Apparatus for preparing medullary cavity of bone for implant, apparatus comprising medical instrument

Abstract

To provide an apparatus for preparing a medullary cavity of a bone for an implant.SOLUTION: There is provided an apparatus 100 for preparing a medullary cavity of a bone for an implant. The apparatus includes a drill 104 for producing a bore in the medullary cavity, a fastening device 106 for a rasp 108 for producing an opening in the medullary cavity, and a housing 102. The drill is arranged in a translationally movable manner relative to the housing. The fastening device is arranged in a translationally movable manner relative to the housing. The apparatus also includes a guide 112. The guide guides the drill in a translational movement direction 110 of the drill for producing the bore and the rasp in the translational movement direction or in substantially the translational movement direction for producing the opening.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] The present invention relates to devices, including medical instruments, for preparing the medullary cavity of a bone for an implant. [Background technology]

[0002] For preparing the medullary cavity of the bone, drills are known for preparing a hole for receiving the rotationally symmetrical part of the implant, and files are known for preparing openings arranged laterally of the hole, in the medullary cavity of the bone, for the fixing part of the implant arranged laterally of the rotationally symmetrical part. Summary of the Invention

[0003] The device according to independent claim 1 allows the cavity and its laterally arranged openings to be prepared by means of an instrument.

[0004] An apparatus for preparing a medullary cavity of a bone for an implant includes a drill for creating a hole in the medullary cavity, a fixing device for a file for creating an opening in the medullary cavity, and a housing, the drill being arranged for translation relative to the housing, the fixing device being arranged for translation relative to the housing, and the apparatus including a guide configured to guide the drill in a translational direction of the drill for creating the hole and to guide the file for creating the opening in or substantially in the translational direction.

[0005] The drill and file are preferably arranged for translational movement relative to one another in a translational direction or substantially in a translational direction.

[0006] The guide preferably includes a guiding device arranged at least partially within the housing, the guiding device being configured to allow movement of the drill guided by the guiding device in a translational direction.

[0007] The guide device is preferably arranged translatably in a translational direction or substantially in a translational direction relative to the housing.

[0008] The device preferably includes a fixing device for the file, the file being fixed to the fixing device.

[0009] The file is preferably releasably secured to the securing device.

[0010] The guide device preferably comprises a fixing device.

[0011] The guide device is preferably configured to absorb impact energy to move the guide device in a translational direction and to transfer impact energy to the fixation device to move the fixation device in a translational or substantially translational direction.

[0012] The guiding device is preferably arranged at least partially in a housing, the housing having a projection configured as a stop for the guiding device.

[0013] The fastening device is preferably arranged at least partially in a housing, the housing having a projection configured as a stop for the fastening device.

[0014] The guide device preferably comprises a drive device for absorbing impact energy.

[0015] The housing preferably has a recess for the driving device, in which the driving device is arranged so as to be movable in a translational direction relative to the housing up to an end of the recess which is configured as a stop.

[0016] The driving device preferably has a surface for absorbing impact energy that stands at least partially from the housing in a direction radial to the translational direction or substantially to the translational direction, the driving device having an undercut behind the surface.

[0017] The apparatus preferably includes a coupling device configured to couple the drill and the driving device in a direction opposite to the translational direction during movement.

[0018] The guide portion preferably comprises at least a portion of a wall of the housing, which portion is configured to allow movement of the file or fastening device guided by said at least a portion of the wall in a translational direction or substantially in a translational direction.

[0019] The device preferably includes a stop for the translational movement of the drill relative to the housing, acting in the translational direction or against the translational direction.

[0020] The drill preferably has a shaft, at least a portion of which is arranged in the guide direction, the portion of the shaft having a taper, the guide device having a narrowed portion forming a stop.

[0021] The housing preferably includes an area on its exterior that is configured as a hand grip.

[0022] The housing preferably includes an external ridge located between an area configured as a hand grip and an area of ​​the device where the drill head or file is located.

[0023] Preferably, at least one notch is arranged in the area configured as a handgrip.

[0024] The file preferably has at least two wings between which a notch for the drill is arranged.

[0025] The housing preferably has a knockout device for absorbing impact energy in a direction opposite to or substantially opposite to the translational direction, the knockout device having a surface for absorbing impact energy that rises from the housing at least partially in a radial direction relative to the translational direction or substantially in the translational direction.

[0026] A medical instrument for preparing a medullary cavity of a bone for an implant comprises at least two interchangeable drills or at least two interchangeable files, the medical instrument comprising a device according to any one of the preceding claims.

[0027] The medical instrument preferably includes a preparation table.

[0028] Further advantageous embodiments can be seen from the following description and the drawings. [Brief description of the drawings]

[0029] [Figure 1] 1 is a schematic perspective view of a portion of one exemplary embodiment of an apparatus for preparing a medullary cavity of a bone for an implant; [Diagram 2] FIG. 2 is an exploded view of a portion of an exemplary embodiment of the device. [Diagram 3] FIG. 2 is a schematic perspective view of an exemplary wing file. [Figure 4] FIG. 1 is a schematic perspective view of an exemplary preparation table. [Diagram 5] FIG. 1 is a schematic perspective view of an exemplary adapter for a motor system. [Figure 6] FIG. [Figure 7] FIG. [Figure 8] FIG. 1 is a first cross-sectional view of the device. [Figure 9] FIG. 2 is a second cross-sectional view of the device. [Figure 10a] FIG. 13 is a schematic diagram of the use of the device in an example tibia preparation. [Figure 10b] FIG. 13 is a schematic diagram of the use of the device in an example tibia preparation. [Figure 10c] FIG. 13 is a schematic diagram of the use of the device in an example tibia preparation. [Figure 10d] FIG. 13 is a schematic diagram of the use of the device in an example tibia preparation. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0030] 1 shows a schematic perspective view of a portion of an apparatus 100 for preparing the medullary cavity of a bone for an implant. The apparatus 100 is a medical instrument.

[0031] The device 100 for preparing a medullary cavity is described on the example of a knee implant, i.e. a knee endoprosthesis, which in this example is configured to prepare the medullary cavity of the tibia.

[0032] The device 100 includes a housing 102, a drill 104 for creating a hole in the medullary cavity, and a fixture 106 for a file 108 for creating an opening in the medullary cavity.

[0033] The drill 104 is disposed for translational movement relative to the housing 102. The fixation device 106 is disposed for translational movement relative to the housing 102.

[0034] The drill 104 and file 108 are arranged for translational movement relative to one another in or substantially in a translational direction 110 .

[0035] The apparatus 100 includes a guide configured to guide the drill 104 in a translational direction of the drill 104 for creating the hole.

[0036] The guide is configured to guide the file 108 in a translational direction or substantially in a translational direction for creating an opening.

[0037] The guide portion, in this example, includes at least a portion of a wall of the housing 102, which is configured to allow movement of the file 108 or fastening device 106 guided by the at least a portion of the wall in a translational direction or substantially in a translational direction.

[0038] The guide includes, for example, a guide 112 arranged at least partially within the housing 102. The guide 112 is configured to allow movement of the drill 104 in a translational direction 110 guided by the guide 112. The guide 112 is configured to allow movement of the drill 104 in a direction opposite to the translational direction 110 guided by the guide 112. The guide 112 is configured to guide the drill 104 on its drill axis in or opposite to the translational direction 110. The guide 112 is configured to allow rotational movement of the drill 104 about the drill axis guided by the guide 112.

[0039] The guide 112 is disposed at least partially within the housing 102 in this example.

[0040] The guide 112 is disposed for translational movement relative to the housing 102 in a translational direction 110 or substantially in a translational direction.

[0041] The file 108 is secured to the fixation device 106. The file 108 is releasably secured to the fixation device 106 in this example. For example, different sizes of files 108 are contemplated that are selectively releasably secureable to the fixation device 106. The device 100 can also be configured with a file 108 that is non-releasably secured to the fixation device 106.

[0042] The guide 112 is configured to absorb impact energy to move the guide 112 in a translational direction 110 and to transmit impact energy to the fixation device 106 to move the fixation device 112 in the translational direction 110 or substantially in the translational direction.

[0043] In the exemplary embodiment of the device 100 , the guide device 112 includes a fixation device 106 .

[0044] In the exemplary embodiment of the device 100, the fixation device 106 is configured as a plunger.

[0045] The fixation device 106 is disposed at least partially within the housing 102 in this example.

[0046] The guide device 112 has a drive device 114 for absorbing impact energy.

[0047] The driving device 114 has a surface 116 for absorbing impact energy, which in this example stands at least partially from the housing 102 in the translation direction 110 or substantially radially relative to the translation direction.

[0048] The housing 102 has, in this example, a recess 118 for the driving device 114, in which the driving device 114 is arranged so as to be movable in a translational direction 110 relative to the housing 102. The driving device 114 is arranged so as to be movable up to an end 120 of the recess, which is configured, for example, as a stop.

[0049] It is possible to provide that the driving device 114 has an undercut behind the surface 116, in particular an undercut that allows for a good grip by hand. The undercut allows for a good retraction of the guide device.

[0050] The housing 102 includes a knockout device 122, in this example, for absorbing impact energy in a direction opposite to or substantially opposite to the translational direction 110.

[0051] The knockout device 122 has a surface 124 for absorbing impact energy, for example standing at least partially from the housing 102 in the translation direction 110 or substantially radially relative to the translation direction.

[0052] The housing 102, in this example, includes an area 126 on its exterior that is configured as a hand grip. Illustratively, the area 126 that is configured as a hand grip has at least one indentation 128 disposed therein.

[0053] The housing 102 includes, in this example on the outside, a raised portion 130 disposed between an area 126 configured as a hand grip and an area 132 of the device 100 in which a head 134 of the drill 104 or a file 108 is disposed.

[0054] At least one indentation 128 in the hand grip improves grip with gloves that are wet, oily, or otherwise soiled with body fluids.

[0055] The ridges 130 separate areas 126 of the housing 102 that are not suitable as grip areas because they are moving parts.

[0056] The file 108 has at least two wings 136 in this example. It is also possible to provide only one wing or more than two wings, for example three or four wings.

[0057] Located between the wings 136 is a notch 138 for the drill 104 .

[0058] The drill 108 has a shaft 140. At least a portion of the shaft 140 is disposed within the introducer 112.

[0059] FIG. 2 is an exploded view of a portion of an exemplary embodiment of the device 100.

[0060] The apparatus 100 includes, for example, a coupling device configured to couple the drill 104 and the driving device 114 during movement in a direction opposite to the translational movement direction 110 .

[0061] The coupling device, in this example, includes a latch 142 that is disposed within a recess 144 in the shaft 140 of the drill 104 .

[0062] The drill 104 is connected to the driving device 114 via a latch 142. The drill 104 and the driving device 114 are connected by the latch 142 in such a way that the drill 104 and the driving device 114 can both be reset to their starting position after bone preparation. The latch 142 is designed, for example, as a rocker lever biased by a spring 146. The rocker lever comprises a rocker beam formed in this example by a pin 148. The pin 148 is held in mutually opposing holes in the side wall of the recess 144 in this example. The spring 146 is a compression spring supported in the rear wall of the recess 144 in this example.

[0063] The shaft 140 has an adapter 150 for the motor system in this example. The adapter 150 is located on the end face of the drill 104 in this example. The adapter 150 has an opening, for example a hex socket, in the shaft 140. In this example, the opening extends from the end face to the recess 144.

[0064] In the area of ​​the adapter 150, the shaft 140 has a hole between the pin 148 and the end face, which hole connects the opening and the recess 114. The end of the latch 142 is positioned in this example so that it can move outwardly through the opening when the motor system is introduced into the adapter 150. This causes the latch 142 to automatically release when the motor system is installed in the opening in the shaft 140 of the drill 104.

[0065] Alternatively, the drill 104 may have an interface that allows direct connection to a motor system without an adapter.

[0066] It is contemplated that the motor system may also be a component part of the device 100 .

[0067] It can be provided that the device 100 includes stops for the translational movement of the drill 104 relative to the housing 102 acting in or against the translational movement direction 110. For example, the portion of the shaft 140 arranged in the guide 112 has a tapered portion 154. For example, the guide 112 has a pin 156 that is held by two holes in the housing 102 in the region of the tapered portion 154 and extends transversely to the movement direction 110, which pin forms both stops for the non-tapered portion of the shaft 140.

[0068] The head 134 of the drill 104 has, in this example, a cutting geometry designed to prepare a hole for a rotationally symmetric portion of an implant in the tibia.

[0069] The drill 104 is held in the starting position in the housing 102 in this example by a spring 158 integrated into the housing 102. The spring 158 is configured, for example, as a leaf spring. The spring 158 engages in a groove 160 arranged on the circumference of the drill 104 in this example. The groove 160 is arranged, for example, between the head 134 and the tapered portion 154. The spring 158 and the groove 160 hold the drill 104 in the starting position by a form-locking connection up to a defined force. The form-locking connection is designed to automatically unlock from a defined force acting on the drill 104 in the drilling direction.

[0070] It is contemplated that the housing 102 has at least one opening 162 disposed in the area 132 of the device 100 in which the head 134 of the drill 104 or the file 108 is disposed. The at least one opening 162 reduces the weight of the housing 102 and improves its cleanability.

[0071] The fixing device 106 comprises a first bore 164 for receiving the plug of the file 108, which in this example extends transversely to the translation direction 110. A second bore 166 is arranged in the first bore 164, which in this example extends in the translation direction 110. A spring 168 and a ball 170 are arranged in the second bore 166, the ball being pressed into the first bore 164 by the spring 168. The ball 170 and the spring 168 are configured such that when the plug of the file is introduced into the first bore 164, the ball 170 snaps into the groove of the file.

[0072] The fixing device 106 includes a bracket 172 arranged transversely to the translation direction 110, which is configured to grip the circumference of the drill 104. The bracket 172 has, in this example, two ends on which one groove in the file 108, arranged transversely to the translation direction 110, can be extruded.

[0073] In this example, the housing 102 has, on the side facing the adapter 150 in the translation direction 110, a first part of an interface 174 to the preparation table. The first part of the interface 174 has an opening for the head 134 of the drill 104 and a plate surrounding the opening by at least one collar 176 in the edge region of the plate.

[0074] The device 100 comprises a snap nose 178, which is in particular chamfered. The snap nose 178 is arranged on a snap latch 180, which is arranged in the housing 102 so as to be movable in the translation direction 110. The snap latch 180 comprises, on the side opposite the snap nose 178 in the translation direction 110, a first pin 182 extending in the translation direction 110. Between the pin 182 and the snap nose 178, the snap latch 180 has an elongated hole 184 extending in the translation direction 110. The first pin 184 is configured to guide a helical spring 186 which is pressed onto the first pin 184. The housing 102 has a sleeve which in this example extends in the translation direction 110, into which the pin 184 can sink. The helical spring 186 is supported by a stop disposed within the housing 102 and urges the snap latch 180 out of the housing 102 and up to the stop. The snap latch 180 is coupled to the guide 112 via a second pin 188 extending from the guide 112 transversely to the translational direction 110.

[0075] In FIG. 3, an exemplary wing file 108 is shown in a schematic perspective view.

[0076] The wing file 108 has a bracket 190 configured to grip the periphery of the fastening device 106. The bracket 190 has connecting grooves 192 in the bracket, one on each side in this example, which are configured to be extruded onto the brackets 176 of the fastening device 106, in particular onto their ends.

[0077] Both brackets are configured to transfer impact energy to the wing file 108 .

[0078] The wing file 108 includes a plug 194 configured to engage the first bore 164 of the fastener 106. The plug 194 includes a groove 196 that radially circumscribes the plug 194, the groove being configured to receive the ball 170. The ball 170 snaps into the groove 196 of the plug 194 of the wing file 108 when the plug 194 is pressed into the first bore 164.

[0079] The brackets 176, 190, the plugs 194 and the grooves 192 are connecting elements extending transversely to the impact direction. Snapping the wing file 108 in by these connecting elements is sufficient to lock the wing file 108 with the device 100, and even after the device 100 is mounted, the wing file 108 can be easily pulled out without having to operate a separate operating element. It is possible to provide all or only a part of the connecting elements.

[0080] 4, an exemplary preparation table 198 is shown in a schematic perspective view. The preparation table 198 is configured to prepare, for example, the tibia.

[0081] In this example, the device 100 and preparation table 198 are configured such that the device 100 can be fitted onto the preparation table 198 from a front direction 200 .

[0082] Unlike a proximal fit, an anterior fit reduces impingement with the femur and soft tissue.

[0083] The preparation platform 198 includes a second portion of the interface 202 .

[0084] The interface is designed in this example as an angled dovetail guide.

[0085] Due to both angles, the interface has a large amount of play at the beginning of the connecting movement and thus can be spliced ​​even with slight misalignments or angular errors between both components. Thus, during connection, the device 100 is automatically centered on the preparation table 198.

[0086] The device 100 and preparation table 198 may alternatively be configured with an interface that can be proximally coupled and decoupled.

[0087] Alternatively, device 100 may include a mounting surface designed to allow it to be set directly on bone without a preparation table 198. Rough structures or spikes incorporated into the mounting surface may optionally prevent possible slippage here. Optional holes may be provided in device 100 that are configured to allow for fixation of device 100 directly on bone with screws or impact pins.

[0088] When the device 100 is coupled up to the stop, it automatically locks via a specially chamfered snap nose 178 .

[0089] In FIG. 5, an exemplary adapter 204 for a motor system is shown in a schematic perspective view.

[0090] The motor system adapter 204 includes, for example, an external hex adapter 206. The hex end 206 of the adapter 204 is designed with a spherical cross-sectional shape in this example, which allows the adapter 204 to transmit rotational motion even if the axes of the drill and the motor system do not match exactly at the same angle.

[0091] 6 shows a side view of the device 100. In the side view, the head 134 of the drill 104 is pushed out of the housing 102 through the interface 174. This shows the drill 104 in an end-of-work position.

[0092] 7 shows a front view of the device 100. In the front view, the drill 104 is shown in an end-of-work position.

[0093] FIG. 8 shows a first cross section AA of the device 100 with the drill 104 in an end position.

[0094] The housing 102 has a protrusion 208 .

[0095] The protrusion 108 is configured as a depth stop for the guide device 112 or fixation device 106 .

[0096] At the end of operation positions of the drill 104 and guide 112, the latch 142 on the drill engages the guide 112, so that retracting the guide 112 simultaneously retracts the drill 104 to its starting position. At the same time, the pin 188 on the guide 112 pulls the snap latches 180 back together, thus unlocking the preparation table 198 from the apparatus 100.

[0097] In FIG. 9 a second cross section BB of the device 100 is shown in the region of the pin 156 , which forms both stops for the non-tapered portion of the shaft 140 of the drill 104 .

[0098] The stops are designed to ensure the correct preparation depth for each implant.

[0099] 10a to 10d show a schematic representation of the use of the device 100 in the example preparation of a tibia 210. FIG.

[0100] 10a shows the tibia 210 already with the preparation table 198 placed thereon. The device 100 is fitted onto the preparation table 198 from the anterior direction 200.

[0101] 10b shows the device 100 positioned on a preparation table 198. In this example, the snap nose 178 of the snap latch 180 is engaged with the preparation table 198. A drill hole is prepared in the tibia 210 with a drill 104. The motor system rotates the drill 104 via an adapter 204 of the motor system and the adapter 150 of the device 100.

[0102] 10c illustrates the driving of the file 108 by the hammer 214. A driving plate 114 at the upper end of the device 100 transfers the impact energy of the hammer 214 through the guide device 112 to the fixation device 106 for the file 108. This drives the file 108, coupled with the fixation device 106, into the tibia 210.

[0103] Because the drill 104 is also centered in the tibia 210 during the driving process of the file 108, angular stability is achieved during driving that exceeds that of separate drill and file instruments that have been conventional in the past.

[0104] 10d shows the knock-out. A knock-out plate 122, rigidly connected to the housing 102 of the device 100, allows knock-out of the entire device 100, including the drill 104 and the file 108.

[0105] The device 100 is further engaged to the preparation table 198 by the snap latch 180. Thus, in this step, the drill 104, the file 108, and the preparation table 198 connected with the device 100 can be removed.

[0106] The preparation table 198 may include fixation pins for fixing the preparation table 198 to the tibia 210. In this case, the fixation pins are removed along with the preparation table 198.

[0107] It is contemplated that the collar portion 176 is disposed on the housing 102 such that it covers a locking pin on the preparation table 198. When the device 100 is launched with the preparation table 198, the locking pin will not be accidentally dropped.

[0108] The device 100, or the device 100 and preparation table 198, can thus be handed over as one piece from the surgeon to the assistant, together with the drill 104, file 108, preparation table 198, and optionally fixation pins.

[0109] For medical instruments requiring holes of different depths, drills 104 of different lengths can be provided, with each drill 104 being removably disposed within the housing 102. Alternatively, for drills 104 that are not removable, an adjustable depth stop can be disposed within the housing. The drills 104 can be provided with the same rotationally symmetric geometry or with different geometries.

[0110] This allows the geometry for a rotationally symmetric plug to be prepared for fixation in bone using drills of different lengths.

[0111] It may be provided that the device 100 has one or more interfaces for an impact hammer with an impact weight, which allows the use of an impact hammer with a guided impact weight for driving in and / or knocking out.

[0112] For implant systems that require the preparation of openings of different depths with the file 108, different depth files 108 or adjustable depth stops for the file 108 can be provided.

[0113] For implant systems that require different positioning of the wings of the file 108 relative to each other or to the central bore, the wings 136 of the file 108 can be configured to be removably or non-removably attachable to the device 100 and / or their position on the device 100 can be adjustable.

[0114] A medical instrument for preparing a spinal canal may include, for example, a device 100 having at least two interchangeable files 108 that differ in length, width, or arrangement of wings 136 .

[0115] It is contemplated that the device 100 is configured for interchangeable drills, where the medical instrument includes at least two interchangeable drills 104 of different lengths or different diameters.

[0116] It may be envisioned that the medical instrument includes a preparation stage 198 .

Claims

1. 1. A device (100) for preparing a medullary cavity of a bone (210) for an implant, comprising: The device (100) includes a drill (104) for creating a hole in the medullary cavity, a fixation device (106) for a file (108) for creating an opening in the medullary cavity, and a housing (102); The drill (104) is disposed so as to be capable of translational movement relative to the housing (102); The fixing device (106) is arranged to be translatable relative to the housing (102); The device (100) includes a guide portion (112); The apparatus (100), characterized in that the guide portion (112) is configured to guide the drill (104) in a translational direction (110) of the drill (104) to create a hole, and to guide the file (108) to create an opening in or substantially in the translational direction.

2. 2. The apparatus of claim 1, wherein the drill (104) and the file (108) are arranged for translational movement relative to one another in or substantially in a translational direction (110).

3. The guide portion (110, 112) includes a guide device (112) disposed at least partially within the housing (102); 3. The apparatus according to claim 1 or 2, characterized in that the guiding device is configured to allow movement of the drill (104) guided by the guiding device (112) in a translational direction (110).

4. 4. The apparatus (100) of claim 3, wherein the guide device (112) is arranged translatably in a translational direction (110) or substantially in a translational direction relative to the housing (102).

5. The device (100) includes a fixing device (112) for the file (108), 5. The device (100) according to claim 3 or 4, characterized in that the file (108) is fixed to said fixing device (112).

6. The apparatus (100) of claim 5, wherein the file (108) is releasably secured to the securing device (106).

7. 7. The device (100) according to claim 5 or 6, characterized in that the guiding device (112) comprises the fixing device (106).

8. 7. The apparatus (100) according to claim 5 or 6, characterized in that the guiding device (112) is configured to absorb impact energy to move the guiding device (112) in a translational direction (110) and to transmit impact energy to the fixing device (108) to move the fixing device (106) in a translational direction (110) or substantially in a translational direction (110).

9. The guide device (112) is disposed at least partially within the housing (102); 9. The device (100) according to claim 8, characterized in that the housing (102) has a protrusion configured as a stop for the guiding device (112).

10. The fixation device (106) is disposed at least partially within the housing (102); 10. The device (100) according to claim 8 or 9, characterized in that the housing has a protrusion configured as a stop for the fixing device (106).

11. 11. The device (100) according to any one of claims 8 to 10, characterized in that the guiding device (112) comprises a driving device (114) for absorbing impact energy.

12. 12. The device (100) according to claim 11, characterized in that the housing (102) has a recess (118) for the driving device (114), in which the driving device (114) is arranged so as to be movable in a translational direction (110) relative to the housing (102) up to an end of the recess (118) configured as a stop.

13. the driving device (114) has a surface (116) for absorbing impact energy, which surface (116) stands at least partially from the housing (102) in a direction radial to the translational direction (110) or substantially in relation to the translational direction; 13. The device (100) of claim 11 or 12, wherein the driving device (114) has an undercut behind the face (116).

14. 14. The apparatus (100) according to any one of claims 11 to 13, characterized in that the apparatus (100) comprises a coupling device configured to couple the drill (104) and the driving device (114) during a movement in a direction opposite to the translational movement direction (110).

15. The guide portion (112) includes at least a portion of a wall of the housing (102); 15. The device (100) according to any one of claims 1 to 14, characterized in that the portion is configured to allow movement of the file (108) or the fixing device (106) guided by the at least one portion of the wall in a translational direction (110) or substantially in a translational direction.

16. 16. The device (100) according to any one of claims 1 to 15, characterized in that the device (100) comprises a stop for translational movement of the drill (104) relative to the housing (102), acting in a translational direction (110) or opposite to the translational direction.

17. The drill (108) has a shaft (140); At least a portion of the shaft (140) is disposed in a guide direction (112); The portion of the shaft (140) has a taper; The device (100) of claim 10, characterized in that the guiding device (112) has a narrowed portion forming the stop.

18. 18. The device of claim 1, wherein the housing (102) includes an area (126) on its exterior that is configured as a hand grip.

19. 19. The device (100) of claim 18, characterized in that the housing (102) includes a ridge (130) on the outside, disposed between an area (126) configured as a hand grip and an area (132) of the device (100) in which the head (134) of the drill (104) or the file (108) is disposed.

20. 20. The device (100) according to claim 18 or 19, characterized in that in said area (126) configured as a hand grip, at least one indentation (128) is arranged.

21. The file (108) has at least two wings; 21. The device (100) according to any one of the preceding claims, characterized in that between the two wings a notch (138) for the drill (104) is arranged.

22. the housing (102) has a knockout device (122) for absorbing impact energy in a direction opposite or substantially opposite to the translational direction (110); 22. The device (100) according to any one of claims 1 to 21, characterized in that the knocking device (122) has a surface (124) for absorbing impact energy, which stands at least partially from the housing (102) in a direction of translation (110) or substantially radially relative to the direction of translation.

23. A medical instrument for preparing a medullary cavity of a bone (210) for an implant, comprising at least two exchangeable drills (104) or at least two exchangeable files (108), characterized in that the medical instrument comprises a device (100) according to any one of claims 1 to 22.

24. The medical instrument of claim 23, wherein the medical instrument includes a preparation stage (198).

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