General-purpose drill guide system

Abstract

A universal drill guide system according to the present disclosure includes a plurality of drill tubes, each having a drill bit passage, and a plurality of drill bits, each insertable into a respective one of the plurality of drill bit passages, each of the drill bit passages having an inner diameter different from the inner diameters of any of the other drill bit passages, each of the plurality of drill bits having an outer diameter different from the outer diameters of any of the other drill bits, the outer diameter of each of the plurality of drill bits corresponding to the inner diameter of each of the drill bit passages, in this manner, each of the plurality of drill tubes is designed to operate with only one of the plurality of drill bits.

Description

[Technical field]

[0001] The present disclosure relates generally to a universal drill guide system for spinal fixation. [Background technology]

[0002] Spinal fusion is a procedure in which a damaged vertebra is removed and the vertebrae adjacent to the removed vertebra are fused together with graft material. The spinal column must be immobilized during fusion. To immobilize the spine, one or more fixation rods are fixed to the vertebrae to limit movement.

[0003] The fixation rods are secured to the vertebrae using bone screws that are driven into the vertebrae. Before the bone screws are driven into the vertebral bodies, holes are prepared in the vertebral bodies in a minimally invasive manner with the aid of a universal drill guide system. In one possible procedure, a drill tube is passed through a small incision and navigated to the desired entry point on the vertebral body. A cortical punch is then advanced through the tube to drill a starter hole in the cortical layer of the bone. The cortical punch is then removed from the tube and a drill bit is advanced through the tube to the starter hole. Once the drill bit is aligned with the starter hole, the surgical drill is turned on to drill a hole of the desired diameter and depth. After the screw hole is drilled, the drill guide is removed and a bone screw can be advanced into the screw hole.

[0004] When drilling screw holes, the drilling depth must be carefully controlled to ensure that the drill bit does not penetrate too deeply into the vertebral body. One option for controlling the drilling depth is to install some type of drill stop on the drill tube to limit how far the tip of the drill bit extends into the patient beyond the end of the drill tube. However, this option is difficult to implement when multiple drill bits and drill tubes of various sizes must be accommodated.

[0005] Guiding the drill bit to the proper location can be difficult. Therefore, some drill bits have passages that allow the drill bit to pass over Kirschner wires or "K-wires." K-wires can be attached to the bone at the desired location to navigate the drill bit and other instruments precisely to that location. Although K-wires aid in navigation, they present many challenges when using other instruments in the vicinity.

[0006] Multiple drill bits and multiple drill tubes are especially necessary when drilling various screw holes. In order to drill screw holes with different sizes, the drill bits are designed to have different drill diameters or different dimensions. Therefore, the surgeon must first carefully select the desired drill bit and the corresponding drill tube before assembling them. On the one hand, it is not easy to recognize the (diameter) difference between the multiple drill bits and the multiple drill tubes, so selection errors may occur. On the other hand, the selection process significantly increases the procedure time. Prior art disclosed in U.S. Patent Application Publication No. 2018 / 0271602 and U.S. Patent Application Publication No. 2012 / 0589192 is known. Summary of the Invention [Problem to be solved by the invention]

[0007] In this regard, the present disclosure is based on the objective of providing a universal drill guide system in which multiple drill bits and multiple drill tubes are easily selected to avoid operation errors while reducing procedure time.

[0008] According to the present disclosure, this object is achieved by a universal drill guide system including a plurality of drill tubes, each having a drill bit passage, and a plurality of drill bits, each insertable into a respective drill bit passage of the plurality of drill tubes. Each of the drill bit passages has an inner diameter different from the inner diameter of any of the other drill bit passages. Each of the plurality of drill bits has an outer diameter different from the outer diameter of any of the other drill bits. The outer diameter of each of the plurality of drill bits corresponds respectively to the inner diameter of each of the drill bit passages. In this manner, each of the plurality of drill tubes is designed to work with only one of each of the plurality of drill bits. This avoids inserting an inappropriate drill bit into an inappropriate drill tube. At the same time, the surgeon can easily select a corresponding pair of drill bits and drill tubes to reduce procedure time. The universal drill guide system further includes a universal drill guide and an automatic drill tube capture including a locking ring rotatable within the universal drill guide between a locked orientation and an unlocked orientation.

[0009] Advantageous embodiments of the present disclosure are claimed in the subclaims and are described more precisely below.

[0010] Preferably, the plurality of drill tubes includes (at least) a first drill tube, a second drill tube, and a third drill tube, and the plurality of drill bits includes (at least) a first drill bit corresponding to the first drill tube, a second drill bit corresponding to the second drill tube, and a third drill bit corresponding to the third drill tube.

[0011] Each of the plurality of drill tubes has a different alignment marking from any of the other drill tubes. Each of the plurality of drill bits has a different alignment marking from any of the other drill bits. The alignment markings of each of the drill bits respectively correspond to the alignment markings of each of the plurality of drill tubes. Preferably, the different alignment markings appear in the form of different color bands around the circumference of each of the plurality of drill tubes and each of the plurality of drill bits. The markings are used to help a user select an appropriate drill tube for a selected drill bit. This facilitates and shortens the selection process of the drill tubes and drill bits while efficiently preventing selection errors.

[0012] Multiple Multiple drill tubes can be inserted into the opening of the universal drill guide. The multiple drill tubes have the same outer dimensions. This allows different drill tubes to be inserted into the universal drill guide / its opening in the same way. This effectively shortens the assembly process of the universal drill guide and the drill tubes.

[0013] Self The movable drill tube capture allows multiple drill tubes to be inserted into the universal drill guide opening with quick-fit connections It is particularly advantageous This allows for an efficient and easy assembly of the universal drill guide and the drill tube: no additional steps such as threading the universal drill guide are required, nor are additional auxiliary elements required for connection.

[0014] Self The automatic drill tube catch further includes a compression spring that applies a biasing force to the lock ring to bias the lock ring in the locking direction. The automatic drill tube catch further includes a switch for manually rotating the lock ring from the locking direction to the unlocking direction against the biasing force of the compression spring.

[0015] The locking ring preferably includes an inwardly extending chamfer oriented / configured such that the sidewall of a drill tube inserted into the automatic drill capture deflects the locking ring from the locking orientation at an angle against the bias of the compression spring. The deflection of the locking ring is maintained until a notch formed in the outer circumferential surface of the drill tube is aligned with the chamfer. In this manner, the drill tube can be inserted into the universal drill guide with the quick-fit connection.

[0016] Each of the plurality of drill bits includes a K-wire passage for receiving one of the plurality of K-wires. The K-wire passage of each of the plurality of drill bits has an inner diameter different from any of the other K-wire passages. Each of the plurality of K-wires has an outer diameter different from those of the other K-wires. The outer diameter of each of the K-wires corresponds to the inner diameter of each of the K-wire passages, respectively. This allows the K-wire to be received only by the corresponding drill bit. In other words, each of the plurality of drill bits is designed to work with only one of the respective K-wires. This allows selection / assembly errors to be prevented while reducing selection / assembly time.

[0017] Additionally, each of the plurality of drill bits has a different drilling diameter than the other drill bits, i.e., the plurality of drill bits have different drilling diameters configured to drill different threaded holes.

[0018] Additionally, each of the plurality of drill bits has a proximal end for attachment to the drill driver and an opposed distal end having a cutting edge for drilling the screw hole.

[0019] Preferably, the universal drill guide includes a drill stop, and each of the plurality of drill bits has a stop surface located between a proximal end and a distal end, the stop surface cooperating with the drill stop to limit the distance the drill bit can advance into the bone during drilling, thereby preventing improper drilling depth. [Brief description of the drawings]

[0020] The foregoing summary and the following detailed description will be better understood in conjunction with the non-limiting examples illustrated in the drawings.

[0021] [Figure 1] FIG. 1 illustrates a perspective view of a universal drill guide system according to one aspect of the present disclosure. [Diagram 2] FIG. 2 shows a front view of a set of drill tubes for use with the universal drill guide system of FIG. [Diagram 3] FIG. 2 shows a front view of a set of drill bits for use with the universal drill guide system of FIG. [Figure 4] FIG. 2 shows a perspective view of the tip of the general-purpose drill guide system of FIG. 1. [Diagram 5] 2 illustrates a tip side view of the universal drill guide system of FIG. 1 showing the spring-loaded lock in a first state. [Figure 6] FIG. 2 illustrates a tip side view of the universal drill guide system of FIG. 1 showing the spring-loaded lock in a second state. [Figure 7] 2 illustrates a perspective tip view of the drill tube capture of the universal drill guide system of FIG. 1 showing the drill tube capture in a first position. [Figure 8] 2 illustrates a perspective tip view of the drill tube capture of the universal drill guide system of FIG. 1 showing the drill tube capture in a second position. [Figure 9A] 2 shows a perspective tip view of the drill tube capture of the universal drill guide system of FIG. 1 during a first step of inserting the drill tube. [Figure 9B] 2 shows a perspective tip view of the drill tube capture of the universal drill guide system of FIG. 1 during a second step of inserting the drill tube. [Figure 9C] 2 shows a perspective view of the tip of the drill tube capture of the universal drill guide system of FIG. 1 during a third step of inserting the drill tube. [Figure 9D] 2 shows a perspective tip view of the drill tube capture of the universal drill guide system of FIG. 1 after the final step of inserting the drill tube. [Figure 10] 2 shows an enlarged, perspective tip view of the drill tube capture of the universal drill guide system of FIG. 1 in the locked orientation. [Figure 11] 2 shows an enlarged, perspective tip view of the drill tube capture of the universal drill guide system of FIG. 1 in the release orientation. [Figure 12] 2 illustrates an enlarged perspective view of the components of the universal drill guide system of FIG. 1 , showing the components when the drill stop is in position to engage the drill bit. [Figure 13] 2 illustrates an enlarged perspective view of the components of the universal drill guide system of FIG. 1 , showing the components when the drill stop is in a position released from the drill bit. [Figure 14] FIG. 2 is a perspective view of the tip of the universal drill guide system of FIG. 1 , showing the universal drill guide system removed from the drill tube. [Figure 15] FIG. 2 is another perspective tip view of the universal drill guide system of FIG. 1 , showing the universal drill guide system removed from the drill tube. [Figure 16] 1 illustrates a perspective view of a hollow drill bit and a K-wire according to another embodiment of the present disclosure. [Figure 17] 13 shows an enlarged tip view of a hollow drill bit, a K-wire, and a K-wire retention mechanism according to another embodiment of the present disclosure. [Figure 18] FIG. 18 shows an enlarged cross-sectional view of the tip of the hollow drill bit K-wire and the K-wire holding mechanism of FIG. [Figure 19] FIG. 2 is an enlarged perspective view of a K-wire according to another embodiment of the present disclosure, showing an intermediate portion of the K-wire. [Figure 20] 1 shows an enlarged perspective view of a K-wire retention mechanism according to another embodiment of the present disclosure. [Figure 21] 1 illustrates a tip perspective view of a hollow drill bit, a K-wire, and a K-wire retention mechanism according to another embodiment of the present disclosure, with the force retaining sleeve shown in a first position. [Figure 22] 22 illustrates a tip perspective view of the hollow drill bit, K-wire, and K-wire retention mechanism of FIG. 21, with the force retaining sleeve shown in a second position. [Diagram 23] 1 illustrates a perspective tip view of a hollow drill bit, a K-wire, and a K-wire retention mechanism according to another embodiment of the present disclosure, the hollow drill bit being attached to a drill driver. [Figure 24] FIG. 24 is another enlarged, perspective tip view of the hollow drill bit, K-wire, and K-wire retention mechanism of FIG. 23, with some features shown in transparent for clarity. [Diagram 25] 1 illustrates a perspective view of a drill removal tool according to another aspect of the present disclosure. [Figure 26] 26 shows a perspective tip view of the drill removal tool of FIG. 25 during attachment to a hollow drill bit and K-wire. [Figure 27] FIG. 13 is a distal side view of a wire clamp according to another aspect of the present disclosure, showing the wire clamp in an unclamped state. [Figure 28] 28 is a side view of the tip of the wire clamp of FIG. 27, showing the wire clamp in a clamped state. [Figure 29] 28 shows an enlarged cross-sectional view of the tip of the wire clamp of FIG. 27. [Diagram 30] 26 shows a tip perspective view of the components of the drill removal tool of FIG. 25. [Diagram 31] 26 shows another perspective end view of the components of the drill removal tool of FIG. 25. [Diagram 32] 26 illustrates another perspective tip view of the drill removal tool of FIG. 25 during removal of the drill bit from the patient. [Diagram 33] FIG. 2 is a perspective view of a bone screwdriver with a K-wire retention module according to another embodiment of the present disclosure, where the bone screwdriver and the K-wire retention module pass over the K-wire. [Diagram 34] FIG. 34 shows an enlarged tip side view of the distal end of the bone screwdriver of FIG. 33. [Diagram 35] 34 shows an enlarged, tip perspective view of the distal end of the bone screwdriver of FIG. 33. [Diagram 36] FIG. 34 shows another perspective view of the bone screwdriver with the K-wire holding module of FIG. 33 during advancement over the K-wire. [Figure 37]FIG. 34 is an enlarged perspective tip view of the bone screwdriver with K-wire retention module of FIG. 33, showing the internal components of the K-wire retention module. [Figure 38] FIG. 34 illustrates a side view of the K-wire retention module of FIG. 33 shown in a first mode of operation, with some components removed for clarity. [Figure 39] 39 shows an enlarged, top perspective view of the K-wire retention module component of FIG. 38 in a first mode of operation. [Diagram 40] FIG. 34 is a side view of the K-wire retention module of FIG. 33 shown in a second mode of operation with some components removed for clarity. [Diagram 41] 41 shows an enlarged perspective top view of the K-wire retention module component of FIG. 40 in a second mode of operation. [Diagram 42] FIG. 13 is a perspective view of an alternative bone screwdriver having a K-wire retention module according to another embodiment of the present disclosure, where the bone screwdriver and the K-wire retention module pass over the K-wire. [Diagram 43] FIG. 43 shows a perspective view of the bone screwdriver with K-wire retention module of FIG. 42, illustrating the internal components of the K-wire retention module in a first mode of operation. [Diagram 44] 44 shows an enlarged perspective view of the internal components of the K-wire retention module of FIG. 43 in a first mode of operation. [Diagram 45] 44 shows an enlarged perspective view of the internal components of the K-wire retention module of FIG. 43 in a second mode of operation. [Figure 46] 26 is an enlarged perspective tip view of the drill removal tool of FIG. 25, illustrating one step of an alternative technique for using the drill removal tool. [Figure 47] 26 shows another enlarged perspective tip view of the drill removal tool of FIG. 25, illustrating another step of the alternative technique. [Figure 48] 26 shows another perspective tip view of the drill removal tool of FIG. 25, illustrating another step of the alternative technique. [Figure 49]26 shows another perspective tip view of the drill removal tool of FIG. 25, illustrating another step of the alternative technique. [Figure 50] 26 shows another enlarged tip side view of the drill removal tool of FIG. 25, illustrating another step of the alternative technique. [Figure 51] 26 shows another enlarged tip side view of the drill removal tool of FIG. 25, illustrating another step of the alternative technique. [Figure 52] 26 shows another perspective tip view of the drill removal tool of FIG. 25, illustrating another step of the alternative technique. [Diagram 53] 26 shows another perspective tip view of the drill removal tool of FIG. 25, illustrating another step of the alternative technique. Detailed Description of the Invention

[0022] The following sections describe various instruments used for fixation of the cervical spine according to the present disclosure.

[0023] In this disclosure, "distal" essentially means "in a direction from the user / surgeon toward the patient" and "proximal" essentially means "in a direction away from the patient toward the user / surgeon."

[0024] General-purpose drill guide system 1-3, a universal drill guide system 100 according to one example is shown. The universal drill guide system 100 features a universal drill guide 110. The universal drill guide 110 includes a tubular guide body 120 and a handle 130 extending obliquely from the guide body 120. The guide body 120 has a proximal end 122 that defines a proximal opening 123 for receiving a drill bit, as described below. The guide body 120 also has a distal end 124 that defines a distal opening 125 for receiving a drill tube, as described below. Additionally, the guide body 120 features a drill stop 140 that limits the drilling depth by limiting how far the drill bit can advance through the guide body 120. An optional navigation star unit 50 is attached to the universal drill guide 110 of FIG. 1, which can be adjusted for use with a conventional navigation system.

[0025] The universal drill guide system 100 also includes a set of interchangeable drill tubes 150 and a set of interchangeable drill bits 200. The set of interchangeable drill tubes 150 includes a first drill tube 150A, a second drill tube 150B, and a third drill tube 150C. The set of interchangeable drill bits 200 includes a first drill bit 200A, a second drill bit 200B, and a third drill bit 200C. However, the number of drill tubes 150 and the number of drill bits 200 are not limited to three. All of the drill tubes 150A, 150B, and 150C and all of the drill bits 200A, 200B, and 200C are connectable to the universal drill guide 110.

[0026] The first, second, and third drill bits 200A, 200B, and 200C are hollow and have features designed to hold K-wires, as described in the next section of this description. The first, second, and third drill bits 200A, 200B, and 200C also have different drilling diameters. Each drilling diameter is configured to drill a particular size screw hole into the vertebral body. The first, second, and third drill bits 200A, 200B, and 200C each have a proximal end 202 for attachment to a drill driver and an opposing distal end 204 with a cutting edge for drilling a hole. The first, second, and third drill bits 200A, 200B, and 200C also have a reduced diameter section 205 adjacent to an enlarged diameter section 207, forming an abrupt transition. This abrupt transition forms a stop surface 206 located between the proximal end 202 and the distal end 204. The stop surface 206 cooperates with the drill stop 140 on the guide body 120 to limit the distance the drill bit can advance within the vertebral body during drilling. The stop surface 206 also serves to remove the drill bits 200A, 200B, and 200C after drilling, as will be described in another section.

[0027] The first, second and third drill tubes 150A, 150B and 150C are designed to guide the advancement of the first, second and third drill bits 200A, 200B and 200C, respectively, during drilling. The first, second and third drill tubes 150A, 150B and 150C also hold the first, second and third drill bits 200A, 200B and 200C axially stable during drilling. Each of the first, second and third drill tubes 150A, 150B and 150C has a proximal end 152 for attachment to the guide body 120 and an opposite distal end 154 for insertion into the patient at the drilling location. The proximal end 152 of each of the drill tubes 150A, 150B and 150C includes a notch 157 that facilitates attachment to the guide body 120, as will be described in more detail below.

[0028] The first, second and third drill tubes 150A, 150B and 150C define drill bit passages 156 having internal diameters specifically sized to receive the first, second and third drill bits 200A, 200B and 200C, respectively. Thus, the first, second and third drill bits 200A, 200B and 200C are designed to work only with the first, second and third drill tubes 150A, 150B and 150C, respectively. Each of the first, second and third drill tubes 150A, 150B and 150C and each of the first, second and third drill bits 200A, 200B and 200C are provided with indicia to assist the user in selecting the appropriate drill tube for the selected drill bit. Any type of indicia may be used. In system 100, first drill tube 150A and first drill bit 200A have alignment indicia 160A, second drill tube 150B and second drill bit 200B have alignment indicia 160B, and third drill tube 150C and third drill bit 200C have alignment indicia 160C. Indicia 160A, 160B and 160C are unique and different from one another and appear in the form of different colored bands around the circumference of each drill tube and drill bit.

[0029] 4, the drill stop 140 includes a shaft 142 and a stop plate 144 extending laterally from the shaft 142. The stop plate 144 includes a slot 146 having a slot dimension wide enough to allow distal portions of the first, second, and third drill bits 200A, 200B, and 200C to pass through the stop plate 144. The slot 146 is smaller than the cross-sectional dimension of the stop faces 206 of the first, second, and third drill bits 200A, 200B, and 200C. In this configuration, the stop plate 144 is configured to allow each of the first, second, and third drill bits 200A, 200B, and 200C to advance through the stop plate 144 until the respective stop faces 206 abut the stop plate 144. At such time, the drill bits have reached the selected drill depth and further advancement of the drill bits through the guide body 120 is prevented.

[0030] 5 and 6, the drill stop 140 can be raised or lowered to set a desired drilling depth setting. A spring loaded lock 126 releasably engages the shaft 142 of the drill stop 140 to lock and unlock the shaft 142. The shaft 142 has a series of circumferential grooves 143 on one side. The spring loaded lock 126 is configured to engage one of the grooves 143 to lock the position of the shaft 142 under the bias of the spring. The spring loaded lock 126 includes a release button 127 that can be pushed inward as shown in FIG. 5. Pressing the release button 127 inward disengages the spring loaded lock 126 from the shaft 142, allowing the shaft 142 to be raised or lowered relative to the guide body 120 to set the depth setting. Once the depth setting is set, the release button 127 is released as shown in FIG. 6 to allow the spring loaded lock 126 to engage the shaft 142 under the bias of the spring. The engagement of the spring loaded lock 126 with the shaft 142 locks the vertical position of the shaft 142 relative to the guide body 120 and fixes the depth setting.

[0031] The universal drill guide 110 has two sets of indicia on its exterior that provide a visual indicator to the user of the selected depth setting. The first set of indicia 128 includes a vertical series of markings 128a on the side of the guide body 120. The second set of indicia 148 includes a vertical series of markings 148a on the shaft 142. Each of the markings 128a, 148a is labeled with a unique number that corresponds to a depth in millimeters or other units of measurement. The markings 128a are oriented on a different side of the universal drill guide 110 than the markings 148a. The placement of overlapping markings on two different sides accommodates situations where the surgeon may only be able to see one side of the universal drill guide 110.

[0032] The guide body 120 includes an automatic drill tube capture 170 that allows each of the first, second, and third drill tubes 150A, 150B, and 150C to be connected to the distal opening 125 with a quick connect coupling / quick fit connection. The automatic drill tube capture 170 allows a user to insert one of the drill tubes 150A, 150B, and 150C into the guide body 120 and lock it into place without touching any locking mechanism on the guide body 120. The drill tube is simply inserted into the distal opening 125 until it engages with the automatic lock. Each of the drill tubes 150A, 150B, and 150C has a different inner diameter to accommodate one of the drill bits, as described above. However, all of the drill tubes 150A, 150B, and 150C have the same outer dimensions that engage with the drill stop 140 and the automatic drill tube capture 170. Thus, drill tubes 150A, 150B and 150C all interact with automatic drill tube capture 170 in the same manner.

[0033] 7 and 8, the automatic drill tube capture 170 includes a spring-loaded locking ring 172 inside the guide body 120. The locking ring 172 is configured to snap into notches 157 formed in each of the drill tubes 150A, 150B, and 150C. The locking ring 172 is rotatable within the guide body 120 between a locked orientation and an unlocked orientation. A pair of compression springs 174 exert a counterclockwise biasing force on the locking ring 172, biasing the locking ring 172 in the locked orientation. Each compression spring 174 abuts a locking tab 176 that extends proximally or upwardly from the remainder of the locking ring 172.

[0034] The locking tabs 176 and compression springs 174 are received within a pair of slots 178. One end of each compression spring 174 abuts an end wall 179 of the slot 178, and the other end of the springs 174 abuts the locking tabs 176. With this arrangement, the locking ring 172 remains in the locked orientation unless the user manually rotates the locking ring 172 in the unlocked direction. The locking ring 172 can be rotated by applying a clockwise force to a switch 173 attached to the locking ring. The switch 173 extends through an elongated opening 121 in the guide body 120 and is exposed on the outside of the guide body 120.

[0035] When the lock ring 172 is in the locked orientation, the compression springs 174 release energy to push the lock tabs 176 in a counterclockwise direction within their respective slots 178, causing the lock ring 172 to rotate counterclockwise, as shown in Fig. 7. When the lock ring 172 is in the unlocked orientation, the lock tabs 176 are rotated in a clockwise direction, compressing the compression springs 174 in their respective slots 178 under the stored energy, as shown in Fig. 8. A user can move the lock ring 172 from the locked orientation to the unlocked orientation by manually rotating the switch 173 in a clockwise direction.

[0036] 9A-9D show the sequence in which a drill tube, in this example a first drill tube 150A, is inserted into guide body 120 and locked in place by locking ring 172. The same sequence occurs when a second drill tube 150B and a third drill tube 150C are inserted into guide body 120.

[0037] Drill tube 150A is inserted through distal opening 125 and into passage 129 formed in guide body 120, as shown in FIG. 9A. Lock ring 172 is initially positioned in a locked orientation. Drill tube 150A advances within passage 129 until it enters lock ring 172, as shown in FIG. 9B. As drill tube 150A continues to advance, drill tube 150A contacts the inner surface of lock ring 172, as shown in FIG. 9C. This contact between drill tube 150A and lock ring 172 rotates lock ring 172 out of the locked orientation. Contact with lock ring 172 occurs at chamfer 177 on lock ring 172 that extends into passage 129. The proximal end and sidewall of drill tube 150A contact chamfer 177 as drill tube 150A advances proximally within passage 129. The chamfer 177 is oriented such that the sidewall of the drill tube 150A deflects the lock ring 172 counterclockwise a small distance / angle against the bias of the compression spring 174, storing additional energy in the spring 174. This deflection begins in Figure 9B and continues in Figure 9C.

[0038] As the drill tube 150A is advanced further into the passageway 129, the locking ring 172 remains biased until the notches 157 in the drill tube 150A align with the chamfers 177, as shown in FIG. 9D. When this alignment occurs, the force biasing the locking ring 172 is temporarily released, allowing the compression spring 174 to expand and return to a relaxed state. This expansion causes the locking ring 172 to rotate back toward the locking orientation. The chamfers 177 snap radially inward into the notches 157 under the biasing force of the compression spring 174. The axial dimension of the locking ring 172 is substantially equal to the axial dimension of the slots 157 such that the axial position of the drill tube 150A is fixedly locked in the guide body 120.

[0039] FIG. 10 shows a cross section of the locking ring 172 in the locked orientation. The portion of the locking ring 172 that engages the notches 157 is circular. FIG. 11 shows a cross section of the locking ring 172 in the unlocked orientation. In this state, no portion of the locking ring 172 extends into the notches 157. As can be seen from these two figures, the drill tube 150A can be removed from the guide body 120 by rotating the switch 173 counterclockwise against the biasing force of the compression spring 174. This rotation moves the chamfer 177 out of the notches 157 as shown in FIG. 11. In this state, the drill tube 150A is no longer axially constrained by the locking ring 172 and can be pulled out of the guide body 120.

[0040] Drill bits 200A, 200B, 200C have an outer diameter that corresponds to the inner diameter of drill tubes 150A, 150B, 150C, respectively. Each of drill bits 200A, 200B, and 200C is long enough to extend above drill stop 140 and beyond the distal end of drill tube 150A when drill tube 150A is attached to guide body 120.

[0041] After drilling is completed, it may be necessary to remove the drill driver and universal drill guide 110 from the operating side while leaving the drill tube and drill bit in place. This can be a technical challenge since the drill stop 140 is engaged with the drill bit as shown in FIG. 1. Therefore, the universal drill guide 110 includes a mechanism that rotates the drill stop 140 counterclockwise and away from the drill bit when the universal drill guide 110 is released from the drill tube. This is accomplished by a cam mechanism 190 that interconnects the locking ring 172 with the shaft 142 of the drill stop 140 as shown in FIGS. 12 and 13.

[0042] Locking ring 172 includes cam slots 181 that drive cam follower pin 145 at the bottom of shaft 142. In this arrangement, rotating locking ring 172 clockwise (or left as shown) simultaneously rotates shaft 142 and drill stop 140 counterclockwise (or right as shown), moving drill stop 140 away from the drill bit such that the drill tube and drill bit remain within the patient while the generic drill guide 110 can be lifted off the drill tube. The process of lifting generic drill guide 110 off drill tube 150A is shown in Figures 14 and 15.

[0043] It can be seen from FIG. 14 that the switch 173 on the locking ring 172 is rotated clockwise or to the left. This rotates the drill stop 140 counterclockwise or to the right. While disengaging the drill stop from the drill bit 200A, the universal drill guide 110 can be lifted unhindered off the drill tube 150A and the drill bit, as shown in FIG.

[0044] Hollow drill with K-wire retention As previously mentioned, the first, second and third drill bits 200A, 200B and 200C are hollow and have features designed to hold a K-wire. The drill bits 200A, 200B and 200C are generally the same, but with some differences. The outer diameters of the drill bits 200A, 200B and 200C are different, each configured to drill a different size hole. The inner diameter of the drill bit 200A is smaller than the inner diameters of the drill bits 200B and 200C, and the inner diameter of the drill bit 200A is configured to allow a 1.0 mm diameter K-wire to pass through the drill bit 200A. The inner diameters of the drill bits 200B and 200C are larger, and each configured to allow a 1.5 mm diameter K-wire to pass through the drill bits 200B and 200C. Drill bits 200A, 200B and 200C also have different colored markings on their exterior to assist the user in pairing each drill bit with a corresponding drill tube.

[0045] 16, a drill bit assembly having drill bit 200A will be described in more detail, with the understanding that the same description applies to drill bits 200B and 200C. Drill bit 200A is shown with a K-wire 300. K-wire 300 extends through a passageway 208 that extends through drill bit 200A from a proximal end 202 to a distal end 204. K-wire 300 has a proximal end 302, a distal end 304, and a wire body 306 that extends between the proximal and distal ends. Distal end 304 has a sharp pointed end 308 that can be drilled into bone at a selected location. Once K-wire 300 is inserted into bone, a surgeon can thread a hollow bone screw, drill bit, or other instrument over the K-wire and advance it to a selected location to perform surgery.

[0046] The K-wire 300 is significantly longer than the drill bit 200A. Thus, the K-wire 300 can extend through the drill bit 200A with the proximal end 302 of the K-wire protruding proximally and outside the proximal end 202 of the drill bit 200A. At the same time, the K-wire 300 can extend through the drill bit 200A with the distal end 304 of the K-wire protruding distally and outside the distal end 204 of the drill bit 200A. The K-wire 300 can be removably secured inside the drill bit 200A as an assembly that allows the K-wire and the drill bit to be inserted together into the bone.

[0047] 17 and 18, a retention mechanism 290 built into the drill bit removably secures the K-wire 300 inside the drill bit 200A during drilling. The retention mechanism 290 is configured to engage the K-wire 300 to prevent axial advancement of the K-wire relative to the drill bit 200A during drilling. This retention ensures that the K-wire 300 and the drill bit 200A are inserted together and advanced the same amount into the bone. The retention mechanism 290 also allows torque applied to the drill bit 200A to be transferred to the K-wire 300. Thus, when the retention mechanism is engaged, the K-wire 300 and the drill bit 200A rotate together. A torque driver can apply torque to the K-wire 300 and the drill bit 200A together to firmly insert the K-wire into the bone and form a pilot hole for the bone screw. Once the pilot hole has been drilled, the drill bit 200A may be disengaged from the K-wire 300 and removed from the patient, leaving the K-wire in the bone.

[0048] The retention mechanism 290 includes a retention clip 292 configured to releasably engage a locking groove 308 on an outer portion of the K-wire 300. Locking grooves and retention clips according to the present disclosure can have a variety of configurations and geometries. For example, the locking groove can extend around a portion of the K-wire or can completely surround the K-wire circumferentially. The retention clip can be clipped onto the outside of the drill bit or formed integrally with the drill bit. The retention clip can also have an inwardly extending retention end that can be pressed into the locking groove to limit axial displacement of the K-wire within the drill bit.

[0049] The retaining clip 292 has a hub portion 294 that attaches the retaining clip to the drill bit 200A. The retaining clip 292 also has a retaining end 296 opposite the hub portion 294. The retaining end 296 projects radially inward through the sidewall of the drill bit 200 and engages a locking groove 308 in the K-wire 300.

[0050] A K-wire according to the present disclosure can have a geometry in the locking groove that allows torque to be transferred from the drill bit / retaining clip to the K-wire. For example, the K-wire can have a flat surface on its outer portion in the groove that engages with a flat edge on the retaining end of the retaining clip. FIG. 19 shows an example of a K-wire 300 having a locking groove 308 with a four-sided rectangular portion 310 in the groove. The K-wire 300 can operate with a retaining clip formed on a drill bit according to any of the previous examples, such as drill bit 200A.

[0051] The locking groove according to the present disclosure may be bounded by a proximal end wall and a distal end wall. The proximal end wall and the distal end wall may have various geometries that control the axial displacement of the K-wire relative to the surrounding drill bit. In the example of FIG. 19, the locking groove 308 has a proximal end wall 312 and a distal end wall 314. The distal end wall 314 is substantially perpendicular to the longitudinal axis 301 of the K-wire 300. This forms a stop 316 that can abut against the retaining end 296 of the retaining clip 292 when the retaining clip 292 is engaged in the locking groove 308, thereby preventing the K-wire 300 from being displaced distally. In contrast to the distal end wall 314, the proximal end wall 312 consists of an inclined surface 318 that extends at an acute angle to the longitudinal axis 301. The inclined surface 318 forms an inclined portion 320 that allows the retaining end 296 of the retaining clip 292 to gradually deflect outward and slide out of the locking groove 308 during withdrawal of the drill bit 200A from the K-wire 300 after drilling is completed.

[0052] The retaining clip 292 is operable in a locked mode and a released mode. In the locked mode, the retaining end 296 is pressed inwardly and held in the locking groove as shown in FIG. 18. This locks the axial position of the K-wire 300 relative to the drill bit 200 during drilling. After drilling is completed, the inward force on the retaining end 296 can be removed, leaving the retaining clip 292 in the released mode. In the released mode, the drill bit 200 can be moved proximally relative to the K-wire 300 until the drill bit is completely detached from the K-wire. This allows the drill bit 200A to be withdrawn from the patient while the K-wire 300 remains in the patient for further use.

[0053] 20, the retaining clip 292 has a partially cylindrical hub portion 294 configured to clip onto the rounded exterior of the drill bit, similar to a pocket clip on a pen. The retaining clip 292 also has a flexible arm 295 between the hub portion 294 and the retaining end 296. The flexible arm 295 allows the retaining end 296 to deflect radially outward under stored energy as the drill bit is withdrawn from the K-wire. The retaining end 296 remains biased to an outward position when the drill bit is removed from the K-wire. Once the drill bit is removed from the K-wire, the retaining end 296 snaps radially inward back to the relaxed state shown in FIG.

[0054] A radially inward force can be applied to the retaining end of the retaining clip to push and hold the retaining clip in engagement mode with the locking groove. The inward force can be applied in a number of ways. FIGS. 21 and 22 show another example of a drill bit assembly with a drill bit 200' and a movable sleeve 298'. The movable sleeve 298' is slidable on the exterior of the drill bit 200' between a first position and a second position. In the first position (FIG. 21), the sleeve 298' covers the retaining end 296' and applies an inward force to hold the retaining clip 292' in engagement mode. In the second position (FIG. 22), the sleeve 298' is moved off the retaining end 296', allowing the retaining end 296' to flex outwardly and disengage the retaining clip 298' from the locking groove of the K-wire 300.

[0055] In other examples, a separate instrument can be used to lock the retaining clip into engagement with the K-wire. Figures 23 and 24 show an example in which the retaining clip 292 of the drill bit 200A is maintained in an engaged mode by a drill driver 400. The drill driver 400 is secured onto the retaining end 296 of the retaining clip 292 and applies an external force to maintain the retaining clip 292 in an engaged mode within the four-sided locking groove 308 of the K-wire 300.

[0056] Drill Removal Tool 25-32, an example drill removal tool 500 is shown. The drill removal tool 500 is designed to remove a hollow drill bit from a bone after a hole has been drilled, while leaving the K-wire in place within the bone. Once the drill bit has been removed from the K-wire, a bone screw can be advanced over the K-wire and into the screw hole. The drill removal tool 500 can be used with any combination of drill bits, drill tubes, and K-wires. For purposes of this description, the drill removal tool 500 will be described using the same drill bit 200A, drill tube 150A, and K-wire 300 described above.

[0057] The drill removal tool 500 includes a first support end 510, a second support end 520, and a toothed rack 530 extending between the first support end 510 and the second support end 520. The first support end 510 includes a wire clamp 540 operable to secure the K-wire 300. The second support end 520 includes a C-shaped base 522 configured to fit snugly around the drill tube 150A. A drill bit removal portion 570 is axially displaceable on the toothed rack 530 between the first support end 510 and the second support end 520.

[0058] 26-29, the wire clamp 540 is configured to pass over the exposed end of the K-wire 300 in an unlocked state and subsequently clamp the K-wire 300 in a locked state. The wire clamp 540 includes a hollow housing 542 extending from the first support end 510. The hollow housing 542 defines a clamp passage 544 having a proximal end 546, a distal end 548, and a convergent portion 549 between the proximal end 546 and the distal end 548. The proximal end 546 has an internal thread 547. The knob 550 includes a dial 552 and a shaft 554 with an external thread 557 that mates with the internal thread 547 in the clamp passage 544. The knob 550 defines a throughbore 558 that axially receives a clamp pin 560. The clamp pin 560 defines a through passage 562 and a wedge-shaped collet 564 at its distal end 566. The collet 564 has an outer diameter that gradually decreases toward the distal end 566, forming a cone-shaped protrusion that matches the shape of the converging portion 549. The through passage 562 has an inner diameter adapted to receive the K-wire 300.

[0059] The knob 550 is rotatable about the knob axis 551 between an unlocked state and a locked state. The knob axis 551 is coaxially aligned with the through hole 558 and the through passage 562. FIG. 27 shows the knob 550 in an unlocked state, and FIG. 28 shows the knob after it has been rotated to the locked state. The internal threads 547 and the external threads 557 facilitate axial displacement of the knob 550 as the knob is rotated. The clamp pin 560 is axially fixed within the knob 550, and the distal end 556 of the knob 550 abuts the collet 564. In this arrangement, the knob 550 and the clamp pin 560 move axially and together within the clamp housing 544 as the knob is rotated. The internal threads 547 and the external threads 557 are oriented such that a clockwise CW rotation of the dial 552 moves the knob 550 and the collet 564 distally into the convergent portion 549. The tapered shape of the convergent portion 549 exerts an inward force on the collet 564 as the clamp pin 560 moves distally, compressing the collet 564 to lock the K-wire 300 in a locked position.

[0060] The drill removal tool 500 can be mounted over the K-wire 300, drill bit 200A, and drill tube in two stages. In the first stage, the wire clamp 540 is threaded over the K-wire. To thread the wire clamp 540 over the K-wire 300, the knob 550 is rotated counterclockwise to an unlocked state such that the collet 564 is not compressed within the converging portion 549 of the clamp passage 544. Once the proximal end of the K-wire 300 has passed the wire clamp 540, the second support end 520 and the C-shaped base 522 are rotated toward the drill tube 150A in the direction shown by the curved arrow in FIG. 26. The C-shaped base 522 is rotated until the opening 523 of the C-shaped base is a snug fit to receive the drill tube 150A.

[0061] 30, the drill bit removal portion 570 includes a fork-shaped anvil 572 that defines a through slot 574. The through slot 574 is aligned with the clamp passage 544 and the opening 523 to form a straight passage through all three portions of the drill removal tool 500. The anvil 572 has a flat forklift surface 576 above the through slot 574. The through slot 574 and the forklift surface 576 are configured to engage the drill bit 200A below the stop surface 206, as previously described. The through slot 574 has a rounded end 575 having a diameter slightly larger than the reduced diameter portion 205 on the drill bit 200A, but smaller than the enlarged diameter portion 207. The anvil 572 is thus configured to receive the reduced diameter portion 205 of the drill bit 200A within the through slot 574 with the forklift surface 576 positioned downward or distal to the stop surface 206. In this position, the forklift surface 576 abuts the enlarged diameter portion 207 at the stop surface 206, as shown in FIG.

[0062] The drill bit removal part 570 includes a sleeve 573 connected to the anvil 572. The sleeve 573 surrounds the rack 530 and interconnects the anvil 572 with the C-shaped base 522. A pinion housing 582 extends from one side of the sleeve 573 and includes a pinion 584. The pinion 584 has a plurality of gear teeth 585 that mesh or engage with the teeth 531 of the rack 530 through an opening between the pinion housing 582 and the rack 530. A wheel handle 586 is attached to the pinion 584 and extends outside the pinion housing 582. The wheel handle 586 and the pinion 584 are rotatable together relative to the pinion housing 582. In this arrangement, the wheel handle 586 can be rotated to move the drill bit removal part 570 up and down along the rack 530.

[0063] 30 and 31, a spring loaded pawl 587 releasably engages the teeth 531 of the rack 530. The pawl 587 is biased into engagement with the teeth 531 by a spring 588. Engagement of the pawl 587 with the teeth 531 occurs automatically after the drill bit removal portion 570 is displaced along the rack 530 and serves to lock the position of the drill bit removal portion 570 relative to the rack 530 to maintain the position of the anvil 572. The pawl 587 is pivotable out of engagement with the teeth 531 against the biasing force of the spring 588 to release the pawl 587 and allow the drill bit removal portion 570 to move on the rack 530. The pawl 587 may be pivoted out of engagement with the teeth 531 by depressing a tab 589 extending from the pawl 587. If desired, the strength of the spring 588 can be designed to hold the pawl 587 against the rack 530, but allow the pawl 587 to move along the rack 530 as the wheel handle 586 is turned, like a ratchet. Alternatively, the strength of the spring 588 can be selected so that the pawl 587 does not disengage from the teeth 531 when the wheel handle 586 is turned, but only disengages from the teeth 531 when the user presses down on the tab 589.

[0064] The pinion 584 is disposed on the left side of the rack 530 when the wheel handle 586 is viewed from the front. In this arrangement, the anvil 572 is raised upward or toward the first support end 510 by rotating the wheel handle 586 in a clockwise direction CW. This causes the forklift surface 576 to contact and support the stop surface 206 of the drill bit 200A upward or proximally, displacing the drill bit 200A proximally. Thus, to remove the drill bit 200A from the patient, without removing the K-wire 300, the user first locks the wire clamp 540 to axially fix the K-wire 300. The user then rotates the wheel handle 586 clockwise to move the drill bit 200A proximally relative to the K-wire 300. This has the effect of withdrawing the drill bit 200A from the patient without displacing the K-wire 300 and holding the K-wire in place. The wheel handle 586 is rotated until the distal end 204 of the drill bit 200A is removed from the patient. Once the drill bit 200A is no longer in the patient, the wire clamp 540 is unlocked and the C-shaped base 522 is removed from the drill tube 150A. This allows the drill removal tool 500 to move again along the K-wire 300. The drill bit removal tool 500 is then lifted off the K-wire 300 with the forklift surface 576 supporting the drill bit 200A so that the drill bit 200A is also removed from the K-wire 300. After the drill bit removal tool 500 is removed from the K-wire 300, the drill tube 150A may be removed from the patient, as may any tissue dilators. In this example, the drill tube 150A extends through multiple nested dilators, the outermost dilator D being shown in FIG.

[0065] In an alternative MIS technique, the drill bit 200A may be inserted into the bone without the K-wire 300. In such a case, the drill removal tool 500 may be used to insert the K-wire 300 through the drill bit 200A into the bone. To begin this technique, a universal drill guide, such as the previous embodiment, is attached to the navigation unit and adjusted. The drill stop height is set and the appropriate drill tube is attached to the universal drill guide. An obturator is then inserted into the universal drill guide and drill tube and locked into place. The universal drill guide and obturator are then inserted to the desired drill location in the patient. The obturator is then removed from the universal drill guide and drill tube and replaced with a cortical punch. The cortical punch is used to create a starter hole in the cortical layer and then removed. An appropriate drill bit is then attached to the driver and inserted into the universal drill guide and advanced through the drill tube to drill a hole in the bone. Once the drill bit is inserted into the bone, the universal drill guide is removed from the drill tube, leaving the drill bit and drill tube in place.

[0066] A tissue expander D is attached to the expander handle and advanced over the drill tube until it contacts the tissue surrounding the drill tube. The expander is then pushed and rotated to expand the tissue. A tissue protector P is then advanced over the expander. A K-wire can then be inserted through the drill bit and into the bone.

[0067] 46-52, one process for inserting a K-wire 300 through a drill bit 200A is shown. In a first step, the K-wire 300 is attached to the drill removal tool 500. The knob 550 is rotated to an unlocked position and the K-wire 300 is inserted through the knob in the direction shown by the arrow in FIG. 46. The K-wire 300 is advanced through the knob 550 until the long markings 303 of the K-wire are completely covered by the drill removal tool 500. Once the K-wire 300 has been advanced to the proper position through the drill removal tool 500, the knob 550 is rotated to a locked position as shown by the arrow in FIG. 47 to lock the K-wire into the wire clamp 540.

[0068] The drill removal tool 500 and K-wire 300 are placed over the proximal end 202 of the drill bit 200A. The K-wire 300 is then guided into the drill bit 200A. The bottom of the drill removal tool 500 is rotated toward the drill bit 200A and dilator D until the drill bit is received in the through slot 574 of the anvil 572, as shown in FIG. 48. The drill removal tool 500 is rotated while ensuring that the anvil 572 is positioned below the stop surface 206. Once the drill removal tool 500 is attached to the drill bit 200A and dilator D, the knob 550 is rotated to the unlocked position in the direction shown in FIG. 49.

[0069] The K-wire 300 is advanced downward into the drill bit 200A, as shown in FIG. 50. Once the long marking 303 is completely covered by the drill bit 200A, the knob 550 is rotated to a locked position, as shown in FIG. 51. The wheel handle 586 is then rotated to move the anvil 572 upward against the toothed rack 530, as shown in FIG. 52, to withdraw the drill bit 200A from the bone. Once the drill bit 200A is withdrawn from the bone, the drill removal tool 500 and the drill bit can be lifted and removed. The drill tube 150A and the dilator D can then be removed from the protector P, as shown in FIG. 53.

[0070] Bone screwdriver with K-wire retention 33-41, there is shown a bone screwdriver assembly having a bone screwdriver 600 according to one example. The bone screwdriver 600 is designed to advance the bone screw over the K-wire and drive the bone screw into the bone while preventing the K-wire from advancing forward (i.e., distally). To accomplish this, the bone screwdriver assembly features a K-wire retention module 700. For purposes of this description, the bone screwdriver 600 and K-wire retention module 700 will be described in conjunction with the same K-wire 300 described above.

[0071] The bone screwdriver 600 has a shaft 601 defining a proximal end 602, a distal end 604 opposite the proximal end 602, and a longitudinal through passage 606 between the proximal end 602 and the distal end 604. The passage 606 is configured to allow the bone screwdriver 600 to pass over the proximal end of the K-wire 300 and advance toward the distal end of the K-wire 300. The proximal end 602 has an attachment mechanism (not shown) to which a handle 603 is attached. The attachment mechanism can be any suitable structure for receiving a handle, including, but not limited to, a hexagonal shaft. The handle 603 is configured to be grasped and rotated by a user operating the bone screwdriver 600, as in a conventional screwdriver. The distal end 604 has male threads 605 configured to mate with female threads in a rod-receiving component of a pedicle screw assembly. A knob 607 is provided on the shaft 601 to facilitate rotation of the shaft 601 and to thread the male threads 605 into a rod-receiving component.

[0072] 34 and 35, the distal end 604 has a driver tip 610. The driver tip 610 has a hexalobular extension 612 that fits into a similarly shaped recess in the head of the bone screw. The driver tip 610 also has a pair of tangs 614 disposed proximally relative to the extension 612. The tangs 614 are configured to slide into diametrically opposed slots in the rod-receiving component when the male threads 605 are threaded into the female threads of the rod-receiving component. In this configuration, the tangs 614 occupy the location where the fixation rod is placed.

[0073] The K-wire holding module 700 includes a housing 710 having a proximal end 712, a distal end 714, and a passageway 716 extending between the proximal end 712 and the distal end 714. The passageway 716 is aligned with the passageway 606 of the bone screwdriver 600. In this arrangement, the bone screwdriver 600 and the K-wire holding module 700 can be advanced as a unit over the K-wire 300. FIG. 36 shows the bone screwdriver 600 (without the handle 603 attached) during advancement over the implanted K-wire 300. The driver tip 610 is secured to a hollow polyaxial screw assembly 800 and a tab protection sleeve 850 that also pass over the K-wire 300.

[0074] 37, the K-wire holding module 700 has a roller assembly 720 housed within a housing 710. The roller assembly 720 is operable in a disengaged mode and an engaged (or driven) mode. In the disengaged mode, the roller assembly 720 allows the K-wire holding module 700 and bone screwdriver 600 to advance freely along the length of the K-wire 300. In the engaged mode, the roller assembly 720 engages the K-wire 300 and feeds the K-wire 300 proximally through the housing 710 as the bone screwdriver 600 advances the polyaxial screw assembly 800 distally.

[0075] The roller assembly 720 includes a first spur gear 722a attached to the shaft 601 of the bone screwdriver 600 and a second spur gear 722b mated to the first spur gear 722a. The roller assembly 720 also includes a third spur gear 722c on the shaft 601 mated to a fourth spur gear 722d. The second spur gear 722b and the fourth spur gear 722d are attached to a secondary shaft 721 that extends parallel to the shaft 601. The secondary shaft 721 includes a worm gear 724 mated to a fifth spur gear 722e. The fifth spur gear 722e is attached to a first roller 726 that is fixed to the fifth spur gear 722e, such that the fifth spur gear 722e and the first roller 726 rotate together. The second roller 728 is disposed adjacent to the first roller 726 in a position to engage the K-wire 300 on the opposite side from the first roller 726 .

[0076] 38-41, engagement and disengagement of the roller assembly 720 is controlled by a lever assembly 730. The lever assembly 730 includes a spring-loaded lever 732 that is biased toward an engaged mode by a compression spring 734. FIG. 38 shows the components of the roller assembly 720 immediately prior to advancement over the K-wire 300. The lever 732 is positioned in the engaged mode by the fully extended spring 734. In this mode, the first and second rollers 726, 728 are positioned closely together with little or no gap between them. To advance the roller assembly 720 over the K-wire 300, the lever 732 is pressed inward toward the K-wire as shown in FIG. 40. This moves the first and second rollers 726, 728 apart, allowing the roller assembly 720 to advance over the K-wire 300. Once the K-wire 300 is received between the first and second rollers 726, 728, the lever 732 can be released to return the roller assembly 720 to the engagement mode under the bias of a spring 734 which places the rollers directly into engagement with the K-wire.

[0077] The polyaxial screw assembly 800 is advanced into the bone over the K-wire 300 by applying a clockwise torque to the proximal end 602 of the bone screwdriver 600. With the roller assembly 720 in the engagement mode, the application of a clockwise torque to the proximal end 602 of the screwdriver 600 causes the roller assembly 720 to drive the K-wire 300 proximally through the housing 710. The clockwise rotation of the shaft 601 causes the first spur gear 722a and the third spur gear 722c to rotate clockwise, which imparts a torque to the secondary shaft 721 through the second spur gear 722c and the fourth spur gear 722d. The secondary shaft 721 and the worm gear 724 rotate in a counterclockwise direction, which imparts a torque to the fifth spur gear 722e. The fifth spur gear 722e drives the first roller 726 in a first direction. The second roller 728 is biased to engage the K-wire 300 and rotate in a second direction opposite to the first direction. The outer surfaces of the first and second rollers 726, 728 grip the surface of the K-wire 300 and pull the K-wire proximally relative to the housing 710 such that the K-wire 300 is fed proximally as the polyaxial screw assembly 800 is advanced distally into the bone.

[0078] The K-wire 300 is prevented from being fed distally through the housing 710 by the ratchet wheel 742 and the pawl 744. The pawl 744 engages the ratchet wheel 742 to prevent the shaft 601 from rotating counterclockwise relative to the housing 710, as shown in FIG. 39. This causes the housing 710 to rotate the first and second rollers 726, 728 in the opposite direction feeding the K-wire distally. The pawl 744 can be rotated out of engagement with the ratchet wheel 742 by pressing the lever 732 inward against the spring 724, as shown in FIG. 41. This switches the roller assembly 720 to a disengagement mode to release the K-wire 300, allowing the bone screwdriver 600 and the K-wire holding module 700 to be removed from the K-wire 300 without risking advancing the K-wire 300 distally.

[0079] The K-wire holding module according to the present disclosure can be a modular unit that can be removably connected to different types of instruments, including but not limited to instruments for tapping and driving. In this embodiment, the K-wire holding module 700 is removably connected to the bone screwdriver 600 by a quick-fit connection 650 shown in FIG. 33. The shaft 601 of the bone screwdriver 600 is snap-fitted into the housing 710 using the quick-fit connection 650, which can be a hex drive, a ¼ inch drive, or an AO drive to control rotation.

[0080] A bone screwdriver according to the present disclosure can include various types of markings to aid in the insertion of the bone screw. For example, the shaft 601 can have spaced lines providing depth markings, similar to those on the universal drill guide 110. The depth markings can provide a user with a visual indication of the depth to which the tip of the bone screw will advance. The bone screwdriver can also include various features to aid in sterilization. For example, the shaft 601 has a series of openings 611 that allow steam to enter the interior of the shaft 601 during autoclaving and cleaning.

[0081] 42-45 show an alternative bone screwdriver 900 and K-wire holding module 1000 according to another embodiment. The K-wire holding module 1000 is similar to the K-wire holding module 700, but features a pinch lever 1032 and pinch rollers 1026, 1028. The pinch lever 1032 is normally in an open position to disengage the pinch rollers 1026, 1028, as shown in Figs. 43 and 44. The pinch lever 1032 can be moved to a closed position to engage the rollers against the K-wire 300, as shown in Fig. 45. The pinch lever 1032 can only remain closed (i.e., keep the drive engaged) if the K-wire 300 is placed between the pinch rollers 1026, 1028.

[0082] The instruments described herein can be manufactured using a variety of materials, including, but not limited to, various alloys of stainless steel. The grade of alloy can be selected based on the desired strength, hardness, corrosion resistance, wear characteristics, and other performance criteria.

[0083] It is therefore intended that the appended claims will cover all such modifications that fall within the scope of this disclosure. The features of the technology disclosed in this specification are listed below. (Item 1) A universal drill guide system (100), comprising: a plurality of drill tubes (150) each having a drill bit passage; a plurality of drill bits (200), each insertable into the drill bit passages of each of the plurality of drill tubes (150); Equipped with each of the drill bit passages has an inner diameter different from the inner diameter of any of the other drill bit passages; each of the plurality of drill bits (200) has an outer diameter different from the outer diameter of any of the other drill bits (200); the outer diameter of each of the plurality of drill bits (200) corresponds to the inner diameter of each of the drill bit passages, respectively; A versatile drill guide system. (Item 2) the plurality of drill tubes (150) includes a first drill tube (150A), a second drill tube (150B), and a third drill tube (150C); The universal drill guide system (100) of item 1, wherein the plurality of drill bits (200) includes a first drill bit (200A) corresponding to the first drill tube (150A), a second drill bit (200B) corresponding to the second drill tube (150B), and a third drill bit (200C) corresponding to the third drill tube (150C). (Item 3) each of the plurality of drill tubes (150) having an alignment mark different from any of the other drill tubes (150); each of the plurality of drill bits (200) having a registration indicia different from any of the other drill bits (200); 3. The universal drill guide system (100) of claim 1 or 2, wherein alignment markings of each of the drill bits (200) correspond to alignment markings of each of the plurality of drill tubes (150), respectively. (Item 4) The universal drill guide system (100) comprises a universal drill guide (110); the plurality of drill tubes (150) are insertable into openings (125) of the universal drill guide (110); 4. The universal drill guide system (100) of any one of items 1 to 3, wherein the plurality of drill tubes (150) have the same outer dimensions. (Item 5) The universal drill guide (110) includes an automatic drill tube capture (170); 5. The universal drill guide system (100) of item 4, wherein the automatic drill tube capture portion (170) allows the multiple drill tubes (150) to be inserted into the openings (125) of the universal drill guide (110) with a quick-fit connection. (Item 6) 6. The universal drill guide system (100) of item 5, wherein the automatic drill tube capture (170) includes a lock ring (172) rotatable within the universal drill guide (110) between a locked orientation and an unlocked orientation. (Item 7) 7. The universal drill guide system (100) of claim 6, wherein the automatic drill tube capture portion (170) includes a compression spring (174) that applies a biasing force to the locking ring (172) to bias the locking ring (172) in the locking direction. (Item 8) 8. The universal drill guide system (100) of item 7, wherein the automatic drill tube capture (170) includes a switch (173) for manually rotating the lock ring (172) from the locked orientation to the unlocked orientation against the biasing force of the compression spring (174). (Item 9) 9. The universal drill guide system (100) of claim 7 or 8, wherein the locking ring (172) has an inwardly extending chamfer (177) that is oriented / configured such that a sidewall of the drill tube (150) inserted into the opening (125) of the automatic drill tube capture (170) biases the locking ring (172) at an angle against the biasing force of the compression spring (174). (Item 10) 10. The universal drill guide system (100) of claim 9, wherein the deflection of the lock ring (172) is maintained until a notch formed in the outer peripheral surface of the drill tube (150) is aligned with the chamfer (177). (Item 11) Each of the plurality of drill bits (200) includes a K-wire passage for receiving one of a plurality of K-wires (300); the K-wire passage of each of the plurality of drill bits (200) having an inner diameter different from the inner diameter of any of the other K-wire passages; Each of the plurality of K-wires (300) has an outer diameter different from the outer diameter of the other K-wires (300); 11. The universal drill guide system (100) of any one of items 1 to 10, wherein an outer diameter of each of the K-wires (300) corresponds to an inner diameter of each of the K-wire passages, respectively. (Item 12) 12. The universal drill guide system (100) of any one of claims 1 to 11, wherein each of the plurality of drill bits (200) has a drilling diameter that is different from the drilling diameters of the other drill bits (200). (Item 13) 13. A universal drill guide system (100) as described in any one of items 1 to 12, wherein each of the plurality of drill bits (200) has a proximal end (202) for attachment to a drill driver and an opposite distal end (204) having a cutting edge for drilling a screw hole. (Item 14) The universal drill guide (110) includes a drill stop (140); Each of the plurality of drill bits (200) has a stop surface (206) located between a proximal end (202) and a distal end (204); 14. The universal drill guide system (100) of any one of items 1 to 13, wherein the stop surface (206) cooperates with the drill stop (140) to limit the distance the drill bit (200) can advance within bone during drilling.

Claims

1. 1. A universal drill guide system, comprising: a plurality of drill tubes, each having a drill bit passage; a plurality of drill bits, each insertable into the drill bit passages of each of the plurality of drill tubes; Equipped with each of the drill bit passages has an inner diameter different from the inner diameter of any of the other drill bit passages; each of the plurality of drill bits has an outer diameter different from an outer diameter of any of the other drill bits; the outer diameter of each of the plurality of drill bits corresponds to the inner diameter of each of the drill bit passages, respectively; In addition, a general-purpose drill guide and an automatic drill tube capture including a locking ring rotatable within the universal drill guide between a locked orientation and an unlocked orientation; Equipped with A versatile drill guide system.

2. the plurality of drill tubes includes a first drill tube, a second drill tube, and a third drill tube; 2. The universal drill guide system of claim 1, wherein the plurality of drill bits includes a first drill bit corresponding to the first drill tube, a second drill bit corresponding to the second drill tube, and a third drill bit corresponding to the third drill tube.

3. each of the plurality of drill tubes having an alignment indicia different from any of the other drill tubes; each of the plurality of drill bits having a registration indicia different from any of the other drill bits; The universal drill guide system of claim 1 or 2, wherein an alignment mark on each of the drill bits corresponds to an alignment mark on each of the plurality of drill tubes, respectively.

4. the plurality of drill tubes are insertable into openings of the universal drill guide; The universal drill guide system according to claim 1 , wherein the plurality of drill tubes have the same outer dimensions.

5. A guide body including the automatic drill tube capture portion, 5. The universal drill guide system of claim 4, wherein the automatic drill tube capture permits each of the plurality of drill tubes to be connected to the aperture by a quick connect coupling that permits one drill tube to be inserted into the guide body and locked into place.

6. 2. The universal drill guide system of claim 1, wherein the automatic drill tube capture includes a compression spring that exerts a biasing force on the locking ring to urge the locking ring in the locking direction.

7. 7. The universal drill guide system of claim 6, wherein the automatic drill tube capture includes a switch for manually rotating the locking ring from the locked orientation to the unlocked orientation against the biasing force of the compression spring.

8. 8. The universal drill guide system of claim 6 or 7, wherein the locking ring includes an inwardly extending chamfer that is oriented / configured such that a side wall of the drill tube inserted into an opening in the automatic drill tube capture biases the locking ring at an angle against the biasing force of the compression spring.

9. 9. The universal drill guide system of claim 8, wherein the deflection of the locking ring is maintained until a notch formed in an outer circumferential surface of the drill tube is aligned with the chamfer.

10. each of the plurality of drill bits includes a K-wire passage for receiving one of a plurality of K-wires; the K-wire passage of each of the plurality of drill bits has an inner diameter different from the inner diameter of any of the other K-wire passages; Each of the plurality of K-wires has an outer diameter different from the outer diameters of the other K-wires, 10. The universal drill guide system of claim 1, wherein an outer diameter of each of the K-wires corresponds to an inner diameter of each of the K-wire passages, respectively.

11. 11. The universal drill guide system of claim 1, wherein each of the plurality of drill bits has a drilling diameter that is different from the drilling diameters of the other drill bits.

12. 12. The universal drill guide system of claim 1, wherein each of the plurality of drill bits has a proximal end for attachment to a drill driver and an opposite distal end having a cutting edge for drilling a threaded hole.

13. The universal drill guide includes a drill stop; Each of the plurality of drill bits has a stop surface located between a proximal end and a distal end; 13. The universal drill guide system of claim 1, wherein the stop surface cooperates with the drill stop to limit the distance the drill bit can advance within bone during drilling.

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