DE202016100245U1 - Surgical guide and surgical drill set - Google Patents

Abstract

Surgical guide aid (10), in particular for surgical instruments and / or osteosynthesis aids, characterized by a guide sleeve (11), which comprises a joint section (30), and a fixing sleeve (12), wherein the fixing sleeve (12) and the guide sleeve (11) are mutually displaceable to each other, that the hinge portion (30) is at least partially blocked or blocked.

Description

The invention relates to a surgical guide aid, in particular for surgical instruments and / or osteosynthesis aids, according to the preamble of claim 1. Furthermore, the invention relates to a surgical drilling set comprising a surgical guide aid according to the invention and a surgical drill according to claim 21.

For fixing osteosynthesis plates to a bone, in addition to standard screws, angle-stable screws are also often used. Such angle-stable screws have a head thread and are anchored in an internal thread in the osteosynthesis or bone plate. In such stable-angle systems, it is necessary to pre-drill the core hole of the screw shaft of the angle-stable screw to be inserted exactly at the preferred angle, so that the angle-stable screw enters the osteosynthesis plate or bone plate as intended. In case of deviations from the preferred angle, it is possible that no stable locking can be achieved with regard to the osteosynthesis plate to be anchored.

When using standard screws, no preferred angle must be observed. However, even with a free angle selection, it must be ensured that the hole center in the plate is hit during pre-drilling.

A further development of the angle-stable screw-bone plate connection is the variable angle locking. In this case, screws can be anchored in the bone plate in a fixed angular range (for example +/- 15 °). On the one hand, it is important to pay attention to the hole center when pre-drilling, as otherwise a lock can not be safely realized. On the other hand, care must be taken to ensure that the maximum angular range permitted for the variable angle stable locking is not exceeded.

Based on this described prior art, the object of the present invention is to provide an advanced surgical guide, in particular for surgical instruments and / or osteosynthesis aids, which allows guidance of a surgical instrument and / or an osteosynthesis adjuvant in a defined angular range, with The same surgical guide should also be an exact vertical guidance of a surgical instrument and / or a Osteosynthesehilfes to be enabled.

Furthermore, it is an object of the present invention to provide a surgical drilling set with a surgical guide according to the invention.

This object is achieved with regard to the surgical guide assistance by the subject matter of claim 1 and with regard to the surgical drilling set by the subject matter of claim 21, wherein the dependent claims comprise at least expedient refinements and developments.

Accordingly, a surgical guide aid, in particular for surgical instruments and / or osteosynthesis aids, is assumed, wherein the surgical guide aid comprises a guide sleeve and a fixing sleeve. The guide sleeve includes a hinge portion. In other words, the guide sleeve on a hinge portion. The fixing sleeve and the guide sleeve are displaceable relative to one another such that the joint portion is at least partially blocked or blocked.

The surgical guide aid therefore comprises at least two sleeves, namely a guide sleeve and a fixing sleeve. Due to its joint section, the guide sleeve serves to align a surgical instrument and / or a steosynthesis aid within a defined angular range in relation to a patient or in relation to a bone plate and / or a medical implant. The fixing sleeve serves to block the hinge portion of the guide sleeve. Furthermore, the fixing sleeve can act as an extension of the guide sleeve.

The surgical instrument can be, for example, a drill or a screwdriver or an endoscope or a similar surgical instrument. The osteosynthetic adjuvant may be, for example, a wire and / or a surgical screw.

Preferably, the fixing sleeve is slid longitudinally displaceable on the guide sleeve. The inner diameter of the fixing sleeve is preferably slightly larger than the outer diameter of the guide sleeve. If a fixing sleeve is pushed over the joint portion of the guide sleeve at least in sections, the joint portion may be at least partially blocked or is partially blocked. In an alternative embodiment of the invention, it is conceivable that the fixing sleeve is mounted longitudinally displaceable within the guide sleeve.

At a first end portion of the guide sleeve, a hollow connecting portion for connection to a bone plate and / or to Be formed connection with a surgical implant. If the guide sleeve is connected to a bone plate and / or a surgical implant by means of a connecting section, the surgical guide aid can be used in the state connected to the bone plate and / or the surgical implant. This is to facilitate delivery of surgical instruments and / or osteosynthetic adjuvant. The connecting portion may have an external thread. In this embodiment, it is therefore possible that the guide aid in a threaded portion which is formed in a bone plate and / or a surgical implant, is screwed.

Additionally or alternatively, it is possible that the connecting portion is formed such that, viewed in the insertion direction, longitudinal elements, in particular longitudinal reinforcements having. The connecting portion may engage, for example latching in an opening of a bone plate or engage in an opening of a bone plate or an implant.

It is possible that the connecting portion comprises a latching element, which can be snapped into a bone plate and / or in a medical implant.

At one / the first end portion of the guide sleeve, an inner cone-shaped guide element may be formed. Preferably, both a innenkonusförmiges guide element and the connecting portion is formed at the first end portion of the guide sleeve.

An inner cone-shaped guide element is to be understood as meaning an element which is hollow, wherein the surface delimiting the cavity is conical or frusto-conical in shape. The limiting surface may also be referred to as an inner wall. The inner cone-shaped guide element serves for a surgical instrument introduced into the surgical guide aid and / or an osteosynthesis aid introduced into the surgical guide aid along the surface section formed along the cavity or along the inner wall in the direction of a bone plate and / or in the direction a medical implant is performed.

The inner cone-shaped guide element is at least partially formed inside the guide aid. Due to the formation of an inner cone or because of the funnel-shaped formation, the surgical instrument and / or the osteosynthesis aid are guided in a targeted manner in the direction of a bone plate and / or in the direction of a medical implant. The inner cone or the funnel is designed such that the cross section in the direction of an exit opening of the surgical guide aid becomes smaller and smaller. The outlet opening is understood to mean the opening of the surgical guide aid which, in the use state, points in the direction of a bone plate and / or in the direction of a medical implant and / or in the direction of the patient.

According to one embodiment of the invention, it is possible that the inner cone-shaped guide element and the connecting portion form a one-piece component. In other words, the inner cone-shaped guide element and the connecting portion are for example monolithic. It is also conceivable that the inner cone-shaped guide element and the connecting portion are initially separate components but firmly connected to each other, in particular welded and / or glued be.

The hollow connecting portion may have an inner cone which is formed opposite to the inner cone-shaped guide member such that a portion of the connecting portion with the smallest inner diameter corresponds to a portion of the guide member with the smallest inner diameter or structurally merges into this portion of the guide member. While the inner cone of the guide element has a smaller and smaller inner diameter in the direction of the exit opening of the surgical guide aid, the inner cone of the connecting section is preferably designed such that the inner diameter increases in the direction of the exit opening of the surgical guide aid. In cross-section in the longitudinal direction of the guide aid is in this respect a double-cone shape, wherein the tips of the two cones rest against each other or merge into one another. However, this does not mean that the two cones of the double cone must have matching volumes. Rather, the two cones of the double cone can have different sizes.

In a further embodiment of the invention, it is possible that the inner cone-shaped guide element and / or the connecting portion is formed integrally with the guide sleeve. In other words, the guide sleeve with the inner cone-shaped guide element and / or with the connecting portion may be formed, for example, monolithic. Furthermore, it is conceivable that the guide sleeve is firmly connected to the inner cone-shaped guide element and / or fixed to the connecting portion. If the guide aid according to the invention consists of as few individual parts as possible, this can on the one hand be assembled more simply and, on the other hand, the guide aid is made more robust in this case.

Furthermore, it is possible for the inner cone-shaped guide element and / or the connecting section to form or form the joint section. In this embodiment, no separate joint portion is formed. The inner cone-shaped guide element and / or the connecting portion at the same time have the function of a joint portion.

In this case, the inner cone-shaped guide element and / or the connecting section can be designed so as to be internal and rotatable at least in sections in the guide sleeve. For example, the inner cone-shaped guide element is simultaneously formed as a ball joint. In addition, it is possible that a one-piece element comprising the inner cone-shaped guide member and the connecting portion is formed as a ball joint.

The articulated section of the guide aid can be designed as a hinge joint, in particular as a double hinge joint, or as a guide sleeve section, which has in particular laser-cut recesses. The joint portion of the guide sleeve is in particular designed such that a defined angular range, which can be adjusted with respect to a portion to be bent of the guide sleeve to another portion, in particular the portion of the guide sleeve, which includes the connecting portion, is limited by the hinge portion. In other words, an angle range, in particular the maximum angular range, is defined with the aid of the joint portion, by which a portion of the guide sleeve can be angled away from the second portion. The joint portion may also be formed as a ball joint or as a spring, in particular as a spiral spring.

If the joint section is designed as a guide sleeve section which has recesses, it is possible for this guide sleeve section to consist of a plurality of individual segments arranged one behind the other in the longitudinal direction of the guide sleeve. Recesses are formed between the individual segments so that the individual segments can be displaced relative to each other. In addition, it is conceivable that the guide sleeve portion has a continuous helically shaped recess. Preferably, the described recesses are introduced by means of a laser in the guide sleeve. Preferably, it is provided in the formation of the joint portion as a guide sleeve portion with recesses that the joint portion in 360 ° about the longitudinal axis of the guide aid can cause angling of a portion of the guide sleeve.

The guide sleeve may have a recess extending in the longitudinal direction, wherein a measuring scale may be formed on the outer surface of the guide sleeve in the region of the recess. As a recess extending in the longitudinal direction is to be understood such a recess whose extension is greater in the longitudinal direction than in the radial direction. On the outer surface can be formed in particular around the recess around the measuring scale. Preferably, the measuring scale is printed or engraved in the outer surface of the guide sleeve. With the help of the measuring scale, a guided inside the guide sleeve surgical instrument and / or guided Osteosynthesehilfsmittel be judged whether it is inserted sufficiently deep in a patient.

In a further embodiment of the invention, the fixing sleeve has a first, the connecting portion of the guide sleeve facing the end portion, and a second, facing away from the connecting portion of the guide sleeve end portion, wherein the hinge portion by at least partially positioning the first end portion of the fixing sleeve at the level of the first end portion the guide sleeve is at least partially blocked. In other words, blocking or disabling of the blocking of the joint portion is caused by positioning the fixing sleeve in relation to the guide sleeve that includes the hinge portion. If the fixing sleeve is pushed completely onto the guide sleeve such that the first end portion of the fixing sleeve is positioned as close as possible to the exit opening of the guide aid, the joint portion is completely blocked. In this case, the joint portion is either completely covered by the fixing sleeve or the fixing sleeve extends within the guide sleeve such that the joint portion can not be actuated due to the blocking positioning of the fixing sleeve.

The joint portion is thereby released or the blocking of the joint portion is achieved by the first end portion of the fixing sleeve is pushed in the direction of the second end portion of the guide sleeve. Due to this movement, only a partial cancellation of the blockage can be caused. It is also conceivable that the fixing sleeve is completely deported or removed from the guide sleeve to release the blockage.

At one / the second end portion of the fixing sleeve, a gripping element may be formed. This gripping element is preferably formed completely on the outer surface of the second end portion of the fixing sleeve. This can be a corrugation. Also the training at least one element enlarging the outer surface of the guide sleeve is possible. The gripping element may in particular be annular.

Additionally or alternatively, it is possible that a Verrastungs- or locking element is formed at the second end portion of the Fixeierhülse. This allows a fixing of the fixing sleeve on the guide sleeve. It is possible to form locking elements and / or screw clamp connections. By fixing the fixing sleeve to the guide sleeve, in particular in the state blocking the hinge section, a pushing off of the fixing sleeve from the guide sleeve can be avoided.

At a second end portion of the guide sleeve, an end wall forming an opening of the guide sleeve may be formed. The opening is an insertion opening for surgical instruments to be used and / or osteosynthesis aids to be used, which are positioned by means of the surgical guide aid in relation to a bone plate and / or in relation to a medical implant.

Along the opening edge of the end wall, the surgical instrument and / or the Osteosynthesehilfsmittel in the inserted state in an angled use of the surgical guide d. H. in such a state in which the hinge portion abuts a bend of a first portion of the guide sleeve in relation to a second portion of the guide sleeve abut.

A surgical instrument inserted into the surgical guide aid and / or an introduced osteosynthetic adjuvant is preferably guided at two points of the guide aid. The entry point is preferably located at the opening edge of the end wall. The exit point is located at the peripheral edge of the exit opening, which is preferably formed at the connecting portion. An imaginary connecting line between the entry point and the exit point assumes such an angle in relation to the longitudinal axis of the guide aid, which corresponds for example to a drilling angle or an angle of a wire to be inserted.

In a particularly preferred embodiment of the invention, the guide aid according to the invention is a drilling jig. The surgical instrument is therefore preferably a surgical drill.

With the help of the guide aid according to the invention, it is possible to guide the drill in a defined angular range, which is defined by the joint portion and / or by the inner cone-shaped guide element. The 0 ° angle can be set separately and fixed with the help of the fixing sleeve. By way of example, the vertical configuration in relation to a bone plate and / or in relation to a medical implant is defined as the 0 ° angle. This is especially true when the corresponding hole of the bone plate has been inserted perpendicular to the plate. Embodiments are also conceivable in which the hole is inclined relative to the plate and a bone screw in this predetermined course is to be screwed into the plate and into the bone of a patient. Also in this case, the screw is not deflected or angled in relation to the borehole, so that there is also a 0 ° angle here. A common feature encompassing the two mentioned embodiments is that the fixation due to the fixation sleeve takes place in such a way that the surgical instrument and / or the osteosynthesis aid (eg screw, bone wire) is aligned parallel to the opening of the bone plate and preferably along the opening axis of the bone Bone plate is aligned.

In particular, due to the formation of a connecting portion, the drilling jig can be securely connected to a bone plate and / or to a medical implant. This represents a considerable safety advantage. The fixing sleeve can be pushed by axial displacement over the joint portion, so that a drilling angle of 0 ° can be adjusted.

In a further embodiment, the surgical guide aid may comprise a lever handle, so that the guide aid can be more easily inserted into an opening of a bone plate and / or a medical implant. The lever handle may comprise a passage opening for a connecting portion of a guide. Alternatively, it is possible that the lever handle itself has a connecting portion for insertion into an opening of a bone plate and / or a medical implant.

It is possible that the fixing sleeve and the guide sleeve, at least temporarily or temporarily, are fixable to each other in position. Preferably, the fixing sleeve and the guide sleeve are fixed in their positions or positions taken with respect to the longitudinal extent of the guide aid. This makes it possible, for example, in a complete blockage of the joint portion that unwanted displacement of the fixing sleeve and thus an unintentional cancellation of the blockage of the joint portion and thus slippage during the performance of a drilling operation is prevented.

A fixation of the fixing sleeve with the guide sleeve, for example, allows a partial blockage of the joint portion, so that the degree of blocking of the joint portion by means of fixing the fixing sleeve is adjustable with the guide sleeve.

For example, the smaller the distance between the first end portion of the fixing sleeve and the first end portion of the guide sleeve, the greater the degree of locking of the hinge portion. If the first end section of the fixing sleeve bears against and / or against the first end section of the guide sleeve, the highest degree of blocking, namely complete blocking, of the joint section is achieved. The greater the distance between the first end portion of the fixing sleeve and the first end portion of the guide sleeve, the lower the degree of locking of the joint portion. The lowest degree of blocking corresponds to a complete release of the joint section.

The fixation of the fixing sleeve with the guide sleeve in the position relative to one another can be carried out, for example, by means of a thread and / or a latching mechanism.

The thread can be formed, for example, in that an external thread section is formed on the outer surface of the guide sleeve and an internal thread section is formed on the inner surface of the fixing sleeve. This is a preferred embodiment of the thread. Alternatively, it is possible that on the outer surface of the guide sleeve, an internally threaded portion is formed and on the inner surface of the fixing sleeve, a male threaded portion is formed.

To form a latching mechanism, latching elements can be formed on the outer surface of the guide sleeve and / or on the inner surface of the fixing sleeve.

By means of the thread and / or the locking mechanism, it may be possible to adjust the degree of locking of the joint portion.

A subsidiary aspect of the invention relates to a surgical drilling set comprising a surgical guide according to the invention and a surgical drill. With regard to the advantages of the surgical drill set according to the invention, reference is made to the statements in connection with the guide aid according to the invention.

The drill of the surgical drill set can have a marking, preferably such that the marking is visible through a recess extending in the longitudinal direction of the guide sleeve of the guide aid during a drilling operation. The mark may be, for example, a color mark. With the help of this marking or color marking can be measured on the basis of a measuring scale formed in the region of how far the drill is already inserted into a bone and if possibly already reached an end position of the drill.

The invention is explained in more detail below on the basis of exemplary embodiments with reference to the accompanying schematic drawings. Show in it

1a - 1c : The guide sleeve and the fixing sleeve of a guide according to the invention in several positions to each other;

2a and 2 B a guide aid designed as a drilling jig in a state blocking and releasing the joint section;

3a - 3c various embodiments and states of differently shaped joint sections;

4a and 4b : a drilling gauge with measuring scale in a side view and in a sectional view; and

5a and 5b : various connecting portions of a guide as well as the bone plate to be connected;

6 an inner cone-shaped guide element with ball-joint-shaped joint section; and

7a + 7b : schematic representations of various embodiments of fixing possibilities of Fixierhülse and guide sleeve in position to each other.

In the following, the same reference numbers are used for identical and equivalent parts.

In the following, various surgical guide aids are shown, which are each designed as drilling jigs.

As in the 1a - 1c shown, includes the surgical guide 10 a guide sleeve 11 and a fixing sleeve 12 , The fixing sleeve 12 is on the guide sleeve 11 postponed. The guide sleeve 11 has a first end portion 21 and a second end portion 22 on. The fixing sleeve, however, has a first end portion 23 and a second end portion 24 on. The fixing sleeve 12 is so on the guide sleeve 11 deferred that the first end section 23 the fixing sleeve 12 in the direction of the first end portion 21 the guide sleeve 11 is postponed. Depending on the position of the fixing sleeve 12 a joint portion (not shown here) can be blocked or released. The fixing sleeve 12 is according to 1a - 1c on the guide sleeve 11 slid longitudinally displaced or relocated.

In the 2a and 2 B is a surgical drill set according to the invention 40 shown. This includes a surgical guide 10 as well as a drill 50 , On the basis of these illustrations, it is made clear that the surgical guide sleeve 10 in a blocked state ( 2a ) and in a unblocked or released state ( 2 B ) can be brought.

In the figures, one is in the surgical guide 10 introduced drill 50 shown. In 2a is the fixing sleeve 12 such on the guide sleeve 11 moved that the first end section 23 the fixing sleeve 12 at the height of the first end section 21 the guide sleeve 11 is located. In this state, the in 2 B illustrated joint portion 30 blocked. The first end section 23 the fixing sleeve 12 in other words is at the height of the first end section 21 the guide sleeve 11 positioned.

According to 2 B It can be seen that to solve the blocking of the first end portion 23 the fixing sleeve 12 in the direction of the second end portion 22 the guide sleeve 11 is moved. To move the fixing sleeve 12 is at the second end portion 24 the fixing sleeve 12 a gripping section 35 educated. The gripping section 35 is as a thickening of the fixing sleeve 12 in the second end section 24 the fixing sleeve 12 educated. This allows a surgeon also with gloves and liquids on the fixing sleeve 12 easy to handle.

When using the guide aid according to the invention 10 becomes a drill 50 with the drill bit 51 first in the entrance opening 25 introduced. The fixing sleeve 12 is when inserting the drill 50 in the guide 10 preferably positioned such that the hinge portion 30 is released and easy insertion of the drill 50 is made possible in the preferred angular position. The drill 50 so far in the guide 10 introduced, leaving the drill 50 with the drill bit 51 from the exit opening 26 emerges. In the 2a and 2 B is also shown that at the first end portion 21 the guide sleeve 11 a hollow connecting section 27 is trained. The connecting section 27 has an external thread 28 on. The connecting section 27 serves in the present case, the management assistance 10 to connect with a bone plate. This is the connection section 27 with the help of external thread 28 inserted into a threaded portion of a bone plate.

The threaded portion of the bone plate is formed in an opening of the bone plate into which, for example, a screw is to be introduced later.

In a preferred procedure, the guide sleeve 10 connected in a first step with a bone plate and / or a medical implant, wherein in this method step, the fixing sleeve 12 a blockage of the joint portion 30 should cause. In a subsequent step, the joint section 30 by retracting the fixing sleeve 12 released, so that then the drill 50 in the guide 10 can be introduced.

In 3a is a first embodiment of a joint portion 30 shown. The articulated section shown 30 is not blocked and is already in an angled state. The joint section 30 is as a guide sleeve section 31 formed, the, in particular laser-cut, recesses 32 having. The recesses 32 are designed such that webs 33 be formed. The bridges 33 are positioned to each other such that at the upper edge 34 Stege 33 lie against each other, causing the recesses 32 or the distances between the webs 33 at the bottom edge 36 of the guide sleeve portion 31 be widened. As a result, with the illustrated guide sleeve portion 21 an angling of the guide sleeve 11 be effected. The recesses 32 and footbridges 33 are formed such that only angling of the guide sleeve 11 in a defined angular range, for example, +/- 15 °, can be done. From a certain angle, the webs can 33 at the upper edge shown here 34 not be positioned further to each other or pushed towards each other.

The in the 3b and 3c illustrated joint portion 30 is as a hinge joint 37 educated. These are pins 38 formed, the rotatable with indentations 39 interact. In 3b is the joint section 30 shown in the blocked state. 3c shows the hinge joint 37 in the actuated state.

In 4a becomes a guide sleeve 10 in one with a bone plate 60 connected state shown. This is the connection section 27 , in particular the associated external thread 28 in an opening (not shown) of the bone plate 60 introduced and screwed in there. The guide sleeve 11 has a longitudinal direction of the guide sleeve 11 extending recess 13 on. The recess 13 is designed as a slot. On the outer surface 15 the guide sleeve 11 in the region of the recess 13 is a measurement scale 14 educated. These are in uniform steps various measured values printed or engraved. One in the guide sleeve 11 introduced surgical tool, such as a drill 50 , is through the recess 13 visible, noticeable. Unless on the drill 50 a mark can be this through the recess 13 be read.

In 4b becomes the guide 10 according to 4a shown in section. Here is a drill 50 in the guide sleeve 11 the guide 10 introduced. The guide sleeve 11 points at the second end portion 22 the guide sleeve 11 an end wall 41 on that one opening 16 the guide sleeve 11 forms. The opening 16 is the entrance opening of the guide sleeve 11 , At the first end section 21 the guide sleeve 11 is the connecting section 27 with the external thread 28 educated. The connecting section 27 is hollow, leaving a drill 50 or a surgical instrument from the exit opening 26 can be executed.

At the first end portion 21 the guide sleeve 11 is further an inner cone-shaped guide element 42 educated. This inner cone-shaped guide element 42 has a funnel-shaped inner wall 43 on. The inner cone-shaped form or the inner cone-shaped guide element 42 is formed such that the inner cross section of the guide element 42 in the direction of the exit opening 26 gets smaller. The connecting section 27 and the inner cone-shaped guide element 42 form a one-piece component 44 ,

The hollow connecting section 27 has an inner cone 45 on, opposite to the inner cone-shaped guide element 42 is trained. A section 29 of the connection section 27 with the smallest inner diameter corresponds to the portion of the guide element 42 with the smallest inner diameter. In other words, the inner cone form 45 and the inner wall 43 the inner cone-shaped guide element 42 a double cone shape, wherein the two cones have different sizes. The two cones meet at the section 29 each other. The illustrated drill 50 can in angled mode of the guide sleeve 11 along the inner wall 43 the inner cone-shaped guide element 42 in the direction of the exit opening 26 be guided. The drill 50 lies at a point of the opening 16 limiting end wall 41 at. In addition, the drill is located 50 at one point of the section 29 at. The drill 50 is therefore at only two points of the guide sleeve 11 guided.

As in 4b can also be seen, includes the guide sleeve 11 a first section 17 as well as a second section 18 , where the second section 18 in relation to the first section 17 due to the joint portion 30 can be angled. The first paragraph 17 is in with the bone plate 60 connected state formed perpendicular to this.

In 5a is a bone plate 60 shown. The guide 10 , in particular the guide sleeve 11 is using the connection section 27 in the opening 61 the bone plate 60 introduced and with the opening 61 connected. The opening 61 has an internal thread 62 on. The external thread 28 gets into the internal thread 62 screwed. This allows one to assist in leadership 10 introduced drill 50 can be performed stable. Slippage of the drill 50 is thus avoided.

In 5b is also a bone plate 60 with an opening 61 shown. The connecting section 27 has longitudinal elements 52 , which are formed as longitudinal reinforcements, on. There is thus no screwing in of the connecting portion 27 , Rather, the connection section 27 in the opening 61 engaged. As a positioning aid can be a lever handle 70 serve. This one has a section 71 with passage opening on. Through this section 71 can the connection section 27 be guided.

6 shows a further embodiment with respect to a hinge portion 30 , In principle, a one-piece component 44 according to 4b formed, with this rounded side surfaces 53 so that the one-piece component 44 at the same time the joint section 30 forms. The component 44 is rotatable in the guide sleeve 11 stored. The inner cone-shaped guide element 42 , the connection section 27 and the joint section 30 are combined in this embodiment in a single component.

7a shows a further embodiment of a guide 10 , where the joint section 30 as a guide sleeve section 31 is formed, the, in particular laser-cut, recesses 32 having. The joint section 30 corresponds to the example in 3a illustrated joint section 30 ,

There is also a thread 80 shown that is formed by that on the outer surface of the guide sleeve 11 a male threaded section 81 is formed and on the inner surface of the fixing sleeve 12 a female thread section 82 is trained. This is a preferred embodiment of the thread 80 , The thread 80 serves to Fixation of the fixing sleeve 12 with the guide sleeve 11 ,

A fixation of the fixing sleeve 12 with the guide sleeve 11 allows a partial blockage of the joint portion 30 so that the degree of blocking of the joint portion 30 by fixing the fixing sleeve 12 with the guide sleeve 11 is adjustable.

The smaller the distance between the first end portion 23 the fixing sleeve 12 and the first end portion 21 the guide sleeve 11 is, the greater the degree of blocking of the joint portion 30 , If the first end section 23 the fixing sleeve 12 on and / or on the first end section 21 the guide sleeve 11 is applied, the highest degree of blocking, namely a complete blockage of the joint portion 30 reached. The concern of the first end section 23 the fixing sleeve 12 on and / or on the first end section 21 the guide sleeve 11 can also be considered as a spaced covering the first end portion 21 the guide sleeve 11 will be realized. The complete blockage is marked 0 ° in the sketched scale.

The greater the distance between the first end portion 23 the fixing sleeve 12 and the first end portion 21 the guide sleeve 11 is, the lower the degree of blocking of the joint portion 30 , The lowest degree of blocking corresponds to a complete release of the joint section 30 , This is indicated in the sketched scale as 15 °. This corresponds to the maximum possible deflection of the joint portion 30 , It is possible that the scale on the guide sleeve 11 and / or the fixing sleeve 12 , in particular on the guide sleeve 11 , formed, in particular imprinted and / or engraved, is. This allows an exact adjustment of the degree of locking of the joint portion 30 ,

Fixing the fixing sleeve 12 with the guide sleeve 11 causes an unintentional displacement of the fixing sleeve 12 and thus an unintentional cancellation of the blockage of the joint portion 30 and thus slippage during the performance of a drilling operation is prevented.

Also in 7b is a way to fix the fixing sleeve 12 with the guide sleeve 11 shown. Here is a locking mechanism 85 educated. On the inner surface of the fixing sleeve 12 and / on the outer surface of the guide sleeve 11 are locking elements 86 educated. With regard to fixation and adjustment of the degree of locking of the joint section 30 will be related to the explanations 7a directed. On the guide sleeve 11 may also be formed a scale. Thus, it is possible to scale both in the area of the first end section 21 as well as in a middle section of the guide sleeve 11 train.

The joint section 30 is as a ball joint joint (see 6 ) educated. In addition, a flange element 87 educated. The flange element 87 is in the blocked state completely on the face 88 the fixing sleeve 12 at. At least partial release of the joint portion 30 can the flange element 87 at least in sections one of the face 88 occupy a spaced position.

The joint section 30 For example, as a combination of a hinge joint (see 3b and 3c ) and a ball-joint-shaped joint (see 6 ) be formed.

LIST OF REFERENCE NUMBERS

10

Accession assistance

11

guide sleeve

12

fixing sleeve

13

recess

14

measurement scale

15

outer surface

16

opening

17

first section guide sleeve

18

second section guide sleeve

21

first end portion guide sleeve

22

second end portion guide sleeve

23

first end section fixing sleeve

24

second end section fixing sleeve

25

entrance opening

26

output port

27

connecting portion

28

external thread

29

section

30

hinge section

31

Guide sleeve section

32

recess

33

web

34

upper edge

35

cross section

36

lower edge

37

hinge

38

spigot

39

indentation

40

surgical drilling set

41

bulkhead

42

inner cone-shaped guide element

43

inner wall

44

one-piece component

45

inner cone

50

drill

51

drill

52

longitudinal elements

53

rounded side surfaces

60

bone plate

61

opening

62

inner thread

70

lever handle

71

section

80

thread

81

Male threaded portion guide sleeve

82

Female thread section fixing sleeve

85

detent mechanism

86

locking element

87

flange

88

face

Claims (22)

Surgical guide ( 10 ), in particular for surgical instruments and / or osteosynthesis aids, characterized by a guide sleeve ( 11 ), which has a joint section ( 30 ), and a fixing sleeve ( 12 ), wherein the fixing sleeve ( 12 ) and the guide sleeve ( 11 ) are displaceable relative to one another such that the joint section ( 30 ) is at least partially blocked or blocked. Guide assistance ( 10 ) according to claim 1, characterized in that the fixing sleeve ( 12 ) on the guide sleeve ( 11 ) is pushed longitudinally displaceable. Guide assistance ( 10 ) according to claim 1 or 2, characterized in that at a first end portion ( 21 ) of the guide sleeve ( 11 ) a hollow connecting portion ( 27 ) for connection to a bone plate ( 60 ) and / or a medical implant is formed. Guide assistance ( 10 ) according to claim 3, characterized in that the connecting portion ( 27 ) an external thread ( 28 ) having. Guide assistance ( 10 ) according to one of the preceding claims, in particular according to one of claims 3 to 4, characterized in that at a / the first end portion ( 21 ) of the guide sleeve ( 11 ) an inner cone-shaped guide element ( 42 ) is trained. Guide assistance ( 10 ) according to claim 5, characterized in that the inner cone-shaped guide element ( 42 ) at least in sections in the guide sleeve ( 11 ) is formed on the inside. Guide assistance ( 10 ) according to claim 5 or 6, characterized in that the inner cone-shaped guide element ( 42 ) and the connecting section ( 27 ) a one-piece component ( 44 ) form. Guide assistance ( 10 ) according to claim 7, characterized in that the hollow connecting portion ( 27 ) an inner cone ( 45 ), which opposite to the inner cone-shaped guide element ( 42 ) such that a section ( 29 ) of the connection section ( 27 ) with the smallest inner diameter of a section ( 29 ) of the guide element ( 42 ) with the smallest inner diameter or structurally in this section of the guide element ( 42 ) passes over. Guide assistance ( 10 ) according to one of claims 5 to 8, characterized in that the inner cone-shaped guide element ( 42 ) and / or the connecting section ( 27 ) in one piece with the guide sleeve ( 11 ) is trained. Guide assistance ( 10 ) according to one of claims 5 to 9, characterized in that the inner cone-shaped guide element ( 42 ) and / or the connecting section ( 27 ) the joint section ( 30 ). Guide assistance ( 10 ) according to claim 10, characterized in that the inner cone-shaped guide element ( 42 ) and / or the joint section ( 30 ) at least in sections in the guide sleeve ( 11 ) is formed internally and rotatably. Guide assistance ( 10 ) according to one of the preceding claims, characterized in that the joint section ( 30 ) as a hinge joint ( 37 ), in particular double hinge joint, or as a guide sleeve section ( 31 ), the, in particular laser-cut, recesses ( 32 ), or as a ball joint or as a spring, in particular spiral spring, is formed. Guide assistance ( 10 ) according to one of the preceding claims, characterized in that the guide sleeve ( 11 ) in the longitudinal direction of the guide sleeve ( 11 ) extending recess ( 13 ), wherein on the outer surface ( 15 ) of the guide sleeve ( 11 ) in the region of the recess ( 13 ) a measuring scale ( 14 ) is trained. Guide assistance ( 10 ) according to one of claims 3 to 13, characterized in that the fixing sleeve ( 12 ) a first, the connecting portion ( 27 ) of the guide sleeve ( 11 ) facing end portion ( 23 ), and a second, from the connecting section ( 27 ) of the guide sleeve ( 11 ) facing away end portion ( 24 ), wherein the joint portion ( 30 ) by at least partially positioning the first end portion ( 23 ) of the fixing sleeve ( 12 ) at the level of the first end section ( 21 ) of the guide sleeve ( 11 ) is at least partially blocked. Guide assistance ( 10 ) according to claim 14, characterized in that at the second end portion ( 24 ) of the fixing sleeve ( 12 ) a gripping element ( 35 ) is trained. Guide assistance ( 10 ) according to one of the preceding claims, in particular according to one of claims 3 to 15, characterized in that at a second end portion ( 24 ) of the guide sleeve ( 11 ) one, one opening ( 16 ) of the guide sleeve ( 11 ) forming, end wall ( 41 ) is trained. Guide assistance ( 10 ) according to one of the preceding claims, characterized in that the fixing sleeve ( 12 ) and the guide sleeve ( 11 ), at least temporarily, are fixable to each other in position. Guide assistance ( 10 ) according to claim 17, characterized in that the fixation by means of a thread ( 80 ) and / or a latching mechanism ( 85 ) is feasible. Guiding aid according to claim 18, characterized in that a degree of blocking of the hinge portion ( 30 ) by means of the thread ( 80 ) and / or the latching mechanism ( 85 ) is adjustable. Guide assistance ( 10 ) according to one of the preceding claims, characterized in that the guide aid ( 10 ) is a drilling jig. Surgical Drill Set ( 40 ), comprising a surgical guide ( 10 ) according to one of claims 1 to 19 and a surgical drill ( 50 ). Surgical Drill Set ( 40 ) according to claim 21, characterized in that the drill ( 50 ) has a marking, preferably in such a way that the marking is characterized by a longitudinal direction of the guide sleeve ( 11 ) of the management assistance ( 10 ) extending recess ( 13 ) is visible during a drilling operation.

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