Medical spreading and measuring instrument, and instrument set comprising the spreading and measuring instrument

Abstract

The invention relates to a medical spreading and measuring instrument (10), wherein the spreading and measuring instrument (10) comprises a body on which a tibial contact plate (12) is arranged distally and a support plate (13) is arranged proximally, wherein the tibial contact plate (12) and the support plate (13) are mounted on the body so as to be displaceable relative to one another in a distal-proximal direction (14), wherein an axis of rotation (15), which is rotatable relative to the support plate (13) and has an angle indicator (16), is arranged in the support plate (13), wherein the axis of rotation (15) extends from an anterior side (17) of the support plate (13) to a posterior side (18) of the support plate (13), and wherein the spreading and measuring instrument (10) is designed either to attach, in particular in a rotationally fixed manner, an accessory for contacting a femur to the axis of rotation (15), or to receive, on the tibial contact plate (12), an accessory for positioning a saw block or an accessory for compensating a height of a saw block already positioned on the femur. The invention also relates to an instrument set comprising the spreading and measuring instrument (10) and at least two of the different accessories.

Description

[0001] Title: Medical spread measurement tool that

[0002] Spreader measuring tool comprehensive instrument set

[0003] Description

[0004] The invention relates to a medical spread measuring tool and an instrument set comprising the spread measuring tool.

[0005] Such spreader measuring tools are used to determine and balance a joint space, e.g., in total condylar knee arthroplasty between the tibia and femur.

[0006] A medical spread measurement tool is designed so that the

[0007] The spreader measuring tool comprises a body on which a tibial contact plate is arranged distally and a support plate proximally, wherein the tibial contact plate and the support plate are arranged on the body so as to be displaceable relative to each other in a distal-proximal direction, wherein a rotation axis rotatable with an angle indicator is arranged in the support plate, wherein the rotation axis extends from an anterior side of the support plate to a posterior side of the support plate, and wherein the spreader measuring tool is designed to attach, in particular in a rotationally fixed manner, an attachment for contact with a femur to the rotation axis, or to receive an attachment for positioning a saw block or an attachment for compensating for a height of a saw block already positioned on the femur to the tibial contact plate.

[0008] The attachment may include a finger for determining femur size, extending in a posterior direction on the proximal side of the attachment.

[0009] In one version for angle measurement, it is provided that the spreading measuring tool includes a conversion display for the angle display arranged on the angle display.

[0010] In one embodiment for alignment, the spreading measuring tool includes an alignment unit comprising a bore for receiving a rod for checking a leg axis, wherein the alignment unit is located on the anterior side of the carrier plate, and the bore extends in a distal-proximal direction in the alignment unit.

[0011] In one version, it is planned that the essay will be about

[0012] Positioning of the saw block includes a cam block which includes a hole, in particular a bore, for receiving a rod arranged in the femur.

[0013] In the positioning design, the hole, in particular the bore, can be arranged at an angle between 0° and 10°, specifically e.g., 0°, 2°, 4°, 6°, 8°, or 10°, within the guide block. Multiple guide blocks can be provided. The guide blocks can be used for both a right and a left knee.

[0014] In one embodiment, it may be provided that the attachment for positioning the saw block includes a releasable closure to which the saw block can be releasably attached on the posterior side of the attachment for positioning the saw block by means of the releasable closure.

[0015] In one embodiment, the attachment for positioning the saw block may have a connecting piece that is arranged between the closure and the support plate.

[0016] In one embodiment, a negative form may be provided, in particular a bore extending in a distal-proximal direction, on which a plate for compensating for the depth of the already resected femur can be arranged, and which extends in a proximal direction with the concomitant depth.

[0017] In one embodiment for compensating for the height of a saw block, the attachment for compensating for the height of the saw block already positioned on the femur includes a plate arranged on the axis of rotation for contact with the saw block, which is shorter in the anterior-posterior direction than the tibial contact plate. This allows the distance to the saw block to be measured.

[0018] To compensate for the height of an already residuated femur, it may be provided that the attachment for contact with the femur includes at least one plate for contact with the residuated femur, which extends in a proximal-distal direction with the simultaneous height of the femur.

[0019] The attachment for contact with the femur comprises, in one embodiment, at least one negative form, in particular a bore, for attaching an augmentation, extending in a proximal-distal direction. This allows augmentations to be attached directly to the plate.

[0020] An exemplary set of instruments includes the spreading measuring tool and several cam blocks that have holes, especially bores, at different angles to each other.

[0021] An exemplary set of instruments includes the spreading measuring tool, wherein at least two of the different attachments are provided in the set of instruments.

[0022] Further advantageous implementation methods can be found in the following description and the drawing. The drawing shows:

[0023] Fig. 1 shows a schematic, perspective view of a medical spreading measuring tool with an angle indicator.

[0024] Fig. 2 shows a schematic, perspective view of the medical spreading measuring tool with the angle display and a conversion display for the angle display.

[0025] Fig. 3 shows a schematic, perspective view of the medical spreader measuring tool with an alignment unit,

[0026] Fig. 4 shows a schematic, perspective view of the medical spreader measuring tool with an attachment for measuring femur size and for positioning a 4-in-l saw block,

[0027] Fig. 5 shows a schematic, perspective view of the medical spreader measuring tool with an attachment for positioning a distal saw block and a connecting piece to the distal saw block.

[0028] Fig. 6 shows a schematic, perspective view of the medical spreader measuring tool with the attachment for measuring femur size and for positioning the 4-in-1 saw block and a plate for compensating for the depth of the already resected femur.

[0029] Fig. 7 shows a schematic, perspective view of the medical spreader measuring tool with the attachment for compensating for the height of the saw block already positioned on the femur,

[0030] Fig. 8 shows a schematic, perspective view of the medical spreader measuring tool with the attachment for contact with the femur and a plate for compensating for the height of the already resected femur.

[0031] Fig. 9 is a schematic, perspective view of the medical spread measurement tool with the attachment for contact with the femur and augmentations,

[0032] Fig. 10 shows a schematic, perspective view of the medical spreader measuring tool with the attachment for contact with the femur, and the plate for compensating for the height of the already resected femur and the augmentations.

[0033] Figure 1 shows a schematic, perspective representation of a medical spreading measuring tool 10.

[0034] The spreading measuring tool 10 comprises a body 11 .

[0035] On body 11, a tibial contact plate 12 is arranged distally and a support plate 13 proximally.

[0036] The tibial contact plate 12 and the support plate 13 are arranged on the body 11 so as to be displaceable relative to each other in a distal-proximal direction 14. In the example, the tibial contact plate is fixedly arranged on the body 11. In the example, the tibial contact plate and the body 11 are formed as a single piece. In the example, the support plate 13 is arranged so as to be movable relative to the body 11.

[0037] A rotation axis 15, rotatable with respect to the support plate 13 and equipped with an angle indicator 16, extends into the support plate 13. The rotation axis 15 is a physical axis.

[0038] In this example, the axis of rotation 15 has at least one pointer 15-1, which extends laterally or medially from the axis of rotation 15 on the anterior side of the axis of rotation 15 and the support plate 13. The pointer 15-1 is an example of an indicator. The indicator can also run from proximal to distal. In this example, two pointers 15-1 are provided, one extending medially and one laterally. The two pointers 15-1 are mirror images of each other. In a corresponding mirror symmetry plane lies a center of rotation of the rotation axis 15. On the anterior side of the support plate 13, on the side to which a pointer 15-1 extends, an angle indication is arranged, in the example for a rotation angle for an inward rotation between -9° and 0°, in particular of -9°, -6°, -3°, for 0°, and for an outward rotation between 0° and 9°, in particular of 3°, 6°, 9°.In the example, the angle values ​​for an internal rotation of -6°, 0°, and an external rotation of +6° are arranged on one side of the axis of rotation. On the other side of the axis of rotation 15, the angle values ​​for an internal rotation of -9°, -3°, and an external rotation of +3°, +9° are arranged.

[0039] The at least one pointer 15-1 is arranged in a recess such that the pointer 15-1 is set back towards a posterior side 18 of the carrier plate 18 with respect to an anterior end face. Accordingly, the at least one pointer 15-1 does not project anteriorly beyond this anterior end face of the carrier plate. The angle markings are arranged on this end face. The at least one pointer 15-1 is a flat component.

[0040] The at least one pointer 15-1 is arranged to be rotationally fixed to the femoral contact plate 24 and can therefore be pivoted together with the femoral contact plate 24 about the center of rotation of the axis of rotation 15. Accordingly, the at least one pointer 15-1 is pivoted relative to the angle values, which are fixed to the tibial contact plate 12 and to the body 11. The axis of rotation 15 extends from an anterior side 17 of the support plate 13 to the posterior side 18 of the support plate 13. This physical axis of rotation 15 extends through the entire support plate 13 from the anterior side 17 to the posterior side. The spreading measuring tool 10 comprises a drive unit 19, which has a drive interface 20. The drive unit 19 is configured via the drive interface 20 to move the tibial contact plate 12 and the support plate 13 relative to each other.The drive unit 19 may include a rack that extends in a distal-proximal direction 14, guided within the body 11. The drive interface 20 includes, for example, a gear whose axis extends from the anterior to the posterior side of the body 11 and whose teeth engage with the rack. When the gear rotates in the distal-proximal direction 14, the rack is moved, depending on the direction of rotation, either to remove the support plate 13 from the tibial contact plate 12 or to bring the support plate 13 closer to the tibial contact plate 12. In this example, the drive interface 20 is arranged on the body 11 such that it is operable from the anterior side of the body. The drive interface 20 includes, for example, a hexagon socket arranged along the axis.

[0041] The drive unit can also be designed differently. A clamp can be provided instead of the drive unit 19.

[0042] The spreading measuring tool 10 includes a display 210, which indicates the distance between the tibial contact plate 12 and the support plate 13. In this example, the display 210 is configured to show the distance between the tibial contact plate 12 and the support plate 13 in millimeters. The values ​​6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, 28, and 30 millimeters are arranged alternately to the right and left of a gap in the body 11. The gap extends in a distal-proximal direction 14.

[0043] The spreader measuring tool 10 comprises a guide and clamping column 22. The guide and clamping column 22 extends in a distal-proximal direction 14 and is movably guided in the body 11 in a distal-proximal direction 14. In this example, the guide and clamping column 22 is guided parallel to the rack.

[0044] The gap extends through the body 11 to an opening in the body 11, in which the guide and clamping column 22 is guided. In this example, the guide and clamping column 22 includes a marking (not shown in Figure 1) for reading the size of the distance in the gap.

[0045] The spreader measuring tool 10 includes a locking lever 23. The locking lever 23 is designed to clamp the guide and clamping column 22, or to release the movement in the distal-proximal direction 14.

[0046] The spreader measuring tool 10 is designed for the rotationally fixed attachment of various attachments. These are described below.

[0047] Depending on the attachment, the spreader measuring tool 10 enables the

[0048] Performing various tasks. Examples include measuring femur size, anteriorly referentially positioning a saw block, posteriorly referentially positioning the saw block, correcting the position of the saw block, and performing the anterior femoral cut.

[0049] The spreading measuring tool 10 is used in flexion in the example. Depending on the surgical technique, individual components of the spreading measuring tool 10 are not strictly necessary.

[0050] Figure 1 shows a first attachment 24 for contact with a femur, i.e., a femoral contact plate 24. The femoral contact plate 24 is rotationally fixed to the axis of rotation 15. The femoral contact plate 24 can also be detachably connected to the axis of rotation 15. In this example, the femoral contact plate 24 is arranged on the posterior side 18 of the support plate 13. The axis of rotation 15 extends from the posterior side 18 of the support plate 13 towards the posterior side 25 of the femoral contact plate 24. The femoral contact plate 24 has a sleeve for receiving the axis of rotation 15. The sleeve is arranged centrally between two wings 26 of the femoral contact plate 24. The wings 26 extend parallel to the tibial contact plate 12. In this example, the tibial contact plate 12 and the femoral contact plate 24 have the same extent in the area of ​​the wings 26.In the state of the spreader measuring tool shown in Figure 1, at the smallest possible distance, the tibial contact plate 12 and the femoral contact plate 24 are in contact over their entire surface. The femoral contact plate 24 includes at least one bore 27 in the distal-proximal direction 14, which is designed to receive a plate for compensating for the height of a previously resected femur (not shown in Figure 1). In this example, the femoral contact plate 24 includes two bores 27, one bore 27 for each wing 26. The bore 27 is an example of a hole in the distal-proximal direction 14. The hole can be round, oval, or rectangular.

[0051] The spreader measuring tool 10 can also be designed to accommodate other attachments. In this example, the spreader measuring tool 10 includes a groove 28 on both the lateral and medial sides for receiving the respective other attachment. The groove 28 extends from the anterior side 17 to the posterior side 18 of the carrier plate 13. The groove 28 extends parallel to the body's axis of rotation 15.

[0052] Figure 2 shows a schematic, perspective view of the medical spreader measuring tool 10 with the angle indicator 16 and a conversion indicator 20 for the angle indicator 16. The conversion indicator 20 displays the conversion of the angle values, in this example for the rotation angles for internal rotation of -9°, -6°, -3°, and 0°, and for external rotation of 3°, 6°, and 9°, to millimeters. In this example, the millimeter values ​​for the angles for internal rotation -6° and 0°, and for external rotation +6°, are arranged on one side of the axis of rotation 15. On the other side of the axis of rotation 15, the millimeter values ​​for the angles for internal rotation -9° and -3°, or for external rotation +3° and +9°, are arranged. The conversion indicator 20 has a spring 21 on both the medial and lateral sides, which corresponds to the groove 28. The spring 21 of the conversion indicator 20 is held on both sides by the groove 28 in the carrier plate 13.

[0053] The conversion display 20 can be adapted to the spreader measuring tool if required, in order to be able to read, for example, an internal / external rotation or varus / valgus of the femur in degrees and / or millimeters.

[0054] The conversion indicator 20 shows, for example, the deviation between medial and lateral in degrees on one side, and in millimeters on the other side.

[0055] Figure 3 shows a schematic, perspective view of the medical spreader measuring tool 10 with an alignment unit 30. The alignment unit 30 has a spring 31 on both the medial and lateral sides, which corresponds to the groove 28. The spring 31 of the alignment unit 30 is held on both sides by the groove 28 in the support plate 13. The alignment unit 30 includes a bore 32 for receiving a rod for checking a leg axis.

[0056] In this example, the alignment unit 30 is arranged on the anterior side of the support plate 13. The bore 32 extends in a distal-proximal direction 14 within the alignment unit 30. In this example, the alignment unit 30 has a bracket 34 that supports the bore 32. The bracket 34 projects beyond the anterior side 17 of the support plate 13. In this example, the bracket 34 extends to the posterior side 18 of the support plate 13. The bracket 34 supports the springs 31. Figure 4 schematically shows the spreader measuring tool 10 and a second attachment 40. The second attachment 40 is designed for positioning a 4-in-1 saw block and for measuring the femur size.

[0057] The second attachment 40 has one spring each on the medial and lateral sides.

[0058] 41, which is designed to correspond with the groove 28. The spring 41 of the second attachment 40 is held on both sides by the groove 28 in the carrier plate 13 when the second attachment 40 is fastened to the carrier plate 13 (not shown in Figure 4).

[0059] The second essay 40 comprises a first frame part 42 and a second frame part 43 .

[0060] The first frame part 42 comprises a bracket 44 extending in the distal-proximal direction 14, and a medial and a lateral wing 45 of the first frame part

[0061] 42 connects. Each wing 45 has three bores 46 in the first frame part 42, spaced apart from each other and arranged side by side in the respective wing 45 in a lateral-medial direction. Two of the bores 46 in the wings 45, located to the left and right of the 0° hole, are correction holes. The holes are at a 2° angle to each other.

[0062] The holes 46 allow pins to be inserted for the 4-in-1 saw block. In the example, holes 46 are provided in pairs for inserting the pins at an angle for an inward rotation of -2°, for 0°, and for an outward rotation of +2°. The center holes 46 of each wing 45 form a pair. The outer hole 46 of one wing 45 forms a pair with the inner hole 46 of the other wing 45.

[0063] The second frame part 43 comprises a bracket 47 extending in the distal-proximal direction 14 and connecting a medial and a lateral wing 48 of the second frame part 43. In the state shown in Figure 4, the inner side of the bracket 47 of the second frame part 43 rests against the outer side of the bracket 44 of the first frame part 42 with the smallest possible distance between the brackets.

[0064] Each wing 48 has three bores 49 in the second frame part 43, spaced apart from one another and arranged side by side in the respective wing 48 in a lateral-medial direction. The bores 49 in the wings 48 of the second frame part 43 are correction holes, located to the left and right of the 0° hole. The holes are at a 2° angle to each other.

[0065] Pins for the 4-in-1 saw block can be inserted through the holes 49 of the second frame part 43. In the example, the holes 49 of the second frame part 43 are provided in pairs for inserting the pins at an angle for an inward rotation of -2°, for 0°, and for an outward rotation of +2°. The middle holes 49 of the second frame part 43 of each wing 45 form a pair. The outer hole 49 of one wing 48 of the second frame part 43 forms a pair with the inner hole 49 of the other wing 48 of the second frame part 43.

[0066] The first frame part 42 and the second frame part 43 are displaceable relative to each other in the distal-proximal direction 14. The first frame part 42 and the second frame part 43 represent a size of the femur. The first frame part 42 has a scale which, with the aid of a marking line arranged on the second frame part 43, defines a femur size.

[0067] The second frame part 43 in the example includes an indicator for checking the epicondylar line, a recess which can be used both for checking the anterior cutting height and for performing the anterior cut. The second frame part 43 includes an interface to a compensation plate. The compensation plate is as thick as a femoral implant. The compensation plate allows for size determination after the femur has already been cut.

[0068] The bracket 44 of the first frame part 42 is designed to accommodate a cam block 400, which is movable in a distal-proximal direction 14 with respect to the first frame part 42.

[0069] The cam block 400 includes a bore 401 for receiving a rod located in the femur. The cam block 400 forms the interface with the rod, thus ensuring 90° flexion.

[0070] For example, bore 401 is arranged at an angle of 0°, 2°, 4°, 6°, 8° or 10° in the cam 400.

[0071] The sliding block 400 is usable for both a left and a right knee in the example. For instance, one bore 401 extends at one angle in the anterior-posterior direction, and another bore 401 extends at another angle in the medial-lateral direction. It may be provided that interchangeable sliding blocks 400 are used, with the sliding blocks having bores 401 extending at different angles.

[0072] This allows a user to choose from 400 different angles, depending on the set piece.

[0073] The second attachment 40 includes, in the example, a finger 402.

[0074] Finger 402 extends in a posterior direction along the proximal side of the second attachment 40.

[0075] Finger 402 has a tactile tip at its posterior end, which can be used to grasp the bone reference to determine the position of the anterior shield of the femoral component.

[0076] The distance to which finger 402 extends in a posterior direction is adjustable in this example by means of an adjustment device. This adjustment device allows finger 402 to be moved in an anterior-posterior direction 403.

[0077] Figure 4 shows a state in which the finger 402 extends in the posterior direction with the shortest possible length. The adjusting device comprises, for example, a clamping device 404 and a lever 405, which is connected to the finger 402 or formed integrally with the finger 402.

[0078] It may be provided that a scale is arranged on finger 402 or on lever 405, from which the femur size can be read.

[0079] The second attachment 40 comprises a clamping axis 406 and a knob 407. The clamping axis 406 extends in the distal-proximal direction 14 through the knob 407, the clamping device 404, and the lever 405 to the cam block 400. The cam block 400 is attached to the clamping axis 406. The clamping device 404 is configured to prevent movement of the cam block 400 when the clamping device 404 clamps the clamping axis 406. The clamping device 404 is configured to lock the height of the cam block 400 when the clamping device 404 clamps. The clamping device 404 is configured to allow movement of the cam block 400 otherwise.

[0080] In the example, the clamping device 404 and the knob 407 have corresponding threads and a cone, wherein the clamping device 404 is configured to clamp the clamping axis 406 when the knob 407 is screwed downwards, thereby creating a cone that causes the clamping device 404 to jam.

[0081] The distance to which the finger 402 extends in the posterior direction can be adjusted in this example by moving the lever 405 relative to the clamping device 404.

[0082] The second attachment 40 has in the second frame part 43 in the bracket 47 a bore 408 each medially and laterally for receiving a plate 60 to compensate for a depth of an already resected femur.

[0083] Figure 5 shows a schematic, perspective view of the medical spreading measuring tool 10 with a third attachment 50. The third attachment 50 is designed for positioning a distal saw block 51.

[0084] The third essay 50 comprises the first framework section 42 .

[0085] The third attachment 50 comprises a releasable closure 52, to which the distal saw block 51 can be releasably attached on the posterior side of the third attachment 50 by means of the releasable closure 52. The releasable closure 52 comprises an opening lever 53. The releasable closure 52 comprises at least one wing 54. In the example, the releasable closure 52 and the wing 54 are formed in one piece. The third attachment 50 comprises the clamping axis 406. The clamping axis 406 extends through the releasable closure 52 and the clamping lever 53. The third attachment 50 comprises the cam block 400. The cam block 400 is held by the clamping axis 406.

[0086] The third attachment 50 has a connecting piece 56. The connecting piece 56 is arranged between the closure 52 and the support plate 13 (not shown in Figure 5). In this example, the first frame part 42 carries the connecting piece 56.

[0087] Figure 6 shows a schematic, perspective representation of the medical spreading measuring tool 10 with the second attachment 40 and a plate 60 to compensate for the depth of the already resected femur.

[0088] In this example, the plate 60 is detachably arranged on the posterior side of the second attachment 40. The plate 60, used for depth compensation, has pins which, in this example, are located in the bores 408 for receiving the plate 60 to compensate for the depth of the already resected femur. The bores 408 are examples of a round negative mold. Instead of the bores 408, a differently shaped negative mold may be provided. The pins hold the plate 60 for depth compensation in the negative molds, e.g., the bores 408, of the second attachment 40.

[0089] Figure 7 shows the spreading measuring tool 10 and a fourth attachment 70 schematically and in perspective.

[0090] The fourth attachment 70 is designed to compensate for the height of a saw block already positioned on the femur.

[0091] The fourth attachment 70 comprises a plate 71 which is detachably arranged on the axis of rotation for contact with the saw block .

[0092] Plate 71 can also be permanently attached to the axis of rotation.

[0093] The plate 71 for contact with the saw block is 403 shorter in the anterior-posterior direction than the tibial contact plate 12 .

[0094] The plate 71 for contact with the saw block forms a unit together with the tibial contact plate.

[0095] The plate 71 for contact with the saw block forms the contact surface for the saw block, which is already positioned and fixed on the femur.

[0096] The height of plate 71 in contact with the saw block is designed in this example to match the implant and, for example, a 4-in-1 saw block, such that plate 71, together with the 4-in-1 saw block, represents the posterior thickness of the (trial) femur implant. The spreading action maps the gap between the resected tibia and the future femur implant. This allows the thickness of the tibial implant to be determined.

[0097] In the example, the axis of rotation 15 is shortened. It may be intended that the support plate 13 is also shortened.

[0098] It is also possible to use the spreading measuring tool 10 in revision operations. The difference between a primary and a revision procedure in this case is the trial tibial plateau, which is already fixed to the tibia in the revision when using the spreading measuring tool 10. Furthermore, in a revision, work is performed against an already resected femur.

[0099] These differences must be taken into account, especially during measurement, to ensure that the correct remaining gap is displayed.

[0100] Figure 8 shows a schematic, perspective view of the medical spreading instrument 10 with the first attachment, i.e., the femoral contact plate 24, and the plate 60 or a plate 80 for compensating for the height of the already resected femur. This means that the plate 80 for compensating for the height represents the thickness of the femoral implant.

[0101] In this example, the plate is detachably arranged via an adaptation interface on the proximal side of the femoral contact plate 24.

[0102] In this example, the plate has pins which are arranged in the bores 27 to receive the plate. The pins hold the plate in the bores 27 of the femoral contact plate 24. The bores 27 are examples of a round negative mold. Instead of the bores 27, a differently shaped negative mold can be provided.

[0103] Figure 9 shows a schematic, perspective view of the medical spread measurement tool 10 with the first attachment, i.e. the femoral contact plate 24, and femoral augmentations.

[0104] 90 is shown. In the example, an augmentation 90 is arranged on each wing 26 of the femoral contact plate 24.

[0105] In the example, a trial tibia plateau 91 and a tibia augmentation 92 are also arranged at an adaptation interface on the distal side of the tibial contact plate 12.

[0106] Figure 10 shows a schematic, perspective view of the medical spreader measuring tool 10 with the first attachment, i.e., the femoral contact plate 24. The plate 80 and augmentate 90 are arranged on the femoral contact plate 24.

[0107] In the example, there are also 12 Trial Tibia Plateau devices at an adaptation interface on the distal side of the tibial contact plate.

[0108] 91 and tibia augmentation 92 were ordered.

[0109] The groove 28 and the springs are examples of an interface between the spreading measuring tool 10 and the attachments held by the groove 28 and the springs. Other forms of fastening these attachments may also be provided.

[0110] The saw block is, for example, a 4-in-1 saw block.

Claims

Patent claims 1. A medical spread measurement tool (10) characterized in that the spread measurement tool (10) comprises a body on which a tibial contact plate (12) is arranged distally and a support plate (13) proximally, wherein the tibial contact plate (12) and the support plate (13) are arranged on the body so as to be displaceable relative to each other in a distal-proximal direction (14), wherein a rotation axis (15) rotatable with respect to the support plate (13) with an angle indicator (16) is arranged in the support plate (13), wherein the rotation axis (15) extends from an anterior side (17) of the support plate (13) to a posterior side (18) of the support plate (13), and wherein the spread measurement tool (10) is designed to attach an attachment (24) for contact with a femur to the rotation axis (15), in particular in a rotationally fixed manner, or to receive an attachment (40,50) for positioning a saw block or an attachment (70) to compensate for a height of a saw block already positioned on the femur on the tibial contact plate (12) is designed ., 2. The spread measurement tool (10) according to claim 1, characterized in that the attachment (40) comprises a finger (402) for determining the femur size, which extends in a posterior direction on the posterior side of the attachment (40).

3. The spreader measuring tool (10) according to one of the preceding claims, characterized in that the Spread measuring tool (10) includes a conversion indicator (20) arranged on the angle indicator (15) for the angle indicator (15).

4. The spread measuring tool (10) according to one of the preceding claims, characterized in that the spread measuring tool (10) comprises an alignment unit (30) which includes a bore (32) for receiving a rod for testing a leg axis, wherein the alignment unit (30) is arranged on the anterior side (17) of the carrier plate (13), and the bore (32) extends in a distal-proximal direction (14) in the alignment unit (30).

5. The spreader measuring tool (10) according to one of the preceding claims, characterized in that the attachment (40) for positioning the saw block has a cam block. (400) includes a hole, in particular a bore (401) , for receiving a rod arranged in the femur .

6. The spreader measuring tool (10) according to claim 5, characterized in that the hole, in particular the bore (401) , is arranged at an angle between 0° and 10°, in particular 0°, 2°, 4°, 6°, 8° or 10° in the cam block (400).

7. The spreader measuring tool (10) according to claim 5 or 6, characterized in that the attachment (50) for positioning the saw block comprises a releasable closure (52) to which the saw block (51) can be releasably attached on the posterior side of the attachment (50) for positioning the saw block by means of the releasable closure (52).

8. The spreader measuring tool (10) according to claim 7, characterized in that the attachment (50) for positioning the saw block has a connecting piece (56) which is arranged between the closure (52) and the carrier plate (13).

9. The spreader measuring tool (10) according to one of claims 5 to 8, characterized in that the attachment (40) for positioning the saw block comprises at least one negative form, in particular a bore (408) which extends in an anterior-posterior direction (403), and on which a plate for compensating for the depth of the already resected femur can be arranged, and extends with the depth to be compensated in a posterior direction.

10. The spreader measuring tool (10) according to one of the preceding claims, characterized in that the attachment (70) for compensating for the height of the saw block already positioned on the femur has a bearing on the axis of rotation (15) arranged plate (71) for contact with the saw block, which is shorter in the anterior-posterior direction (403) than the tibial contact plate (12).

11. The spreader measuring tool (10) according to one of the preceding claims, characterized in that the attachment (24) for contact with the femur comprises a plate (60, 80) for contact with the resected femur, which extends in a proximal-distal direction (14) with the height of the femur to be compensated.

12. The spread measurement tool (10) according to one of the preceding claims, characterized in that the attachment (24) for contact with the femur has at least one The negative form, in particular a bore, for the attachment of an augmentation, extends in a proximal-distal direction (14).

13. Instrument set, characterized in that the instrument set comprises the spreading measuring tool (10) according to one of the preceding claims and several cam blocks (400) having holes, in particular bores (401), at different angles to each other.

14. Instrument set, characterized in that the instrument set comprises the spreading measuring tool (10) according to one of the preceding claims, wherein at least two of the different attachments (24, 40, 50, 70) are provided in the instrument set.

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