JP2014057649A - Medical chisel - Google Patents

Medical chisel Download PDF

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JP2014057649A
JP2014057649A JP2012203246A JP2012203246A JP2014057649A JP 2014057649 A JP2014057649 A JP 2014057649A JP 2012203246 A JP2012203246 A JP 2012203246A JP 2012203246 A JP2012203246 A JP 2012203246A JP 2014057649 A JP2014057649 A JP 2014057649A
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blade
screw
medical
head
callus
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JP5174983B1 (en
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Hidekazu Machida
英一 町田
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TAMA MEDICAL KK
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TAMA MEDICAL KK
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Abstract

PROBLEM TO BE SOLVED: To easily cut and remove a callus formed on the head of a medical screw.SOLUTION: A medical chisel 10 includes a T-shaped grip part 10a, a bar body part 10b, and blade parts 10c. A plurality of thin and tongue piece-like blade parts 10c having corners are arranged on a tip of the bar body part 10b in a circumferential direction. The blade parts 10c, for which springy and restorable metal is used, expand outward by being brought into contact with and pressed against a head of a screw. By rotating the blade parts 10c expanded outward, a callus formed on the head of the screw can be cut as if peeled from the circumferential direction, which allows the callus to be efficiently removed.

Description

本発明は、例えば骨に埋め込んだ医療用スクリューの頭部に形成された仮骨等を除去するために使用する医療用のみに関するものである。   The present invention relates only to medical use, for example, for removing a callus formed on the head of a medical screw embedded in a bone.

医療用スクリュー１は医療分野で骨の接合のために使用されている。図９に示すようにスクリュー１の頭部１ａに設けた回転操作部１ｂと螺合するドライバ等の回転治具２を用いて、先端部２ａによりスクリュー１の外ねじ部１ｃを骨折部位Ａを含む骨Ｂに捩じ込むことにより、スクリュー１を骨折部位Ａを貫通させる処理を行う。そして、スクリュー１の頭部１ａが骨皮質面Ｃに到達すると、骨折部位Ａは固定されたことになり接合処理を完了する。   The medical screw 1 is used for joining bones in the medical field. As shown in FIG. 9, by using a rotation jig 2 such as a screwdriver that is screwed with a rotation operation unit 1 b provided on the head 1 a of the screw 1, the external threaded portion 1 c of the screw 1 is removed from the fracture site A by the tip 2 a. The screw 1 is passed through the fracture site A by being screwed into the bone B including it. When the head 1a of the screw 1 reaches the bone cortical surface C, the fracture site A is fixed and the joining process is completed.

接合処理から数ヶ月経過すると骨折部位Ａが癒合するので、不要となったスクリュー１を取り出す処理を行う。皮膚Ｄ、皮下組織Ｅを切開した後に、再び回転治具２の先端部２ａをスクリュー１の回転操作部１ｂに嵌合し、回転治具２を反時計回りに回転させることで、捩じ込んだ外ねじ部１ｃを緩めて骨Ｂからスクリュー１を抜き出す。   When several months have passed since the joining process, the fracture site A is healed. After incising the skin D and the subcutaneous tissue E, the tip 2a of the rotating jig 2 is again fitted into the rotating operation unit 1b of the screw 1, and the rotating jig 2 is rotated counterclockwise to be screwed in. The outer screw 1c is loosened and the screw 1 is extracted from the bone B.

しかし、接合処理から数ヶ月経過すると、スクリュー１の頭部１ａの近傍に新しく仮骨Ｆが形成される。人によっては図１０に示すように頭部１ａを覆うように仮骨Ｆが形成される場合もあり、この場合には仮骨Ｆによりスクリュー１の頭部１ａが固定されてしまい、頭部１ａ周辺の仮骨Ｆを除去しない限り、回転治具２によりスクリュー１を抜き出すことができない。   However, when several months have passed since the joining process, a new callus F is formed in the vicinity of the head 1a of the screw 1. Depending on the person, the callus F may be formed so as to cover the head 1a as shown in FIG. 10. In this case, the head 1a of the screw 1 is fixed by the callus F, and the head 1a. Unless the peripheral callus F is removed, the screw 1 cannot be extracted by the rotating jig 2.

そこで、仮骨Ｆが過剰に形成された場合の頭部１ａ上の仮骨Ｆを除去するために、特許文献１に記載された図１１に示すようなオステムトーム、チゼル、骨鑿等と呼ばれる切削治具３を使用することがある。この切削治具３の筒状の先端部３ａには、仮骨Ｆを切削、除去できるように鋸歯状の刃部３ｂが円環状に設けられている。   Therefore, in order to remove the callus F on the head 1a when the callus F is excessively formed, cutting called an ostem tome, chisel, urn as shown in FIG. A jig 3 may be used. The cylindrical tip 3a of the cutting jig 3 is provided with a serrated blade 3b in an annular shape so that the callus F can be cut and removed.

仮骨Ｆを取り除くには、図１２に示すように先ずスクリュー１の頭部１ａの上方の皮膚Ｄ等を開口した後に、切削治具３を下降させながら、スクリュー１の頭部１ａ付近に形成された仮骨Ｆに当接させる。そして、切削治具３を頭部１ａに押し付けながら回転させることで、刃部３ｂにより仮骨Ｆを切削、除去する。切削治具３を体内から抜き出した後に、回転治具２によりスクリュー１を骨Ｂ内から抜き取る。   In order to remove the callus F, as shown in FIG. 12, first, the skin D and the like above the head 1a of the screw 1 is opened, and then the cutting jig 3 is lowered and formed near the head 1a of the screw 1. It is made to contact | abut to the made callus F. And the callus F is cut and removed by the blade part 3b by rotating the cutting jig 3 while pressing it against the head 1a. After extracting the cutting jig 3 from the body, the screw 1 is extracted from the bone B by the rotating jig 2.

特開２００７−２９５６６号公報JP 2007-29566 A

しかし、仮骨Ｆが過剰に形成されると、これを取り除くために径の大きな切削治具を必要とし、スクリュー１の頭部１ａと同程度の大きさに切開しなければならず、切口が大きくなるため切口が治癒するまでに時間がかかるという問題がある。   However, if the callus F is excessively formed, a cutting tool having a large diameter is required to remove the callus F, and the incision must be made in the same size as the head 1 a of the screw 1. There is a problem that it takes time for the cut to heal because it becomes large.

また、スクリュー１の頭部１ａを覆うように形成された仮骨Ｆは、頭部１ａの表面に沿うように治具を挿入した場合は容易に剥がれるが、図１２に示すような切削治具３は仮骨Ｆを上方から粉砕しながら仮骨Ｆを掘削する場合は、容易に頭部１ａの円周の仮骨Ｆを除去できないという問題点もある。   Further, the callus F formed so as to cover the head 1a of the screw 1 is easily peeled off when a jig is inserted along the surface of the head 1a, but a cutting jig as shown in FIG. 3 has a problem that when the callus F is excavated while the callus F is crushed from above, the callus F around the circumference of the head 1a cannot be easily removed.

本発明の目的は、上述の問題点を解消し、棒体部の先端は細く、複数枚の刃部はスクリューの頭部に当接することで刃部が外側に広がり、引き出しに際しては刃部がすぼまる医療用のみを提供することにある。   The object of the present invention is to eliminate the above-mentioned problems, the tip of the rod body portion is thin, the plurality of blade portions abut on the head of the screw, the blade portion spreads outward, and the blade portion is pulled out when being pulled out. The purpose is to provide medical care only.

上記課題点を解決するための本発明に係る医療用のみは、把持部と棒体部とから成り、弾発性及び復元性を有する金属製の角部を有する複数枚の舌片状の刃部を前記棒体部の先端部の円周方向に沿って下方に向けて略円筒状に配置したことを特徴とする。   In order to solve the above-mentioned problems, only the medical use according to the present invention is composed of a gripping portion and a rod portion, and a plurality of tongue-like blades having metallic corners having elasticity and resilience The portion is arranged in a substantially cylindrical shape facing downward along the circumferential direction of the distal end portion of the rod body portion.

本発明に係る医療用のみによれば、複数の舌片状の刃部が、スクリューの頭部に当接し、押し付けることで外側に広がる。スクリューの頭部の表面に沿うように外側に拡がった刃部を回転させることで、仮骨を剥がすように掘削することが可能となる。これにより、スクリューの頭部を覆うように形成された仮骨を効率的に除去することができる。   According to only the medical use according to the present invention, the plurality of tongue-shaped blade portions are in contact with the head portion of the screw and spread outward by pressing. By rotating the blade portion that spreads outward along the surface of the head of the screw, it is possible to excavate so as to peel off the callus. Thereby, the callus formed so that the head of a screw may be covered can be removed efficiently.

また、刃部が広がるので、刃部を支持する棒体部は従来の切削治具に比べて細くすることが可能である。そのため、皮膚、皮下組織に切開する切口を小さくすることができ、皮膚、皮下組織への負担を軽減できる。   Further, since the blade portion is widened, the rod body portion that supports the blade portion can be made thinner than a conventional cutting jig. Therefore, the cut incised into the skin and subcutaneous tissue can be reduced, and the burden on the skin and subcutaneous tissue can be reduced.

更に、刃部は弾発性及び復元性を有する金属から成るため、刃部をスクリューの頭部に押し付けることで広げられた形状は、引き抜く際には元の形状に戻っている。   Furthermore, since the blade portion is made of a metal having elasticity and resilience, the shape widened by pressing the blade portion against the head of the screw returns to the original shape when the blade portion is pulled out.

実施例１の医療用のみの（ａ）正面図及び（ｂ）側面図である。It is (a) front view and (b) side view only for medical use of Example 1. 使用前又は使用後の刃部の拡大斜視図である。It is an expansion perspective view of the blade part before use or after use. 医療用スクリューの斜視図である。It is a perspective view of a medical screw. 使用中の刃部の拡大斜視図である。It is an expansion perspective view of the blade part in use. 医療用のみを挿し込んだ状態の説明図である。It is explanatory drawing of the state which inserted only medical use. 医療用のみの変形例の先端の断面拡大図である。It is a cross-sectional enlarged view of the front-end | tip of the modification only for medical uses. 実施例２の刃部の（ａ）使用前又は使用後、（ｂ）使用中の拡大斜視図である。(A) Before or after use of the blade part of Example 2, (b) It is an expansion perspective view in use. 実施例２先端が幅広の刃部の（ａ）使用前又は使用後、（ｂ）使用中の拡大斜視図である。Example 2 (a) Before and after use of a blade part having a wide tip, (b) is an enlarged perspective view during use. 骨に医療用スクリューを捩じ込んだ状態の説明図である。It is explanatory drawing of the state which screwed the medical screw into the bone. 医療用スクリューの頭部に仮骨が形成された状態の説明図である。It is explanatory drawing of the state by which the callus was formed in the head of a medical screw. 従来の切削治具の正面図である。It is a front view of the conventional cutting jig. 従来の切削治具の使用中の断面図である。It is sectional drawing in use of the conventional cutting jig.

本発明を図１〜図８に図示の実施例に基づいて詳細に説明する。   The present invention will be described in detail based on the embodiment shown in FIGS.

図１（ａ）は医療用のみ１０の正面図であり、（ｂ）は側面図である。医療用のみ１０はＴ字状の把持部１０ａと、中空状の円筒部から成る棒体部１０ｂと、棒体部１０ｂの先端に設けた刃部１０ｃとから構成されている。把持部１０ａはＴ字状にすることにより、回転が容易で力を入れ易くなる。なお、把持部１０ａは通常のドライバの握り部のような形状であってもよい。   Fig.1 (a) is a front view of the medical use 10 only, (b) is a side view. The medical only 10 includes a T-shaped gripping portion 10a, a rod body portion 10b made of a hollow cylindrical portion, and a blade portion 10c provided at the tip of the rod body portion 10b. By making the holding part 10a T-shaped, it is easy to rotate and to apply force. Note that the gripping portion 10a may be shaped like a grip portion of a normal driver.

図２は医療用のみ１０の先端部１０ｄの使用前又は使用後の斜視図である。先端部１０ｄの円周方向に沿って複数個の金属製の刃部１０ｃが溶接等により下方に向けて略円筒状に配置されている。実施例では、６枚の刃部１０ｃを取り付けているが、枚数は適宜に変更することができる。刃部１０ｃには弾発性及び復元性を有する金属が用いられており、超弾性合金であることが更に好ましい。   FIG. 2 is a perspective view of the tip portion 10d of the medical only 10 before or after use. A plurality of metal blade portions 10c are arranged in a substantially cylindrical shape downward by welding or the like along the circumferential direction of the tip portion 10d. In the embodiment, six blade portions 10c are attached, but the number can be changed as appropriate. The blade portion 10c is made of a metal having elasticity and resilience, and is more preferably a superelastic alloy.

各刃部１０ｃは角部を有する薄い舌片状であり、長手方向に沿って先端が外側を向いた緩やかなＳ字状の曲面とされている。このようにＳ字状にすることにより、挿入時に刃部１０ｃにより皮下組織Ｅへの引っ掛かり難くなると共に、医療用スクリューの頭部に当接すると外側に広がり易くなる。   Each blade portion 10c has a thin tongue-like shape having a corner portion, and is a gentle S-shaped curved surface with the tip facing outward along the longitudinal direction. By making it S-shaped in this way, it becomes difficult to be caught on the subcutaneous tissue E by the blade portion 10c at the time of insertion, and when it comes into contact with the head of the medical screw, it tends to spread outward.

また、平常時の刃部１０ｃの先端同士を結ぶ略円形の包絡線の径は、棒体部１０ｂの水平断面の径よりも小さくすることが好ましく、スクリュー１１の回転操作部１１ｄの径よりも若干大きくなっている。   Moreover, it is preferable that the diameter of the substantially circular envelope connecting the tips of the blade portions 10c in the normal state is smaller than the diameter of the horizontal section of the rod body portion 10b, and is larger than the diameter of the rotation operation portion 11d of the screw 11. Slightly larger.

図３は骨折した骨Ｂの接合に使用する医療用スクリュー１１の斜視図である。チタン等の金属材料により製作したスクリュー１１の先端部１１ａには、外表面に外ねじ部１１ｂが形成されている。頭部１１ｃには断面六角形の穴状の回転操作部１１ｄが設けられ、この回転操作部１１ｄにドライバ等の回転治具の先端部を嵌め込んで回転させることで、スクリュー１１の骨Ｂ内への捩じ込み及び抜き出し作業を行う。   FIG. 3 is a perspective view of the medical screw 11 used for joining the fractured bone B. FIG. An outer thread portion 11b is formed on the outer surface of the tip portion 11a of the screw 11 made of a metal material such as titanium. The head 11c is provided with a rotary operation portion 11d having a hexagonal cross section, and the rotation operation portion 11d is fitted with a distal end portion of a rotary jig such as a driver to be rotated, so that the inside of the bone B of the screw 11 Perform screwing and unloading work.

また、スクリュー１１の頭部１１ｃの頂面は緩やかな円弧状とされている。この形状により、医療用のみ１０の刃部１０ｃが頭部１１ｃの頂面に接した際に、自然に刃部１０ｃの先端は外側に広がることになる。   Further, the top surface of the head 11c of the screw 11 has a gentle arc shape. With this shape, when the blade 10c for medical use only 10 is in contact with the top surface of the head 11c, the tip of the blade 10c naturally spreads outward.

スクリュー１１は長さ、大きさ等の違いにより複数種が用意されており、指骨、大腿骨等の骨折時の部位の大きさ、骨折個所により適宜に使い分けて使用される。   A plurality of types of screws 11 are prepared depending on differences in length, size, etc., and they are properly used depending on the size of the fractured part such as the phalange and femur and the location of the fracture.

スクリュー１１の頭部１１ｃを覆う仮骨を切削するには、医療用のみ１０の刃部１０ｃを頭部１１ｃに押し付けると、刃部１０ｃは自然に図４に示すように外側に広がる。広がった状態の刃部１０ｃの先端は、頭部１１ｃの円弧状の表面に沿うようにして、頭部１１ｃに形成された仮骨Ｆに接することになる。   In order to cut the callus covering the head portion 11c of the screw 11, when the blade portion 10c for medical use only is pressed against the head portion 11c, the blade portion 10c naturally spreads outward as shown in FIG. The distal end of the blade portion 10c in the spread state is in contact with the callus F formed on the head portion 11c so as to follow the arcuate surface of the head portion 11c.

刃部１０ｃを仮骨Ｆに押し付けながらＴ字状の把持部１０ａを持って棒体部１０ｂを回転させることで、図５に示すように刃部１０ｃの先端の拡がった角部によって、スクリュー１１の抜き出しの邪魔になる仮骨Ｆを円周方向から剥がすように切削除去を行う。   By rotating the rod body portion 10b while holding the T-shaped gripping portion 10a while pressing the blade portion 10c against the callus F, the screw 11 is rotated by the corner portion where the tip of the blade portion 10c is widened as shown in FIG. Cutting and removal are performed so as to peel off the callus F that obstructs the extraction from the circumferential direction.

仮骨Ｆを切削除去した後に、医療用のみ１０を引き抜く際は、広がった刃部１０ｃは図２の形状に復元するため、引っ掛かることなく容易に引き抜くことができる。医療用のみ１０を体内から引き抜いた後に、医療用のみ１０の棒体部１０ｂと先端部の径が同等であるドライバ等の回転治具を挿入して、スクリュー１１を緩めながら抜き出すことで体内からスクリュー１１を取り出す。取り出す際にスクリュー１１の頭部１１ｃは、ゴムのように伸びる皮膚Ｄ及び皮下組織Ｅを押し広げながら体外へ引き出される。   When the medical bone 10 is pulled out after cutting off the callus F, the widened blade portion 10c is restored to the shape shown in FIG. 2 and can be easily pulled out without being caught. After the medical only 10 is pulled out from the body, a rotating jig such as a screwdriver whose diameter is the same as the rod 10b of the medical only 10 is inserted, and the screw 11 is pulled out while loosening from the body. Remove the screw 11. At the time of taking out, the head 11c of the screw 11 is pulled out of the body while pushing the skin D and the subcutaneous tissue E extending like rubber.

図６は変形例の医療用のみ１０の先端部１０ｄの拡大断面図であり、複数枚の刃部１０ｃは弾発性及び復元性を有する金属から成る円筒状の棒体部１０ｂから切り出されることで製造されている。   FIG. 6 is an enlarged cross-sectional view of the distal end portion 10d of the medical use only 10 of the modified example, and the plurality of blade portions 10c are cut out from a cylindrical rod body portion 10b made of a metal having elasticity and resilience. Manufactured by.

図７（ａ）は実施例２の医療用のみ２０の棒体部２０ｂの先端部に設けた刃部２０ｃの使用前又は使用後の斜視図、図７（ｂ）はスクリュー１１の頭部１１ｃに当接して使用中の拡大斜視図を示している。先端部２０ｄに固定された弾発性、復元性を有する金属から成る複数枚の刃部２０ｃの先端は鋸歯刃２０ｅとされている。   FIG. 7A is a perspective view before or after use of the blade portion 20c provided at the distal end portion of the rod portion 20b of the medical-only 20 of Example 2, and FIG. 7B is a head portion 11c of the screw 11. An enlarged perspective view in use is shown in contact with FIG. The tips of a plurality of blade portions 20c made of a metal having elasticity and resilience fixed to the tip portion 20d are sawtooth blades 20e.

刃部２０ｃに鋸歯刃２０ｅを設けることで、棒体部２０ｂの回転時に、鋸歯刃２０ｅを使用して仮骨Ｆをより多くの尖り部で掘削できるので、更に効率的な仮骨Ｆの掘削が可能となる。   By providing the saw blade 20e in the blade portion 20c, the callus F can be excavated with more sharp portions using the saw blade 20e when the rod body portion 20b is rotated. Is possible.

更に、刃部２０ｃは先端に近付くにつれて幅が広くなるようにしてもよい。即ち、図８（ａ）は先端が幅広の医療用のみ２０の刃部２０ｃの使用前又は使用後の斜視図、（ｂ）はスクリュー１１の頭部１１ｃに当接して使用中の拡大斜視図を示している。刃部２０ｃの先端の幅を広くすることにより、鋸歯刃２０ｅの鋸歯の数が増えるため、より効率的に仮骨Ｆを掘削することができる。   Further, the blade portion 20c may be widened as it approaches the tip. That is, FIG. 8A is a perspective view before or after use of the blade portion 20c having a wide tip 20 for medical use only, and FIG. 8B is an enlarged perspective view in contact with the head portion 11c of the screw 11 in use. Is shown. By increasing the width of the tip of the blade portion 20c, the number of saw blades of the saw blade 20e increases, so that the callus F can be excavated more efficiently.

１０、２０ 医療用のみ
１０ａ 把持部
１０ｂ、２０ｂ 棒体部
１０ｃ、２０ｃ 刃部
１１ 医療用スクリュー
２０ｅ 鋸歯刃 10, 20 Medical only 10a Grasping part 10b, 20b Rod part 10c, 20c Blade part 11 Medical screw 20e Saw blade

Claims (6)

把持部と棒体部とから成り、弾発性及び復元性を有する金属製の角部を有する複数枚の舌片状の刃部を前記棒体部の先端部の円周方向に沿って下方に向けて略円筒状に配置したことを特徴とする医療用のみ。   A plurality of tongue-shaped blade portions each having a gripping portion and a rod portion and having a metal corner portion having elasticity and resilience are lowered along the circumferential direction of the tip end portion of the rod portion. Only for medical use characterized by being arranged in a substantially cylindrical shape toward the head. 前記刃部は長手方向に沿って先端が外側を向いたＳ字状の曲面となるように形成したことを特徴とする請求項１に記載の医療用のみ。   The medical blade according to claim 1, wherein the blade portion is formed so as to be an S-shaped curved surface with a distal end facing outward along a longitudinal direction. 複数枚の前記刃部の先端同士を結ぶ略円形の包絡線の径は、前記棒体部の径よりも小さいことを特徴する請求項１又２に記載の医療用のみ。   The medical use according to claim 1 or 2, wherein a diameter of a substantially circular envelope connecting the tips of the plurality of blade portions is smaller than a diameter of the rod portion. 前記各刃部の先端に鋸歯刃を形成したことを特徴する請求項１〜３の何れか１つの請求項に記載の医療用のみ。   The medical use according to any one of claims 1 to 3, wherein a saw blade is formed at a tip of each blade portion. 前記各刃部は先端に近付くにつれて幅が広くなることを特徴とする請求項１〜４の何れか１つの請求項に記載の医療用のみ。   Each said blade part becomes wide as it approaches a front-end | tip, The medical use only as described in any one of Claims 1-4 characterized by the above-mentioned. 前記刃部は超弾性合金としたことを特徴とする請求項１〜５の何れか１つの請求項に記載の医療用のみ。   The medical blade according to any one of claims 1 to 5, wherein the blade portion is a superelastic alloy.
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