System and method for interosseous ligament reconstruction

• US 10,639,050 B2
• Filed: 10/02/2017
• Issued: 05/05/2020
• Est. Priority Date: 10/02/2017
• Status: Active Grant

• Current Assignee: Robin Kamal
• Original Assignee: Robin Kamal
• Inventors: Kamal, Robin
• Primary Examiner(s): Weiss, Jessica
• Application Number:
  US15/722,671
• Publication Number:
  US 20190099192A1
• Time in Patent Office: 946 Days
• Field of Search: 606 96- 98
• CPC Class Codes: A61B 17/1782 for the hand or wrist
• CPC Class Codes: A61B 17/7291 for small bones, e.g. in the foot, ankle, hand or wrist
• CPC Class Codes: A61F 2/0811 Fixation devices for tendons or ligaments
• CPC Class Codes: A61F 2/28 Bones joints A61F2/30

Abstract

A method for interosseous ligament reconstruction (e.g., of a scapholunate or lunotriquetral ligament) includes drilling holes through both of the bones to allow for a graft to be placed on the volar and dorsal aspects of the bones, replicating the normal anatomic structure of the interosseous ligament, while requiring only an incision on the dorsal side of the wrist. The method includes using a drill guide that directs the drill to place a drill hole from dorsal to volar (front to back) in the bone, while making sure the drilled hole is within the joint on the volar side. The drill guide includes a hollow guide tube to advance a drill through, the hollow tube movably coupled to a shaft of the drill guide with a distal end that generally aligns with the distal end of the hollow tube. The shaft can have a sharp end that the drill will meet if passed through the drill guide, the sharp end of the drill guide being either hollow or solid, and can serve to release part of the wrist capsule (volar extrinsic carpal ligaments) from the bone in order to keep the drill hole within the wrist joint (and not outside of the joint).

Claims

1. A drill guide for use in interosseous ligament reconstruction of a wrist, comprising:

a monolithic shaft comprising a proximal end, a distal end defining a distal-most edge, a central axis, an elongated proximal portion that extends along the central axis of the shaft, and a curved distal portion that extends to the distal-most edge of the shaft, wherein the shaft is hollow along its entire length, wherein the entirety of the distal-most edge extends substantially perpendicular to the central axis of the shaft, and wherein the distal-most edge defines an opening configured to receive a drill bit therein;

a handle coupled to the proximal end of the shaft;

and

a monolithic hollow tube extending along a central axis from a proximal end to a distal end and having a bore configured to receive a drill bit therethrough, the hollow tube laterally spaced apart from the shaft by one or more supports, each of the one or more supports coupled to both the shaft and the hollow tube, the distal end of the hollow tube spaced apart from the distal-most edge of the shaft to define an adjustable opening therebetween configured to receive a human wrist therein, the hollow tube being movably coupled relative to the shaft by a sliding mechanism configured to allow the hollow tube to move in a direction parallel to the central axis of the shaft in order to vary a size of the adjustable opening, wherein the hollow tube is selectively movable by a user to adjust the size of the adjustable opening about the user'"'"'s wrist such that the distal end of the hollow tube is configured to contacts a dorsal side of a wrist bone and the distal-most edge of the shaft is configured to be positioned proximal to a volar side of the wrist bone, and

wherein the distal-most edge of the shaft is configured to be used to release ligaments from the volar side of the wrist bone so that the drill bit can be extended through the hollow tube and through the wrist bone to the distal-most edge of the shaft while avoiding ligaments and nerves on the volar side of the wrist.

2. The drill guide of claim 1, wherein one or both of the distal end of the shaft and the distal end of the hollow tube are made of a radiopaque material.

3. The drill guide of claim 2, wherein a remainder of the one or both of the shaft and the hollow tube are made of a radiolucent material.

4. The drill guide of claim 1, wherein the shaft is configured to receive a suture therethrough to direct the suture through one or more holes formed in the wrist bone.