Surgery – Instruments – Orthopedic instrumentation
Reexamination Certificate
1998-02-19
2001-10-30
Reip, David O. (Department: 3731)
Surgery
Instruments
Orthopedic instrumentation
C606S080000
Reexamination Certificate
active
06309396
ABSTRACT:
BACKGROUND OF THE INVENTION
This invention relates to a tool for inserting an intramedullary guide wire.
Over the past twenty years, closed intramedullary rodding of the fractured femur has become a standard procedure. The procedure involves making a hole at the proximal end (top) of the femur, aligned with the femoral medullary canal, the inserting a guide wire through the hole into the canal, and then passing reamers down over the guide wire to enlarge the canal sufficiently that a long metal nail of sufficient diameter to reinforce and maintain alignment and orientation of the bone while it is healing may be inserted substantially the full length of the canal. Several difficult steps of this procedure have been simplified with new techniques and instrumentation, but accurate swift placement of the intramedullary guide wire is still a problem demanding time and tedious dissection.
Inserting a guide wire into the intramedullary canal of the femur would be much simpler if the surgeon could “see” along the axis of the canal. The leg is generally adducted (bent inward at the hip) to improve the situation, but the leg simply cannot be adducted enough so that the canal axis projects clear of the abductor muscle to allow straight insertion of a guide wire. In most cases, an attempt to insert a guide wire into the cancellous bone of the greater trochanter produces a deviated hole, and abrupt contact with the medial cortex, as shown in FIG.
1
.
SUMMARY OF THE INVENTION
An object of the invention is to bend a guide wire so that its point can be drilled into the proximal femur while the remainder and the guide wire are positioned off to the side, away from the bulk of muscle and soft tissue between the greater trochanter and the iliac crest. This technique obviates the need to dissect the area of the piriformus fossa under direct vision. And there is no need to use an awl to open the femoral canal. Rather, the canal is opened by sliding an end-cutting reamer directly down the guide wire to the cortex and then turning the reamer. The present invention is intended to reduce the time required for guide wire placement, reduce bloody dissection near the bone, and thus reduce postoperative morbidity.
These and other objects are met by a tool for inserting an intramedullary guide wire, the tool having a curved metal guide tube with a through lumen and a sharp pointed bevel at its distal end, a handle for manipulating the tube, and a sighting guide affixed to the tube. The curvature of the guide tube enables the surgeon to align a drilling tool passed through the lumen with the axis of the femoral canal. The sighting guide has a straight distal portion parallel to a line tangent to the lumen axis at the distal end, so that the surgeon can better judge the position and orientation of the tip of the tool within the patient.
REFERENCES:
patent: 3439671 (1969-04-01), Kuntscher
patent: 5624447 (1997-04-01), Myers
Self Guiding Femoral AWL, Orthopaedic Designs Inc., Undated.
Fracture Management, Surgical Technique, ZMS Intramedullary Fixation with the ZMS Recon Nail, pp. 1-25, Richard F. Kyle, M.D., Chairman, Undated.
The Uniflex Nailing System, Surgical Technique, pp. 1-17, Biomet. Inc., Undated.
Reip David O.
Shoemaker and Mattare
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