j. The finger recess 72 and dome handle 76 also facilitate one-handed operation of the surgical tool 30j as the surgeon rotates the tool 30j and its counter-clockwise threads 70j about the body axis 34j of the surgical tool 30 i.

The surgical tools 30i and 30j of fig. 17 and 18 have potential advantages in maintaining the one-handed utility of the present invention while reducing the size of the extension outward from the tool bodies 32i and 32 j. Other configurations with similar advantages are also possible within the intended scope of the invention. For example, fig. 19 depicts a surgical tool 30k of the present invention having a square handle 80 with four straight sides 82k to enhance one-handed operation during surgery while still allowing guide hole 48k to extend into tool body 32k, and the size of surgical tool 30k extending outwardly from tool body 32k is similarly reduced.

A slight variation is depicted in the surgical tool 30m of fig. 20, the surgical tool 30m having a triangular handle 84m with three straight sides 82 m. The three straight sides 82m also allow for one-handed operation and include a pilot hole 48m extending into the tool body 32m and opening through the tip 50m of the counter-clockwise thread 70m at the threaded end 36m of the tool 30 m.

A further variation is depicted in surgical tool 30n of fig. 21, with surgical tool 30n having a circular handle 86 with a roughened outer surface 88. The roughened outer surface 88 is roughened to allow enhanced tool handling, although the outer surface 88 is in a curled shape. The circular handle 86 also includes a guide hole 48n that extends into the tool body 32n and opens through the tip 500 of the counter-clockwise thread 70n at the threaded end 36n of the tool 30 n.

The dual winged handle configuration may also be used to reduce the size of the surgical tool and/or to configure the surgical tool of the present invention to allow additional manipulation using external tools or devices. For example, fig. 22 depicts a surgical tool 30p of the present invention having a protruding T-shaped handle 90 at the operative end 38p and having two wings 91 extending outwardly from the tool body 32p substantially along a plane common to the legs of the tool body 32p and tool stop 44 p. The protruding T-handle 90 also includes a flat tool engagement surface 92 that enables a machine or external tool to be engaged with the surgical tool 30p for additional tool operations. The protruding tee handle 90 also includes a pilot hole 48p that extends into the tool body 32p and opens at the threaded end 36p of the tool 30p through the head 50p of the counter-clockwise thread 70 p.

It is further contemplated that some embodiments may incorporate an extension structure or a multi-component body structure, particularly where it may be advantageous to conceal all or a portion of the positioning guide or to increase the distance between the drilling location and the handle or other manipulation structure. For example, fig. 23A depicts a front view of the surgical tool 30q of the present invention, the surgical tool 30q having a detachable extension 94 attached to the operative end 38q of the tool body 32 q. Fig. 23B depicts an exploded cross-sectional view of surgical tool 30 q. As best understood by comparing fig. 23A and 23B, the extension 94 includes a handle 46q and an extension body 96 having male extension threads 98. Male extension threads 98 are positioned at operative end 38q of tool body 32q to thread into female operative threads 100 of pilot bore 48 q. When the extension 94 has been fully screwed into place at the operative end 38q of the tool body 32q, the extension body 96 extends along the main body axis 34C. In this position, guide bore 48q also extends along main body axis 34C, completely through extension body 96, opening at the top of extension body 94 between handles 46 q.

As shown in fig. 23A and 23B, a length of guidewire 52q has been selected and extends completely through tool body 32q, with a majority of the exposed wire extending through operative end 38q and out of guide bore 52 q. This is generally considered advantageous after driving the guide wire 52q into the bone and when the tool body 32q is positioned over the guide wire 52q itself. However, during the rotational drilling of the counter-clockwise thread 70q into the bone, it is generally considered problematic because the guidewire 52q may be considered an obstacle to the surgeon as the tool 30q rotates.

23A and 23B, extension 94 is attached to operative end 38q of tool body 32q and over the remaining exposed length of guidewire 52q such that the remaining exposed length of guidewire 52q can be fully received within combined guide bore 48q of tool body 32q and extension body 96. In the particular embodiment of fig. 23A and 23B, the male extension threads 98 of the extension 94 and the female operating threads 100 of the tool body 32a are generally tightened counterclockwise to allow the engagement between the threads 98 and 100 to tighten as the surgeon rotates the surgical tool 30q about the body axis 34C to drill into the bone with the counterclockwise threads 70 q. However, it should be understood that in other contemplated embodiments, similar male extension threads and female operating threads will be clockwise tightened into place to allow tightening of a tool having clockwise-located threads.

It should also be appreciated that in some contemplated embodiments, additional accessories may be added at different locations on the surgical tool for specific surgical purposes within the contemplated scope of the present invention. For example, fig. 24A and 24B depict a surgical tool 30r of the present invention having a wire loop 102 positioned at a location along an outer surface of the tool body 32 r. In the embodiment shown in fig. 24A and 24B, one ring 102 is positioned at a location closer to the operative end 38r of the tool 30r, and the other ring 102 is positioned closer to the threaded end 36r. In this configuration, the ring 102 extends outwardly from the tool body 32r in opposite directions along a plane shared by the legs of the tool body 32r, the handle 46r, and the tool stop 44 r. However, it should be understood that other numbers of rings and ring orientations are within the intended scope of the present invention.

As shown in fig. 24A and 24B, the ring 102 will be particularly useful in performing procedures such as the bunion correction procedure shown and described in fig. 7-10, wherein the ring 102 allows for guiding additional wires (not shown) for holding the severed skull fragments/metatarsal heads 26 in place relative to the rest of the first metatarsal 20 after the osteotomy 56 has been formed and after the guide wire 52a and tool have been used to complete bone repositioning. Thus, the loops will enable the additional wires to provide temporary fixation of the orthotic skull fragments/metatarsal heads 26.

It should also be understood that additional tools and techniques may be used to perform bone surgery techniques within the intended scope of the present invention. For example, in some contemplated surgical approaches, a drill (not shown) may be used on the guidewire prior to insertion of the tool. In such an embodiment, a soft tissue protector (not shown) would be used.

Referring now to fig. 25A, another contemplated surgical technique of the present invention will involve the use of an angle tool 104 to align the guidewire. The angle tool 104 includes a flat bottom surface 106, an angled top surface 108, and a side handle 110. The angled top surface 108 is at a 45 degree angle to the flat bottom surface 106 and includes a hollow conduit 112 on top of the angled top surface 108 and extending along the length of the angled top surface 108. The conduit 112 is sized to accommodate a length of k-wire and allow the k-wire to be positioned at 45 degrees to the planar bottom surface 106.

Fig. 25B depicts a surgical technique utilizing the angle tool 104 of fig. 25A, which is a modification of the bunion correction surgical technique depicted in fig. 7-10 for the left foot 10. Referring to fig. 25B, a side view of a large toenail 113 having skin and non-bone tissue 114 surrounding the first metatarsal 20, seed 24, and hallux 58 is depicted. A small incision 116 is made adjacent the first metatarsal head 26. The angle tool 104 is then placed with its flat bottom surface 106 over the big toe 58, so that the conduit 112 is oriented at 45 degrees directly relative to the big toe 58 and the first metatarsal head 26 as shown.

Once the angle tool 104 is in this position as shown in fig. 25B, the guidewire 52s, typically a length of k-wire, is fed into the guidewire tube 112 and then directed into and through the incision 116 until it approaches or contacts the first metatarsal head 26 at the correct 45 degree angle provided by the angle tool 104 at the drilling location 60 s. A k-wire driver (not shown) is then used while the guide wire 52s remains positioned by the angle tool 104 to drive the end of the guide wire 52s into the first metatarsal head 26 as shown. The angle tool 104 may then be removed, leaving the guide wire 52s in place, and then the repositioning of the metatarsal heads 26 may be accomplished using a tool of the invention, such as the surgical tool 30a of fig. 5A and 5B.

Although the surgical technique depicted in fig. 25A and 25B depicts the use of an angle tool to optimally position the guide wire at 45 degrees to the thumb 58 and first metatarsal head 26, it should be understood that in some contemplated embodiments of the described surgical method and angle tool, the optimal angle of insertion of the preferred wire may be predetermined to be 25-35 degrees or another angle using a suitably angled tool within the intended scope of the invention.

Those skilled in the art will recognize that the present invention is capable of embodiments other than those shown and described. It is to be understood that the details of the structure of the disclosed apparatus and method can be changed in various ways without departing from the invention itself. Accordingly, the drawings and detailed description are to be regarded as including equivalents which do not depart from the spirit and scope of the present invention.

Claims

1. A surgical tool for engaging and manipulating bone, comprising:

A tool body having a main axis, a threaded end, and an operative end;

the threaded end having threads and a tool stop;

the operating end is positioned to allow a user to grasp, manipulate and rotate the tool body about the main body axis;

The threads being positioned to allow the surgical tool to drill into and engage the bone when the tool body is rotated about the main body axis in a drilling direction, the threads allowing tightening engagement with the bone when the tool body is rotated about the main body axis in the drilling direction;

The tool stop is positioned to prevent the surgical tool from being rotated further about the body axis and from drilling further into the bone when the tool stop contacts the bone; and

The surgical tool allows manipulation, movement and rotation of the bone with the surgical tool while the surgical tool is in tight engagement with the bone.

2. The surgical tool of claim 1, wherein the threads are positioned to bore into and engage the bone by the tool body being rotated in a clockwise direction to the right about the main axis.

3. The surgical tool of claim 1, wherein the threads are positioned to bore into and engage the bone by the tool body being rotated in a left, counter-clockwise direction about the main axis.

4. The surgical tool according to claim 1, characterized in that the surgical tool further comprises:

The tool stop has at least one leg extending outwardly from the tool body;

the operating end having at least one handle extending outwardly from the tool body; and

The at least one leg of the tool stop and the at least one handle of the operating end lie substantially in a plane common to the body axis, the surgical tool remaining substantially flat when placed on a flat surface.

5. The surgical tool according to claim 1, characterized in that the surgical tool further comprises:

the tool stop has two legs extending outwardly from the tool body;

The operating end has two handles extending outwardly from the tool body; and

The two legs of the tool stop and the two handles of the operating end lie substantially in a common plane with the body axis, the surgical tool remaining substantially flat when placed on a flat surface.

6. A surgical tool as in claim 1, wherein the tool stop comprises a flange.

7. A surgical tool as in claim 1, wherein the tool stop comprises at least one plate-like leg.

8. A surgical tool as in claim 1, wherein the tool stop comprises at least one pin leg.

9. A surgical tool as claimed in claim 1, wherein the tool stop extends entirely around the body axis.

10. The surgical tool according to claim 1, characterized in that the surgical tool further comprises:

The tool body having an operating thread positioned at the operating end;

an extension having an extension axis and an extension thread;

the extension thread of the extension is threadably connectable to the operating thread of the tool body, the extension axis of the extension being substantially collinear with the main axis of the tool body; and

The extension threads of the extension are positioned to screw onto the operating threads of the tool body as the extension and the tool body are rotated about the main axis and the extension axis in the drilling direction.

11. The surgical tool of claim 1, wherein the operative end is positioned to be connected to an external drill for rotation of the surgical tool about the body axis.

12. The surgical tool of claim 1, further comprising a knob at the operative end to allow rotation of the surgical tool about the body axis.

13. The surgical tool of claim 1, further comprising a slotted handle at the operative end to permit rotation of the surgical tool about the body axis.

14. The surgical tool of claim 1, further comprising a domed handle at the operative end to permit rotation of the surgical tool about the body axis.

15. The surgical tool of claim 1, further comprising a square handle at the operative end to allow rotation of the surgical tool about the body axis.

16. The surgical tool of claim 1, further comprising a triangular handle at the operative end to allow rotation of the surgical tool about the body axis.

17. The surgical tool of claim 1, further comprising a circular handle at the operative end to allow rotation of the surgical tool about the body axis.

18. The surgical tool of claim 1, further comprising a protruding T-handle at the operative end to allow rotation of the surgical tool about the body axis.

19. The surgical tool of claim 1, further comprising an engagement surface for attaching an external tool for rotating the tool body about the main axis.

20. The surgical tool of claim 1, further comprising a loop at a location along the tool body to guide an additional wire to provide temporary fixation of bone material.

21. A surgical tool for engaging and manipulating bone, comprising:

A tool body having a main body axis, a threaded end, an operative end, and a pilot bore extending through the tool body substantially along the main body axis;

the threaded end having threads and a tool stop;

The guide hole allows a positioning guide to extend at least partially through the tool body and into bone at a bone drilling location to align and guide the threads of the surgical tool to the bone drilling location;

The threads being positioned to allow the surgical tool to drill into the bone and engage the bone at the bone drilling location when the tool body is rotated about the main body axis in a drilling direction, the threads allowing screw-on engagement with the bone when the tool body is rotated about the main body axis in the drilling direction;

22. The surgical tool of claim 21, wherein the threads are positioned to bore into and engage the bone by the tool body being rotated in a clockwise direction to the right about the main axis.

23. The surgical tool of claim 21, wherein the threads are positioned to bore into and engage the bone by the tool body being rotated in a left, counter-clockwise direction about the main axis.

24. A surgical tool as in claim 21, wherein the positioning guide is a guidewire.

25. The surgical tool of claim 21, wherein the positioning guide is a guide wire pre-embedded in the bone at the bone drilling location.

26. The surgical tool of claim 21, wherein the positioning guide is a 0.45mm diameter k-wire.

27. The surgical tool of claim 21, wherein the surgical tool further comprises:

The tool stop has at least one leg extending outwardly from the tool body;

28. The surgical tool of claim 21, wherein the surgical tool further comprises:

the tool stop has two legs extending outwardly from the tool body;

The operating end has two handles extending outwardly from the tool body; and

29. A surgical tool as in claim 21, wherein the tool stop comprises a flange.

30. A surgical tool as in claim 21, wherein the tool stop comprises at least one plate-like leg.

31. A surgical tool as in claim 21, wherein the tool stop comprises at least one pin leg.

32. A surgical tool as claimed in claim 21, wherein the tool stop extends entirely around the body axis.

33. The surgical tool of claim 21, wherein the surgical tool further comprises:

The tool body having an operating thread positioned at the operating end;

an extension having an extension axis, an extension bore extending substantially along the extension axis, and an extension thread;

The extension thread of the extension is threadably connectable to the operating thread of the tool body, the extension axis of the extension is substantially collinear with the main axis of the tool body, and the pilot hole is substantially collinear with the extension bore;

the guide hole and the extension hole are positioned to allow the positioning guide to extend at least partially through the tool body and the extension; and

34. The surgical tool of claim 21, wherein the operative end is positioned to be connected to an external drill for rotation of the surgical tool about the body axis.

35. The surgical tool of claim 21, further comprising a knob at the operative end to allow rotation of the surgical tool about the body axis.

36. The surgical tool of claim 21, further comprising a slotted handle at the operative end to permit rotation of the surgical tool about the body axis.

37. The surgical tool of claim 21, further comprising a domed handle at the operative end to permit rotation of the surgical tool about the body axis.

38. The surgical tool of claim 21, further comprising a square handle at the operative end to allow rotation of the surgical tool about the body axis.

39. The surgical tool of claim 21, further comprising a triangular handle at the operative end to allow rotation of the surgical tool about the body axis.

40. The surgical tool of claim 21, further comprising a circular handle at the operative end to allow rotation of the surgical tool about the body axis.

41. The surgical tool of claim 21, further comprising a protruding T-handle at the operative end to allow rotation of the surgical tool about the body axis.

42. The surgical tool of claim 21, further comprising an engagement surface for attaching an external tool for rotating the tool body about the main axis.

43. The surgical tool of claim 21, further comprising an engagement surface for attaching an external tool for rotating the tool body about the main axis.

44. The surgical tool of claim 21, further comprising a ring at a location along the tool body to allow guiding of additional wires to provide temporary fixation of bone material.

45. A surgical tool for performing a bunyatis procedure on a left foot, comprising:

the threaded end having threads and a tool stop;

The guide hole allows a positioning guide to extend at least partially through the tool body and into a first metatarsal head of the left foot at a bone drilling location to align and guide the threads of the surgical tool to the bone drilling location;

The threads being positioned to allow the surgical tool to drill into and engage the first metatarsal head at the bone drilling location when the tool body is rotated about the main body axis in a clockwise drilling direction to the right, the threads allowing tightening engagement with the first metatarsal head when the tool body is rotated about the main body axis in the clockwise drilling direction to the right;

the tool stop is positioned to prevent the surgical tool from being rotated further about the body axis in the clockwise rightward direction and from drilling further into the first metatarsal head when the tool stop contacts bone; and

The surgical tool allows manipulation and movement of the first metatarsal head on the frontal, sagittal, and transverse planes of the left foot and rotation of the first metatarsal head clockwise to the right when the surgical tool is in tight engagement with the first metatarsal head.

46. A surgical tool as recited in claim 45, wherein the positioning guide is a guidewire.

47. The surgical tool of claim 45, wherein the positioning guide is a guide wire pre-embedded in the bone at the bone drilling location.

48. The surgical tool of claim 45, wherein the positioning guide is a 0.45mm diameter k-wire.

49. A surgical tool as recited in claim 45, further comprising:

The tool stop has at least one leg extending outwardly from the tool body;

50. A surgical tool as recited in claim 45, further comprising:

the tool stop has two legs extending outwardly from the tool body;

The operating end has two handles extending outwardly from the tool body; and

51. A surgical tool as in claim 45, wherein the tool stop comprises a flange.

52. A surgical tool as in claim 45, wherein the tool stop comprises at least one plate-like leg.

53. A surgical tool as in claim 45, wherein the tool stop comprises at least one pin leg.

54. A surgical tool as in claim 45, wherein the tool stop extends entirely around the body axis.

55. A surgical tool as recited in claim 45, further comprising:

The tool body having an operating thread positioned at the operating end;

56. A surgical tool as recited in claim 45, wherein the operative end is positioned for connection to an external drill for rotation of the surgical tool about the body axis.

57. A surgical tool as recited in claim 45, further comprising a knob at the operative end to permit rotation of the surgical tool about the body axis.

58. The surgical tool of claim 45, further comprising a slotted handle at the operative end to permit rotation of the surgical tool about the body axis.

59. The surgical tool of claim 45, further comprising a domed handle at the operative end to permit rotation of the surgical tool about the body axis.

60. The surgical tool of claim 45, further comprising a square handle at the operative end to allow rotation of the surgical tool about the body axis.

61. A surgical tool as recited in claim 45, further comprising a triangular handle at the operative end for allowing rotation of the surgical tool about the body axis.

62. A surgical tool as recited in claim 45, further comprising a circular handle at the operative end for allowing rotation of the surgical tool about the body axis.

63. The surgical tool of claim 45, further comprising a protruding T-handle at the operative end to allow rotation of the surgical tool about the body axis.

64. A surgical tool as recited in claim 45, further comprising an engagement surface for attaching an external tool for rotating the tool body about the main axis.

65. A surgical tool as recited in claim 45, further comprising an engagement surface for attaching an external tool for rotating the tool body about the main axis.

66. The surgical tool of claim 45, further comprising a ring at a location along the tool body to allow guiding of additional wires to provide temporary fixation of bone material.

67. A surgical tool for performing a bunyatis procedure on a right foot, comprising:

the threaded end having threads and a tool stop;

The guide hole allows a positioning guide to extend at least partially through the tool body and into a first metatarsal head of the right foot at a bone drilling location to align and guide the threads of the surgical tool to the bone drilling location;

The threads being positioned to allow the surgical tool to drill into and engage the first metatarsal head at the bone drilling location when the tool body is rotated about the main body axis in a left counter-clockwise drilling direction, the threads allowing tightening engagement with the first metatarsal head when the tool body is rotated about the main body axis in the left counter-clockwise drilling direction;

The tool stop is positioned to prevent the surgical tool from being rotated further about the body axis in the left counterclockwise direction and from drilling further into the first metatarsal head when the tool stop contacts bone; and

The surgical tool allows manipulation and movement of the first metatarsal head on the frontal, sagittal, and transverse planes of the right foot and rotation of the first metatarsal head counterclockwise to the left when the surgical tool is in tight engagement with the first metatarsal head.

68. A surgical tool as in claim 67, wherein the positioning guide is a guidewire.

69. The surgical tool of claim 67, wherein the positioning guide is a guide wire pre-embedded in the bone at the bone drilling location.

70. A surgical tool as in claim 67, wherein the positioning guide is a 0.45mm diameter k-wire.

71. A surgical tool as in claim 67, further comprising:

The tool stop has at least one leg extending outwardly from the tool body;

72. A surgical tool as in claim 67, further comprising:

the tool stop has two legs extending outwardly from the tool body;

The operating end has two handles extending outwardly from the tool body; and

73. A surgical tool as in claim 67, wherein the tool stop comprises a flange.

74. A surgical tool as in claim 67, wherein the tool stop comprises at least one plate-like leg.

75. A surgical tool as in claim 67, wherein the tool stop comprises at least one pin leg.

76. A surgical tool as in claim 67, wherein the tool stop extends entirely around the body axis.

77. A surgical tool as in claim 67, further comprising:

The tool body having an operating thread positioned at the operating end;

78. A surgical tool as in claim 67, wherein the operative end is positioned for connection to an external drill for rotation of the surgical tool about the body axis.

79. A surgical tool as recited in claim 67, further comprising a knob at the operative end to permit rotation of the surgical tool about the body axis.

80. A surgical tool as recited in claim 67, further comprising a slotted handle at the operative end for allowing rotation of the surgical tool about the body axis.

81. A surgical tool as recited in claim 67, further comprising a domed handle at the operative end to permit rotation of the surgical tool about the body axis.

82. A surgical tool as recited in claim 67, further comprising a square handle at the operative end for allowing rotation of the surgical tool about the body axis.

83. A surgical tool as recited in claim 67, further comprising a triangular handle at the operative end for allowing rotation of the surgical tool about the body axis.

84. A surgical tool as recited in claim 67, further comprising a circular handle at the operative end for allowing rotation of the surgical tool about the body axis.

85. A surgical tool as recited in claim 67, further comprising a protruding T-shaped handle at the operative end for allowing rotation of the surgical tool about the body axis.

86. A surgical tool as recited in claim 67, further comprising an engagement surface for attaching an external tool for rotating the tool body about the main axis.

87. A surgical tool as recited in claim 67, further comprising an engagement surface for attaching an external tool for rotating the tool body about the main axis.

88. The surgical tool of claim 67, further comprising a ring at a location along the tool body to allow guiding of additional wires to provide temporary fixation of bone material.