Surgery – Instruments – Orthopedic instrumentation
Reexamination Certificate
1999-11-08
2001-08-07
Smith, Jeffrey A. (Department: 3732)
Surgery
Instruments
Orthopedic instrumentation
Reexamination Certificate
active
06270501
ABSTRACT:
TECHNICAL FIELD
This invention relates to a surgical method and apparatus and cannulated scalpel for use therein.
BACKGROUND ART
Bone fractures are a relatively common injury requiring orthopaedic care. While some fractures can be treated through reduction and immobilization, certain types of bone fractures cannot be effectively healed without fixation, typically utilizing bone screws or fixation pins. The placement of pins or screws is typically accomplished by inserting a guide pin through the skin and into contact with the bone surface. Then, a power surgical drill or reamer is used to clear tissue and drive a fixation device, such as a cannulated bone screw or pin, over the guide pin and into the bone across the fracture area.
Prior to driving the fixation device into place, the tissue surrounding the guide pin should be loosened to allow for passage of the cannulated screw or pin through to the bone. At present, this is accomplished by cutting around the guide pin with a conventional scalpel. However, using a standard scalpel to cut precisely around the guide pin is difficult and time consuming due the small circumference of the guide pin and the depth that the bone may lie from the skin surface. As a result, the soft tissue surrounding the pin typically undergoes unnecessary damage, which only prolongs its healing process. In addition, the cosmetic result of such imprecise cuts is not desirable for the patient.
DISCLOSURE OF INVENTION
Therefore, it is an object of the present invention to provide a surgical method and apparatus and cannulated scalpel for use therein that results in a more precise, efficient incision through tissue during surgical procedures.
Accordingly, a cannulated scalpel is provided for use in surgical procedures, wherein the scalpel is used to make an incision through intervening tissue about a guide pin having an end for engaging a target tissue, such as bone. The scalpel includes a hollow, elongated shaft adapted to slide over the guide pin and a head mounted at one end of the shaft. The head has at least one leading cutting edge that is adapted to cut along a plane through the intervening tissue as the shaft slides over the guide pin toward the target tissue engaging end of the guide pin.
Preferably, the head has a trailing guide edge to facilitate removal of the scalpel from the incision along the plane. The trailing guide edge can also be adapted to cut along the plane through the intervening tissue. In a preferred embodiment, the head has a pair of spaced leading cutting edges adapted to cut along a pair of planes through the tissue. With this embodiment, a pair of spaced trailing guide edges can be provided to facilitate removal of the scalpel from the incision along the pair of planes.
Correspondingly, a method for making an incision about a guide pin is provided, where the guide pin has a target tissue engaging end that is engaged with a target tissue. The method includes sliding a cannulated scalpel over the guide pin toward the target tissue engaging end of the guide pin in order to cut along a plane through the intervening tissue, wherein the cannulated scalpel has a hollow, elongated shaft and a head mounted at one end of the shaft, the head having at least one cutting edge.
In addition, an apparatus for providing fixation of a target tissue, such as bone, is provided. The apparatus includes a guide pin having a target tissue engaging end and a cannulated scalpel for making an incision through intervening tissue about the guide pin. The scalpel has a hollow, elongated shaft adapted to slide over the guide pin and a head mounted at one end of the shaft. The head has at least one leading cutting edge adapted to cut along a plane through the intervening tissue as the shaft slides over the guide pin toward the target tissue engaging end of the guide pin. The apparatus further includes a driving tool, such as a power surgical drill, for driving a cannulated fastener along the guide pin and through the incision to embed the fastener in the target tissue and provide fixation of the target tissue.
Correspondingly, a method for providing fixation of a target tissue is provided. The method includes inserting a guide pin having a target tissue engaging end through intervening tissue and into engagement with the target tissue, such as bone. The method further includes sliding a cannulated scalpel over the guide pin toward the target tissue engaging end of the guide pin in order to make an incision through the intervening tissue about the guide pin. The cannulated scalpel has a hollow, elongated shaft and a head mounted at one end of the shaft, wherein the head has at least one leading cutting edge for cutting along a plane through the intervening tissue. Next, the method includes removing the cannulated scalpel from the incision along the plane, preferably using a trailing guide edge to facilitate removal. Lastly, the method includes driving a cannulated fastener along the guide pin and through the incision to embed the fastener in the target tissue and provide fixation of the target tissue.
The above object and other objects, features, and advantages of the present invention are more readily understood from a review of the attached drawings and the accompanying specification and claims.
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Freiberg Andrew A.
Goldstein Steven A.
Brooks & Kushman P.C.
Robert Eduardo C.
Smith Jeffrey A.
The Regents of the University of Michigan
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