Drill/driver hybrid instrument for interphalangeal fusion

Patent metadata

Field	Value
Publication number	US-9687256-B2
Application number	US-201414206885-A
Country	US
Kind code	B2
Filing date	Mar 12, 2014
Priority date	Mar 13, 2013
Publication date	Jun 27, 2017
Grant date	Jun 27, 2017

Abstract

Surgical techniques, instruments and systems for bone fusions and repairs (for example, phalangeal fusion) which allow alignment of small bones (for example, phalanges) without the use of guidewire and cannulated instrumentation such as, for example, drills and drivers, and cannulated screws. A drill/driver hybrid instrument (a combined drill/driver device) may be used in fusion of two small bones (for example, in interphalangeal fusion). One end of the hybrid instrument is provided with a plurality of flutes so that the instrument can be used as a drill to remove bone. The other end is shaped to mate with a device to be inserted intraarticularly (for example, interphalangeally), acting as a driver for that device.

First claim

What is claimed is:

1. A method of repairing two bones of an articular joint, comprising the steps of:
drilling a first hole in a first bone with a first end of a hybrid drill/driver instrument;
inserting a fixation device within the first hole;
securing the fixation device within the first hole with a second end of the hybrid drill/driver instrument;
drilling a second hole through a second bone with the first end of the hybrid drill/driver instrument such that at least a portion of the hybrid drill/driver is received in the second hole;
engaging the second end of the hybrid drill/driver instrument into an end of the fixation device; and
driving the fixation device with the second end of the hybrid drill/driver instrument into the second bone to align the first bone to the second bone.

2. The method of claim 1 , wherein the first bone is the proximal phalanx and the second bone is the middle phalanx.

3. The method of claim 1 , wherein the first end of the hybrid drill/driver instrument is provided with a plurality of drill flutes or threads to facilitate drilling of the first hole, and wherein the second end is provided with a drive head configured to engage and mate with a socket of the fixation device to facilitate driving of the fixation device within the first hole.

4. The method of claim 1 , wherein the hybrid drill/driver instrument has a diameter of about 1.0 to about 4.5 mm.

5. The method of claim 1 , wherein the hybrid drill/driver instrument has a diameter of about 1.5 to about 2.0 mm.

6. The method of claim 1 , wherein the fixation device is a screw with a proximal thread provided at a proximal end of the screw and a separated distal thread provided at the distal end of the screw, the proximal and distal threads are opposing threads.

7. A method of bone fusion and repair, comprising the steps of:
drilling a first tunnel in a first bone fragment;
threading an end of a rigid fixation device in the first tunnel in the first bone fragment;
drilling a second tunnel in a second bone fragment;
threading an opposite end of the rigid fixation device in the second tunnel in the second bone fragment to align the second bone fragment to the first bone fragment;
wherein the fixation device includes a proximal thread provided at a proximal end of the fixation device and a separated distal thread provided at the distal end of the fixation device, and the proximal and distal threads are opposing threads such that the opposite end is threaded into the second tunnel at least partially simultaneously with the threading of the end into the first tunnel; and
wherein the drilling and the threading are performed using a single drill/drive pin.

8. The method of claim 7 , wherein all steps are conducted intraarticularly.

9. The method of claim 7 , wherein the drill/drive pin includes a first end having a plurality of drilling flutes or threads and a second end having a drive head to engage and mate with the fixation device and comprising the steps of:
drilling the first tunnel with the first end of the drill/drive pin;
drilling the second tunnel with the first end of the drill/drive pin; and
engaging the opposite end of the rigid fixation device with the second end of the drill/drive pin and securing the rigid fixation device across the first and second bone fragments to complete the bone fusion and repair.

10. The method of claim 7 , wherein the rigid fixation device has a diameter of 4.5 mm or less.

11. The method of claim 10 , wherein the rigid fixation device has a diameter of 2.0 mm or less.

12. The method of claim 7 , wherein the rigid fixation device is a screw with a length of about 12 to 40 mm.

13. The method of claim 12 , wherein the rigid fixation device is a screw with a length of about 20 to 40 mm.

14. The method of claim 7 , wherein the first and second bone fragments are adjacent phalanges, metatarsals, metacarpals, tarsals or carpal bones.

15. A method of installing a fixation device across a DIPJ or PIPJ joint, comprising the steps of:
partially inserting a fixation device within a first tunnel of a first bone of a DIPJ or PIPJ joint, the fixation device being provided with a first set of threads at a first end and a separate, second set of threads at a second end, wherein the first and second set of threads are opposing threads, so that the first set of threads is at least partially within the first tunnel;
securing the second set of threads within a second tunnel of an adjacent second bone of the DIPJ or PIPJ joint simultaneously with moving the first set of threads within the first tunnel, so that the fixation device extends across the first and second bones of the DIPJ or PIPJ joint, to join together the first and second bones; and
wherein the first tunnel and the second tunnel are formed by a drill end of a hybrid drill/drive instrument and the fixation device is inserted into the first tunnel and the second tunnel by a drive end of the hybrid drill/drive instrument.

16. The method of claim 15 , wherein the first set of threads has a direction opposite the second set of threads.

17. A method of fusion of small bones by a minimally invasive technique, comprising the steps of:
forming a first bone tunnel or socket with one end of a drill/driver hybrid instrument in a first small bone;
engaging a fixation device with the other end of the drill/driver hybrid instrument and inserting a first end of the fixation device into the first bone tunnel or socket;
forming a second bone tunnel or socket with the one end of the drill/driver hybrid instrument in a second small bone; and
engaging a second end of the fixation device with the other end of the drill/driver hybrid instrument to align the first and second small bones, the second end of the fixation device being opposite the first end.

18. The method of claim 17 , wherein the first and second small bones form an interphalangeal joint.

19. The method of claim 17 , wherein the fixation device is a compression screw provided with a first set of threads at a proximal end of the screw and a separate, second set of threads at a distal end of the screw, so that the first set of threads has an orientation and direction different from the orientation and direction of the second set of threads.

20. The method of claim 19 , wherein the compression screw is fully solid and non-cannulated.

21. A joint repair method, comprising:
drilling a first bone tunnel in a first bone with a first end of a hybrid drill/driver instrument;
inserting a fixation device partially into the first tunnel;
drilling a second bone tunnel through a second bone with the first end of the hybrid drill/driver instrument;
engaging a second end of the hybrid drill/driver instrument with an end of the fixation device while at least a portion of the hybrid drill/driver is still received in the second bone tunnel; and
turning the hybrid drill/driver instrument to simultaneously move the fixation device into the second bone tunnel and further into the first bone tunnel to align the first bone to the second bone.

22. The joint repair method of claim 21 , wherein drilling the second bone tunnel includes drilling through the second bone until the first end of the hybrid drill/driver instrument protrudes from a tip of the second bone.

23. The joint repair method of claim 22 , comprising moving a handle from the second end of the hybrid drill/driver instrument to the first end after drilling the second tunnel, wherein moving th

Assignees

• Arthrex Inc

Inventors

• Granberry William M
• Bare Stephanie A
• Powell Chris M

Classifications

• A61B17/863

  with thread interrupted or changing its form along shank, other than constant taper · CPC title

• A61B17/7291

  for small bones, e.g. in the foot, ankle, hand or wrist · CPC title

• A61B17/1682 Primary

  for the foot or ankle · CPC title

• B25F3/00

  Associations of tools for different working operations with one portable power-drive means; Adapters therefor · CPC title