Device and method for producing osteotomies

• US 6,027,504 A
• Filed: 12/05/1997
• Issued: 02/22/2000
• Est. Priority Date: 12/06/1996
• Status: Expired due to Term

• Current Assignee: David A. Mcguire
• Original Assignee: David A. Mcguire
• Inventors: McGuire, David A.
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): REIP, DAVID OWEN
• Application Number:
  US08/985,568
• Time in Patent Office: 809 Days
• Field of Search: 606/72, 606/73, 606/75, 606/79, 606/86, 606/87, 606/88, 606/89, 606/102, 606/104, 606/77, 128/898
• US Class Current: 606/87
• CPC Class Codes: A61B 17/0206 with antagonistic arms as supports for retractor elements
• CPC Class Codes: A61B 17/15 Guides therefor arrangements for guiding straight saw blades in general B23D51/025
• CPC Class Codes: A61B 17/151 for corrective osteotomy
• CPC Class Codes: A61B 17/171 for external fixation
• CPC Class Codes: A61B 17/66 Alignment, compression or distraction mechanisms
• CPC Class Codes: A61B 17/683 comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut
• CPC Class Codes: A61B 17/8891 at its periphery
• CPC Class Codes: Y10S 606/907 Composed of particular material or coated
• CPC Class Codes: Y10S 606/916 Tool for installing or removing orthopedic fastener

Abstract

Devices and methods for producing minimally invasive osteotomies to correct angular deformities of bones in and about the knee are disclosed. The method includes locating a plane in which the angle exhibited by the deformity is situated. An oblique cut is then made along a surface of the bone, such that the cut is transverse to the plane in which the angle is situated. Thereafter, the bone pieces are rotated about the cut relative to one another until a desired alignment between the bone pieces is achieved. To maintain the bone pieces in alignment, a device having an elongated body for extending into a tunnel between the bone pieces is provided. The device also includes a rigid member fixedly positioned at one end of the body. The rigid member is transverse to the body to engage one bone piece. The device further includes a locking mechanism at an opposite end of the body to engage the other bone piece. The device permits the bone pieces to be pulled against one another between the rigid member and the locking mechanism.

Claims

1. A method for producing osteotomy in a bone having a width and an angle of deformity, the method comprising the steps of:

(a) drilling a tunnel through a surface of the bone, such that the tunnel is transverse to a plane in which the angle of deformity is situated;

(b) making an oblique cut partially across the bone, such that the cut is transverse to the plane in which the angle of deformity is situated and at an angle to the tunnel;

(c) securing the bone about the cut;

(d) completing the oblique cut across the bone to form two bone pieces, each including a portion of the tunnel; and

(e) rotating the bone pieces about the tunnel and relative to one another until a desired alignment is achieved.

2. A method according to claim 1, wherein the step of securing in step (c) includes placing a device through the tunnel so as to subsequently maintain the bone pieces in approximation.

3. A method according to claim 2 further comprising:

(f) tightening the device, such that the bone pieces are pulled against one another at the cut in a direction transverse to the cut, so that the bone pieces may remain in close approximation and alignment.

4. A method according to claim 1, wherein the step of securing in step (c) includes affixing a supporting framework to the bone so as to maintain the bone pieces in position after completing the oblique cut.

5. A method for producing osteotomy in a bone having a width and an angle of deformity, the method comprising the steps of:

(a) providing a pivotable support structure to support the bone in position;

(b) positioning the support structure along a surface of the bone parallel to a plane in which the angle of deformity is situated;

(c) drilling a tunnel through the bone from the surface along which the structure is positioned, so that the tunnel is through to the plane in which the angle of deformity is situated;

(d) forming a oblique cut partially across the bone, so as to intersect the tunnel at an angle;

(e) positioning a bone anchor through the tunnel;

(f) completing the oblique cut across the bone so that two bone pieces are formed; and

(g) pivoting one bone piece about the bone anchor relative to the other bone piece until a desired alignment between the pieces is achieved.

6. A method according to claim 5, wherein in the step of drilling in step (c) further includes drilling through a goniometer attached to the support structure adjacent the angle of deformity.

7. A method according to claim 5, wherein the oblique cut in the step of forming in step (d) is formed about two third to three quarter of the way across the width of the bone.

8. A method according to claim 5, wherein the step of pivoting in step (g) further includes pivoting the support structure.

9. A method according to claim 5, wherein the desired alignment in the step of pivoting in step (g) is measured by a goniometer.

10. A method according to claim 5 further comprising:

(h) securing the bone anchor within the tunnel so as to pull the bone pieces together at the cut to maintain the pieces in approximation; and

(i) removing the support from the bone.

11. A method according to claim 5, wherein the bone anchor positioned through the tunnel in the step of positioning includes:

an elongated body having a distal end and a proximal end;

a rigid member fixedly positioned at the distal end transverse to the body to engage one bone piece; and

a locking mechanism at the proximal end of the body to engage the other bone piece, such that the bone pieces may be pulled against one another between the rigid member and the locking mechanism.

12. A method according to claim 11, wherein the oblique cut in the step of forming in step (d) is formed about two third to three quarter of the way across the width of the bone.

13. A method according to claim 5, wherein the bone anchor positioned through the tunnel in the step of positioning includes:

an anchoring member for engaging against one bone piece;

a cannulated extension perpendicularly fixed at one end to the member for extending into a tunnel between the bone pieces; and

a securing member for engaging an end of the extension opposite the anchoring member to secure the bone pieces against one another.

14. A method for relieving contact pressure between a first bone having an angle of deformity and a second bone, the method comprising the steps of:

(a) drilling a tunnel through a surface of the first bone, such that the tunnel is transverse to a plane in which the angle is situated;

(b) making an oblique cut partially across the first bone on a surface parallel to the tunnel, the cut being at an angle to the tunnel to permit the first bone, when realigned, to reduce the contact pressure between the first bone and the second bone;

(c) securing the bone about the oblique cut;

(d) determining the amount angular correction needed, so as to bring the contact pressure within a physiologic tolerance;

(e) completing the oblique cut across the bone to form two bone pieces, each including a piece of the tunnel; and

(f) rotating the bone pieces about the tunnel and relative to one another until a an alignment conforming to the determined angular correction is achieved.

15. A method according to claim 14, wherein oblique cut in step (b) is formed so that it intersects the tunnel at an angle.

16. A method according to claim 14, wherein the step of securing in step (c) includes affixing a supporting framework to the bone.

17. A method according to claim 14, wherein the step of securing in step (c) includes placing a device through the tunnel so as to subsequently maintain the bone pieces in approximation.

18. A method according to claim 17 further comprising:

(g) tightening the device, such that the bone pieces are pulled against one another at the cut in a direction transverse to the cut, so that the bone pieces may remain in close approximation and alignment.

19. A method according to claim 17, wherein the device placed through the tunnel in the step of securing in step (c) includes:

an elongated body having a distal end and a proximal end;

a rigid member fixedly positioned at the distal end transverse to the body to engage one bone piece; and

a locking mechanism at the proximal end of the body to engage the other bone piece, such that the bone pieces may be pulled against one another between the rigid member and the locking mechanism.

20. A method according to claim 19, wherein the step of determining in step (d) includes placing a pressure transducer between the first and second bones so as to measure the contact pressure therebetween.

21. A method according to claim 14, wherein the step of determining in step (d) includes placing a pressure transducer between the first and second bones so as to measure the contact pressure therebetween.