Tool for bonding bone

Abstract

To provide a tool for effectively bonding a bone for treatment of bone fracture.SOLUTION: A tool of the present invention is adopted so as to apply heat to a break surface by hot wind, high-frequency current, or electric heat in order to locally dry the break surface of a bone or a cortical bone surface in the vicinity of the break surface.SELECTED DRAWING: Figure 7

Description

Technical Field

[0001] The present invention relates to an instrument for adhering bone.

Background Art

[0002] Conventionally, for the treatment of fractures, it has been known to place a plate along the bone so as to cross the fracture site of the bone, stabilize the fracture site, and promote its healing. Titanium or a biodegradable polymer is used as the material of the plate (Patent Document 1). Also, for the same purpose, it is also known to attach a sheet made of a scaffolding material to the fracture site via an adhesive.

Prior Art Documents

Patent Documents

[0003]

Patent Document 1

Patent Document 2

[0004] However, for the treatment of bones with relatively large loads such as the femur and fibula, a relatively rigid plate is required. Even if an adhesive is used for stable fixation of the plate, there is a problem that a strong adhesive action of the adhesive cannot always be obtained.

Summary of the Invention

Problems to be Solved by the Invention

[0005] In view of such problems of the prior art, the main object of the present invention is to provide an instrument for effectively adhering bone for the treatment of fractures.

Means for Solving the Problems

[0006] According to the present invention, such an object is achieved by providing an instrument (1, 20, 30) for adhering bone, which is adapted to apply heat and / or compressed air toward the cortical bone surface in order to locally dry the fractured surface (41) of the bone (40) or the cortical bone surface in the vicinity thereof.

[0007] By locally drying the fractured surface of the bone or the cortical bone surface in the vicinity thereof and applying an adhesive (42) to the dried portion, the high adhesive ability of the adhesive can be surely exhibited. In addition, since the portion of the fractured surface of the bone to which heat is not applied is kept in a sound state, the natural healing power of the bone is not substantially inhibited.

[0008] Preferably, the instrument (1) may include a compressed air generator (7), a heating device (8) for heating the compressed air obtained by the compressed air generator, and a nozzle (4) for blowing the heated compressed air toward the fractured surface or the cortical bone surface in the vicinity thereof.

[0009] By locally blowing hot air toward the fractured surface of the bone, it is possible to surely locally dry or necrotize the fractured surface of the bone or the cortical bone surface in the vicinity thereof.

[0010] Preferably, the instrument (1) may include a flow rate sensor (9) for detecting the flow rate of the compressed air passing through the heating device, a setting input device (12) for setting a target temperature of the heated compressed air, and a temperature control device (12) for controlling the heating device so that the temperature of the compressed air to be blown becomes the target temperature based on the flow rate of the compressed air detected by the flow rate sensor.

[0011] Thereby, stable control of accurate local drying of the fractured surface of the bone or the cortical bone surface in the vicinity thereof becomes possible.

[0012] Preferably, the instrument (20) includes a high-frequency power supply device (25), a heating electrode (22) for applying the high-frequency power supplied by the high-frequency power supply device to the fracture surface (41) or the cortical bone surface in the vicinity thereof, and a counter electrode plate (23) for forming a return path of the high-frequency power.

[0013] According to this, it becomes possible to precisely locally heat the fracture surface of the bone or the cortical bone surface in the vicinity thereof.

[0014] Preferably, the instrument (20) includes a high-frequency power supply device (25) and a pair of heating electrodes (28) for applying the high-frequency power supplied by the high-frequency power supply device to the fracture surface.

[0015] According to this, it becomes possible to more precisely locally heat the fracture surface of the bone or the cortical bone surface in the vicinity thereof.

[0016] Preferably, the instrument (30) includes a trowel tip member (32) to be abutted against the fracture surface (41) or the cortical bone surface in the vicinity thereof, a heating element (34) disposed so as to be heatable with respect to the trowel tip member, and a power supply (36) for supplying current to the heating element.

[0017] According to this, it becomes possible to locally heat the fracture surface of the bone or the cortical bone surface in the vicinity thereof with a relatively inexpensive and simple instrument.

[0018] According to another aspect of the present invention, there is provided an auxiliary piece (60) for adhering bones, which includes a substantially flat substrate (61), and a protruding piece (62) that extends across the central portion of one surface of the substrate 61 and extends substantially at a right angle from the one surface of the substrate 61, and the free end of the protruding piece is formed to be sharp.

[0019] By forming a wedge-shaped cut using the above-described instrument or the like in a part of the fracture surface of the bone, and inserting the protruding piece of the auxiliary piece into the cut with an adhesive interposed therebetween, the therapeutic effect of the fracture can be improved.

[0020] Preferably, the substrate may be substantially rectangular or substantially circular.

[0021] Alternatively, the substrate may be curved and formed into a cylindrical or spherical shape so as to conform to the outer contour of the bone.

[0022] According to yet another aspect of the present invention, there is provided a plate (70) applied to the side surface of a bone so as to cross a fracture site, the plate having protrusions (71) or dimples provided on a surface thereof facing the bone.

[0023] According to yet another aspect of the present invention, there is provided a plate (85) applied to the side surface of a bone, the plate having a dike-shaped ridge (87) provided on an outer peripheral portion of a surface thereof facing the bone, and holes (88) or notches (89) provided in a part of the ridge for introducing an adhesive.

[0024] According to yet another aspect of the present invention, there is provided a plate applied to the side surface of a bone, the plate having a first portion (51a) having window holes (55) and holes for screws (52), and a second portion (51b) having an outer contour to be fitted into the window holes and having holes for screws.

[0025] According to yet another aspect of the present invention, there is provided an intramedullary nail (91) to be inserted into a bone, the intramedullary nail having protrusions or dimples (92) provided thereon.

[0026] According to yet another aspect of the invention, there is provided a kit including the above-described instrument, the above-described plate, a plate applied to the side surface of a fractured bone other than the above-described configuration or an intramedullary nail disposed inside the bone so as to cross the fracture site, and / or an adhesive or an adhesive sheet for adhering bones to each other or a bone to a plate or an intramedullary nail. The kit may further include instructions for a surgical method using these instruments, plates or intramedullary nails, and / or adhesives or adhesive sheets.

Advantages of the Invention

[0027] Thus, according to the present invention, an instrument is provided for effectively adhering bones for the treatment of fractures.

Brief Description of the Drawings

[0028]

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Mode for Carrying Out the Invention

[0029] FIG. 1 shows an instrument for adhering a bone 40 (see FIG. 7) based on an embodiment of the present invention in the form of a hot air blower 1. Inside a rod-shaped main body 2 of the hot air blower 1 suitable for gripping, an internal passage 3 extending in its longitudinal direction is provided, one end of which constitutes a nozzle 4, and the other end is connected to a compressed air source 7 via an adjustment valve 5 and a passage 6. Inside the main body 2, a heater 8 surrounding the internal passage 3 and a flow velocity sensor 9 in the form of a Pitot tube for measuring the flow velocity of air on its upstream side are provided.

[0030] Outside the main body 2, a control device 12 connected to a power source 13 is provided. The control device 12 is provided with an input device for setting the temperature of the hot air. When the user sets the blowing speed of the hot air by the adjustment valve 5 and sets the desired temperature of the hot air from the input device, the control device 12 controls the heater 8 based on the output from the flow velocity sensor 9 and the desired temperature of the hot air. As a result, hot air at a desired temperature can be ejected from the nozzle 4 at a desired speed. The heater 8 is connected to the control device 12 via a wire 10. The flow velocity sensor 9 is connected to the control device 12 via a wire 11.

[0031] Figure 2 shows a nozzle 4' as a modified embodiment of the nozzle 4. The nozzle 4 in Figure 1 is configured to inject hot air in the axial direction, while the nozzle 4' in Figure 2 is configured to inject hot air at a predetermined angle with respect to the axial direction. Thereby, depending on the position of the affected part, the convenience of the hot air blowing device 1 can be improved.

[0032] Figure 3 shows an instrument for adhering a bone 40 (see Figure 7) according to an embodiment of the present invention in the form of an electric scalpel 20. An elongated flat plate-shaped electrode 22 is provided on a rod-shaped main body 21 of the electric scalpel 20 that is suitable for gripping. The tip of the electrode 22 is appropriately curved and adapted to abut against the affected part with a convex surface. This convex surface may be a cylindrical surface or a spherical surface. Further, the tip of the electrode 22 may be a simple flat plate shape with rounded corners. Further, this instrument is provided with a counter electrode plate 23 to be applied to the human body in the vicinity of the affected part. The electrode 22 and the counter electrode plate 23 are connected to a high-frequency power source 25 via a wire 24.

[0033] This electric scalpel 20 has a structure that is generally similar in principle to an instrument called a monopolar electric scalpel. In particular, it is advisable to select the shape and size of the tip of the electrode 22 to suit the geometric shape of the bone 40 (see Figure 7) to be adhered.

[0034] Figure 4 is the same as that shown in Figure 3, but is configured as a bipolar electric scalpel 26. Electrodes 28 that are parallel to each other with a small interval are provided on the main body 27. These electrodes 28 are connected to a high-frequency power source 25 via a wire 24. In this case, it is advisable to select the shape and size of the tips of the electrodes 28 and the interval between the two electrodes 28 to suit the geometric shape of the bone 40 (see Figure 7) to be adhered.

[0035] FIG. 5 shows an instrument for adhering a bone 40 (see FIG. 7) according to an embodiment of the present invention in the form of an electric iron 30. The main body 31 of the electric iron 30 has a rod-like shape suitable for gripping, and at the tip thereof, an iron tip member 32 is fixed in a thermally insulated state. The tip of the iron tip member 32 may have the same shape as the electrode 22 in the embodiment shown in FIG. 3. A heating wire 34 is provided on the outer periphery of the base end of the iron tip member 32, and a current is supplied to the heating wire 34 from a power supply device 36 via a wire 35. Also in this embodiment, a configuration for adjusting the temperature of the iron tip member 32 is provided, but since the configuration itself may be of a known type, the description thereof is omitted.

[0036] FIG. 6 shows a modified example of the instrument shown in FIG. 5. A heat shield plate 37 made of a heat-resistant resin or ceramic is attached or laminated on one surface of the elongated flat iron tip member 32. According to this instrument, heat can be intensively transmitted to the affected area without affecting the periphery of the affected area by heat.

[0037] FIG. 7 shows a treatment procedure for a fracture such as a femur. Heat is applied to, for example, three locations of the fracture surface 41 of the bone 40 using any one or a combination of the instruments shown in FIGS. 1 to 5 to cause drying or necrosis. Next, an adhesive 42 is applied to the dried or necrotic portion, and the two portions of the bone 40 are joined. Since the portion to which the adhesive 42 is applied is dried or necrotic, the adhesive strength of the adhesive can be ensured. Since the portions other than the dried or necrotic portions of the fracture surface 41 of the bone 40 are healthy, early healing of the fractured portion is possible due to the natural healing power of the bone 40 in combination with the fixing action of the adhesive.

[0038] Figures 8 and 9 show another treatment procedure for fractures of the femur and the like. In this case, along the two broken parts of the bone 40, the plate 51 is pressed against the fracture surface, and the plate 51 is fixed to the bone 40 by two screws 52. In this case, by interposing an adhesive 53 between the opposing surfaces of the bone 40 and the plate 51, the fixing effect of the plate 51 can be improved. Specifically, heat is applied to the surface of the bone 40 to which the adhesive 53 is to be applied, using any one of the instruments shown in FIGS. 1 to 6 or a combination of multiple ones, which may cause drying or necrosis. Next, the screw 52 is tightened until there is a slight gap between the plate 51 and the surface of the bone 40. After applying the adhesive 53 to the surface of the plate 51 and / or the bone 40, the screw 52 may be fully tightened. As a result, the surface of the bone 40 and the opposing surface of the plate 51 can be firmly bonded by the adhesive 53. Also in this case, the fixing effect of the plate 51 is improved, enabling early healing of the fracture.

[0039] In this case, if the instrument shown in FIG. 6 is used, when the screw 52 is tightened until there is a slight gap between the plate 51 and the surface of the bone 40, the tip member 32 of the instrument shown in FIG. 6 can be used to heat the area to be bonded. In this way, heat transfer to the plate 51 and other unnecessary parts can be minimized.

[0040] Figure 10 shows a modified treatment procedure for fractures of the femur and the like using a sheet-like adhesive. In this case, instead of the layer of the adhesive 53, an adhesive sheet 54 is interposed between the plate 51 and the bone 40, and the screw 52 is fastened. This adhesive sheet 54 may be a separate sheet from the plate 51 or may be in a state pre-bonded to the inner surface of the plate 51. Further, hydroxyapatite or a microstructure structure (a knitted structure that makes it easier for the bone used in artificial joints to penetrate) can be interposed between the plate 51 and the bone 40 as a separate sheet or incorporated into the adhesive sheet 54.

[0041] FIG. 11 shows an auxiliary piece 60 used in the treatment of a fracture. This auxiliary piece 60 has a flat base plate 61 and a protruding piece 62 extending at a substantially right angle from one side of the base plate 61. The illustrated auxiliary piece 60 is substantially rectangular, but may be circular or have other shapes. The protruding piece 62 is in the form of a plate having substantially the same width as the base plate 61, and its free end is in the form of a tapered blade. In addition, it is preferable that the protruding piece 62 is provided so as to cross the center of the base plate 61 so as to form a T-shape in a side view.

[0042] FIG. 12 shows how to use the auxiliary piece 60. A wedge-shaped incision 40a is formed from one end of the cut surface of the fractured bone 40 using any of the tools shown in FIGS. 3 to 5. Both parts of the fractured bone 40 may be glued together at the cut surface as shown in FIG. 6. An adhesive is applied to the inside of the incision 40a and the facing surface of the protruding piece 62 of the auxiliary piece 60 and / or the base plate 61, and the protruding piece 62 of the auxiliary piece 60 is inserted into the incision 40a until the base plate 61 of the auxiliary piece 60 abuts against the outer surface of the bone 40. As a result, healing of the fractured bone 40 is promoted.

[0043] In the example shown in Fig. 13, as shown in Figs. 8 and 9, both parts of the fractured bone 40 are joined together using a plate 51, and then a wedge-shaped incision 40a is formed on the fractured surface of the bone 40 opposite to the plate 51 using any of the tools shown in Figs. 3 to 5. In this case, as shown in Figs. 8 and 9, an adhesive may or may not be interposed between the plate 51 and the bone 40. Furthermore, an auxiliary piece 60 is pushed into the incision 40a in the manner shown in Fig. 12. In this case, both parts of the fractured bone 40 can be firmly joined together.

[0044] Figure 14 shows the state of treating a bone 40 such as the fibula fractured with an oblique fracture surface. In this case, similar to that shown in FIGS. 8 and 9, the plate 51 is fixed by screws 52 so as to cross the fracture surface. Next, when the side of the plate 51 of the bone 40 is taken as the front, cuts 40a are provided in each of the portions of the fracture surface located on the left and right sides of the bone 40, and the protruding pieces 62 of the auxiliary piece 60 are inserted into the respective cuts 40a, whereby the two portions of the fractured bone 40 can be firmly joined.

[0045] In the example shown in FIG. 15, the plate 51 is fixed by screws 52 so as to cross the fracture surface, a window hole 55 is provided in the plate 51, a cut 40a is provided in the portion of the fracture surface of the bone 40 located within the window hole 55, and the protruding piece 62 of the auxiliary piece 60 is inserted into the cut 40a, whereby the two portions of the fractured bone 40 can be firmly joined.

[0046] Figure 16 shows a plate 70 provided with a plurality of protrusions 71 on the surface facing the bone. When the plate 70 is applied to the bone to be treated and a screw is screwed into the bone from its hole 72, the plate 70 is pressed against the bone and the protrusions 71 are pressed into the bone. As a result, a depression is formed in the bone, and a wide contact area is formed between the plate 70 and the bone. Therefore, not only can an adhesive substance be spread over a wide range, but also the physical bone gripping force of the plate 70 itself is improved. This protrusion is not limited to a needle-like one, and may be one forming a segmented ridge or one having a relatively blunt tip. Further, a plurality of dimples, that is, recesses, can also be formed on the surface of the plate 70 facing the bone.

[0047] In the embodiment shown in FIG. 17, not only are a plurality of protrusions 71 provided on the surface of the plate 70 facing the bone, but also an adhesive layer 73 made of hydroxyapatite or a microstructure structure (a knitted structure that facilitates the intrusion of bone used for artificial joints) that has been pre-adhered or can be adhered thereto during surgery is provided. Also in this case, the hydroxyapatite or the microstructure structure can be interposed between the plate 51 and the bone 40 in such a manner that it is incorporated as a separate sheet or into an adhesive sheet.

[0048] In the embodiment shown in FIG. 18, the plate 80 is in the form of an elastically deformable sheet made of resin or metal, and the surface of the plate 80 facing the bone is concave. Therefore, with an adhesive interposed between the plate 80 and the bone, by screwing a screw (not shown) from the hole 81 of the plate 80 into the bone, the plate 80 will deform to conform to the curved contour of the bone. As a result, the adhesion between the plate 80 and the bone is improved, and the ability of the plate 80 to stabilize the fractured part is improved. The plate 80 may be curved in a cylindrical shape or a spherical shape. Further, the plate 80 may be elastically deformable and flat. In that case, holes for inserting the screws need to be provided at a plurality of locations on the outer peripheral portion of the plate 80.

[0049] In the embodiment shown in FIG. 19(a), a dike-shaped ridge 87 is provided along the outer periphery of the surface of the plate 85 facing the bone. Therefore, when the plate 85 is applied to the bone, a cavity is formed between the plate 85 and the bone. The plate 85 is provided with a hole 86 for inserting a screw and one or two introduction holes 88 penetrating the ridge 87. In that case, after pressing the plate 85 against the bone by tightening the screw, the cavity can be filled by injecting an adhesive through the introduction hole 88. According to this, the plate 85 can be firmly fixed by allowing the adhesive to be interposed without any gaps between the plate 85 and the bone.

[0050] In the modified embodiment shown in Fig. 19(b), the introduction hole 89 is formed by the cooperation of a notch provided in the dike-shaped ridge 87 and the opposing surface of the bone.

[0051] In the embodiments shown in Figs. 20(a) and 20(b), the plate is composed of a first portion 51a and a second portion 51b. A window hole 55 is provided in the first portion 51a, and the second portion 51b has a shape to be fitted into the window hole 55 with relatively little clearance. In this case, first, as shown in Fig. 20(a), the first portion 51a is applied to the bone 40 so as to cross the fracture cross-section of the fractured part by tightening the screw 52. At this time, an adhesive may or may not be interposed between the first portion 51a and the bone 40. Next, the second portion 51b is fitted into the window hole 55 with an adhesive interposed therebetween, and the second portion 51b is applied to the bone 40 by tightening the screw 52.

[0052] In this case, with only the first portion 51a applied, a sufficient fracture reduction operation can be performed on the fractured part. Also, before applying the second portion 51b, a sufficient amount of adhesive can be directly spread around the fractured part, so the fixing force is increased compared to the prior art.

[0053] Fig. 21 shows the procedure for fracture treatment using an intramedullary nail 91. The intramedullary nail 91 is inserted into the bone so as to cross the fracture cross-section of the fractured part, and an adhesive layer is interposed between the outer periphery of the intramedullary nail 91 and the inner surface of the opposing bone. The outer periphery of the intramedullary nail 91 may be flat, but as shown in the figure, by providing a plurality of dimples 92 or projections or ridges, the bonding force between the intramedullary nail 91 and the bone can be improved.

[0054] With the above description of the specific embodiments completed, the present invention is not limited to the above embodiments and modifications, and can be widely modified and implemented. The adhesive may be arranged between the bone and the plate in a state taken out of the container, but the adhesive may be arranged between the bone and the plate together with the container, and the container may be configured to break by an artificial operation, such as applying pressure through the plate. The protrusions or dimples of the embodiments shown in FIGS. 16 and 17 may be provided on the plates of other embodiments.

Explanation of Reference Numerals

[0055] 1: Hot air blower (instrument) 2: Main body 3: Internal passage 4: Nozzle 4´: Nozzle 5: Control valve 6: Passage 7: Compressed air source 8: Heater 9: Flow rate sensor 12: Control device (setting input device for setting the target temperature, temperature control device) 13: Power supply 20: Electric scalpel (instrument) 21: Main body 22: Electrode 23: Counter electrode plate 24: Wire 25: High-frequency power supply 26: Electric scalpel 27: Main body 28: Electrode 30: Electric iron (instrument) 31: Main body 32: Iron tip member 34: Heating wire 35: Wire 36: Power supply device 37: Heat shield 40: Bone 40a: Notch 41: Fracture surface 42: Adhesive 51: Plate 51a: First part 51b: Second part 52: Screw 53: Adhesive 54: Adhesive sheet 55: Window hole 60: Auxiliary piece 61: Substrate 62: Protruding piece 70: Plate 71: Protrusion 72: Hole 73: Adhesive layer 80: Plate 81: Hole 85: Plate 86: Hole 87: Ridge 88: Introduction hole 89: Introduction hole 91: Intramedullary nail 92: Dimple

Claims

**Claim 1** An instrument for adhering bones, An instrument adapted to apply heat and / or compressed air toward a fracture surface or a cortical bone surface in the vicinity thereof in order to locally dry the fracture surface or the cortical bone surface in the vicinity thereof. **Claim 2** The instrument according to claim 1, comprising a compressed air generator, a heating device for heating the compressed air obtained by the compressed air generator, and a nozzle for spraying the heated compressed air toward the fracture surface or the cortical bone surface in the vicinity thereof. **Claim 3** The instrument according to claim 2, comprising a flow rate sensor for detecting the flow rate of the compressed air passing through the heating device, a setting input device for setting a target temperature of the heated compressed air, and a temperature control device for controlling the heating device such that the temperature of the compressed air to be sprayed becomes the target temperature based on the flow rate of the compressed air detected by the flow rate sensor. **Claim 4** The instrument according to claim 1, comprising a high-frequency power supply device, a heating electrode for applying the high-frequency power supplied by the high-frequency power supply device to the fracture surface or the cortical bone surface in the vicinity thereof, and a counter electrode plate for forming a return path of the high-frequency power. **Claim 5** The instrument according to claim 1, comprising a high-frequency power supply device and a pair of heating electrodes for applying the high-frequency power supplied by the high-frequency power supply device to the fracture surface or the cortical bone surface in the vicinity thereof. **Claim 6** The instrument according to claim 1, comprising a tip member of an iron to be brought into contact with the fracture surface or the cortical bone surface in the vicinity thereof, a heating element disposed so as to be capable of electroheating with respect to the tip member of the iron, and a power supply for supplying current to the heating element.

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