U.S. patent number 3,765,034 [Application Number 05/114,976] was granted by the patent office on 1973-10-16 for femoral hip prosthesis with positioning and drill guide assembly.
Invention is credited to Furnie W. Johnston.
United States Patent |
3,765,034 |
Johnston |
October 16, 1973 |
FEMORAL HIP PROSTHESIS WITH POSITIONING AND DRILL GUIDE
ASSEMBLY
Abstract
A hip joint prosthesis of generally conventional configuration
in that it includes an elongated tapered spindle curving slightly
laterally at its major dimension end with the latter including a
partial spherical head for universal engagement in a pelvis mounted
socket provided therefor. The prosthesis departs from the
conventional prosthesis or similar apparatus in that the spindle is
provided with longitudinally spaced and transversely extending
apertures and one side of the head is provided bores with laterally
outwardly opening parallel bores. A combined jig and drill guide is
also provided and includes a plurality of locating pins
telescopingly receivable in the bores and sleeve portions supported
in fixed relation relative to the locating pins aligned with the
apertures when the guide has its locating pins disposed in the
bores. The spindle is first driven into the medullary cavity and
thereafter the guide is positioned alongside the femur with the
locating pins received in the bores. Thereafter, a suitable drill
may be inserted through and guided by the sleeve portions for
drilling bores in the femur aligned with the apertures formed in
the spindle disposed in the medullary cavity. After removal of the
drill guide suitable threaded fasteners may be threaded through the
bres formed in the femur and the apertures formed in the spindle of
the prosthesis to thereby lock the spindle in fixed relation
relative to the femur so as to eliminate relative movement between
the prosthesis spindle and the femur.
Inventors: |
Johnston; Furnie W. (Dothan,
AL) |
Family
ID: |
22358605 |
Appl.
No.: |
05/114,976 |
Filed: |
February 12, 1971 |
Current U.S.
Class: |
623/22.4;
606/98 |
Current CPC
Class: |
A61F
2/36 (20130101); A61B 17/1753 (20130101); A61F
2002/3631 (20130101) |
Current International
Class: |
A61B
17/16 (20060101); A61B 17/17 (20060101); A61F
2/36 (20060101); A61f 001/24 (); A61f 005/04 () |
Field of
Search: |
;128/92C,92CA,92R,92B,92BA,92BB,92BC,92F,92G,92EB,83 ;3/1 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
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|
|
|
|
|
|
742,618 |
|
Jan 1933 |
|
FR |
|
1,541,151 |
|
Dec 1969 |
|
DT |
|
1,118,773 |
|
Jul 1968 |
|
GB |
|
453,570 |
|
Jun 1968 |
|
CH |
|
Other References
"A Metallic Femoral Head Prosthesis for the Hip Joint" by Earl D.
McBride, Reprint from The Journal of the International College of
Surgeons, Vol. XV, No. 4, Apr. 1951, pp. 498-503. .
"Osborne-Ball Osteotomy Plate" (advertisement pages X-XI), The
Journal of Bone & Joint Surgery, Vol. 48-B, Nov. 1966..
|
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Frinks; Ronald L.
Claims
What is claimed as new is as follows:
1. In combination, a prosthesis comprising an elongated spindle
having a head on one end and being adapted at its other end for
endwise insertion into the exposed end of a bone component, said
spindle being provided with longitudinally spaced transverse
apertures, a positioning jig and drill guide assembly, said
assembly including an elongated body, said head and one end of said
body including coacting releasably engaged indexing means
supporting said body from said head against longitudinal as well as
transverse shifting and angular displacement relative to said
prosthesis and with the other end portion of said body extending
along said spindle, said other end portion of said body including
means defining longitudinally spaced transversely extending guide
means aligned with said apertures, said guide means being adapted
to guidingly support a rotatable drill bit axially advanced toward
said bone component with said drill bit aligned with said
apertures, thereby insuring that the apertures or bores formed in
the bone will be aligned with the apertures formed in the
prosthesis spindle, said guide means comprising generally
semi-cylindrical sleeve portions carried by and opening laterally
outwardly of one marginal edge portion of said body, a secondary
plate pivotally supported from said body for swinging movement of
one edge portion thereof toward and away from the aforementioned
edge portion of said body, the second mentioned edge portion
including generally semi-cylindrical sleeve portions registrable
with the first mentioned semi-cylindrical sleeve portions upon
swinging of said edge portions together to form generally
cylindrical sleeve portions through which said drill bit may be
guidingly advanced.
2. The combination of claim 1 wherein said body member and the
pivoted portion thereof include coacting means for releasably
retaining said body and swingable portion against angular
displacement relative to each other with said edge portions swung
toward each other and said semi-cylindrical sleeve portions
opposing each other to form cylindrical sleeves.
Description
The femoral hip prosthesis of the instant invention has been
designed primarily to provide a device affording for firm fixation
of an intramedullary prosthesis stem or spindle. The basic
principle of providing indexing means on the prosthesis, apertures
in the spindle and a jig for accurately guiding a drill bit in
alignment with the spindle apertures may be extended to other
appliances which require intramedullary stems for fixation.
At the present time, firm fixation of an intramedullary stem can be
accomplished only by the utilization of bone cement (which is still
in the experimental stage) or by providing the stem with slots or
large apertures extending therethrough in the hope that bone will
grow through the slots or apertures and thereby firmly fix the
intramedullary stem. However, sufficient growth of bone may or may
not occur and the chances of such bone growth occurring are
substantially eliminated unless the initial placement of the
intramedullary stem is sufficiently firm to prevent shifting for a
length of time sufficient to allow for the desired new bone
growth.
It may therefore be seen that the incidents of firm fixation of an
intramedullary stem at present is low with the result being that
the patient experiences considerable pain due to the shifting of
the intramedullary stem.
It is accordingly the main object of this invention to provide a
femoral hip prosthesis and positioning jig and drill guide
therefore enabling suitable fasteners, such as threaded screws, to
be utilized in firmly fixing the intramedullary stem in position
once the stem has been inserted in the femur.
Another object of this invention is to provide a prosthesis and
positioning jig and drill guide therefore to be utilized in a
manner such that immediate firm fixation of the intramedullary stem
of the prosthesis may be realized by a post-operative patient.
A final object of this invention to be specifically enumerated
herein is to provide a hip prosthesis and positioning jig and drill
guide which will conform to conventional forms of manufacture, be
of simple construction and easy to use so as to provide a device
that will be economically feasible and time saving in
installation.
These together with other objects and advantages which will become
subsequently apparent reside in the details of construction and
operation as more fully hereinafter described and claimed,
reference being had to the accompanying drawings forming a part
ereof, wherein like numerals refer to like parts throughout, and in
which:
FIG. 1 is a side elevational view of the prosthesis with the stem
thereof seated within the femur and before firm fixation of the
stem by threaded fasteners to the femur;
FIG. 2 is a view similar to FIG. 1 but with the positioning jig and
drill guide in position prior to drilling the bores in the
femur;
FIG. 3 is an elevational view of the assemblage illustrated in FIG.
2 as seen from the left side thereof and with an associated drill
and drill bit illustrated in phantom lines;
FIG. 4 is a perspective view of the positioning jig and drill
guide;
FIG. 5 is a view similar to FIG. 2 but illustrating a modified form
of the positioning jig and drill guide enabling the guide to be
also utilized in initially guiding the anchoring screws into
position;
FIG. 6 is an elevational view of the assemblage illustrated in FIG.
5 as seen from the left side thereof;
FIG. 7 is a perspective view of the modified form of jig and drill
guide;
FIG. 8 is a fragmentary elevational view of the modified form of
jig and drill guide illustrating the manner in which the relatively
pivotable portions thereof may be locked in the closed
position;
FIG. 9 is a fragmentary elevational view illustrating the upper
portion of the femur with one of the anchoring screws in position
anchoring the stem of the prosthesis in position; and
FIG. 10 is a fragmentary sectional view taken substantially upon
the plane indicated by the section line 10--10 of FIG. 9.
Referring now more specifically to the drawings, the numeral 10
generally designates the improved prosthesis of the instant
invention including a longitudinally bowed and tapered stem 12
provided with longitudinally spaced and transversely extending
apertures 14 which may or may not be threaded. The major dimension
end of the stem 12 includes a bulbous or partial spherical head 16
and one side of the head 16 is provided with a plurality of
parallel indexing bores 18.
With attention now invited more specifically to FIG. 4 of the
drawings, there may be seen an indexing or positioning jig and
drill guide referred to in general by the reference numeral 20. The
guide 20 includes a generally planar body plate 22 which is
elongated and longitudinally bowed. One end of the body plate has a
plurality of positioning or indexing pins 24 secured therethrough
and the pins 24 have their mid-portions secured through the body
plate 22 so as to include two sets of corresponding ends disposed
on the opposite sides of the plate 22. In addition, three
longitudinally slotted drill guide sleeves 26 are secured through
the body plate 22 at points spaced longitudinally therealong. The
sleeves 26 also have their mid-portions secured through the body
plate 22 in order that corresponding sets of ends of the sleeves 26
are disposed on opposite sides of the body plate 22. In operation,
after the stem 12 of the prosthesis 10 has been seated within the
femur 28 in the manner illustrated in FIG. 1 of the drawings, the
guide 20 is disposed alongside the upper end of the femur 28 and
the head 16 and laterally shifted so as to insert one pair of
corresponding ends of the pins 24 in the bores 18. When thus
positioned, the sleeves 26 are aligned with the apertures 24 and a
drill bit 30 such as that illustrated in FIG. 3 of the drawings
supported from a drill truck 32 may be successively guidingly
received in the sleeves 26 in order to drill bores in the femur 28
precisely aligned with the apertures 14 formed in the stem 12. The
bore may be formed in only one side of the femur or they may be
formed completely through the femur as the bores 34 illustrated in
FIG. 10 of the drawings. Thereafter, the guide 20 is removed and
suitable threaded fasteners such as the fasteners 36 in FIGS. 9 and
10 may be utilized to firmly fix the stem 12 of the prosthesis
within the femur 28.
With attention now invited more specifically to FIGS. 5-8 of the
drawings, there may be seen a modified form of guide referred to in
general by the reference numeral 40. The guide 40 includes a base
plate 42 corresponding to the base plate 22 and positioning or
indexing pins 44 corresponding to the pins 24. In addition, one
edge portion of the base plate 40 includes semicylindrical drill
guide sleeves 46 corresponding to the guide sleeves 26.
The guide 40, however, includes a secondary body plate 42'
pivotally supported from the body plate 42 as at 43 and one edge
portion of the plate 42' includes semi-cylindrical guide sleeves
46' which, when the free end portion of the plate 42' is swung
toward the free end of the plate 42, coact with the semicylindrical
guide 46 to form cylindrical guide sleeves.
The free end of the plate 42 includes a stiff but somewhat
resilient hook portion 48 comprising a snap latch for engagement
with the endmost semi-cylindrical guide sleeve 46 on the plate 42
in order to retain the plate 42' in the closed position thereof
illustrated in FIG. 5 of the drawings.
The operation of the guide 40 is quite similar to the operation of
the guide 20 in that the pins 44 are telescoped into the bores 18
whereupon the coacting semi-cylindrical guide sleeves 46' are
aligned with the apertures 14 formed in the stem 12 of the
prosthesis 10. Thereafter, the drill bit 30 and truck 32 supported
from the drill may be utilized to form bores corresponding to the
bores 34. Thereafter, and with the guide 40 still in position,
fasteners 50 corresponding to the fasteners 36 may be passed
between the pairs of coacting semi-cylindrical guide sleeves 46 and
46' and threaded in the bores formed in the femur 28 until the
heads of the fasteners 50 are positioned closely adjacent the outer
ends of the semi-cylindrical drill guide sleeves 46 and 46'. In
this manner, the fasteners 50 are properly guided as they are
threaded into the femur 28 and the stem 12 of the prosthesis 10.
After all of the fasteners 50 have been at least initially threaded
into the femur 28, the plate 42' may be swung to the open position
thereof illustrated in FIG. 7 of the drawings to that the guide 40
may be removed from the prosthesis and femur prior to the fasteners
50 being fully seated. hereof,
The pins 24 and 44 project from opposite sides of the plates 22 and
42 in order that the guides 20 and 40 may be used on either side of
the femur 28, according to the desire of the surgeon. Of course,
either or both sides of the head 16 may be provided with bores 18
or the latter may comprise through bores as long as the pattern
thereof is regular.
Although the stem 12 might be anchored in position by the
utilization of fasteners 50 without the use of either the guide 20
or the guide 40, in order to insure absolute alignment of the bores
formed in the femur 28 and the apertures 14 formed in the stem 12,
the bores 34 and apertures 14 would have to be simultaneously
formed and while bone dust caused by such a drilling operation
would not necessarily be excessively objectionable, metal filings
and chips as a result of the apertures 14 being formed in the stem
12 in situ would be highly objectionable and thus simultaneous
forming of the bores 34 and apertures 14 in situ is intolerable.
Furthermore, the guide 40 not only provides a means whereby the
bores 34 may be formed in precise alignment with the preformed
apertures 14, but also enables the fasteners 50 to be guided during
initial engagement thereof with the femur 28.
While the spindle and jig of the invention are illustrated and
described herein as being specifically adapted for use in affording
firm fixation of an intramedullary prosthesis stem or spindle, the
invention may also be practiced in affording firm fixation of any
intramedullary nail or the like as long as one end portion of the
nail is exposed and provided with indexing means of some type for
coaction with complementary indexing means on a corresponding jig
end.
The foregoing is considered as illustrative only of the principles
of the invention. Further, since numerous modifications and changes
will readily occur to those skilled in the art, it is not desired
to limit the invention to the exact construction and operation
shown and described, and accordingly all suitable modifications and
equivalents may be resorted to, falling within the scope of the
invention.
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