Scaphoid Fracture Reduction Tool with Cannulated Handle
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Solution Overview
Problem
Current methods for treating scaphoid fractures, particularly through surgical exposure, often result in large incisions that jeopardize ligaments and blood circulation, and accurate placement of guide wires is difficult, leading to potential wrist arthritis due to disruption of articular cartilage.
Innovation Solution
A reduction and fixation tool comprising a spoon with a distal blade and a handle that allows for minimally invasive fracture reduction and stabilization, featuring a cannulated handle with adjustable guide wire placement to avoid soft tissue disruption and ensure accurate screw insertion.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Manufacturing precision
If surgical exposure is used for fracture reduction, then adequate fracture reduction can be achieved, but large incisions are required that jeopardize ligaments and blood circulation
Solution Approach 1:
The surgical approach is segmented into two separate steps: first, minimally invasive insertion of the spoon and guide wire through small incisions; second, fracture reduction using the spoon as a lever. This segmentation allows each step to be performed through minimal exposure, avoiding the need for large incisions while achieving adequate reduction.
Solution Approach 2:
The spoon acts as an intermediary tool that can be inserted through small incisions and used to lever the fracture fragments into reduction. The guide wire serves as another intermediary to establish accurate screw placement pathways without requiring extensive surgical exposure. These intermediaries enable precise fracture reduction while minimizing soft tissue damage.
2Strength
If cannulated screws are placed over a central guide wire, then rigid stabilization is achieved, but accurate placement of the guide wire is extremely difficult
Solution Approach 1:
The spoon serves a dual function: it acts as a lever for fracture reduction and simultaneously serves as a guide for accurate guide wire insertion. The spoon's positioning within the joint capsule and its engagement with the fracture fragments provide inherent guidance for wire placement, eliminating the need for separate complex guidance techniques.
Solution Approach 2:
The spoon is designed to perform multiple functions: it reduces the fracture by leveraging the distal fragment, establishes the correct trajectory for guide wire insertion, and can be used to confirm proper wire placement. This multi-functionality simplifies the overall procedure and improves ease of operation compared to using separate tools for each step.
3Manufacturing precision
If multiple placement attempts are made for the guide wire, then central screw placement can be achieved, but the precious articular cartilage on the proximal pole is disrupted leading to wrist arthritis
Solution Approach 1:
The spoon is inserted and positioned correctly before guide wire insertion begins. This preliminary positioning establishes the accurate trajectory for wire placement in advance, allowing the surgeon to insert the wire on the first attempt without multiple trials that would disrupt the articular cartilage.
Solution Approach 2:
The spoon acts as an intermediary guide structure that protects the articular cartilage by providing a defined pathway for guide wire insertion. The wire passes through or alongside the spoon, which confines the trajectory and prevents deviation that would cause cartilage damage from multiple placement attempts.
Data Source
AI summary
A reduction and fixation tool has two principle component parts—an intra-articular spoon with a blade, and a handle that docks with the spoon. The spoon has a proximal hub onto which the handle docks. In one example of the tool as it would be used with a fractured scaphoid, the spoon has a distal blade, curved and narrow to slip beneath the undersurface of the scaphoid and to lift the distal fragment of the bone back into proper alignment (fracture reduction). The handle, docked to the spoon, serves as a lever to easily accomplish the reduction, and as a guide for the central insertion of a guide wire into the scaphoid across the fracture site.