System and method for bone fracture fixation

Abstract

A system for minimally invasive rib fixation including a plate for fixating a rib. The plate has a plate boss extending from a surface of the plate. The system further includes a shield having a collar releasably coupled to the plate boss such that the shield is oriented perpendicular to the plate and an engagement portion integrally formed with the collar. The engagement portion is configured to engage a screw being driven into the plate and to flex for uncoupling the shield from the plate boss.

Description

SYSTEM AND METHOD FOR BONE FRACTURE FIXATIONCROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims priority to U.S. Provisional Patent Application No. 63 / 634,185, filed April 15, 2024, the entire contents of which is incorporated herein by reference.FIELD OF THE DISCLOSURE

[0002] The present disclosure relates to a system for bone fracture fixation.BACKGROUND OF THE DISCLOSURE

[0003] Chest wall trauma can require surgical stabilization of rib fractures using plate and screw fixation like many other bones in the body. Certain surgical techniques for rib fracture fixation involve the correction of the altered rib anatomy and rigid fixation of the fracture by placing a screw at 90 degrees to the plate to thread into the plate itself as well as the underlying rib. Such techniques require either very large incisions or the use of 90-degree drills and screwdrivers and, therefore, are not minimally invasive.

[0004] Due to their invasive nature, such techniques are available only to the most severely injured patients. Patients who are less injured can rely on pain medication as a primary management strategy. Certain attempts at a minimally invasive technique have failed due to plate design, suboptimal screw-plate interference, drills or drivers that are unable to accommodate the angles within the chest cavity, and risk of lost hardware within the chest cavity.

[0005] Accordingly, there is a need for a minimally invasive technique for the stabilization of rib fractures.SUMMARY OF THE DISCLOSURE

[0006] The present disclosure provides, in one aspect, a system for minimally invasive rib fixation including a plate for fixating a rib. The plate includes a plate boss extending from a surface of the plate. The system further includes a shield including a collar releasably coupled tothe plate boss such that the shield is oriented perpendicular to the plate and an engagement portion integrally formed with the collar. The engagement portion is configured to engage a screw being driven into the plate and to flex for uncoupling the shield from the plate boss.

[0007] The present disclosure provides, in another aspect, a method for minimally invasive rib fixation. The method includes positioning a plate relative to a rib. The plate includes a plate boss. The method further includes releasably coupling a shield to the plate boss and driving a screw through the shield and into the plate in an insertion direction oriented perpendicular to the plate. The screw engaging the shield such that the shield flexes as the screw is driven in the insertion direction. Moreover, the method includes uncoupling the shield from the plate boss as the shield flexes to uncouple the plate boss and the screw is completely inserted into the plate.

[0008] The present disclosure provides, in another aspect, a system for minimally invasive rib fixation including a plate for fixating a rib and a screwdriver configured to drive a screw into the plate to fixate the rib. The screwdriver includes a head disposed at a proximal end of the screwdriver and operably coupled to the screw, and a handle disposed at a distal end of the screwdriver, opposite the proximal end. The handle is operable to drive the screw into the plate and control pivotal movement of the head along an angle of rotation. The screwdriver further includes a shaft disposed between the head and the handle. The shaft defines a longitudinal axis of the screwdriver. Moreover, the screwdriver includes a linkage extending centrally through the shaft along the longitudinal axis. The linkage is configured to be driven by the handle to reciprocate and cause pivotal movement of the head about a pivot axis oriented perpendicular to the longitudinal axis.

[0009] The present disclosure provides, in another aspect, a system for minimally invasive rib fixation including a plate for fixating a rib. The plate includes a plate boss extending perpendicular from a surface of the plate. The system further includes a screwdriver configured to drive a screw into the plate to fixate the rib. The screwdriver includes a head operably coupled to the screw and a sheath having a first end and a second end opposite the first end. The first end of the sheath is coupled to the head such that the screw extends through the sheath. The second end of the sheath is removably coupled to the plate boss. The screwdriver further includes a quick-release mechanism disposed within an opening defined in the sheath. Thequick-release mechanism is removably coupled to the sheath to provide access to the screw through the opening. Moreover, the screwdriver includes a handle operable to control pivotal movement of the head and drive the screw through the sheath and into the plate to fixate the rib.

[0010] The present disclosure provides, in another aspect, a system for minimally invasive rib fixation including a screwdriver configured to drive a screw for fixating a rib. The screwdriver includes a driver bit coupled to the screw. The driver bit includes a body having a first end and a second end opposite the first end, and a shank formed on the second end of the body. The shank is configured to extend though the screw to couple the screw to the driver bit for co-rotation. The driver bit further includes a drill tip extending from the shank such that the drill tip is disposed at an end of the screw for drilling a pilot hole.BRIEF DESCRIPTION OF DRAWINGS

[0011] FIG. l is a top view of a screwdriver for minimally invasive rib fixation, according to an embodiment of the present disclosure.

[0012] FIG. 2 is a side view of the screwdriver of FIG. 1.

[0013] FIG. 3 is an enlarged perspective view of a head of the screwdriver of FIG. 1, the head disposed at a first position.

[0014] FIG. 4 is cross-sectional view of the head of FIG. 3.

[0015] FIG. 5 is a side view of the head of FIG. 3 with portions removed.

[0016] FIG. 6 is a side view of the screwdriver of FIG. 1 with portions removed.

[0017] FIG. 7 is an enlarged view of a handle of the screwdriver of FIG. 1 with portions removed.

[0018] FIG. 8A is a top view of a gear assembly for the handle of FIG. 7.

[0019] FIG. 8B is a top view of an alternative gear assembly for the handle of FIG. 7.

[0020] FIG. 8C is a top view of an alternative gear assembly for the handle of FIG. 7.

[0021] FIG. 9 is a side view of the head of FIG. 3 with portions removed, the head disposed at a second position.

[0022] FIG. 10 is an enlarged perspective of the head of FIG. 3, the head disposed at a third position.

[0023] FIG. 11 is an enlarged perspective view of the head of FIG. 10 with portions removed.

[0024] FIG. 12 is a perspective view of a plate, according to another embodiment of the disclosure.

[0025] FIG. 13 is a side view of the plate of FIG. 12.

[0026] FIG. 14 is a top view of the plate of FIG. 12.

[0027] FIG. 15 is cross-sectional view of the plate of FIG. 12 with multiple screws.

[0028] FIG. 16A is a cross-sectional view of a shield in a first position, according to another embodiment of the disclosure.

[0029] FIG. 16B is a cross-sectional view of the shield of FIG. 16A in a second position.

[0030] FIG. 16C is a side view of the shield of FIG. 16A.

[0031] FIG. 17A is a cross-sectional view of the shield of FIG. 16A coupled to the plate ofFIG. 12, a screw positioned within the shield at a first position.

[0032] FIG. 17B is a cross-sectional view of the shield of FIG. 16A coupled to the plate of FIG. 12, a screw positioned within the shield at a second position.

[0033] FIG. 18 is a front perspective view of a shield, according to another embodiment of the disclosure.

[0034] FIG. 19A is a front perspective view of the shield of FIG. 18 being coupled to the plate of FIG. 12.

[0035] FIG. 19B is a front perspective view of the shield of FIG. 18 coupled to the plate of FIG. 12, a screw positioned within the shield.

[0036] FIG. 20 is a top view of a screwdriver, according to another embodiment of the present disclosure.

[0037] FIG. 21 is a perspective view of the screwdriver of FIG. 1 with a sheath configured to be coupled to a plate, according to another embodiment of the present disclosure.

[0038] FIG. 22 is a top perspective view of the plate of FIG. 21.

[0039] FIG. 23 is a bottom perspective view of the plate of FIG. 21.

[0040] FIG. 24 is a perspective view of the sheath of FIG. 21 coupled to the plate of FIG. 21.

[0041] FIG. 25 is a perspective view of the sheath of FIG. 21 coupled to the plate of FIG. 21, with portions removed from the sheath.

[0042] FIG. 26 is a perspective view of the sheath and the plate of FIG. 21 with portions removed and a screw at a first position within the sheath and the plate.

[0043] FIG. 27 is a cross-sectional view of the sheath and the plate of FIG. 26.

[0044] FIG. 28 is a perspective view of the sheath and the plate of FIG. 21 with portions removed and a screw at a second position within the sheath and the plate.

[0045] FIG. 29 is a cross-sectional view of the sheath and the plate of FIG. 28.

[0046] FIG. 30 is a perspective view of a quick-release mechanism removed from the sheath of FIG. 21.

[0047] FIG. 31 is an exploded view of a screw, a driver bit, and a driven gear, according to another embodiment of the present disclosure.

[0048] FIG. 32 is a side view of the screw, the driver bit, and the driven gear of FIG. 31 coupled together.

[0049] FIG. 33 is a cross-sectional view of the screw, the driver bit, and the driven gear of FIG. 32.

[0050] FIG. 34 is a top perspective view of a plate according to another embodiment of the present disclosure.

[0051] FIG. 35 is a bottom perspective view of the plate of FIG. 34.

[0052] FIG. 36 is a top perspective view a plate according to another embodiment of the present disclosure.

[0053] FIG. 37A is a perspective view of an acetabular cup according to another embodiment of the present disclosure, the acetabular cup including a shell, a housing, and an insert.

[0054] FIG. 37B is a top perspective view of the acetabular cup of FIG. 37A.

[0055] FIG. 38A is a perspective view of the acetabular cup of FIG. 37A with portions removed.

[0056] FIG. 38B is a cross-sectional view of the acetabular cup of FIG. 37A.

[0057] FIG. 39 is an enlarged cross-sectional view of the acetabular cup of FIG. 37A.

[0058] FIG. 40A is a bottom perspective view of the shell and the housing of the acetabular cup of FIG. 37A.

[0059] FIG. 40B is an enlarged bottom view of the shell and the housing of the acetabular cup of FIG. 37A.

[0060] FIG. 41A is a perspective view of the housing and the insert of the acetabular cup of FIG. 37 A.

[0061] FIG. 41B is a bottom view of the housing and the insert of the acetabular cup of FIG. 37A.

[0062] FIG. 42 is an enlarged cross-sectional view of the housing and the insert of the acetabular cup of FIG. 37A.

[0063] FIG. 43 A is a top perspective view of the shell of FIG. 37A.

[0064] FIG. 43B is a bottom perspective view of the shell of FIG. 37A.

[0065] FIG. 44A is a bottom perspective view of the housing of FIG. 37A.

[0066] FIG. 44B is a bottom view of the housing of FIG. 37A.

[0067] FIG. 44C is a top view of the housing of FIG. 37A.

[0068] FIG. 45 A is a top perspective view of the insert of FIG. 37A.

[0069] FIG. 45B is a bottom perspective view of the insert of FIG. 37A.

[0070] Before any embodiments of the disclosure are explained in detail, it is to be understood that the disclosure is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the following drawings. The disclosure is capable of other embodiments and of being practiced or of being carried out in various ways. Also, it is to be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting.DETAILED DESCRIPTION

[0071] The present disclosure is a system for a bone fracture fixation procedure, such as a minimally invasive rib fixation procedure. With reference to FIGS. 1 and 2, the system includes a screwdriver 10 having a handle 14 disposed at a distal end of the screwdriver 10, a head 18 disposed at a proximal end of the screwdriver 10 opposite the distal end, and a tube 22 coupled to and disposed between the handle 14 and the head 18. The tube 22 interconnects the handle 14 and the head 18 such that the handle 14 is operably couple the handle 14. The head 18 is coupled to a screw 26 (FIGS. 15 and 17A) having a top end 28. In some embodiments, the screw 26 may be a self-drilling screw. The handle 14 is operable by a user to control pivotal movement of the head 18 and to drive the screw 26 into a fractured rib for fixation of the rib.

[0072] The handle 14 includes a housing 30 defining a pair of indentations 34a, 34b on opposite sides of the housing 30. The indentations 34a, 34b are sized to receive a user’s fingersduring operation of the screwdriver 10. In the illustrated embodiment, the indentations 34a, 34b are offset from each other. In other embodiments, the indentations 34a, 34b may be aligned with each other. Also, the handle 14 includes a first actuation knob 38 and a second actuation knob 42 operably coupled to the housing 30. The first actuation knob 38 is configured to be rotated by a user to pivot the head 18 to a desired angular position. The second actuation knob 42 is configured to be rotated by a user to drive the screw 26 into a rib in an insertion direction Al (FIG. 17A).

[0073] In the illustrated embodiment, the handle 14 defines a diameter DI at the widest area of the housing 30. The diameter DI ranges between 1.50 inches (38.1 mm) and 1.70 inches (43.2 mm), and preferably is 1.60 inches (40.6 mm). The handle 14 also defines a handle length LI between the first actuation knob 38 and a portion of the housing 30 connected to the tube 22. The handle length LI ranges between 8.50 inches (216 mm) and 9.50 inches (241 mm), and preferably is 9.10 inches (231 mm). The first actuation knob 38 defines a knob length L2 of about 1.40 inches (35.6 mm). The second actuation knob 42 defines a knob diameter D2 of about 1.20 inches (30.5 mm). In some embodiments, the first and second actuation knobs 38, 42 may have the same knob length and knob diameter. In other embodiments, the first and second actuation knobs 38, 42 may have a different knob length and knob diameter. The head 18 defines a head length L3 that ranges between 0.95 inches (24 mm) and 1.50 inches (38.1 mm), and preferably is 1 .0 inch (25 mm). The head 18 also defines a head height Hl that ranges between 1.4 inches (3.6 mm) and 1.6 inches (4.1 mm), and preferably is 1.5 inches (3.8 mm). The screwdriver 10 defines a screwdriver length L4 between the first actuation knob 38 and the head 18. The screwdriver length L4 ranges between 16 inches (406 mm) and 18 inches (457 mm), and preferably is 17 inches (432 mm). The tube 22 defines a tube diameter D3 that ranges between 0.61 inches (15.5 mm) and 0.65 (16.5 mm), and preferably is 0.63 inches (16 mm).

[0074] With reference to FIGS. 3-5, the head 18 includes a stationary yoke 46 integrally formed with the tube 22. The stationary yoke 46 has a first supporting arm 50a and a second supporting arm 50b extending from the tube 22 and disposed opposite each other. Each supporting arm 50a, 50b has a hole 54a, 54b extending therethrough. The head 18 further includes a rotating yoke 58 pivotably coupled to the stationary yoke 46 for articulation of the head 18 with the tube 22. The rotating yoke 58 has a first movable arm 66a and a secondmovable arm 66b with a receptacle 68 defined therebetween. The first movable arm 66a is pivotably coupled to the first supporting arm 50a of the stationary yoke 46. The second movable arm 66b is pivotably coupled to the second supporting arm 50b of the stationary yoke 46. Each movable arm 66a, 66b has a hole 70a, 70b coaxial with the hole 54a, 54b of a corresponding supporting arm 50a, 50b. As such, the rotating yoke 58 is pivotably coupled to the stationary yoke 46 by respective fasteners 74a, 74b (FIGS. 1 and 2). In the illustrated embodiment, the stationary yoke 46 is arranged along an exterior portion of the rotating yoke 58. In other embodiments, the rotating yoke 58 may be arranged along an exterior portion of the stationary yoke 46, as illustrated in FIGS. 1 and 2.

[0075] With continued reference to FIGS. 3-5, the screwdriver 10 includes a drive shaft 78 defining a longitudinal axis 80 of the screwdriver 10, a first gear assembly 82 supported by the head 18, an axle 86, and a linkage 88. The drive shaft 78 extends through tube 22 to be operably coupled to and disposed between the handle 14 and the head 18. As such, the drive shaft 78 is configured to be rotated about the longitudinal axis 80 of the screwdriver 10 when the second actuation knob 42 is rotated by a user.

[0076] The first gear assembly 82 includes a drive gear 90 having a diameter of about 0.43 inches (11 mm), an idler gear 94 having a diameter of about 0.79 inches (20 mm), and a driven gear 106 having a diameter of about 0.43 inches (11 mm). The drive gear 90, the idler gear 94, and the driven gear 106 are bevel gears. The drive gear 90 is fixed to the drive shaft 78 for corotation with the drive shaft 78 about the longitudinal axis 80. A shaft 108 of the idler gear 94 extends through the hole 70a of the first movable arm 66a and the hole 54a of the first supporting arm 50a such that the idler gear 94 is disposed within the head 18 to mesh with the drive gear 90. The idler gear 94 is configured to rotate about a pivot axis 110 (FIG. 5) of the head 18 that is oriented perpendicular to the longitudinal axis 80. A bearing (not shown) may be provided within the holes 54a, 70a of the arms 50a, 66a to support rotation of the idler gear 94. The driven gear 106 has a drill bit holder 118 with a bore 119 (FIG. 10) configured to receive and hold a replaceable driver bit 120 (FIG. 3) configured to engage the screw 26. The driver bit 120 is replaceable to accommodate different screw sizes. The drill bit holder 118 is configured to be received within the receptacle 68 of the rotating yoke 58, thereby coupling the driven gear 106 tothe rotating yoke 58. A sleeve 121 (FIGS. 1 and 2) is coupled to the rotating yoke 58 to surround the driver bit 120 and the screw 26 during operation of the screwdriver 10.

[0077] The axle 86 is disposed within the head 18 and fixed to the rotating yoke 58 such that a portion of the axle 86 extends along the pivot axis 110. The axle 86 has a central bar 122 and two connecting portions 126a, 126b respectively disposed on each end of the central bar 122. Each connecting portion 126a, 126b has a cam plate 130a, 130b (FIG. 11) connected to a respective end of the central bar 122 and a rod 134b (the rod connected to the cam plate 130a is not illustrated) extending along the pivot axis 110 to be connected to a corresponding cam plate 130a, 130b and the rotating yoke 58. As such, the connecting portions 126a, 126b are configured to interconnect the rotating yoke 58 to the central bar 122 of the axle 86.

[0078] The linkage 88 extends through the drive shaft 78 to be operably coupled to the handle 14 and the axle 86. The linkage 88 is secured to the central bar 122 of the axle 86 by a fastener 124 (e.g., screw). The linkage 88 is configured to reciprocate along the longitudinal axis 80 when the user rotates the first actuation knob 38. As the linkage 88 moves in a first direction A2 (i.e., towards the handle 14), the central bar 122 of the axle 86 rotates about the pivot axis 110 to pivot the rotating yoke 58 in a clockwise direction via the connecting portions 126a, 126b. As the linkage 88 moves in a second direction A3 opposite the first direction A2 (i.e., away from the handle 14), the central bar 122 rotates about the pivot axis 110 to pivot the rotating yoke 58 in a counterclockwise direction via the connecting portions 126a, 126b. Therefore, the axle 86 converts reciprocating motion of the linkage 88 into pivotal movement of the rotating yoke 58. The rotating yoke 58 of the head 18 is pivotable about the pivot axis 110 along an angle of rotation 136 (FIG. 9) relative to the longitudinal axis 80. The angle of rotation 136 helps the screw 26 reach necessary areas within a chest cavity during the minimally invasive rib fixation procedure. The angle of rotation 136 may be 90 degrees or greater. The angle of rotation 136 preferably ranges between 0 degrees and 110 degrees. In the illustrated embodiment, the head 18 is disposed within a first position such that the receptacle 68 of the rotating yoke 58 is coaxial with the longitudinal axis 80 of the screwdriver 10, thereby orienting the rotating yoke 58 at 0 degrees.

[0079] With reference to FIGS. 6 and 7, the screwdriver 10 includes a second gear assembly 138 and a reciprocation assembly 142 disposed within the housing 30 of the handle 14. The tube 22, the drive shaft 78, and the linkage 88 extend into the housing 30 of the handle 14. The second gear assembly 138 includes an input gear 146 and an output gear 150. The input gear 146 is coupled to the second actuation knob 42 for co-rotation. The output gear 150 is coupled to the drive shaft 78 for co-rotation about the longitudinal axis 80. The input gear 146 meshes with the output gear 150 to operably couple the second actuation knob 42 to the drive shaft 78. When the user rotates the second actuation knob 42, the second gear assembly 138 transfers rotary motion from the second actuation knob 42 to the drive shaft 78. The reciprocation assembly 142 is coupled to first actuation knob 38 for rotation. The linkage 88 extends into the reciprocation assembly 142 such that rotation of the reciprocation assembly 142 causes the linkage 88 to reciprocate within the drive shaft 78 along the longitudinal axis 80.

[0080] With reference to FIG. 8 A, the input gear 146 and the output gear 150 of the second gear assembly 138 is illustrated. The second gear assembly 138 has a 2: 1 gear ratio. As such, the illustrated embodiment of the second gear assembly 138 produces two full revolutions of the screw 26 when a user fully rotates the second actuation knob 42 once. When the second actuation knob 42 is rotated about 4.5 times, then the screw 26 is in a fully inserted position for the fixation of a rib.

[0081] Another embodiment of the second gear assembly 138’ is illustrated in FIG. 8B. The second gear assembly 138’ has a 1 : 1 gear ratio. As such, the second gear assembly 138’ produces a single revolution of the screw 26 when a user fully rotates the second actuation knob 42 once. When the second actuation knob 42 is rotated about nine times, then the screw 26 is in a fully inserted position for the fixation of a rib.

[0082] An additional embodiment of the second gear assembly 138” is illustrated in FIG. 8C. The second gear assembly 138” has a 3: 1 gear ratio. As such, the second gear assembly 138” produces three revolutions of the screw 26 when a user fully rotates the second actuation knob 42 once. When the second actuation knob 42 is rotated about three times, then the screw 26 is in a fully inserted position for the fixation of a rib. The second gear assemblies 138, 138’ require less hand torque during operation than the second gear assembly 138”, thereby providingan intuitive feel of an insertion progress of the screw 26. Also, the second gear assembly 138” may increase the size of the housing 30 of the handle 14 while the second gear assemblies 138, 138’ may allow the housing 30 of the handle 14 to be small.

[0083] With reference to FIG. 9, the head 18 of the screwdriver 10 is disposed within a second position. The user rotates the first actuation knob 38 to move the linkage 88 in the first direction A2 so that the rotating yoke 58 pivots about pivot axis 110 in the clockwise direction. The rotating yoke 58 is oriented at 110 degrees relative to the longitudinal axis 80 of the screwdriver 10. In other embodiments, the rotating yoke 58 may be pivoted in the counterclockwise direction.

[0084] With reference to FIGS. 10 and 11, the head 18 of the screwdriver 10 is disposed within a third position. The user rotates the first actuation knob 38 to move the linkage 88 in the first direction A2 so that the rotating yoke 58 pivots about pivot axis 110 in the clockwise direction. The rotating yoke 58 is oriented at an oblique angle relative to the longitudinal axis 80 of the screwdriver 10.

[0085] With reference to FIGS. 12-15, the system includes a plate 200. The plate 200 defines a first surface 204 and a second surface 208 opposite the first surface 204. The second surface 208 is configured to be positioned relative to a fractured rib during the minimally invasive rib fixation procedure. The plate 200 can be formed of suitable materials such as metals, biodegradable polymers, and non-degradable polymers that permits movement of the plate 200 during diaphragmatic excursion. The plate 200 includes a plurality of plate bosses 212 extending perpendicular from the first surface 204 to be operably coupled to the screwdriver 10. In the illustrated embodiment, the plurality of plate bosses 212 includes a first plate boss 212a, a second plate boss 212b, and a third plate boss 212c. A cylindrical boss defines the first plate boss 212a. An angular boss defines the second plate boss 212b. A raised lip defines the third plate boss 212c. Each plate boss 212a-c has a fastener hole 216a-c extending therethrough and configured to receive the screw 26. In other embodiments, the plate 200 may have less than or more than three plate bosses 212.

[0086] With reference to FIGS. 16A-17B, a shield 300 is illustrated. In an alternative embodiment of the screwdriver 10, the shield 300 is configured to be coupled to the rotatingyoke 58 instead of the sleeve 121 . The shield 300 is defined by a collar 304 integrally formed with an engagement portion 308 that has a wedge-shaped cross-section. A fastener hole 312 extends through the shield 300 and is configured to receive the screw 26. The engagement portion 308 defines an opening 314 that is narrower than the fastener hole 312. The collar 304 is configured to be releasably coupled to one of the plate bosses 212 such that the shield 300 is oriented perpendicular to the plate 200 when coupled to one of the plate bosses 212. As the screw 26 is driven through the shield 300 and into the plate 200, the top end 28 of the screw 26 engages the engagement portion 308 of the shield 300 and causes the engagement portion 308 to flex and retract to push the engagement portion 308 apart. Once the screw 26 is fully inserted into the plate 200 to fixate a rib, the engagement portion 308 of the shield 300 flexes to retract to an extent in which the collar 304 uncouples a corresponding plate boss 212. The shield 300 may be formed of suitable materials such as metals and rigid polymers (e.g., plastic material). Therefore, the shield 300 is configured to be coupled to the plate 200 to maintain a 90-degree angle between the screw 26 and the plate 200. Also, the shield 300 can prevent the screw 26 from falling into a pleural space during the minimally invasive rib fixation procedure.

[0087] With reference to FIGS. 18-19B, a shield 400 is illustrated. In another alternative embodiment of the screwdriver 10, the shield 400 is configured to be coupled to the rotating yoke 58 instead of the sleeve 121. The shield 400 has a collar 404 and a fastener hole 408 extending therethrough the shield 400 and is configured to receive the screw 26. In the illustrated embodiment, the shield 400 has a cylindrical shape. In other embodiments, the shield 400 may have a triangular shape, a square shape, or other suitable configurations. The collar 404 is configured to be releasably coupled to one of the plate bosses 212 such that the shield 400 is oriented perpendicular to the plate 200 when coupled to one of the plate bosses 212. As the screw 26 is driven through the shield 400 and into the plate 200, the top end 28 of the screw 26 engages the shield 400 and causes the shield 400 to flex and retract. Once the screw 26 is fully inserted into the plate 200 to fixate a rib, the shield 400 flexes to retract to an extent in which the collar 404 uncouples a corresponding plate boss 212. The shield 400 may be formed of suitable materials such as metals and rigid polymers (e.g., plastic material). Like the shield 300 of FIGS. 16A-17B, the shield 400 is arranged along the plate 200 to maintain a 90-degree angle between the screw 26 and the plate 200. Also, the shield 400 is provided to prevent the screw 26 from falling into a pleural space during the minimally invasive rib fixation procedure.

[0088] The plate 200 is positioned relative to a fractured rib during a minimally invasive rib fixation procedure. To prepare the screwdriver 10 for the procedure, the screw 26 is coupled to the driver bit 120 to be surrounded by the sleeve 121. As such, the screw 26 is drivingly coupled to the head 18 of the screwdriver 10. The user may then rotate the first actuation knob 38 to move the linkage 88 in the first direction A2 or the second direction A3. Movement of the linkage 88 along the longitudinal axis 80 causes the rotating yoke 58 to pivot until a desired angular position is established. Once the rotating yoke 58 reaches the desired angular position, the user may engage the sleeve 121 with one of the plate bosses 212a-c. The user may apply no more than five pounds-force (Ibf ) to the screwdriver 10 to properly engage the sleeve 121 with one of the plate bosses 212a-c. To manually insert the screw 26 into a rib, the user may apply no more than 2.5 Newtown-meters (N-m) of torque on a tip of the screwdriver 10. The user may rotate the second actuation knob 42 to drive rotation of the second gear assembly 138 and cause the drive shaft 78 to rotate about the longitudinal axis 80. Rotation of the drive shaft 78 is transferred to the first gear assembly 82 to drive rotation of the driver bit 120 so that the screw 26 can be driven into the plate 200 and the rib to complete the procedure. The sleeve 121 of the screwdriver 10 can be disengaged from the corresponding plate boss 212a-c by applying no more than five Ibf. to the screwdriver 10 for the removal of the sleeve 121.

[0089] In other embodiments, the screwdriver 10 may cooperate with the shield 300 of FIGS. 16A-17B or the shield 400 of FIGS. 18-19B when performing a minimally invasive rib fixation procedure. During the procedure, the plate 200 is positioned relative to a fractured rib. When preparing the screwdriver 10 for the procedure, the screw 26 is coupled to the driver bit 120 to be drivingly coupled to the head 18 of the screwdriver 10. The shield 300, 400 is also coupled to the rotating yoke 58 to surround the screw 26 and the driver bit 120. The user may then rotate the first actuation knob 38 to move the linkage 88 in the first direction A2 or the second direction A3. Movement of the linkage 88 along the longitudinal axis 80 causes the rotating yoke 58 to pivot until a desired angular position is established. Once the rotating yoke 58 reaches the desired angular position, the collar 304, 404 of the shield 300, 400 is then coupled to one of the plate bosses 212a-c. The user may rotate the second actuation knob 42 to drive rotation of the second gear assembly 138 and cause the drive shaft 78 to rotate about the longitudinal axis 80. Rotation of the drive shaft 78 is transferred to the first gear assembly 82 to drive rotation of the driver bit 120 so that the screw 26 can be driven into the plate 200 and the rib to complete theprocedure. When the screw 26 is fully inserted into the plate 200, the shield 300, 400 flexes to retract to an extent in which the collar 304, 404 uncouples the corresponding plate boss 212a-c, thereby uncoupling the screwdriver 10 from the plate 200.

[0090] FIG. 20 illustrates another screwdriver 510. The screwdriver 510 is similar to the screwdriver 10 of FIGS. 1-11; therefore, like structure will be identified by like reference number plus “500” and only the differences will be discussed hereafter.

[0091] The handle 514 of the screwdriver 510 has a pair of indentations 534 (illustrated embodiment only shows one indentation) that are shallow and symmetrical. The housing 530 of the handle 514 defines a handle housing length L3 that is less than the handle housing length LI of the screwdriver 10. As such, the handle 514 is smaller than the handle 14 of the screwdriver 10.

[0092] FIGS. 21-30 illustrates a sheath 600 and another plate 700. The sheath 600 is configured to be coupled to the rotating yoke 58 and used with the screwdriver 10 of FIGS. 1-11. In other embodiments, the sheath 600 may also be used with the screwdriver 510 of FIG. 20. The sheath 600 includes a first end 604, a second end 608 opposite the first end 604, and a bore 612 extending therethrough and between the first and second ends 604, 608. The first end 604 of the sheath 600 is configured to be coupled to the rotating yoke 58 such that the sheath 600 is pivotable with the rotating yoke 58 during operation of the screwdriver 10. The drill bit holder 118 extends through the bore 612 at the first end 604 of the sheath 600, thereby allowing the driver bit 120 to also extend through the sheath 600. The second end 608 of the sheath 600 is configured to receive a portion of the plate 700 to operably couple the screwdriver 10 to the plate 700. As such, the sheath 600 is provided to prevent the screw 26 from falling into a pleural space during the minimally invasive rib fixation procedure. To couple the screw 26 to the screwdriver 10, a user may insert the screw 26 into the bore 612 at the second end 608 of the sheath 600 and couple the screw 26 to the driver bit 120. An opening 618 (FIG. 30) is defined within the sheath 600 to permit access to the bore 612. A groove 622 is also defined within the sheath 600 and extends between the opening 618.

[0093] With reference to FIGS. 21 -23, the plate 700 is illustrated. The plate 700 is similar to the plate 200 of FIGS. 12-15; therefore, like structure will be identified by like reference number plus “500” and only the differences will be discussed hereafter.

[0094] The plate 700 includes a first surface 704, a second surface 708 opposite the first surface 704, and a plurality of plate bosses 712 extending perpendicular from the first surface 704. Each plate boss 712 is configured to be received by the sheath 600 to operably couple the screwdriver 10 to the plate 700. As a result, the sheath 600 and the plate bosses 712 are used to maintain a 90-degree angle between the screw 26 and the plate 700.

[0095] Each plate boss 712 has a cylindrical cross-section and is configured to be received within the bore 612 of the sheath 600 at the second end 608. In other embodiments, each plate boss 712 may have a different cross-sectional shape complementary with the bore 612 of the sheath 600. In the illustrated embodiment, the plurality of plate bosses 712 includes eight plate bosses 712a-h. In other embodiments, the plurality of plate bosses 712 may include less than or more than eight plate bosses 712a-h. Also, each plate boss 712a-h has a threaded fastener hole 716a-h extending therethrough. Each fastener hole 716a-h is configured to receive and lock onto the screw 26 to hold the screw 26 in place during the procedure. Each fastener hole 716a-h is defined by an enlarged portion 720 and a narrow portion 724 (FIGS. 27 and 29). Also, the illustrated plate 700 has sides 728a, 728b with a straight configuration. In other embodiments, the sides 728a, 728b of the plate 700 may have a wavy or undulated configuration.

[0096] With reference to FIGS. 21 and 24, the screwdriver 10 further includes a quickrelease mechanism 800 removably coupled to the sheath 600. The quick-release mechanism 800 includes a plug 804 disposed within the opening 618 of the sheath 600. The plug 804 has a threaded portion 808 configured to define at least a portion of the bore 612 of the sheath 600 when the plug 804 is coupled to the sheath 600. As such, the plug 804 is arranged to threadedly engage the screw 26. Also, the plug 804 has a groove 812 (FIG. 27) defined therein and positioned to align with the groove 622 of the sheath 600 when the plug 804 is coupled to the sheath 600. The quick-release mechanism 800 also includes a fastener 816 (e.g., ring clamp) configured to be received within the groove 622 of the sheath 600 and the groove 812 of the plug 804 to secure the plug 804 to the sheath 600.

[0097] FIGS. 24-30 illustrates the screwdriver 10 coupled to the plate 700 for the minimally invasive rib fixation procedure. During the procedure, the plate 700 is initially positioned relative to a fractured rib. When preparing the screwdriver 10 for the procedure, the screw 26 is inserted into the sheath 600 to engage the driver bit 120 to be drivingly coupled to the head 18 of the screwdriver 10. The user may then rotate the first actuation knob 38 to move the linkage 88 in the first direction A2 or the second direction A3. Movement of the linkage 88 along the longitudinal axis 80 causes the rotating yoke 58 to pivot until a desired angular position is established. Once the rotating yoke 58 reaches the desired angular position, the user may couple the second end 608 of the sheath 600 to one of the plate bosses 712a-h such that the bore 612 of the sheath 600 becomes coaxial with a corresponding fastener hole 716a-h. In some embodiments, the user may apply no more than five pounds-force (Ibf ) to the screwdriver 10 to properly engage the sheath 600 with one of the plate bosses 712a-h. The user may rotate the second actuation knob 42 to drive rotation of the second gear assembly 138 and cause the drive shaft 78 to rotate about the longitudinal axis 80. Rotation of the drive shaft 78 is transferred to the first gear assembly 82 to drive rotation of the driver bit 120. A spring 820, that is provided within the drill bit holder 118, is configured to bias the driver bit 120 in a direction toward the plate 700. As such, the biasing action of the spring 820 and the rotational movement of the driver bit 120 allows the screw 26 to be driven through the respective plate boss 712a-h and into the rib for fixating the rib. In some embodiments, the user may apply no more than 2.5 Newt own-meters (N-m) of torque on a tip of the screwdriver 10 to manually insert the screw 26 into a rib. The screw 26 is driven into the rib and the plate 700 until the top end 28 of the screw 26 is seated within the enlarged portion 720 of the corresponding threaded hole 716a-h. Once the screw 26 is properly inserted into the plate 700 and the rib, the user may remove the sheath 600 from the corresponding plate boss 712a-h such that the driver bit 120 disengages the screw 26. In some embodiments, the sheath 600 can be disengaged from the plate 700 by applying no more than five Ibf. to the screwdriver 10.

[0098] In the case that there is a problem with the placement of the screw 26, the user may remove the screw 26 by using the quick-release mechanism 800. As such, the user may extract the fastener 816 from the groove 622 of the sheath 600 and the groove 812 of the plug 804. The user may then be able to remove the plug 804 from the sheath 600 to permit access to the bore612 of the sheath 600 via the opening 618. The screw 26 can then be removed from the sheath600.

[0099] With reference to FIGS. 31-33, another driver bit 900 is illustrated. The driver bit 900 may be coupled to and used with the screwdriver 10, 510 of FIGS. 1-11 and 20. The driver bit 900 of FIGS. 30-32 is similar to the driver bit 120 of FIGS. 1-11 and 24-29. Only differences will be discussed hereafter.

[0100] The driver bit 900 includes a body 904 having a first end 906a and a second end 906b opposite the first end 906a. The first end 906a of the body 904 is configured to be received within the drill bit holder 118 to couple the driver bit 900 to the driven gear 106 for co-rotation. The driver bit 900 also includes a flange 908 formed on the body 904 and proximate the first end 906a. The flange 908 has a hexagonal cross-section and is configured to engage the bore 119 of the drill bit holder 118, which has a corresponding hexagonal cross-section. As such, the driver bit 900 is configured to rotate with the driven gear 106 about the longitudinal axis 80 when the user rotates the second actuation knob 42 of the screwdriver 10.

[0101] The driver bit 900 further includes a shank 912 formed at the second end 906b of the body 904 and a drill tip 916 extending from the shank 912. The shank 912 of the driver bit 900 is configured to extend through a screw 918 to couple the driver bit 900 and the screw 918 for co-rotation. More specifically, the shank 912 of the driver bit 900 extends through a bore 920 defined within the screw 918. The bore 920 of the screw 918 and the shank 912 of the driver bit 900 each have cooperating geometries that are suitable for rotatably coupling the screw 918 with the driver bit 900.

[0102] Additionally, a step-like feature is formed at a central portion of the body 904 of the driver bit 900 to provide an abutment surface 924 proximate the shank 912. When coupling the screw 918 to the driver bit 900, the screw 918 slides along the shank 912 until the screw 918 engages the abutment surface 924. The abutment surface 924 of the driver bit 900 prevents the screw 918 from moving along the body 904 and towards the first end 906a of the driver bit 900.

[0103] When the screw 918 is coupled to the driver bit 900, the shank 912 extends through the screw 918 such that the drill tip 916 is disposed at a drilling end 928 of the screw 918. Thedrill tip 916 of the driver bit 900 is configured to drill a pilot hole into a rib during the minimally invasive rib fixation procedure. As such, the user does not need a separate device to create a pilot hole for the minimally invasive rib fixation procedure.

[0104] With reference to FIGS. 34 and 35, another plate 1000 is illustrated. The plate 1000 is operable to be used with the screwdriver 10, 510 of FIGS. 1-11 and 20. The plate 1000 is similar to the plate 700 of FIGS. 21-23; therefore, like structure will be identified by like reference number plus “300” and only the differences will be discussed hereafter.

[0105] The plate 1000 includes a first surface 1004, a second surface 1008 opposite the first surface 1004, and a plurality of plate bosses 1012 extending perpendicular from the first surface 1004. Each plate boss 1012 is configured to be received by the sheath 600 to operably couple the screwdriver 10 to the plate 1000. As a result, the sheath 600 and the plate bosses 1012 are used to maintain a 90-degree angle between the screw 26 and the plate 1000.

[0106] Each plate boss 1012 has a cylindrical cross-section and is configured to be received within the bore 612 of the sheath 600 at the second end 608. In other embodiments, each plate boss 1012 may have a different cross-sectional shape complementary with the bore 612 of the sheath 600. In the illustrated embodiment, the plurality of plate bosses 1012a-f includes six plate bosses 1012a-f. In other embodiments, the plurality of plate bosses 1012a-f may include less than or more than six plate bosses 1012a-f. Also, each plate boss 1012a-f has a threaded portion 1016a-f formed at a top portion and a non-threaded portion 1020a-f that forms a smooth surface extending below the threaded portion 1016a-f. Each plate boss 1012a-f is configured to receive and lock onto the screw 26 to hold the screw 26 in place during the procedure. The non-threaded portions 1020a-f are provided within the plate bosses 1012a-f to ensure that the screw 26 engages the rib while also being threadably coupled to the plate 1000. Also, the illustrated plate 1000 has sides 1028a, 1028b with a wavy or undulated configuration proximate the plurality of plate bosses 1012a-f.

[0107] The plate 1000 further includes a bar 1030 extending between opposite portions of the plate 1000 that are integrally formed with the plate bosses 1012a-f. As such, the bar 1030 produces an elongated plate 1000. In other embodiments, the bar 1030 may be omitted from the plate 1000 to produce a short plate 1000.

[0108] With reference to FIG. 36, another plate 1 100 is illustrated. The plate 1100 is operable to be used with the screwdriver 10, 510 of FIGS. 1-11 and 20. The plate 1100 is similar to the plate 1000 of FIGS. 34 and 35; therefore, like structure will be identified by like reference number plus “100” and only the differences will be discussed hereafter.

[0109] The plate 1100 includes a first surface 1104, a second surface 1108 opposite the first surface 1104, and a plurality of plate bosses 1112 extending perpendicular from the first surface 1104. Each plate boss 1112 is configured to be received by the sheath 600 to operably couple the screwdriver 10 to the plate 1100. In the illustrated embodiment, the plurality of plate bosses 1112a-f includes six plate bosses 1112a-f. In other embodiments, the plurality of plate bosses 1112a-f may include less than or more than six plate bosses 1112a-f. Also, each plate boss 1112a-f has a threaded portion 1116a-f formed at a top portion and a non-threaded portion 1120a-f that forms a smooth surface extending below the threaded portion 1116a-f. As a result, the sheath 600 and the plate bosses 1112 are used to maintain a 90-degree angle between the screw 26 and the plate 1100. In the illustrated embodiment, each plate boss 1112 extends a length from the first surface 1104 that is less than a length at which the plate bosses 1012 extend from the first surface 1004 of the plate 1000 of FIGS. 34 and 35. As such, the plate 1100 of FIG. 36 has short plate bosses 1112 and the plate 1000 of FIGS. 34 and 35 has long plate bosses 1012.

[0110] FIGS. 37A-45B illustrate an acetabular cup 2000 according to another embodiment. The acetabular cup 2000 is utilized for a minimally invasive hip fixation procedure. The acetabular cup 2000 is operable to be used with the screwdriver 10, 510 of FIGS. 1-11 and 20 during the hip fixation procedure.

[0111] With reference to FIGS. 37A-38B, the acetabular cup 2000 is illustrated. The acetabular cup 2000 includes a shell 2004, a housing 2008, and an insert 2012. The shell 2004 is made of a metallic osteoconductive material. The housing 2008 is also made of a metallic osteoconductive material. The insert 2012 is made of a polymer.

[0112] The shell 2004 forms an exterior casing of the acetabular cup 2000 that surrounds the housing 2008. The insert 2012 is coupled to the housing 2008 to thereby form an interior surface of the acetabular cup 2000. As such, the housing 2008 forms an intermediate cup disposed between the shell 2004 and the insert 2012. The housing 2008 is configured to support the insert2012 as the shell 2004 covers the housing 2008 to protect an exterior surface 2016 (FIG. 44A) of the housing 2008. The acetabular cup 2000 further includes a plurality of fastener holes 2020 defined therein.

[0113] With reference to FIGS. 43A and 43B, the shell 2004 includes a shell body 2024 and a plurality of holes 2028 defined therein. Each hole 2028 is arranged at a top portion of the shell 2004 and spaced from adjacent holes 2028. Also, the shell body 2024 of the shell 2004 has a shell rim 2032 formed at a bottom portion of the shell 2004.

[0114] With reference to FIGS. 40A, 40B, and 44A-C, the housing 2008 includes a housing body 2036 and a plurality of bores 2040 extending through the housing body 2036. Each bore 2040 is formed at a top portion of the housing 2008 and spaced from adjacent bores 2040. At least a portion of each bore 2040 is formed with a threaded portion (e g., conical threads; not shown) or a thread locking mechanism (not shown) so that each bore 2040 is capable of accepting a respective screw. The housing 2008 also includes a flange 2044 extending from the housing body 2036 at a bottom portion of the housing 2008. Multiple grooves 2048 are defined within the flange 2044.

[0115] With reference to FIGS. 45A and 45B, the insert 2012 includes an insert body 2052 and an insert rim 2056 formed along a bottom portion of the insert body 2052. The insert body 2052 forms an exterior insert surface 2060 and an interior insert surface 2064. The insert 2012 further includes a plurality of tabs 2068 extending outwardly from the insert rim 2056. In the illustrated embodiment, the plurality of tabs 2068 includes four tabs 2068. In other embodiments, the plurality of tabs 2068 may include less than or more than four tabs.

[0116] FIGS. 41A, 41B, and 42 illustrate the housing 2008 and the insert 2012 coupled together. When coupled together, each tab 2068 of the insert 2012 is received within a respective groove 2048 of the housing 2008. The housing 2008 covers the exterior insert surface 2060 so that the housing 2008 encases the insert 2012. As such, each bore 2040 of the housing 2008 interfaces with the exterior insert surface 2060.

[0117] With reference to FIGS. 38A, 38B, and 39, the shell 2004, the housing 2008, and the insert 2012 are assembled together. As the shell 2004 is coupled to the housing body 2036, theshell rim 2032 is positioned along the flange 2044 of the housing 2008. Also, each hole 2028 of the shell 2004 is arranged to encircle and be coaxial with a respective bore 2040. As such, the fastener holes 2020 of the acetabular cup 2000 is formed by the plurality of holes 2028 of the shell 2004 and the plurality of bores 2040 of the housing 2008.

[0118] During the hip fixation procedure, the acetabular cup 2000 is positioned such that the insert 2012 interacts with the hip. The screwdriver 10, 510 drives a respective screw (not shown) through the acetabular cup 2000 and into a fractured hip for fixation of the hip. More specifically, the screwdriver 10, 510 drives a respective screw into each fastener hole 2020 and the insert 2012.

[0119] As the screwdriver 10, 510 is operated to drive screws through the acetabular cup 2000 for fixating the hip, the screwdriver 10, 510 cooperates with the acetabular cup 2000 to ensure that a respective screw is protected from a body cavity of the patient. The interaction between the screwdriver 10, 510 and the acetabular cup 2000 thereby prevent the screw from falling into the body cavity during the hip fixation procedure. Also, the screwdriver 10, 510 and the acetabular cup 2000 cooperate so that the respective screw is oriented perpendicular to the acetabular cup 2000. As such, the screwdriver 10, 510 is operable with the plate 200, 700 or the acetabular cup 2000 to decrease procedural time and improve procedure accuracy.

[0120] Although the disclosure has been described in detail with reference to certain preferred embodiments, variations and modifications exist within the scope and spirit of one or more independent aspects of the disclosure as described.

[0121] Various features of the present invention are set forth in the following claims.

Claims

CLAIMSWhat is claimed is:

1. A system for minimally invasive rib fixation comprising: a plate for fixating a rib, the plate including a plate boss extending from a surface of the plate; and a shield including a collar releasably coupled to the plate boss such that the shield is oriented perpendicular to the plate, and an engagement portion integrally formed with the collar, the engagement portion configured to engage a screw being driven into the plate and to flex for uncoupling the shield from the plate boss.

2. The system of claim 1, further comprising a screwdriver configured to drive the screw into the plate, the screwdriver including a head coupled to the shield and configured to engage the screw, a handle operable to drive the screw into the plate and control pivotal movement of the head, and a linkage operably coupled to the head and the handle, the linkage configured to reciprocate by operation of the handle to pivot the head to a desired angular position.

3. The system of claim 2, wherein the head pivots along an angle of rotation ranging between 0 degrees and 110 degrees.

4. The system of claim 2, wherein the screwdriver further includes a shaft rotatably coupled to the head and the handle such that the shaft is disposed therebetween, and wherein the linkage extends centrally through the shaft.

5. The system of claim 4, wherein the screwdriver further includes a gear assembly supported by the head and operably coupled to the shaft, the gear assembly configured to drive the screw into the plate as the shaft is rotated by operation of the handle.

6. The system of claim 1, wherein the engagement portion of the shield has a wedge-shaped cross-section.

7. The system of claim 1, wherein the plate boss is a first plate boss defining a raised lip, wherein the plate further includes a second plate boss defining an angled boss and a third plate boss defining a cylindrical boss.

8. A method for minimally invasive rib fixation, the method comprising: positioning a plate relative to a rib, the plate including a plate boss; releasably coupling a shield to the plate boss; driving a screw through the shield and into the plate in an insertion direction oriented perpendicular to the plate, the screw engaging the shield such that the shield flexes as the screw is driven in the insertion direction; and uncoupling the shield from the plate boss as the shield flexes to uncouple the plate boss and the screw is completely inserted into the plate.

9. The method of claim 8, further comprising, prior to driving the screw: providing a screwdriver; coupling the screw to a head of the screwdriver; and reciprocating a linkage of the screwdriver operably coupled to the head to pivot the head to a desired angular position, the linkage centrally disposed within the screwdriver.

10. The method of claim 9, wherein the shield is coupled to the head of the screwdriver.

11. The method of claim 9, wherein driving the screw includes operating a handle of the screwdriver to drive the screw through the shield and into the plate.

12. The method of claim 8, wherein the screw is a self-drilling screw.

13. A system for minimally invasive rib fixation comprising: a plate for fixating a rib; and a screwdriver configured to drive a screw into the plate to fixate the rib, the screwdriver including a head disposed at a proximal end of the screwdriver and operably coupled to the screw, a handle disposed at a distal end of the screwdriver, opposite the proximal end, the handle operable to drive the screw into the plate and control pivotal movement of the head along an angle of rotation, a shaft disposed between the head and the handle, the shaft defining a longitudinal axis of the screwdriver, and a linkage extending centrally through the shaft along the longitudinal axis, the linkage configured to be driven by the handle to reciprocate and cause pivotal movement of the head about a pivot axis oriented perpendicular to the longitudinal axis.

14. The system of claim 13, wherein the screwdriver further includes an axle fixed to the head and coupled to the linkage, the axle configured to convert reciprocating motion of the linkage into pivotal movement of the head.

15. The system of claim 13, wherein the angle of rotation ranges between 0 degrees and 110 degrees.

16. The system of claim 13, wherein the handle is operable to drive rotation of the shaft about the longitudinal axis, and wherein the screwdriver further includes a gear assembly having a drive gear coupled to the shaft for co-rotation, a driven gear coupled to the head for pivotal movement therewith and configured to engage the screw, and an idler gear configured to transfer rotary motion from the drive gear to the driven gear for driving the screw into the plate.

17. The system of claim 16, wherein the driven gear has a bit holder configured to hold a replaceable driver bit engageable with the screw.

18. The system of claim 16, wherein the gear assembly is a first gear assembly disposed within the head, and wherein the screwdriver further includes a second gear assembly disposed within the handle and configured to drive rotation of the shaft.

19. The system of claim 18, wherein the second gear assembly has a 2: 1 gear ratio.

20. The system of claim 18, wherein the second gear assembly has a 1 : 1 gear ratio.21 . A system for minimally invasive rib fixation comprising: a plate for fixating a rib, the plate including a plate boss extending perpendicular from a surface of the plate; and a screwdriver configured to drive a screw into the plate to fixate the rib, the screwdriver including a head operably coupled to the screw, a sheath having a first end and a second end opposite the first end, the first end of the sheath is coupled to the head such that the screw extends through the sheath, the second end of the sheath is removably coupled to the plate boss, a quick-release mechanism disposed within an opening defined in the sheath, the quick-release mechanism is removably coupled to the sheath to provide access to the screw through the opening, and a handle operable to control pivotal movement of the head and drive the screw through the sheath and into the plate to fixate the rib.

22. The system of claim 21, wherein the quick-release mechanism includes a plug disposed within the opening of the sheath and a fastener configured to secure the plug to the sheath.

23. The system of claim 22, wherein the plug defines a first groove and the sheath defines a second groove aligned with the first groove, and wherein the fastener is received within the first groove and the second groove to secure the plug to the sheath.

24. The system of claim 22, wherein the plug includes a threaded portion configured to engage the screw.

25. The system of claim 24, wherein the sheath has a bore through which the screw extends, and wherein the threaded portion of the plug defines at least a portion of the bore.

26. The system of claim 22, wherein the fastener is a ring clamp.

27. The system of claim 21 , wherein the plate boss has a threaded portion and a non-threaded portion such that the plate boss is configured to receive the screw.

28. The system of claim 27, wherein the plate boss is one of a plurality of plate bosses.

29. A system for minimally invasive rib fixation comprising: a screwdriver configured to drive a screw for fixating a rib, the screwdriver including a driver bit coupled to the screw, the driver bit includes a body having a first end and a second end opposite the first end, a shank formed on the second end of the body, the shank configured to extend though the screw to couple the screw to the driver bit for co-rotation, and a drill tip extending from the shank such that the drill tip is disposed at an end of the screw for drilling a pilot hole.

30. The system of claim 29, wherein the screwdriver further includes a head coupled to the driver bit, and a handle operable to control pivotal movement of the head and rotate the driver bit to drive the screw into the rib.

31. The system of claim 30, further comprising a plate configured to be positioned relative the rib, and wherein the screwdriver is configured to be coupled to the plate and drive the screw through the plate and into the rib.

Images