阅读说明：本技术 螺钉靶向引导件系统和方法 (Screw targeting guide system and method ) 是由 约瑟夫·瑞安·伍达德 布莱恩·罗伯特·索伦 保罗·卢特雷尔 乔尔·韦诺斯 大卫·雷德芬 于 2018-07-27 设计创作，主要内容包括：靶向引导件包括限定第一引导孔的本体,该第一引导孔设定尺寸并构造成接收穿过其中的引导套筒。第一引导孔沿第一轴线延伸穿过本体。对准臂在第一端与第二端之间延伸。第一端联接至本体。末端从对准臂的第二端延伸。末端的自由端与第一引导孔的第一轴线对准。(Targeting guide includes the ontology for limiting the first guide hole, which is sized and configured to receive the guide sleeve passed through.First guide hole extends through ontology along first axle.Alignment arm extends between the first and second ends.First end is attached to ontology.End extends from the second end of alignment arm.The free end of end is aligned with the first axle of the first guide hole.)

1. a kind of targeting guide, comprising:

The ontology of the first guide hole is limited, first guide hole is sized and configured to receive the guide sleeves passed through Cylinder, wherein first guide hole extends through the ontology along first axle；

The alignment arm extended between the first and second ends, wherein the first end is attached to the ontology；And

From the end that the second end of the alignment arm extends, wherein the first axle pair of the end and first guide hole It is quasi-.

2. targeting guide according to claim 1, wherein the ontology restriction extends through described along second axis Second guide hole of ontology.

3. targeting guide according to claim 2, wherein the first axle and the second axis are substantially parallel.

4. targeting guide according to claim 1, wherein the end includes with first angle from the alignment arm The first part and the second part that is extended with second angle from the first part that second end extends, and wherein described second Part is aligned with the first axle at least one hole.

5. targeting guide according to claim 1, wherein the ontology include have second axis at least one is right Quasi- hole corresponds to the pass the guidance of the guide sleeve insertion when the guide sleeve is inserted by first guide hole The alignment of element.

6. targeting guide according to claim 1, wherein the alignment arm is approximately along horizontal axis from described first End extends to the second end.

7. targeting guide according to claim 1, wherein the alignment arm restriction extends to described from the first end The arc of second end.

8. targeting guide according to claim 1, including the first guidance pin extended from the ontology and the second guidance Pin, wherein the first guidance pin and the second guidance pin are configured to indicate alignment of the targeting guide relative to bone.

9. a kind of system, comprising:

Targeting guide comprising:

The ontology of the first guide hole is limited, wherein first guide hole extends through the ontology along first axle；

The alignment arm extended between the first and second ends, wherein the first end is attached to the ontology；And

From the end that the second end of the alignment arm extends, wherein the first axle pair of the end and first guide hole It is quasi-；

First guide sleeve is sized and configured to be inserted through first guide hole, wherein first guide sleeves Cylinder limits and extends through channel therein.

10. system according to claim 9, including the second guide sleeve, be sized and configured to be inserted through by The second guide hole that the ontology of the targeting guide limits, the second guide sleeve restriction extend through channel therein.

11. system according to claim 10, wherein when the first and second guide sleeves are inserted into corresponding first and second When in guide hole, the channel of the channel of first guide sleeve and second guide sleeve is substantially parallel.

12. system according to claim 9, wherein the ontology of the targeting guide limits at least one alignment hole, institute At least one alignment hole is stated to be configured to correspond to described first when first guide sleeve is inserted into first guide hole The alignment in the channel of guide sleeve.

13. system according to claim 9, wherein the ontology of the targeting guide includes extending therefrom first drawing Guide pin and the second guidance pin, wherein the first guidance pin and the second guidance pin are configured to indicate the targeting guide phase For selecting the alignment of reference point.

14. targeting guide according to claim 9, wherein the alignment arm is approximately along horizontal axis from described One end extends to the second end.

15. targeting guide according to claim 9, wherein the alignment arm limits from the first end and extends to institute State the arc of second end.

16. a kind of method, comprising:

Targeting guide is positioned adjacent to the first bone, wherein the targeting guide includes ontology, is being attached to the ontology First end and second end between the alignment arm that extends and the end for extending and having free end from the second end of the alignment arm End；

First guide sleeve is inserted through to the first guide hole being formed in the ontology, wherein first guide sleeve limits Surely first passage therein is extended through；

First induction element is inserted through the channel of first guide sleeve and is inserted into the first bone, wherein the targeting is drawn A part of the end of guiding element corresponds to the outlet port that the first induction element leaves first bone.

17. according to the method for claim 16, comprising: the first screw is inserted into first bone, wherein described first Screw is inserted on first induction element.

18. according to the method for claim 16, wherein the free end of the end of the targeting guide corresponds to described the One induction element leaves the outlet port of the first bone segment.

19. according to the method for claim 16, comprising:

Second guide sleeve is inserted through to the second guide hole being formed in the ontology, wherein second guide sleeve limits Surely second channel therein is extended through, and wherein corresponding in first guide sleeve and second guide sleeve insertion The first guide hole and the second guide hole after, the first passage of the second channel and first guide sleeve is substantially flat Row；And

Second induction element is inserted through the channel of second guide sleeve and is inserted into first bone.

20. according to the method for claim 16, comprising: before the first sleeve is inserted into first guide hole, The first alignment characteristics and the second alignment characteristics of the targeting guide are directed in predetermined axial line.

21. a kind of system, comprising:

Targeting guide comprising:

The ontology for limiting guide hole and alignment hole, wherein the guide hole extends through the ontology, and institute along first axle It states alignment hole and extends through the ontology along the second axis for being roughly parallel to the first axle；

The alignment arm extended between the first and second ends, wherein the first end is attached to the ontology；And

From the end that the second end of the alignment arm extends, wherein the first axle pair of the end and first guide hole It is quasi-；And

Alignment device, the alignment device is selected from the group being made of hollow screw, Kirschner wire and guidance pin, wherein the alignment fills It sets and is configured for insertion into across the alignment hole.

Background technique

During operation (such as foot surgery), it may be necessary to fix the position of the first bone segment and the second bone segment.Example Such as, in some cases, osteotomy is formed in bone to correct one or more defects.After forming osteotomy, by bone The first segment and bone the positioning of the second segment with rectification of defects, and utilize one or more fixing element fix in position.In In other embodiments, due to damage and/or medical procedure, one or more bone segments are formd.

Current system depends on and places induction element before being inserted into fixing element.The placement of induction element is cured by surgery It is raw to execute, and usually require surgeon before realizing desired placement and be inserted into and remove in multiple times induction element.Guidance Element is repeatedly inserted into and removes the additional wound for leading to patient, and increases pain, recovery time and operative complications (including difficulty Degree, increased operating time etc.).

Summary of the invention

In various embodiments, a kind of targeting guide for positioning guide members is disclosed.The targeting guide packet The ontology for limiting the first guide hole is included, which is sized and configured to receive the guide sleeve passed through.The One guide hole extends through ontology along first axle.Alignment arm extends between the first and second ends.First end is attached to this Body.End extends from the second end of alignment arm.The free end of end is aligned with the first axle of the first guide hole.

In various embodiments, a kind of system is disclosed.The system includes targeting guide, and the targeting guide has Limit the ontology of the first guide hole.First guide hole extends through ontology along first axle.Alignment arm is in first end and second end Between extend.First end is attached to ontology.End extends from the second end of alignment arm.The free end of end and the first guide hole First axle alignment.First sleeve is sized and configured to be inserted through the first guide hole.First sleeve restriction extends through Channel therein.

In various embodiments, a kind of method for fixing the first bone segment and the second bone segment is disclosed.The method packet It includes and targeting guide is positioned adjacent to the first bone.The targeting guide includes ontology, in the first end that is attached to ontology and the The alignment arm that extends between two ends and the end for extending and having free end from the second end of alignment arm.First sleeve insertion It is formed through the first guide hole in the body.First sleeve restriction extends through first passage therein.First induction element It is inserted into and is inserted into the first bone by the channel of first sleeve.A part of the end of targeting guide corresponds to the first guiding element Part leaves the outlet port of the first bone.

Detailed description of the invention

By following detailed description of the preferred embodiment, the features and advantages of the present invention more fully will disclose or become It is clear that these preferred embodiments will consider together with attached drawing, wherein identical label indicates identical component, and furthermore Wherein:

Fig. 1 shows the side view of targeting guide in accordance with some embodiments.

Fig. 2 shows the rearviews of the targeting guide of Fig. 1 in accordance with some embodiments.

Fig. 3 shows the cross-sectional view for the targeting guide that the line A-A in accordance with some embodiments along Fig. 2 is intercepted.

Fig. 4 shows the Surgery of the targeting guide with neighbouring first bone parts positioning in accordance with some embodiments Position.

Fig. 5 shows the operative site of Fig. 4 in accordance with some embodiments, has corresponding first by targeting guide With the first guide sleeve and the second guide sleeve of the positioning of the second guide hole.

The hand that Fig. 6 shows the first guide sleeve of Fig. 5 in accordance with some embodiments and the second guide sleeve is removed from it Art position.

Fig. 7 shows the rearview of the operative site of Fig. 6 in accordance with some embodiments.

Fig. 8 shows the operative site that the targeting guide of Fig. 6 in accordance with some embodiments is removed from it.

Fig. 9 A shows the operative site of Fig. 8 in accordance with some embodiments, has the first bone parts of insertion and the second bone The first fixed device and the second fixed device in part.

Fig. 9 B shows the cross-sectional view of the fixation device of Fig. 9 A in accordance with some embodiments.

It includes the targeting guide with the first alignment hole and the second alignment hole that Figure 10, which is shown in accordance with some embodiments, Operative site.

Figure 11 shows the side view of the operative site of Figure 10 in accordance with some embodiments.

Figure 12 shows the front view of the operative site of Figure 10 in accordance with some embodiments.

It includes the targeting guide with the first alignment pin and the second alignment pin that Figure 13, which is shown in accordance with some embodiments, Operative site.

Figure 14 shows the targeting guide of Figure 13 in accordance with some embodiments, has first be aligned along predetermined axial line Alignment pin and the second alignment pin.

Figure 15 shows the targeting guide in accordance with some embodiments with the arc alignment arm extended from the body.

Figure 16 shows the targeting guidance of the curved lower surfaces in accordance with some embodiments with arc alignment arm and ontology Part.

Figure 17 shows targeting guides in accordance with some embodiments, have and are formed on the first arc axis of ontology First group of guide hole and second group of guide hole being formed on the second arc axis of ontology.

Figure 18 shows targeting guide in accordance with some embodiments, has and is formed on the first level axis of ontology First group of guide hole and second group of guide hole being formed on the second horizontal axis of ontology.

Figure 19 shows the targeting guide in accordance with some embodiments with continuous bulk and alignment arm.

Figure 20 shows the targeting guide in accordance with some embodiments with continuous bulk and alignment arm, the alignment arm packet Include the multiple guide holes for passing through and being formed.

Figure 21 shows the targeting guide in accordance with some embodiments with adjustable body.

Figure 22 is the flow chart in accordance with some embodiments for showing and the first bone segment being fixed to the method for the second bone segment.

Specific embodiment

The description of exemplary embodiment is intended to be read in conjunction with the figure, and attached drawing is considered as a part of entire written description. In the de-scription, such as "lower", "upper", "horizontal", "vertical", " top ", " lower section ", " upward ", " downward ", "top", "bottom", " nearside ", " distal side ", " first-class ", " inferior ", " centre " and " transverse direction " and its derivative (for example, " horizontally ", " down ", ) etc " upward " etc. relative terms should be interpreted to refer to orientation shown in the drawings then describing or in discussion. These relative terms be for ease of description, and do not require with specific orientation construct or operate equipment.About attachment, connection etc. Term (such as " connection ") refer to pass that wherein each structure is fixed to one another or is attached indirectly directly or through intermediate structure System and the two is all removable or rigidly attached or relationship, unless otherwise being expressly recited.Identical element is given identical attached Icon is remembered to promote the understanding to this theme.

As it is used herein, term " substantially " indicates the member with relationship of enumerating (for example, parallel, vertical, alignment etc.) Part is in acceptable manufacturing tolerance.For example, as it is used herein, term is " substantially parallel " for indicating parallel or can The element different from parallel arrangement in the bouds on error (such as +/- 5 °) of receiving, but it is to be understood that, it is based on manufacturing process And/or other manufactures require may exist bigger and/or smaller deviation.

In various embodiments, a kind of targeting guide is disclosed.The targeting guide includes that restriction is one or more The ontology of guide hole, the guide hole are configured to receive the guide sleeve passed through.First guide hole extends along first axle Across ontology.Alignment arm is attached to ontology in first end.Alignment arm extends between the first and second ends.Alignment arm can edge Horizontal axis, vertical axis and/or arc axis extend.Guide tip extends from the second end of alignment arm.Guide tip A part be directed at the first axle of the first guide hole so that pass through guide hole be inserted into guide sleeve and/or induction element and The selected part of guide tip is aligned.Induction element is inserted through guide sleeve and/or the guide hole by not guide sleeve, And guide sleeve is left at the position of the predetermined portions of guide tip instruction.

Fig. 1-Fig. 3 shows targeting guide 10 in accordance with some embodiments.Such as it is discussed more fully relative to Fig. 4-Figure 10 , targeting guide 10 is configured to for one or more induction elements being located in bone.As best seen in Fig. 2 and Fig. 3, target It include extending between top edge 26a and lower edge 26b and between the first side 28a and second side 28b to guiding piece 10 Ontology 12.Ontology 12 limits the first guide hole 14a that ontology 12 is extended through from first surface 30a to second surface 30b and the Two guide hole 14b.First guide hole 14a extends through ontology 12 along first axle 32a, and the second guide hole 14b along Second axis 32b extends through ontology 12.In some embodiments, first axle 32a and second axis 32b are substantially parallel, but It should be understood that first axle 32a and second axis 32b can limit the path of not parallel (for example, intersection).Each guide hole 14a, 14b are sized and configured to receive the guide sleeve (referring to fig. 4) passed through.

In some embodiments, channel 18 extends in the interior section of ontology 12 from the lower edge 26b of ontology 12.Channel 18 are sized and configured to receive one or more induction elements passed through, so that being inserted into one or more draw Targeting guide 10 can be removed from operative site after guiding element, it is such as discussed in detail below in relation to Fig. 4-Figure 10.To the greatest extent Manage each embodiment and be shown as include from the channel 18 that the bottom margin 26b of ontology 12 extends, it will be appreciated that, in each implementation In example, channel 18 can extend internally and/or can be omitted from any outer surface of ontology 12.

In some embodiments, alignment arm 24 extends from the top edge 26a of ontology 12.Alignment arm 24 (joins from first end 42a It is connected to ontology 12) extend to second end 42b.In some embodiments, guide tip 34 is attached to the second end of alignment arm 24 42b.Alignment arm 24, which has, to be configured to for guide tip 34 being located in away from the predetermined length at 12 preset distance of ontology.In some realities It applies in example, which corresponds to the anatomical features of patient.In the shown embodiment, alignment arm 24 is prolonged along horizontal axis 32c It stretches, it will be appreciated that, alignment arm 24 may include extending along one or more horizontal, vertical and/or arc axis Any number of segment, such as a straight segment, multiple short straight segments, the segmental arc of certain curvature etc..Although being discussed herein Embodiment include there is the alignment arm 24 of predetermined length, it will be appreciated that, in some embodiments, alignment arm 24 can have Flexible or revocable length.

In some embodiments, alignment arm 24 is tapered from first end 42a to second end 42b.The bottom of alignment arm 24 Edge 48b can be tapered, so that the thickness of alignment arm 24 reduces from first end 42a to second end 42b, while keep horizontal Axis 32c is aligned with the first axle 32a and second axis 32b of corresponding first and second guide holes 14a, 14b.In other realities It applies in example, other than bottom margin 48b and/or alternatively, top edge 48a can be tapered.In some embodiments, Alignment arm 24 tapers to second of the thickness corresponding to guide tip 34 from the first thickness for the thickness for corresponding to ontology 12 Thickness.

Guide tip 34 extends from the second end 42b of alignment arm 24.Guide tip 34 is configured to instruction and draws with targeting is passed through The relevant position of one or more induction elements that guiding element 10 is inserted into.For example, in some embodiments, the one of guide tip 34 Part, which corresponds to, leaves the first bone across one or more induction elements that guide hole 14a, 14b of targeting guide 10 are inserted into Partial outlet port.Guide tip 34 may include middle section 36, terminal part 38, free end 38a and middle section Transition part 40 between 36 and terminal part 38, the position therein that each can correspond to one or more induction elements.

In the shown embodiment, guide tip 34 includes from the middle section 36 that alignment arm 24 extends and from middle section 36 The terminal part 38 of extension.Guide tip 34 from alignment arm 24 extend preset distance so that the free end 38a of terminal part 38 with The first axle 32a of first guide hole 14a is aligned.Terminal part 38 is configured to position against the surface of bone, passes through target with instruction The outlet port of the first induction element in bone is inserted into guiding piece 10, so that user (such as surgeon) is by induction element Before being inserted into the bone it can be seen that position of the first induction element, to reinsert number needed for during reducing operation.

In some embodiments, 36 definite length extended of middle section, so that terminal part 38 is located in away from alignment arm 24 At interface preset distance between guide tip 34.Middle section 36 is extended with first angle θ 1 from alignment arm 24, and eventually End part 38 is extended with second angle θ 2 from middle section 36.In some embodiments, middle section 36 and terminal part 38 it Between joint portion 40 correspond to the pass one of guide hole 14a, 14b limited by ontology 12 insertion induction element outlet position It sets.Although the embodiment being discussed herein includes middle section 36, it will be appreciated that, in some embodiments, middle section 36 It can be omitted, and terminal part 38 can directly extend from alignment arm 24.In other embodiments, additional middle section can To be arranged between alignment arm 24 and terminal part 38, each additional middle section corresponds to additional and/or substitution guidance Hole or guidance axially bored line.In other embodiments, middle section 36 and/or terminal part 38 are with continuous and/or variable arc Extend from alignment arm 24.

Fig. 4-Figure 10 shows the targeting guide 10 used at operative site 100.Operative site 100 includes multiple Bone, such as the first bone 102 and the second bone 104.In the shown embodiment, the first bone 102 is metatarsal, and the second bone 104 is close Phalanx is saved, it will be appreciated that, the first bone 102 and/or the second bone 104 can be any suitable bone, such as one or more A hand bone, sufficient bone etc..Targeting guide 10 is discussed above in association with Fig. 1-Fig. 3, and similar description is not repeated herein.

In use, the lower surface 26b of the ontology 12 of targeting guide 10 is located against neighbouring first bone 102 of patient Outer surface, such as foot neighbouring metatarsal outer surface.Guide tip 34 is located against the remote of the first part 102a of bone 102 Side end.In some embodiments, first part 102a be included in it is being formed during medical operating (such as osteotomy), in injury Bone segment that is that period is formed and/or being separated in other ways with second part 102b.First guide sleeve 116a is inserted through The first guide hole 14a in ontology 12, and the second guide sleeve 116b is inserted through the second guide hole 14b in ontology 12. First guide sleeve 116a extends when being inserted through the first guide hole 14a along first axle 32a, and the second guide sleeve 116b extends when being inserted through the second guide hole 14b along second axis 32b.First and second guide sleeves 116a, 116b It is positioned to contact and/or neighbouring first bone segment 102a.

In some embodiments, each guide sleeve 116a, 116b defines centre gangway, which is sized And it is configured to receive the induction element passed through.Centre gangway and corresponding axis 32a, 32b are coaxial, so that passing through guide sleeves The induction element of cylinder 116a, 116b insertion extends along corresponding axis 32a, 32b.For example, as shown in Figure 4, the first guidance Element 110a is inserted through the first guide sleeve 116a along first axle 32a, and the second induction element 110b is along second Axis 32b is inserted through the second guide sleeve 116b.In some embodiments, each guide sleeve 116a, 116b includes expansion Or larger diameter portion 118, it is configured to the insertion for preventing guide sleeve 116a, 116b from passing through guide hole 14a, 14b, but Ying Li Solution, expansion 118 can be omitted.First and second induction element 110a, 110b may include being configured to fasten Part is directed to implant site and/or forms any suitable induction element of pilot hole.For example, in the shown embodiment, first It respectively include Kirschner wire (K-wire) with second induction element 110a, 110b, it will be appreciated that, it can be used any suitable Induction element, such as pin, wire rod, screw etc..

As best shown in FIG. 5, the alignment arm 24 of targeting guide 10 and guide tip 34 are configured in induction element The visualization of its position is provided before 110a, 110b insertion.The of the free end 38a of terminal part 38 and the first guide hole 14a One axis 32a alignment.When targeting guide 10 is positioned adjacent to and/or contacts the first bone parts 102a, free end 38a is One induction element 110a is located in the first induction element when being inserted through the first guide sleeve 116a and the first bone segment 102a Exit point.In some embodiments, the joint portion 40 between the middle section 36 and terminal part 38 of guide tip 34 is corresponding In the second induction element when the second induction element 110b is inserted through the second guide sleeve 116b and the first bone segment 102a Position.Terminal part 38 can be used for the prelocalization in the insertion first or second induction element 110a, 110b and be directed at targeting to draw Guiding element 10 so that it is guaranteed that induction element 110a, 110b are positioned correctly, and eliminate that repetition is removed and reinserted and draws The needs of guiding element 110a, 110b.In some embodiments, induction element 110a, 110b can be inserted into, until they are abutted The predetermined portions of guide tip 34, such as terminal part 38, joint portion 40 and/or any other suitable part.In other realities It applies in example, induction element 110a, 110b can be inserted partially into the first bone 102, without contact guidance end 34.In some realities It applies in example, guide tip 34 defines one or more holes, and the hole is sized and configured to receive drawing of passing through Guiding element 110a, 110b.

In some embodiments, ontology 12 includes one or more alignment hole 16a-16d.Alignment hole 16a-16d construction At the induction element that reception passes through, such as Kirschner wire.The axis that alignment hole 16a-16d has and guide hole 14a, 14b Axis 32a, 32b alignment.Across one of alignment hole 16a-16d positioning induction element with across corresponding guide hole 14a, 14b Guide sleeve 116a, 116b and/or induction element 110a, 110b of insertion position in parallel, and provide guide sleeve 116a, 116b and/or induction element 110a, 110b are visually indicated relative to the position of anatomical structure (such as first bone).For example, In In some embodiments, alignment hole 16a-16d allows user (for example, surgeon) to be located in one or more induction elements The outside of the anatomical structure of patient, to be visually directed at targeting guide 10 with anatomical structure.In some embodiments, right Quasi- hole 16a-16d is omitted.

As best shown in fig. 6, after being inserted into induction element 110a, 110b, from targeting guide 10 and/or can draw Guiding element 110a, 110b remove guide sleeve 116a, 116b.In some embodiments, guide sleeve 116a, 116b is in guiding element Part 110a, 110b are upper slideably to be removed to nearside, it will be appreciated that, induction element 110a, 110b can be any suitable Direction on remove.Targeting guide 10 is for visually verifying the first induction element 110a and the second induction element 110b the Placement in one bone segment 102a.For example, as shown in Figure 7, in some embodiments, by verifying induction element in guide hole It is placed in the middle in 14a, 14b, and/or predetermined portions contact between induction element 110a, 110b of verifying guide tip 34, to examine The positioning of induction element 110a, 110b are looked into, it will be appreciated that, it can use other visually indicate to verify induction element The placement of 110a, 110b.Any suitable visualization technique, such as x-ray imaging, fluoroscopy etc. can be used for being inserted into Targeting guide is imaged and verified before or after induction element 110a, 110b.

As best shown in figure 8, targeting guide 10 can be removed from operative site 100.For example, can be by making to target Guiding piece 10 comes in remove targeting guide 10 in the direction uplink far from the first bone 102.Channel 18 allows do not interfering guidance Targeting guide 10 is removed from operative site 100 in the case where element 110a, 110b, because drawing when removing targeting guide 10 Guiding element 110a, 110b cross channel 18.Before or after removing targeting guide 10, induction element 110a, 110b can To advance in the second bone segment 102b.

Induction element 110a, 110b can be inserted in the second bone segment 102b, with temporarily fix the first bone segment 102a and The position of second bone segment 102b.In some embodiments, fixing element is inserted on induction element 110a, 110b.Example Such as, as illustrated in figure 9 a, in some embodiments, the first hollow screw 120a is slidably located in the first induction element 110a The first bone segment 102a and the second bone segment 102b are gone up and are inserted through, and the second hollow screw 120b is slidably located in On second induction element 110b and it is inserted through the first bone segment 102a and the second bone segment 102b.First and second hollow screws 120a, 120b fix the relative position of the first bone segment 102a and the second bone segment 102b.Can by fixing element 120a, Induction element 110a, 110b are removed from bone 102 after the fixed bone of 120b.Fig. 9 B, which shows to have, extends through guiding element therein The cross-sectional view of screw 120a, 120b of part 110a, 110b.

Although each embodiment is shown as including hollow screw 120a, 120b, it will be appreciated that, any suitable fixed dress It sets and could be attached to the first bone segment 102a and/or the second bone segment 102b.For example, in some embodiments, cannulated fasteners (such as hollow screw, pin, pin etc.) is inserted on each induction element 110a, 110b, with fix the first bone segment 102a and The position of second bone segment 102b.As another example, in some embodiments, induction element 110a, 110b can be from first It is removed with the second bone segment 102a, 102b, and fastener (such as hollow and/or non-cannulated fasteners) can be inserted by guiding In the guide hole that element 110a, 110b are formed in the first and second bone segments 102a, 102b.It should be understood that can be used Additional and/or substitution fastener and insertion method.

In various embodiments, targeting guide 10 may include one or more alignment characteristics, be configured to inserting Before entering induction element 110a, 110b and/or the verifying of the alignment to targeting guide 10 is assisted and/or provided to period.For example, In some embodiments, targeting guide 10 may include across ontology 12 formed one or more alignment hole 16a-16d, One or more alignment holes (as discussed below in relation to Figure 10-Figure 12), one or more formed across alignment arm 24 A alignment protrusion (as discussed below in relation to Figure 13-Figure 14), fluoroscopy and/or other imaging compatible alignment elements swash Signal and/or any other suitable alignment characteristics.

Figure 10-Figure 12 shows the operative site 100a in accordance with some embodiments including targeting guide 10a, the targeting Guiding piece, which has, multiple is laterally aligned to hole 46a, 46b across what alignment arm 24a was formed.Operative site 100a and targeting guide 10a is similar to the above operative site 100 and targeting guide 10 for combining Fig. 1-Fig. 9 discussion, and similar description is herein not It repeats.Alignment guide 10a includes extending through the first of alignment arm 24a and being laterally aligned to hole 46a and second to be laterally aligned to hole 46b.First and second, which are laterally aligned to hole 46a, 46b, is configured to be positioned adjacent to the first bone parts 102a as guide tip 24a When provide to user (such as surgeon) and visually indicated about the alignment of targeting guide 10a.

In some embodiments, hole 46a, 46b is laterally aligned to be located so that when the targeting guide from predetermined angular Any part of hole 46a, 46b is not from predetermined angular when 10a.For example, as shown in Figure 11, as targeting guide 10a It is aligned with the first bone parts 102a and when from flank angle, first and second to be laterally aligned to hole 46a, 46b invisible.In In the construction, the alignment arm 24a of targeting guide 10a will be aligned with the axis of the first bone parts, so that guide tip 34a is indicated The outlet port of one or more induction element 110a, 110b, as discussed above.

Figure 13-Figure 14 shows the operative site 100b including targeting guide 10b, which has first pair Quasi- protrusion 50a and the second alignment protrusion 50b.Alignment protrusion 50a, 50b extends from the second surface 30b of ontology 12b, it should be understood that , alignment protrusion 50a, 50b can be from any suitable part of targeting guide 10b (such as ontology 12b, alignment arm 24b And/or guide tip 34b) extend.Alignment pin 50a, 50b are aligned along alignment axis, so that working as targeting guide 10b and the first bone 102 when being rotatably aligned, and first and second alignment pin 50a, 50b are vertically aligned.

For example, as shown in Figure 13, when targeting guide 10b is not correctly aligned with the first bone 102, alignment protrusion 50a, 50b are not vertically aligned, and from the visible each alignment protrusion of the top view of operative site 100b.Such as institute in Figure 14 Show, when targeting guide 10b and the first bone 102a is correctly aligned, alignment protrusion 50a, 50b is vertically aligned, and only one A alignment protrusion 50a is as it can be seen that because the second alignment protrusion 50b is hidden in behind the first alignment protrusion 50a.In some embodiments In, it may include additional alignment protrusion, to provide different alignment axis and/or different alignment angles.

Figure 15-Figure 21 shows the additional embodiment of targeting guide according to various embodiments.Although certain features can It is not shown in other embodiments with showing in some embodiments, it will be appreciated that, the feature of any embodiment can In conjunction with the feature of any other disclosure and/or element.For example, targeting guide 10 includes extending from bottom margin Slit 18.Each targeting guide shown in Figure 15-Figure 21 may include the slit to extend internally from any part of ontology. Other potential combinations and/or modification will be apparent, and within the scope of this disclosure.

Figure 15 shows the targeting guidance in accordance with some embodiments with the arc alignment arm 24c extended from ontology 12c Part 10c.The targeting guide 10 that targeting guide 10c is similar to above in conjunction with Fig. 1-Fig. 9 discussion, and similar description is herein It is not repeated.The alignment arm 24c of targeting guide 10c is extended to along arc axis from the first end 42a for being attached to ontology 12c Second end 42b.The arc of alignment arm 24 is chosen to be attached to the predetermined portions of the guide tip 34c of alignment arm 24c and prolongs The axis alignment of at least one guide hole 14a, 14b of ontology 12c is extended through, as discussed in more detail below.

In some embodiments, alignment arm 24c is tapered from first end 42a to second end 42b.For example, in some realities It applies in example, the top edge 48a of alignment arm 24c extends along the first arc, and the bottom margin 48b of alignment arm 24c is along Two arcs extend, so that the thickness of alignment arm 24c reduces from first end 42a to second end 42b.In other embodiments, top Edge 48a and/or bottom margin 48b can have variable arc.

The ontology 12c of targeting guide 10c may include the rectangular shape with flat bottom edge 28b.Bottom margin 28b is configured to outer surface adjacent and/or against the outer surface of patient, such as foot.Although each embodiment is shown as with rectangle Ontology 12c, it will be appreciated that, ontology 12c can have any suitable shape.Ontology 12c can be bent from the first side 28a To second side 28 and/or can be flat.

In some embodiments, guide tip 34c extends along predetermined arc from alignment arm 24c.For example, in shown implementation In example, guide tip 34c is substantially above extending with the arc square of alignment arm 24c in the opposite direction.Guide tip 34c can be with The transition part (or bending part) 76 of variation between arc with arc and guide tip 34c corresponding to alignment arm 24c.In In some embodiments, transition part 76 can correspond to the horizontal axis of one of guide hole 14a, 14b being formed in ontology 12c, And the free end 38a of guide tip 34c corresponds to second horizontal axis in guide hole 14a, 14b.In shown implementation In example, guide tip 34c extends essentially upward (and separate ontology 12c) from transition part 76, it will be appreciated that, guide tip 34c can be extended in any suitable direction from alignment arm 24c, so that a part of guide tip 34c corresponds to guide hole The horizontal axis of one of 14a, 14b, as discussed above.

Figure 16 shows the curved lower surfaces 28b's in accordance with some embodiments with arc alignment arm 24d and ontology 12d Targeting guide 10d.The targeting guide 10c that targeting guide 10d is similar to above in conjunction with Figure 15 discussion, and similar retouch It states and is not repeated herein.Targeting guide 10d includes curved lower surfaces 28b, is configured to conform to the outer surface of patient, such as The outer surface of foot, hand, shoulder, elbow, knee etc..

Figure 17 shows targeting guide 10e in accordance with some embodiments, have the first arc axis in ontology 12e First group of guide hole 214a-214g on 70a and second group of guide hole 314a- on the second arc axis 70b of ontology 12e 314g.Targeting guide 10e is similar to the targeting guide 10d for combining Figure 16 description, and similar description is no longer heavy herein It is multiple.Guide hole 214a-214g, 314a-314g extend through ontology 12e, and edge from first surface 30a to second surface 30b From the first side 28a of ontology 12e extend to second side 28b corresponding curved path 70a, 70b alignment.Each guide hole 214a-214g, 314a-314g are sized and configured to receive the guide sleeve (not shown) passed through.First group of guidance Hole 214a-214g and second group of guide hole 314a-314g allows user to select the positions of one or more guide sleeves, and nothing The position of targeting guide 10e need to be adjusted.In the shown embodiment, the first arc axis 70a and the second arc axis 70b be substantially In parallel, it will be appreciated that, in some embodiments, arc axis 70a, 70b can be not parallel.

Figure 18 shows targeting guide 10f in accordance with some embodiments, has the on first level axis 72a One group of guide hole 214a-214g and second group of guide hole 314a-314g on the second horizontal axis 72b.Targeting guide 10f is similar to the targeting guide 10e for combining Figure 17 description, and similar description is not repeated herein.In illustrated embodiment In, first level axis 72a and the second horizontal axis 72b are substantially parallel, it will be appreciated that, the first and second horizontal axis 72a, 72b can be not parallel.In some embodiments, ontology 12e can have bending and/or arcuate shape, be configured to accord with Close the outer surface of patient.

Figure 19 shows the targeting guide 10g in accordance with some embodiments with continuous bulk 12g and alignment arm 24g. Targeting guide 10g is similar to the targeting guide 10 for combining Fig. 1-Fig. 9 description, and similar description is not repeated herein. Ontology 12g includes extending through the first guide hole 14a therein and the second guide hole 14b.Ontology 12g and alignment arm 24g is from originally The first end of body 12g continuously extends to guide tip 34g.In some embodiments, the width of ontology 12g and/or alignment arm 24g And/or thickness is tapered from first end 28b to guide tip 34g.For example, in the shown embodiment, ontology 12g and alignment arm 24g has the width that is continuously gradually reduced and the thickness being continuously gradually reduced so that ontology 12g it is most thick at first end 28b and It is most wide, and alignment arm is most thin at guide tip 34g, it will be appreciated that, ontology 12g and/or alignment arm 24g can be to appoint What is suitably sized to be gradually reduced.

In some embodiments, the first guide hole 14a extends through ontology 12g, and the second guidance along first axle 32a Hole 14b extends through ontology 12g along second axis 32b.In some embodiments, first axle 32a and second axis 32b are uneven Row.For example, in some embodiments, first axle 32a and second axis 32b alignment, so that axis 32a, 32b draw corresponding to It leads and intersects at the point of the predetermined portions (such as free end 38a) of end 34g.In other embodiments, first axle 32a and second Axis 32b alignment, so that axis 32a, 32b are inserted into the first bone parts 102a and the second osseous part along respective axis 32a, 32b Divide the expectation path of the induction element in 102b non-intersecting.

Figure 20 show it is in accordance with some embodiments have the targeting guide 10h of continuous bulk 12h and alignment arm for 24 hours, The alignment arm defines the multiple guide hole 14a-14g for passing through and being formed.Targeting guide 10h, which is similar to, combines Figure 19 to describe Targeting guide 10g, and similar description is not repeated herein.Targeting guide 10h includes along corresponding axially bored line 32a-32g extends through multiple guide hole 14a-14g of ontology 12g.Axially bored line 32a-32g limits intersecting paths.In some realities Apply in example, each axially bored line 32a-32g a single point (such as correspond to guide tip 34h and/or guide tip 34h freedom End 40 point) at intersect.In other embodiments, two or more in axially bored line 32a-32g can be in guide tip 34h Nearside, be aligned with guide tip 34h and/or intersect at the difference in the distal side of guide tip 34h.Multiple guide hole 14a- The information that 14g allows user (such as surgeon) to determine based on the specific anatomical structure of patient and/or other operability selects Multiple angle of approach install induction element.

Figure 21 shows the targeting guide 10i with adjustable alignment arm 24i in accordance with some embodiments.Targeting guidance Part 10i includes the ontology 12i with first part 80a and second part 80b.First part 80a is included in top edge 26a under The ontology 82 extended between edge 26b and between the first side 28a and second side (not shown).Ontology 82 is defined in The first slit 84 in the 28a of side, the first slit extend in ontology 12i from top edge 26a.Slit 84 is sized and constructs At reception second part 80b wherein.In some embodiments, the second slit (not shown) is formed in second side 28b, from upper Edge 26a is extended in first part 80a.

First part 80a limits the guide hole 14 that second surface 30b is extended to from first surface 30a.Guide hole 14 is set Size simultaneously is configured to receive the guide sleeve passed through and/or induction element.In some embodiments, guide hole 14 is positioned to The lower edge 26b of neighbouring first part 80a, it will be appreciated that, guide hole 14 may be positioned such that across first part 80a and/ Or any suitable part of second part 80b.

Ontology 12i further comprises extending from first part 80a and relative to the slidable second part of first part 80b.Second part 80b includes the elongated curved ontology 86 that second end 88b is extended to from first end 88a.Arc ontology 86 is set Size simultaneously is configured to be received in one or more interior in the slit 84 limited by the first part 80a of ontology 12i.Example Such as, in the shown embodiment, arc ontology 86 limits I-beam shape, the slit that there is insertion to be formed in first part 80a First part in 84 and the second part for extending beyond slit 84.In other embodiments, arc ontology 86, which can have, appoints What suitable shape, is configured to be received in one or more slits 84 limited by first part 80a and/or utilize Any suitable mechanism relative to first part 80a slidably.

Alignment arm 24i extends from the second end 88b of the second part 80b of ontology 12i.Alignment arm 24i is along curved path Second end 46b is extended to from first end 46a.In some embodiments, second part 80b of the alignment arm 24i relative to ontology 12i It is adjustable.For example, in some embodiments, the second part 80b of ontology 12i defines channel, the path setting size and structure Cause a part for receiving alignment arm 24i slidably therein.Alignment arm 24i (and guide tip 34i of attachment) is opposite It can be by alignment arm 24i being slid into and/or being skidded off the second part of ontology 12i in the position of the second part 80b of ontology 12i 80b is adjusted.In other embodiments, alignment arm 24i and second part 80b has fixed relationship.

In use, by sliding second part 80b in first part 80a and/or making alignment arm 24i at second Divide sliding in 80b, the position of the adjustable guide tip 34i for being attached to alignment arm 24i.Guide tip 34i can be deployed into most Big expansion degree (as shown in Figure 21).In the position, a part (such as free end 38a) of guide tip 34i corresponds to and wears Cross the axis of the guide hole 14 of the first part 80a formation of ontology 12i.

In some embodiments, ontology 12i and/or the arc structure of alignment arm 24 are at ought slideably adjust first part The alignment between the free end 40 of the axially bored line 32a and guide tip 34i of guide hole 14 is kept when 80a and second part 80b.Example Such as, in some embodiments, when the overlapping increase (for example, ontology 12i shortens) between first part 80a and second part 80b When, the arc of ontology 12i keeps the alignment between guide hole 14 and the free end 38a of guide tip 34i.In other embodiments In, only when the second part 80b of ontology 12i is fully deployed from first part 80a, the axis and guide tip of guide hole 14 Free end 38a be just aligned.

Figure 22 shows the method in accordance with some embodiments that the first bone segment 102a is fixed to the second bone segment 102b 200.Although herein using targeting guide 10 come discussion method 200, it will be appreciated that, method 200 can be schemed using combining Any targeting guide 10-10i of 1- Figure 21 discussion, and be within the scope of this disclosure.In step 202, targeting is guided Part 10 is positioned adjacent to the first bone 102.Targeting guide 10 includes ontology 12, in the first end 42a and second for being attached to ontology The alignment arm 24 that extends and from the end 34 that the second end 42b of alignment arm 24 extends between the 42b of end.End 34 includes freely End 38.When the first induction element 110a and/or the second induction element 110b is across the guide sleeve for being attached to targeting guide 10 When 116a, 116b are inserted into, the free end 38 of the end 34 of targeting guide 10 corresponds to the first induction element 110a and/or second Induction element 110b leaves the outlet port of the first bone segment 102a, as discussed in more detail below.

In optional step 204, the alignment characteristics of targeting guide 10 (for example are laterally aligned to hole 46a, 46b and/or alignment Protrusion 50a, 50b) it is aligned along predetermined axial line.The alignment feature of alignment characteristics at by targeting guide 10 relative to one or more A bone segment 102a, 102b is located in predetermined orientation and/or position.

In step 206, the first guide hole 14a being passed through in ontology 12 is inserted into the first guide sleeve 116a.First Guide sleeve 116a, which is defined, extends through first passage therein.In step 206, the first induction element 110a draws by first The channel of guide sleeve cylinder 116a is inserted into and is inserted into the first bone 102.A part of the end 38 of targeting guide 10 corresponds to first Induction element 110a leaves the outlet port of the first bone 102.

In optional step 208, second sleeve 116b is inserted by the second guide hole 14b being formed in ontology 12.Second Guide sleeve 116b, which is defined, extends through second channel therein.In the first guide sleeve 116a and the second guide sleeve 116b It is inserted into after corresponding first guide hole 14a and the second guide hole 14b, second channel is roughly parallel to the first guide sleeve 116a First passage.

In step 210, the first induction element 110a and/or the second induction element 110b are passed through into corresponding first guide sleeves The channel of cylinder 116a and the second guide sleeve 116b is inserted into and is inserted into the first bone 102.Induction element 110a, 110b are extended through First bone segment 102a simultaneously enters the second bone segment 102b, and the first and second bone segments 102a, 102b are maintained at corresponding Predetermined position.In some embodiments, induction element 110a, 110b may include Kirschner wire, it will be appreciated that, it can be used Any suitable induction element.

In step 212, targeting guide 10 is removed from operative site, and by one or more hollow screw 120a, 120b is attached to the first bone.For example, the first hollow screw 120a can be slidably located on the first induction element 110a, and It is inserted through the first bone segment 102a and the second bone segment 102b, and the second hollow screw 120b can be slidably located in On second induction element 110b, and it is inserted through the first bone segment 102a and the second bone segment 102b.First and/or second is hollow Screw 120a, 120b fix the relative position of the first bone segment 102a and the second bone segment 102b.In step 214, by solid After determining the fixed bone of element 120a, 120b, induction element 110a, 110b are removed from bone 102.

Although describing the present invention in terms of exemplary embodiment, but the invention is not restricted to this.On the contrary, appended power Sharp requirement should be interpreted broadly to embrace other modifications and embodiment of the invention, these modifications and embodiment can be by these Field technical staff realization, field and range without departing from equivalent of the invention.