JP6573263B2 - Artificial bone shaft - Google Patents
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- JP6573263B2 JP6573263B2 JP2018192984A JP2018192984A JP6573263B2 JP 6573263 B2 JP6573263 B2 JP 6573263B2 JP 2018192984 A JP2018192984 A JP 2018192984A JP 2018192984 A JP2018192984 A JP 2018192984A JP 6573263 B2 JP6573263 B2 JP 6573263B2
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Description
本発明は、人工骨幹の改良、詳しくは、悪性骨腫瘍等の手術によって分離状態となった骨幹同士を、切除分の間隔を空けて繋ぐことができ、また日常生活において治療部位に負荷がかかった場合でも、骨幹と髄内釘の固定部分に負荷が集中し難く、しかも、骨幹間の負荷に対しても充分な強度を有する人工骨幹に関するものである。 The present invention is an improvement of an artificial bone shaft, and more specifically, bone shafts separated by surgery such as a malignant bone tumor can be connected with an interval of excision, and a load is applied to a treatment site in daily life. Even in such a case, the present invention relates to an artificial bone shaft in which the load is difficult to concentrate on the fixed portion between the bone shaft and the intramedullary nail and has sufficient strength against the load between the shafts.
一般的に、骨幹の悪性骨腫瘍を切除した場合、骨幹の一部が欠損して分離状態となるケースがある。その場合、骨幹が分離した状態のままでは日常生活に支障をきたすため、骨幹の髄腔に挿入して固定される髄内釘や、骨幹表面に固定される連結プレート等を利用して分離した骨幹同士を繋ぐ必要がある(例えば、特許文献１参照)。 In general, when a malignant bone tumor of the diaphysis is excised, there is a case where a part of the diaphysis is lost and separated. In that case, in order to disturb the daily life if the diaphysis is separated, it was separated using an intramedullary nail inserted into the medullary cavity of the diaphysis and a connection plate fixed to the diaphysis surface. It is necessary to connect the shafts to each other (for example, see Patent Document 1).
しかしながら、上記分離状態となった骨幹を、切除分の間隔を空けて髄内釘や連結プレートで繋いだ場合、骨幹と髄内釘または連結プレートとを固定している両端のボルト留め部分(またはネジ留め部分)に負荷が集中し易いため、日常生活において治療部位に負荷がかかった際にボルト(またはネジ)周辺の骨に罅が入る危険がある。 However, when the bone shaft in the separated state is connected with an intramedullary nail or a connection plate with an interval of excision, bolted portions (or bolts) at both ends fixing the bone shaft and the intramedullary nail or the connection plate (or Since the load tends to concentrate on the screwed portion), there is a risk of wrinkles entering the bones around the bolt (or screw) when the treatment site is loaded in daily life.
また上記髄内釘については、骨幹の髄腔に挿入できる太さのものに限定されるため、骨幹間に大きな負荷がかかった際、髄内釘の骨幹間の部位がその負荷に耐えられずに折れ曲がる危険がある。これは連結プレートについても同様で、使用可能な連結プレートの厚さには限界があるため、大きな負荷で折れ曲がる危険がある。 The intramedullary nail is limited to a thickness that can be inserted into the medullary cavity of the diaphysis, so when a large load is applied between the diaphysis, the portion between the diaphysis of the intramedullary nail cannot withstand the load. There is a risk of bending. The same applies to the connecting plate, and since there is a limit to the thickness of the connecting plate that can be used, there is a risk of bending with a large load.
一方、上記のように髄内釘等を用いて分離した骨幹を連結する場合には、骨幹間に生じた隙間に骨セメントを充填する方法も考えられるが、骨セメントは注入時に隙間から漏れ出る等の危険があるだけでなく、強度もそれほど高くないため、治療部位に大きな負荷がかかった際に骨セメントから成る補填部位が損傷する危険がある。 On the other hand, when the separated bone shafts are connected using intramedullary nails or the like as described above, a method of filling the bone cement into the gap formed between the bone shafts is also conceivable, but the bone cement leaks from the gap during injection. In addition, the strength is not so high, so that there is a risk of damaging a filling site made of bone cement when a large load is applied to the treatment site.
そこで本発明は、上記の如き問題に鑑みて為されたものであり、その目的とするところは、悪性骨腫瘍等の手術によって分離状態となった骨幹同士を、切除分の間隔を空けて繋ぐことができ、また取り付けも安全に行うことができ、しかも、日常生活において治療部位に負荷がかかった場合でも、骨幹と髄内釘の固定部分に負荷が集中し難く、骨幹間の負荷に対しても充分な強度を有する人工骨幹を提供することにある。 Therefore, the present invention has been made in view of the above-described problems, and an object of the present invention is to connect the shafts separated by surgery such as malignant bone tumors with an interval of excision. It can be attached safely, and even when a load is applied to the treatment site in daily life, it is difficult to concentrate the load on the fixed part of the diaphysis and intramedullary nail. However, it is to provide an artificial bone shaft having sufficient strength.
本発明者が上記課題を解決するために採用した手段を添付図面を参照して説明すれば次のとおりである。 Means employed by the present inventor for solving the above-described problems will be described with reference to the accompanying drawings.
即ち、本発明は、分断状態の骨幹Ｂ・Ｂ’を繋ぐ際に使用される人工骨幹において、前記分断状態となった一対の骨幹Ｂ・Ｂ’の各髄腔に、骨幹Ｂ・Ｂ’間に所定大きさの間隔が空くように刺し通して挿入され、更に挿入された両端部を各骨幹Ｂ・Ｂ’に止着して取り付けられる金属製の髄内釘１と；前記分断状態の骨幹Ｂ・Ｂ’間の部位において、髄内釘１に被せて装着される筒状、断面円弧型または断面Ｕ型の形状を成す金属製の補填部材２と；前記補填部材２と各骨幹Ｂ・Ｂ’に跨がるように配置され、かつ、補填部材２と各骨幹Ｂ・Ｂ’にそれぞれ止着して取り付けられる金属製の固定用プレート３とを含んで構成した点に特徴がある(図１〜図６参照)。 That is, the present invention relates to an artificial bone shaft used when connecting the divided bone shafts B and B ', and between the bone shafts B and B' in each medullary cavity of the paired bone shafts B and B '. And a metal intramedullary nail 1 that is inserted by being pierced so as to have an interval of a predetermined size, and the inserted both ends are fixed to each of the diaphyses B and B '; A metal-made filling member 2 having a cylindrical shape, a circular arc shape or a U-shaped cross section, which is mounted on the intramedullary nail 1 at a portion between B and B ′; It is characterized in that it is arranged so as to straddle B 'and includes a fixing member 2 and a metal fixing plate 3 that is fixedly attached to each of the diaphyses B and B'. 1 to 6).
また手術時において、上記固定用プレート３を挿入するための切開範囲を小さく抑えるために、一対の骨幹Ｂ・Ｂ’に跨がる長さのプレート材を、長さ方向の中央部で二つに分割して固定用プレート３・３を構成し、これら二枚の固定用プレート３・３を、一方の骨幹Ｂ・Ｂ’と補填部材２にそれぞれ止着して取り付け可能とするのが望ましい(図１参照)。 At the time of surgery, in order to keep the incision range for inserting the fixing plate 3 small, two plate members having a length straddling a pair of diaphyses B and B ′ are provided at the center in the length direction. It is desirable that the fixing plates 3 and 3 are divided into two, and these two fixing plates 3 and 3 are fixed to one of the bones B and B ′ and the compensation member 2 so as to be attachable to each other. (See Figure 1).
また本発明では、手術時において、上記固定用プレート３がネジ留め前に大きく位置ズレしないように、固定用プレート３と補填部材２の対向面に、遊嵌形状の摺動凹部32と摺動凸部22を長さ方向に沿って設けると共に、前記摺動凹部32の両側縁部に、内向きに突出した浮き止め部32a・32aを、また前記摺動凸部22の両側面部に、内向きに凹んだガイド溝21a・21aをそれぞれ形成して、このガイド溝21a・21aに浮き止め部32a・32aが挿入された状態で固定用プレート３を補填部材２上でスライド可能に構成することもできる(図１、図２参照)。 Further, in the present invention, during the operation, the loosely-fitted sliding recess 32 and the sliding surface are slid on the opposing surfaces of the fixing plate 3 and the compensation member 2 so that the fixing plate 3 is not greatly displaced before screwing. Protrusions 22 are provided along the length direction, and floating stoppers 32a and 32a projecting inwardly are formed on both side edges of the sliding recess 32. The guide grooves 21a and 21a that are recessed in the direction are formed, and the fixing plate 3 is configured to be slidable on the compensation member 2 in a state where the floating portions 32a and 32a are inserted into the guide grooves 21a and 21a. (See FIGS. 1 and 2).
また更に、上記一対の骨幹Ｂ・Ｂ’に跨がる長さのプレート材を、長さ方向の中央部で二つに分割して固定用プレート３・３を構成する場合には、各固定用プレート３・３の分割端側に、それぞれ摺動凹部32・32を設けると共に、各固定用プレート３・３の摺動凹部32・32の長さを、補填部材２の長さの半分の大きさとすることで、手術時において、各固定用プレート３・３を補填部材２上に位置決めした状態で仮留めすることができる(図１、図２参照)。 Furthermore, when the plate material having a length straddling the pair of bone shafts B and B ′ is divided into two at the central portion in the length direction to form the fixing plates 3 and 3, each fixing is performed. Sliding recesses 32 and 32 are provided on the divided end sides of the plates 3 and 3, respectively, and the length of the sliding recesses 32 and 32 of the fixing plates 3 and 3 is half the length of the compensation member 2. By setting the size, it is possible to temporarily fix the fixing plates 3 and 3 while being positioned on the compensation member 2 at the time of surgery (see FIGS. 1 and 2).
一方、本発明では、上記人工骨幹の基本構成を変更することもでき、具体的には、分断状態となった一対の骨幹Ｂ・Ｂ’の各髄腔に挿入して取り付けられる金属製の髄内釘１を、挿入される骨幹Ｂ・Ｂ’ごとに第一髄内釘Ｎ1と第二髄内釘Ｎ2に分割して構成する一方、前記第一髄内釘Ｎ1及び第二髄内釘Ｎ2については、各骨幹Ｂ・Ｂ’に止着可能な一端部を備えると共に、他端部に骨幹Ｂ・Ｂ’の髄腔よりも断面積が大きく、かつ、端面が相欠き形状を成す骨幹補填部11・11を設けて、これらの骨幹補填部11・11を相欠き接ぎした状態で相欠き部11a・11a同士を止着して骨幹Ｂ・Ｂ’間で第一髄内釘Ｎ1と第二髄内釘Ｎ2を連結可能に構成することもできる(図７〜図１０参照)。 On the other hand, in the present invention, the basic structure of the artificial bone shaft can also be changed. Specifically, the metal bone marrow is inserted and attached to each medullary cavity of the paired bone shafts B and B ′. the inner nail 1, while constituting inserted diaphyseal B · B 'first intramedullary nail N 1 each are a divided into second intramedullary nail N 2, the first nail N 1 and the second pith The inner nail N 2 has one end portion that can be fixed to each of the bone shafts B and B ′, the other end portion has a larger cross-sectional area than the medullary cavity of the bone shafts B and B ′, and the end surface has a phase-out shape. In the first bone marrow between the bones B and B 'by fixing the bones 11a and 11a to each other with the shafts 11 and 11 in contact with each other. The nail N 1 and the second intramedullary nail N 2 can be configured to be connectable (see FIGS. 7 to 10).
また、上記の基本構成を採用する場合には、第一髄内釘Ｎ1及び第二髄内釘Ｎ2の各骨幹補填部11・11において、髄内釘１の長さ方向の対向面に凹凸部Ｐ・Ｑをそれぞれ設けて、これらの凹凸部Ｐ・Ｑを嵌め合わせた状態で骨幹補填部11・11同士を相欠き接ぎ可能に構成することができ、これによって相欠き部のネジ留め部分にかかる負担を軽減できる(図７参照)。 In addition, when the above basic configuration is adopted, the length of the intramedullary nail 1 is opposite to each other in the length of the intramedullary nail 1 in each of the shaft replacement parts 11 and 11 of the first intramedullary nail N 1 and the second intramedullary nail N 2. It is possible to construct the concavo-convex portions P and Q, respectively, so that the skeletal prosthetic portions 11 and 11 can be connected to each other with the concavo-convex portions P and Q fitted together. The burden on the part can be reduced (see FIG. 7).
他方、本発明では、上記人工骨幹の基本構成を変更することもでき、具体的には、分断状態となった一対の骨幹Ｂ・Ｂ’のうち、一方の骨幹Ｂの髄腔に、分断された側の端部から挿入されて、その挿入された一端部が骨幹Ｂに止着して取り付けられ釘本体部12と、骨幹Ｂの髄腔に挿入されない他端部側に形成された、骨幹Ｂの髄腔よりも断面積が大きい骨幹補填部11とを有する金属製の髄内釘１と；前記骨幹補填部11と各骨幹Ｂ・Ｂ’に跨がるように配置され、かつ、骨幹補填部11と各骨幹Ｂ・Ｂ’にそれぞれ止着して取り付けられる金属製の固定用プレート３とを含む構成を採用することができる(図１１〜図１７参照)。 On the other hand, in the present invention, the basic configuration of the artificial bone shaft can also be changed. Specifically, of the pair of bone shafts B and B ′ in a divided state, the artificial bone shaft is divided into the medullary cavity of one bone shaft B. The diaphysis is inserted from the end on the other side, and the inserted one end is fixedly attached to the diaphysis B and attached to the nail main body 12 and the other end that is not inserted into the medullary cavity of the diaphysis B. A metal intramedullary nail 1 having a diaphyseal filling portion 11 having a larger cross-sectional area than the medullary cavity of B; and arranged so as to straddle the diaphyseal filling portion 11 and each of the diaphyses B and B ′; A configuration including the filling portion 11 and a metal fixing plate 3 fixedly attached to each of the diaphyses B and B ′ can be employed (see FIGS. 11 to 17).
また、上記構成を採用する場合には、一対の骨幹Ｂ・Ｂ’に跨がる長さのプレート材を、長さ方向の中央部で二つに分割して固定用プレート３・３を構成して、これら二枚の固定用プレート３・３を、一方の骨幹Ｂ・Ｂ’と骨幹補填部11にそれぞれ止着して取り付け可能とすることにより、手術時における切開範囲を小さく抑えることができる(図１２、図１３参照)。 Further, when the above configuration is adopted, the plate material having a length straddling the pair of skeletons B and B ′ is divided into two at the center portion in the length direction to form the fixing plates 3 and 3. Then, by fixing these two fixing plates 3 and 3 to one of the diaphysis B and B ′ and the diaphyseal prosthesis 11 respectively, the incision range at the time of surgery can be kept small. (See FIGS. 12 and 13).
また更に、上記構成を採用する場合には、髄内釘１の骨幹補填部11を、長さ方向の中央部で二つに分割して、釘本体部12と一体に形成された第一の骨幹補填片Ｃ1と、釘本体部12と別体で構成された第二の骨幹補填片Ｃ2とから構成すると共に、一対の骨幹Ｂ・Ｂ’に跨がる長さのプレート材から成る一枚の固定用プレート３を、骨幹Ｂ・Ｂ’を跨ぐように配置して、この固定用プレート３を、各骨幹補填片と骨幹Ｂ・Ｂ’とにそれぞれ止着して取り付け可能とすることにより、手術時において、髄内釘１を骨幹の髄腔に挿入し易くすることができる(図１４、図１５参照)。 Furthermore, in the case of adopting the above-described configuration, the shaft replacement portion 11 of the intramedullary nail 1 is divided into two at the central portion in the length direction, and the first nail body portion 12 is integrally formed. It consists of a diaphyseal prosthesis piece C 1 and a second diaphyseal prosthesis piece C 2 formed separately from the nail body 12 and a plate material having a length straddling a pair of diaphyses B and B ′. One fixing plate 3 is arranged so as to straddle the diaphysis B / B ', and the fixing plate 3 can be fixedly attached to each diaphyseal replacement piece and the diaphysis B / B'. This makes it easier to insert the intramedullary nail 1 into the medullary cavity of the diaphysis during surgery (see FIGS. 14 and 15).
また、上記のように髄内釘１の骨幹補填部11を、第一の骨幹補填片Ｃ1と第二の骨幹補填片Ｃ2とに分割する構成において、一対の骨幹Ｂ・Ｂ’に跨がる長さのプレート材を、長さ方向の中央部で二つに分割して構成された二枚の固定用プレート３・３を用いることもでき、その場合には、第一の骨幹補填片Ｃ1と第二の骨幹補填片Ｃ2を相欠き接ぎした状態で相欠き部11a・11a同士を止着して骨幹Ｂ・Ｂ’間で骨幹補填片同士を連結可能に構成すると共に、各固定用プレート３・３を、第一の骨幹補填片Ｃ1と一方の骨幹Ｂ、並びに第二の骨幹補填片Ｃ2ともう一方の骨幹Ｂ’を跨ぐようにそれぞれ配置して、各骨幹補填片と骨幹Ｂ・Ｂ’に止着して取り付け可能に構成することができる(図１６、図１７参照)。 Further, as described above, in the configuration in which the shaft replacement portion 11 of the intramedullary nail 1 is divided into the first shaft replacement piece C 1 and the second shaft replacement piece C 2 , the pair of shafts B and B ′ is straddled. It is also possible to use two fixing plates 3 and 3 formed by dividing the plate material having a long length into two at the central portion in the length direction. In a state where the piece C 1 and the second diaphyseal replacement piece C 2 are in contact with each other, the phase replacement portions 11a and 11a are fastened together so that the diaphyseal replacement pieces can be connected between the diaphyses B and B ′. The fixing plates 3 and 3 are arranged so as to straddle the first shaft replacement piece C 1 and one of the shafts B, and the second shaft replacement piece C 2 and the other shaft B ′, respectively. It can be configured such that it can be fixedly attached to the replacement piece and the diaphysis B / B ′ (see FIGS. 16 and 17).
本発明では、人工骨幹を、分離状態となった骨幹の髄腔に刺し通して挿入される髄内釘だけでなく、髄内釘の骨幹間の部位に装着される金属製の補填部材、及びこの補填部材と骨幹とを連結する固定プレートを加えて構成したことにより、補填部材によって骨幹間の隙間を埋めることができるため、髄内釘と骨幹のボルト留め部分(またはネジ留め部分)にかかる負担を大幅に軽減できる。 In the present invention, the artificial bone shaft is not only an intramedullary nail that is inserted through the medullary cavity of the separated bone shaft, but also a metal replacement member that is attached to a site between the bone shafts of the intramedullary nail, and Since the gap between the shafts can be filled with the replacement member by adding the fixing plate that connects the replacement member and the shaft, it is applied to the bolted portion (or screwed portion) of the intramedullary nail and the shaft. The burden can be greatly reduced.
また本発明では、人工骨幹を、骨幹補填部を有する二つの髄内釘から構成することもでき、その場合にも、骨幹補填部で骨幹間の隙間を埋めることができるため、上記と同様の効果が得られる。また本発明では、関節部付近の治療に用いる人工骨幹を、骨幹補填部を有する髄内釘と固定プレートから構成することもでき、その場合にも骨幹補填部で骨幹間の隙間を埋めて上記と同様の効果が得られる。 Further, in the present invention, the artificial bone shaft can be composed of two intramedullary nails having a shaft replacement portion, and even in that case, the gap between the shafts can be filled with the shaft replacement portion. An effect is obtained. Further, in the present invention, the artificial bone shaft used for the treatment in the vicinity of the joint portion can also be constituted by an intramedullary nail having a shaft filling portion and a fixing plate. In this case, the gap between the shafts is filled by the bone filling portion. The same effect can be obtained.
しかも、本発明では、上記骨幹間の隙間を埋める補填部材や骨幹補填部を、金属製の部材から構成しているため、骨セメント等の充填材よりも強度が高く、骨幹間に大きな負荷がかかった場合でも、人工骨幹が折れ曲がる等の心配がない。また本発明の人工骨幹は、骨セメントのような注入作業が不要であるため、手術の安全性も高い。 Moreover, in the present invention, since the filling member and the shaft filling portion that fill the gap between the above-described shafts are made of a metal member, the strength is higher than the filler such as bone cement, and a large load is applied between the shafts. Even if it hits, there is no worry that the artificial bone shaft is bent. In addition, the artificial bone shaft of the present invention does not require an injection work such as bone cement, and thus has high surgical safety.
したがって、本発明により、手術で簡単に取り付けを行うことができ、日常生活でかかる負荷にも充分に耐えられる安全性に優れた人工骨幹を提供できることから、本発明の実用的利用価値は頗る高い。 Therefore, according to the present invention, it is possible to provide an artificial bone shaft having excellent safety that can be easily attached by surgery and can sufficiently withstand a load applied in daily life. Therefore, the practical utility value of the present invention is very high. .
『実施例１』
本発明の実施例１について、図１及び図２に基いて説明する。同図において、符号１で指示するものは、髄内釘であり、符号２で指示するものは、補填部材である。また符号３で指示するものは、固定用プレートであり、符号Ｂで指示するものは、骨幹である。また符号Ｓで指示するものは、止着部材である。
“Example 1”
A first embodiment of the present invention will be described with reference to FIGS. In the figure, what is indicated by reference numeral 1 is an intramedullary nail, and what is indicated by reference numeral 2 is a compensation member. Also, what is indicated by reference numeral 3 is a fixing plate, and what is indicated by reference numeral B is a diaphysis. Also, what is indicated by the symbol S is a fastening member.
「人工骨幹の構成及び使用方法」
[1-1]基本構成について
この実施例１では、図１(a)(b)に示すように、分離した骨幹Ｂ・Ｂ’を繋ぐための人工骨幹を、各骨幹Ｂ・Ｂ’内に挿入される棒状の髄内釘１、およびこの棒状の髄内釘１に被せて装着される筒状の補填部材２、およびこれらの骨幹Ｂ・Ｂ’や補填部材２にネジやボルト等の止着部材Ｓ・Ｓ…で取り付けられる固定用プレート３から構成している。
"Configuration and usage of artificial bone shaft"
[1-1] Basic Configuration In Example 1, as shown in FIGS. 1 (a) and 1 (b), an artificial bone shaft for connecting the separated bone shafts B and B ′ is provided in each bone shaft B and B ′. A rod-shaped intramedullary nail 1 to be inserted, a cylindrical compensation member 2 mounted on the rod-shaped intramedullary nail 1, and screws, bolts, etc. It is comprised from the plate 3 for fixing attached by the attachment member S * S ....
[1-2]使用方法について
次に上記人工骨幹の使用方法について説明する。まず髄内釘１を、分断状態となった一対の骨幹Ｂ・Ｂ’の各髄腔に、骨幹Ｂ・Ｂ’間に所定大きさの間隔が空くように刺し通して挿入する。この際、分断状態の骨幹Ｂ・Ｂ’間の部位には補填部材２を配置し、この補填部材２の中空部に髄内釘１を刺し通して補填部材２を髄内釘１に装着する。
[1-2] Usage Method Next, the usage method of the artificial bone shaft will be described. First, the intramedullary nail 1 is inserted into each of the medullary cavities of the paired bone shafts B and B ′ so as to be pierced so that a predetermined amount of space is left between the bone shafts B and B ′. At this time, the filling member 2 is disposed in a portion between the bone shafts B and B ′ in a divided state, and the intramedullary nail 1 is inserted into the hollow portion of the filling member 2 and the filling member 2 is attached to the intramedullary nail 1. .
そして、上記骨幹Ｂ・Ｂ’に挿入した髄内釘１の両端部を各骨幹Ｂ・Ｂ’に止着して取り付けた後(図示せず)、これらの補填部材２と各骨幹Ｂ・Ｂ’に跨がるように固定用プレート３・３を配置して、固定用プレート３・３と補填部材２および固定用プレート３・３と各骨幹Ｂ・Ｂ’をそれぞれ止着部材Ｓ・Ｓ…で固定して人工骨幹の取り付けを行う。 Then, after fixing both ends of the intramedullary nail 1 inserted into the above-mentioned diaphysis B / B 'to each diaphysis B / B' (not shown), these supplementary members 2 and each diaphysis B / B The fixing plates 3 and 3 are arranged so as to straddle the fixing plates 3 and 3 and the compensation member 2, and the fixing plates 3 and 3 and the diaphyses B and B 'are fixed members S and S, respectively. Attach the artificial bone shaft by fixing with….
[1-3]機能について
上記のように人工骨幹を取り付けることにより、分断状態の骨幹Ｂ・Ｂ’を繋ぐことができるだけでなく、補填部材２によって骨幹Ｂ・Ｂ’同士の間に生じる隙間を埋めることができるため、骨幹Ｂ・Ｂ’と髄内釘１の止着部分にかかる負荷を大幅に軽減できる。また補填部材２を装着することによって、骨幹Ｂ・Ｂ’間の部位を髄内釘１単体で構成するよりも強度を向上させることができる。
[1-3] Function By attaching the artificial bone shaft as described above, not only can the disconnected bone shafts B and B ′ be connected, but also the gap generated between the bone shafts B and B ′ by the filling member 2 Since it can be buried, the load applied to the anchoring portions of the diaphysis B / B ′ and the intramedullary nail 1 can be greatly reduced. In addition, by installing the supplementary member 2, the strength can be improved as compared with the case where the portion between the diaphysis B and B ′ is constituted by the intramedullary nail 1 alone.
[1-4]髄内釘について
次に上記人工骨幹の各構成要素について説明する。まず上記髄内釘１に関しては、本実施例では図１(a)に示すように、骨幹Ｂ・Ｂ’の髄腔形状に対応した直線型の棒状としているが、弯曲形状の骨幹Ｂ・Ｂ’(例えば、肋骨や鎖骨等)に使用する場合には、骨幹Ｂ・Ｂ’の形状に合わせて弯曲させた形状とすることもできる。
[1-4] Intramedullary nail Next, each component of the artificial bone shaft will be described. First, the intramedullary nail 1 has a straight rod shape corresponding to the shape of the medullary cavity of the diaphysis B · B ′ as shown in FIG. When it is used for '(for example, ribs, collarbones, etc.), it may be bent to match the shape of the diaphysis B / B'.
また上記髄内釘１の材質に関しては、本実施例では、軽量で強度に優れたチタン合金を使用しているが、生体親和性に優れた金属材料であれば、チタン合金以外のステンレスや純チタン、コバルトニッケル合金等を使用することもできる。 As for the material of the intramedullary nail 1, in this embodiment, a titanium alloy that is lightweight and excellent in strength is used. However, as long as it is a metal material excellent in biocompatibility, stainless steel other than titanium alloy or pure titanium can be used. Titanium, cobalt nickel alloy, etc. can also be used.
[1-5]補填部材について
また上記補填部材２に関しては、本実施例では図１及び図２(a)に示すように、骨幹Ｂ・Ｂ’の断面形状に対応した筒状としているが、骨幹Ｂ・Ｂ’間の隙間を埋めることができ、かつ、髄内釘１に被せて装着できる形状であれば、筒状以外の断面円弧型または断面Ｕ型の形状を採用することもできる(詳しい形状については後述する)。また本実施例では、図１(a)に示すように、止着部材Ｓとして使用するネジ部材を固定するための雌ネジ孔21・21を補強部材２の所定箇所に設けている。
[1-5] Regarding the Compensation Member The compensation member 2 has a cylindrical shape corresponding to the cross-sectional shape of the diaphysis B / B ′ as shown in FIG. 1 and FIG. As long as the gap between the diaphyses B and B ′ can be filled and can be mounted on the intramedullary nail 1, a cross-sectional arc shape other than a cylindrical shape or a cross-sectional U shape can also be adopted ( The detailed shape will be described later). Further, in this embodiment, as shown in FIG. 1A, female screw holes 21 and 21 for fixing a screw member used as the fastening member S are provided at predetermined positions of the reinforcing member 2.
また上記補填部材２の材質に関しては、本実施例では、軽量で強度に優れたチタン合金を使用しているが、生体親和性に優れた金属材料であれば、チタン合金以外のステンレスや純チタン、コバルトニッケル合金等を使用することもできる。 Further, regarding the material of the above-mentioned supplementary member 2, in this embodiment, a titanium alloy that is light and excellent in strength is used. However, if the metal material is excellent in biocompatibility, stainless steel other than titanium alloy or pure titanium is used. Cobalt nickel alloy or the like can also be used.
[1-6]固定用プレートについて
また上記固定用プレート３については、本実施例では図１及び図２(b)に示すように、断面円弧型の形状としているが、少なくとも当接面が、骨幹Ｂ・Ｂ’及び補填部材２の外周面に沿う形状であれば、片面のみが凹面となった形状を採用することもできる。また本実施例では、図１(a)に示すように、止着部材Ｓを差し込むための挿通孔31・31…を固定用プレート３の所定箇所に設けている。
[1-6] Fixing plate Further, the fixing plate 3 has a circular arc shape in this embodiment as shown in FIGS. 1 and 2 (b). As long as it is a shape along the outer peripheral surfaces of the shafts B and B ′ and the compensation member 2, a shape in which only one surface is a concave surface can be adopted. In this embodiment, as shown in FIG. 1A, insertion holes 31, 31... For inserting the fastening member S are provided at predetermined positions of the fixing plate 3.
また本実施例では、上記固定用プレート３・３を、図１(a)(b)に示すように、一対の骨幹Ｂ・Ｂ’に跨がる長さのプレート材を長さ方向の中央部で二つに分割して構成し、この二枚の固定用プレート３・３を、一方の骨幹Ｂ・Ｂ’と補填部材２とにそれぞれ止着して取り付けている。これにより、手術時において、骨幹Ｂ・Ｂ’に跨がる長さの一枚のプレート材を挿入するよりも切開範囲を小さく抑えることができるため、患者の身体にかかる負担を軽減することができる。 Further, in this embodiment, the fixing plates 3 and 3 are formed by using a plate material having a length straddling a pair of skeletons B and B ′ as shown in FIGS. 1 (a) and 1 (b). The two fixing plates 3 and 3 are fixedly attached to one of the shafts B and B ′ and the compensation member 2 respectively. As a result, it is possible to reduce the incision range smaller than inserting a single plate material having a length straddling the diaphysis B and B ′ at the time of surgery, thereby reducing the burden on the patient's body. it can.
また上記固定用プレート３の材質に関しては、本実施例では、軽量で強度に優れたチタン合金を使用しているが、生体親和性に優れた金属材料であれば、チタン合金以外のステンレスや純チタン、コバルトニッケル合金等を使用することもできる。 Further, regarding the material of the fixing plate 3, in this embodiment, a titanium alloy that is light and excellent in strength is used. However, as long as the metal material has excellent biocompatibility, stainless steel other than titanium alloy or pure titanium Titanium, cobalt nickel alloy, etc. can also be used.
[1-7]固定用プレートの仮留め構造について
また本実施例では、図１(a)及び図２(a)(b)に示すように、補填部材２と固定用プレート３の対向面に、遊嵌形状の摺動凸部22と摺動凹部32を長さ方向に沿って設けると共に、摺動凹部32の両側縁部に、内向きに突出した浮き止め部32a・32aを、また摺動凸部22の両側面部に、内向きに凹んだガイド溝21a・21aをそれぞれ形成している。
[1-7] Temporary Fastening Structure of Fixing Plate Also, in this embodiment, as shown in FIGS. 1 (a) and 2 (a) (b), the opposing surface of the compensation member 2 and the fixing plate 3 is provided. The loosely-fitted sliding convex portion 22 and the sliding concave portion 32 are provided along the length direction, and the anti-floating portions 32a and 32a protruding inwardly are formed on both side edges of the sliding concave portion 32. Guide grooves 21a and 21a that are recessed inward are formed on both side surface portions of the moving convex portion 22, respectively.
これにより、図２(c)に示すように、上記補填部材２のガイド溝22a・22aに、固定用プレート３の浮き止め部32a・32aを挿入した状態で、固定用プレート３を補填部材２の端部からスライドさせて取り付けることができるため、手術時において固定用プレート３を補填部材２に止着部材Ｓ・Ｓ…で固定する前に、固定用プレート３が浮いて大きく位置ズレする問題を防止できる。 As a result, as shown in FIG. 2 (c), the fixing plate 3 is inserted into the guide grooves 22a and 22a of the filling member 2 with the floating portions 32a and 32a of the fixing plate 3 inserted therein. Since the fixing plate 3 can be attached by being slid from the end of the fixing plate 3 before the fixing plate 3 is fixed to the supplementary member 2 with the fastening members S, S. Can be prevented.
また本実施例では、図２(b)に示すように、二枚の固定用プレート３・３の分割端側に、それぞれ摺動凹部32・32を設けると共に、各固定用プレート３・３に設ける摺動凹部32・32の長さを、補填部材２の長さの半分の大きさとすることで、手術時において、固定用プレート３・３同士の境界部分が補填部材２の中央からズレないように位置決めした状態で、固定用プレート３・３の仮留めを行うことができる。 In this embodiment, as shown in FIG. 2 (b), sliding concave portions 32 and 32 are provided on the divided end sides of the two fixing plates 3 and 3, respectively. By making the length of the sliding recesses 32, 32 to be half the length of the compensation member 2, the boundary portion between the fixation plates 3, 3 is not displaced from the center of the compensation member 2 at the time of surgery. In this state, the fixing plates 3 and 3 can be temporarily fixed.
『実施例２』
[1-8]断面Ｕ型の補填部材
次に本発明の実施例２について、図３に基いて以下に説明する。この実施例２では、図３(a)(b)に示すように、固定用プレート３を、一対の骨幹Ｂ・Ｂ’に跨がる長さの一枚のプレート材から構成すると共に、骨幹Ｂ・Ｂ’間に配置される固定用プレート３の中央部の形状を平板型の形状としている。また、補填部材２については、断面Ｕ型の形状として、両側の端面に止着部材Ｓとして使用するネジ部材を止着するための雌ネジ孔21・21…をそれぞれ設けている。(※その他の条件は実施例１と同様である。)
“Example 2”
[1-8] U-shaped Compensation Member Next, a second embodiment of the present invention will be described below with reference to FIG. In Example 2, as shown in FIGS. 3 (a) and 3 (b), the fixation plate 3 is composed of a single plate material having a length straddling a pair of diaphyses B and B 'and the diaphysis. The shape of the central portion of the fixing plate 3 disposed between B and B ′ is a flat plate shape. Further, the supplementary member 2 has a U-shaped cross section and is provided with female screw holes 21, 21... For fastening screw members used as fastening members S on both end faces. (* Other conditions are the same as in Example 1.)
そして上記のように構成したことにより、各骨幹Ｂ・Ｂ’の髄腔に髄内釘１を刺し通した後、骨幹Ｂ・Ｂ’間のスペースに露出した髄内釘１に断面Ｕ型の補填部材２を被せ、更にこの補填部材２の両側の端面に固定用プレート３の中央部を当接させた状態でネジ部材を止着することにより、補填部材２と固定用プレート３とを連結一体化することができる。 And by having comprised as mentioned above, after inserting the intramedullary nail 1 in the medullary cavity of each diaphysis B * B ', the intramedullary nail 1 exposed to the space between diaphysis B * B' is U-shaped cross section. The compensation member 2 and the fixing plate 3 are connected by covering the compensation member 2 and fastening the screw member in a state where the center portions of the fixing plate 3 are in contact with the end faces on both sides of the compensation member 2. Can be integrated.
『実施例３』
[1-9]半円筒型に分割した補填部材
次に本発明の実施例３について、図４及び図５に基いて以下に説明する。この実施例３では、図４(a)(b)に示すように、補填部材２・２’を、断面円弧型の一対の半円筒体から構成すると共に、一方の補填部材２’に止着部材Ｓを差し込むための挿通孔23・23…を、もう一方の補填部材２の両側の端面に、止着部材Ｓとして使用するネジ部材を止着するための雌ネジ孔21・21をそれぞれ設けている。また本実施例では、筒状としたときに対向する補填部材２・２’の端面に嵌合形状の凹凸部24・24’をそれぞれ設けている。(※その他の条件は実施例１と同様である。)
“Example 3”
[1-9] Compensation Member Divided into Semi-Cylinder Type Next, Embodiment 3 of the present invention will be described below with reference to FIG. 4 and FIG. In the third embodiment, as shown in FIGS. 4 (a) and 4 (b), the compensation members 2 and 2 'are formed of a pair of semi-cylindrical bodies having an arc cross section, and are fixed to one of the compensation members 2'. ... through holes 23, 23 ... for inserting the member S, and female screw holes 21, 21 for fixing a screw member used as the fixing member S are provided on both end faces of the other filling member 2, respectively. ing. Further, in the present embodiment, fitting-shaped concavo-convex portions 24 and 24 ′ are provided on the end surfaces of the complementary members 2 and 2 ′ that face each other when they are formed into a cylindrical shape. (* Other conditions are the same as in Example 1.)
そして上記のように構成したことにより、各骨幹Ｂ・Ｂ’の髄腔に髄内釘１を刺し通した後、骨幹Ｂ・Ｂ’間のスペースに露出した髄内釘１に半円筒型の一対の補填部材２・２’を筒状にして被せ、更に端面の凹凸部24・24’を嵌合させた状態で、一方の補填部材２’の挿通孔23から差し込んだ止着部材Ｓを、もう一方の補填部材２の雌ネジ孔21に止着することにより、一対の補填部材２・２’を連結一体化することができる。 And by having comprised as mentioned above, after inserting the intramedullary nail 1 in the medullary cavity of each diaphysis B * B ', the intramedullary nail 1 exposed to the space between diaphysis B * B' is semi-cylindrical type. A fixing member S inserted through the insertion hole 23 of one of the supplementary members 2 'in a state where the pair of supplementary members 2 and 2' are covered in a cylindrical shape and the uneven portions 24 and 24 'of the end face are fitted. The pair of supplementary members 2 and 2 'can be connected and integrated by being fixed to the female screw hole 21 of the other supplementary member 2.
また本実施例では、上記一対の補填部材２・２’同士を連結するためのネジ部材の頭部が固定プレート３に触れないように、固定プレート３の側縁部に切欠部33・33を設けている。一方、上記半円筒型の補填部材２・２’同士を連結するための構造としては、図５(a)(b)に示すような凹凸部24・24’のみによる構造(例えば、抜止め用のツメ部を有する係止突起を用いた構造等)を採用することもできる。 In the present embodiment, notches 33 and 33 are formed on the side edges of the fixing plate 3 so that the heads of the screw members for connecting the pair of compensation members 2 and 2 ′ do not touch the fixing plate 3. Provided. On the other hand, as a structure for connecting the semi-cylindrical filling members 2 and 2 'to each other, as shown in FIGS. 5 (a) and 5 (b), a structure having only concave and convex portions 24 and 24' (for example, for retaining) It is also possible to employ a structure using a locking projection having a claw portion.
『実施例４』
[1-10]骨幹補填部を備えた固定用プレート
次に本発明の実施例４について、図６に基いて以下に説明する。この実施例４では、図６(a)(b)に示すように、一対の骨幹Ｂ・Ｂ’に跨がる長さのプレート材から構成される固定用プレート３の中央部に、髄内釘１を被覆可能な断面円弧型の骨幹補填部34を設けると共に、この骨幹補填部34の所定箇所に、止着部材Ｓを差し込むための挿通孔31・31を設けている。また補填部材２については、断面円弧型の形状にすると共に、両側の端面に止着部材Ｓとして使用するネジ部材を止着するための雌ネジ孔21・21をそれぞれ設けている。(※その他の条件は実施例１と同様である。)
Example 4
[1-10] Fixing plate provided with diaphysis filling portion Next, a fourth embodiment of the present invention will be described below with reference to FIG. In this Example 4, as shown in FIGS. 6 (a) and 6 (b), the intramedullary region is placed in the center of the fixing plate 3 composed of a plate material having a length straddling a pair of shafts B and B '. A diaphyseal filling portion 34 having a circular arc shape capable of covering the nail 1 is provided, and insertion holes 31 and 31 for inserting the fastening member S are provided at predetermined positions of the diaphyseal filling portion 34. The supplementary member 2 has a circular arc shape in cross section and is provided with female screw holes 21 and 21 for fastening screw members used as fastening members S on both end faces. (* Other conditions are the same as in Example 1.)
そして上記のように構成したことにより、各骨幹Ｂ・Ｂ’の髄腔に髄内釘１を刺し通した後、骨幹Ｂ・Ｂ’間のスペースに露出した髄内釘１に、固定用プレート３の骨幹補填部34と半円筒型の補填部材２を筒状にして被せ、更に固定用プレート３の挿通孔31から差し込んだネジ部材を補填部材２の雌ネジ孔21に止着することにより、固定用プレート３と補填部材２とを連結一体化することができる。 And by having comprised as mentioned above, after inserting the intramedullary nail 1 in the medullary cavity of each diaphysis B * B ', it fixes to the intramedullary nail 1 exposed in the space between diaphysis B * B'. 3 and the semi-cylindrical filling member 2 are covered with a cylindrical shape, and the screw member inserted from the insertion hole 31 of the fixing plate 3 is fixed to the female screw hole 21 of the filling member 2. The fixing plate 3 and the compensation member 2 can be connected and integrated.
『実施例５』
「人工骨幹の構成及び使用方法」
[2-1]基本構成について
次に本発明の実施例５について、図７〜図１０に基いて以下に説明する。この実施例５では、図７(a)(b)に示すように、分離した骨幹Ｂ・Ｂ’を繋ぐための人工骨幹を、挿入される骨幹Ｂ・Ｂ’ごとに第一髄内釘Ｎ1と第二髄内釘Ｎ2に分割して構成された髄内釘１から構成している。また第一髄内釘Ｎ1と第二髄内釘Ｎ2には、図７(c)に示すように、各骨幹Ｂ・Ｂ’に止着される側と反対側の端部に、骨幹Ｂ・Ｂ’の髄腔よりも断面積が大きく、かつ、端面が相欠き形状を成す骨幹補填部11・11をそれぞれ設けている。
“Example 5”
"Configuration and usage of artificial bone shaft"
[2-1] Basic Configuration Next, a fifth embodiment of the present invention will be described below with reference to FIGS. In Example 5, as shown in FIGS. 7 (a) and 7 (b), the first intramedullary nail N is provided for each of the inserted bone shafts B and B '. 1 to constitute a intramedullary nail 1 configured by dividing the second intramedullary nail N 2. Also the first intramedullary nail N 1 in the second nail N 2, as shown in FIG. 7 (c), the end opposite to the side to be fastened to the metaphyseal B · B ', diaphysis The diaphyseal filling parts 11 and 11 each having a larger cross-sectional area than the medullary cavity of B and B ′ and having an end face in a phase-out shape are provided.
[2-2]使用方法について
次に上記人工骨幹の使用方法について説明する。まず髄内釘１の第一髄内釘Ｎ1と第二髄内釘Ｎ2を、分断状態となった一対の骨幹Ｂ・Ｂ’の各髄腔にそれぞれ挿入して、第一髄内釘Ｎ1と第二髄内釘Ｎ2の骨幹補填部11・11を相欠き接ぎする。そして、この第一髄内釘Ｎ1と第二髄内釘Ｎ2の相欠き部11a・11a同士を止着部材Ｓ・Ｓ…で連結一体化して人工骨幹の取り付けを行う。
[2-2] Usage Method Next, the usage method of the artificial bone shaft will be described. First, the first intramedullary nail N 1 and the second intramedullary nail N 2 are respectively inserted into the medullary cavities of the paired diaphyses B and B ′, and the first intramedullary nail 1 is inserted. N 1 and the second intramedullary nail N 2 are in contact with the shaft replacement parts 11 and 11. Then, the mounting of the artificial diaphysis are integrally connected to the first intramedullary nail N 1 and second intramedullary-lap portion 11a · 11a each other of the nail N 2 in fastening member S · S ....
[2-3]機能について
上記のように人工骨幹を取り付けることにより、分断状態の骨幹Ｂ・Ｂ’を繋ぐことができるだけでなく、第一髄内釘Ｎ1と第二髄内釘Ｎ2の骨幹補填部11・11によって骨幹Ｂ・Ｂ’間に生じる隙間を埋めることができるため、骨幹Ｂ・Ｂ’と髄内釘１の止着部分にかかる負荷を大幅に軽減できる。また骨幹補填部11・11の断面積を骨幹Ｂ・Ｂ’の髄腔の断面積よりも大きくする(骨幹補填部11・11を太く形成する)ことによって、骨幹Ｂ・Ｂ’間の部位を髄腔に挿入可能な細い髄内釘１で構成するよりも強度を高めることができる。
[2-3] Function By attaching the artificial bone shaft as described above, not only can the disconnected bone shafts B and B 'be connected, but also the first intramedullary nail N 1 and the second intramedullary nail N 2 Since the gap generated between the shafts B and B ′ can be filled by the shaft replacement parts 11 and 11, the load applied to the fixing portion between the shafts B and B ′ and the intramedullary nail 1 can be greatly reduced. Further, by making the cross-sectional area of the diaphyseal replacement parts 11 and 11 larger than the cross-sectional area of the medullary cavity of the diaphysis B and B '(form the diaphyseal replacement parts 11 and 11 thick), the region between the diaphysis B and B' The strength can be increased as compared with the case of the thin intramedullary nail 1 that can be inserted into the medullary cavity.
[2-4]髄内釘について
次に上記人工骨幹の各構成要素について説明する。まず上記髄内釘１の第一髄内釘Ｎ1と第二髄内釘Ｎ2に関しては、本実施例では図７(a)(b)に示すように、骨幹Ｂ・Ｂ’の髄腔形状に対応した直線型の棒状としているが、弯曲形状の骨幹Ｂ・Ｂ’(例えば、肋骨や鎖骨等)に使用する場合には、骨幹Ｂ・Ｂ’の形状に合わせて弯曲させた形状とすることもできる。
[2-4] Intramedullary nail Next, each component of the artificial bone shaft will be described. First, regarding the first intramedullary nail N 1 and the second intramedullary nail N 2 of the intramedullary nail 1 , in this embodiment, as shown in FIGS. 7 (a) and 7 (b), the medullary cavity of the diaphysis B and B ′. Although it is a straight bar shape corresponding to the shape, when used for a curved skeleton B / B ′ (for example, ribs or clavicle), the shape is curved in accordance with the shape of the skeleton B / B ′ You can also
また本実施例では、図７(c)に示すように、第一髄内釘Ｎ1と第二髄内釘Ｎ2の相欠き部11a・11aに、止着部材Ｓとして使用するボルト部材を挿入するための挿通孔11b・11bをそれぞれ設けている。そして、この挿通孔11b・11bに挿入したボルト部材をナット部材で締結して相欠き部11a・11a同士を連結できるように構成している。 In this embodiment also, as shown in FIG. 7 (c), the first intramedullary nail N 1 and the phase-out portion 11a · 11a of the second intramedullary nail N 2, the bolt member used as a fastening member S Insertion holes 11b and 11b for insertion are respectively provided. The bolt members inserted into the insertion holes 11b and 11b are fastened with nut members so that the phase notches 11a and 11a can be connected to each other.
また上記髄内釘１の材質に関しては、本実施例では、軽量で強度に優れたチタン合金を使用しているが、生体親和性に優れた金属材料であれば、チタン合金以外のステンレスや純チタン、コバルトニッケル合金等を使用することもできる。 As for the material of the intramedullary nail 1, in this embodiment, a titanium alloy that is lightweight and excellent in strength is used. However, as long as it is a metal material excellent in biocompatibility, stainless steel other than titanium alloy or pure titanium can be used. Titanium, cobalt nickel alloy, etc. can also be used.
[2-5]骨幹補填部の相欠き形状について
また本実施例では、図７(c)に示すように、上記第一髄内釘Ｎ1及び第二髄内釘Ｎ2の各骨幹補填部11・11に、髄内釘１の長さ方向の対向面に凹凸部Ｐ・Ｑをそれぞれ設けている。そして、これらの凹凸部Ｐ・Ｑを嵌め合わせた状態で骨幹補填部11・11同士を相欠き接ぎすることによって相欠き部11a・11a同士を仮留めできると共に、相欠き部11a・11aの止着部分にかかる負担を軽減できる。
[2-5] In the half-lap also present embodiment the shape of the metaphyseal interpolator, as shown in FIG. 7 (c), the first intramedullary nail N 1 and the diaphyseal filling of the second intramedullary nail N 2 11 and 11 are provided with concavo-convex portions P and Q on opposite surfaces of the intramedullary nail 1 in the length direction. In addition, when these concavo-convex portions P and Q are fitted together, the diaphyseal portion 11a and 11a can be temporarily fastened to each other by temporarily connecting the diaphyseal filling portions 11 and 11 together, and the stop of the phased portions 11a and 11a can be stopped. The burden on the wearing part can be reduced.
[2-6]骨幹補填部の相欠き形状の変更例について
また本実施例では、図７(c)に示すように、第一髄内釘Ｎ1と第二髄内釘Ｎ2の相欠き部11a・11aの形状を、一方(第二髄内釘Ｎ2の相欠き部11a)を厚く、他方(第一髄内釘Ｎ1の相欠き部11a)を薄く形成しているが、図８に示すように、双方(第一髄内釘Ｎ1と第二髄内釘Ｎ2の相欠き部11a・11a)が同じ厚みとなるように構成することもできる。
[2-6] In the half-lap also present embodiment will modifications of the shape of diaphyseal interpolator, as shown in FIG. 7 (c), the first intramedullary nail N 1 and lack of phase second intramedullary nail N 2 the shape of the parts 11a · 11a, whereas (second intramedullary-lap portion 11a of the nail N 2) a thick, although other forms thin (first intramedullary-lap portion 11a of the nail N 1), FIG. as shown in 8, it is also possible to both (first intramedullary nail N 1 and second intramedullary-lap portion 11a · 11a of the nail N 2) is configured to have the same thickness.
また本実施例では、図７(a)(b)に示すように、第一髄内釘Ｎ1と第二髄内釘Ｎ2の相欠き部11a・11aの形状を、相欠き接ぎした際の両者の境界線がほゞ直角に屈曲する直線から描かれる形状としているが、これも図９(a)(b)または図１０(a)(b)に示すように、両者の境界線が波状に屈曲する曲線から描かれる形状に変更することもできる。なお図１０に示される人工骨幹は、第一髄内釘Ｎ1と第二髄内釘Ｎ2の相欠き部11a・11aの先端が、図９に示される人工骨幹よりも細くなるように形成している。 In this embodiment also, as shown in FIG. 7 (a) (b), when the shape of the first intramedullary nail N 1 and second intramedullary nail N 2 phase-outs 11a · 11a, and Rabbet The boundary line between the two is drawn from a straight line that bends at a substantially right angle. However, as shown in FIG. 9 (a) (b) or FIG. 10 (a) (b), the boundary line between the two is It can also be changed to a shape drawn from a curved curve. Note Artificial diaphyseal shown in Figure 10, the distal end of the first nail N 1 and second intramedullary-lap portion 11a · 11a of the nail N 2 is formed to be thinner than the artificial diaphyseal shown in FIG. 9 doing.
『実施例６』
「人工骨幹の構成及び使用方法」
[3-1]基本構成について
次に本発明の実施例１について、図１１に基いて以下に説明する。この実施例６では、図１１(a)(b)に示すように、分離した骨幹Ｂ・Ｂ’を繋ぐための人工骨幹を、一方の骨幹Ｂの髄腔に挿入される釘本体部12を有し、かつ、骨幹Ｂの髄腔に挿入されない端部側に、骨幹Ｂの髄腔よりも断面積が大きい骨幹補填部11が形成された棒状の髄内釘１と、この髄内釘１の骨幹補填部11と各骨幹Ｂ・Ｂ’に対して止着部材Ｓ・Ｓ…で取り付けられる固定用プレート３とから構成している。
“Example 6”
"Configuration and usage of artificial bone shaft"
[3-1] Basic Configuration Next, Embodiment 1 of the present invention will be described below with reference to FIG. In Example 6, as shown in FIGS. 11 (a) and 11 (b), an artificial bone shaft for connecting the separated shafts B and B 'is used as a nail body portion 12 inserted into the medullary cavity of one shaft B. A rod-shaped intramedullary nail 1 having a shaft replacement portion 11 having a larger cross-sectional area than the medullary cavity of the diaphysis B is formed on the end side which is not inserted into the medullary cavity of the diaphysis B, and the intramedullary nail 1 , And a fixing plate 3 attached to each of the shafts B, B ′ by fastening members S, S.
[3-2]使用方法について
次に上記人工骨幹の使用方法について説明する。まず髄内釘１の釘本体部12を、分断状態となった一対の骨幹Ｂ・Ｂ’のうち、一方の骨幹Ｂの髄腔に、分断された側の端部から差し込んで挿入し、髄腔に挿入された端部を、止着部材Ｓ(ネジ部材やボルト部材等)で骨幹Ｂに止着して取り付ける。その後、髄内釘１と分断された各骨幹Ｂ・Ｂ’に跨がるように固定用プレート３を配置して、固定用プレート３と骨幹補填部11、及び固定用プレート３と各骨幹Ｂ・Ｂ’をそれぞれ止着部材Ｓ(ネジ部材やボルト部材等)で固定して人工骨幹の取り付けを行う。
[3-2] Usage Method Next, the usage method of the artificial bone shaft will be described. First, the nail body portion 12 of the intramedullary nail 1 is inserted into the medullary cavity of one of the shafts B of the paired diaphyses B and B 'from the divided side, and inserted. The end portion inserted into the cavity is fixed to the diaphysis B with a fixing member S (screw member, bolt member or the like) and attached. After that, the fixing plate 3 is arranged so as to straddle the intramedullary nail 1 and each of the separated bone shafts B and B ′, and the fixing plate 3 and the shaft replacement portion 11 and the fixing plate 3 and each shaft B -The artificial bone shaft is attached by fixing B 'with a fastening member S (screw member, bolt member or the like).
[3-3]機能について
上記のように人工骨幹を取り付けることにより、分断状態の骨幹Ｂ・Ｂ’を繋ぐことができるだけでなく、骨幹補填部11によって骨幹Ｂ・Ｂ’同士の間に生じる隙間を埋めることができるため、骨幹Ｂ・Ｂ’と髄内釘１の止着部分にかかる負荷を大幅に軽減できる。また骨幹補填部11の断面積を骨幹Ｂの髄腔の断面積よりも大きくする(骨幹補填部11を太く形成する)ことによって、骨幹Ｂ・Ｂ’間の部位を髄腔に挿入可能な細い髄内釘１で構成するよりも強度を高めることができる。また本実施例では、一方の骨幹Ｂ’の髄腔に髄内釘１を挿入しなくても人工骨幹の取り付けを行うことができるため、関節部付近の治療に用いることができる。
[3-3] Function By attaching the artificial bone shaft as described above, not only can the broken bone shafts B and B 'be connected, but also the gap generated between the bone shafts B and B' by the bone filling portion 11 Therefore, it is possible to greatly reduce the load applied to the anchoring portions of the diaphysis B / B ′ and the intramedullary nail 1. Further, by making the cross-sectional area of the diaphyseal replacement part 11 larger than the cross-sectional area of the medullary cavity of the diaphysis B (forming the diaphyseal replacement part 11 thick), a thin part that can be inserted into the medullary cavity between the diaphysis B and B ′ The strength can be increased as compared with the case of the intramedullary nail 1. In this embodiment, since the artificial bone shaft can be attached without inserting the intramedullary nail 1 into the medullary cavity of one of the bone shafts B ′, it can be used for treatment in the vicinity of the joint.
[3-4]髄内釘について
次に上記人工骨幹の各構成要素について説明する。まず上記髄内釘１に関しては、本実施例では図１１(a)(b)に示すように、骨幹Ｂの髄腔形状に対応した直線型の棒状としているが、弯曲形状の骨幹Ｂ(例えば、肋骨や鎖骨等)に使用する場合には、骨幹Ｂの形状に合わせて弯曲させた形状とすることもできる。また本実施例においては、図１１(a)に示すように、髄内釘１の骨幹補填部11と釘本体部12に対し、止着部材Ｓを差し込むための挿通孔11b・12aを所定箇所にそれぞれ設けている。
[3-4] Intramedullary nail Next, each component of the artificial bone shaft will be described. First, the intramedullary nail 1 is a straight rod corresponding to the shape of the medullary cavity of the diaphysis B as shown in FIGS. 11 (a) and 11 (b) in this embodiment. , Ribs, collarbones, etc.), it can also be bent to match the shape of the diaphysis B. Further, in this embodiment, as shown in FIG. 11 (a), insertion holes 11b and 12a for inserting the fastening member S into the diaphyseal replacement portion 11 and the nail body portion 12 of the intramedullary nail 1 are provided at predetermined positions. Respectively.
また上記髄内釘１の材質に関しては、本実施例では、軽量で強度に優れたチタン合金を使用しているが、生体親和性に優れた金属材料であれば、チタン合金以外のステンレスや純チタン、コバルトニッケル合金等を使用することもできる。 As for the material of the intramedullary nail 1, in this embodiment, a titanium alloy that is lightweight and excellent in strength is used. However, as long as it is a metal material excellent in biocompatibility, stainless steel other than titanium alloy or pure titanium can be used. Titanium, cobalt nickel alloy, etc. can also be used.
[3-5]固定用プレートについて
また上記固定用プレート３については、本実施例では図１１(a)に示すように、断面円弧型の形状としているが、少なくとも当接面が、骨幹Ｂ・Ｂ’及び骨幹補填部11の外周面に沿う形状であれば、片面のみが凹面となった形状を採用することもできる。また本実施例では、図１１(a)に示すように、止着部材Ｓを差し込むための挿通孔31・31…を固定用プレート３の所定箇所に設けている。また本実施例では、上記固定用プレート３の一端側を、二股形状とすることによって膝蓋骨を避けて取り付けが行えるようにしている。
[3-5] Fixing plate The fixing plate 3 has an arcuate cross section as shown in FIG. 11 (a) in the present embodiment. If it is a shape along the outer peripheral surface of B ′ and the diaphyseal replacement portion 11, a shape in which only one surface is a concave surface can be adopted. In this embodiment, as shown in FIG. 11A, insertion holes 31, 31... For inserting the fastening member S are provided at predetermined positions of the fixing plate 3. In this embodiment, one end of the fixing plate 3 is bifurcated so that it can be attached while avoiding the patella.
また上記固定用プレート３の材質に関しては、本実施例では、軽量で強度に優れたチタン合金を使用しているが、生体親和性に優れた金属材料であれば、チタン合金以外のステンレスや純チタン、コバルトニッケル合金等を使用することもできる。 Further, regarding the material of the fixing plate 3, in this embodiment, a titanium alloy that is light and excellent in strength is used. However, as long as the metal material has excellent biocompatibility, stainless steel other than titanium alloy or pure titanium Titanium, cobalt nickel alloy, etc. can also be used.
『実施例７』
[3-6]固定プレートを分割した構造について
次に本発明の実施例７について、図１２及び図１３に基いて以下に説明する。この実施例７では、図１２(a)(b)に示すように、固定用プレート３・３を、一対の骨幹Ｂ・Ｂ’に跨がる長さのプレート材を長さ方向の中央部で二つに分割して構成している。そして、この二枚の固定用プレート３・３を、一方の骨幹Ｂ・Ｂ’と髄内釘１の骨幹補填部11とにそれぞれ止着して取り付けている。これにより、手術時において、骨幹Ｂ・Ｂ’に跨がる長さの一枚のプレート材を挿入するよりも切開範囲を小さく抑えることができるため、患者の身体にかかる負担を軽減できる。
“Example 7”
[3-6] Structure in which Fixed Plate is Divided Next, a seventh embodiment of the present invention will be described below with reference to FIGS. In Example 7, as shown in FIGS. 12 (a) and 12 (b), the fixing plates 3 and 3 are made of a plate material having a length straddling a pair of skeletons B and B ′. It is divided into two. The two fixing plates 3 and 3 are fixedly attached to one of the shafts B and B ′ and the shaft filling portion 11 of the intramedullary nail 1. Thereby, at the time of an operation, since the incision range can be suppressed smaller than inserting a single plate material having a length extending over the diaphysis B and B ′, the burden on the patient's body can be reduced.
[3-7]固定用プレートの仮留め構造について
また本実施例では、図１２(a)(c)に示すように、髄内釘１の骨幹補填部11と固定用プレート３の対向面に、遊嵌形状の摺動凸部13と摺動凹部32を長さ方向に沿って設けると共に、摺動凹部32の両側縁部に、内向きに突出した浮き止め部32a・32aを、また摺動凸部13の両側面部に、内向きに凹んだガイド溝13a・13aをそれぞれ形成している。
[3-7] Temporary Fastening Structure of Fixing Plate Also, in this embodiment, as shown in FIGS. The loosely-fitted sliding convex portion 13 and the sliding concave portion 32 are provided along the length direction, and the floating portions 32a and 32a protruding inwardly are formed on both side edges of the sliding concave portion 32. Inwardly recessed guide grooves 13a and 13a are formed on both side surface portions of the moving convex portion 13, respectively.
これにより、上記摺動凸部13のガイド溝13a・13aに、摺動凹部32の浮き止め部32a・32aを挿入した状態で、固定用プレート３を骨幹補填部11の端部からスライドさせて取り付けることができるため、手術時において固定用プレート３を骨幹補填部11に止着部材Ｓ・Ｓ…で固定する前に、固定用プレート３が浮いて大きく位置ズレする問題を防止できる。 As a result, the fixing plate 3 is slid from the end of the diaphyseal filling portion 11 in a state in which the floating preventing portions 32a and 32a of the sliding concave portion 32 are inserted into the guide grooves 13a and 13a of the sliding convex portion 13. Since the fixing plate 3 can be attached, before the fixing plate 3 is fixed to the shaft replacement portion 11 with the fastening members S, S...
また本実施例では、図１２(c)に示すように、二枚の固定用プレート３・３の分割端側に、それぞれ摺動凹部32・32を設けると共に、各固定用プレート３・３に設ける摺動凹部32・32の長さを、骨幹補填部11の長さの半分の大きさとすることで、手術時において、固定用プレート３・３同士の境界部分が骨幹補填部11の中央からズレないように位置決めした状態で、固定用プレート３・３の仮留めを行うことができる。 In this embodiment, as shown in FIG. 12 (c), sliding concave portions 32 and 32 are provided on the divided end sides of the two fixing plates 3 and 3, respectively. By setting the length of the sliding recesses 32, 32 to be half the length of the diaphyseal replacement portion 11, the boundary portion between the fixation plates 3, 3 from the center of the diaphyseal replacement portion 11 during surgery. The fixing plates 3 and 3 can be temporarily fixed in a state where they are positioned so as not to be displaced.
[3-8]固定用プレートの形状の変更例について
また本実施例では、上記固定用プレート３の一方を二股形状とすることによって膝蓋骨を避けて取り付けが行えるようにしているが、図１３(a)(b)(c)に示すように、分割された両方の固定用プレート３・３を直線状に形成して、膝以外の例えば肘等の関節部付近に人工骨幹を使用することもできる。(※その他の条件は実施例６と同様である。)
[3-8] Example of changing the shape of the fixing plate In the present embodiment, one of the fixing plates 3 is bifurcated so that it can be attached while avoiding the patella. As shown in a), (b) and (c), both of the divided fixing plates 3 and 3 may be formed in a straight line, and an artificial bone shaft may be used in the vicinity of a joint portion such as an elbow other than the knee. it can. (* Other conditions are the same as in Example 6.)
『実施例８』
[3-9]骨幹補填部を分割した構造について
次に本発明の実施例８について、図１４及び図１５に基いて以下に説明する。この実施例７では、図１４(a)(b)(c)に示すように、髄内釘１の骨幹補填部11を長さ方向の中央部で二つに分割して、釘本体部12と一体に形成された第一の骨幹補填片Ｃ1と、釘本体部12と別体で構成された第二の骨幹補填片Ｃ2とから骨幹補填部11を構成している。
Example 8
[3-9] Structure in which the shaft replacement portion is divided Next, an eighth embodiment of the present invention will be described below with reference to FIGS. In Example 7, as shown in FIGS. 14 (a), (b) and (c), the diaphyseal replacement portion 11 of the intramedullary nail 1 is divided into two at the central portion in the length direction, so that the nail body portion 12 The first shaft replacement piece C 1 formed integrally with the second shaft replacement piece C 2 formed separately from the nail body portion 12 constitutes the shaft replacement portion 11.
また本実施例では、図１４(a)(c)に示すように、上記第一の骨幹補填片Ｃ1と第二の骨幹補填片Ｃ2を端面が相欠き形状を成すように構成すると共に、これらの骨幹補填片の所定箇所に、止着部材Ｓ(ボルト部材)を差し込むための挿通孔11b・11bを設けて、この挿通孔11b・11bにボルト部材を差し込んでナットで締結することにより、第一の骨幹補填片Ｃ1と第二の骨幹補填片Ｃ2を相欠き接ぎした状態で連結一体化できるように構成している。 In this embodiment also, as shown in FIG. 14 (a) (c), with an end face of the first metaphyseal filling piece C 1 and the second metaphyseal filling piece C 2 is configured to form a half-lap shape By providing insertion holes 11b and 11b for inserting fastening members S (bolt members) at predetermined locations of these diaphyseal pieces, inserting bolt members into the insertion holes 11b and 11b and fastening them with nuts The first diaphyseal prosthesis piece C 1 and the second diaphyseal prosthesis piece C 2 are configured so as to be connected and integrated in a state where they are in contact with each other.
そして本実施例では、上記髄内釘１を取り付けた、骨幹Ｂ・Ｂ’を跨ぐように一枚の固定用プレート３を配置して、この固定用プレート３を、第一の骨幹補填片Ｃ1と一方の骨幹Ｂ、及び第二の骨幹補填片Ｃ2ともう一方の骨幹Ｂ’にそれぞれ止着して人工骨幹の取り付けを行えるようにしている。 In this embodiment, a single fixing plate 3 is disposed so as to straddle the bone shafts B and B ′ to which the intramedullary nail 1 is attached, and this fixing plate 3 is used as the first bone shaft filling piece C. The artificial bone shaft can be attached by being fixed to 1 and one of the shafts B, and the second shaft replacement piece C 2 and the other shaft B ′.
上記のように構成したことにより、手術時において、小型の第一の骨幹補填片Ｃ1のみが付いた状態で髄内釘１の釘本体部12を骨幹Ｂの髄腔に挿入することができるため、大型の骨幹補填部11が付いた状態で釘本体12を髄腔に挿入するよりも、髄内釘１の挿入をよりスムーズに行うことができる。 With the above-described configuration, the nail main body portion 12 of the intramedullary nail 1 can be inserted into the medullary cavity of the diaphysis B with only the small first diaphysis replacement piece C 1 attached at the time of surgery. Therefore, the intramedullary nail 1 can be inserted more smoothly than when the nail body 12 is inserted into the medullary cavity with the large diaphysis replacement portion 11 attached.
また本実施例では、図１４(a)(c)に示すように、上記第一の骨幹補填片Ｃ1と第二の骨幹補填片Ｃ2に、骨幹補填部11の長さ方向の対向面に凹凸部Ｐ・Ｑをそれぞれ設けて、これらの凹凸部Ｐ・Ｑを嵌め合わせた状態で骨幹補填片同士を相欠き接ぎ可能に構成しているため、相欠き部11a・11a同士を仮留めが行えるだけでなく、相欠き部11a・11aの止着部分にかかる負担も軽減できる。(※その他の条件は実施例６と同様である。) In the present embodiment, as shown in FIG. 14 (a) (c), in the first metaphyseal filling piece C 1 and the second metaphyseal filling piece C 2, opposing surfaces of the longitudinal direction of the diaphysis interpolator 11 Are provided with concavo-convex portions P and Q, respectively, and the skeletal prosthesis pieces 11a and 11a are temporarily fastened to each other because the skeletal prosthesis pieces can be connected to each other with the concavo-convex portions P and Q fitted together. Not only can be carried out, but also the load on the fixing part of the phase missing portions 11a and 11a can be reduced. (* Other conditions are the same as in Example 6.)
[3-10]固定用プレートの形状の変更例について
また本実施例では、上記固定用プレート３の一方を二股形状とすることによって膝蓋骨を避けて取り付けが行えるようにしているが、図１５(a)(b)(c)に示すように、分割された両方の固定用プレート３・３を直線状に形成して、膝以外の例えば肘等の関節部付近に人工骨幹を使用することもできる。
[3-10] Example of changing shape of fixing plate In this embodiment, one of the fixing plates 3 is bifurcated so that it can be attached while avoiding the patella. As shown in a), (b) and (c), both of the divided fixing plates 3 and 3 may be formed in a straight line, and an artificial bone shaft may be used in the vicinity of a joint portion such as an elbow other than the knee. it can.
『実施例９』
[3-11]固定プレートと骨幹補填部の両方を分割した構造について
次に本発明の実施例９について、図１６及び図１７に基いて以下に説明する。この実施例９では、図１６(a)(b)(c)に示すように、固定用プレート３・３を、一対の骨幹Ｂ・Ｂ’に跨がる長さのプレート材を長さ方向の中央部で二つに分割して構成すると共に、髄内釘１の骨幹補填部11を長さ方向の中央部で二つに分割して構成している。。
Example 9
[3-11] Structure in which both fixing plate and diaphysis filling part are divided Next, a ninth embodiment of the present invention will be described below with reference to FIGS. 16 and 17. In Example 9, as shown in FIGS. 16 (a), 16 (b), and 16 (c), the fixing plates 3 and 3 are made of a plate material having a length straddling a pair of skeletons B and B ′. The diaphyseal portion 11 of the intramedullary nail 1 is divided into two at the central portion in the length direction. .
また、上記骨幹補填部11の第一の骨幹補填片Ｃ1と第二の骨幹補填片Ｃ2については、実施例８と同様、相欠き接ぎした状態で相欠き部11a・11a同士を止着して骨幹Ｂ・Ｂ’間で骨幹補填片同士を連結可能に構成している。また二枚の固定用プレート３・３は、第一の骨幹補填片Ｃ1と一方の骨幹Ｂ、並びに第二の骨幹補填片Ｃ2ともう一方の骨幹Ｂ’を跨ぐようにそれぞれ配置して、各骨幹補填片と骨幹Ｂ・Ｂ’に止着部材Ｓで固定できるように構成している。 In addition, the first diaphyseal replacement piece C 1 and the second diaphyseal replacement piece C 2 of the diaphyseal replacement part 11 are fastened to each other in the state where they are in contact with each other as in Example 8. Thus, the shaft replacement pieces are configured to be connectable between the shafts B and B ′. The two fixing plates 3 and 3 are arranged so as to straddle the first diaphyseal replacement piece C 1 and one diaphysis B, and the second diaphyseal replacement piece C 2 and the other diaphysis B ′. , Each bone shaft filling piece and the shafts B and B ′ are configured to be fixed by the fastening member S.
そして上記のように構成したことにより、本実施例の人工骨幹では、実施例７の人工骨幹で得られる切開範囲を小さく抑える効果と、実施例８の人工骨幹で得られる髄内釘１が挿入し易くなる効果を両方とも得ることができる。(※その他の条件は実施例６と同様である。) And by having comprised as mentioned above, in the artificial bone shaft of a present Example, the effect which restrains the incision range obtained with the artificial bone shaft of Example 7 small, and the intramedullary nail 1 obtained with the artificial bone shaft of Example 8 are inserted. Both effects can be obtained. (* Other conditions are the same as in Example 6.)
[3-12]固定用プレートの形状の変更例について
また本実施例では、上記固定用プレート３の一方を二股形状とすることによって膝蓋骨を避けて取り付けが行えるようにしているが、図１６(a)(b)(c)に示すように、分割された両方の固定用プレート３・３を直線状に形成して、膝以外の例えば肘等の関節部付近に人工骨幹を使用することもできる。
[3-12] Example of changing the shape of the fixing plate In the present embodiment, one of the fixing plates 3 is bifurcated so that it can be attached while avoiding the patella. As shown in a), (b) and (c), both of the divided fixing plates 3 and 3 may be formed in a straight line, and an artificial bone shaft may be used in the vicinity of a joint portion such as an elbow other than the knee. it can.
本発明は、概ね上記のように構成されるが、本発明は図示の実施形態に限定されるものではなく、「特許請求の範囲」の記載内において種々の変更が可能であって、例えば、止着部材Ｓについては、ナットを使用して締結するボルト部材であっても、下孔に捻じ込んで固定するネジ部材であってもよく、何れのものも本発明の技術的範囲に属する。 The present invention is generally configured as described above. However, the present invention is not limited to the illustrated embodiment, and various modifications can be made within the description of “Claims”. The fastening member S may be a bolt member that is fastened using a nut or a screw member that is screwed into a lower hole and fixed, and any of them belongs to the technical scope of the present invention.
１ 髄内釘
11 骨幹補填部
11a 相欠き部
11b 挿通孔
12 釘本体部
12a 挿通孔
13 摺動凸部
13a ガイド溝
２ 補填部材
21 雌ネジ孔
22 摺動凸部
22a ガイド溝
23 挿通孔
24 凹凸部
３ 固定用プレート
31 挿通孔
32 摺動凹部
32a 浮き止め部
33 切欠部
34 骨幹補填部
Ｂ 骨幹
Ｐ 凸部
Ｑ 凹部
Ｓ 止着部材
Ｃ 骨幹補填片
1 Intramedullary nail
11 Stem replacement part
11a Phase notch
11b insertion hole
12 Nail body
12a Insertion hole
13 Sliding projection
13a Guide groove 2 Filling member
21 Female thread hole
22 Sliding projection
22a Guide groove
23 Insertion hole
24 Concavity and convexity 3 Fixing plate
31 Insertion hole
32 Sliding recess
32a Lifting part
33 Notch
34 Bone shaft replacement B Bone shaft P Convex portion Q Concavity S Fastening member C Bone shaft replacement piece
Claims (6)
前記分断状態となった一対の骨幹(Ｂ)(Ｂ’)のうち、一方の骨幹(Ｂ)の髄腔に、分断された側の端部から挿入されて、その挿入された一端部が骨幹(Ｂ)に止着して取り付けられる釘本体部(12)と、骨幹(Ｂ)の髄腔に挿入されない他端部側に形成された、骨幹(Ｂ)の髄腔よりも断面積が大きい骨幹補填部(11)とを有する髄内釘(１)を含んで構成される一方、
前記髄内釘(１)の骨幹補填部(11)が、長さ方向の中央部で端面が相欠き形状を成すように二つに分割されて、釘本体部(12)と一体に形成された第一の骨幹補填片(Ｃ1)と、釘本体部(12)と別体で構成された第二の骨幹補填片(Ｃ2)とから構成されると共に、
前記第一の骨幹補填片(Ｃ1)と第二の骨幹補填片(Ｃ2)を相欠き接ぎした状態で相欠き部(11a)(11a)同士を止着して骨幹(Ｂ)(Ｂ’)間で骨幹補填片同士が連結可能となっており、かつ、前記第一の骨幹補填片(Ｃ 1 )と第二の骨幹補填片(Ｃ 2 )には、骨幹補填部(11)の長さ方向の対向面にそれぞれ凹凸部(Ｐ)(Ｑ)が設けられて、これらの凹凸部(Ｐ)(Ｑ)を嵌め合わせた状態で骨幹補填片同士が相欠き接ぎ可能となっており、
更に前記第二の骨幹補填片(Ｃ2)に固定用プレート(３)が取着されて、当該固定用プレート(３)が骨幹(Ｂ’)に止着して取り付けられることを特徴とする人工骨幹。 An artificial bone shaft used to connect a fractured bone shaft (B) (B '),
Of the pair of shafts (B) and (B ′) in the divided state, the bone is inserted into the medullary cavity of one of the shafts (B) from the end of the divided side, and the inserted one end is the shaft. nail body portion that is attached to fixed to the (B) and (12), diaphysis formed at the other end portion side that is not inserted into the medullary canal of (B), the cross-sectional area than the medullary cavity of the diaphyseal (B) While comprising an intramedullary nail (1) with a large diaphyseal replacement (11),
The bone filling portion (11) of the intramedullary nail (1) is divided into two so that the end surface forms a phase-out shape at the center in the length direction, and is integrally formed with the nail body (12). A first diaphyseal replacement piece (C 1 ) and a second diaphyseal replacement piece (C 2 ) formed separately from the nail body (12),
In the state where the first diaphyseal replacement piece (C 1 ) and the second diaphyseal replacement piece (C 2 ) are in contact with each other, the phase notch portions (11 a) and (11 a) are fixed to each other and the diaphysis (B) (B ′) Can be connected to each other, and the first diaphyseal replacement piece (C 1 ) and the second diaphyseal replacement piece (C 2 ) are connected to the diaphyseal replacement part (11). Concavities and convexities (P) (Q) are provided on the opposing surfaces in the length direction, and the diaphyseal prosthesis pieces can be in contact with each other with these irregularities (P) (Q) fitted together. ,
Furthermore, a fixing plate (3) is attached to the second bone shaft replacement piece (C 2 ), and the fixing plate (3) is fixedly attached to the bone shaft (B ′). Artificial bone shaft.
前記分断状態となった一対の骨幹(Ｂ)(Ｂ’)のうち、一方の骨幹(Ｂ)の髄腔に、分断された側の端部から挿入されて、その挿入された一端部が骨幹(Ｂ)に止着して取り付けられる釘本体部(12)と、骨幹(Ｂ)の髄腔に挿入されない他端部側に形成された、骨幹(Ｂ)の髄腔よりも断面積が大きい骨幹補填部(11)とを有する髄内釘(１)を含んで構成される一方、
前記髄内釘(１)の骨幹補填部(11)が、長さ方向の中央部で端面が相欠き形状を成すように二つに分割されて、釘本体部(12)と一体に形成された第一の骨幹補填片(Ｃ1)と、釘本体部(12)と別体で構成された第二の骨幹補填片(Ｃ2)とから構成されると共に、
前記第一の骨幹補填片(Ｃ1)と第二の骨幹補填片(Ｃ2)を相欠き接ぎした状態で相欠き部(11a)(11a)同士を止着して骨幹(Ｂ)(Ｂ’)間で骨幹補填片同士が連結可能となっており、
更に前記第二の骨幹補填片(Ｃ2)に固定用プレート(３)が取着されて、当該固定用プレート(３)が骨幹(Ｂ’)に止着して取り付け可能となっている一方、前記固定用プレート(３)と骨幹補填部(11)の対向面に、遊嵌形状の摺動凹部(32)と摺動凸部(13)が長さ方向に沿って設けられると共に、前記摺動凹部(32)の両側縁部に、内向きに突出した浮き止め部(32a)(32a)が、また前記摺動凸部(13)の両側面部に、内向きに凹んだガイド溝(13a)(13a)がそれぞれ形成されて、このガイド溝(13a)(13a)に浮き止め部(32a)(32a)が挿入された状態で固定用プレート(３)が骨幹補填部(11)上でスライド可能となっていることを特徴とする人工骨幹。 An artificial bone shaft used to connect a fractured bone shaft (B) (B '),
Of the pair of shafts (B) and (B ′) in the divided state, the bone is inserted into the medullary cavity of one of the shafts (B) from the end of the divided side, and the inserted one end is the shaft. nail body portion that is attached to fixed to the (B) and (12), diaphysis formed at the other end portion side that is not inserted into the medullary canal of (B), the cross-sectional area than the medullary cavity of the diaphyseal (B) While comprising an intramedullary nail (1) with a large diaphyseal replacement (11),
The bone filling portion (11) of the intramedullary nail (1) is divided into two so that the end surface forms a phase-out shape at the center in the length direction, and is integrally formed with the nail body (12). A first diaphyseal replacement piece (C 1 ) and a second diaphyseal replacement piece (C 2 ) formed separately from the nail body (12),
In the state where the first diaphyseal replacement piece (C 1 ) and the second diaphyseal replacement piece (C 2 ) are in contact with each other, the phase notch portions (11 a) and (11 a) are fixed to each other and the diaphysis (B) (B ') Can be connected to each other.
Furthermore, a fixing plate (3) is attached to the second bone shaft replacement piece (C 2 ), and the fixing plate (3) can be fixedly attached to the bone shaft (B ′) . In addition, loosely-fitted sliding recesses (32) and sliding protrusions (13) are provided along the length direction on opposing surfaces of the fixing plate (3) and the diaphyseal replacement portion (11), and Inwardly projecting floating portions (32a) (32a) are formed on both side edges of the sliding recess (32), and guide grooves are formed inwardly on both side surfaces of the sliding projection (13) ( 13a) and (13a) are formed, and the fixing plate (3) is placed on the shaft replacement portion (11) with the floating portions (32a) and (32a) inserted into the guide grooves (13a) and (13a). An artificial bone shaft that is slidable with
前記分断状態となった一対の骨幹(Ｂ)(Ｂ’)のうち、一方の骨幹(Ｂ)の髄腔に、分断された側の端部から挿入されて、その挿入された一端部が骨幹(Ｂ)に止着して取り付けられる釘本体部(12)と、骨幹(Ｂ)の髄腔に挿入されない他端部側に形成された、骨幹(Ｂ)の髄腔よりも断面積が大きい骨幹補填部(11)とを有する髄内釘(１)と；
前記骨幹補填部(11)と各骨幹(Ｂ)(Ｂ’)に跨がるように配置され、かつ、骨幹補填部(11)と各骨幹(Ｂ)(Ｂ’)にそれぞれ止着して取り付けられる金属製の固定用プレート(３)と；
を含んで構成される一方、
前記髄内釘(１)の骨幹補填部(11)が、長さ方向の中央部で端面が相欠き形状を成すように二つに分割されて、釘本体部(12)と一体に形成された第一の骨幹補填片(Ｃ 1 )と、釘本体部(12)と別体で構成された第二の骨幹補填片(Ｃ 2 )とから構成されて、前記第一の骨幹補填片(Ｃ 1 )と第二の骨幹補填片(Ｃ 2 )を相欠き接ぎした状態で相欠き部(11a)(11a)同士を止着して骨幹(Ｂ)(Ｂ’)間で骨幹補填片同士が連結可能となっており、
更に前記第一の骨幹補填片(Ｃ 1 )と第二の骨幹補填片(Ｃ 2 )には、骨幹補填部(11)の長さ方向の対向面にそれぞれ凹凸部(Ｐ)(Ｑ)が設けられて、これらの凹凸部(Ｐ)(Ｑ)を嵌め合わせた状態で骨幹補填片同士が相欠き接ぎ可能となっていることを特徴とする人工骨幹。
ていることを特徴とする人工骨幹。 An artificial bone shaft used to connect a fractured bone shaft (B) (B '),
Of the pair of shafts (B) and (B ′) in the divided state, the bone is inserted into the medullary cavity of one of the shafts (B) from the end of the divided side, and the inserted one end is the shaft. nail body portion that is attached to fixed to the (B) and (12), diaphysis formed at the other end portion side that is not inserted into the medullary canal of (B), the cross-sectional area than the medullary cavity of the diaphyseal (B) An intramedullary nail (1) with a large shaft replacement (11);
It is arranged so as to straddle the diaphyseal replacement portion (11) and each diaphysis (B) (B ′), and is fixed to the diaphyseal replacement portion (11) and each diaphysis (B) (B ′). A metal fixing plate (3) to be attached;
While that will be configured to include,
The bone filling portion (11) of the intramedullary nail (1) is divided into two so that the end surface forms a phase-out shape at the center in the length direction, and is integrally formed with the nail body (12). The first diaphyseal replacement piece (C 1 ) and the second diaphyseal replacement piece (C 2 ) configured separately from the nail body portion (12) , the first diaphyseal replacement piece ( C 1 ) and the second diaphyseal replacement piece (C 2 ) are in contact with each other, and the notch portions (11 a) and (11 a) are fastened to each other, and the diaphyseal replacement pieces are connected between the diaphyses (B) and (B ′). Are connectable,
Further, the first diaphyseal replacement piece (C 1 ) and the second diaphyseal replacement piece (C 2 ) have concavo-convex portions (P) (Q) on the opposing surfaces in the length direction of the diaphyseal replacement portion (11). A prosthetic diaphysis characterized in that it is provided and the diaphyseal replacement pieces can be connected to each other in a state where these concavo-convex portions (P) (Q) are fitted together .
An artificial bone shaft characterized by
前記分断状態となった一対の骨幹(Ｂ)(Ｂ’)の各髄腔に挿入して取り付けられる金属製の髄内釘(１)が、挿入される骨幹(Ｂ)(Ｂ’)ごとに第一髄内釘(Ｎ1)と第二髄内釘(Ｎ2)に分割して構成される一方、
前記第一髄内釘(Ｎ1)及び第二髄内釘(Ｎ2)については、各骨幹(Ｂ)(Ｂ’)に止着可能な一端部を備えると共に、他端部に骨幹(Ｂ)(Ｂ’)の髄腔よりも断面積が大きく、かつ、端面が相欠き形状を成す骨幹補填部(11)(11)が設けられて、これらの骨幹補填部(11)(11)を相欠き接ぎした状態で相欠き部(11a)(11a)同士を止着して骨幹(Ｂ)(Ｂ’)間で第一髄内釘(Ｎ1)と第二髄内釘(Ｎ2)が連結可能となっており、
更に前記第一髄内釘(Ｎ 1 )及び第二髄内釘(Ｎ 2 )の各骨幹補填部(11)(11)において、髄内釘(１)の長さ方向の対向面に凹凸部(Ｐ)(Ｑ)がそれぞれ設けられて、これらの凹凸部(Ｐ)(Ｑ)を嵌め合わせた状態で骨幹補填部(11)(11)同士が相欠き接ぎされることを特徴とする人工骨幹。 An artificial bone shaft used to connect a fractured bone shaft (B) (B '),
A metal intramedullary nail (1) to be inserted and attached to each medullary cavity of the pair of bone shafts (B) (B ') in the divided state is provided for each bone shaft (B) (B') to be inserted. While divided into a first intramedullary nail (N 1 ) and a second intramedullary nail (N 2 ),
The first intramedullary nail (N 1 ) and the second intramedullary nail (N 2 ) are provided with one end portion that can be fixed to each diaphysis (B) (B ′), and the diaphysis (B ) (B ′) is provided with a shaft replacement portion (11) (11) having a cross-sectional area larger than that of the medullary cavity and having an end face with a phased shape, and these shaft replacement portions (11) (11) are provided. In a state where the phases are in contact with each other, the phased portions (11a) and (11a) are fixed to each other, and the first intramedullary nail (N 1 ) and the second intramedullary nail (N 2 ) between the diaphysis (B) and (B ′) Are connectable,
Further , in each of the diaphyseal replacement parts (11) and (11) of the first intramedullary nail (N 1 ) and the second intramedullary nail (N 2 ), an uneven part is formed on the opposing surface in the length direction of the intramedullary nail (1). (P) (Q) is provided, and the skeletal filling portions (11) and (11) are connected to each other in a state in which these uneven portions (P) and (Q) are fitted together. Diaphysis.
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| CN113413248A (en) * | 2021-07-27 | 2021-09-21 | 上海交通大学医学院附属第九人民医院 | Clasping type prosthesis capable of retaining intramedullary nail |
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| JPS6450808U (en) * | 1987-09-25 | 1989-03-29 | ||
| US5211664A (en) * | 1992-01-14 | 1993-05-18 | Forschungsinstitut, Davos Laboratorium Fur Experimentelle Chirugie | Shell structure for bone replacement |
| JP3360747B2 (en) * | 1993-05-11 | 2002-12-24 | 勝成 平良 | Long bone spacer |
| DE19633865A1 (en) * | 1996-08-16 | 1998-02-19 | Guenter Prof Dr Med Lob | Endoprosthesis |
| JP3692216B2 (en) * | 1997-07-31 | 2005-09-07 | 京セラ株式会社 | Bioprosthesis |
| JP2000189436A (en) * | 1998-12-28 | 2000-07-11 | Takiron Co Ltd | Device for joining bone |
| JP3529322B2 (en) * | 2000-04-07 | 2004-05-24 | 株式会社エム・エム・ティー | Artificial bone prosthesis |
| JP2003180704A (en) * | 2001-12-18 | 2003-07-02 | Homuzu Giken:Kk | Joining implement for femur |
| US7967820B2 (en) * | 2006-02-07 | 2011-06-28 | P Tech, Llc. | Methods and devices for trauma welding |
| GB0813659D0 (en) * | 2008-07-25 | 2008-09-03 | Smith & Nephew | Fracture putty |
| JP5355127B2 (en) * | 2009-02-12 | 2013-11-27 | 京セラメディカル株式会社 | Bioprosthesis |
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