Instrument for bone surgery

Abstract

To provide an instrument for bone surgery that enables prepared hole formation work by a drill or the like while maintaining a state of constantly compressing and sandwiching a bone with a sufficient force, enables fixation of a tibial tuberosity part by using both a washer and a screw without releasing the compressing and sandwiching the bone, and thereby, enables accurate and rapid bone surgery.SOLUTION: A slide bar 1 includes a reception part 5 that can abut on one side surface of a bone W. A mobile device 2 movable along a longitudinal direction of the slide bar 1 is provided. The mobile device 2 includes: a holder part 7 through which a rod-shaped member 19 passes; and a compression part 8 that abuts on the other side surface of the bone W.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates to a surgical instrument used for forming pilot holes in bones and installing screws. [Background technology]

[0002] In knees deformed by osteoarthritis or other conditions, the load on the knee is concentrated on one side, and it is common to see damage to only the cartilage on one side.

[0003] Knee osteotomy is a procedure in which an incision is made in the tibia or femur, and the bone is opened or closed to correct the alignment of the knee and shift the position of weight bearing to a pain-free area.

[0004] For example, in bone-opening procedures, the tip of an incision made in the bone is used as a rotation axis to open and correct the bone. In this method, a gap is created in the opened bone after alignment correction, so in order to maintain the corrected position, metal plates and screws are used to fix the gap, and artificial bone is filled in and reinforced.

[0005] Open Wedge High Tibial Osteotomy (OWHTO) was the mainstream method of tibial osteotomy, but the relative movement of the patella after surgery became an issue, and now, in addition to OWHTO, Open Wedge Distal Tuberosity Osteotomy (OWDTO), which does not change the position of the patella, is being performed.

[0006] The patellar tendon is attached to the tibial tuberosity, and when the knee is flexed, the patellar tendon pulls the tibial tuberosity forward, causing it to float. In OWDTO, if the tibial tuberosity is not sufficiently fixed, it may become unstable, leading to complications such as no or delayed union.

[0007] Therefore, after osteotomy, it is necessary to apply pressure from the front and back of the tibial tuberosity and then insert and fix the screws.It is important to insert the screws from the front to the back of the tibial tuberosity while maintaining pressure and fix them.

[0008] However, the popliteal artery runs behind the tibia, and consideration must be given to protecting the popliteal artery and other parts in order to prevent damage to the artery from drills, screws, and the like.

[0009] For this reason, conventionally, there have been provided instruments, such as those disclosed in Patent Document 1 below, in which the tip of a tubular jig that guides a drill or the like is brought into contact with the tibia, and which assists in forming a pilot hole with the drill or the like from the front to the back of the tibia, and those disclosed in Patent Document 2 below, in which a screw is inserted by holding a washer while applying pressure to the bone. [Prior art documents] [Patent documents]

[0010] [Patent Document 1] International Publication No. 2020 / 059405 [Patent Document 2] Japanese Patent Publication No. 2022-103652 Summary of the Invention [Problem to be solved by the invention]

[0011] When fastening a screw to the tibial tuberosity, it is important not only to apply pressure when creating a pilot hole, but also to maintain pressure on the tibial tuberosity when inserting the screw.

[0012] The surgical instrument disclosed in Patent Document 1 above has an example of how a screw can be inserted while applying pressure with a surgical instrument, but a washer cannot be used in combination with the screw. In other words, when inserting a screw, it is important to use a washer in combination to prevent the screw from becoming embedded and to apply surface pressure to the tibial tuberosity with the washer.

[0013] However, if the washer cannot be used in combination, it is necessary to remove the surgical instrument and insert the washer and screw in actual use, which eliminates the compressive force applied by the surgical instrument and prevents the screw from sufficiently fixing the tibial tuberosity.

[0014] Furthermore, when applying pressure to the tibial tuberosity, for example, if a click mechanism is used, it is thought that sufficient pressure must be applied using a separate rongeur or similar tool, whereas applying pressure manually by rotating the handle places a heavy burden on the surgeon.

[0015] On the other hand, in the device of Patent Document 2, a washer can be attached to the compression part, and the screw and washer can be used in combination to screw fix the tibial tuberosity.

[0016] However, the principle of attaching and detaching the washer is a method that utilizes the friction between the washer and the tool, or requires a structure that takes into consideration preventing the washer from falling off, such as by processing grooves in the washer to enable it to be attached and detached, or requires the use of specially processed washers, making it difficult to use easily.

[0017] In view of the above, an object of the present invention is to provide a bone surgery instrument that not only maintains a state in which the bone is constantly compressed and clamped with sufficient force to allow pilot holes to be formed using a drill or the like, but also enables fixation of the tibial tuberosity using a combination of a washer and a screw without releasing the compression clamping of the bone, thereby enabling bone surgery to be performed quickly and with high precision. [Means for solving the problem]

[0018] In order to achieve this object, the present invention provides a bone surgery instrument for positioning and guiding a rod-shaped member used in bone surgery when the rod-shaped member is inserted into a bone, the instrument comprising: a rod-shaped slide bar; and a moving device that can move along the longitudinal direction of the slide bar; the slide bar having a receiving portion that can abut against one side of the bone; the moving device having a holder portion that is disposed opposite the receiving portion and through which the rod-shaped member can pass; and a compression portion that is located between the holder portion and the receiving portion, with a predetermined gap from the holder portion, and abuts against the other side of the bone; the compression portion and the receiving portion approach each other to clamp the bone as the moving device moves (first invention).

[0019] In addition, in the present invention, the compression portion is semicircular in shape when viewed from above and is formed so as to compress the bone around the position where the rod-shaped member passes through the holder portion and heads toward the bone (second invention).

[0020] Furthermore, the compressing portion is characterized in that a locking portion that bites into and locks onto the bone is provided on the surface that contacts the bone (third invention).

[0021] In addition, in the present invention, the holder portion detachably holds a cylindrical guide member that guides the rod-shaped member toward the receiving portion (fourth invention).

[0022] In addition, in the present invention, the receiving portion is characterized by having a flat surface portion that extends in a direction intersecting the opposing direction to the compression portion, a peripheral wall portion that stands up from the periphery of the flat surface portion, and an opening portion formed in a part of the peripheral wall portion (5th invention).

[0023] In addition, in the present invention, the moving device is characterized by comprising a feed plate through which the slide bar passes and whose engagement with the slide bar is maintained by a first biasing means, a stopper plate through which the slide bar passes and whose engagement with the slide bar is maintained by a second biasing means, a feed operation lever that moves the feed plate in the direction in which the receiving portion moves toward the compression portion, which is the feed direction of the slide bar, against the bias of the first biasing means, and a fixation release lever that disengages the stopper plate from the slide bar against the bias of the second biasing means (sixth invention).

[0024] The second to sixth inventions can be combined with each other and adopted in the first invention as long as they are not contradictory to each other. [Effects of the Invention]

[0025] By being equipped with the above-mentioned configuration, the present invention can provide a bone surgical instrument that not only keeps the bone in a state of being compressed and clamped with sufficient force at all times, allowing for the formation of pilot holes using a drill or the like, but also enables the fixation of the tibial tuberosity using a combination of a washer and a screw without releasing the compression clamping of the bone, thereby enabling bone surgery to be performed quickly and with high precision. [Brief explanation of the drawings]

[0026] [Figure 1] FIG. 1 is a side view showing one embodiment of a bone surgical instrument of the present invention. [Figure 2] FIG. 2 is an explanatory cross-sectional view showing the internal configuration of the moving device. [Figure 3] FIG. [Figure 4] FIG. 4 is a diagram showing the shape of a slide bar. [Figure 5] FIG. 1 is an explanatory diagram showing a state in which the bone surgical instrument is used. [Figure 6] FIG. [Figure 7] 10A and 10B are diagrams showing other shapes of the compression portion. [Figure 8] FIG. 1 is an explanatory diagram showing a state in which the bone surgical instrument is used. [Figure 9]FIG. 4 is an explanatory perspective view showing the shape of a receiving portion. [Figure 10] FIG. 10 is an explanatory cross-sectional view showing a state in which the receiving portion abuts against the bone. [Figure 11] FIG. 10 is an explanatory perspective view showing another shape of the receiving portion. [Figure 12] FIG. 10 is a side view showing another shape of the arm portion. [Figure 13] A diagram showing other shapes of the holder part DETAILED DESCRIPTION OF THE INVENTION

[0027] An embodiment of the present invention will be described with reference to the drawings. As shown in Figure 1, the bone surgical instrument of this embodiment includes a slide bar 1 and a moving device 2. The slide bar 1 is a rod-shaped body that extends linearly, and the moving device 2 is provided so as to be movable along the slide bar 1.

[0028] A protrusion 3 that restricts the movement of the moving device 2 is formed at the tip (lower end in the figure) of the slide bar 1, and further towards the tip side (lower end in the figure) via the protrusion 3, a curved arm portion 4 and a receiving portion 5 are provided.

[0029] The moving device 2 includes a moving mechanism, which will be described later. The moving mechanism is housed inside a case 6. The case 6 is provided with a holder portion 7 and a pressing portion 8. The holder portion 7, the pressing portion 8, and the receiving portion 5 described above are positioned such that their respective axes coincide with each other.

[0030] As the moving device 2 moves, the pressing part 8 and the receiving part 5 move towards or away from each other. At this time, the positional relationship between the holder part 7 and the pressing part 8 does not change, and a constant distance is maintained.

[0031] As shown in Figure 2, the movement mechanism of the movement device 2 includes two feed plates 9, 10 through which the slide bar 1 passes, a first biasing means 11 that biases the feed plates 9, 10 toward the tip of the slide bar 1, and a feed operation lever 13 that is attached to the case 6 via a pivot 12 so as to be able to swing freely.

[0032] Furthermore, the movement mechanism of the movement device 2 includes a stopper plate 14 through which the slide bar 1 passes and which is inclined within the case 6, a second biasing means 15 that biases the stopper plate 14 toward the tip of the slide bar 1, and a lock-release lever 17 that is attached to the case 6 via a pivot 16 so as to be freely swingable.

[0033] The slide bar 1 passes through a through hole in the feed plates 9, 10, which is larger in diameter than the outer diameter of the slide bar 1, and is not engaged with the slide bar 1 when the feed plates 9, 10 are in a horizontal position as shown in FIG.

[0034] When the feed operating lever 13 is tilted from this state, the tip of the feed operating lever 13 pushes up the ends of the feed plates 9, 10 at the start of the tilting, and the feed plates 9, 10, now in an inclined position, frictionally engage with the slide bar 1.

[0035] Next, when the feed operating lever 13 is tilted, the feed plates 9, 10 in the tilted position maintain frictional engagement with the slide bar 1, and the slide bar 1 is pushed up against the biasing force of the first biasing means 11. Then, by tilting the feed operating lever 13 multiple times, the compression part 8 and the receiving part 5 approach each other, and the bone W is clamped between the compression part 8 and the receiving part 5 as shown in FIG.

[0036] As shown in FIG. 2, the slide bar 1 passes through a through hole in the stopper plate 14 that is larger than the outer diameter of the slide bar 1, and the stopper plate 14 is in an inclined position, and the frictional engagement state with the slide bar 1 is maintained by the biasing force of the second biasing means 15.

[0037] In this state, the slide bar 1 is allowed to move in the direction in which the pressing portion 8 and the receiving portion 5 approach each other, but is not allowed to move in the direction in which the pressing portion 8 and the receiving portion 5 move away from each other.

[0038] From this state, when the lock release lever 17 is tilted, the stopper plate 14 is brought into a horizontal position against the biasing force of the second biasing means 15, and the frictional engagement of the stopper plate 14 with the slide bar 1 is released. This allows the slide bar 1 to move in the direction away from the compressing part 8 and the receiving part 5, and the clamping of the bone W by the compressing part 8 and the receiving part 5 can be released.

[0039] The moving device of the present invention is not limited to the configuration shown in this embodiment. The moving device 2 used in this embodiment has a configuration similar to a so-called quick bar clamp using a slide bar 1 shown in Fig. 4(A), but may also have a configuration similar to a so-called ratchet bar clamp using a slide bar 18 shown in Fig. 4(B).

[0040] 3 and 5, the holder portion 7 is capable of detachably holding a cylindrical guide member 20 that guides a rod-shaped member such as a drill 19 (see FIG. 5). In addition to the guide member 20 for the drill 19, a guide member 20 for guiding a rod-shaped member such as a guide wire (not shown) is also detachably attached.

[0041] As shown in Figure 3, the compression portion 8 has a semicircular shape when viewed from above, and abuts against the bone W around the passage position of a rod-shaped member such as a drill 19 that passes through the holder portion 7 toward the bone W, thereby forming a positioning state by compression.

[0042] As shown in Fig. 3, the lower end 8a of the compression part 8 that comes into contact with the bone W is curved to fit the shape of the bone W. As shown in Fig. 6A, the shape of the compression part 8 may be made relatively large to increase the area in which the lower end 8a comes into contact with the bone W. Furthermore, as shown in Fig. 6B, the length of the tip of the compression part 8 may vary in the medial-lateral and anterior-posterior directions.

[0043] 7, the compression unit 8 may be provided with a locking portion 21 that bites into and locks into the contact surface with the bone W. By providing the locking portion 21, it is possible to maintain a strong locking state caused by the compression of the compression unit 8 against the bone W, and to achieve highly accurate positioning.

[0044] As shown in Figure 8, the compression portion 8 is designed to be able to hold a washer 22, and with the washer 22 held in place, a rod-shaped member such as a screw 23 can be screwed into the bone W.

[0045] At this time, a sufficiently wide gap is formed between the holder part 7 and the compression part 8, so that the drill 19 and guide member 20 can be removed from the holder part 7, and the washer 22 can be easily attached to the compression part 8 and the screw 23 can be easily screwed in.

[0046] As shown in Fig. 9, the receiving portion 5 has a flat surface portion 24 and a peripheral wall portion 25. The flat surface portion 24 faces the compression portion 8, and the peripheral wall portion 25 is provided standing on the periphery of the flat surface portion 24. An open portion 26 is formed in a part of the peripheral wall portion 25. Furthermore, a tongue portion 27 connected to the flat surface portion 24 is formed in the open portion 26.

[0047] 10, the upper surface of the peripheral wall portion 25 of the receiving portion 5 abuts against the bone W. The space formed above the flat surface portion 24 by the peripheral wall portion 25 allows the receiving portion 5 to maintain abutment against the bone W even if the tip of a rod-shaped member such as the screw 23 threaded into the bone W penetrates the bone and protrudes toward the receiving portion 5.

[0048] 10, an opening 26 is formed, which prevents interference between the receiving part 5 and the screw 23 and allows the screw 23 to escape from the space in the receiving part 5 when the clamping of the bone W between the compressing part 8 and the receiving part 5 is released and the receiving part 5 is removed.

[0049] As shown in FIG. 10, it is preferable that the upper surface of the peripheral wall portion 25 of the receiving portion 5 is knurled to prevent slipping, but this is not limited to this, and the upper surface of the peripheral wall portion 25 may be formed smoothly as shown in FIG. 11.

[0050] In addition, in this embodiment, as shown in FIG. 1, the receiving portion 5 is provided via the curved arm portion 4, but this is not limited to this, and a hook-shaped or approximately L-shaped arm portion may also be used, for example, as in the arm portion 28 shown in FIG. 12.

[0051] In addition to the shape of the holder portion 7 shown in FIG. 3 in this embodiment, a holder portion 29 that is long in the vertical direction may be provided as shown in FIG. 13A in order to increase the stability of the guide member 20 that guides a rod-shaped member such as a drill 19.

[0052] 13B, a holder part 31 may be provided with a convex part 30 formed on the inner peripheral surface thereof, extending in the vertical direction. In this case, although not shown, a concave part corresponding to the convex part 30 on the inner peripheral surface of the holder part 31 may be provided on the outer peripheral surface of a guide member that guides a rod-shaped member such as a drill 19, and the stability of the guide member may be improved by fitting the concave and convex parts together. [Explanation of symbols]

[0053] W…Bone 1,18...Slide bar 2...Mobile device 5...Receiving part 7,29...Holder part 8...Compression area 9,10...Feed plate 11...first biasing means 13...Feed control lever 14...Stopper plate 15...Second biasing means 17...Fixing release lever 19...Drill (rod-shaped component) 20...Guide member 21...Latching part 23...Screw (rod-shaped member) 24...Flat surface part 25…Surrounding wall 26…Open Department

Claims

1. A bone surgery instrument for positioning and guiding a rod-shaped member used in bone surgery when inserting the rod-shaped member into a bone, comprising: A rod-shaped slide bar and a moving device that is movable along the longitudinal direction of the slide bar, the slide bar has a receiving portion that can come into contact with one side surface of a bone; the moving device includes a holder portion that is provided opposite the receiving portion and through which the rod-shaped member can pass, and a compression portion that is located between the holder portion and the receiving portion, that is provided with a predetermined gap from the holder portion, and that abuts against the other side surface of the bone, A bone surgery instrument, characterized in that the compression portion and the receiving portion approach each other so as to clamp the bone by movement of the moving device.

2. 2. The bone surgical instrument according to claim 1, wherein the compression portion has a semicircular shape in a plan view and is formed so as to compress the bone around a position where the rod-shaped member passing through the holder portion toward the bone is passed inside the compression portion.

3. 3. The bone surgery instrument according to claim 2, wherein the compression portion has a locking portion on a surface that contacts the bone, the locking portion being configured to bite into and lock onto the bone.

4. 2. The bone surgical instrument according to claim 1, wherein the holder portion detachably holds a cylindrical guide member that guides the rod-shaped member toward the receiving portion.

5. 2. The bone surgical instrument according to claim 1, wherein the receiving portion comprises a flat surface portion extending in a direction intersecting the direction facing the compressing portion, a peripheral wall portion standing up from the periphery of the flat surface portion, and an opening formed in a part of the peripheral wall portion.

6. 2. The bone surgical instrument according to claim 1, wherein the moving device comprises: a feed plate through which the slide bar passes and whose engagement with the slide bar is maintained by a first biasing means; a stopper plate through which the slide bar passes and whose engagement with the slide bar is maintained by a second biasing means; a feed operation lever that moves the feed plate in the feed direction of the slide bar, that is, in the direction in which the receiving portion moves toward the compressing portion, against the bias of the first biasing means; and a fixation / release lever that disengages the stopper plate from the slide bar against the bias of the second biasing means.

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