JP2003339725A - Fracture reintegration induction apparatus and method - Google Patents
Fracture reintegration induction apparatus and methodInfo
- Publication number
- JP2003339725A JP2003339725A JP2002147185A JP2002147185A JP2003339725A JP 2003339725 A JP2003339725 A JP 2003339725A JP 2002147185 A JP2002147185 A JP 2002147185A JP 2002147185 A JP2002147185 A JP 2002147185A JP 2003339725 A JP2003339725 A JP 2003339725A
- Authority
- JP
- Japan
- Prior art keywords
- fracture
- bone
- reduction
- bone fragment
- dimensional
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
- 238000000034 method Methods 0.000 title claims abstract description 28
- 230000006833 reintegration Effects 0.000 title abstract 5
- 230000006698 induction Effects 0.000 title abstract 2
- 210000000988 bone and bone Anatomy 0.000 claims abstract description 205
- 238000004088 simulation Methods 0.000 claims abstract description 40
- 208000010392 Bone Fractures Diseases 0.000 claims description 182
- 239000012634 fragment Substances 0.000 claims description 167
- 230000009467 reduction Effects 0.000 claims description 127
- 239000003550 marker Substances 0.000 claims description 54
- 238000012545 processing Methods 0.000 claims description 17
- 230000005540 biological transmission Effects 0.000 claims description 7
- 238000003384 imaging method Methods 0.000 claims description 6
- 238000012937 correction Methods 0.000 claims description 5
- 238000006243 chemical reaction Methods 0.000 abstract 1
- 206010017076 Fracture Diseases 0.000 description 90
- 210000000689 upper leg Anatomy 0.000 description 8
- 238000010586 diagram Methods 0.000 description 4
- 230000008569 process Effects 0.000 description 4
- 238000002594 fluoroscopy Methods 0.000 description 3
- 230000035876 healing Effects 0.000 description 3
- 238000005259 measurement Methods 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 206010061599 Lower limb fracture Diseases 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 230000007246 mechanism Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 230000003287 optical effect Effects 0.000 description 1
- 230000002093 peripheral effect Effects 0.000 description 1
- 238000011002 quantification Methods 0.000 description 1
- 238000002601 radiography Methods 0.000 description 1
- 230000008439 repair process Effects 0.000 description 1
- 230000002194 synthesizing effect Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
- A61B17/66—Alignment, compression or distraction mechanisms
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/10—Computer-aided planning, simulation or modelling of surgical operations
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Medical Informatics (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Apparatus For Radiation Diagnosis (AREA)
- Orthopedics, Nursing, And Contraception (AREA)
- Surgical Instruments (AREA)
Abstract
Description
【０００１】[0001]
【発明の属する技術分野】本発明は、骨折した患部にお
ける骨片ずれを修復する骨折整復誘導装置及び方法に関
する。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a bone fracture reduction guide device and method for repairing a bone fragment shift in a fractured affected part.
【０００２】[0002]
【従来の技術】人体の骨折患部の治療は、患者をベッド
に寝かせた状態で、患者の骨折患部を複数回Ｘ線撮影
（例えば、上下、左右の撮影）して骨片のずれを確認し
た後、牽引することで骨折患部を整復し、骨折患部の整
復位置が適正かどうかを再度Ｘ線撮影して確認してい
る。2. Description of the Related Art For treatment of a fractured part of a human body, a patient is laid on a bed and X-rays of the fractured part of the patient are performed a plurality of times (for example, up, down, left and right) to confirm the displacement of bone fragments. After that, the affected part of the fracture is reduced by being towed, and whether or not the reduced position of the affected part of the fracture is appropriate is confirmed again by X-ray photography.
【０００３】[0003]
【発明が解決しようとする課題】ところが、従来の骨折
整復治療では、骨折患部のＸ線撮影画像に基づいて術者
が骨折患部を牽引して適正な接合位置に整復するもので
あるが、骨折した骨片の牽引方向や牽引力等は定量性が
なく、各術者の経験によるところが大きい。また術者の
肉体労働を強いていることになる。そのため、術者の技
量によって骨折治療の完治期間にずれが生じてしまうと
いう問題がある。更に、Ｘ線撮影を頻繁に行うため、患
者及び術者に対する被爆の問題がある。However, in the conventional bone fracture reduction treatment, an operator pulls the bone fracture affected portion based on an X-ray image of the bone fracture affected portion to reduce the bone fracture to an appropriate joint position. The pulling direction and pulling force of the bone fragments are not quantitative and depend largely on the experience of each operator. Moreover, it means that the surgeon is forced to do physical labor. Therefore, there is a problem in that there is a gap in the healing period of the fracture treatment depending on the skill of the operator. Further, since radiography is frequently performed, there is a problem of exposure to the patient and the operator.
【０００４】本発明はこのような問題を解決するもので
あり、骨折整復治療における定量性を確保して整復作業
の作業性及び作業効率の向上を図った骨折整復誘導装置
及び方法を提供することを目的とする。The present invention solves such a problem, and provides a bone fracture reduction guide device and method which ensure the quantitativeness in the bone fracture reduction treatment and improve the workability and the work efficiency of the bone reduction work. With the goal.
【０００５】[0005]
【課題を解決するための手段】上述の目的を達成するた
めの請求項１の発明の骨折整復誘導装置は、骨折患部を
撮影する骨折患部撮影手段と、該骨折患部撮影手段が撮
影した撮影画像に基づいて骨折断端の接合位置を指定し
て骨折位置から該接合位置までの骨片の移動軌跡及び移
動量を設定する整復シミュレーション設定手段と、前記
骨折患部における一方の骨片に保持して移動可能な骨片
移動手段と、前記整復シミュレーション設定手段が設定
した骨片の移動軌跡及び移動量に基づいて前記骨片移動
手段の移動順序、移動量、移動方向を設定する制御量設
定手段とを具えたことを特徴とするものである。In order to achieve the above-mentioned object, the fracture reduction guide device of the invention of claim 1 is a bone fracture affected part photographing means for photographing a bone fracture affected part, and a photographed image photographed by the bone fracture affected part photographing means. Reduction simulation setting means for setting the movement locus and movement amount of the bone fragment from the fracture position to the joint position by designating the joint position of the fracture end based on, and holding it in one bone fragment in the fracture affected part A movable bone piece moving means, and a control amount setting means for setting a moving order, a moving amount, and a moving direction of the bone piece moving means based on the moving trajectory and the moving amount of the bone piece set by the reduction simulation setting means. It is characterized by having.
【０００６】請求項２の発明の骨折整復誘導装置では、
前記骨折患部撮影手段を３次元の撮影画像を取得するＸ
線透視装置とし、該Ｘ線透視装置にマーカを付けて該マ
ーカの３次元位置を計測する３次元計測装置を設け、前
記骨折患部に対して複数箇所の３次元撮影画像と前記マ
ーカの３次元位置・方向座標により整復に必要な範囲の
骨全体の画像に作成する画像処理手段を設けたことを特
徴としている。According to the bone fracture reduction guide device of the invention of claim 2,
The bone fracture affected area photographing means is used to obtain a three-dimensional photographed image X
A fluoroscopy device is provided with a three-dimensional measuring device for measuring the three-dimensional position of the marker by attaching a marker to the X-ray fluoroscopic device, and a three-dimensional photographed image of a plurality of locations and the three-dimensional image of the marker with respect to the affected part of the bone fracture. It is characterized in that image processing means is provided for creating an image of the entire bone within the range necessary for reduction using the position / direction coordinates.
【０００７】請求項３の発明の骨折整復誘導装置では、
前記画像処理手段は作成した骨折患部の３次元画像に基
づいて骨片の分離を行って各骨片の３次元画像を作成
し、前記整復シミュレーション設定手段は、該骨片の３
次元画像に基づいて骨折断端の接合位置を指定すること
を特徴としている。In the bone fracture reduction guide device of the third aspect of the invention,
The image processing means creates a three-dimensional image of each bone fragment by separating the bone fragment based on the created three-dimensional image of the fracture affected part, and the reduction simulation setting means sets the three-dimensional image of the bone fragment.
The feature is that the joint position of the fracture end is designated based on the three-dimensional image.
【０００８】請求項４の発明の骨折整復誘導装置では、
前記整復シミュレーション設定手段は、前記骨折患部撮
影手段が撮影した撮影画像と予め記憶した骨正常位置と
を比較して前記骨折断端の接合位置を指定することを特
徴としている。According to the bone fracture reduction guide device of the invention of claim 4,
The reduction simulation setting unit specifies the joint position of the fracture end by comparing a captured image captured by the fracture affected part imaging unit with a normal bone position stored in advance.
【０００９】請求項５の発明の骨折整復誘導装置では、
前記骨片移動手段が保持した一方の骨片にマーカを付け
る骨片マーカ付着手段と、該骨片マーカ付着手段が付け
たマーカの３次元位置を計測する３次元計測装置とを設
け、前記制御量設定手段は、該３次元計測装置が測定し
たマーカの移動軌跡及び移動量と、前記整復シミュレー
ション設定手段が設定した骨片の移動軌跡及び移動量と
の誤差を検出し、この誤差が所定値を越えたときには前
記骨片移動手段の補正量を設定することを特徴としてい
る。In the bone fracture reduction guide device of the fifth aspect of the present invention,
The bone fragment marker attaching means for attaching a marker to one bone fragment held by the bone fragment moving means and the three-dimensional measuring device for measuring the three-dimensional position of the marker attached by the bone fragment marker attaching means are provided, and the control is performed. The amount setting means detects an error between the movement locus and movement amount of the marker measured by the three-dimensional measuring device and the movement locus and movement amount of the bone fragment set by the reduction simulation setting means, and this error has a predetermined value. When it exceeds, the correction amount of the bone piece moving means is set.
【００１０】請求項６の発明の骨折整復誘導装置では、
前記整復シミュレーション設定手段は、術者の手に装着
されるデータグローブを有し、該術者は前記骨折患部撮
影手段が撮影した撮影画像に基づいて該データグローブ
を操作して骨折断端の接合位置を指定して骨折位置から
該接合位置までの骨片の移動軌跡及び移動量を設定する
ことを特徴としている。According to a sixth aspect of the bone fracture reduction guide device of the present invention,
The reduction simulation setting means has a data glove that is attached to the operator's hand, and the operator operates the data glove based on the image taken by the fracture affected part imaging means to join the fracture ends. It is characterized in that a position is designated and a movement locus and a movement amount of the bone fragment from the fracture position to the joint position are set.
【００１１】請求項７の発明の骨折整復誘導装置では、
前記整復シミュレーション設定手段と前記制御量設定手
段との間でデータを送受信可能なデータ送受信機を設け
たことを特徴としている。In the fracture reduction guide device of the invention of claim 7,
A data transmitter / receiver capable of transmitting and receiving data between the reduction simulation setting means and the control amount setting means is provided.
【００１２】請求項８の発明の骨折整復誘導装置では、
前記制御量設定手段に音声指示装置を接続したことを特
徴としている。In the bone fracture reduction guide device of the invention of claim 8,
A feature is that a voice instruction device is connected to the control amount setting means.
【００１３】請求項９の発明の骨折整復誘導装置では、
前記制御量設定手段と前記音声指示装置との間でデータ
を送受信可能なデータ送受信装置を設けたことを特徴と
している。In the bone fracture reduction guide device of the invention of claim 9,
A data transmission / reception device capable of transmitting / receiving data between the control amount setting means and the voice instruction device is provided.
【００１４】請求項１０の発明の骨折整復方法は、骨折
患部を撮影し、該撮影画像に基づいて骨折断端の接合位
置を指定し、骨折位置から該接合位置までの骨片の移動
軌跡及び移動量を設定し、該移動軌跡及び移動量に基づ
いて牽引装置を操作して前記骨折患部を整復することを
特徴とするものである。According to the method of reducing bone fractures of the tenth aspect of the present invention, the affected part of the fracture is photographed, the joint position of the fracture edge is designated based on the photographed image, and the movement locus of the bone fragment from the fracture position to the joint position and It is characterized in that a movement amount is set, and a traction device is operated based on the movement locus and the movement amount to reduce the fracture affected part.
【００１５】請求項１１の発明の骨折整復方法では、前
記骨折患部に対して複数箇所の３次元撮影画像を取得
し、該複数箇所の撮影画像を座標変換して合成して述部
全体の３次元画像を作成し、該骨折患部の３次元画像に
基づいて骨片の分離を行い、該骨片の３次元画像に基づ
いて骨折断端の接合位置を指定することを特徴としてい
る。According to the fracture reduction method of the invention of claim 11, three-dimensional photographed images of a plurality of locations are acquired for the affected part of the fracture, and the photographed images of the plurality of locations are coordinate-converted and combined to generate 3 of the entire predicate. It is characterized in that a three-dimensional image is created, the bone fragments are separated based on the three-dimensional image of the affected part of the fracture, and the joint position of the fracture end is designated based on the three-dimensional image of the bone fragment.
【００１６】請求項１２の発明の骨折整復方法では、前
記牽引装置が保持した骨片にマーカを付け、該骨片マー
カの３次元位置を常時計測して該骨片マーカの移動軌跡
及び移動量と、前記骨片の移動軌跡及び移動量との誤差
を検出し、この誤差が所定値を越えたときには前記牽引
装置を補正操作することを特徴としている。In the bone fracture reduction method of the invention of claim 12, a marker is attached to the bone fragment held by the traction device, the three-dimensional position of the bone fragment marker is constantly measured, and the movement locus and movement amount of the bone fragment marker are measured. Then, an error between the movement locus and the movement amount of the bone fragment is detected, and when the error exceeds a predetermined value, the traction device is corrected.
【００１７】請求項１３の発明の骨折整復方法では、前
記骨折患部に対して複数箇所の撮影画像を取得し、該複
数の撮影画像を座標変換して合成して３次元画像を作成
し、該骨折患部の３次元画像に基づいて骨片の分離を行
って各骨片の３次元画像を作成し、術者は該骨片の３次
元画像を見ながら手に装着したデータグローブを操作し
て骨折断端の接合位置を指定し、骨折位置から該接合位
置までの骨片の移動軌跡及び移動量を設定することを特
徴としている。In the bone fracture reduction method of the invention of claim 13, a plurality of photographed images of the affected part of the fracture are acquired, the plurality of photographed images are coordinate-converted and combined to create a three-dimensional image. The bone fragments are separated based on the three-dimensional image of the fractured part to create a three-dimensional image of each bone fragment, and the operator operates the data glove attached to the hand while viewing the three-dimensional image of the bone fragment. It is characterized in that the joint position of the fracture end is designated and the movement locus and the movement amount of the bone fragment from the fracture position to the joint position are set.
【００１８】[0018]
【発明の実施の形態】以下、図面に基づいて本発明の実
施の形態を詳細に説明する。BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described in detail below with reference to the drawings.
【００１９】図１に本発明の第１実施形態に係る骨折整
復誘導装置の概略構成、図２に本実施形態の骨折整復誘
導装置による整復方法を表すフローチャート、図３乃至
図５に本実施形態の骨折整復誘導装置により整復方法を
表す概略を示す。FIG. 1 is a schematic configuration of a bone fracture reduction guide apparatus according to a first embodiment of the present invention, FIG. 2 is a flowchart showing a reduction method by the bone fracture reduction guide apparatus of the present embodiment, and FIGS. 3 to 5 show the present embodiment. The outline showing the reduction method by the fracture reduction reduction guide device of FIG.
【００２０】本実施形態の骨折整復誘導装置は、図１に
示すように、骨折患部を撮影する骨折患部撮影手段とし
ての３次元画像が合成可能なＸ線透視装置１１と、骨折
した骨片に付ける骨片マーカ１２ａと、Ｘ線透視装置１
１に付ける装置マーカ１２ｂと、この骨片マーカ１２ａ
と装置マーカ１２ｂの３次元位置を計測する３次元計測
装置１３と、Ｘ線透視装置１１で合成された骨片の３次
元画像を用いて３次元計測装置１３が計測したマーカの
３次元位置から骨片の３次元位置を推定し、整復シミュ
レーション及び整復制御量を出力する整復誘導装置１８
と、骨折患部における一方の骨片に保持して移動可能な
骨片移動手段としての牽引装置１５とから構成されてい
る。この整復誘導装置１８は骨片の３次元画像に基づい
て骨折断端の接合位置を指定して骨折位置から接合位置
までの骨片の移動軌跡及び移動量を設定する整復シミュ
レーション設定装置１６と、この整復シミュレーション
設定装置１６が設定した骨片の移動軌跡及び移動量に基
づいて牽引装置１５の位置・姿勢操作量を設定する制御
量設定装置１７とから構成されている。As shown in FIG. 1, the bone fracture reduction guide device of the present embodiment includes an X-ray fluoroscopic device 11 capable of synthesizing a three-dimensional image as a bone fracture affected part photographing means for photographing a bone fracture affected part, and a broken bone fragment. Bone fragment marker 12a to be attached and X-ray fluoroscope 1
1 is attached to the device marker 12b and this bone fragment marker 12a
From the three-dimensional position of the marker measured by the three-dimensional measuring device 13 using the three-dimensional measuring device 13 that measures the three-dimensional position of the device marker 12b and the three-dimensional image of the bone fragment synthesized by the X-ray fluoroscope 11. Reduction guidance device 18 that estimates the three-dimensional position of the bone fragment and outputs reduction simulation and reduction control amount 18
And a traction device 15 as a bone piece moving means that can be held and moved by one bone piece in the fractured part. The reduction guidance device 18 is a reduction simulation setting device 16 for designating a joint position of a fracture end based on a three-dimensional image of a bone fragment and setting a movement trajectory and a movement amount of the bone fragment from the fracture position to the joint position. The reduction simulation setting device 16 includes a control amount setting device 17 that sets the position / posture operation amount of the traction device 15 based on the movement trajectory and the movement amount of the bone fragment set by the reduction simulation setting device 16.
【００２１】Ｘ線透視装置１１は、例えば、骨折患部と
しての大腿部の外周部に位置してリング形状をなすＣ字
形アームであって、大腿部の周方向に回動自在であると
共に、長手方向に移動可能であり、骨折患部を複数の位
置や角度からＸ線撮影可能となっており、３次元画像を
生成する。骨片マーカ１２ａは、骨折患部にて骨折した
側の骨片に刻設すると共に、皮膚に皮膚マーカを貼着す
るものである。装置マーカ１２ｂは、Ｘ線透視装置１１
に付設するものである。３次元計測装置１３は、この骨
片マーカ１２ａの３次元位置と装置マーカ１２ｂの３次
元位置を計測するものである。The X-ray fluoroscope 11 is, for example, a C-shaped arm which is located in the outer peripheral part of the thigh as a fractured part and has a ring shape, and is rotatable in the circumferential direction of the thigh. , Can be moved in the longitudinal direction, and the affected part of the fracture can be radiographed from a plurality of positions and angles to generate a three-dimensional image. The bone fragment marker 12a is engraved on the bone fragment on the fractured side in the fracture affected area, and the skin marker is attached to the skin. The device marker 12b is used for the fluoroscope 11
It is attached to. The three-dimensional measuring device 13 measures the three-dimensional position of the bone fragment marker 12a and the three-dimensional position of the device marker 12b.
【００２２】Ｘ線透視装置１１で骨折患部周辺を、位置
を変えて複数箇所撮影するが、Ｘ線透視装置１１の位置
は装置マーカ１２ｂを３次元計測装置１３で計測されて
画像処理装置１４に入力される。この画像処理装置１４
は、Ｘ線透視装置１１からの骨折患部周辺の複数箇所の
３次元画像により手術する骨部全体を合成する。また、
画像処理装置１４は、３次元計測装置１３が計測した各
マーカの３次元位置（３次元座標）から骨片の３次元位
置を推定する。The X-ray fluoroscopy device 11 takes a plurality of images around the affected area of the fracture by changing the position. The position of the X-ray fluoroscopy device 11 is measured by the three-dimensional measuring device 13 with the device marker 12b and the image processing device 14 is measured. Is entered. This image processing device 14
Is to synthesize the entire bone part to be operated by using three-dimensional images of a plurality of locations around the fractured part from the X-ray fluoroscope 11. Also,
The image processing device 14 estimates the three-dimensional position of the bone fragment from the three-dimensional position (three-dimensional coordinate) of each marker measured by the three-dimensional measuring device 13.
【００２３】整復シミュレーション設定装置１６は、Ｘ
線透視装置１１が撮影した撮影画像に基づいて画像処理
装置１４が作成した骨片の３次元画像から骨折断端の接
合位置を指定し、骨片がずれた骨折位置から骨片が適正
に接触する接合位置までの骨片の移動軌跡及び移動量を
設定するものである。この場合、骨片の適正な接合位置
は、骨折していない側の大腿部のＸ線撮影画像や平均的
な骨の接合形状とのマッチングにより行うことが望まし
い。The reduction simulation setting device 16 uses X
The joint position of the fracture end is specified from the three-dimensional image of the bone fragment created by the image processing device 14 based on the image captured by the fluoroscopic device 11, and the bone fragment appropriately contacts from the fracture position where the bone fragment is displaced. The movement locus and the movement amount of the bone fragment to the joining position are set. In this case, it is desirable that the proper joining position of the bone fragments is performed by matching with the X-ray image of the thigh on the side where the bone is not fractured and the average bone joining shape.
【００２４】制御量設定装置１７は、整復シミュレーシ
ョン設定装置１６が設定した骨片の移動軌跡及び移動量
に基づいて牽引装置１５の位置・姿勢の操作量を演算す
ることで、実際の骨折患部にて牽引装置１５が保持した
骨片をずれた骨折位置から適正な接合位置まで移動指示
するものである。この場合、制御量設定装置１７は、３
次元計測装置１３が計測した各マーカの３次元位置に基
づいて画像処理装置１４が推定した骨片の実移動軌跡及
び実移動量と、整復シミュレーション設定装置１６が設
定した骨片の移動軌跡及び移動量との誤差を検出し、こ
の誤差が減少するように牽引装置１５を補正制御する。The control amount setting device 17 calculates the operation amount of the position / posture of the traction device 15 on the basis of the movement trajectory and the movement amount of the bone fragment set by the reduction simulation setting device 16, so that the actual fracture affected part is detected. And directs movement of the bone fragments held by the traction device 15 from the displaced fracture position to the proper joining position. In this case, the control amount setting device 17
The actual movement trajectory and actual movement amount of the bone fragment estimated by the image processing device 14 based on the three-dimensional position of each marker measured by the dimension measurement device 13, and the movement trajectory and movement of the bone fragment set by the reduction simulation setting device 16. An error from the quantity is detected, and the traction device 15 is corrected and controlled so as to reduce this error.
【００２５】そして、牽引装置１５は、ベッドに横にな
った患者の骨折した足に履かせて保持するブーツと、こ
のブーツを６自由度（３次元方向への直線移動、３次元
方向に沿った軸回りの回動）の移動動作を可能とする移
動機構とを有しており、骨片を６自由度の方向に牽引可
能となっている。The traction device 15 has a boot for holding the broken leg of a patient lying on the bed and holding the boot, and the boot having 6 degrees of freedom (linear movement in the three-dimensional direction, along the three-dimensional direction). And a moving mechanism capable of moving about an axis), and the bone fragments can be pulled in the directions of six degrees of freedom.
【００２６】ここで、本実施形態の骨折整復誘導装置に
よる骨折整復方法について、図２に記載したフローチャ
ートと図３乃至図５に記載した骨折患部の概略に基づい
て詳細に説明する。Here, the bone fracture reduction method using the bone fracture reduction guide device of the present embodiment will be described in detail based on the flow chart shown in FIG. 2 and the outline of the fracture affected part shown in FIGS. 3 to 5.
【００２７】図２に示すフローチャートにて、ステップ
Ｓ１では、Ｘ線透視装置１１を用いて大腿部の周方向に
回動すると共に長手方向に移動し、骨折患部を異なる位
置でＸ線撮影を行い、図３(ａ)に示すように、複数の３
次元画像Ａ，Ｂ，Ｃ，Ｄを取得する。ステップＳ２で
は、３次元画像Ａ，Ｂ，Ｃ，Ｄに対応する装置マーカ１
２ｂの位置データを用いて、図３(ｂ)に示すように、術
部全体が把握できるように骨折患部周辺の３次元画像を
作成する。そして、ステップＳ３では、図３(ｃ)に示す
ように、この骨折患部周辺の３次元画像に基づいて、骨
折した各骨片ごとの分離を行って各骨片（骨折の断端）
の３次元画像を作成する。In the flowchart shown in FIG. 2, in step S1, the X-ray fluoroscope 11 is used to rotate in the circumferential direction of the thigh and move in the longitudinal direction so that the affected area of the bone fracture can be radiographed at different positions. Then, as shown in FIG.
Obtain the three-dimensional images A, B, C, and D. In step S2, the device marker 1 corresponding to the three-dimensional images A, B, C, D
Using the position data of 2b, as shown in FIG. 3B, a three-dimensional image around the fracture affected area is created so that the entire surgical site can be grasped. Then, in step S3, as shown in FIG. 3 (c), based on the three-dimensional image around the fracture affected area, each fractured bone fragment is separated and each bone fragment (a fracture end of the fracture)
3D image is created.
【００２８】ステップＳ４にて、整復シミュレーション
設定装置１６は、画像処理装置１４が作成した分離骨片
の３次元画像にて、図４(ａ)に示すように、骨片の適正
な接合位置を指定するが、この場合、予め骨折していな
い側の大腿部のＸ線撮影画像を取得し、骨折患部の分離
骨片に対応する３次元画像を記憶しておき、骨折してい
ない大腿部の３次元画像に基づいて、骨折した大腿部に
おける骨片の接合位置を指定する。そして、図４(ｂ)に
示すように、３次元画像上で骨片を指定した接合位置ま
でシミュレーション移動することで骨折患部の整復状態
を確認し、移動軌跡及び移動量を設定する。予め骨折し
ていない側の大腿部のＸ線画像が得られない場合、図４
(ｃ)に示すように、骨折断端に接合位置（ａ，ｂ，
ｃ）、（ａ′，ｂ′，ｃ′）を設定し、この接合位置ま
での骨片の移動軌跡及び移動量を設定し、この移動軌跡
及び移動量に基づいて骨片のシミュレーション移動し、
骨片の整復状態を確認することもできる。In step S4, the reduction simulation setting device 16 determines the proper joining position of the bone fragments in the three-dimensional image of the separated bone fragments created by the image processing device 14 as shown in FIG. 4 (a). In this case, in this case, an X-ray image of the femur on the side without fracture is acquired in advance, and the three-dimensional image corresponding to the separated bone fragment of the fracture affected area is stored in advance, and the femur without fracture is specified. The joint position of the bone fragment in the fractured thigh is specified based on the three-dimensional image of the part. Then, as shown in FIG. 4B, the reduction state of the fracture affected part is confirmed by simulating movement of the bone fragment to the specified joint position on the three-dimensional image, and the movement trajectory and movement amount are set. When the X-ray image of the thigh on the side where the bone has not been fractured is not obtained in advance, FIG.
As shown in (c), the joint position (a, b,
c), (a ′, b ′, c ′) are set, the movement locus and the movement amount of the bone fragment to this joint position are set, and the bone fragment is simulated and moved based on this movement locus and movement amount.
It is also possible to confirm the reduction state of the bone fragments.
【００２９】このように整復シミュレーション設定装置
１６にて、接合位置までの骨片の移動軌跡及び移動量が
設定されたら、ステップＳ５にて、制御量設定し油断１
７は、牽引装置１５による制御量、即ち、骨片の移動軌
跡及び移動量に対応したブーツにおける６方向の移動順
序、移動量、移動速度等を換算する。そして、ステップ
Ｓ６にて、牽引装置１５は、図５(ａ)(ｂ)に示すよう
に、ブーツを設定した移動順序、移動量、移動方向等に
基づいて移動されて骨片をずれた骨折位置から適正な接
合位置まで移動する。なお、牽引装置１５は自動で駆動
される必要はなく、手動で操作してもよい。In this way, when the movement trajectory and the movement amount of the bone piece to the joint position are set by the reduction simulation setting device 16, the control amount is set in step S5, and the failure 1
Reference numeral 7 converts the control amount of the traction device 15, that is, the moving order, the moving amount, the moving speed, etc. of the boot in the six directions corresponding to the moving locus and the moving amount of the bone fragment. Then, in step S6, as shown in FIGS. 5 (a) and 5 (b), the traction device 15 is moved based on the set moving order, moving amount, moving direction, etc. Move from the position to the proper joining position. The towing device 15 does not have to be automatically driven, and may be manually operated.
【００３０】この場合、予め骨片マーカａが刻設される
と共に皮膚にマーカが貼着され、ステップＳ７にて、３
次元計測装置１３が各マーカの３次元位置を計測してい
る。そして、ステップＳ８では、３次元計測装置１３が
計測した各マーカの３次元位置に基づいて画像処理装置
１４が推定した骨片の実移動軌跡及び実移動量と、整復
シミュレーション設定装置１６が設定した骨片の移動軌
跡及び移動量とを比較し、牽引装置１５の作動によって
移動する骨片が指定した軌跡上にあるかどうかをリアル
タイムで判定している。In this case, the bone fragment marker a is engraved in advance and the marker is affixed to the skin.
The dimension measuring device 13 measures the three-dimensional position of each marker. Then, in step S8, the actual movement trajectory and actual movement amount of the bone fragment estimated by the image processing apparatus 14 based on the three-dimensional position of each marker measured by the three-dimensional measurement apparatus 13 and the reduction simulation setting apparatus 16 set. By comparing the movement trajectory and the movement amount of the bone fragment, it is determined in real time whether or not the bone fragment that is moved by the operation of the traction device 15 is on the specified trajectory.
【００３１】従って、ステップＳ８にて、骨片の実移動
軌跡と骨片の設定移動軌跡とを比較し、その誤差が所定
値を越えたときには牽引装置１５の作動によって移動す
る骨片が指定した軌跡上にないと判定し、ステップＳ９
にてこの誤差が減少するように牽引装置１５を位置補正
し、ステップＳ６に戻る。一方、骨片の実移動軌跡と骨
片の設定移動軌跡との誤差が所定値以内であれば、移動
する骨片が指定した軌跡上にあると判定し、ステップＳ
１０に移行する。ここに、ステップＳ９の位置補正は制
御量設定装置１７にて実施される。Therefore, in step S8, the actual movement trajectory of the bone fragment is compared with the set movement trajectory of the bone fragment, and when the error exceeds a predetermined value, the bone fragment to be moved by the operation of the traction device 15 is designated. It is determined that it is not on the trajectory, and step S9
The position of the traction device 15 is corrected so that this error is reduced, and the process returns to step S6. On the other hand, if the error between the actual movement trajectory of the bone fragment and the set movement trajectory of the bone fragment is within a predetermined value, it is determined that the moving bone fragment is on the designated trajectory, and step S
Go to 10. Here, the position correction in step S9 is performed by the control amount setting device 17.
【００３２】このステップＳ１０では、骨片の実移動軌
跡及び実移動量と、骨片の設定移動軌跡及び設定移動量
とを比較し、牽引装置１５の作動によって移動する骨片
が指定した接合位置に移動したかどうかを判定する。こ
のステップＳ１０で、骨片の実移動軌跡及び実移動量
と、骨片の設定移動軌跡及び設定移動量とが一致してい
なければ、骨片がまだ指定した接合位置に移動していな
いものと判定し、ステップＳ６に戻って処理を繰り返
す。In step S10, the actual movement locus and the actual movement amount of the bone fragment are compared with the set movement locus and the set movement amount of the bone fragment, and the joint position designated by the bone fragment moved by the operation of the traction device 15 is compared. To see if it has moved to. In this step S10, if the actual movement locus and actual movement amount of the bone fragment do not match the set movement locus and set movement amount of the bone fragment, it is determined that the bone piece has not moved to the specified joining position. The determination is made, and the process returns to step S6 and is repeated.
【００３３】一方、骨片の実移動軌跡及び実移動量と設
定移動軌跡及び設定移動量とが一致していれば、骨片が
指定した接合位置に移動したものと判定する。そして、
ステップＳ１１にて、Ｘ線透視装置１１により骨折患部
を撮影し、ステップＳ１２で、骨片が所定の接合位置に
移動して適正に整復されているかどうかを判定し、骨片
が所定の接合位置に移動せずに適正に整復されていなけ
れば、ステップＳ４に戻って全ての処理を繰り返す一
方、骨片が所定の接合位置に移動して適正に整復されて
いることが確認されたら整復作業を完了する。そして、
図示しないが、骨折患部の手術やギブスによる固定など
の適切な処置を行う。On the other hand, if the actual movement trajectory and the actual movement amount of the bone fragment match the set movement trajectory and the set movement amount, it is determined that the bone piece has moved to the designated joining position. And
In step S11, the affected part of the fracture is imaged by the fluoroscope 11, and in step S12, it is determined whether or not the bone fragment is moved to a predetermined joint position and properly reduced, and the bone fragment is in the predetermined joint position. If the bone fragments have not been properly moved and have not been properly reduced, the process returns to step S4 and repeats all the processes, while if it is confirmed that the bone fragments have moved to the predetermined joint position and properly reduced, then the reduction work is performed. Complete. And
Although not shown, appropriate treatment such as surgery of the fractured part or fixation with a cast is performed.
【００３４】このように本実施形態の骨折整復誘導装置
にあっては、Ｘ線透視装置１１により骨折患部を撮影
し、骨片の３次元画像を作成し、画像処理装置１４が撮
影した複数の３次元撮影画像を座標変換して手術する骨
全体に合成し、整復シミュレーション設定装置１６が作
成した骨片の３次元画像に基づいて骨折断端の接合位置
を指定して骨折位置から接合位置までの骨片の移動軌跡
及び移動量を設定し、制御量設定装置１７は骨片の移動
軌跡及び移動量に基づいて牽引装置１５の操作量、操作
方向を設定し、これに基づいて牽引装置１５を駆動して
骨折患部を整復するようにしている。As described above, in the bone fracture reduction guide device of the present embodiment, the affected area of the bone fracture is photographed by the X-ray fluoroscopic device 11, a three-dimensional image of the bone fragment is created, and a plurality of images photographed by the image processing device 14 are taken. From the fracture position to the joint position by specifying the joint position of the fracture end based on the three-dimensional image of the bone fragment created by the reduction simulation setting device 16 The movement amount and the movement amount of the bone fragment are set, and the control amount setting device 17 sets the operation amount and the operation direction of the traction device 15 based on the movement trajectory and the movement amount of the bone fragment, and based on this, the traction device 15 Driven to reduce the fractured part.
【００３５】従って、骨片を予め設定した移動軌跡及び
移動量に基づいて牽引装置１５により接合位置まで移動
して整復するため、骨折した骨片の牽引方向や牽引力は
定量的なものとなり、術者の経験に拘らずほぼ一定な技
量となり、骨折治療の完治期間にずれが生じることはな
く、その結果、骨折整復治療における定量性を確保して
整復作業の作業性及び作業効率を向上できる。Therefore, since the bone fragments are moved to the joining position and reduced by the traction device 15 based on the preset movement locus and movement amount, the traction direction and traction force of the fractured bone fragments become quantitative, and the surgery is performed. The skill is almost constant regardless of the person's experience, and there is no gap in the healing period of the fracture treatment. As a result, the workability and work efficiency of the reduction work can be improved by ensuring the quantitativeness in the fracture reduction treatment.
【００３６】また、骨片マーカ１２ａが骨片に刻設され
ると共に皮膚にマーカを貼着し、３次元計測装置１３が
計測した各マーカの３次元位置に基づいて推定した骨片
の実移動軌跡及び実移動量と、整復シミュレーション設
定装置１６が設定した骨片の実移動軌跡及び実移動量と
を比較し、両者の誤差が減少するように牽引装置１５を
補正制御しており、骨片の移動を常時監視して早期に修
正することができる。更に、患者及び術者に対してＸ線
透視装置１１の使用回数を減少することで、Ｘ線被爆を
防止することができる。Further, the bone fragment marker 12a is engraved on the bone fragment, the marker is attached to the skin, and the actual movement of the bone fragment estimated based on the three-dimensional position of each marker measured by the three-dimensional measuring device 13 is performed. The trajectory and the actual movement amount are compared with the actual movement trajectory and the actual movement amount of the bone fragment set by the reduction simulation setting device 16, and the traction device 15 is corrected and controlled so that the error between them is reduced. The movement of can be constantly monitored and corrected early. Further, the X-ray exposure can be prevented by reducing the number of times of using the X-ray fluoroscope 11 for the patient and the operator.
【００３７】図６乃至図８に本発明の第２〜４実施形態
に係る骨折整復誘導装置の概略構成を示す。なお、前述
した実施形態で説明したものと同様の機能を有する部材
には同一の符号を付して重複する説明は省略する。6 to 8 show a schematic configuration of a fracture reduction guide device according to second to fourth embodiments of the present invention. It should be noted that members having the same functions as those described in the above-described embodiment are designated by the same reference numerals, and redundant description will be omitted.
【００３８】第２実施形態の骨折整復誘導装置におい
て、図６に示すように、整復シミュレーション設定装置
２１は、Ｘ線透視装置１１が撮影した撮影画像に基づい
て画像処理装置１４が作成した骨片の３次元画像を映し
出すディスプレイ２２と、術者の手に装着されるデータ
グローブ２３と、このデータグローブ２３の作動を検出
する各種センサ類２４と、この各種センサ類２４の出力
に基づいて骨片の移動位置を推定する演算装置２５とを
有している。なお、この各種センサ類２４は磁気センサ
あるいは光学センサであって、データグローブ２３の６
自由度（３次元方向への直線移動、３次元方向に沿った
軸回りの回動）の移動動作を検出できるセンサであれば
どれでもよい。In the bone fracture reduction guide device of the second embodiment, as shown in FIG. 6, the reduction simulation setting device 21 is a bone fragment created by the image processing device 14 based on an image captured by the X-ray fluoroscope 11. A display 22 that displays a three-dimensional image of the data, a data glove 23 worn on the operator's hand, various sensors 24 that detect the operation of the data glove 23, and bone fragments based on the outputs of the various sensors 24 And an arithmetic unit 25 for estimating the moving position of the. The various sensors 24 are magnetic sensors or optical sensors, and are included in the data glove 23.
Any sensor may be used as long as it can detect a movement operation with a degree of freedom (linear movement in the three-dimensional direction, rotation about an axis along the three-dimensional direction).
【００３９】従って、この整復シミュレーション設定装
置２１では、ディスプレイ２２に骨折患部における骨片
の３次元画像が映し出された状態で、術者がデータグロ
ーブ２３を操作、つまり、骨片を保持していると仮定し
て骨折断端の接合位置まで移動させると、センサ類２４
がこのデータグローブ２３の移動軌跡及び移動量を検出
し、演算装置２５がこの移動軌跡及び移動量に基づいて
骨片の移動位置を推定し、ディスプレイ２２に表示され
る。そして、術者が骨片を骨折位置から適正な接合位置
まで移動させたときの骨片の移動軌跡及び移動量を、骨
折位置から接合位置までの骨片の設定移動軌跡及び設定
移動量として設定する。Therefore, in the reduction simulation setting device 21, the operator operates the data glove 23, that is, holds the bone fragment while the three-dimensional image of the bone fragment in the fractured part is displayed on the display 22. If it is moved to the joint position of the fracture end assuming that
Detects the movement locus and the movement amount of the data globe 23, and the arithmetic unit 25 estimates the movement position of the bone fragment based on the movement locus and the movement amount and is displayed on the display 22. Then, the movement trajectory and the movement amount of the bone fragment when the operator moves the bone fragment from the fracture position to the proper joint position are set as the set movement trajectory and the set movement amount of the bone fragment from the fracture position to the joint position. To do.
【００４０】そして、整復シミュレーション設定装置２
１にて、接合位置までの骨片の移動軌跡及び移動量が設
定されたら、前述の実施形態と同様に、制御量設定装置
１７が牽引装置１５による操作量、即ち、骨片の移動軌
跡及び移動量に対応した牽引装置１５の６方向の移動順
序、移動量、移動方向等を換算し、これに基づいて牽引
装置１５を駆動して骨片をずれた骨折位置から適正な接
合位置まで移動する。The reduction simulation setting device 2
When the movement trajectory and the movement amount of the bone fragment to the joint position are set in 1, the control amount setting device 17 operates the operation amount by the traction device 15, that is, the movement trajectory of the bone fragment and the movement trajectory of the bone fragment, as in the above-described embodiment. The movement order, movement amount, movement direction, etc. of the traction device 15 in six directions corresponding to the movement amount are converted, and the traction device 15 is driven based on this to move the bone fragments from the fractured position to the proper joint position. To do.
【００４１】このように本実施形態の骨折整復誘導装置
にあっては、整復シミュレーション設定装置２１にて、
術者がデータグローブ２３を操作して骨片を骨折位置か
ら適正な接合位置まで移動させて設定移動軌跡及び設定
移動量を設定している。従って、骨片の接合位置を適正
に設定することができ、整復作業の作業性及び作業効率
を向上できる。As described above, in the fracture reduction guidance device of this embodiment, the reduction simulation setting device 21
The operator operates the data glove 23 to move the bone fragment from the fracture position to an appropriate joint position to set the set movement locus and the set movement amount. Therefore, the joint position of the bone fragments can be set appropriately, and the workability and work efficiency of the reduction work can be improved.
【００４２】第３実施形態の骨折整復誘導装置では、図
７に示すように、第２実施形態で説明した演算装置２５
と整復誘導装置１８とをデータ送受信装置３１，３２に
接続し、両者間でデータの送受信を可能としている。In the bone fracture reduction guide device of the third embodiment, as shown in FIG. 7, the arithmetic unit 25 described in the second embodiment is used.
And the reduction guidance device 18 are connected to the data transmission / reception devices 31 and 32 to enable data transmission / reception between them.
【００４３】従って、患者がいる病院に熟練の術者が不
在であるときは、Ｘ線透視装置１１が撮影した撮影画像
に基づいて画像処理装置１４が作成した骨片の３次元画
像を熟練の術者がいる病院にデータ送受信装置３１，３
２を用いて送信する。熟練の術者は受信したデータをデ
ィスプレイ２２に表示しながらデータグローブ２３を操
作し、骨片を骨折位置から適正な接合位置まで移動させ
て設定移動軌跡及び設定移動量を設定する。そして、骨
片の設定移動軌跡及び設定移動量を患者がいる病院にデ
ータ送受信装置３１，３２を用いて送信すると、制御量
設定装置１７による操作量、即ち、骨片の移動軌跡及び
移動量に対応した６方向の移動順序、移動量、移動方向
等を換算し、これに基づいて牽引装置１５を駆動して骨
片をずれた骨折位置から適正な接合位置まで移動する。Therefore, when there is no skilled operator in the hospital where the patient is, the three-dimensional image of the bone fragment created by the image processing device 14 based on the image taken by the X-ray fluoroscope 11 is used by the skilled operator. Data transmission / reception device 31, 3 at the hospital where the surgeon is
Send using 2. The skilled operator operates the data glove 23 while displaying the received data on the display 22 to move the bone fragment from the fracture position to the proper joining position to set the set movement locus and the set movement amount. Then, when the set movement locus and the set movement amount of the bone fragment are transmitted to the hospital where the patient is using the data transmission / reception devices 31 and 32, the operation amount by the control amount setting device 17, that is, the movement locus and the movement amount of the bone fragment are displayed. The corresponding 6-direction movement order, movement amount, movement direction, etc. are converted, and based on this, the traction device 15 is driven to move the bone fragment from the displaced fracture position to the proper joining position.
【００４４】このように本実施形態の骨折整復誘導装置
にあっては、骨片の３次元画像や骨片の設定移動軌跡及
び設定移動量をデータ送受信装置３１，３２により送受
信可能とすることで、熟練の術者が不在である遠隔地な
どの病院であっても、骨折患部を適正に修復することが
できる。As described above, in the fracture reduction guidance device of this embodiment, the data transmitting / receiving devices 31 and 32 can transmit and receive the three-dimensional image of the bone fragment, the set movement trajectory and the set movement amount of the bone fragment. Even in a hospital such as a remote place where a trained operator is absent, the fractured part can be properly repaired.
【００４５】第４実施形態の骨折整復誘導装置では、図
８に示すように、第１実施形態で説明した制御量設定装
置１７に音声指示装置４１を接続している。In the bone fracture reduction guide device of the fourth embodiment, as shown in FIG. 8, a voice instruction device 41 is connected to the controlled variable setting device 17 described in the first embodiment.
【００４６】従って、制御量設定装置１７が牽引装置１
５を駆動制御して骨片をずれた骨折位置から適正な接合
位置まで移動しているとき、骨片の実移動軌跡及び実移
動量と設定移動軌跡及び設定移動量とに誤差が発生した
ときには、音声指示装置４１から制御量設定装置１７に
音声で指示を送ることで、骨片の修正移動を早期に実行
することができ、また、不測の事態には牽引装置１５を
緊急停止することができる。なお、第３実施形態で説明
したように、音声指示装置４１と整復誘導装置１８とを
データ送受信装置３１，３２に接続し、遠隔地より熟練
の術者が音声で指示する方法も可能である。Therefore, the control amount setting device 17 is the pulling device 1.
When the bone fragment is moved from the deviated fracture position to the proper joining position by driving control of No. 5 and an error occurs between the actual movement trajectory and the actual movement amount of the bone fragment and the set movement trajectory and the set movement amount. By sending a voice instruction from the voice instruction device 41 to the control amount setting device 17, the correction movement of the bone fragment can be executed early, and the traction device 15 can be emergency stopped in an unexpected situation. it can. As described in the third embodiment, a method is also possible in which the voice instruction device 41 and the reduction guidance device 18 are connected to the data transmission / reception devices 31 and 32, and a trained operator gives a voice instruction from a remote location. .
【００４７】[0047]
【発明の効果】以上、実施形態において詳細に説明した
ように請求項１の発明の骨折整復誘導装置によれば、骨
折患部を撮影する骨折患部撮影手段と、撮影した撮影画
像に基づいて骨折断端の接合位置を指定して骨折位置か
ら接合位置までの骨片の移動軌跡及び移動量を設定する
整復シミュレーション設定手段と、骨折患部における一
方の骨片に保持して移動可能な骨片移動手段と、整復シ
ミュレーション設定手段が設定した骨片の移動軌跡及び
移動量に基づいて骨片移動手段の移動順序、移動量、移
動方向を設定する制御量設定手段とを設けたので、骨片
を予め設定した移動軌跡及び移動量に基づいて接合位置
まで移動して整復することとなり、骨折した骨片の移動
方向や移動力は定量的なものとなり、術者の経験に拘ら
ずほぼ一定な技量となり、骨折治療の完治期間にずれが
生じることはなく、その結果、骨折整復治療における定
量性を確保して整復作業の作業性及び作業効率を向上す
ることができる。As described above in detail in the embodiments, according to the bone fracture reduction guide apparatus of the invention of claim 1, the bone fracture affected part photographing means for photographing the bone fracture affected part, and the fracture fracture based on the photographed image. Reduction simulation setting means for specifying the joint position of the end and setting the movement locus and movement amount of the bone fragment from the fracture position to the joint position, and the bone fragment moving means that can move while holding one bone fragment in the fractured part And the control amount setting means for setting the movement order, movement amount, and movement direction of the bone piece moving means based on the movement trajectory and movement amount of the bone piece set by the reduction simulation setting means. Based on the set movement trajectory and movement amount, it will move to the joint position and reduce it, the movement direction and movement force of the fractured bone fragment will be quantitative, and the skill will be almost constant regardless of the experience of the operator. Will not be deviation occurs in the complete cure period fracture treatment, as a result, it is possible to improve the workability and working efficiency of the reduction work to ensure quantitative properties in fracture reduction treatment.
【００４８】請求項２の発明の骨折整復誘導装置によれ
ば、骨折患部撮影手段を３次元の撮影画像を取得するＸ
線透視装置とし、このＸ線透視装置にマーカを付けて３
次元位置を計測する３次元計測装置を設け、骨折患部に
対して複数箇所の３次元撮影画像とマーカの３次元位置
・方向座標により整復に必要な範囲の骨全体の画像に作
成する画像処理手段を設けたので、患者の術部全体を把
握することで骨折の様子を適切に認識することができ
る。According to the fracture reduction guide device of the second aspect of the present invention, the bone fracture affected area photographing means is used to obtain a three-dimensional photographed image.
A fluoroscope is used, and a marker is attached to this X-ray fluoroscope.
An image processing unit that is provided with a three-dimensional measuring device that measures a three-dimensional position, and creates an image of the entire bone within a range necessary for reduction based on three-dimensional imaged images of a plurality of points and a three-dimensional position / direction coordinate of a marker with respect to a fracture affected part Since it is provided, it is possible to appropriately recognize the state of the fracture by grasping the entire surgical site of the patient.
【００４９】請求項３の発明の骨折整復誘導装置によれ
ば、画像処理手段は骨折患部の３次元画像に基づいて骨
片の分離を行って各骨片の３次元画像を作成し、整復シ
ミュレーション設定手段は骨片の３次元画像に基づいて
骨折断端の接合位置を指定するので、簡単な制御により
骨片の整合位置を設定することができる。According to the bone fracture reduction guide apparatus of the third aspect of the present invention, the image processing means separates the bone fragments based on the three-dimensional image of the affected part of the fracture to create a three-dimensional image of each bone fragment, and perform the reduction simulation. Since the setting means specifies the joint position of the fracture end based on the three-dimensional image of the bone fragment, the alignment position of the bone fragment can be set by simple control.
【００５０】請求項４の発明の骨折整復誘導装置によれ
ば、整復シミュレーション設定手段は骨折患部撮影手段
が撮影した撮影画像と予め記憶した骨正常位置とを比較
して骨折断端の接合位置を指定するので、簡単な制御に
より骨片の整合位置を適切に設定することができる。According to the fracture reduction guide device of the invention of claim 4, the reduction simulation setting means compares the photographed image photographed by the fracture affected part photographing means with the previously stored normal bone position to determine the joint position of the fracture end. Since it is designated, the alignment position of the bone fragment can be appropriately set by simple control.
【００５１】請求項５の発明の骨折整復誘導装置によれ
ば、骨片移動手段が保持した一方の骨片にマーカを付け
る骨片マーカ付着手段と、骨片マーカ付着手段が付けた
マーカの３次元位置を計測する３次元計測装置とを設
け、制御量設定手段は、３次元計測装置が測定したマー
カの移動軌跡及び移動量と、整復シミュレーション設定
手段が設定した骨片の移動軌跡及び移動量との誤差を検
出し、この誤差が所定値を越えたときには骨片移動手段
の補正量を設定するので、骨片移動手段による骨片移動
ルートの逸脱を早期に検出して適切な骨片の移動制御を
可能とすることができる。According to the bone fracture reduction guide apparatus of the fifth aspect of the present invention, there are three types of bone fragment marker attaching means for attaching a marker to one bone piece held by the bone piece moving means and marker attached by the bone piece marker attaching means. A three-dimensional measuring device for measuring a three-dimensional position is provided, and the control amount setting means has a marker moving locus and a moving amount measured by the three-dimensional measuring device and a bone fragment moving locus and a moving amount set by the reduction simulation setting means. Error is detected, and when this error exceeds a predetermined value, the correction amount of the bone fragment moving means is set, so that the deviation of the bone fragment moving route by the bone fragment moving means is detected early to detect an appropriate bone fragment. Movement control can be enabled.
【００５２】請求項６の発明の骨折整復誘導装置によれ
ば、整復シミュレーション設定手段は術者の手に装着さ
れるデータグローブを有し、術者は骨折患部撮影手段が
撮影した撮影画像に基づいてデータグローブを操作して
骨折断端の接合位置を指定して骨折位置から接合位置ま
での骨片の移動軌跡及び移動量を設定するので、骨片の
接合位置を適正に設定することができ、整復作業の作業
性及び作業効率を向上できる。According to the bone fracture reduction guide device of the sixth aspect of the invention, the reduction simulation setting means has a data glove to be attached to the hand of the operator, and the operator is based on the image taken by the bone fracture affected area imaging means. Operate the data glove to specify the joint position of the fracture stump and set the movement trajectory and movement amount of the bone fragment from the fracture position to the joint position, so that the joint position of the bone fragment can be set appropriately. The workability and work efficiency of the reduction work can be improved.
【００５３】請求項７の発明の骨折整復誘導装置によれ
ば、整復シミュレーション設定手段と制御量設定手段と
の間でデータを送受信可能なデータ送受信機を設けたの
で、熟練の術者が不在である遠隔地などの病院であって
も、骨折患部を適正に修復することができる。According to the bone fracture reduction guide device of the invention of claim 7, since a data transmitter / receiver capable of transmitting and receiving data between the reduction simulation setting means and the control amount setting means is provided, a skilled operator does not exist. Even in a hospital such as a remote place, it is possible to properly repair a fractured part.
【００５４】請求項８の発明の骨折整復誘導装置によれ
ば、制御量設定手段に音声指示装置を接続したので、骨
片移動手段による骨片移動ルートの逸脱に対して早期に
骨片の移動修正を可能とすることができる。According to the bone fracture reduction guide apparatus of the eighth aspect of the present invention, since the voice instruction device is connected to the control amount setting means, the bone fragments are moved early even if the bone fragment moving means deviates from the bone fragment moving route. Modifications may be possible.
【００５５】請求項９の発明の骨折整復誘導装置によれ
ば、制御量設定手段と音声指示装置との間でデータを送
受信可能なデータ送受信装置を設けたので、遠隔地より
熟練の術者が音声で指示することができる。According to the bone fracture reduction guide apparatus of the ninth aspect of the present invention, since the data transmitting / receiving apparatus capable of transmitting / receiving data between the control amount setting means and the voice instruction apparatus is provided, a skilled operator from a remote place can operate. You can give instructions by voice.
【００５６】請求項１０の発明の骨折整復方法によれ
ば、骨折患部を撮影し、撮影画像に基づいて骨折断端の
接合位置を指定し、骨折位置から接合位置までの骨片の
移動軌跡及び移動量を設定し、移動軌跡及び移動量に基
づいて牽引装置を作動して骨折患部を整復するようにし
たので、骨折した骨片の移動方向や移動力は定量的なも
のとなり、術者の経験に拘らずほぼ一定な技量となり、
骨折治療の完治期間にずれが生じることはなく、その結
果、骨折整復治療における定量性を確保して整復作業の
作業性及び作業効率を向上することができる。According to the fracture reduction method of the invention of claim 10, the affected part of the fracture is photographed, the joint position of the fracture end is designated based on the photographed image, and the movement locus of the bone fragment from the fracture position to the joint position and Since the movement amount is set and the traction device is operated based on the movement locus and the movement amount to reduce the fracture affected part, the movement direction and movement force of the fractured bone fragment become quantitative, and the operator's Regardless of experience, it will be almost constant skill,
There is no difference in the healing period of the bone fracture treatment, and as a result, it is possible to improve the workability and work efficiency of the reduction work by ensuring the quantification in the bone fracture reduction treatment.
【００５７】請求項１１の発明の骨折整復方法によれ
ば、骨折患部に対して複数箇所の撮影画像を取得し、複
数の撮影画像を座標変換して合成して３次元画像を作成
し、骨折患部の３次元画像に基づいて骨片の分離を行っ
て各骨片の３次元画像を作成し、骨片の３次元画像に基
づいて骨折断端の接合位置を指定するようにしたので、
患者の術部全体を把握することで骨折の様子を適切に認
識することができると共に、簡単な制御により骨片の整
合位置を設定することができる。According to the fracture reduction method of the eleventh aspect of the present invention, photographed images at a plurality of locations are acquired for the affected area of the bone fracture, the photographed images are coordinate-converted and synthesized to create a three-dimensional image, and the fracture is fractured. Since the bone fragments are separated based on the three-dimensional image of the affected part to create a three-dimensional image of each bone fragment, and the joint position of the fracture stump is specified based on the three-dimensional image of the bone fragment,
By grasping the entire surgical site of the patient, the state of the bone fracture can be appropriately recognized, and the alignment position of the bone fragment can be set by simple control.
【００５８】請求項１２の発明の骨折整復方法によれ
ば、牽引装置が保持した骨片にマーカを付け、骨片マー
カの３次元位置を常時計測して骨片マーカの移動軌跡及
び移動量と、骨片の移動軌跡及び移動量との誤差を検出
し、この誤差が所定値を越えたときには牽引装置を補正
制御するようにしたので、簡単な制御により骨片の整合
位置を適切に設定することができる。According to the bone fracture reduction method of the twelfth aspect of the present invention, a marker is attached to the bone fragment held by the traction device, the three-dimensional position of the bone fragment marker is constantly measured, and the movement trajectory and movement amount of the bone fragment marker are calculated. An error between the movement trajectory and the movement amount of the bone fragment is detected, and when the error exceeds a predetermined value, the traction device is corrected and controlled, so that the alignment position of the bone fragment is appropriately set by simple control. be able to.
【００５９】請求項１３の発明の骨折整復方法によれ
ば、骨折患部に対して複数箇所の撮影画像を取得し、複
数の撮影画像を座標変換して合成して３次元画像を作成
し、骨折患部の３次元画像に基づいて骨片の分離を行っ
て各骨片の３次元画像を作成し、術者は骨片の３次元画
像を見ながら手に装着したデータグローブを操作して骨
折断端の接合位置を指定し、骨折位置から接合位置まで
の骨片の移動軌跡及び移動量を設定するようにしたの
で、骨片の接合位置を適正に設定することができ、整復
作業の作業性及び作業効率を向上できる。According to the bone fracture reduction method of the thirteenth aspect of the present invention, captured images of a plurality of locations are acquired for the affected part of the fracture, and the captured images are coordinate-converted and combined to create a three-dimensional image. The bone fragments are separated based on the three-dimensional image of the affected area to create a three-dimensional image of each bone fragment, and the surgeon operates the data glove worn on the hand while viewing the three-dimensional image of the bone fragment to fracture the bone. The joint position of the end is specified, and the movement locus and movement amount of the bone fragment from the fracture position to the joint position are set, so the joint position of the bone fragment can be set appropriately, and the workability of the reduction work is improved. And work efficiency can be improved.
【図１】本発明の第１実施形態に係る骨折整復誘導装置
の概略構成図である。FIG. 1 is a schematic configuration diagram of a bone fracture reduction guide device according to a first embodiment of the present invention.
【図２】本実施形態の骨折整復誘導装置による整復方法
を表すフローチャートである。FIG. 2 is a flow chart showing a reduction method by the fracture reduction guide device of the present embodiment.
【図３】本実施形態の骨折整復誘導装置により整復方法
を表す概略図である。FIG. 3 is a schematic view showing a reduction method by the fracture reduction guide device of the present embodiment.
【図４】本実施形態の骨折整復誘導装置により整復方法
を表す概略図である。FIG. 4 is a schematic view showing a reduction method by the fracture reduction guide device of the present embodiment.
【図５】本実施形態の骨折整復誘導装置により整復方法
を表す概略図である。FIG. 5 is a schematic view showing a reduction method by the fracture reduction guide device of the present embodiment.
【図６】本発明の第２実施形態に係る骨折整復誘導装置
の概略構成図である。FIG. 6 is a schematic configuration diagram of a bone fracture reduction guide device according to a second embodiment of the present invention.
【図７】本発明の第３実施形態に係る骨折整復誘導装置
の概略構成図である。FIG. 7 is a schematic configuration diagram of a bone fracture reduction guide device according to a third embodiment of the present invention.
【図８】本発明の第４実施形態に係る骨折整復誘導装置
の概略構成図である。FIG. 8 is a schematic configuration diagram of a bone fracture reduction guide device according to a fourth embodiment of the present invention.
１１ Ｘ線透視装置（骨折患部撮影手段） １２ 骨片マーカ付着装置 １３ ３次元計測装置 １４ 画像処理装置 １５ 牽引装置（骨片移動手段） １６，２１ 整復シミュレーション設定手段 １７ 制御量設定装置 ２２ ディスプレイ ２３ データグローブ ２４ 演算装置 ３１，３２ データ送受信装置 ４１ 音声指示装置 11 X-ray Fluoroscope (Bone fracture affected area imaging means) 12 Bone fragment marker attachment device 13 Three-dimensional measuring device 14 Image processing device 15 Traction device (bone fragment moving means) 16,21 Reduction simulation setting means 17 Control amount setting device 22 Display 23 Data Grove 24 arithmetic unit 31, 32 data transceiver 41 Voice instruction device
───────────────────────────────────────────────────── フロントページの続き (71)出願人 596116765 田村 進一 兵庫県西宮市上ヶ原十番町１番16号 (72)発明者 鮫島 誠 兵庫県高砂市荒井町新浜二丁目１番１号 三菱重工業株式会社高砂研究所内 (72)発明者 古結 義浩 兵庫県高砂市荒井町新浜二丁目１番１号 三菱重工業株式会社高砂研究所内 (72)発明者 米延 策雄 兵庫県芦屋市西芦屋６番８号 (72)発明者 菅野 伸彦 大阪府吹田市桃山台３丁目33番３号 (72)発明者 田村 進一 兵庫県西宮市上ヶ原十番町１−16 (72)発明者 佐藤 嘉伸 大阪府吹田市千里山西２−１−46 (72)発明者 中島 義和 大阪府茨木市若園町32−１ ソフィア若園 603 Ｆターム(参考） 4C060 LL13 LL18 MM21 4C093 AA01 AA25 CA22 CA23 FF20 FF42 FG13 4C098 AA03 BB08 BB11 BC21 BC50 BD04 BD11 ─────────────────────────────────────────────────── ─── Continued front page (71) Applicant 596116765 Shinichi Tamura 16-16 Uegamiharajubancho, Nishinomiya-shi, Hyogo (72) Inventor Makoto Samejima 2-1-1 Niihama, Arai-cho, Takasago City, Hyogo Prefecture Takasago Laboratory, Mitsubishi Heavy Industries, Ltd. (72) Inventor Yoshihiro Furui 2-1-1 Niihama, Arai-cho, Takasago City, Hyogo Prefecture Takasago Laboratory, Mitsubishi Heavy Industries, Ltd. (72) Inventor Takuo Yonenobu 6-8 Nishi-Ashiya, Ashiya-shi, Hyogo (72) Inventor Nobuhiko Sugano 3-33-3-3 Momoyamadai, Suita City, Osaka Prefecture (72) Inventor Shinichi Tamura 1-16 Kamigaharajubancho, Nishinomiya-shi, Hyogo (72) Inventor Yoshinobu Sato 2-1-6 Senriyama Nishi, Suita City, Osaka Prefecture (72) Inventor Yoshikazu Nakajima 32-1 Wakaen-cho, Ibaraki-shi, Osaka Sofia Wakaen 603 F-term (reference) 4C060 LL13 LL18 MM21 4C093 AA01 AA25 CA22 CA23 FF20 FF42 FG13 4C098 AA03 BB08 BB11 BC21 BC50 BD04 BD11
Claims (13)
と、該骨折患部撮影手段が撮影した撮影画像に基づいて
骨折断端の接合位置を指定して骨折位置から該接合位置
までの骨片の移動軌跡及び移動量を設定する整復シミュ
レーション設定手段と、前記骨折患部における一方の骨
片に保持して移動可能な骨片移動手段と、前記整復シミ
ュレーション設定手段が設定した骨片の移動軌跡及び移
動量に基づいて前記骨片移動手段の移動順序、移動量、
移動方向を設定する制御量設定手段とを具えたことを特
徴とする骨折整復誘導装置。1. A bone fracture affected part photographing means for photographing a bone fracture affected part, and a joint position of a fracture end point is designated based on a photographed image photographed by the bone fracture affected part photographing means to determine a bone fragment from the bone fracture position to the joint position. Reduction simulation setting means for setting the movement trajectory and movement amount, bone piece moving means that can be held and moved on one bone piece in the fracture affected part, and movement trajectory and movement of the bone piece set by the reduction simulation setting means. The movement order of the bone piece moving means based on the amount, the movement amount,
A fracture reduction guide device comprising: a control amount setting means for setting a moving direction.
段を３次元の撮影画像を取得するＸ線透視装置とし、該
Ｘ線透視装置にマーカを付けて該マーカの３次元位置を
計測する３次元計測装置を設け、前記骨折患部に対して
複数箇所の３次元撮影画像と前記マーカの３次元位置・
方向座標により整復に必要な範囲の骨全体の画像に作成
する画像処理手段を設けたことを特徴とする骨折整復誘
導装置。2. The bone fracture affected part imaging means according to claim 1, wherein the device is an X-ray fluoroscope for acquiring a three-dimensional radiographic image, and a marker is attached to the X-ray fluoroscope to measure the three-dimensional position of the marker. A three-dimensional measuring device is provided, and three-dimensional imaged images of a plurality of locations and the three-dimensional position of the marker for the fractured part
An apparatus for reducing bone fracture reduction, comprising image processing means for creating an image of the entire bone within the range required for reduction using directional coordinates.
作成した骨折患部の３次元画像に基づいて骨片の分離を
行って各骨片の３次元画像を作成し、前記整復シミュレ
ーション設定手段は、該骨片の３次元画像に基づいて骨
折断端の接合位置を指定することを特徴とする骨折整復
誘導装置。3. The image processing means according to claim 2, wherein the bone fragments are separated based on the created three-dimensional image of the fracture affected part to create a three-dimensional image of each bone fragment, and the reduction simulation setting means. A fracture reduction guide device characterized by designating a joint position of a fracture edge based on a three-dimensional image of the bone fragment.
ション設定手段は、前記骨折患部撮影手段が撮影した撮
影画像と予め記憶した骨正常位置とを比較して前記骨折
断端の接合位置を指定することを特徴とする骨折整復誘
導装置。4. The reduction simulation setting means according to claim 1, wherein the joint position of the fracture end is designated by comparing a photographed image photographed by the fracture affected part photographing means with a bone normal position stored in advance. A fracture reduction guide device.
保持した一方の骨片にマーカを付ける骨片マーカ付着手
段と、該骨片マーカ付着手段が付けたマーカの３次元位
置を計測する３次元計測装置とを設け、前記制御量設定
手段は、該３次元計測装置が測定したマーカの移動軌跡
及び移動量と、前記整復シミュレーション設定手段が設
定した骨片の移動軌跡及び移動量との誤差を検出し、こ
の誤差が所定値を越えたときには前記骨片移動手段の補
正量を設定することを特徴とする骨折整復誘導装置。5. The bone piece marker attaching means for attaching a marker to one bone piece held by the bone piece moving means, and the three-dimensional position of the marker attached by the bone piece marker attaching means according to claim 1. A three-dimensional measuring device is provided, and the control amount setting means includes a moving locus and a moving amount of the marker measured by the three-dimensional measuring device and a moving locus and a moving amount of the bone fragment set by the reduction simulation setting means. A bone fracture reduction guide device, which detects an error and sets a correction amount of the bone fragment moving means when the error exceeds a predetermined value.
ション設定手段は、術者の手に装着されるデータグロー
ブを有し、該術者は前記骨折患部撮影手段が撮影した撮
影画像に基づいて該データグローブを操作して骨折断端
の接合位置を指定して骨折位置から該接合位置までの骨
片の移動軌跡及び移動量を設定することを特徴とする骨
折整復誘導装置。6. The reduction simulation setting means according to claim 1, wherein the reduction simulation setting means has a data glove attached to an operator's hand, and the operator uses the data based on an image taken by the fracture affected part imaging means. A bone fracture reduction guide device characterized in that a glove is operated to specify a joint position of a fracture end and a movement locus and a movement amount of a bone fragment from the fracture position to the joint position are set.
ション設定手段と前記制御量設定手段との間でデータを
送受信可能なデータ送受信機を設けたことを特徴とする
骨折整復誘導装置。7. The fracture reduction guide device according to claim 6, further comprising a data transceiver capable of transmitting and receiving data between the reduction simulation setting means and the control amount setting means.
に音声指示装置を接続したことを特徴とする骨折整復誘
導装置。8. The bone fracture reduction guide device according to claim 1, wherein a voice instruction device is connected to the control amount setting means.
と前記音声指示装置との間でデータを送受信可能なデー
タ送受信装置を設けたことを特徴とする骨折整復誘導装
置。9. The bone fracture reduction guide device according to claim 8, further comprising a data transmission / reception device capable of transmitting / receiving data between the control amount setting means and the voice instruction device.
いて骨折断端の接合位置を指定し、骨折位置から該接合
位置までの骨片の移動軌跡及び移動量を設定し、該移動
軌跡及び移動量に基づいて牽引装置を操作して前記骨折
患部を整復することを特徴とする骨折整復方法。10. A bone fracture affected area is imaged, a joint position of a fracture edge is designated based on the photographed image, a movement locus and a movement amount of a bone fragment from the fracture position to the joint position are set, and the movement locus And a method for reducing a fracture by operating a traction device based on the movement amount to reduce the affected part of the fracture.
対して複数箇所の３次元撮影画像を取得し、該複数箇所
の撮影画像を座標変換して合成して述部全体の３次元画
像を作成し、該骨折患部の３次元画像に基づいて骨片の
分離を行い、該骨片の３次元画像に基づいて骨折断端の
接合位置を指定することを特徴とする骨折整復方法。11. The three-dimensional image of a predicate as a whole according to claim 10, wherein three-dimensional imaged images of a plurality of locations are acquired with respect to the fracture affected area, and the imaged images of the plurality of locations are coordinate-transformed and combined. Then, a bone fragment is separated based on the three-dimensional image of the affected part of the fracture, and the joint position of the fracture end is designated based on the three-dimensional image of the bone fragment.
保持した骨片にマーカを付け、該骨片マーカの３次元位
置を常時計測して該骨片マーカの移動軌跡及び移動量
と、前記骨片の移動軌跡及び移動量との誤差を検出し、
この誤差が所定値を越えたときには前記牽引装置を補正
操作することを特徴とする骨折整復方法。12. The bone fragment held by the traction device according to claim 10, wherein a marker is attached, and the three-dimensional position of the bone fragment marker is constantly measured to measure a movement locus and a movement amount of the bone fragment marker, and the bone. Detects the error between the movement locus and movement amount of one piece,
A method for reducing bone fracture, characterized in that when the error exceeds a predetermined value, the traction device is corrected.
対して複数箇所の撮影画像を取得し、該複数の撮影画像
を座標変換して合成して３次元画像を作成し、該骨折患
部の３次元画像に基づいて骨片の分離を行って各骨片の
３次元画像を作成し、術者は該骨片の３次元画像を見な
がら手に装着したデータグローブを操作して骨折断端の
接合位置を指定し、骨折位置から該接合位置までの骨片
の移動軌跡及び移動量を設定することを特徴とする骨折
整復方法。13. The method according to claim 10, wherein a plurality of photographed images of the fractured part are acquired, the coordinates of the plurality of photographed images are coordinate-converted and combined to create a three-dimensional image. The bone fragments are separated based on the three-dimensional image to create a three-dimensional image of each bone fragment, and the operator operates the data glove attached to the hand while observing the three-dimensional image of the bone fragment and A fracture reduction method characterized by specifying a joint position and setting a movement locus and a movement amount of a bone fragment from the fracture position to the joint position.
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