JP2019111136A - Surgical instrument - Google Patents

Surgical instrument Download PDF

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JP2019111136A
JP2019111136A JP2017246975A JP2017246975A JP2019111136A JP 2019111136 A JP2019111136 A JP 2019111136A JP 2017246975 A JP2017246975 A JP 2017246975A JP 2017246975 A JP2017246975 A JP 2017246975A JP 2019111136 A JP2019111136 A JP 2019111136A
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holding
slider
surgical
longitudinal direction
spring
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JP7005336B2 (en
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加藤　弘一
Koichi Kato
弘一 加藤
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Kyocera Corp
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Abstract

To provide a surgical instrument in which holding of a surgical member is hardly released, even when receiving strong impact in an instrument longitudinal direction.SOLUTION: A broach handle 10 being a surgical instrument comprises: a holding tool body 1 which is a first member; a holding tool sub body 2 for operation which is a second member; and a first pin 3 and a second pin 4 as coupling shaft members for coupling the holding tool body 1 and the holding tool sub body 2 so as to relatively rotate. The holding tool body 1 has a first holding part 1a for holding a surgical member at one end part thereof, the holding tool sub body 2 has a second holding part 2a for sandwiching the surgical member between itself and the first holding part for holding the surgical member. At least one of the holding tool body 1 and holding tool sub boody 2 forming the surgical instrument has a lock mechanism composed of a slider 5, a spring 6, and a spring receiver 7 being arranged at a position closer to the other end part side than the coupling shaft members. The lock mechanism restricts relative rotation of the holding tool body 1 and holding tool sub body 2.SELECTED DRAWING: Figure 1

Description

本発明は、手術用部材を保持するための手術用器具に関する。   The present invention relates to a surgical instrument for holding a surgical member.

関節の一部または全部を人工関節に置換する人工関節置換術等においては、ステム等の埋入部材用の外形に沿った穴または孔を骨の髄腔内に形成するために、のこぎり状の切削刃を有するステムブローチや、リーマ、やすり等の切削工具が用いられる。また、これら切削工具等の手術用部材は、施術中、適正な位置や姿勢を保持するために、ハンドルやアダプタ等と呼ばれる、手術用部材を保持する手術用器具に取り付けて使用される。   In an artificial joint replacement or the like in which a part or all of a joint is replaced with an artificial joint, a saw-like shape is formed to form a hole or a hole along the outer shape for a implant member such as a stem. A stem broach having a cutting edge, or a cutting tool such as a reamer or a file is used. In addition, surgical members such as these cutting tools are attached to a surgical instrument for holding a surgical member, such as a handle or an adapter, in order to maintain an appropriate position and posture during treatment.

たとえば、このような手術用器具の一例として、特許文献１，２には、大腿骨の髄腔内にステム埋入孔を形成するためのステムブローチ（以下、ブローチ）を、その一端に配設されたかぎ状の係合部に嵌合させて保持する、ブローチハンドルが開示されている。   For example, as an example of such a surgical instrument, in Patent Literatures 1 and 2, a stem broach (hereinafter referred to as broach) for forming a stem implantation hole in the intrathecal space of a femur is disposed at one end thereof A broach handle is disclosed which fits and holds in a hook-like engagement.

ブローチを一端に保持したブローチハンドルは、ブローチが取り付けられていない側の他端（後端部）をハンマーで叩いて使用される。大腿骨の髄腔に打ち込まれたブローチは、これを引き抜く際、ブローチの外周に形成された、のこぎり状の切刃が、大腿骨の髄腔の内面を削り取ることによって、この大腿骨の髄腔内に、ステムの外形に沿った形状の埋入孔を形成する。   The broach handle which holds the broach at one end is used by striking the other end (rear end portion) on the side where the broach is not attached with a hammer. When the broach driven into the marrow cavity of the femur is pulled out, a saw-like cutting edge formed on the outer periphery of the broach scrapes the inner surface of the marrow cavity of the femur, thereby cutting the marrow cavity of the femur. Inside, an implantation hole of a shape along the outer shape of the stem is formed.

特開２０１６−１６０５６号公報JP, 2016-16056, A 特開２０１７−６４０６９号公報JP, 2017-64069, A

ところで、前述のブローチハンドル等の手術用器具は、ブローチを髄腔内に打ち込んだ後、該ブローチを、髄腔外である上方向に引き抜く際にも用いられる。この引き抜きの際、ブローチハンドルにおける保持部とは反対側の他端に衝撃を与えると、その衝撃の力によって、一端部に保持されたブローチの保持が開放され、ブローチが手術用器具から脱落してしまう場合があった。   By the way, the surgical instrument such as the broach handle described above is also used when the broach is driven into the intrathecal space and then the broach is pulled out, which is the extramedullary space. During this extraction, when an impact is applied to the other end of the broach handle on the opposite side of the holding portion, the force of the impact releases the holding of the broach held at one end, and the broach drops out of the surgical instrument There was a case that

なお、上記の問題は、ブローチハンドルに限るものではなく、人工関節置換術や他の施術で使用される、手術用部材を保持する手術用器具のなかで、衝撃を繰り返し受けることの多い手術用器具全般において、同様に発生する問題である。   The above problem is not limited to the broach handle, and is used in artificial joint replacement and other procedures, among surgical instruments holding a surgical member, for surgical operations that often receive repeated impacts. The same is a problem that occurs in instruments in general.

本発明の目的は、器具長手方向に強い衝撃を受けた場合でも、手術用部材の保持が開放されにくい手術用器具を提供することである。   An object of the present invention is to provide a surgical instrument in which the holding of the surgical member is difficult to release even when a strong impact is received in the longitudinal direction of the instrument.

本開示の手術用器具は、一端に手術用部材を保持可能な手術用器具であって、
第１部材および第２部材と、
前記第１部材と前記第２部材とを連結する連結部材と、を備え、
前記連結部材は、前記第１部材と前記第２部材とを相対的に回転可能に連結しており、
前記第１部材は、その一端部に、前記手術用部材を保持するための第１保持部を有し、
前記第２部材は、その一端部に、前記第１保持部との間に前記手術用部材を保持する第２保持部を有し、
前記第１部材または前記第２部材の少なくとも一方は、前記連結部材よりもそれぞれの他端部側の位置に、前記第１部材と前記第２部材との相対的な回転を制限するロック機構を有することを特徴とする。 The surgical instrument of the present disclosure is a surgical instrument capable of holding a surgical member at one end,
A first member and a second member,
And a connecting member for connecting the first member and the second member,
The connecting member rotatably connects the first member and the second member relative to each other,
The first member has, at one end thereof, a first holding portion for holding the surgical member,
The second member has, at one end thereof, a second holding portion for holding the surgical member between the second holding portion and the first holding portion.
At least one of the first member or the second member has a lock mechanism for limiting relative rotation between the first member and the second member at a position closer to the other end than the coupling member. It is characterized by having.

本開示によれば、器具長手方向に強い衝撃を受けた場合でも、手術用部材の保持が開放されにくい手術用器具とすることができる。   According to the present disclosure, it is possible to provide a surgical instrument in which the holding of the surgical member is unlikely to be released even when a strong impact is received in the longitudinal direction of the instrument.

本発明の実施形態の手術用器具の分解斜視図である。It is an exploded perspective view of a surgical instrument according to an embodiment of the present invention. 手術用器具を組み立てた状態を示す図である。It is a figure which shows the state which assembled the surgical instrument. 図２の手術用器具を反対側の側方から見た図である。It is the figure which looked at the surgical instrument of FIG. 2 from the opposite side. 手術用器具のロックを解除して保持部を開いた状態を示す図である。It is a figure which shows the state which released the lock of the surgical instrument and opened the holding | maintenance part. 図４の手術用器具を反対側の側方から見た図である。It is the figure which looked at the surgical instrument of FIG. 4 from the opposite side. （ａ）は手術用器具を見下ろした平面図であり、（ｂ）は（ａ）のＰ部拡大図である。また、（ｃ），（ｄ）はスライダの突部であるスライダノブの形状例を示す側面図である。(A) is the top view which looked down at the instrument for surgery, (b) is the P section enlarged view of (a). (C) and (d) are side views showing an example of the shape of a slider knob which is a protrusion of the slider.

本実施形態で説明する手術用器具は、その一端に、大腿骨の髄腔内にステム埋入孔を形成するための手術用部材であるステムブローチ（各図中では符号Ｂで表示）を保持して、大腿骨を穿孔（「ブローチング」という）するために用いられる、ブローチハンドルである。   The surgical instrument described in this embodiment holds at one end a stem broach (indicated by symbol B in each figure), which is a surgical member for forming a stem insertion hole in the intrathecal space of the femur. And a broach handle used to drill the femur (referred to as "broaching").

図１の分解斜視図に示すように、ブローチハンドル１０は、第１部材である保持具本体１と、第２部材である操作用の保持具副体２と、保持具本体１と保持具副体２とを連結する連結軸部材としての第１ピン３および第２ピン４と、保持具副体２に取り付けられる、スライダ５，ばね６，ばね受け７等からなるロック機構を含んで構成される。なお、以降の実施形態で使用する「器具長手方向」とは、最長の部材である保持具本体１の長さ（全長）に沿った方向であり、施術時のブローチング方向と同じ方向をいう。   As shown in the exploded perspective view of FIG. 1, the broach handle 10 includes the holder main body 1 as a first member, the holder secondary body 2 for operation as a second member, the holder main body 1 and the holder secondary The lock mechanism includes a first pin 3 and a second pin 4 as connecting shaft members for connecting to the body 2, and a slider 5, a spring 6, a spring receiver 7 and the like attached to the holder sub-body 2. Ru. The “instrument longitudinal direction” used in the following embodiments is the direction along the length (full length) of the holder body 1 which is the longest member, and means the same direction as the broaching direction at the time of treatment .

保持具本体１は、図６（ａ）の平面図に示すように、一方向から見て、ブローチハンドル１０における器具長手方向に直線状に延びる部材である。側方から見た図１〜図５において、その器具長手方向の一端部である図示左側（紙面では下方側）には、手術用部材であるステムブローチＢ〔図１では実線、図２〜図５では仮想線（二点鎖線）で記載〕を保持するための第１保持部１ａが形成されている。なお、第１保持部１ａの形状は、一端部に取り付けるブローチ側の取り付け部Ｂ１（図では見えないが凹状）の形状に合わせて変えることが可能である。図の例では、ブローチ側の取り付け部Ｂ１の内側に嵌め入れることのできる形状になっている。   The holder main body 1 is a member extending linearly in the longitudinal direction of the tool in the broach handle 10 as viewed from one direction, as shown in the plan view of FIG. 6A. In FIGS. 1 to 5 as viewed from the side, on the left side (lower side in the drawing) which is one end in the longitudinal direction of the instrument, a stem broach B as a surgical member [solid line in FIG. 1, FIG. In 5, the first holding portion 1a for holding the virtual line (indicated by a two-dot chain line) is formed. The shape of the first holding portion 1a can be changed in accordance with the shape of the broach-side attachment portion B1 (not visible in the drawing but concave) attached to one end. In the example of the figure, it has a shape that can be fitted inside the attachment portion B1 on the broach side.

また、保持具本体１には、その器具長手方向の中央部の一端部寄りである第１保持部１ａ側の位置に、後記の保持具副体２との連結に用いられる第１の貫通穴１ｃが形成されている。この第１の貫通穴１ｃには、連結軸部材である第１ピン３および第２ピン４が挿通される。さらに、第１の貫通穴１ｃに隣接する他端側は、図示上面に向けて開口する凹部１ｄになっており、後記の保持具副体２の他端側のロック機構部分を収容することができるようになっている。   Further, in the holder main body 1, a first through hole used for connection with the holder sub-body 2 described later at a position on the first holding portion 1 a side which is closer to one end of the central portion in the instrument longitudinal direction. 1c is formed. The first pin 3 and the second pin 4 which are connecting shaft members are inserted into the first through holes 1c. Further, the other end side adjacent to the first through hole 1c is a concave portion 1d opened toward the upper surface in the figure, and the lock mechanism portion on the other end side of the holder sub-body 2 described later can be accommodated. It can be done.

そして、保持具本体１の他端側（紙面上方で図示右側）の端部１ｂには、ブローチハンドル１０を大腿骨に打込む際、保持具本体１を、器具長手方向であるブローチング方向にハンマー等によって打撃するために使用されるインパクトプレート９が、取り付けられている。   When the broach handle 10 is inserted into the femur at the end 1b of the other end of the holder body 1 (the upper side in the drawing, the right side in the figure), the holder body 1 is in the broaching direction, which is the longitudinal direction of the instrument. An impact plate 9 used for striking with a hammer or the like is attached.

保持具副体２も、図６（ａ）の平面図に示すように、ブローチハンドル１０におけるブローチング方向に直線状に延びる部材である。その器具長手方向の長さは、保持具本体１より短くなっており、連結した状態において、図２，図４に示すように、前述の保持具本体１の凹部１ｄ内に収容できるようになっている。   The holder sub-assembly 2 is also a member extending linearly in the broaching direction of the broach handle 10, as shown in the plan view of FIG. 6 (a). The length in the longitudinal direction of the tool is shorter than that of the holder body 1, and in the connected state, as shown in FIGS. 2 and 4, it can be accommodated in the recess 1d of the holder body 1 described above. ing.

保持具副体２の器具長手方向の一端部である図示左側（紙面下方）には、前述の第１保持部１ａとの間に、手術用部材であるブローチの端部を挟み込んで保持するための第２保持部２ａが形成されている。なお、第２保持部２ａの形状は、第１保持部１ａと同様、一端部に取り付けるブローチ側の、取り付け部Ｂ２の形状に合わせて変更される。図の例では、ブローチ側の取り付け部Ｂ２の外側に係合する、かぎ状またはフック形状になっている。   In order to hold the end of the broach, which is a surgical member, between the first holding portion 1a and the left side (the lower side of the drawing), which is one end of the tool subassembly 2 in the instrument longitudinal direction. The second holding portion 2a is formed. The shape of the second holding portion 2a is changed in accordance with the shape of the attachment portion B2 on the broach side attached to the one end portion, similarly to the first holding portion 1a. In the example of a figure, it has a hook shape or hook shape engaged with the outer side of the attaching part B2 by the side of a broach.

また、保持具副体２には、保持具本体１と同様、連結された場合に前記の第１の貫通穴１ｃに対応する、器具長手方向の中央部の一端部寄りである第２保持部２ａ側の位置に、保持具本体１との連結に用いられる第２の貫通穴２ｃが形成されている。この第２の貫通穴２ｃは、第１の貫通穴１ｃと同心状に配置された状態で、第１ピン３および第２ピン４が挿通される。   Further, in the holder sub-body 2, like the holder main body 1, a second holding portion which is closer to one end of the central portion in the longitudinal direction of the tool corresponding to the first through hole 1 c when being connected. A second through hole 2c used for connection with the holder body 1 is formed at the position 2a. The first pin 3 and the second pin 4 are inserted through the second through hole 2 c in a state of being disposed concentrically with the first through hole 1 c.

連結部材である第１ピン３および第２ピン４は、たとえば、小径の第２ピン４を大径の第１ピン３の内周に嵌め入れることにより、軸支ピンとも呼ばれる、１つの軸部材を形成する。これら第１ピン３および第２ピン４は、保持具副体２を保持具本体１の凹部１ｄ内に収容して、第２の貫通穴２ｃと第１の貫通穴１ｃとが同心状に配置された状態で形成される連結部Ｊに、挿通される。そして、これら第１ピン３および第２ピン４からなる連結軸部材は、連結部Ｊに挿通された状態で、保持具本体１と保持具副体２とを、相対的に回転可能に連結している。すなわち、第１ピン３および第２ピン４は、保持具本体１と保持具副体２とを、相対回転可能に軸支する。   The first pin 3 and the second pin 4 which are connecting members are, for example, one shaft member, also called a pivoting pin, by inserting the small diameter second pin 4 into the inner periphery of the large diameter first pin 3. Form The first pin 3 and the second pin 4 accommodate the holder sub-body 2 in the recess 1 d of the holder body 1, and the second through hole 2 c and the first through hole 1 c are arranged concentrically The connection portion J formed in the closed state is inserted. The connecting shaft member including the first pin 3 and the second pin 4 relatively rotatably connects the holder main body 1 and the holder sub-body 2 in a state of being inserted into the connecting portion J. ing. That is, the first pin 3 and the second pin 4 pivotally support the holder body 1 and the holder sub-body 2 in a relatively rotatable manner.

なお、保持具副体２が保持具本体１の凹部１ｄ内に収容される前に予め、保持具本体１の凹部１ｄと保持具副体２の他端部２ｂとの間には、コイルばね８が、これらの間に挟まれるように配設される。そのため、第１ピン３および第２ピン４が連結部Ｊに挿通され、保持具本体１と保持具副体２とが連結された状態では、前記コイルばね８の押圧または付勢により、図２，図３に示すように、保持具本体１の凹部１ｄと保持具副体２の他端部２ｂとの間の上下方向の間隙が、押し広げられる。   In addition, before the holder sub-body 2 is accommodated in the recess 1 d of the holder main body 1, a coil spring is formed between the recess 1 d of the holder main body 1 and the other end 2 b of the holder sub-body 2 in advance. 8 are disposed to be sandwiched between them. Therefore, in a state where the first pin 3 and the second pin 4 are inserted into the connecting portion J and the holder body 1 and the holder sub-body 2 are connected, as shown in FIG. As shown in FIG. 3, the vertical gap between the recess 1 d of the holder body 1 and the other end 2 b of the holder sub-assembly 2 is expanded.

また、これら凹部１ｄおよび他端部２ｂとは、連結部Ｊを挟んで器具長手方向反対側に位置する、一端部側の保持具本体１の第１保持部１ａと保持具副体２の第２保持部２ａとの間には、テコの原理によって、ブローチ等の手術用部材を挟み込んで保持する力が発生する。この構成により、本実施形態のブローチハンドル１０は、その一端の第１保持部１ａと第２保持部２ａとの間に、ブローチ等の手術用部材をしっかりと挟み込んで、確実に保持することができる。   Further, the recess 1 d and the other end 2 b are located on the opposite side in the longitudinal direction of the device with the connecting portion J in between, and the first holding portion 1 a of the holder main body 1 on the one end side and the first holder subassembly 2 A force for sandwiching and holding a surgical member such as a broach is generated between the second holding portion 2a and the second holding portion 2a according to the principle of leverage. With this configuration, the broach handle 10 according to the present embodiment can securely hold a surgical member such as a broach or the like between the first holding portion 1a and the second holding portion 2a at one end thereof. it can.

なお、保持具本体１の凹部１ｄにおける、コイルばね８の端部に対応する面には、コイルばね８の径に対応する、コイルばね８の端部保持用の穴１ｆが設けられている。さらに、その穴１ｆから保持具本体１の外面に向けて下向きに、コイルばね８の径より小径の貫通孔１ｇが、形成されている。この小径の貫通孔１ｇは、器具の清掃や滅菌消毒時に、洗浄液や薬液等が、穴１ｆの中に嵌まり込んだコイルばね８の端部近傍に、充分に行き渡るようにするために形成されているものである。   A hole 1 f for holding the end of the coil spring 8 corresponding to the diameter of the coil spring 8 is provided on the surface of the recess 1 d of the holder body 1 corresponding to the end of the coil spring 8. Furthermore, a through hole 1g having a diameter smaller than the diameter of the coil spring 8 is formed downward from the hole 1f toward the outer surface of the holder body 1. The small diameter through hole 1g is formed to allow cleaning liquid, chemical solution, etc. to sufficiently spread around the end portion of the coil spring 8 fitted in the hole 1f at the time of cleaning of the instrument or sterilization and disinfection. It is

また、第１ピン３と第２ピン４とは、連結部Ｊに挿通された状態で、施術操作中に分解することのないよう、溶接等により固着されている。各部材を個別に洗浄等する必要がある場合は、この溶接等を外して、器具を分解してもよい。   In addition, the first pin 3 and the second pin 4 are fixed by welding or the like so as not to be disassembled during the operation in a state where the first pin 3 and the second pin 4 are inserted into the connecting portion J. If it is necessary to individually clean each member, the welding may be removed to disassemble the device.

つぎに、保持具本体１（第１部材）と保持具副体２（第２部材）との相対的な回転を制限するとともに、一端部におけるステムブローチの保持を維持するためのロック機構について説明する。   Next, the lock mechanism for limiting the relative rotation between the holder main body 1 (first member) and the holder sub-body 2 (second member) and maintaining the retention of the stem broach at one end is described. Do.

ロック機構は、図１に示すように、保持具副体２に取り付けられたスライダ５と、ばね６と、ばね受け７とから構成されている。なお、保持具副体２には、このロック機構の配設に対応して、スライダ５のスライド移動を案内するための案内溝２ｄと、抜け止め部２ｅとが設けられている。ロック機構が、保持具本体１側に配設される場合、前述の案内溝と抜け止め部は、保持具本体１の対応する位置に設けられる。   As shown in FIG. 1, the lock mechanism includes a slider 5 attached to the holder sub-assembly 2, a spring 6 and a spring receiver 7. A guide groove 2d for guiding the slide movement of the slider 5 and a retaining portion 2e are provided in the holder sub-body 2 corresponding to the arrangement of the lock mechanism. When the lock mechanism is disposed on the holder body 1 side, the aforementioned guide groove and the retaining portion are provided at corresponding positions of the holder body 1.

ばね受け７は、案内溝２ｄに嵌め入れられた状態で、案内溝２ｄ端部に形成された抜け止め部２ｅにより、スライド方向（紙面上方で図示右側）への抜けが防止されている。なお、ばね受け７と保持具副体２の抜け止め部２ｅとの間は、通常、溶接等により固着されるが、溶接等は行わなくてもよい。   The spring receiver 7 is prevented from coming off in the sliding direction (right side in the drawing) by the retaining portion 2e formed at the end of the guide groove 2d in a state of being fitted in the guide groove 2d. The spring receiver 7 and the retainer 2e of the holder sub-assembly 2 are normally fixed by welding or the like, but welding or the like may not be performed.

ばね６としては、コイル形状のばねが好適に用いられるが、その様式や形状は、特に限定されるものではない。   Although a coil-shaped spring is suitably used as the spring 6, the type and shape thereof are not particularly limited.

スライダ５は、その下部５ｂが前記の案内溝２ｄに嵌まり込む形状に形成され、案内溝２ｄから上方に突出する上部は、スライダ５をスライド操作するためのスライドノブ（突部５ａ）になっている。下部５ｂの側方（紙面裏面側で図示奥側）に形成された凸部５ｄは、保持具本体１と保持具副体２とを連結した状態で、保持具本体１の凹部１ｄに形成された、下方に折れ曲がる形状の長穴１ｅ（図１および図３，図５の形状を参照）に嵌め入れられるものである。   The lower part 5b of the slider 5 is formed to fit into the guide groove 2d, and the upper part projecting upward from the guide groove 2d is a slide knob (protrusion 5a) for sliding the slider 5 ing. The convex part 5d formed on the side of the lower part 5b (the back side in the drawing (the back side in the drawing)) is formed in the concave part 1d of the holder main body 1 in a state where the holder main body 1 and the holder submember 2 are connected. In addition, it is to be fitted into a long hole 1e (refer to the shapes of FIG. 1, FIG. 3 and FIG. 5) having a shape bent downward.

そして、前記スライダ５の移動に起因する、この凸部５ｄの長穴１ｅ内での移動が、図２，図３に示す本ロック機構のロック位置と、図４，図５に示す本ロック機構のロック解除位置とを、切り替える操作になっている。なお、本発明における「ロック」とは、以下に示す２種類のロック（回転の固定と、保持の解除操作の施錠）を含む概念である。   The movement of the slider 5 in the elongated hole 1e of the convex portion 5d corresponds to the lock position of the main lock mechanism shown in FIGS. 2 and 3 and the main lock mechanism shown in FIGS. It is an operation to switch between the lock release position of. The term "lock" in the present invention is a concept including two types of locks (rotational locking and locking of the release operation of holding) described below.

すなわち、「ロック状態」を示す図２，図３のように、スライダ５が案内溝２ｄにおけるロック位置側（器具長手方向の一端部側でかつ保持部側）にある場合、スライダ下部５ｂ側方の凸部５ｄも同時に、長穴１ｅ内における凸部５ｄの上下方向の移動が規制された位置である、長穴１ｅの一端部側端部に位置している。そのため、ロック状態のブローチハンドル１０は、これら凸部５ｄと長穴１ｅとの係合によって、保持具本体１と保持具副体２とは、相対回転が制限された回転ロック状態にある。また、この相対回転が制限された状態は、上側の保持具副体２を下方に向かって押し下げて保持具本体１に近づける、すなわち第１保持部１ａと第２保持部２ａとの間を押し広げる操作が、できない状態を作り出している。これにより、スライダ５がロック位置にあるブローチハンドル１０は、第１保持部１ａと第２保持部２ａとの間に挟まれたブローチＢ等の手術用部材の保持ロックを、解除（開錠）または開放できないようになっている。   That is, as shown in FIGS. 2 and 3 showing the “locked state”, when the slider 5 is on the lock position side (one end side and the holding portion side in the longitudinal direction of the instrument) of the guide groove 2d, the slider lower portion 5b side At the same time, the convex portion 5d is located at one end side end of the long hole 1e, which is a position at which the movement of the convex portion 5d in the long hole 1e in the vertical direction is restricted. Therefore, the broach handle 10 in the locked state is in the rotation locked state in which the relative rotation between the holder main body 1 and the holder sub-body 2 is restricted by the engagement between the convex portions 5 d and the elongated holes 1 e. Further, in a state in which the relative rotation is limited, the upper holding tool sub-body 2 is pushed downward toward the holding tool main body 1, that is, it is pushed between the first holding portion 1a and the second holding portion 2a. The unfolding operation creates a state where it can not be done. As a result, the broach handle 10 in which the slider 5 is in the lock position releases (locks out) the holding lock of the operation member such as the broach B or the like sandwiched between the first holding portion 1a and the second holding portion 2a. Or you can not open it.

他方、「ロック解除状態」を示す図４，図５のように、スライダ５が、指等の押圧によって、案内溝２ｄにおけるロック解除位置側（器具長手方向の他端部側でかつ保持部の反対側）に移動した場合、スライダ下部５ｂ側方の凸部５ｄは、長穴１ｅ内において凸部５ｄの上下方向の移動が許容された位置である、長穴１ｅの他端部側に位置している。そのため、ロック解除状態のブローチハンドル１０は、長穴１ｅ内における凸部５ｄの上下動に連動して、保持具本体１と保持具副体２との相対回転が可能な、回転アンロック（フリー）状態にある。なお、この相対回転が可能な状態とは、上側の保持具副体２を下方に向かって押し下げて保持具本体１に近づけ、一端部側の第１保持部１ａと第２保持部２ａとの間を押し広げる操作が可能な状態のことをいう。したがって、スライダ５がロック解除位置にあるブローチハンドル１０は、第１保持部１ａと第２保持部２ａとの間に挟まれたブローチＢ等の手術用部材の把持（ロック）を、コイルばね８の押圧に反して、図４，図５に示すように解除（開錠）または開放させることができる。   On the other hand, as shown in FIG. 4 and FIG. 5 showing the “unlocked state”, the slider 5 is pressed by a finger or the like to the unlocked position side (the other end side in the device longitudinal direction and the holding portion When moved to the opposite side, the convex portion 5d on the side of the slider lower portion 5b is a position at which the vertical movement of the convex portion 5d in the elongated hole 1e is permitted, the position being on the other end side of the elongated hole 1e doing. Therefore, the broach handle 10 in the unlocked state can rotate relative to the holder main body 1 and the holder sub-body 2 in synchronization with the vertical movement of the protrusion 5 d in the long hole 1 e (rotation unlock (free) ) Is in the state. In this state where relative rotation is possible, the upper holding tool sub-body 2 is pushed downward toward the holding tool main body 1, and the first holding portion 1a and the second holding portion 2a at one end are It means a state where it is possible to perform an operation to extend the interval. Therefore, the broach handle 10 in which the slider 5 is in the unlocking position holds the lock (lock) of the surgical member such as the broach B or the like sandwiched between the first holding portion 1a and the second holding portion 2a. In contrast to the pressure of the key, it can be released (unlocked) or released as shown in FIG. 4 and FIG.

そして、スライダ５をスライド操作するための突部５ａは、案内溝２ｄから、案内溝または器具の長手方向に沿って山形に突出する形状（頂部５ｃ）に形成されている。その頂部５ｃの位置は、図６（ｃ），（ｄ）に示すように、スライダ５における器具長手方向で、かつ、案内溝２ｄにおけるスライド（ロック−ロック解除）方向の中点Ｃ〔図６（ｃ）〕、または、前記中点Ｃよりも図示左側の、器具長手方向における前記ロック位置側〔図６（ｄ）〕、に形成されている。また、術者等の指先が当接する、頂部５ｃよりロック位置側の斜面（図示左側）には、段状あるいは凹凸状等の滑り止め形状が設けられている。   And, a projection 5a for sliding the slider 5 is formed in a shape (apex 5c) projecting from the guiding groove 2d into a guiding groove or a chevron along the longitudinal direction of the instrument. The position of the top 5c is, as shown in FIGS. 6 (c) and 6 (d), the middle point C in the instrument longitudinal direction of the slider 5 and in the slide (lock-unlock) direction in the guide groove 2d. (C)] Or, it is formed on the left side of the middle point C in the figure in the longitudinal direction of the instrument (FIG. 6 (d)). Further, on the slope (the left side in the figure) closer to the lock position than the top 5c with which the fingertip of the operator or the like abuts, a non-slip shape such as stepped or uneven is provided.

前記の突部５ａの形状は、スライダ５のスライドし易さ、すなわち、スライド操作の行い易さを考慮したものであり、前述のように、突部５ａの頂部５ｃが、スライダ５長手方向の中点Ｃまたは中点Ｃよりロック位置側にあることにより、この頂部５ｃよりロック位置側の斜面で、前記の滑り止め形状を有する操作面に指等を掛けてスライド操作を行った場合でも、スライド中に、スライダ５が傾いたり浮き上がったりすることなく、安定して、スライダ５をロック解除位置まで移動させることができる。したがって、ロック機構のロックを解除およびブローチの挟み込み保持を開放する場合の、操作性が向上している。   The shape of the projection 5 a takes into consideration the ease of sliding of the slider 5, that is, the ease of performing the sliding operation, and as described above, the top 5 c of the projection 5 a is in the longitudinal direction of the slider 5. By being on the lock position side from the middle point C or the middle point C, even when a slide operation is performed by putting a finger or the like on the operation surface having the non-slip shape on the slope on the lock position side from the top 5c, During sliding, the slider 5 can be stably moved to the unlocking position without the slider 5 being inclined or floating. Therefore, the operability in the case of releasing the lock of the lock mechanism and releasing the pinch holding of the broach is improved.

以上の構成のロック機構を備えるブローチハンドル１０によれば、一端部に保持されたブローチＢの保持を維持するロック状態（ロック位置）と、一端部に保持されたブローチＢの保持を開放するロック解除状態（ロック解除位置）とを、スライダ５のスライド移動により交互に切り替えて使用することができる。   According to the broach handle 10 provided with the lock mechanism having the above configuration, the lock state (lock position) for maintaining the holding of the broach B held at one end and the lock for releasing the holding of the broach B held at the one end The release state (lock release position) can be alternately switched and used by the slide movement of the slider 5.

なお、ロック機構において、案内溝２ｄに嵌まり込む、ばね受け７の下部のなかで、コイル状のばね６の端部に対応する面には、ばね６の径に対応する、ばね６の端部保持用の穴７ａが設けられている。さらに、その穴７ａからばね受け７の外面に向けて、ばね６の径より小径の貫通孔７ｂが、形成されている。この小径の貫通孔７ｂは、前述の保持具本体１ａの貫通孔１ｇと同様、器具の清掃や滅菌消毒時に、洗浄液や薬液等が、穴７ａの中に嵌まり込んだばね６の端部近傍に、充分に行き渡るようにするためである。   In the lock mechanism, the end of the spring 6 corresponding to the diameter of the spring 6 is provided on the surface corresponding to the end of the coiled spring 6 in the lower part of the spring receiver 7 fitted in the guide groove 2d. A hole 7a for holding a part is provided. Furthermore, a through hole 7 b having a diameter smaller than the diameter of the spring 6 is formed from the hole 7 a toward the outer surface of the spring receiver 7. The small diameter through hole 7b is similar to the through hole 1g of the holder main body 1a described above, in the vicinity of the end of the spring 6 in which the cleaning solution or the chemical solution is fitted into the hole 7a at the time of cleaning or sterilization of the instrument. In order to be sufficiently distributed.

つぎに、以上の構成のロック機構を組み立てる場合、まず、スライダ５の下部を、保持具副体２の案内溝２ｄに嵌め入れ、スライド移動可能に保持する。ついで、スライダ５を、ロック機構のロック側である保持具副体２の第２保持部２ａ側（一端部側で、かつ、案内溝２ｄの奥側）に押し込んだ状態で、ばね６とばね受け７を、同じ案内溝２ｄに嵌め入れる。   Next, when assembling the lock mechanism having the above configuration, first, the lower portion of the slider 5 is fitted into the guide groove 2 d of the holder sub-body 2 and held slidably. Next, the spring 6 and the spring are in a state where the slider 5 is pushed into the second holding portion 2a side (one end side and the back side of the guide groove 2d) of the holder sub-body 2 which is the lock side of the lock mechanism. The receptacle 7 is fitted into the same guide groove 2d.

この時、ばね６はその長手方向に圧縮された状態で案内溝２ｄに押し込まれる。すなわち、ばね６の一方側の端部が、スライダ５に当接した状態で、かつ、他方側の端部が、ばね受け７の穴７ａの中に嵌まり込んだ状態で、ばねを構成するコイルどうしが密着するまで圧縮されて、案内溝２ｄ内に押し込まれる。そして、ばね６の圧縮が開放されると、ばね受け７は、案内溝２ｄの他方端側にまで押し付けられ、先に述べた保持具副体２の抜け止め部２ｅに嵌合されて、固定される。   At this time, the spring 6 is pushed into the guide groove 2d while being compressed in its longitudinal direction. That is, in a state where one end of the spring 6 is in contact with the slider 5 and the other end is fitted into the hole 7 a of the spring receiver 7, the spring is configured. The coils are compressed until they are in close contact with each other and pushed into the guide groove 2d. Then, when the compression of the spring 6 is released, the spring receiver 7 is pressed to the other end side of the guide groove 2d, and is fitted to the retaining portion 2e of the holder sub-body 2 described above to fix it. Be done.

ここで、ロック機構が組み立てられた状態を、上方から平面視すると、先に述べた図６（ａ）の拡大図である図６（ｂ）に示すような部材配置になる。すなわち、組み立て後、スライダ５とばね６とばね受け７とが、案内溝２ｄ内の所定位置に配置され状態で、スライダ５とばね受け７との間の、器具および案内溝長手方向の間隙（長さＬａ）は、ばね受け７の、前記長手方向の長さ（全長Ｌｂ）よりも短く、かつ、ばね６の、嵌め入れ時の圧縮長さ〔ばね密着時の最小長さＬｃ：図６（ｂ）内の圧縮時のばね６’（二点鎖線）を参照〕よりも短い。   Here, when the state where the lock mechanism is assembled is viewed in plan from above, the member arrangement is as shown in FIG. 6 (b) which is an enlarged view of FIG. 6 (a) described above. That is, when the slider 5, the spring 6 and the spring receiver 7 are arranged at the predetermined positions in the guide groove 2 d after assembly, the gap between the slider 5 and the spring receiver 7 in the longitudinal direction of the instrument and the guide groove The length La) is shorter than the length (long length Lb) of the spring receiver 7 in the longitudinal direction, and the compression length at the time of fitting of the spring 6 [minimum length Lc at the time of close contact with the spring: FIG. (B) see compression spring 6 '(dash-dotted line) in [b].

この構成により、本実施形態のブローチハンドル１０は、ロック機構を構成する部材であるスライダ５とばね６とばね受け７の、意図しない取り外しや分解ができないようになっている。   With this configuration, the broach handle 10 of this embodiment can not be removed or disassembled unintentionally from the slider 5, the spring 6 and the spring receiver 7 which are members constituting the lock mechanism.

すなわち、ブローチハンドル１０は、大腿骨の穿孔時に、ハンマー等で器具長手方向他端側のインパクトプレート９を打撃する場合や、ブローチＢの抜去時に、専用のアダプタやハンマー等を用いてブローチの抜去方向に衝撃が与えられる場合があった。しかしながら、このブローチハンドル１０のロック機構は、前述の打撃や衝撃による力がロック機構に伝搬した場合でも、これらの衝撃や荷重変化等によってブローチＢの保持が外れたりすることがない。   That is, when the broach handle 10 strikes the impact plate 9 at the other end in the instrument longitudinal direction with a hammer or the like during perforation of the femur, or when the broach B is removed, the broach is removed using a dedicated adapter, hammer or the like. There was a case that an impact was given in the direction. However, in the lock mechanism of the broach handle 10, even when the above-mentioned impact or impact force is transmitted to the lock mechanism, the broach B is not released due to the impact or the load change.

また、本実施形態のブローチハンドル１０のロック機構は、それを構成するスライダ５，ばね６，ばね受け７が、案内溝２ｄからずれたり外れたりして、ロック機構が分解されてしまうことがない。したがって、本実施形態のブローチハンドル１０は、上記のような衝撃を生じる操作を、術中でも安全に行うことができる。   Further, in the lock mechanism of the broach handle 10 of the present embodiment, the slider 5, the spring 6, and the spring receiver 7 constituting the broach handle 10 are not dislocated or deviated from the guide groove 2d and the lock mechanism is not disassembled. . Therefore, the broach handle 10 of the present embodiment can safely perform the above-described operation that generates an impact during surgery.

なお、以上の実施形態では、ステムブローチを保持する場合について述べたが、保持する手術用部材としては、ステムブローチに限るものではなく、たとえば、膝関節、肘関節などの各種の部位に埋設される人工関節用ステムなどの手術用部材を把持するための手術用器具等においても、本発明を好適に実施することができる。   In the above embodiment, the stem broach is held, but the surgical member to be held is not limited to the stem broach, and may be embedded in various parts such as a knee joint and an elbow joint, for example. The present invention can be suitably implemented also in a surgical instrument or the like for gripping a surgical member such as an artificial joint stem.

また、本発明は上述の実施の形態に限定されるものではなく、本発明の要旨を逸脱しない範囲内において、種々の変更、改良等が可能である。   Furthermore, the present invention is not limited to the above-described embodiment, and various changes, improvements, and the like can be made without departing from the scope of the present invention.

１ 保持具本体
１ａ 第１保持部
１ｃ 第１の貫通穴
２ 保持具副体
２ａ 第２保持部
２ｃ 第２の貫通穴
２ｄ 案内溝
２ｅ 抜け止め部
３ 第１ピン
４ 第２ピン
５ スライダ
５ａ 突部
６ ばね
７ ばね受け
１０ ブローチハンドル
Ｊ 連結部 DESCRIPTION OF SYMBOLS 1 Holder main body 1a 1st holding part 1c 1st through hole 2 2nd holder subpart 2a 2nd holding part 2c 2nd through hole 2d guide groove 2e guide part 2 securing part 3 1st pin 4 2nd pin 5 slider 5a projection Part 6 spring 7 spring holder 10 broach handle J connection part

Claims (5)

一端に手術用部材を保持可能な手術用器具であって、
第１部材および第２部材と、
前記第１部材と前記第２部材とを連結する連結部材と、を備え、
前記連結部材は、前記第１部材と前記第２部材とを相対的に回転可能に連結しており、
前記第１部材は、その一端部に、前記手術用部材を保持するための第１保持部を有し、
前記第２部材は、その一端部に、前記第１保持部との間に前記手術用部材を保持する第２保持部を有し、
前記第１部材または前記第２部材の少なくとも一方は、前記連結部材よりもそれぞれの他端部側の位置に、前記第１部材と前記第２部材との相対的な回転を制限するロック機構を有する、手術用器具。 A surgical instrument capable of holding a surgical member at one end, comprising:
A first member and a second member,
And a connecting member for connecting the first member and the second member,
The connecting member rotatably connects the first member and the second member relative to each other,
The first member has, at one end thereof, a first holding portion for holding the surgical member,
The second member has, at one end thereof, a second holding portion for holding the surgical member between the second holding portion and the first holding portion.
At least one of the first member or the second member has a lock mechanism for limiting relative rotation between the first member and the second member at a position closer to the other end than the coupling member. Have a surgical instrument. 前記ロック機構は、
前記第１部材または前記第２部材のいずれか一方に対して、前記一端部から前記他端部に向かう器具長手方向に移動可能に取り付けられたスライダと、
前記スライダを、前記第１部材または前記第２部材の前記いずれか一方の、前記器具長手方向におけるロック位置側に向けて押しつけるばねと、
前記ばねを挟んで前記ロック位置とは反対側の、前記器具長手方向のロック解除位置側に位置するばね受けと、
を含む請求項１に記載の手術用器具。 The lock mechanism is
A slider movably attached to any one of the first member and the second member in the longitudinal direction of the device from the one end to the other end;
A spring for pressing the slider toward the lock position in the longitudinal direction of the device, of either one of the first member and the second member;
A spring receiver located on the side of the device in the longitudinal direction, the lock release position opposite to the lock position with the spring interposed therebetween;
The surgical instrument according to claim 1, comprising 前記スライダが取り付けられた前記第１部材または前記第２部材に、前記スライダの移動を案内する案内溝が設けられ、
前記案内溝において前記スライダが位置する前記ロック位置とは前記器具長手方向反対側の前記ロック解除位置に、前記ばね受けが配設されている、請求項２に記載の手術用器具。 The first member or the second member to which the slider is attached is provided with a guide groove for guiding the movement of the slider;
The surgical instrument according to claim 2, wherein the spring holder is disposed at the unlocked position opposite to the instrument longitudinal direction from the locked position at which the slider is located in the guide groove. 前記案内溝における前記ロック解除位置側の端部に、前記ばね受けの、前記端部方向への前記案内溝からの脱落を不能とする抜け止め部が形成されている、請求項３に記載の手術用器具。   4. The locking groove according to claim 3, wherein the end of the guide groove on the unlocking position side is formed with a retaining portion that prevents the spring receiver from coming off the guiding groove toward the end. Surgical instruments. 前記スライダは、前記スライダが取り付けられた前記第１部材または第２部材から外方に向かって突出する突部を備え、
前記突部の頂部は、前記スライダにおける前記器具長手方向の中点または前記中点よりも前記器具長手方向における前記ロック位置側にある、請求項２〜４のいずれか１つに記載の手術用器具。 The slider includes a protrusion protruding outward from the first member or the second member to which the slider is attached,
The surgical device according to any one of claims 2 to 4, wherein a top portion of the protrusion is at a midpoint in the longitudinal direction of the device in the slider or at the lock position side in the longitudinal direction of the device than the midpoint. Appliance.
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CN114246634A (en) * 2021-12-21 2022-03-29 天衍医疗器材有限公司 Quick-insertion type beating and pulling device for file body
CN114246634B (en) * 2021-12-21 2023-12-26 天衍医疗器材有限公司 Quick-insertion type file body beating and pulling device

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