Tibia aiming clamp

Abstract

A aiming jig for a tibial plate includes a head portion interfacing a head portion of the tibial plate, the head portion including: a screw guide hole corresponding to a screw hole in the head portion of the tibial plate; a fixation protrusion that engages a fixation opening in the head of the tibial plate, where engagement of the fixation protrusion with the fixation opening aligns the head with the head of the tibial plate; and an arm extending from the head, the arm comprising a guide, where the guide is configured to extend along an anterior portion of a tibia when the aiming clamp is secured to the tibial plate, and the guide comprising a support screw guide hole, the support screw guide hole guides a support screw to be placed into the tibia in a generally anterior-to-posterior direction such that the support screw does not interfere with a plate screw placed in the head of the tibial plate.

Description

[0001] Cross Reference to Related Applications This application claims priority to U.S. Non-Provisional Patent Application No. 18 / 352,209, filed July 13, 2023, in the U.S. Patent and Trademark Office, the contents of which are hereby incorporated by reference in their entirety. TECHNICAL FIELD

[0002] Various exemplary embodiments disclosed herein relate to a tibial aiming jig, and in particular to a proximal tibial aiming jig for anterior and posterior screw insertion over a lateral panel raft of screws. BACKGROUND

[0003] Tibial plates have been developed for addressing fractures in the tibia, including fractures of the proximal tibia. A lateral proximal tibial plate can include a head and a body. The body can extend along the tibia and include screw holes such that the tibial plate can be attached to the tibia. The head can include a row of screw holes at an end of the tibial plate. When screws are placed in these holes, they can be used to capture, reduce, and secure fractured bone fragments. This row of screws can be referred to as a raft of screws because they provide a raft-like support to the articular surface of the fractured tibia. In a clinical procedure for addressing fractures of the proximal tibia, isolated screws are often placed from anterior to posterior just over and very close to a proximal-most row of raft screws of a lateral proximal tibial plate. These screws can be referred to as buttress screws. The purpose of these buttress screws is to provide additional stability to the articular surface, which is often comminuted or broken into multiple small fragments. Additionally, these buttress screws allow fixation of posterolateral fracture fragments, which remains a clinical challenge. Further, these buttress screws can provide support to the articular surface as the plate and raft of screws are further away from the articular surface (as they are closer to the articular surface). Also, there is a posterior corner of the tibia adjacent to the fibular head that is difficult to reach with a lateral proximal tibial plate, so these buttress screws can reach this area and provide support to the tibia and can capture, reduce, and secure other bone fragments when repairing the fracture. SUMMARY

[0004] The following presents a summary of various exemplary embodiments.

[0005] Various embodiments relate to an aiming clamp for a tibial plate, the aiming clamp comprising: a head configured to interface with a head of the tibial plate, the head including: a plurality of screw guide holes corresponding to a plurality of screw holes in the head of the tibial plate; a fixing protrusion configured to engage a fixing opening in the head of the tibial plate, wherein engagement of the fixing protrusion with the fixing opening aligns the head with the head of the tibial plate; and an arm extending from the head, the arm including a guide, wherein the guide is configured to extend along an anterior portion of the tibia when the aiming clamp is secured to the tibial plate, and the guide includes a support screw guide hole configured to guide a support screw placed in the tibia in a generally anterior-to-posterior direction, such that the support screw avoids interfering with a plate screw placed in the head of the tibial plate.

[0006] Various embodiments are described, wherein the head further includes a plurality of guide holes corresponding to a plurality of plate guide holes in the tibial plate.

[0007] Various implementations are described in which the arm is configured such that the guide avoids contact with the patient when the aiming clamp is secured to the tibial plate.

[0008] Various implementation schemes are described, in which the guide includes multiple guide holes.

[0009] Various implementations are described, and the aiming clamp also includes a sleeve configured to insert into the support screw guide hole and contact the anterior surface of the tibia.

[0010] Various embodiments are described, and the aiming clamp also includes a retaining pin configured to insert into a retaining opening in the guide, wherein the retaining pin retains the sleeve and secures the sleeve to the guide.

[0011] Various embodiments are described, wherein the support screw guide hole has a position and orientation that allows the support screw to be placed between the plate screw and the articular surface of the tibia.

[0012] Various embodiments are described, wherein the support screw guide hole has such that the support screw is positioned such that a portion of the plate screw is positioned and oriented between the support screw and the articular surface of the tibia.

[0013] Various implementation schemes are described, wherein the end of the support screw is located within the tibia.

[0014] Various embodiments are described, wherein the head includes a fixing screw hole and the aiming clamp includes a fixing screw configured to engage a fixing opening in the tibial plate via the fixing screw hole.

[0015] Various embodiments are described, wherein the head includes a body having a first portion of the plurality of screw guide holes, the first portion being configured to guide a first portion of the plate screw placed in the head of the tibial plate to support the articular surface of the tibia.

[0016] Various embodiments are described, wherein the head includes a flange extending from the body, wherein a second portion of the plurality of screw guide holes is configured to guide a second portion of the plate screw placed in the head of the tibial plate, and wherein the flange includes a fixing screw hole configured to receive a fixing screw, wherein the fixing screw is configured to engage a fixing opening in the tibial plate via the fixing screw hole.

[0017] Other embodiments relate to a method for placing a support screw into the anterior surface of the tibia using an aiming clamp for a tibial plate, the method comprising: placing and aligning the tibial plate onto the tibia; initially securing the tibial plate to the tibia; placing the aiming clamp onto the tibial plate; and using a guide on the aiming clamp to place the support screw in a generally anterior to posterior direction on the tibia such that the support screw avoids interfering with a plate screw placed in the head of the tibial plate.

[0018] Various implementations are described, wherein initial fixation of the tibial plate to the tibia includes placing a plate screw in the tibial plate using a guide hole in the aiming jig.

[0019] Various implementation schemes are described, wherein initial fixation of the tibial plate to the tibia includes placing a K-wire into the tibia through a guide hole in the aiming jig and a plate fixation hole in the tibial plate.

[0020] Various embodiments are described, wherein placing and aligning the tibial plate onto the tibia includes placing a fixing protrusion on the aiming clamp into a fixing opening in the tibial plate.

[0021] Various implementations are described, wherein placing a support screw includes: drilling a hole in the anterior surface of the tibia using a guide; and driving the support screw into the drilled hole using the guide.

[0022] Various implementations are described, wherein drilling the hole includes using a first sleeve in the guide, and driving the support screw includes using a second sleeve in the guide.

[0023] Various implementation schemes are described, including using a retaining pin in the guide to retain the first sleeve via the guide.

[0024] Various implementation schemes are described, in which placing the support screw involves a minimally invasive surgical incision through soft tissue cutting to expose the cortex of the anterior surface of the tibia.

[0025] Various embodiments are described, wherein the aiming clamp includes: a head configured to interface with a head of a tibial plate, the head including: a plurality of screw guide holes corresponding to a plurality of screw holes in the head of the tibial plate; a fixing protrusion configured to engage a fixing opening in the head of the tibial plate, wherein engagement of the fixing protrusion with the fixing opening aligns the head with the head of the tibial plate; and an arm extending from the head, the arm including a guide, wherein the guide extends along an anterior portion of the tibia when the aiming clamp is secured to the tibial plate, and the guide includes a support screw guide hole configured to guide a support screw placed in the tibia in a generally anterior-to-posterior direction, such that the support screw avoids interfering with a plate screw placed in the head of the tibial plate.

[0026] The foregoing has provided a fairly broad overview of the features and technical advantages of the examples according to this disclosure in order to better understand the detailed description that follows. Additional features and advantages will be described below. The disclosed concepts and specific examples can be readily used as the basis for modifying or designing other structures for the same purposes of this disclosure. Such equivalent constructions do not depart from the scope of the appended claims. The characteristics of the concepts disclosed herein (both their organization and manner of operation) and the associated advantages will be better understood from the following description when considered in conjunction with the accompanying drawings. Each drawing in the accompanying drawings is provided for illustrative and descriptive purposes and not as a definition of limitation of the claims. Attached Figure Description

[0027] To gain a more detailed understanding of the foregoing features of this disclosure, reference can be made to various aspects of the brief overview described above, some of which are illustrated in the accompanying drawings. However, it should be noted that the drawings illustrate only certain typical aspects of this disclosure and should not be construed as limiting the scope of the disclosure, as other equivalent aspects are permissible in this description. The same reference numerals in different drawings may identify the same or similar elements.

[0028] Figures 1A-1D The application of the aiming clamp to the tibia is shown.

[0029] Figures 2A-2B The tibial plate, which is mounted on the tibia, is shown.

[0030] Figure 3 A aiming clamp that engages with the tibial plate is shown.

[0031] Figures 4A-4B A top perspective view of the aiming fixture is shown.

[0032] Figure 4C A bottom perspective view of the aiming fixture is shown.

[0033] Figures 4D-4F The top, top, and side views of the aiming fixture are shown.

[0034] Figures 4G-4H Two end views of the aiming clamp are shown.

[0035] Figure 5A The aiming clamp and retaining pin are shown.

[0036] Figures 5B-5C A perspective view of the retaining pin is shown.

[0037] Figures 6A-6B A triple sleeve system is shown, inserted through one of the guide holes in the aiming clamp.

[0038] Figures 7A-7B A perspective view and unfolded view of one construction of a triple sleeve system are shown.

[0039] Figures 7C-7D A perspective view and unfolded view of another construction of the triple sleeve system are shown. Detailed Implementation

[0040] Various aspects of this disclosure are described more fully below with reference to the accompanying drawings. However, this disclosure may be embodied in many different forms and should not be construed as limited to any particular structure or function given throughout this disclosure. Rather, these aspects are provided to make this disclosure thorough and complete and to fully communicate the scope of this disclosure to those skilled in the art. Based on the teachings herein, those skilled in the art will understand that the scope of this disclosure is intended to cover any aspect of this disclosure disclosed herein, whether implemented independently of or in combination with any other aspect of this disclosure. For example, an apparatus or method may be implemented using any number of aspects set forth herein. Furthermore, the scope of this disclosure is intended to cover such apparatuses or methods practiced using structures, functionalities, or structures and functionalities other than or different from the aspects of this disclosure set forth herein. It should be understood that any aspect of this disclosure disclosed herein may be embodied by one or more elements of the claims.

[0041] Several aspects of the bone plate clamping system will now be presented with reference to various devices and techniques. These devices and techniques will be described in detail below and illustrated in the accompanying drawings by various boxes, modules, components, steps, processes, methods, etc. (collectively, “elements”).

[0042] Tibial plates have been developed for resolving fractures in the tibia, including those of the proximal tibia. A laterally proximal tibial plate may comprise a head and a body. The body may extend along the tibia and include screw holes, allowing the tibial plate to be attached to the tibia. The head may include a row of screw holes at the end of the tibial plate. When screws are placed in these holes, they can be used to capture, reduce, and secure fractured bone fragments. This row of screws may be referred to as raft screws because they provide raft-like support to the articular surface of the fractured tibia. In clinical routines for resolving fractures of the proximal tibia, isolated screws are often placed from anterior to posterior, just above and very close to the nearest row of raft screws on the laterally proximal tibial plate. These screws may be referred to as support screws. The purpose of these support screws is to provide additional stability to the articular surface, which is often shattered or broken into multiple small fragments. Additionally, these support screws allow fixation of posterolateral fracture fragments, which remains a clinical challenge. Throughout the tibial plate, screws can be placed in any of the holes to meet the specific clinical requirements of the patient.

[0043] Currently, surgeons position support screws manually because no guiding or assisting devices are available. However, placing the support screw as close as possible to the lateral raft screws is crucial, as these support screws provide resistance against subsidence, which the tibial plate needs to avoid by any means. Therefore, extensive imaging is currently used to place support screws, which results in high radiation exposure. Additionally, surgeons often encounter lateral raft screws while drilling anterior-posterior screw holes. This can lead to damage to these screws and subsequent failures, or drill bit breakage, which can cause difficulties in removing the broken drill tip from the body.

[0044] This document discloses an aiming clamp to assist in the placement of these support screws. The aiming clamp serves as a guide block to aid in the placement of the screws within the tibial plate. The aiming clamp further includes an extension arm extending to the anterior aspect of the tibia, which guides the support screws for insertion over a lateral raft screw in a generally anterior-to-posterior direction. The aiming clamp is placed on the laterally proximal tibial plate. Both the aiming clamp and the tibial plate include interfaces to ensure precise positioning of the clamp. Fixation of the aiming clamp to the tibial plate is achieved, for example, via a screw interface that engages a threaded hole in the tibial plate specifically designed for the aiming clamp or a conventional guide block on the plate. The portion of the aiming clamp on the tibial plate has a similar shape and functionality to a conventional guide block, and therefore also allows for the insertion of a guide nominal screw from a proximal plate hole (in conjunction with, for example, a triple sleeve system used with other systems). The extension arm is designed to remain above the soft tissue. It may include three holes into which a triple sleeve system can be inserted. These sleeves are pushed through the arm and through the soft tissue (possibly with a prior small incision) to reach the bone. The triple sleeve provides options for inserting Kirschner wires, drilling guide holes, and inserting screws. The outer sleeve also allows for screw hole depth measurement using existing depth probes from other systems. In another embodiment, the depth probe can slide over the Kirschner wire to measure hole depth. A calibrated drill bit can also be used to measure depth. In some embodiments, the hole in the extension arm may include a retaining mechanism to prevent the sleeve from slipping out. The distance between the extension arm and the anterior proximal tibial cortex can be optimized to minimize soft tissue interference in minimally invasive, percutaneous applications while ensuring the sleeve always reaches the anterior cortex, regardless of variations in tibial morphology between subjects.

[0045] Figures 1A-1D The application of the aiming clamp 100 to the tibia 2 is shown. The fibula 4 is also shown along with the tibia 2. The tibial plate 6 is attached to the tibia 2 using plate screws 8 through plate screw holes 10 in the tibial plate 6. The aiming clamp 100 is positioned above the head of the tibial plate 6 and properly aligned with the tibial plate 6 through the interface between the aiming clamp 100 and the tibial plate 6. The fixing screw 12 passes through the fixing screw hole 116 (see...). Figure 3 The triple sleeve system 200 is placed in the guide hole 114 of the guide 112 on the aiming clamp 100, as described above.

[0046] Figures 2A-2BA tibial plate 6 mounted on the tibia 2 is shown. The tibial plate 6 has a body that is fixed to the length of the tibia 2 using plate screws 8, which are inserted into the tibia 2 through plate screw holes 10. The plate screw holes 10 can be a combination of threaded and unthreaded portions. The threaded portion can be used with screws having threaded heads. Furthermore, the plate screw holes 10 allow screws to be placed at various angles. The unthreaded portion allows the plate to be compressed into the bone, where screws can also be placed at various angles. Furthermore, the tibial plate 6 includes a head with various plate screw holes 10. The head of the tibial plate 6 is shaped to follow the contour of the tibial condyle. At the end of the head of the tibial plate 6, near the tibial articular surface, there are, for example, four plate screw holes 10 to provide support to the tibial articular surface. These four plate screw holes 10 can receive raft screws. The tibial plate 6 may also have plate guide holes 18. The plate guide holes 18 can be used to place Kirschner wires into the bone during placement of the tibial plate 6.

[0047] The tibial plate 6 may also include threaded plate fixing holes 14. Fixing screws 12 can be inserted through fixing screw holes 116 in the aiming clamp 100 to engage the plate fixing holes 14, thereby securing the aiming clamp 100 to the tibial plate 6. The tibial plate 6 also includes a fixing opening 16 that receives a fixing protrusion 120 on the aiming clamp 100. The fixing opening 16 and the fixing protrusion 120 create an alignment interface that ensures the aiming clamp 100 is properly aligned with the tibial plate 6 when placed on it. Although a tibial plate 6 with a specific number and location of plate screw holes 10, fixing openings 16, and plate guide holes 18 is shown, other numbers and locations of these elements may also be used. In another embodiment, the fixing protrusion 120 may be a single fixing protrusion 120 having a specific shape (e.g., triangular, star-shaped, cross-shaped, etc.) that engages a fixing opening 16 having a complementary shape that guides the aiming clamp 100 to a proper orientation relative to the tibial plate 6. In this case, only a single fixing protrusion 120 and fixing opening 16 may be used. Furthermore, the specific shape of the tibial plate 6 may also be other shapes. In another embodiment, the fixing protrusion 120 and fixing opening 16 may be interchangeable; that is, the tibial plate 6 may have a fixing protrusion, and the aiming clamp 100 may have a fixing opening. Thus, the interface between the tibial plate 6 and the aiming clamp 100 can be generally described as having a first interface element and a second interface element, wherein the first interface element and the second interface element interact to align the tibial plate 6 and the aiming clamp 100. The first interface element and the second interface element are complementary and may include a fixing protrusion and a fixing opening.

[0048] Figure 3A targeting clamp 100 is shown that engages with the tibial plate 6. When the targeting clamp 100 engages with the tibial plate 6, the fixing protrusion 120 engages the fixing opening 16 to align the targeting clamp 100 with the tibial plate 6. Further, the screw guide hole 108 and the Kirschner wire guide hole 118 in the targeting clamp 100 are aligned with the plate screw hole 10 and the plate guide hole 18, respectively. The targeting clamp 100 can be secured to the tibial plate 6 by inserting a fixing screw 12 through the fixing screw hole 116 to engage the plate fixing hole 14. The screw guide hole 108 can be used to assist in guiding the placement of the plate screw 8 in the tibial plate 6. The screw guide hole 108 can guide the drill in a suitable orientation to place the plate screw 8 in the plate screw hole 10 of the tibial plate 6. The screw guide hole 108 can interface with a drill guide used to guide the drill during drilling. For example, an outer sleeve 202 can be used as a drill guide. The position and orientation of the screw guide holes 108 were carefully selected so that the plate screw 8, used as the raft screw, was in a precisely known position so that the support screws could be placed later near the raft screw while avoiding interference with it. Furthermore, these support screws do not extend through or away from the tibia.

[0049] Figures 4A-4B A top perspective view of the aiming clamp 100 is shown. Figure 4C A bottom perspective view of the aiming clamp 100 is shown. Figures 4D-4F The bottom, top, and side views of the aiming fixture 100 are shown. Figures 4G-4H Two end views of the aiming clamp 100 are shown. The aiming clamp 100 includes a head 102 and an arm 110.

[0050] The head 102 may have a shape that generally corresponds to the shape of the head of the tibial plate 6. The head 102 may include a body 104 and a flange 106. In this example, the body is a generally narrow structure having four screw guide holes 108 and three Kirschner wire guide holes 118. Other numbers of screw guide holes 108 and Kirschner wire guide holes 118 may also be used in the body 104. The flange 106 may extend from the body 104 and, in this example, includes two Kirschner wire guide holes 118, two screw guide holes 108, and a fixing screw hole 116. Other numbers of Kirschner wire guide holes 118 and screw guide holes 108 may also be used in the flange 106. The Kirschner wire guide holes 118, screw guide holes 108, and fixing screw holes 116 of the head 102 are aligned with the plate guide hole 18, the plate screw hole 10, and the plate fixing hole 14, respectively. The underside of the head 102 may include a fixing protrusion 120 (i.e., a first interface element). The position of the fixing protrusion 120 corresponds to the position of the fixing opening 16 (i.e., the second interface element) in the tibial plate 6. Three fixing protrusions 120 are shown, but other numbers of fixing protrusions 120 may also be used. In an alternative embodiment, two or more Kirschner wire guide holes 118 may be used to align the aiming clamp 100 to the tibial plate 6. This can be accomplished by driving a Kirschner wire through the plate guide hole 18 into the tibia 2. The aiming clamp 100 can then slide onto the Kirschner wire using the Kirschner wire guide hole 118 corresponding to the position of the Kirschner wire to subsequently engage the tibial plate 6. Once the aiming clamp 100 is engaged with the tibial plate 6, the fixing screw 12 may engage the fixing opening 16 of the tibial plate 6 to secure the aiming clamp 100 to the tibial plate 6. The fixing screw 12 may be part of the aiming clamp 100, wherein the aiming clamp 100 captures the fixing screw 12. This means that the fixing screw 12 is always readily available for attaching the aiming clamp 100 to the tibial plate 6. In an alternative embodiment, the fixing screw 12 can be inserted through the fixing screw hole 116 into the fixing opening 16 of the tibial plate 6 to secure the aiming clamp 100 to the tibial plate 6. In this case, the fixing screw 12 is detached from the aiming clamp 100.

[0051] Arm 110 extends from head 102 and includes guide 112. The position, shape, and length of arm 110 are selected such that guide 112 clears the patient's soft tissue, allowing instruments to reach the tibia and properly align the support screw placed in the patient's body. It should be noted that in some applications, the support screw may be placed above the raft screw, i.e., closer to the joint surface, but in other applications, the support screw may be placed below the raft screw, i.e., between the raft screw and the joint surface. Therefore, the shape and size of arm 110 and guide 112 are selected to allow the support screw to be placed in the desired location.

[0052] When the aiming clamp 100 is secured to the tibial plate 6, the guide 112 extends in a direction extending along the lateral aspect of the anterior proximal tibia. In this example, the guide 112 includes three guide holes 114, but other numbers of guide holes 114 may be used in the guide 112. The position and axis of the guide holes 114 are selected such that the support screw can be placed into the anterior proximal tibia in a generally anterior-to-posterior direction and in a manner that does not interfere with the raft screw placed through the tibial plate 6. The triple sleeve system 200 may be used with the guide holes 114 to allow for the placement of Kirschner wires, drilling, and placement of screws into the anterior proximal tibial cortex. The guide holes 114 in the guide 112 are shown as having parallel central axes, but in other embodiments, the orientation of one or more of the central axes of the guide holes 114 may be different. Note that the angle between the head 102 and the arm 110 determines the orientation of the axis of the guide hole 114 and is also selected to achieve the desired angle of the support screw.

[0053] Figure 5A The aiming clamp 100 and retaining pin 122 are shown. Figures 5B-5C A perspective view of retaining pin 122 is shown. Retaining pin 122 helps secure the triple sleeve system 200 to the guide 112 of the aiming clamp 100. Retaining pin 122 is positioned in a retaining hole that extends along the length of retaining pin 122 and partially intersects with the guide hole 114. Retaining pin 122 includes a groove 126. Groove 126 corresponds to the guide hole 114. Retaining pin 122 also includes a slot 124 for assembly. Once the triple sleeve system 200 has been inserted through the guide hole 114, retaining pin 122 can deform and engage the triple sleeve system 200. Retaining pin 122 acts like a spring to engage the groove 126 with the triple sleeve system 200 and secure it to the guide 112.

[0054] Figures 6A-6B A triple sleeve system 200 is shown inserted through one of the guide holes 114 of the aiming clamp 100.

[0055] Figures 7A-7B A perspective view and unfolded view of one configuration of the triple sleeve system 200 are shown. Figures 7A-7BThe diagram shows an outer sleeve 202, an intermediate sleeve 204, and an inner sleeve 206. Each of these sleeves has a different inner diameter, allowing items of different diameters to be inserted into them. For example, a Kirschner wire can be inserted through the inner sleeve 206. The inner sleeve 206 can then be removed, and a drill bit can then be positioned to drill a hole in the tibia 2 through the intermediate sleeve 204. Next, the intermediate sleeve 204 is removed, and a screw is inserted through the outer sleeve 202 to be placed in the tibia 2. The triple sleeve system 200 can also be used in other ways. For example, it can be used with screw holes 108.

[0056] Figures 7C-7D A perspective view and unfolded view of another configuration of the triple sleeve system 200 are shown. Figures 7C-7D The outer sleeve 202 and the intermediate sleeve 204 are shown. An actuator (not shown) is used to drive the screw into the tibia 2. A guide hole 114 is used to guide other instruments and tools using other guiding systems. The guide hole 114 is oriented such that a "support screw" can be placed without interfering with a raft screw placed through the tibial plate 6. Furthermore, these support screws do not extend through or out of the tibia.

[0057] The method of using the aiming clamp 100 with the tibial plate 6 will now be described. First, the surgeon opens the area near the patient's knee where the tibial plate 6 will be placed. The tibial plate 6 is then placed onto the patient's tibia 2. This can be done by sliding the body of the tibial plate 6 downward along the axis of the tibia 2 into the surgical opening. The surgeon then positions and holds the tibial plate 6 in the desired position relative to the tibia 2. The tibial plate 6 can then be initially fixed to the tibia 2 using, for example, one or more Kirschner wires. The Kirschner wires can be driven through the plate fixation hole 14 to provide the initial position of the tibial plate 6 on the tibia 2. At this point, one or more plate screws 8 can be inserted into the tibia 2 through the plate screw hole 10 to secure the tibia 2. In this case, the Kirschner wires can be removed. In another embodiment, the plate screws 8 have not yet been placed, and the Kirschner wires are held in place to temporarily fix the tibial plate 6 to the tibia 2. Next, the surgeon can place the aiming clamp 100 onto the tibia 2. If the Kirschner wire is in place, the aiming clamp 100 is positioned over the Kirschner wire using the appropriate guide hole 114 corresponding to the plate fixation hole 14 with the Kirschner wire. If the Kirschner wire is not present, the aiming clamp 100 is simply positioned over the head of the tibial plate 6. The fixation protrusion 120 is aligned with and inserted into the fixation opening 16. This ensures that the aiming clamp 100 is properly aligned with the tibial plate 6. Next, the fixation screw 12 can engage the fixation screw hole 116 to secure the aiming clamp 100 to the tibial plate 6. In an alternative embodiment, the aiming clamp 100 can be placed on the tibial plate 6 before it is temporarily fixed to the patient. In this case, the aiming clamp 100 can be used to help slide the tibial plate 6 along the tibia 4. The Kirschner wire can then be used to temporarily attach the tibial plate 6 to the tibia 4. Next, if these screws were not previously placed as part of the initial fastening of the tibial plate 6 to the tibia 2, the surgeon places the plate screws 8 in the uppermost plate screw holes 10 on the tibial plate 6, which are adjacent to the articular surface of the tibia 2. These are the aforementioned raft screws. The aiming clamp 100 can be used as a guide for drilling and placing these plate screws 8. This placement of the screws involves inserting Kirschner wires, drilling holes in the tibia 2, and then driving the screws into the holes in the tibia 2. The aiming clamp 100 can be used in conjunction with the triple sleeve system 200 to guide the drilling of the holes and the driving of the plate screws 8, or another drilling guide can be used. Alternatively, the triple sleeve system 200 or the screw driving guide can be used to assist in properly orienting the screw as it is driven into the tibia 2. Next, the surgeon can use the guide 112 of the aiming clamp 100 to drive one or more support screws into the tibia 2 in a generally anterior-to-posterior direction. This can be achieved using the triple sleeve system 200.The outer sleeve 202 can be inserted and positioned through one of the guide holes 114 to contact the patient's skin to determine the location of the incision in the skin to reach the cortex of the tibia 2. This incision can be a minimally invasive surgery (MIS) incision. The surgeon then makes the MIS incision to expose the cortex of the tibia 2. The triple sleeve system 200 can then be used to drive Kirschner wires into the bone, drill holes in the tibia 2, and drive support screws into the holes drilled in the tibia 2. The surgeon can then place any additional support screws as needed. The surgeon can then place any other screws required to secure the tibial plate 6 to the tibia 2, as well as to capture bone fragments and reduce fractures. The surgeon can remove the aiming clamp 100 from the tibial plate 6. The aiming clamp 100 can be removed from the tibial plate 6 by disengaging the fixation screw 12 from the plate fixation hole 116 and then lifting the aiming clamp 100 from the tibial plate 6. The surgeon can then complete the procedure by closing the various incisions and performing any other normal surgical steps. It should be noted that the exact order of the above steps, especially those related to temporarily fixing the tibial plate 6 to the tibia 2, placing the plate screw 8, placing the aiming clamp 100, and removing the aiming clamp from the tibial plate 6, can vary.

[0058] The foregoing disclosure provides explanations and descriptions, but is not intended to be exhaustive, nor to limit the aspects to the precise form disclosed. Modifications and variations can be made based on the foregoing disclosure, or modifications and variations can be derived from the practices of the various parties involved.

[0059] As used herein, the term "component" is intended to be interpreted broadly as hardware, firmware, and / or a combination of hardware and software. As used herein, a processor is implemented as hardware, firmware, and / or a combination of hardware and software.

[0060] Unless otherwise stated, terms such as “first” and “second” are used to arbitrarily distinguish the elements described by such terms. Therefore, these terms are not necessarily intended to indicate the temporal or other priority of such elements.

[0061] Those skilled in the art will understand that any block diagrams herein represent conceptual diagrams of illustrative hardware that embody the principles of various aspects.

[0062] Although each implementation scheme has been described above in terms of its structural arrangement, it should be understood that the related methods using the above implementation schemes are also covered.

[0063] Although specific combinations of features are described in the claims and / or disclosed in the specification, these combinations are not intended to limit the disclosure of the aspects. In fact, many of these features can be combined in ways not specifically described in the claims and / or not disclosed in the specification. Although each dependent claim listed below may be directly subordinated to only one claim, the disclosure of the aspects includes combinations of each dependent claim with each other claim in the claim set. The phrase “at least one of” in the list of items refers to any combination of those items, including single members. As an example, “at least one of a, b, or c” is intended to cover a, b, c, ab, ac, bc, and abc, as well as any combination with multiple identical elements (e.g., aa, aaa, aab, aac, abb, acc, bb, bbb, bbc, cc, and ccc, or any other ordering of a, b, and c).

[0064] Unless explicitly stated otherwise, no element, action, or instruction used herein should be construed as essential or necessary. Furthermore, as used herein, the articles “a” and “an” are intended to include one or more items and may be used interchangeably with “one or more.” Additionally, as used herein, the terms “set” and “group” are intended to include one or more items (e.g., related items, unrelated items, a combination of related and unrelated items, etc.) and may be used interchangeably with “one or more.” Where only one item is intended to be described, the phrase “only one” or similar language is used. Also, as used herein, the terms “have,” “possess,” “contain,” etc., are intended as open-ended terms. Furthermore, unless explicitly stated otherwise, the phrase “based on” is intended to mean “at least partially based on.”

Claims

1. A aiming clamp for a tibial plate, the aiming clamp comprising: A head, configured to interface with the head of the tibial plate, the head comprising: Multiple screw guide holes, the multiple screw guide holes corresponding to multiple screw holes in the head of the tibial plate; A fixing protrusion configured to engage a fixing opening in the head of the tibial plate, wherein engagement of the fixing protrusion with the fixing opening aligns the head with the head of the tibial plate; and An arm, extending from the head, the arm including a guide, wherein The guide is configured to extend along the anterior portion of the tibia when the aiming clamp is secured to the tibial plate, and The guide includes a support screw guide hole configured to guide a support screw into the tibia in a generally anterior-to-posterior direction, such that the support screw avoids interfering with a plate screw placed in the head of the tibial plate.

2. The aiming fixture according to claim 1, wherein the head further includes a plurality of guide holes corresponding to a plurality of plate guide holes in the tibia plate.

3. The aiming clamp of claim 1, wherein the arm is configured such that the guide avoids contact with the patient when the aiming clamp is secured to the tibial plate.

4. The aiming fixture according to claim 1, wherein the guide includes a plurality of guide holes.

5. The aiming clamp of claim 1, further comprising a sleeve configured to be inserted into the support screw guide hole and to contact the anterior surface of the tibia.

6. The aiming clamp of claim 5, further comprising a retaining pin configured to insert into a retaining opening in the guide, wherein the retaining pin retains the sleeve and secures the sleeve to the guide.

7. The aiming clamp of claim 1, wherein the support screw guide hole has a position and orientation such that the support screw is placed between the plate screw and the articular surface of the tibia.

8. The aiming clamp of claim 1, wherein the support screw guide hole has a position and orientation such that the support screw is positioned such that a portion of the plate screw is positioned between the support screw and the articular surface of the tibia.

9. The aiming clamp of claim 1, wherein the end of the support screw is located within the tibia.

10. The aiming clamp according to claim 1, wherein The head includes fixing screw holes, and The aiming clamp includes a fixing screw configured to engage a fixing opening in the tibial plate via a fixing screw hole.

11. The aiming clamp of claim 1, wherein the head includes a body having a first portion of the plurality of screw guide holes, the first portion being configured to guide a first portion of the plate screw placed in the head of the tibial plate to support the articular surface of the tibia.

12. The aiming clamp according to claim 11, wherein The head includes a flange extending from the body, wherein the second portion of the plurality of screw guide holes is configured to guide the second portion of the plate screw placed in the head of the tibial plate, and The flange includes a fixing screw hole configured to receive a fixing screw, wherein the fixing screw is configured to engage a fixing opening in the tibial plate via the fixing screw hole.

13. A method of placing a support screw into the anterior surface of the tibia using an aiming clamp for a tibial plate, the method comprising: Place the tibial plate and align it onto the tibia; The tibial plate is initially fixed to the tibia; Place the aiming clamp onto the tibial plate; as well as Using the guide on the aiming clamp, a support screw is placed in the direction from approximately the front to the rear of the tibia, such that the support screw does not interfere with the plate screw placed in the head of the tibial plate.

14. The method of claim 13, wherein initially securing the tibial plate to the tibia comprises placing a plate screw in the tibial plate using a guide hole in the aiming clamp.

15. The method of claim 13, wherein initially fixing the tibial plate to the tibia comprises placing a Kirschner wire into the tibia through a guide hole in the aiming fixture and a plate fixing hole in the tibial plate.

16. The method of claim 13, wherein placing and aligning the tibial plate onto the tibia comprises placing a fixing protrusion on the aiming clamp into a fixing opening in the tibial plate.

17. The method of claim 13, wherein placing the support screw comprises: Drilling holes in the anterior surface of the tibia using the guide; as well as The guide is used to drive the support screw into the drilled hole.

18. The method of claim 17, wherein Drilling the hole includes using a first sleeve in the guide, and Driving the support screw involves using a second sleeve in the guide.

19. The method of claim 18, further comprising using a retaining pin in the guide to retain the first sleeve through the guide.

20. The method of claim 17, wherein placing the support screw comprises making a minimally invasive surgical incision through a soft tissue cutting to expose the cortex of the anterior surface of the tibia.

21. The method of claim 13, wherein the aiming clamp comprises: A head, configured to interface with the head of the tibial plate, the head comprising: Multiple screw guide holes, the multiple screw guide holes corresponding to multiple screw holes in the head of the tibial plate; A fixing protrusion configured to engage a fixing opening in the head of the tibial plate, wherein engagement of the fixing protrusion with the fixing opening aligns the head with the head of the tibial plate; and An arm, extending from the head, the arm including a guide, wherein When the aiming clamp is secured to the tibial plate, the guide extends along the anterior portion of the tibia, and The guide includes a support screw guide hole configured to guide a support screw into the tibia in a generally anterior-to-posterior direction, such that the support screw avoids interfering with a plate screw placed in the head of the tibial plate.

Images