US2547571A - Hip fracture drill guide - Google Patents

Description

April 3, 1951 J. J. ETTINGER HIP FRACTURE DRILL GUIDE Filed June 2, 1950 INVENTOR /5/ J Wz'yfegg ATTORNEY Patented Apr. 3, 1951 UNITED STATES PATENT OFFICE HIP FRAC'I'URE DRILL GUIDE Joe J. Ettinger, Warsaw, Ind., assigner to Zimmer Manufacturing Company, Warsaw, Ind.

Application .I une 2, 1950, Serial No. 165,659

Claims. l

This invention relates to surgical appliances and has special reference to a drill guide and gage particularly adapted for use in hip fractures such as those at the neck of the femur in which the use of a canulated nail of the Smith-Peterson type or a canulated screw of the Moreira type is indicated and in which a guide pin guides the nail or screw.

In fractures of the kind above mentioned it is highly desirable that a correct angular relation be attained between the long axis of the shaft of the femur and the axis `of the femur neck and head. This angle is not the same in all persons in the unbroken bone and if, in the surgical repair of a fracture of the kind mentioned, an improper angle exists upon healing of the break, permanent deformation and awkwardness in locomotion usually occurs. In surgical repairs of such fractures it is usual to drill a hole from a point slightly below the greater trcchanter along the axial line of the neck and head. The drill is then withdrawn and a guide pin tted in the hole. The nail or screw used is then fittedv on the guide pin and driven home. Obviously the hole may be reamed out if desired prior to the insertion of the nail or screw. If the drilling accurately follows the proper angle the insertion of the nail or screw will necessarily follow this angle and union of` the bone at the break will be effected in normal relation and distortion of the femur from normal movement in locomotion will be avoided.

In order to accomplish the above purposes it is one important object of this invention to provide a novel drill guide adapted especially to insure drilling along the axis of the head and neck of a femur at a selected angle to the long axis of the femur.

A second important object of this invention is to provide a novel device for the purpose set forth having means whereby the base of the device maybe supported parallel to the long axis of the femur in the neck of which the fracture exists.

A third important object of the invention is to provide a novel device of this character having a base plate and a drill guide carried by the base plate and angularly adjustable relative thereto.

With the above and other objects in View, as will be hereinafter apparent, the invention consists in general of certain novel details of construction and combinations of parts hereinafter fully described, illustrated in the accompanying drawings and particularly claimed.

In the drawings like characters of reference indicate like parts in the several views, and--A Fig. 1 is a side elevation of one form of the invention showing the manner in which it is utilized.

Fig. 2 is a plan View thereof.

Fig. 3 is an elevation taken from the right hand side of Fig. 1.

Fig. 4 is a section on the line 4 4 of Fig. 2.

Fig. 5 is a view similar to Fig. 1 but showing a modified form of the invention.

Fig. 6 is a plan view of this modified form.

Fig. 7 is a detail section on the line 1 1 of Fig. 5.

In each form of the invention as here shown there is provided an elongated base plate IG which is arcuate in cross section to t a femur below the greater trochanter. On the convex face of the plate Ii! adjacent its upper end is a pair of ears II. A guide tube I2 is provided adjacent one end with an ear I3 projecting from the side of the tube and fitting between the ears I I. A hinge pin I4 extends through the ears I3 and I il, the guide tube I2 being thus hingedly connected to the base plate I0. Spaced below the ears II an ear I5 projects from the plate Ill.

In the form shown in Figs. 1 to 4 inclusive there is provided a barrel It having a diametrically disposed opening I'I wherethrough the guide tube passes; the barrel I6 is thus slidably mounted on the tube I2. Adjacent each end of the barrel I6 is an opening I8 extending parallel to the opening Il. This form of the invention is provided with a handle I9 consisting of a wire or rod having a U-bend 2S from which extend parallel sides 2| so spaced as to be comfortably gripped by an operators hand. From the ends of the sides 2! the sides converge as at 22 and are bent to extend downwardly through the openings I 3 and form guide bars 23 on which the barrel ISS is slidably mounted, the ends of the bars 23 extending laterally into the eye I5. The wire structure including the handle and guide bars is thus hingedly connected to the plate it. Screwed radially into the barrel I6 to engage the guide tube I2 is a set screw 2L! by means of which the barrel I Ii may be held from movement on the guide tube I2 and thus the angle between the plate I!) and guide tube I2 will be held in ad justed position since securing of the barrel Vin adjusted position on the guide also prevents movement of the barrel on the bar 23. The guide tube may be graduated as at 25 to indicate angles complementary to the angles between the guide tube I2 and plate I0, the indications thus showing included angles between the long axis of the femur and the axis of its neck.

The form of the device shown in Figs. 5, 6 and 7 operates on the same principle as the first form but here there is employed a barrel 26 having diametrically disposed openings 21 and 28. These openings lie at right angles to each other and open slightly into each other at the point of intersection. The guide tube I2 extends through the opening 21. In this form the handle has a loop 29 formed on one end of a single wire or bar somewhat heavier than that used in the first form. From the loop 29 the wire extends straight as at 30 and then bends downward to form a guide bar 3| having its end engaged in the eye l5. The guide bar 3| extends through the opening 2%. A set screw 32 extends axially into one end of the barrel 26 and, when screwed up, forces the guide bar 3l against the guide tube I2 thus frictionally securing the parts against relative movements.

In use the proper angle for setting the guide tube in relation to the plate I is derived by adjustment of the broken portions under X-ray observation and immobilizing these adjusted parts. The set screw is loosened and the barrel adjusted on the guide tube to suit the required angle and there held by setting up the set screw. The plate is then applied to the shank of the femur as in Fig. 1 and there securely held by a bone clamp or other suitable means. A drill such as D is inserted in the guide tube and operated in the usual manner to form the guide pin channel.

What is claimed is:

1. In a device o the kind described, a bone plate adapted to engage the femur below the greater trochanter and form a base, a guide tube having one end hinged to the plate at its upper end for angular adjustment relative to the plate, a barrel through which the guide tube passes transversely, means hinged to the bone plate in spaced relation to its upper end and supporting said barrel, and a single set screw extending into the barrel radially thereof and engaging said guide tube and thereby holding said plate, barrel and guide tube in xed relation.

2. In a device of the kind described, a bone plate adapted to engage the femur below the greater trochanter and form a base, a guide tube having one end hinged to the plate at its upper end for angular adjustment relative to the plate, a barrel through which the guide tube passes transversely, said barrel being adjustably slidable on the tube, said barrel having an opening therein for the tube and having also at least one other opening transversely of the barrel, a guide bar extending slidably through the last mentioned opening and having one end hinged to the plate in spaced relation to its upper end, and a single set screw extending into the barrel radially thereof and engaging said guide tube and thereby holding said plate, barrel and guide tube in fixed relation.

3. In a 'device of the kind described, a bone plate adapted to engage the femur below the greater trochanter and form a base, a guide tube having one end hinged to the plate at its upper end for angular adjustment relative to the plate, a barrel through which the guide tube passes transversely, said barrel being adjustably slidable on the tube, said barrel having an opening therein for the tube and having also at least one other opening transversely of the barrel, said openings extending at right angles to each other and slightly intersecting at adjacent arcs, a guide bar extending slidably through the last mentioned opening and having one end hinged to the plate in spaced relation to its upper end, and a single set screw engaging axially in said barrel and forcing said guide tube and guide bar into frictional engagement and thereby holding said plate, barrel and guide tube in xed relation.

4. In a device of the kind described, a bone plate adapted to engage the femur below the greater trochanter and form a base, a guide tube having one end hinged to the plate at its upper end for angular adjustment relative to the plate. a barrel through which the guide tube passes transversely, said barrel being adjustably slidable on the tube, said barrel having an opening therein for the tube and having also at least one other opening transversely of the barrel, said openings extending at right angles to each other and slightly intersecting at adjacent arcs, a guide bar extending slidably through the last mentioned opening and having one end hinged to the plate in spaced relation to its upper end, and a handle on the free end of said guide bar, a single set screw extending into the barrel radially thereof and engaging said guide tube, and thereby holding said plate, barrel and guide tube in fixed relation.

5. In a device of the kind described, a bone plate adapted to engage the femur below the greater trochanter and form a base, a guide tube having one end hinged to the plate at its upper end for angular adjustment relative to the plate, a barrel through which the guide tube passes transversely,lmeans hinged to the bone plate in spaced relation to its upper end and supporting said barrel, and a set screw engaging in said barrel and acting to hold the guide tube from moving through the barrel.

JOE J. ET'IINGER.

REFERENCES CITED The following references are of record in the le of this patent:

UNITED STATES PATENTS Number Name Date 2,200,120 Nauth May 7, 1940 OTHER REFERENCES Surgery, Gynecology and Obstetrics, for September 1938, pages 356-362. (Original in Scientic Library.)

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