MODULAR SURGICAL INSTRUMENT
20190374349 · 2019-12-12
Inventors
Cpc classification
A61F2002/4627
HUMAN NECESSITIES
A61F2002/30131
HUMAN NECESSITIES
A61F2002/30607
HUMAN NECESSITIES
A61F2002/4681
HUMAN NECESSITIES
International classification
Abstract
A modular surgical instrument for knocking out or implanting a prosthesis that defines a prosthesis axis and which has a prosthesis neck includes a tool head with a passthrough for accommodating the prosthesis neck, a locking device for locking the mounted prosthesis neck, and a chuck, which has an axis for transferring a clamping force for the locking device. The passthrough and the chuck are arranged on opposite ends of the tool head relative to a lengthwise direction defined by the axis of the chuck, wherein the passthrough defines a passthrough axis which coincides substantially with the prosthesis neck axis when the prosthesis neck is locked in place. The axis of the chuck is at a distance from a plane defined by the lengthwise direction and the passthrough axis and/or is at a distance from a passthrough lengthwise axis that extends in the lengthwise direction and through the passthrough.
Claims
1. Modular surgical instrument for knocking out or implanting a prosthesis (2), which defines a prosthesis axis (6) and which has a prosthesis neck (4) that defines a prosthesis neck axis (8) which extends in a direction not parallel to the prosthesis axis, comprising a tool head (10) with a passthrough (28) for accommodating the prosthesis neck (4), a locking device for locking the mounted prosthesis neck (4) and a chuck (18) which has an axis (20) for transferring a clamping force for the locking device, wherein the passthrough (28) and the chuck (18) are arranged on opposite ends of the tool head (10) relative to a lengthwise direction (48) defined by the axis (20) of the chuck, and wherein the passthrough (28) defines a passthrough axis (29) which coincides substantially with the prosthesis neck axis (8) when the prosthesis neck (4) is locked; wherein the axis (20) of the chuck (18) is at a distance from the plane (50) defined by lengthwise direction and the passthrough axis (29) and/or the axis (20) of the chuck (18) is at a distance from a passthrough lengthwise axis which extends in lengthwise direction (48) and through passthrough (28).
2. Modular surgical instrument according to claim 1, wherein the distance (d) of the axis (20) of chuck (18) from the plane defined by the lengthwise direction (48) and the passthrough axis (29) is in the range from 2 cm-20 cm, preferably 5 cm-15 cm.
3. Modular surgical instrument according to claim 1, wherein the locking device comprises a blocking element (26) which engages movably in passthrough (28) to lock the prosthesis neck (4), wherein the passthrough axis (29) extends substantially perpendicularly to a direction of movement of the blocking element.
4. Modular surgical instrument according to claim 1, further comprising a clamping assembly (12) which is detachably connected to the tool head (10) at the chuck (18) and which has a clamping element (22) for applying a clamping force and actuators for transferring the clamping force.
5. Modular surgical instrument according to claim 4, further comprising an impact frame (14) which is detachably connected to the clamping assembly (12) and which has a first connection device (52) with a first axis (54) for an impacting device for transferring an impact force.
6. Modular surgical instrument according to claim 5, comprising the impacting device, which is attached to the first connection device (52), wherein the impacting device comprises an impact plate (16), a slide hammer (42) or a pneumatic impact machine (44) and is configured such that the impact force is exerted along the first axis (54).
7. Modular surgical instrument according to claim 5, wherein the first connection device (52) or a fixed connection is arranged in the lengthwise direction (48) when viewed from the passthrough (28), so that the first axis (54) is coincident with the prosthesis axis (6) when the prosthesis neck (4) is locked.
8. Modular surgical instrument according to claim 5, wherein the impact frame (14) comprises a first and a second leg; wherein the first connection device (52) or a fixed connection, preferably the connection device with the first axis (56) is arranged on one end of the first leg for the impacting device; wherein a second connection device (56) or a fixed connection, preferably the connection device with a second axis (58) parallel to the first axis (54) is arranged on one end of the second leg for the clamping assembly (12); wherein a space remains free between the ends of the legs in the direction of the first (54) and the second axis (58); and wherein the first axis (54) and the second axis (58) are at a distance from each other.
9. Modular surgical instrument according to claim 5, wherein the impact frame (14) has an L-shape, wherein the clamping assembly (12) is connected detachably to a second leg of the L-shape by means of a second connection device or a fixed connection, and wherein the first connection device or a fixed connection is arranged on a first leg of the L-shape for the impacting device.
10. Impact frame or a modular surgical instrument for knocking out or implanting a prosthesis (2), which defines a prosthesis axis (6) and which has a prosthesis neck (4) that defines a prosthesis neck axis (8) that extends in a direction not parallel to the prosthesis axis, including a first and a second leg; wherein a first connection device (52) with a first axis (54) is arranged on one end of the first leg for an impacting device; wherein a second connection device (56) with a second axis (58) that is parallel to the first axis (54) is arranged on one end of the second leg, parallel to the second axis (58) for a clamping assembly (12); wherein a space remains between the ends of the legs in the direction of the first and second axes (54, 58).
11. Impact frame according to claim 10, wherein the distance (d) between the first axis (54) and the second Axis (58) is in the range from 0 cm-20 cm, preferably 5 cm-10 cm.
12. Impact frame according to claim 10, wherein the impact frame (14) comprises multiple frame sections, wherein the first leg and the second leg form frame sections, the ends of which extend substantially perpendicularly to the first and second axes (54, 58), and wherein at least a part of at least one further frame section, which connects the first leg and the second leg, extends in the direction defined by the first and the second axes.
13. Impact frame according to claim 10, wherein in addition a third connection device (60) with a third axis (62) is provided, which preferably includes a passthrough hole on the impact frame is arranged on the first leg for an impacting device, wherein the third axis (62) is coincident with the second axis (58).
14. Impact frame according to claim 10, wherein an impact plate (16), particularly a flat or a concave impact plate or a slide hammer (42) is attached to the first connection device (52).
15. Impact frame according to claim 10, wherein the first and/or the second connection device each has a passthrough hole (30) in the impact frame (14), an elastomer bushing (38), preferably made of silicone, which is arranged in the passthrough hole (30), and a connection screw (32), which extends through the connection hole and which is fastened by means of a nut, wherein the nut is a hemispherical nut (34) which is supported in an hemispherical nut bed (36) on the impact frame (14).
Description
BRIEF DESCRIPTION OF THE DRAWING
[0034] In the following section, exemplary embodiments of the present invention will be described in greater detail with reference to the figures, wherein
[0035]
[0036]
[0037]
[0038]
[0039]
[0040]
[0041]
[0042] The same reference signs are used for identical or similar elements or components in both the description and the drawing. A list of reference signs is also provided, which applies for all figures. The variants represented in the figures are diagrams only, and do not necessarily represent actual dimensional proportions.
DETAILED DESCRIPTION OF THE INVENTION
[0043]
[0044] The modular surgical instrument represented in
[0045] Tool head 10 as shown in
[0046] The passthrough may be open at the side to make it possible and easier to accommodate the prosthesis neck. The rim of the passthrough is then typically in the form of a ring segment.
[0047] Tool head 10 further comprises a locking device which serves to lock (clamp) the mounted prosthesis neck 4 with a clamping force. The locking device may comprise a blocking element 26 which engages movably in the passthrough 28 and is guided in lateral grooves. The blocking element 26 is movable substantially perpendicularly to the passthrough axis 29, so that a cross section of the passthrough 28 can be modified and the prosthesis neck 4 can be locked or clamped in place by the application of a clamping force. The clamping force for the locking device is transferred at a chuck 18, and from there to the locking device; e.g., via actuators 24, 25 as illustrated in
[0048] Chuck 18 has an axis 20 which defines a lengthwise direction 48. Passthrough 28 and chuck 18 are arranged on opposite ends of the tool head 10 relative to the lengthwise direction 48. There is preferably angle of approximately 45 or approximately 135 (approximately means that variations of up to 5 are possible) between the passthrough axis 29 and the lengthwise direction 48. The parallel displacement of passthrough axis 29 in lengthwise direction 48 defines a plane (perpendicular to the plane of the drawing in the frontal view on the left side of
[0049] The chuck is thus offset laterally from the passthrough relative to the plane defined by the passthrough axis and the lengthwise direction. An offset parallel to this plane or within this plane which may also exist in addition to or without the above. For example, a passthrough lengthwise axis extending through passthrough 28 and in lengthwise direction 48 (that is to say one which differs from passthrough axis 29), may lie within the plane defined by the passthrough axis 29 and the lengthwise direction 48 and still be located at a distance from the axis 20 of chuck 18. In such a case, in the frontal view of
[0050]
[0051] Clamping assembly 12 has an axis which coincides with axis 20 of chuck 20 when the clamping assembly 12 is connected to tool head 10 on chuck 18, so that the offset is transferred to the clamping assembly 12, and the clamping assembly 12, which is typically a component of elongated construction, does not protrude into the operating site. The clamping assembly 12 may also be configured to enable a variable preset displacement of the locking device (i.e., an adjustable displacement of the locking device before application of the actual clamping force which clamps the prosthesis neck in place) so that it may be used for various prosthesis necks with different dimensions and/or diameters. In the example given above, an adjustment thread may be provided in the clamping assembly, so that the distance between the clamping lever 22 and the chuck 18 can be changed, exerting a preload on the actuator.
[0052] An impact frame 14 is also represented in
[0053] The impacting device may comprise for example an impact plate 16, which may in particular be flat or level, but is preferably concave (as represented in
[0054] The detachable connection of the clamping assembly 12 to the impact frame 14 is made by means of a second connection device 56 with a second axis 58, wherein in the connected state the second axis 58 coincides with the axis of the clamping assembly 12 and consequently with axis 20 of chuck 18 as well. The first axis 54 and the second axis 58 are preferably parallel and at a distance from each other, more preferably the first connection device 52 should be arranged approximately in lengthwise direction 48 when viewed from passthrough 28, so that the when the prosthesis neck 4 is locked in position the first axis 54 substantially coincides with the prosthesis axis 6 of the prosthesis 2 locked in position on the prosthesis neck 4.
[0055] The distance between the first and second axes preferably corresponds to the distance d between the axis 20 of chuck 18 and the plane defined by the lengthwise direction 48 and the passthrough axis 8, that is to say it is preferably at least 2 cm, more preferably at least 5 cm. Similarly, the distance between the two axes is preferably in the range from 2 cm-20 cm, more preferably 5 cm-15 cm, still more preferably in the range from 5 cm-10 cm. In this way, the first axis 54, along which the impact force acts, coincides with the prosthesis axis 6, along which the prosthesis 2 is to be knocked out or implanted; consequently, transverse forces which would be generated by the lateral offset of tool head 10 and which might cause damage to the bone, for example, only arise to a very limited degree, if at all, and may be minimised further by corresponding design of the connection devices.
[0056] A first option for achieving this, as indicated in
[0057] A preferred second embodiment of the impact frame comprises an impact frame 14 having a first and a second leg, wherein the first connection device 52 with the first axis 54 is arranged on an end of the first leg, and the second connection device 56 with the second axis 58 is arranged on an end of the second leg. (Note: The legs in this second option are described only as legs as distinct from the legs of the L-shape described in the previous, first option.) The first axis 54 and the second axis 58 extend parallel and at a distance from each other; the first connection device 52 is provided for fastening the impacting device 16, and the second connection device 56 is provided for fastening the clamping assembly 12. A space between the ends of the legs is left free in the direction of the two axes 54, 58, so that this space is available for the operator; in order to strike an impact plate 16 with a hammer 40, for example, as shown in the figures.
[0058] In the second embodiment of the impact frame, a third connection device 60 with a third axis 62 is preferably arranged on the first leg, and particularly in such manner that the third axis 62 coincides with the second axis 58. This makes it possible for a corresponding impact frame also to be used in conjunction with tool heads that do not have a lateral offset; see also
[0059] In specific terms, the impact frame 14 according to the second embodiment of the impact frame may be created if the impact frame 14 comprises a frame element which is curved in a C-shape or a U-shape, the end sections of which form the first and second legs, wherein one leg is longer than the other leg, the first connection device is arranged on the end of the longer leg, and the second connection device is arranged on the end of the shorter leg. However, since it is more flexible and can be used in a greater range of applications, it is preferred if the impact frame 14 comprises a plurality of frame sections, wherein the first and second legs form two frame sections which are connected to each other either directly or, preferably, via (at least one) further frame section(s), which extend at least in part in the direction that is defined by the first or second axis. The ends of the first and the second legs preferably extend substantially perpendicularly to the first and second axes. The individual frame sections may be straight or curved (as in
[0060] The frame sections are preferably connected to each other in fixed or rigid manner, to ensure that the impact frame is of sufficient stiffness. Alternatively, the frame sections may be connected to each other in such manner as to be adjustable and fixable, e.g., by means of screw connections, thereby enabling the shape of the impact frame 14 to be changed and adapted to various tool heads and clamping assemblies. The impact frame may further be furnished with possible attachment means, e.g., recesses or holes, for a handle for holding the impact frame or the surgical instrument (see for example
[0061] There are very many different possibilities for creating each of the connection devices (first, second and third), e.g., threaded connections, clamping connections, tongue-and-groove systems, bayonet catches, etc. In one preferred, at least one (preferably both) connection device(s) has/have a passthrough hole 30 in the impact frame 14, which hole extends in the direction of the first or second axis; the clamping assembly and the impacting device is then fastened by inserting for example a screw or a threaded bolt through the respective passthrough hole and screwing it tight.
[0062] This is shown for example in
[0063] The connection device of the embodiment according to
[0064]
[0065]
[0066]
[0067] In summary, the tool head 10 and the impact frame 14 are preferably aligned so that not only is the first axis 54 is coincident with the prosthesis axis 6 but also the second axis 58 is coincident with the axis 20 of chuck 18 and, where applicable with the third axis 62, wherein the first and second axes are at a distance from each other; in this way it is possible to enable a minimally invasive operation and to ensure that force is exerted along the prosthesis axis.
LIST OF REFERENCE SIGNS
[0068] 2 Prosthesis
[0069] 4 Prosthesis neck
[0070] 6 Prosthesis axis
[0071] 8 Prosthesis neck axis
[0072] 10 Tool head
[0073] 12 Clamping assembly
[0074] 14 Impact frame
[0075] 16 (concave) Impact plate
[0076] 18 Chuck
[0077] 20 Chuck axis
[0078] 22 Clamping lever/Clamping element
[0079] 24 Actuator
[0080] 25 Actuator
[0081] 26 Blocking element
[0082] 28 Passthrough
[0083] 29 Passthrough axis
[0084] 30 Passthrough hole
[0085] 32 Connection screw
[0086] 34 Nut/Hemispherical nut
[0087] 36 Hemispherical nut bed
[0088] 38 Elastomer bushing
[0089] 40 Hammer
[0090] 42 Slide hammer
[0091] 44 Pneumatic impact machine
[0092] 46 Diagram of force vectors
[0093] 48 Lengthwise direction
[0094] 50 Plane defined by passthrough axis and lengthwise direction
[0095] 52 First connection device
[0096] 54 First axis
[0097] 56 Second connection device
[0098] 58 Second axis
[0099] 60 Third connection device
[0100] 62 Third axis
[0101] A Detail
[0102] d Distance