The invention relates to an instrument for making openings in bone in form of a bone lid, which generates the opening and the bone lid in a shape resembling a equilateral polygon with rounded edges. Such a bone saw or bone mill can be employed advantageously in all situations, where an opening shall be made in a bony hollow space by removing one compact piece of bone (the so called bone lid) and this opening shall be closed again with the removed piece of bone. The instrument is driven with the aid of a rotating drive mechanism.
For producing openings in bone and bone lids a variety of different means are known (for instance DE4029676A1, EP0962192A1, GB110179A, GB941420A, GB1455566A, GB2420979A, U.S. Pat. No. 4,768,504 A1, U.S. Pat. No. 5,201,749 A1, WO9710765A1). These can basically be categorized in the following four groups:
A) Small circular saws guided by hand with either rotating or angularly oscillating saw blades. With the aid of these circular saws only straight cuts into the bone can be produced. In order to make an opening into the bone or a bone lid respectively, several straight cuts must be performed. Usually these cuts are arranged in the shape of a rectangle.
B) Small oscillating jigsaws, which are also guided by hand. By means of a saw blade oscillating up and down contours can be sawn into bone having a minimal radius. In order to penetrate the bone for the first time either a small hole is pre-drilled into which the jigsaw is inserted or at the beginning of the cut the jigsaw is placed sloping to the surface of the bone in a very shallow angle and penetrates the bone in a rasping manner. After the first penetration through the bone the jigsaw is positioned perpendicular and the desired contour can be cut out.
C) Cylindrical hole-saws having their teeth arranged along the front edge of the cylindrical part and rotating around a center shaft. With this type of hole-saws exact circular holes are achieved. Some embodiments of such hole-saws have a the centering shaft to be inserted into a pre-bored center boring.
D) Ultrasound-applicators oscillating with ultrasound, which abrade the bone in small quantities in a rubbing or grinding manner. The shape of the opening is either determined by the shape of the applicator or the ultrasound-applicator has the shape of a blade or a miller and is guided by hand along the desired contour. The surface of these ultrasound-applicators can be coated with an abrading medium or have a multitude of small sharp cutting edges.
To A) Employment of circular saws has the following disadvantages:
To B) Employment of oscillating jigsaws has the following disadvantages:
To C) Employment of cylindrical hole-saws has the following disadvantages:
To D) Employment of ultrasound-applicators has the following disadvantages:
Object of the invention is to make openings in bone and bone lids and to shape the contour of the opening in such a way that even after the inevitable loss of bone substance due to the cutting process the bone lid after re-insertion touches the edges of the opening not only in some points but along a continuous edge as long as possible. Additionally a fast way of working should be possible. The depth of penetration of the device should first be easily controlled and second as small as possible. Finally the device should be driven by a rotating drive mechanism as those used frequently in surgical and dental disciplines.
The foregoing objectives are achieved by the present invention in the following way:
x((φ)=R[(1-1/VR).cos((φ)+(Va/VR).cos((VR-1). φ)]
y((φ)=R[(1-1/VR).sin((φ)−(Va/VR).sin((VR-1). (φ)]
φ: angle to the center the rolling circle (curve-parameter)
R: Radius of the fixed circle
VR=R/r: Ratio between radius R of the fixed circle and radius r of the rolling circle
Va=a/r: Ratio between the distance a of the curve-generating point P from the center of the rolling circle and the radius r of the rolling circle
Further advantages, features and details of the invention will become clear from the following drawings and descriptions thereof, in which:
As already done under point 2 of the description two ratios should be defined:
VR=R/r: Ratio between radius R of the fixed circle and radius r of the rolling circle
Va=a/r: Ratio between the distance “a” of the curve-generating point from the center of the rolling circle and the radius r of the rolling circle
A hollow cylinder open only on one end side (1) is provided with an internal toothing. This hollow cylinder is realization of the fixed circle for the generation of the hypotrochoid. The pitch radius of the internal toothing corresponds to R the radius of the fixed circle (see point 2 of the description). The hollow cylinder has a hole on the closed end side trough which the axis of the revolving support (2) sticks through. For specific embodiments, this axis is secured against axial movement by mechanical elements, for other embodiments the revolving support can slide axially in the hole. A second axis or pin on the opposite side of the revolving support centers the device in a pre-bored guiding hole in the bone.
Several (in this case five) smaller cogwheels (3a, 3b, 3c, 3d, 3e) are attached to the revolving support; they can rotate freely on the support. Their toothings engage with the internal toothing of the hollow cylinder (1). The pitch radius of these smaller cogwheels corresponds to “r” the radius of the rolling circle (see point 2 of the description).
Each of the smaller cogwheels has one hole into which a cutting pin is pressed in; one for each smaller cogwheel (4a, 4b, 4c, 4d, 4e). Examples for different shapes of the cutting pin are shown in
When the axis of the revolving support (2) is driven by an external drive mechanism, the smaller cogwheels (3a, 3b, 3c, 3d, 3e) roll along the internal toothing of the hollow cylinder (1) and the cutting pins (4a, 4b, 4c, 4d, 4e) perform a movement along a hypotrochoid determined by the parameters VR and VA.
For all cutting pins and their corresponding smaller cogwheels the distance between the center of the cutting edge of the pin and the center of the smaller cogwheel is the same and corresponds to “a” of point 2 of the description and
All cutting pins have the same shape and same dimensions. They are all pressed into the smaller cogwheels perpendicular to the end surfaces of the cogwheel, i.e. parallel to the axis of rotation of the smaller cogwheels. They are pressed into the smaller cogwheels in such a way that projections of the cutting surfaces are always collinear to the radial beams from the center of the smaller cogwheels. Therefore the cutting surfaces cut always perpendicular to the rotational movement of the smaller cogwheels. This fact is shown in detail in
The angular position of the hole for the cutting pin is positioned in a certain angel to the side of a tooth of the rolling cogwheel. This angel is the same for all rolling cogwheels. If the direction of view is exactly the direction of the axis, then the projection of surface A of the cutting pin is collinear with the radial beam (b). The distance between the center of the cutting edge and the center of the smaller cogwheel corresponds to “a” of the parameter Va (see also point 2 of the description).