Patent Application
20090043306
An acromioclavicular separation injury (“AC separation”) is a common injury to the acromioclavicular joint of the shoulder that typically results from a fall on an outstretched hand or from sudden and direct contact with the shoulder such as that received through sports like football, rugby, or hockey. AC separation is categorized into one of six types (types I-VI), with the latter types being the most severe.
In types I-III, the ligaments that stabilize the clavicle are either sprained or partially severed. However, the clavicle is not significantly displaced from the scapula. These types of injuries can often heal through non-surgical treatments such as immobilization and anti-inflammatory drugs.
In types IV-VI, the ligaments that stabilize the clavicle are completely severed. In addition, the clavicle is vertically displaced from the scapula with the severity of the vertical displacement increasing as the type category increases. AC separation characterized as type IV-VI often requires surgical fixation, repair or reconstruction.
While there are a number of conventional surgical procedures for fixing, repairing or reconstructing the ligaments of the acromioclavicular joint, a need presently exists for reducing the vertical displacement of the clavicle with respect to the scapula prior to the performing those surgical procedures.
An aspect of the present disclosure relates to a clavicle clamp mechanism. The clavicle clamp mechanism includes an angular guide having a profile, a first end portion, and a second end portion. The clavicle clamp mechanism further includes a first compression member, and a second compression member. The first compression member is disposed along the profile of the angular guide and is selectively rotatable about the angular guide. The second compression member is disposed along the profile of the angular guide between the first compression member and the second end portion. The second compression member defines a central axis and is selectively moveable along the central axis of the second compression member.
Another aspect of the present disclosure relates to a clavicle clamp configured to vertically orient a clavicle with respect to a scapula during repair of an acromioclavicular separation injury. The clavicle clamp includes an angular guide, a first compression member and a second compression member. The angular guide of the clavicle clamp has an arcuate profile, a first end portion, and a second end portion. The first compression member is disposed along the arcuate profile of the angular guide and includes a collar that is selectively rotatable about the angular guide and a pin member that is coupled to the collar. The second compression member includes a threaded rod and defines a central axis. The second compression member is in threaded engagement with the angular guide and is selectively moveable along the central axis of the second compression member.
Another aspect of the present disclosure relates to a method of using a clavicle clamp mechanism. The method includes placing an engaging surface of a second compression member on a superior surface of a displaced clavicle of an injured shoulder. The first compression member is rotated and translated about and along an angular guide until the first compression member is secured to a scapula of the injured shoulder. An actuation end portion of the second compression member is actuated so as to reduce the displacement of the clavicle with respect to the scapula.
A variety of additional aspects will be set forth in the description that follows. These aspects can relate to individual features and to combinations of features. It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the broad concepts upon which the embodiments disclosed herein are based.
Reference will now be made in detail to the exemplary aspects of the present disclosure that are illustrated in the accompanying drawings. Wherever possible, the same reference numbers will be used throughout the drawings to refer to the same or like structure.
Referring now to
The shoulder 11 further includes an acromioclavicular joint (“AC joint”), generally designated 29, disposed at the top of the shoulder 11 between the acromion 23 and a distal end 31 of the clavicle 15. The AC joint 29 is a gliding joint that allows the arm to be raised above the head. The AC joint 29 is stabilized by a plurality of ligaments including coracoclavicular ligaments, generally designated 33, and an acromioclavicular ligament 35.
The coracoclavicular ligaments 33 are attached to the superior side 25 of the coracoid process 21 and the inferior surface 19 of the clavicle 15 such that the coracoclavicular ligaments 33 connect the clavicle 15 to the coracoid process 21. The coracoclavicular ligaments 33 include a trapezoid ligament 37 and a conoid ligament 39, which is disposed posteriorly and medially to the trapezoid ligament 37.
The acromioclavicular ligament 35 is attached to a medial side 41 of the acromion 23 and the distal end 31 of the clavicle 15 such that the acromioclavicular ligament 35 extends between the acromion 23 and the clavicle 15.
Referring now to
Referring now to
In the subject embodiment, the angular guide 45 includes a rod 51 having a circular cross-section and an arcuate profile. It will be understood, however, that the scope of the present disclosure is not limited to the rod 51 of the angular guide 45 having a circular cross-section or an arcuate profile. The angular guide 45 further includes a first end portion 53 and a second end portion 55. In the subject embodiment, the first end portion 53 and the second end portion 55 are coplanar with the first end portion 53 being at an orientation that is approximately 90 degrees with respect to the orientation of the second end portion 55. It will be understood, however, that the scope of the present disclosure is not limited to the first end portion 53 and the second end portion 55 being coplanar or to the first end portion 53 being at a 90 degree orientation with respect to the second end portion 55.
The first compression member 47 includes a collar, generally designated 57, a pin member, generally designated 59, and a set screw 61. In the subject embodiment, the collar 57 is cylindrical in shape. It will be understood, however, that the scope of the present disclosure is not limited to the collar 57 being cylindrical in shape. The collar 57 includes a first axial end 63 and a second axial end 65. The collar 57 defines a thru-hole 67, which in the subject embodiment is generally perpendicular to a center axis 69 (shown as a dashed line in
In the subject embodiment, the pin member 59 is in connected engagement with the first axial end 63 of the collar 57 so as to be generally perpendicular to the angular guide 45 at the location of the collar 57. The pin member 59 includes a first end 71 and a second end 73 (shown in
The second end 73 of the pin member 59 is in connected engagement with a mounting hole 79 located on the first axial end 63 of the collar 57. In the subject embodiment, the pin member 59 is secured in the mounting hole 79 by a screw 81 that is threadedly engaged with the collar 57. The screw 81 selectively engages the second end 73 of the pin member 59 so as to bind the pin member 59 in the mounting hole 79. However, as the second end 73 of the pin member 59 could alternatively be threaded, press fit, bonded, or soldered into the mounting hole 79, the scope of the present disclosure is not limited to the screw 81 selectively engaging the second end 73 of the pin member 59.
The set screw 61 is in threaded engagement with a threaded hole 83 (shown only in
The second compression member 49 includes a rod member 85 defining a central axis 86 (shown in
The engaging end portion 89 includes an engaging surface 95, the purpose of which will be described in greater detail subsequently. In the subject embodiment, the engaging end portion 89 is in threaded engagement with the rod member 85. A nut 97 secures the engaging end portion 89 to the rod member 85.
In the embodiments of
Referring now to
The collar member 257 includes a set screw 261 and defines a thru-hole 267 and a threaded aperture 299. In the alternate embodiment of the second compression member 249, the thru-hole 267 is sized slightly larger than the rod 51 of the angular guide 45 to allow for movement of the collar member 257 with respect to the angular guide 45. While the collar member 257 is shown disposed at the second end portion 55 of the angular guide 45, the collar member 257 may be selectively moved to any location along the profile of the angular guide 45 between the second end portion 55 and the first compression member 47. In addition, the collar member 257 can be selectively rotated about the rod 51 of the angular guide 45.
The set screw 261 is in threaded engagement with a threaded hole 283 (shown as dashed lines in
In the subject embodiment, the components of the clavicle clamp mechanism 43 are manufactured from a stainless steel material. However, due to the variety of different manufacturing materials of which the components of the clavicle clamp mechanism 43 could be manufactured, it will be understood that the scope of the present disclosure is not limited to the material of the clavicle clamp mechanism 43 being stainless steel.
Referring now to
With the second compression member 49 positioned on the superior surface 17 of the clavicle 15, the first compression member 47 is translated along the angular guide 45 and rotated about the rod 51 of the angular guide 45 until the gripping surface 75 of the pin member 59 is engaged with the inferior side 27 of the coracoid process 21. By engaging the gripping surface 75 of the clavicle clamp mechanism 43 and the inferior side 27 of the coracoid process 21, the clavicle clamp mechanism 43 is secured or anchored to the shoulder 11. The anchoring of the clavicle clamp mechanism 43 to the scapula 13 of the shoulder 11 allows for the engaging surface 95 of the second compression member 49 to directly transmit the movement of the second compression member 49 to the vertically displaced clavicle 15. With the first compression member 47 engaged to the inferior side 27 of the coracoid process 21, the set screw 61 is tightened to retain the first compression member 47 in its position along the angular guide 45.
As previously described, the gripping surface 75 of the first compression member 47 in the subject embodiment is a stud having a pointed end 77. The pointed end 77 of the gripping surface 75 engages the inferior side 27 of the coracoid process 21 and reduces the risk of the first compression member 47 becoming disengaged with the coracoid process 21 during use of the clavicle clamp mechanism 43. It will be understood, however, that the scope of the present disclosure is not limited to the gripping surface 75 having a pointed end 77.
With the first compression member 47 securing the clavicle clamp mechanism 43 to the shoulder 11 and the second compression member 49 disposed on the vertically displaced clavicle 15, the actuation end portion 87 of the second compression member 49 can be actuated to reduce the vertical displacement of the clavicle 15. As previously described, the actuation end portion 87 is actuated by rotating the actuation end portion 87 in either the clockwise or counterclockwise direction. In order to reduce the vertical displacement of the clavicle 15 with respect to the scapula 13, the actuation end portion 87 should be rotated such that the distance D (shown in
When the vertical distance between the clavicle 15 and the scapula 13 is reduced to an acceptable amount, conventional fixation, repair, or reconstruction techniques can be used to stabilize the clavicle 15. After the clavicle 15 is stabilized, the clavicle clamp mechanism 43 can be removed by rotating the actuation end portion 87 of the second compression member 49 such that the distance D decreases and by disengaging the first compression member 47 from the inferior surface 27 of the coracoid process 21.
While the clavicle clamp mechanism 43 and the method for using the clavicle clamp mechanism 43 has been described with regard to an acromioclavicular joint separation injury, it will be understood that the scope of the present disclosure is not limited to acromioclavicular joint separation injuries as the present disclosure could be used with other injuries, such as distal clavicle fractures.
Various modifications and alterations of this disclosure will become apparent to those skilled in the art without departing from the scope and spirit of this disclosure, and it should be understood that the inventive scope of this disclosure is not to be unduly limited to the illustrative embodiments set forth herein.
