Interosseous Ligament Reconstruction Drill Guide
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Solution Overview
Problem
Current surgical techniques for reconstructing interosseous ligaments like the scapholunate and lunotriquetral ligaments in the wrist often fail to recreate the normal anatomy, lead to abnormal wrist motion, and require multiple incisions, increasing the risk of complications and stiffness.
Innovation Solution
A method and drill guide system that allows for drilling holes through the wrist bones from the dorsal side, using a hollow tube and shaft with an adjustable opening to ensure accurate placement of grafts or sutures, recreating the volar and dorsal aspects of the ligaments while avoiding the central axis and minimizing tissue disruption.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If existing reconstruction techniques use multiple incisions (volar and dorsal) to access the wrist bones, then the surgeon can release volar ligaments and drill holes, but this increases the risk of complications, tissue disruption, and wrist stiffness
Solution Approach 1:
The invention extracts the harmful element of multiple incisions by eliminating the volar incision entirely. The drill guide is designed to access the volar side of the wrist bones through a single dorsal incision, thereby removing the source of additional tissue disruption and complication risk associated with making separate volar and dorsal incisions.
Solution Approach 2:
The drill guide serves as an intermediary device that enables drilling through the wrist bones from the dorsal side without requiring direct volar access. The guide includes a hollow tube with a sharp leading end that can penetrate the volar ligaments and capsule to establish a drilling path through the bone, allowing the surgeon to perform the procedure through a single dorsal incision while maintaining control over the drilling trajectory.
2Stability of the object's composition
If reconstruction techniques place devices or grafts through the central axis of the two bones, then the bones can be connected, but this leads to abnormal kinematics (motion) of the wrist bones
Solution Approach 1:
The drill guide is designed to create holes at specific non-central locations on the wrist bones (scaphoid and lunate) that correspond to the anatomical attachment sites of the scapholunate ligament. By drilling at these localized anatomical positions rather than through the central axis, the graft can be placed to recreate the natural ligament path and restore normal wrist kinematics while maintaining bone stability.
3Ease of manufacture
If reconstruction techniques do not recreate the normal anatomy of the volar and dorsal parts of the ligament, then the procedure is simpler, but the functional outcome is compromised
Solution Approach 1:
The drill guide is designed to create separate drilling paths that correspond to the volar and dorsal portions of the scapholunate ligament. The guide can be positioned to drill holes at different locations and angles, allowing the surgeon to place graft material that recreates both the volar and dorsal anatomical components of the ligament, thereby restoring normal ligament function while maintaining procedural efficiency.
4Productivity
If holes are drilled through the wrist bones without a guide from the dorsal incision, then the procedure can be performed, but multiple incisions are required and increased care is needed to ensure proper hole orientation
Solution Approach 1:
The drill guide is a multi-functional device that combines several functions into a single instrument: it provides a template for proper hole orientation, serves as a protective barrier during drilling, guides the drill bit through the bone, and can be positioned from a single dorsal incision. This eliminates the need for separate volar and dorsal incisions while ensuring accurate hole placement and orientation.
Data Source
AI summary
A method for interosseous ligament reconstruction (e.g., of a scapholunate or lunotriquetral ligament) includes drilling holes through both of the bones to allow for a graft to be placed on the volar and dorsal aspects of the bones, replicating the normal anatomic structure of the interosseous ligament, while requiring only an incision on the dorsal side of the wrist. The method includes using a drill guide that directs the drill to place a drill hole from dorsal to volar (front to back) in the bone, while making sure the drilled hole is within the joint on the volar side. The drill guide includes a hollow guide tube to advance a drill through, the hollow tube movably coupled to a shaft of the drill guide with a distal end that generally aligns with the distal end of the hollow tube. The shaft can have a sharp end that the drill will meet if passed through the drill guide, the sharp end of the drill guide being either hollow or solid, and can serve to release part of the wrist capsule (volar extrinsic carpal ligaments) from the bone in order to keep the drill hole within the wrist joint (and not outside of the joint).