Set of drill attachments designed for drilling canals in bone and inserting screws, and method of use

Abstract

FIELD: traumatology; orthopaedics.SUBSTANCE: invention can be used for surgical treatment during osteosynthesis and other operations in patients with traumatic and orthopaedic bone pathology requiring the use of screw fixation. The drill bit set includes a spade bit and a screwdriver bit, which is a cylindrical body with a working part at one end and a shank at the opposite end. The working part of the drill has two oblique converging chamfers. The tops of the chamfers are cutting edges of right rotation, oriented at an angle of 35° to the drill axis and at an angle of 70° to each other. The drill shank is made in the form of three straight chamfers parallel to the drill axis and oriented at an angle of 60° to each other. A screwdriver bit is a tubular body with a working part at one end, a flattened middle part and a shank at the opposite end. The working part is made in the form of a screwdriver tip. The shank is made with an inlet opening coaxial with the axis of the tubular body and a through flushing opening, the axis of which is oriented perpendicular to the longitudinal axis of the tubular body. The inner diameter of the tubular body exceeds the diameter of the feather drill by 0.1 mm, the middle part is made flattened to a clearance width 0.1 mm greater than the thickness of the working part of the feather drill. The spade bit is fixed in the drill spindle by clamping the spindle jaws against the straight flats of the tail of the spade bit. A channel is drilled into the bone. The drill is removed from the drilled channel. The screw that needs to be inserted into the drilled channel is placed on the screwdriver tip of the bit. This screwdriver bit is placed on the spade bit in such a way that the bevelled chamfers of the working part of the spade bit enter the cavity of the flattened middle part of the screwdriver bit through the entry hole of the shank. The screw is installed coaxially into the entrance hole of the channel drilled into the bone. The drill is switched to right-hand rotation and turn on the drill. The rotation is transmitted through the straight chamfers of the shank and the bevelled chamfers of the working part of the spade bit to the screwdriver bit, the rotation of which drives the screw into the channel drilled in the bone. If it is necessary to unscrew the installed screw, switch the drill to reverse and use left-hand rotation to unscrew the screw from the channel in the bone.EFFECT: simplified and accelerated surgical procedure for bone osteosynthesis.6 cl, 10 dwg

Description

[0001] The invention relates to medicine, namely to traumatology and orthopedics, and can be used for surgical treatment during osteosynthesis and other operations in patients with traumatic and orthopedic bone pathology requiring the use of fixation with screws, as well as other internal devices that involve the use of screws.

[0002] In traumatology and orthopedics, the use of screws is one of the most common osteosynthesis techniques used in bone surgery. Bone fixation screws are used both in bone or intramedullary osteosynthesis, and independently, when screws are used as an independent or sole means of fixation [1].

[0003] According to traditional technology, a channel for a screw is first drilled with a drill of standard diameter, then a thread is cut in it and the screw is inserted with a screwdriver [1, 2].

[0004] The development of osteosynthesis technology, and in particular the improvement of power equipment, led to the use of a drill's screwdriver rotation function. Initially, the drill bit in the drill spindle was replaced with a screwdriver, resulting in a significant increase in productivity. Later, removable spindles were developed, allowing one to hold a drill bit for drilling, another to hold a tap, and a third to hold a screwdriver for inserting screws. The spindles and tools in the drill could be sequentially swapped, dramatically accelerating the screw insertion process. A set of power equipment for bone processing, including replaceable spindles, can be considered the prototype of our proposed method [3].

[0005] The disadvantage of the prototype is the high complexity of the devices, the price of a set consisting of a drill with three replaceable quick-release spindles, as well as the need to change the spindle for each subsequent stage of the technology, which complicates the work and reduces labor productivity.

[0006] No reports could be found on similar techniques and instruments used in osteosynthesis operations using screws.

[0007] The objective of the invention is to develop a technology based on the use of a method and a set of attachments for a drill, designed for drilling canals in bone and inserting screws, and allowing the insertion of screws without changing complex devices on the drill: one spindle, one drill, one drilling, one screwing in of the screw and, if necessary, its unscrewing without significant changes in the system.

[0008] The technical result consists in ensuring a high speed of screw installation or its intraoperative removal (screwing in or unscrewing) without removing the drill from the drill, without additional changes in the power equipment and at minimal costs.

[0009] The technical result of the invention is achieved by a set of attachments for a drill intended for drilling canals in bone and conducting screws and including a spade drill and a screwdriver bit, where the spade drill is a cylindrical body with a working part at one end and a shank at the opposite end, on the working part of the drill there are two oblique converging chamfers with cutting edges, the tops of which are cutting edges of right rotation, oriented at an angle of 35 ° to the axis of the drill and at an angle of 70 ° to each other, and the shank of the drill is made in the form of three straight chamfers parallel to the axis of the drill and oriented to each other at an angle of 60 °, and the screwdriver bit is a tubular body with a working part at one end, a flattened middle part and a shank at the opposite end, the working part is made in the form of a screwdriver tip, the shank is made with an inlet hole coaxial with the axis of the tubular body,the flattened middle part is made with a through flushing hole, the axis of which is oriented perpendicular to the longitudinal axis of the tubular body, and the internal diameter of the tubular body exceeds the diameter of the feather drill by 0.1 mm, the middle part is made flattened to a clearance width 0.1 mm greater than the thickness of the working part of the feather drill.

[0010] In particular embodiments of the kit, the oblique converging chamfers of the working part of the feather drill are made with a length of eight diameters of the drill; and / or the feather drill is made with a diameter of 2.8 mm, or 3.2 mm, or 4.2 mm; and / or the input hole of the shank of the screwdriver bit is made with an internal diameter of 2.9 mm, or 3.3 mm, or 4.3 mm; and / or the screwdriver tip of the screwdriver bit is made with a shape and size corresponding to the shape and size of the seating cell of the head of the osteosynthesis screw.

[0011] The technical result is also achieved by a method of drilling channels in bone and inserting screws using a set of drill attachments, in which a feather drill is fixed in the drill spindle by clamping the straight chamfers of the feather drill shank with the spindle cams, a channel is drilled in the bone, the drill is removed from the drilled channel, a screw that needs to be inserted into the drilled channel is put on the screwdriver tip of the bit-screwdriver, this bit-screwdriver is put on the feather drill in such a way that two oblique converging chamfers of the working part of the feather drill enter the cavity of the flattened middle part of the bit-screwdriver through the inlet of the shank, then the screw is installed coaxially in the inlet of the channel drilled in the bone, the drill is switched to right-hand rotation and the drill is turned on, setting the spindle into rotation, which through the straight chamfers of the shank and the beveled chamfers of the working part of the feather drill the drill bit is transferred to the screwdriver bit,by rotating which the screw is inserted into the channel drilled in the bone, and if it is necessary to unscrew the installed screw, the drill is switched to reverse and by turning it left, the screw is unscrewed from the channel in the bone.

[0012] The key distinguishing feature is that, unlike the classical method, the proposed set of tools and screw insertion method eliminates the need for modifications to the power equipment, including the drill and the drill bit clamped in the spindle. The drill bit remains in the drill both while drilling the channel for the screw and while inserting the screw into the channel and, if necessary, while removing it. A screwdriver bit with a screw of the appropriate size (diameter and length) is attached to the drill bit and screwed in or, if necessary, removed.The spade drill in the set can be made in the most commonly used size (diameter 2.8 mm, 3.2 mm, 4.2 mm), and the screwdriver bit can be made in shape and size in exact accordance with the shape and size of the screwdriver seat of the screw head for osteosynthesis of the most commonly used sizes: 2.5 mm and 3.5 mm hexagons, as well as tips in the form of a six-pointed star “Stardrive” of the European standard ISO TORX-15 and European standard ISO TORX-20, allowing you to work with more than 80% of the screws of the AO-ASIF standard used for osteosynthesis.

[0013] Intraoperative screw removal is sometimes necessary when an error is detected on a staged intraoperative radiograph that requires rapid correction to comply with the surgical technology.

[0014] Unlike the prototype, you can use just one very cheap drill (even a household screwdriver) without replaceable spindles to quickly insert a screw.

[0015] The claimed invention is illustrated by images showing:

[0016] Figure 1. Feather drill, general view;

[0017] Figure 2. Shank of a spade drill, rear view;

[0018] Figure 3. Screwdriver bit, 3.5 mm hexagon version, oblique view from the back and side;

[0019] Figure 4. Screwdriver bit, 2.5 mm hexagon version, oblique view from the front and side;

[0020] Figure 5. Screwdriver bit, 3.5 mm hexagon version, oblique view from the front and side;

[0021] Figure 6. Screwdriver bit, version in the form of a “six-pointed star” of the European standard ISO TORX-20, oblique view from the back and side;

[0022] Figure 7. Screwdriver bit, version in the form of a “six-pointed star” of the European standard ISO TORX-15, oblique view from the back and front;

[0023] Figure 8. Screwdriver bit, version in the form of a “six-pointed star” of the European standard ISO TORX-20, oblique view from the front and side;

[0024] Figure 9. A screwdriver bit is placed on a spade drill, the internal relationships are shown in the longitudinal section of the bit, 1 - spade drill, 2 - working part, 3 - beveled chamfer, 4 - cutting edges, 8 - 3.5 mm hexagon screwdriver bit, 9 - 3.5 mm hexagon screwdriver tip, 16 - cylindrical tube with an internal diameter exceeding the diameter of the corresponding drill by 0.1 mm, 17 - middle part, 18 - flattened section, 19 - through flushing hole.

[0025] Figure 10. A drill attachment set (the "drill-drill-bit-screw-bone" system) mounted on a drill, ready for use. The drill shank is clamped in the jaws of the drill spindle, and a screwdriver bit is attached to the working part of the drill, onto which a screw is attached and oriented in the direction of the channel drilled into the bone. The wide arrows indicate the right-hand (forward) and left-hand (reverse) rotation of the system.

[0026] In the figure, the following positions are indicated:

[0027] 1 - spade drill;

[0028] 2 - working part of the feather drill;

[0029] 3 - spade drill shank;

[0030] 4 - oblique converging chamfers of the working part of the spade drill;

[0031] 5 - cutting edges of oblique converging chamfers;

[0032] 6 - feather drill axis;

[0033] 7 - straight flats of the shank of the spade drill;

[0034] 8 - screwdriver bit;

[0035] 9 - working part of the screwdriver bit;

[0036] 10 - middle part of screwdriver bit;

[0037] 11 - screwdriver bit shank;

[0038] 12 - input hole of the screwdriver bit shank;

[0039] 13 - tubular body axis (screwdriver bits);

[0040] 14 - through flushing hole of the flattened middle part of the screwdriver bit;

[0041] 15 - the axis of the through flushing hole of the flattened middle part of the screwdriver bit;

[0042] 16 - operating drill spindle;

[0043] 17 - surgical drill;

[0044] 18 - drill spindle cams;

[0045] 19 - screw channel;

[0046] 20 - bone;

[0047] 21 - screw.

[0048] A set of tools for drilling channels for screws and installing (screwing in or unscrewing) screws includes a spade bit and a screwdriver bit.

[0049] The spade bit 1 is a cylindrical body with a working part 2 at one end and a shank 3 at the opposite end (Fig. 1, 2). On the working part 2 of the drill, two oblique converging chamfers 4 are formed with cutting edges 5 (the tops of the chamfers are cutting edges of right rotation), oriented at an angle of 35° to the axis 6 of the drill and at an angle of 70° to each other. The shank 3 of the drill is made in the form of three straight chamfers 7, parallel to the axis 6 of the drill and oriented to each other at an angle of 60°.

[0050] Screwdriver bit 8 is a tubular body with a working portion 9 at one end, a flattened middle portion 10 and a shank 11 at the opposite end (Fig. 3-8). The working portion 9 is made in the form of a screwdriver tip. The shank 11 is made with an input hole 12 coaxial with the axis 13 of the tubular body. The flattened middle portion 10 is made with a through flushing hole 14 (at the boundary of the transition of the flattened portion into a screwdriver tip), the axis 15 of which is oriented perpendicular to the longitudinal axis 12 of the tubular body. In this case, the inner diameter of the tubular body exceeds the diameter of the spade drill by 0.1 mm, the middle portion 10 is made flattened to a clearance width 0.1 mm greater than the thickness of the working portion 2 of the spade drill.

[0051] The 8mm screwdriver bit can be made with a screwdriver tip of any configuration, such as: “2.5mm hexagon”, “3.5mm hexagon”, “ISO TORX-15 European standard six-pointed star drive”, “ISO TORX-20 European standard six-pointed star drive”.

[0052] The proposed method is carried out as follows.

[0053] In the spindle 16 of the operating drill 17, the spade drill 1 is fixed by clamping the straight chamfers 7 of the shank 3 of the spade drill with the jaws 18 of the spindle, and a channel 19 is drilled in the bone 20 for the screw 21. The drill 1 is removed from the drilled channel 19. Next, the screw 21, which must be inserted into the drilled channel 19, is put on the working part 9 of the screwdriver bit 8: for this, the working part 9 in the form of a screwdriver tip is inserted into the groove of the head of the screw 21. Then, the screwdriver bit 8 is put on the spade drill 1 in such a way that the oblique converging chamfers 4 of the working part 2 of the spade drill enter the cavity of the flattened middle part 10 of the screwdriver bit 8 through the inlet hole 12 of the shank 11.After this, the screw is installed coaxially into the input hole of channel 19 drilled in bone 20, the drill is turned on for right-hand rotation and the drill is turned on, causing spindle 16 to rotate, which is transmitted through straight chamfers 7 of shank 3 and oblique converging chamfers 4 of working part 2 of the feather drill to screwdriver bit 8, by rotation of which screw 21 is driven into channel 19 drilled in bone 20. If it is necessary to unscrew the installed screw 21, drill 17 is switched to reverse and screw 21 is unscrewed from channel 19 in bone 20 by left-hand rotation.

[0054] To install subsequent screws, remove the screwdriver bit 8 from drill 1 during drilling and put on a bit with a screw of the appropriate size while screwing in the last one.

[0055] Thus, the method can be used in the surgical treatment of any patients whose surgical plan includes the insertion of screws into the bone.

[0056] The set of devices and the method of their application allow for a significant (twofold, and sometimes even threefold) increase in the productivity of the stage of the operation during which channels for screws are drilled and inserted into bone fragments.

[0057] The set of devices and the method of their application allow to significantly reduce the load on the surgeon's hands and reduce the likelihood of overload pathology (epicondylitis) in the operator when using a large number of screws with angular stability.

[0058] The set of the claimed devices is several times cheaper than power equipment with a set of replaceable spindles carrying drills and screwdrivers and allows you to do without them, providing an important function of import substitution.

[0059] BIBLIOGRAPHY

[0060] 1. Müller ME, Allgover M, Schneider R, Willenegger H. Guide to internal osteosynthesis (methodology recommended by the AO Group Switzerland). - Springer-Verlag .-Berlin-Moscow.-pp442-443.

[0061] 2. McRae, R. Practical fracture treatment / R. McRae, M. Esser. - Edinburgh. etc : Churchill Livingstone Fifth edition, 2008. - 447 p

[0062] 3. Catalog of power equipment for trauma and orthopedics DePuiSynthes Power Tools pp. 18-19. https: / / medtehural.ru / images / cat_apr23 / Depuy_Synthes_buklet.pdf?ysclid=mnep7sja1j107115359

Claims

1. A set of drill attachments designed for drilling canals in bone and inserting screws, including a spade bit and a screwdriver bit, while - a spade drill is a cylindrical body with a working part at one end and a shank at the opposite end; on the working part of the drill there are two oblique converging chamfers with cutting edges, the tops of which are cutting edges of right rotation, oriented at an angle of 35° to the axis of the drill and at an angle of 70° to each other, and the shank of the drill is made in the form of three straight chamfers, parallel to the axis of the drill and oriented to each other at an angle of 60°; - a screwdriver bit is a tubular body with a working part at one end, a flattened middle part and a shank at the opposite end, the working part is made in the form of a screwdriver tip, the shank is made with an input hole coaxial with the axis of the tubular body, the flattened middle part is made with a through flushing hole, the axis of which is oriented perpendicular to the longitudinal axis of the tubular body, and the internal diameter of the tubular body exceeds the diameter of the spade drill by 0.1 mm, the middle part is made flattened to a clearance width 0.1 mm greater than the thickness of the working part of the spade drill.

2. A set according to item 1, characterized in that the oblique converging chamfers of the working part of the spade drill are made with a length of eight diameters of the drill.

3. A set according to item 1, characterized in that the feather drill has a diameter of 2.8 mm, or 3.2 mm, or 4.2 mm.

4. A set according to item 1, characterized in that the input hole of the screwdriver bit shank is made with an internal diameter of 2.9 mm, or 3.3 mm, or 4.3 mm.

5. A set according to item 1, characterized in that the screwdriver tip of the screwdriver bit is made with a shape and size corresponding to the shape and size of the seat of the head of the osteosynthesis screw.

6. A method for drilling channels in bone and inserting screws using a set of attachments according to paragraph 1 for a drill, in which a spade drill is fixed in the drill spindle by clamping the straight chamfers of the spade drill shank with the spindle jaws, a channel is drilled in the bone, the drill is removed from the drilled channel, a screw that needs to be inserted into the drilled channel is put on the screwdriver tip of the screwdriver bit, this screwdriver bit is put on the spade drill in such a way that two oblique converging chamfers of the working part of the spade drill enter the cavity of the flattened middle part of the screwdriver bit through the inlet opening of the shank, then the screw is installed coaxially in the inlet opening of the channel drilled in the bone, the drill is switched to right-hand rotation and the drill is turned on, setting the spindle into rotation, which is transmitted to a screwdriver bit, which is used to rotate the screw into the channel drilled in the bone,in this case, if it is necessary to unscrew the installed screw, switch the drill to reverse and use the left rotation to unscrew the screw from the channel in the bone.

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