Surgical pin guide
United States Patent 2434431

The present invention relates to a device for inserting Kirschner wire or metallic pins through fractured bones. This appliance was particularly designed in the form shown for use in treating fractured mandible or jaw bones. However, the accurate drilling features of this device will be advantageous...

Pincock, Douglas F.
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Filing Date:
Jack, Pava R.
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International Classes:
A61B17/17; A61F2/28
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The present invention relates to a device for inserting Kirschner wire or metallic pins through fractured bones. This appliance was particularly designed in the form shown for use in treating fractured mandible or jaw bones. However, the accurate drilling features of this device will be advantageous in the treatment of fractures of other bones.

There have been a number of different methods of treating fractures of the mandible but these are generally undesirable, either having the objection that they do not permit mandibular motion, making it difficult to eat and speak, and do not facilitate good oral hygiene. External appliance methods are unsightly and cleansing of the areas involved under the appliance is limited if not prevented.

It is an object of this invention to provide a simple and efficient device by which a Kirschner wire may be introduced through the body of the mandible across the fracture and both ends of the pin embedded in the cortical bone, the unused wire being cut short, the skin being raised over the end of the pin, leaving no external evidence of the fixating pin. Other objects and advantages will appear hereinafter from the following specifications and drawings.

Referring to the drawings, which are for illustrative purposes only: Fig. 1 is a side elevation of the device embodying a preferred form of my invention, showing the same located in position for performing the operation of inserting the Kirschner wire in the mandible; Fig. 2 is a view similar to Fig. 1, illustrating the Kirschner wire in place; Fig. 3 is an enlarged elevational view, partly in section, of the device shown in the preceeding figures; Fig. 4 is a cross sectional view on line 4-4, Fig. 3, looking in the direction of the arrows; Fig. 5 is an enlarged sectional view showing a slip nut used on the feed screw; and Fig. 6 is an enlarged view of the end of the director tube with director pin therein.

Referring more particularly to the drawings, the device consists generally of an adjustable frame indicated at 10. This frame consists of two arms 1 I and 12, the arm 12 having guide tubes 13 and 14 extending inwardly therefrom in the direction of the arm I I, and the arm II being provided with two rods 15 and 16 extending inwardly therefrom and through the respective tubes 13 and 14 which act as guide tubes; this construetion just described forming what may be termed a telescoping frame. The relative position of the arms 11 and 12 is adjusted by means of a feed screw indicated at 18, mounted on the arm II, such screw having a collar 19 pinned thereon, the collar being held against longitudinal movement by means of a bracket indicated at 20 formed as part of the arm II. The unthreaded portion of the screw 18 extends freely through the arm I I and is provided with a knurled head indicated at 21.

Means are provided for permitting free and quick adjustment of the arms 11 and 12 with respect to each other, that is, the arm 12 may slide freely on the rods 15 and 16 so that the two arms may be quickly adjusted to approximate position desired. However, for fine adjustment after the approximate position has been obtained, I have provided what may be termed a clamping nut 23. This nut is slideably mounted on a sleeve indicated at 24 mounted between the arm 12 and a rib 25 which extends between the guide tubes 13 and 14. This sleeve 24 freely receives the screw 18 and is slotted as indicated in dotted lines at 26 in Fig. 5 to receive dogs 27 which are threaded to engage the screw 18, the dogs being yieldingly held outwardly out of engagement with the screw 18 by means of flat springs indicated at 23, the. inner ends of which are fixed in the sleeve 24. The interior of the nut 23 is recessed as indicated at 29 to receive the dogs 27 and the nut 23 is provided with cam faces indicated at Z3 which engage the dogs 27, and when moved into the position shown in Fig. 5 bring the dogs into engagement with the screw so that fine adjustment can then be made with respect to the arms II and 12 by operation of the head 21. This clamping nut just described is of common form and is merely utilized in the present device for the purposes indicated.

The upper end of the arm 12 is provided with a threaded opening which receives a threaded centering pin indicated at 33, such pin having a thumb nut 34 at its outer end and a shoulder 35 which engages against the outer face of the arm 12.

The upper end of the arm 1 is provided with a threaded opening which receives the threaded portion 37 of a director tube indicated at 38, such director tube having a knurled head 39 for threading the tube in proper position in the arm. The tube has a shoulder 40 which engages against the outer face of the arm I. 42 indicates a director pin provided at its outer end with a knurled head 43 for securing the pin 42 in the tube 38, 2,434,431 3 the head 43 being internally threaded at its inner Although end to engage the threaded outer end of the di- particularly rector tube 38. The inner end of the tube 38 is plated that provided with a series of bevelled faces indicated be made wi at 45 and the inner end of the tube 42 is also 5 invention a provided with bevelled faces, forming a point and modifi indicated at 46 on the pin 42 and the bevelled the claims. face 45 of the tube 38 terminates in sharp points I claim a 47 which permit the entry of the point of the pin 1. A surg 33 and the pointed tube into the mandible as 10 arms; teles hereinafter described. The director pin 33 is also feed screw pointed at its inner end as indicated at 49 for the tive engage same purpose. the positioi It is to be noted that the pins 33 and 42 are other; a cei directly in a straight line, that is, the same longi- 15 rector tube tudinal axis extends through both of these pins, movable di: the purpose of such arrangement appearing more tending in fully hereinafter, sharp innel The instrument herein described is used in the mounted o0 following manner. The pin guide is applied by 20 of said feed first inserting the point 49 of the centering pin arms towar 33 into the posterior border of the mandible. The 2. A devi point of the director pin 42 and the director tube tured bone, 38 is introduced into the area lateral to the of spaced a symphysis as illustrated in Fig. 1 of the draw- 25 between, a ings, the outline of the jaw bone being indicated arms, a ce in dotted lines. The head 21 of the feed screw in coaxial 18 is then tightened as the pin guide is rotated and means on the axis of the centering pin and the director each other pin, that is, the instrument is raised and lowered 30 bone-pierci about the axis of these pins and at the same time sponse to the pins are brought toward each other, drilling opposite sid themselves into the cortical bone. After the pin 3. In a guide is firmly clamped into psition posterior- fractured I anterior and lateral jaw X-ray films are taken 35 arms for for checking the position of the pins. The di- each other rector pin 42 is then screwed out of the director end of one tube 38 and the Kirschner wire indicated in Fig. outer end 2 at 50 is run through the director and drilled into posed in c( position. Digital examination is then made to 40 sharp bone find the posterior end of the pin, but prior to this in respons examination the clamping nut 23 is released and each other the arms of the instrument spread so that the points on o instrument is removed from the patient. If, after 4. In a the digital examination, the posterior end of the 45 fractured I pin cannot be located, the drilling is continued a arms for a short distance only until the end of the pin can other, a tu be felt just through the posterior border of the a , an ramus. The exposed end of the Kirschner wire arms, an or pin 50 is then cut to permit pulling of the skin 50 in having and subcutaneous tissue over it, leaving no ex- inner ends ternal evidence of the pin. other arm From the above description it will be under- mentioned stood that the Kirschner wire or pin extends movab through the fractured part of the jaw and firmly 55 adjustmen holds the parts together. However, if additional bo ne on o support is needed, it may be necessary to insert another Kirschner wire in the same manner as above described although the instrument would be changed in its location to place the second wire 60 angular with respect to the first wire. From experience in a great number of cases it has been The foll, found that the Kirschner wire can be removed file of thi in about six weeks merely by making a small stab incision and locating the end of the wire, the 65 wire being grasped by a heavy plier and wtih- Number drawn with a rotative motion. 718,055 one form of the invention has been Sshown and described, it is contemvarious changes and modifications can thout departing from the scope of the nd it is intended to cover such changes cations as come within the scope of s my invention: ical pin guide comprising: a pair of copic means connecting said arms; a mounted on one of said arms cooperaable with the other arm for varying n of the arms with respect to each Itering pin mounted in one arm; a dimounted on the other arm, and a rerector pin in said tube; said pins exthe same longitudinal axis and having r end portions; and releasable means I one of said arms for disengagement Sscrew to permit free movement of the d and from each other.

ce for applying a wire through a fraccomprising a frame presenting a pair rms adapted to receive the bone therewire-passing pin carried by one of the ntering pin carried by the other arm alinement with the wire-passing pin, for moving the pins axially towards , said pins having relatively sharp .ng inner end portions whereby, in resaid movement, to pierce the bone at les of the fracture.

device for applying a wire through a cone, a frame carrying a pair of spaced adjustment towards and away from , and a guide pin carried by the outer Sarm, a centering pin carried by the of the other arm, said pins being d:soaxial alinement and having relatively e-piercing pointed inner ends whereby, e to adjustment of the arms towards , to pierce a fractured bone at alined pposite sides of the fracture.

device for applying a wire through a lone, a frame carrying a pair of spaced djustment towards and away from each ebular guide pin carried by one of the inner pin removably mounted axially lar guide pin, said guide pin and inner relatively sharp bone-piercing pointed , and a second guide pin mounted in the in coaxial alinement with said firstguide pin and inner pin, said pins bele towards each other in response to t of the arms to pierce a fractured iposite sides of the fracture.


REFERENCES CITED owing references are of record in the s patent: FOREIGN PATENTS Country Date France ------------ Jan. 19, 1932