BROACH HANDLE FOR A RASP AND SURGICAL DEVICE COMPRISING SAID HANDLE
20220401113 · 2022-12-22
Inventors
- Francesco Siccardi (Castel San Pietro, CH)
- Frederic LAUDE (Castel San Pietro, CH)
- Massimiliano BERNARDONI (Castel San Pietro, CH)
- Christian TROMBETTA (Castel San Pietro, CH)
- Ermete ROSSI (Castel San Pietro, CH)
Cpc classification
A61B2017/0046
HUMAN NECESSITIES
A61B2017/00738
HUMAN NECESSITIES
International classification
Abstract
A broach handle for a rasp includes a proximal part extending along a first axis between a first portion of the handle and a second portion of the handle, and a proximal part extending partially along a second axis between a third portion of the handle, connected to the second portion, and a fourth portion of the handle, and partially along a third axis between a fifth portion of the handle, connected to the fourth portion, and a sixth portion of the handle connectable to a rasp. The sixth portion of the handle has a connection surface for connecting to the rasp having a normal extending along a normal axis defining a connection axis between the handle and the rasp. A first convex angle is defined between the first axis and the second axis, and a second convex angle is defined between the third axis and the normal axis.
Claims
1. A broach handle for a rasp comprising: a proximal part extending along a first axis between a first portion of the handle and a second portion of the handle, and a distal part extending partially along a second axis between a third portion of the handle, connected to the second portion, and a fourth portion of the handle, and partially along a third axis between a fifth portion of the handle, connected to the fourth portion, and a sixth portion of the handle connectable to a rasp; wherein the sixth portion of the handle has a connection surface for connecting to the rasp having a normal extending along a normal axis defining a connection axis between the handle and the rasp, wherein a first convex angle is defined between the first axis and the second axis, and a second convex angle is defined between the third axis and the normal axis; wherein said first axis, said second axis, said third axis, and said normal axis lie on the same placement plane.
2. The broach handle according to claim 1, wherein the first angle and the second angle have respective convexities turned in opposite directions.
3. The broach handle according to claim 1, wherein the second axis and the third axis coincide.
4. The broach handle according to claim 3, wherein the first angle and the second angle have respective convexities turned towards opposite half-planes defined by the second axis and by the third axis.
5. A broach handle for a rasp comprising: a proximal part extending along a first axis between a first portion of the handle and a second portion of the handle, and a distal part extending partially along a second axis between a third portion of the handle, connected to the second portion, and a fourth portion of the handle, and partially along a third axis between a fifth portion of the handle, connected to the fourth portion, and a sixth portion of the handle connectable to a rasp; wherein the sixth portion of the handle has a connection surface for connecting to the rasp having a normal extending along a normal axis defining a connection axis between the handle and the rasp; wherein a first convex angle is defined between the first axis and the second axis, and a second convex angle is defined between the third axis and the normal axis; wherein the distal part comprises a skew portion extending, between the fourth portion and the fifth portion of the handle, along a skew axis that is transverse in relation to the second axis and the third axis.
6. The broach handle according to claim 5, wherein the first angle and the second angle have respective convexities turned in opposite directions in relation to a transverse plane where the second axis and the third axis lie.
7. The broach handle according to claim 5, wherein the first angle has a value ranging between 90° and 180°.
8. The broach handle according to claim 5, wherein the second angle has a value ranging between 125° and 165°.
9. The broach handle according to claim 5, wherein the sixth portion extends along the normal axis defining an extension portion (26) of the distal part.
10. The broach handle according to claim 5, wherein the connection surface has at least one mutual coupling element configured to couple with the rasp, wherein said at least one mutual coupling element is a pin extending along a prevailing extension direction that is parallel to the normal axis.
11. The broach handle according to claim 5, comprising: a joining element configured for being reversibly coupled to said rasp, and a lever mechanism, connected to the joining element, arranged inside a cavity of the handle and configured to move the joining element through the connection surface along a coupling direction that is parallel to the normal axis between a coupling position and an uncoupling position.
12. The broach handle according to claim 5, comprising an abutment head arranged at the first portion and configured to be struck by a percussion element.
13. The broach handle according to claim 5, comprising a gripping and/or abutment element arranged so that it straddles the second portion and the third portion and configured to be grasped by a user and/or to be struck by a percussion element.
14. A surgical device for the preparation of a femoral canal comprising: a broach handle according to claim 1, and a rasp extending along a prevailing extension axis coinciding with an insertion axis of the rasp inside a femur for the preparation of a femoral canal, said rasp being connected to the handle at the connection surface along the connection axis; wherein a convex inclination angle of the rasp is defined between the prevailing extension axis of the rasp and the third axis of the handle.
15. The surgical device according to claim 14, wherein the first angle and the inclination angle of the rasp (γ) have their respective convexities turned in opposite directions.
16. The surgical device according to claim 15, wherein the inclination angle of the rasp has a value ranging between 90° and 135°.
17. The surgical device according to claim 15, wherein the first axis, the second axis, the third axis, the normal axis, and the prevailing extension axis of the rasp lie within the same placement plane of the device.
18. The surgical device according to claim 14, wherein a convex inclination angle of the proximal part is defined between the prevailing extension axis of the rasp and the first axis of the handle, the angle having a value ranging between 0° and 45°, preferably equal to 30°.
19. The surgical device according to claim 14, wherein the handle comprises an abutment head arranged at the first portion of the handle and configured to be struck by a percussion element, wherein said abutment head has an essentially planar abutment surface, so that a convex abutment angle is defined between the normal of said abutment surface and the prevailing extension axis, the angle having a value ranging between 0° and 50°.
20. The surgical device according to claim 14, wherein the distal part of the handle and the proximal part of the handle are joined to each other and wherein the distal part of the handle is joined to the rasp, so that the surgical device has a double curvature.
21. A surgical device for the preparation of a femoral canal comprising a handle and a rasp connected to each other and made of one piece; wherein said rasp extends along a prevailing extension axis coinciding with an insertion axis of the rasp inside a femur for the preparation of a femoral canal; wherein said broach handle comprises: a proximal part extending along a first axis between a first portion of the handle and a second portion of the handle, and a distal part extending partially along a second axis between a third portion of the handle, connected to the second portion, and a fourth portion of the handle, and partially along a third axis between a fifth portion of the handle, connected to the fourth portion, and a sixth portion of the handle connectable to the rasp; wherein a first convex angle is defined between the first axis and the second axis and a convex inclination angle of the rasp is defined between the prevailing extension axis of the rasp and the third axis of the handle; wherein said first axis, said second axis, said third axis, and said prevailing extension axis of the rasp lie on the same placement plane.
22. A surgical device for the preparation of a femoral canal comprising a handle and a rasp connected to each other and made of one piece; wherein said rasp extends along a prevailing extension axis coinciding with an insertion axis of the rasp inside a femur for the preparation of a femoral canal; wherein said broach handle comprises: a proximal part extending along a first axis between a first portion of the handle and a second portion of the handle, and a distal part extending partially along a second axis between a third portion of the handle, connected to the second portion, and a fourth portion of the handle, and partially along a third axis between a fifth portion of the handle, connected to the fourth portion, and a sixth portion of the handle connected to the rasp; wherein a first convex angle is defined between the first axis and the second axis and a convex inclination angle of the rasp is defined between the prevailing extension axis of the rasp and the third axis of the handle; wherein the distal part of the handle comprises a skew portion extending, between the fourth portion and the fifth portion of the handle, along a skew axis that is transverse in relation to the second axis and the third axis.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0043] Additional characteristics and advantages of this invention will become more apparent from the indicative, and therefore non-limiting, description of one preferred, but not exclusive, embodiment of a broach handle for a rasp and a surgical device for the preparation of a femoral canal comprising said handle, as illustrated in the attached figures, wherein:
[0044]
[0045]
[0046]
[0047]
[0048]
DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS OF THE INVENTION
[0049] With reference to the attached figures, the reference number 100 indicates, as a whole, a surgical device for the preparation of a femoral canal, from hereon in, simply, the device 100.
[0050] The device 100 comprises a broach handle for a rasp 1, from hereon in, simply, the handle 1, and a rasp 50 connected to the handle 1.
[0051] With reference to
[0052] After the step of cutting the head of the femur, in particular, the operating procedure involves the hyperextension of the leg, the femur F of the patient being preventatively extra-rotated towards the outside of the body so as to sufficiently expose the severed femoral head to the surgeon for the insertion of the rasp 50. In the example illustrated in
[0053] The rasp 50 illustrated in the attached figures extends along a prevailing extension axis X coinciding with an insertion axis Y of the rasp inside the femur F.
[0054] The rasp 50 preferably comprises a multitude of superficial crests, not illustrated, configured to exert a rasping action during the repeated insertion of the rasp 50 inside the medullary canal of the femur F.
[0055] The rasp 50, illustrated in the attached figures, preferably has a basically truncated pyramid shape, wherein the directrix follows a curved or fragmented trajectory coinciding, for a predominant section, with the prevailing extension axis X, defining a “sickle” shape. In other words, the directrix of the truncated pyramid deviates at the connection zone with the handle 1.
[0056] The handle 1, to which this invention relates, comprises a proximal part 10 and a distal part 20.
[0057] In particular, the term “proximal” is intended to refer to the part of the handle 1 closest to the surgeon while the term “distal” the part furthest from the body of the surgeon.
[0058] With reference to the attached figures, therefore, the term “proximal part” 10 is intended to refer to the part of the handle 1 that, in use, is arranged furthest from the body of the patient, while the term “distal part” 20 is intended to refer to the part of the handle 1 that, in use, is arranged closest to the patient's body. In particular, the proximal part 10 defines the part of the handle 1 that the surgeon grasps, while the distal part 20 is the part of the handle 1 connected or connectable to the rasp 50.
[0059] With particular reference to
[0060] The distal part 20 extends: [0061] partially along a second axis A2 between a third portion 21 of the handle 1, connected to the second portion 12, and a fourth portion 22 of the handle 1, and [0062] partially along a third axis A3 between a fifth portion 23 of the handle 1, connected to the fourth portion 22, and a sixth portion 24 of the handle 1 connectable to a rasp 50.
[0063] It should be noted that the term “axis” A1, A2, A3 is intended to refer to a prevailing extension direction.
[0064] The sixth portion 24 has, in particular, a connection surface 2 for connecting to the rasp 50, preferably a planar surface, with a normal extending along a normal axis N defining a connection axis Z connecting the handle 1 with the rasp 50.
[0065] The connection surface 2 preferably defines the free end of the sixth portion 24.
[0066] Advantageously, a first convex angle α is defined between the first axis A1 and the second axis A2, and a second convex angle β is defined between the third axis A3 and the normal axis N, so that the handle 1 according to this invention, if seen from the side, as show in
[0067] In particular, the first convex angle α defines the inclination value between the proximal part 10 and the distal part 20, while the second angle β defines the inclination between the connection axis Z connecting the handle 1 with the rasp 50 and the axis A3.
[0068] As illustrated in the attached figures, the term “first angle α” refers, thus, to the convex angle arranged between the proximal portion 10 and the distal portion 20, while the term “second angle β” refers to the convex angle opposite the first angle α in relation to the distal portion 20 of the handle 1. In other words, the two angles α, β are opposite each other in relation to the volume of the handle 1.
[0069] With reference to
[0070] With reference to
[0071] The presence of two convexities, defined by the angels α and β, make it possible, advantageously, to create a handle 1 conveniently designed so as not to interfere with the abdomen of the patient and that, at the same time, makes it possible to insert the rasp 50 inside the severed head of the femur F without having to extract it from its seat.
[0072] In
[0073] In this regard, it should be noted that
[0074] In accordance with this reference system, the proximal part 10 thus extends mainly along the direction k1, oriented in the negative direction, thus direction −k1.
[0075] The first angle α and the second angle β preferably have respective convexities turned in opposite directions in relation to the handle itself, or, in particular, in relation to the distal portion 20 of the handle.
[0076] Advantageously, opposite convexities make it possible to create a handle 1 in which the distal part 20 extends away from the body of the patient, reducing the dimensions in the abdominal zone, and in which the proximal part 10 has an inclination in relation to the body of the patient, so as to enable a correct transmission of the percussions (for example, hammer blows) to the rasp 50.
[0077] In fact, the handle 1 preferably comprises an abutment head 3 arranged at the first portion 11 and configured to be struck by a percussion element, for example a hammer, for which the inclination of the proximal portion 10 of the handle 1 in relation to the femur F is particularly ergonomic for the surgeon and enables the efficacious advancement of the rasp 50 in the femur F following a blow beaten on the abutment head 3.
[0078] The fact that the first axis A1 and the second axis A2 and/or the third axis A3 are transverse makes it possible, advantageously, to create a handle 1 wherein there are two different inclinations for the distal part 20 and for the proximal part 10. The fact that the two convexities are opposite to each other makes it possible, therefore, to create a handle 1 that is practical and ergonomic to use.
[0079] With reference to the first embodiment of the handle 1, illustrated in
[0080] In accordance with the first embodiment, the first angle α and the second angle β preferably have respective convexities turned towards opposite half-planes defined by the second axis A2 and by the third axis A3.
[0081] In particular, as illustrated in
[0082] With reference to the group of three k1, k2, k3 indicated in
[0085] In accordance with a second embodiment of the handle 1 illustrated in
[0086] Thus, the fourth portion 22 is connected to the fifth portion 23 by means of the skew portion 25.
[0087] In other words, with reference to the
[0088] With reference to the group of three k1, k2, k3 indicated in
the skew portion 25 extends in the direction +k1, +k2, +k3, defining an offset along k3 of the handle 1 in relation to the plane passing through k1, k2. Preferably, in addition, the first angle α and the second angle β have respective convexities turned in opposite directions in relation to the handle itself, and in particular in relation to a plane on which the second axis A2, the third axis A3, and the skew axis S lie.
[0090] Advantageously, the insertion of the rasp 50 in the medullary canal of the femur F, using a handle 1 with a skew portion 25 of the type shown in
[0091] In particularly osteoporotic patients, the risk of femur F fractures is very high if the patient's leg undergoes a strong extra-rotation.
[0092] Typically, the surgeon, in fact, grasps the foot of the patient and rotates it, towards the floor, to obtain the rotation of the femur F that is necessary to expose the access zone for accessing the femoral canal in order to insert the rasp 50.
[0093] The femur F, in any case, does not precisely follow the foot's rotation due to kinematic loss at the knee joint, so that, to obtain, for example, a 90° rotation at the level of the greater trochanter of the femur F, the foot of the patient must be rotated by a rotation angle significantly greater than 90°. Osteoporotic patients often cannot bear this rotation, in any case, so that the rotation that can be obtained is less than necessary, when the operation is performed with a handle for a rasp without the skew portion. As a result, the access zone for the femoral canal will be less exposed to the surgeon and difficult to reach with the rasp 50. Thanks to the handle 1 with the skew portion 25, to which this invention relates, it is, in contrast, possible to reach the access zone for the femoral canal in a practical and efficacious manner, since the presence of the skew portion 25 makes it possible to partially deviate the extension of the distal portion 20 so that it does not interfere with the patient's anatomy, in particular with the pelvic bone.
[0094] With reference to the attached figures, the sixth portion 24 preferably extends along the normal axis N defining an extension portion 26 of the distal part 20: the connection surface 2, in this case, is thus arranged at the free end of the extension portion 26.
[0095] As can be seen in
[0096] In particular, the pin 4 is suitable for insertion into a coupling seat 51 of the rasp 50.
[0097] With reference to
[0100] In other words, the surgeon, by activating the lever mechanism 6, can move the joining element 5, for example a pin, away from the connection surface 2, so that this is inserted inside a coupling seat 52 of the rasp 50, which is suitable for receiving it and holding it inside in the coupling position.
[0101] The surgeon, to uncouple the rasp 50, for example to replace it with a larger size, by activating the lever mechanism 6 can remove and disengage the joining element 5 from the coupling seat 52, by withdrawing it through the connection surface 2.
[0102] With reference to the attached figures, the handle 1 preferably comprises, in addition, a gripping and/or abutment element 8 arranged so that it straddles the second portion 12 and the third portion 21 and configured to be grasped by a user and/or to be struck by a percussion element, which is not illustrated.
[0103] The gripping and/or abutment element 8 preferably has the shape of a projecting wedge.
[0104] The gripping and/or abutment element 8 advantageously enables the surgeon, during use of the handle 1 connected to the rasp 50, to comfortably grasp the handle 1 for inserting and removing the rasp 50 in the/from the femoral canal C and to hit the handle 1 with a hammer to facilitate the extraction of the rasp from the canal C when fitted.
[0105] With reference to
[0108] In particular, the kit preferably comprises a plurality of rasps 50 of different sizes, so as to be able to rasp the femoral canal in order to prepare the femoral canal C adapting it to receive the stem of the prosthesis with dimensions suitable for the dimensions of the patient's femur F.
[0109] Also part of this invention is a device 100 comprising: [0110] a handle 1 according to this invention, and [0111] a rasp 50, preferably of the type described above;
wherein a convex inclination angle of the rasp γ is defined between the prevailing extension axis X of the rasp 50 and the third axis A3 of the handle.
[0112] In other words, the convex inclination angle of the rasp γ defines the angle between the prevailing extension direction of the end zone of the distal portion 20 (that which extends between the fifth portion 23 and the sixth portion 24) and the prevailing extension direction of the rasp 50.
[0113] In particular, for the first embodiment of the device 100, illustrated in
[0114] In particular, the inclination angle of the rasp γ and the second angle β both pass over the distal portion 20.
[0115] In addition, the first angle α and the inclination angle of the rasp γ preferably have respective convexities turned in opposite directions in relation to the handle 1 itself, or in relation to the distal portion 20 of the handle.
[0116] Advantageously, the double convexity makes it possible to create a device 100 that can be easily and efficiently inserted into the femur F without interfering with the patient's abdomen.
[0117] The inclination angle of the rasp γ preferably has a value ranging between 90° and 135°, still more preferably equal to 105°.
[0118] In accordance with the first embodiment, the first axis A1, the second axis A2, the third axis A3, the normal axis N, and the prevailing extension axis of the rasp X preferably lie on the same placement plane of the device 100.
[0119] A convex inclination angle of the proximal part δ part, with a value ranging between 0° and 45°, still more preferably equal to 30°, is preferably defined between the prevailing extension axis X of the rasp and the first axis A1 of the handle 1.
[0120] Advantageously, the value of the inclination angle of the proximal part δ (
[0121] The abutment head 3 preferably has an essentially planar abutment surface 3a, so that a convex abutment angle ε (
[0122] The normal axis N and the normal to the abutment surface 3a are preferably parallel.
[0123] The abutment surface 3a is preferably slightly spherical (i.e. it has a curvature radius tending to infinity) so that the surgeon is more likely to strike the central part of the spherical cap when inserting the rasp 50, to transmit an optimal percussion to the rasp, without dispersing the force.
[0124] Advantageously, the value of the abutment angle ε makes it possible to ensure that the thrusts imparted on the handle 1 are suitably transmitted to the rasp 50.
[0125] The surgical device 100 is, preferably, a stiff system, so that the proximal part 10, the distal part 20, and the rasp 50 cannot be moved in relation to each other and the angles described above cannot be altered.
[0126] With reference to the attached figures, the distal part 20 of the handle 1 and the proximal part 10 of the handle 1 are preferably joined to each other, and the distal part 20 is joined to the rasp 50, so that the surgical device 100 has a double curvature.
[0127] Also part of this invention is a device 100, not illustrated in the attached figures, in which the handle 1 and the rasp 50 are made of a single piece.
[0128] The operating method for preparing a femoral canal using the handle 1 and/or the device 100 and/or the kit to which this invention relates and in accordance with the two embodiments described involves, thus, the following steps: [0129] cutting the leg of the patient at the front and separating the soft tissues so as to render the acetabular zone and that of the femoral head visible; [0130] severing the femoral neck and removing the femoral head from the patient's body; [0131] milling the acetabular cup to prepare it for an acetabular prosthetic cup; [0132] positioning the prosthetic acetabular cup; [0133] hyperextending the patient's leg and rotating the patient's leg externally; [0134] inserting the rasp 50 and proceeding with rasping the femoral medullary canal until the desired size is obtained for inserting the definitive prosthetic stem; [0135] inserting the definitive prosthetic stem
[0136] Finally, the prosthetic head is inserted onto the definitive stem and the head is engaged inside the acetabular cup, rotating the leg again to return it to its natural position.
[0137] These steps do not involve femoral release, i.e. removing the femur from its natural seat and moving the upper part of the femur towards the wound. This invention achieves the proposed purposes, overcoming the drawbacks complained of in the prior art, and providing a versatile handle 1 for a rasp 50 that can be appropriately designed to adapt to the physiological needs of the patient. The invention also provides a surgical device 100 for preparing a femoral canal C, which reduces invasiveness and operating times by avoiding bone dislocation and trauma to the patient.
[0138] In particular, the device 100 makes it possible to avoid extracting the access area to the femoral canal, operating in greater safety.