Apparatus and methods for bone access and cavity preparation

• US 8,961,518 B2
• Filed: 01/19/2011
• Issued: 02/24/2015
• Est. Priority Date: 01/20/2010
• Status: Active Grant

• Current Assignee: Conventus Orthopaedics, Inc.
• Original Assignee: Conventus Orthopaedics, Inc.
• Inventors: Hertel, Stefan J., Peterson, Alex A., Brenzel, Michael P., Kruse, Steve D., Krinke, Todd A., Hindrichs, Paul, Taylor, Kyle
• Primary Examiner(s): WOODALL, NICHOLAS W
• Application Number:
  US13/009,657
• Publication Number:
  US 20110190832A1
• Time in Patent Office: 1,497 Days
• Field of Search: 606 79- 81
• US Class Current: 606/79
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1617 with mobile or detachable parts
• CPC Class Codes: A61B 17/1637 Hollow drills or saws producing a curved cut, e.g. cylindrical A61B10/025, A61B17/1695 take precedence
• CPC Class Codes: A61B 17/164 intramedullary
• CPC Class Codes: A61B 17/1662 for particular parts of the body
• CPC Class Codes: A61B 17/1671 for the spine
• CPC Class Codes: A61B 17/1703 using imaging means, e.g. by X-rays
• CPC Class Codes: A61B 17/1725 for applying transverse screws or pins through intramedullary nails or pins
• CPC Class Codes: A61B 17/1782 for the hand or wrist

Abstract

Apparatus and methods for preparing the interior of a bone for therapy. The therapy may include therapy for a bone fracture. The apparatus and methods may involve orienting a surgical instrument for proper deployment in the interior of the bone. An instrument guide may be positioned and retained against translation along, and rotation about one or more of three substantially orthogonal axes. Apparatus placed exterior to the bone may register the guide to a region inside the bone that is designated for preparation or treatment. One or more broaching members may be used to prepare the region for treatment. A broaching member may be expandable inside the bone. A broaching member may be flexible such that it broaches bone having a relatively lower density and it leaves bone having a relatively higher density substantially intact.

Claims

1. Apparatus for broaching a bone, the apparatus comprising;

a rotator defining a first axis; and

a broaching member including an edge fixed to the rotator and configured to be moved relative to the rotator to displace first bone material that is radially away from the rotator, a distal end of the broaching member looping through a distal end of the rotator to form a loop about a second axis that is transverse to the first axis so that in operation a section of the broaching member extends away from the loop and deflects around second bone material, the second bone material having a higher density than the first bone material.

2. The apparatus of claim 1 wherein the broaching member is configured to form in the bone a space having a first contour that corresponds to a shape of the broaching member and a second contour that corresponds to anatomy of the second bone material.

3. The apparatus of claim 2 wherein:

the section of the broaching member is a first section; and

the broaching member comprises a second section that is disposed opposite the first section of the broaching member.

4. The apparatus of claim 1 wherein operationally the section deflects around the second bone material more than the section deflects around the first bone material.

5. The apparatus of claim 1 wherein the loop is disposed about a transverse member that is coupled to the rotator.

6. The apparatus of claim 5 wherein

the transverse member is supported by the distal end of the rotator.

7. The apparatus of claim 1 wherein the loop is looped at least one full turn about a transverse member that is supported by the distal end of the rotator.

8. The apparatus of claim 7 wherein

the transverse member has a lengthwise axis that is transverse to the first axis.

9. The apparatus of claim 8 wherein the lengthwise axis intersects the first axis.

10. The apparatus of claim 8 wherein the first axis is a central axis of the rotator.

11. The apparatus of claim 8 wherein the lengthwise axis is the second axis.

12. The apparatus of claim 1 wherein

the loop comprises a broaching member segment that is wrapped about a transverse member that is supported by the distal end of the rotator.

13. The apparatus of claim 12 wherein the segment is wrapped at least one full turn around the transverse member.

14. The apparatus of claim 12 wherein the segment traverses more than one time a distal portion of the transverse member.

15. The apparatus of claim 12 wherein the segment biases the first broaching member section away from the first axis, the first axis being a central axis of the rotator.

16. The apparatus of claim 12 wherein the transverse member has a lengthwise axis that is transverse to the first axis.

17. The apparatus of claim 16 wherein the lengthwise axis intersects the first axis.

18. The apparatus of claim 16 wherein the first axis is a central axis of the rotator.

19. The apparatus of claim 16 wherein the lengthwise axis is the second axis.

20. The apparatus of claim 1 wherein:

the section is a first section;

the broaching member is monolithic and comprises a second section, opposite the first section, that extends away from the loop;

the loop expands the broaching member radiallv outward front the rotator by biasing the first and second sections away from each other.

21. The apparatus of claim 1 wherein the broaching member includes a first proximal end and a second proximal end.

22. The apparatus of claim 21 wherein:

the first proximal end is fixed to the rotator at a first position;

the second proximal end is fixed to the rotator at a second position; and

the first position is, relative to the rotator, diametrically opposite the second position.

23. The apparatus of claim 22 wherein the loop applies to the first proximal end and the second proximal end a force that is directed radially away from the first axis of the rotator.

24. The apparatus of claim 23 wherein the first axis is a central axis of the rotator.

25. The apparatus of claim 1 wherein the rotator includes an end cap disposed distal the loop.

26. The apparatus of claim 25 wherein the end cap has a smooth, atraumatic surface.

27. The apparatus of claim 25 wherein the distal end of the rotator includes a channel proximal the end cap, the loop looping about a transverse member that is disposed in the channel.

28. The apparatus of claim 1 further comprising:

a pin; and

a cylindrical form supported by the pin, wherein the loop is supported by the cylindrical form.

29. The apparatus of claim 28 wherein the cylindrical form is coaxially mounted on the pin.

30. The apparatus of claim 28 wherein the loop has an orientation and the cylindrical form constrains the orientation.

32. The apparatus of claim 28 wherein the cylindrical form is fixed, relative to the first axis of the rotator.

33. The apparatus of claim 32 wherein the first axis is a central axis of the rotator.

34. The apparatus of claim 28 wherein the cylindrical form is rotatable relative to the rotator.

35. The apparatus of claim 1 wherein the first axis is a central axis of the rotator.

31. The apparatus 30 wherein the distal end of the broaching member is fixed to the cylindrical form.

36. Apparatus for broaching a bone, the apparatus comprising:

a rotator defining a first axis; and

a broaching member including an edge fixed to the rotator and configured to be moved relative to the rotator to displace first bone material that is radially away from the rotator, the broaching member looping about a portion of a distal end of the rotator to form a loop about a second axis that is transverse to the first axis so that in operation a section of the broaching member extends away from the loop and deflects around second bone material, the second bone material having a higher density than the first bone material.

37. The apparatus of claim 36 wherein the broaching member is configured to form in the bone a space having a first contour that corresponds to a shape of the broaching member and a second contour that corresponds to anatomy of the second bone material.

38. The apparatus of claim 36 wherein:

the section of the broaching member is a first section; and

the broaching member comprises a second section that is disposed opposite the first section of the broaching member.

39. The apparatus of claim 36 wherein operationally the section deflects around the second bone material more than the section deflects around the first bone material.

40. The apparatus of claim 36 wherein the loop is disposed about a transverse member that is coupled to the rotator.

41. The apparatus of claim 40 wherein

the transverse member is supported by the distal end of the rotator.

42. The apparatus of claim 36 wherein the loop is looped at least one full turn about a transverse member that is supported by the distal end of the rotator.

43. The apparatus of claim 42 wherein

the transverse member has a lengthwise axis that is transverse to the first axis.

44. The apparatus of claim 43 wherein the lengthwise axis intersects the first axis.

45. The apparatus of claim 43 wherein the first axis is a central axis of the rotator.

46. The apparatus of claim 43 wherein the lengthwise axis is the second axis.

47. The apparatus of claim 36 wherein:

the loop comprises a broaching member segment that is wrapped about a transverse member that is supported by the distal end of the rotator.

48. The apparatus of claim 47 wherein the segment is wrapped at least one full turn about the transverse member.

49. The apparatus of claim 47 wherein the segment traverses more than one time a distal portion of the transverse member.

50. The apparatus of claim 47 wherein the segment biases the first broaching member section away from the first axis, the first axis being a central axis of the rotator.

51. The apparatus of claim 47 wherein the transverse member has a lengthwise axis that is transverse to the first axis.

52. The apparatus of claim 51 wherein the lengthwise axis intersects the first axis.

53. The apparatus of claim 51 wherein the first axis is a central axis of the rotator.

54. The apparatus of claim 51 wherein the lengthwise axis is the second axis.

55. The apparatus of claim 36 wherein:

the section is a first section;

the broaching member is monolithic and comprises a second section, opposite the first section, that extends away from the loop;

the loop expands the broaching member radial outward from the rotator by biasing the first and second sections away from each other.

56. The apparatus of claim 36 wherein the broaching member includes a first proximal end and a second proximal end.

57. The apparatus of claim 56 wherein:

the first proximal end is fixed to the rotator at a first position;

the second proximal end is fixed to the rotator at a second position; and

the first position is, relative to the rotator, diametrically opposite the second position.

58. The apparatus of claim 57 wherein the loop applies to the first proximal end and the second proximal end a force that is directed radially away from the first axis of the rotator.

59. The apparatus of claim 58 wherein the first axis is a central axis of the rotator.

60. The apparatus of claim 36 wherein the rotator includes an end cap disposed distal the loop.

61. The apparatus of claim 60 wherein the end cap has a smooth, atraumatic surface.

62. The apparatus of claim 60 wherein the distal end of the rotator includes a channel proximal the end cap, the loop looping about a transverse member that is disposed in the channel.

63. The apparatus of claim 36 further comprising:

a pin; and

a cylindrical form supported by the pin, wherein the loop is supported by the cylindrical form.

64. The apparatus of claim 63 wherein the cylindrical form is coaxially mounted on the pin.

65. The apparatus of claim 63 wherein the loop has an orientation and the cylindrical form constrains the orientation.

66. The apparatus of claim 65 wherein the distal end of the broaching member is fixed to the cylindrical form.

67. The apparatus of claim 63 wherein the cylindrical form is fixed, relative to the first axis of the rotator.

68. The apparatus of claim 67 wherein the first axis is a central axis of the rotator.

69. The apparatus of claim 63 wherein the cylindrical form is rotatable relative to the rotator.

70. apparatus of claim 36 wherein the first axis is a central axis of the rotator.

71. Apparatus for broaching a bone, the apparatus comprising:

a rotator defining a first axis; and

a broaching member including an edge fixed to the rotator and configured to be moved relative to the rotator to displace first bone material that is radially away from the rotator, a distal end of the broaching member looping about a distal end of the rotator to form a loop about a second axis that is transverse to the first axis so that in operation a section of the broaching member extends away from the loop and deflects around second bone material, the second bone material having a higher density than the first bone material.

72. The apparatus of claim 71 wherein the broaching member is configured to form in the bone a space having a first contour that corresponds to a shape of the broaching member and a second contour that corresponds to anatomy of the second bone material.

73. The apparatus f claim 71 wherein:

the section of the broaching member is a first section; and

the broaching member comprises a second section that is disposed opposite the first section of the broaching member.

74. The apparatus of claim 71 wherein operationally the section deflects around the second bone material more than the section deflects around the first bone material.

75. The apparatus of claim 71 wherein the loop is disposed about a transverse member that is coupled to the rotator.

76. The apparatus of claim 75 wherein

the transverse member is supported by the distal end of the rotator.

77. The apparatus of claim 71 wherein the loop is looped at least one full turn about a transverse member that is supported by the distal end of the rotator.

78. The apparatus of claim 77 wherein

the transverse member has a lengthwise axis that is transverse to the first axis.

79. The apparatus of claim 78 wherein the lengthwise axis intersects the first axis.

80. The apparatus of claim 78 wherein the first axis is a central is of the rotator.

81. The apparatus us of claim 78 wherein the lengthwise axis is the second axis.

82. The apparatus of claim 71 wherein:

the loop comprises a broaching member segment that is wrapped about a transverse member that is supported by the distal end of the rotator.

83. The apparatus of claim 82 wherein the segment is wrapped at least one full turn about the transverse member.

84. The apparatus of claim 82 wherein the segment traverses more than one time a distal portion of the transverse member.

85. The apparatus of claim 82 wherein the segment biases the first broaching member section away from the first axis, the first axis being a central axis of the rotator.

86. The apparatus of claim 82 wherein the transverse member has a lengthwise axis that is transverse to the first axis.

87. The apparatus of claim 86 wherein the lengthwise axis intersects the first axis.

88. The apparatus of claim 86 wherein the first axis is a central axis of the rotator.

89. The apparatus of claim 86 wherein the lengthwise axis is the second axis.

90. The apparatus of claim 71 wherein:

the section is a first section;

the broaching member is monolithic and comprises a second section, opposite the first section, that extends away from the loop;

the loop expands the broaching radially outward from the rotator by biasing the first and second sections away from each other.

91. The apparatus of claim 71 wherein the broaching member includes a first proximal end and a second proximal end.

92. The apparatus of claim 91 wherein:

the first proximal end is fixed to the rotator at a first position;

the second proximal end is fixed to the rotator at a second position; and

the first position is, relative to the rotator, diametrically opposite the second position.

93. The apparatus of claim 92 wherein the loop applies to the first proximal end and the second proximal end a force that is directed radially away from the first axis of the rotator.

94. The apparatus of claim 93 wherein the first axis is a central axis of the rotator.

95. The apparatus of claim 71 wherein the rotator includes an end cap disposed distal the loop.

96. The apparatus of claim 95 wherein the end cap has a smooth, atraumatic surface.

97. The apparatus of claim 95 wherein the distal end of the rotator includes a channel proximal the end cap, the loop looping about a transverse member that is disposed in the channel.

98. The apparatus of claim 71 further comprising:

a pin; and

a cylindrical form supported by the pin, wherein the loop is supported by the cylindrical form.

99. The apparatus of claim 98 wherein the cylindrical form is coaxially mounted on the pin.

100. The apparatus of claim 98 wherein the loop has an orientation and the cylindrical form constrains the orientation.

101. The apparatus of claim 100 wherein the distal end of the broaching member is fixed to the cylindrical form.

102. The apparatus of claim 98 wherein the cylindrical form is fixed, relative to the first axis of the rotator.

103. The apparatus of claim 102 wherein the first axis is a central axis of the rotator.

104. The apparatus of claim 98 wherein the cylindrical form is rotatable relative to the rotator.

105. The apparatus of claim 71 wherein the first axis is a central axis of the rotator.