JPH01308559A - Bone fixing apparatus - Google Patents

Abstract

PURPOSE:To stably and accurately perform the positioning of a bone and to accurately and safely grasp the growing state of the bone by providing a pin head, which is mounted to a shaking plate so as to be shakable around the axis in a Y-axis direction and holds an insert pin in a freely detachable manner and a position control mechanism for moving a holding frame on a main body frame. CONSTITUTION:Shaking plates 5, 6 protrude from the side surface of a main body frame 2 in a Y-axis direction and pin heads 7, 8 are mounted to the leading ends thereof and hold two or more insert pins P, P,...P inserted in bones 100, 100 in a freely detachable manner. The main body frame 2 extends in an X-axis direction and a holding frame 3a is adjusted to the position on an X-axis to be fixed at that position and the positional adjustment thereof is performed by a position control mechanism 15 and the end part of an adjustment screw 16 is threaded with the lower part of the guide plate 4 of the holding frame 3a. The adjustment screw 16 has a head 16a and the holding frame 3a is slid along a slide rod 2a by rotating the head 16a. The end part of the extensible rod of a position measuring apparatus 40 is in contact with the guide plate 4 of the holding frame 3a and the position of the holding frame 3a can be always accurately grasped by the position measuring apparatus 40 and the positions of both bones 100, 100 can be grasped accurately.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to a bone fixation device used as an orthopedic instrument for fixing fractures or elongating bones.

[Conventional technology]

Generally, when a bone is fractured, a bone fixation device is used as a surgical instrument to fix the fracture.
This bone fixation device is telescopic and can also be used to adjust bone elongation.

As shown in FIG. 8, this bone fixation device has a telescopic main body 70, and an adjustment screw mechanism 73 is provided on the outside of the main body 70, and the adjustment screw mechanism 73 has an adjustment knob. 74 are provided. Holders #, 71.72 are provided on the left and right sides of the main body 70, and each holding body 71.72
are respectively provided with pin supports 75, 76, and each of the pin supports 75, 76 holds a plurality of insertion pins 77, . . . , 77 to be inserted into the bone 100. The supports 75, 76 for holding the insertion bin 77 and the holders 71, 72 for supporting these supports are connected by pole joints J, J, respectively, and this ball joint J is fixed by bolts b. be done. Also, the main body 70
The expansion and contraction of the supports 75 and 76 are also adjusted by the fixing bolts b, and the state of tightening of the supports 75 and 76 to the insertion bin 77 is also adjusted by the fixing bolts b, b, . . . b.

In such a fixing device, the bolt b of the main body 70 is loosened, the adjustment knob 74 is rotated, the adjustment screw mechanism 73 is extended and contracted, and the gap between the holders 71 and 72 is adjusted, and the gap between the holders 71 and 72 is adjusted. Loosen the fixing bolt b and loosen the ball joint J, move the supports 75 and 76 to a desired position centering on the ball joint J, and adjust the position of the insertion pin relative to the bone 100 in this way. becomes possible.

[Invention or problem to be solved]

However, in such a fixing device, the holding body and the supporting body are connected by a ball joint J, so when the fixing bolt b is loosened, the supporting bodies 75 and 76 are moved to two three-dimensional positions. It moves a lot, which is not good for bone stability. That is, when determining the position of the supports 75 and 76, two positions are selected in three-dimensional space, the fixing bolt b is first loosened, the support is moved to that position, and then the fixing bolt b is tightened. 75 and 76 are unstable, and there is a problem in that both of the supports move while the fixing bolt b is being tightened, making it impossible to stably fix the bone 100 in a predetermined position.

Further, the device can be operated to widen the distance between the affected bone parts 101 at regular intervals in accordance with the growth or elongation of the bone, but the main body 70 is expanded and contracted by rotating the adjustment knob while relying on intuition. .

At this time, if excessive extension is applied to the bone, there is a risk of inducing complications, and some people spend more treatment time than necessary because the body 70 is extended at a slow extension rate even though the bone is growing quickly. There was also the problem that the This is because the device does not have a mechanism that can grasp the initial state of bone formation, which is not visible on X-rays.

In addition, to complete the formation, in the final stage 1, when the affected area is about to harden, only the axial direction of the bone is left free so that natural loads (muscle strength, body weight, etc.) are applied to the bone only in the axial direction. A method has been reported that provides more reliable bone formation by This method is called dynamization. In this dynamization, it is necessary to select an appropriate time in the growth stage of the bone and apply an appropriate load to the affected area, but at this time, if the strength of the affected area 101 is insufficient, the tubes may shrink until they touch each other. There was a risk of it getting lost. In the conventional fixing device, it is possible to dynamize by removing the outer adjustment screw mechanism 73 and loosening the fixing bolt b' of the main body 70, but it is difficult to adjust the limit of the amount of contraction. This is impossible, and furthermore, the time to dynamize cannot be determined and must be done by intuition, which poses a problem in that it is impossible to dynamize accurately.

In view of the above points, the present invention has been made to provide a method for stably and accurately positioning bones, accurately and safely grasping bone growth conditions, and accurately performing dynamization. The purpose is to provide a bone fixation device.

[Means to solve the problem]

Therefore, the present invention provides a main body frame extending in the X-axis direction having linear rigidity, and a main body frame fixed to the main body frame so as to be position adjustable.
Holding the insertion bottle inserted into the bone extending in the X-axis direction 2
a holding frame, a rocking plate that extends from the holding frame in the Y-axis direction and can swing around an axis in the X-axis direction on the holding frame; It is configured to include a swingable bin head for detachably holding the insertion bin, and a position adjustment mechanism for moving at least one of the two holding frames on the main wooden frame.

[Effect]

Two holding frames that hold the insertion pin are fixed to a main wooden frame that has linear rigidity in the X-axis direction so that their positions can be adjusted, and a rocking plate is extended from the holding frames in the Y-axis direction. The rocking plate is rotatable around an axis in the X-axis direction, and a pin head for removably holding an insertion pin to be inserted into a bone is attached to the tip of the rocking plate. The bin head is configured to be able to swing around an axis in the Y-axis direction at the tip of the swing plate.

In this way, the positions of both the holding frames can be adjusted in the X-axis direction, and the rocking plate can rotate around the axis in the X-axis direction.
The bin head can be rotated around the Y-axis at the tip of the rocking plate, and the position can be adjusted independently on three axes centered on the X-axis, allowing accurate and reliable bone position adjustment. The stability is great.

In addition, the bone fixation device has a compressive load detection device between the main body and the holding frame to detect the compressive load applied to the holding frame via the insertion pin, and by continuously measuring the compressive load. The state of bone growth can be accurately grasped, and the time to perform tynamization or the time to remove the fixation device from the affected area can be accurately determined.

Further, at least one of the two holding frames is screwed together in an adjusted manner, the holding frame is moved to a desired position on the main body frame by the adjustment screw, and the holding frame is fixed to the main body frame. A fixing means is provided, the head of the adjusting screw is regulated by one end plate of the main body frame, and during the dynamizing operation, the adjusting screw is lifted from the end plate, and then the holding frame is fixed to the main body frame. Loosen the device and release the holding frame. Then, a load is applied to this holding frame in the direction toward the insertion pins on both sides due to the action of muscles, etc., and even if the affected part 101 should shorten, the head of the adjustment screw will stop in contact with the end plate. .

Dynamization is thus carried out without the risk of significant shortening. By means of such a fixing device for the adjustment/adjustment screw and the holding frame, and further by an end plate that restricts the movement of the adjustment screw, the maximum amount of movement of the insertion pin in the Dyna Nice can be precisely regulated.

〔Example〕

An embodiment of the present invention will be described below with reference to the drawings.

1 to 4, the bone fixation device 1 of the present invention has a main body frame 2 extending in the X-axis direction, and this main body frame 2 has four
Rigid slide rods 2a, 2a for books.

... is formed from 2a. End plates 20 and 21 are provided at both ends of the main body frame 2, and two holding frames 3a and 3b are slidably provided on the slide rod 2a, and guides are provided on both sides of the holding frame 3a on the left side in the figure. A plate 4.4 is provided. Each of the guide plates 4 is provided with a fixing plate 4a, and the fixing plate 4a is provided with fixing screws. By tightening the fixing screws 1) and Jl, the fixing plate 4a is pressed against the side surface of the kite plate 4, and in this way, the holding frame 3a is positioned and fixed on the slide rod 2a.

Further, the holding frame 3b has kite plates 12.1 on both sides thereof.
2, and the guide plate 12 on the left side in the figure faces the fixed plate 13 fixed to the slide rod 2a. The holding frame 3b is held between the end plate 21 and the fixed plate 13 so as to be able to slide for only about one inch along the slide rod 2a. There is a pressing member 3 in the fixing plate 13.
1 is provided, and this pressing member 31 is provided with the kite plate 12.
The load cell 30 provided inside is connected to the load cell 30.

When the guide plate 12 of the holding frame 3b is pressed in the direction of the fixing plate 13, the load cell 30 is operated and the pressing force at this time, that is, the compressive load of the bone is measured. The fixed plate 13
A connector 120 is installed on the side of the ct, and this connector 120 is connected to the recorder 17 via the amplifier 16.
In this recorder 17, the status of the compressive load applied to the bone is constantly displayed on the paper surface 18 by the display device 19.

The main body frame 2 extends in the X-axis direction, and the holding frame 3a on the left side in the figure is adjusted and fixed at a position on the X-axis. This position adjustment is performed by a position adjustment mechanism 15, and this position adjustment R side 15 has an adjustment screw 16, and the right end of this adjustment screw 16 in the figure is screwed into the lower part of the guide plate 4 of the holding frame 3a. are doing. Further, this adjustment screw 16 has a head 16a, and by rotating this head 16a, the holding frame 3a slides along the slide rod 2a. The adjustment screw 16 extends through a hole 40 (FIG. 5) in the end plate 20. As shown in FIGS. 2 and 3, a position measuring device 40 is located near the left end of the slide rod 2a in the drawing.
The end of the telescopic rod of this position measuring device 40 is in contact with the guide plate 4 of the holding frame 3a, and the position of the holding frame 3a can be accurately grasped by this position measuring device 40 at all times. , the positions of the two tubes 100, 100 can be accurately grasped.

A swing plate 5.6 is held in the holding frames 3a and 3b so as to be able to swing around an axis in the X-axis direction, and the rotation of the swing plate 5.6 about the axis in the X-axis direction is locked by a locking mechanism 60 consisting of a fixing bolt and a disc 10. The swing plates 5 and 6 protrude from the side surface of the main body frame 2 in the Y-axis direction, and pin heads 7 and 8 are respectively housed at their tips. This pin head 7.8 removably holds a plurality of insertion pins p, p, . . . P to be inserted into the bones 100, 100.

The pin heads 7.8 each have a fixing plate 9, 110, which fixing bolts",",...
・A plurality of insertion pins P are removably pressed against the main body side of the pin head by j. These pin heads 7.8 are each rotatable around an axis in the Y-axis direction, and the rotational movement around the Y-axis is caused by the lock R structure 50, 5.
Locked by 0 (Figure 2). This lock mechanism 5
0 is the fixing bolt 1. jl .

Next, a method of using the bone fixation device of the present invention will be explained.

In FIG. 1, the insertion pins p are inserted into the bone on both sides of the affected part 101 of the bone 100, respectively. Thereafter, each insertion pin P is fixed to the pin head 7.8. Next, the adjustment screw 16 of the position adjustment 1!15 is rotated to move the holding frame 3a on the right side of the figure to a desired position while sliding it on the slide rod 2a. After the holding frame 3a is moved to the desired position in this way, the holding frame 3a is
The fixing plate 4a is fixed on the slide rod 2a by tightening the fixing bolt 1.1. Next, each of the locking mechanisms 50.60 is operated to adjust the rotational position of each of the rocking plates 5.6 in the X-axis direction and the pin head 7.8.
Adjust the rotational position in the Y-axis direction.

In this way, both the canals 1
Fix 00,100.

In this way, in the X-axis direction, the holding frame 3a is moved to a predetermined position, and the movement of the holding frame in the X-axis direction, the movement of the rocking plate around the axis in one direction, and the movement of the pin head around the Y-axis direction. These movements are carried out independently, and not only do the rocking plates 5.6 held within the holding frames 3a and 3b not move significantly, but the pin head also does not move significantly. Therefore, since the insertion pin does not move significantly during adjustment with respect to the axis of bone elongation, the bones 100 on both sides. The position of the Zoo can be adjusted accurately and stably, and the position of the insertion pin can be adjusted accurately without significantly moving the bone 1oo.
Even in the final stage of bone formation, some positional correction may be necessary, and this can be easily done. Furthermore, since fixing plates 4a, 4a are attached to the guide plates of the holding frame, even if the adjustment screw of the position adjustment mechanism 15 becomes loose, the holding frame 3a will not move, ensuring the safety of the bone. Retained.

When this device is set on both pipes 100, 100, these two pipes 100. ．． The insertion pins P on both sides tend to approach each other due to the muscles and muscles surrounding the pin 100. Therefore, at this time, the kite plate 12 of the right holding frame 3b comes into contact with the fixed plate 13 firmly fixed to the slide rod 2a, and a compressive load acts between these two members. This compressive load is electrically output to the recorder 17 through the amplifier 116 by the output cell 30 and recorded. This recorder 17 constantly records the compressive load on the bone, and the growth state of the bone can be accurately grasped according to the compressive load condition.

As shown in FIGS. 2 and 3, a position measuring device 40 is provided near the left end of the slide rod 2a in the drawing, and the end of the telescopic rod of this position measuring device 40 is connected to the guide plate of the holding frame 3a. 4, and by this position measuring device 40, the position of the holding frame 3a can be accurately grasped at all times, and therefore the positions of the two tubes 100 and 100 can be accurately grasped.

This bone fixation device can be used not only to fix bones at the time of fracture, but also to lengthen the legs of patients with dwarfism. By rotating the adjusting screw I6, the gap between the bones is gradually increased in accordance with the growth state of the bone, and in this way, the elongation of the bone can be safely promoted.

Not only do the rocking plates 5.6 held within the holding frames 3a and 3b not move significantly, but the pin head also does not move significantly, so that they cannot be inserted into the axis of bone elongation. Since the pin does not move when adjusting the size, as shown in FIGS. 6 and 7, no matter which direction the bone 100 is curved, the Y-axis direction of the pin head 7.8 Correct correction can be achieved by rotation or by rotation of the rocking plate 5.6 around two axes, and furthermore, by adjusting the position adjustment mechanism 15, the bone can be elongated even after correction. On the other hand, conventional bone correction cannot be performed using only the fixation device itself; an adapter is required, and the adapter can only correct in one direction.

The state of recovery of the affected bone part 101 and the state of growth of the bone differ depending on age differences or individual differences, but since this growth state or recovery state is constantly detected by the detection member equipped with the load cell 30, any It is possible to accurately grasp the state of growth or recovery of a person's bones, and it is also possible to accurately determine when it is the appropriate time to dynamize or when to remove the external fixation device from the patient.

Once the timing of the dynamization is accurately determined, the dynamization is performed as follows.

In FIG. 5, the adjustment screw 16 is screwed into the lower part of the kite plate 4 of the holding frame 3a, and the adjustment screw 16 is inserted through the hole 40 of the plate 20 (Figure 5a). Next, the fifth
As shown in Figure b, the head 16a of the adjusting screw 16 is rotated to lift the adjusting screw 16 a distance W from the end plate 20. In this state, the fixing plate 4 of the holding frame 3a
If a is loosened, the holding frame 3a, together with its guide plate 4, can be moved to the right in the figure by a maximum distance W by a tensile load applied by muscles or the like. In this way, by lifting the adjustment screw 16 by a predetermined distance W without applying any force, the holding frame 3a can approach the opposing holding frame 3b by an appropriate distance.

This allows timerization to be performed appropriately and safely. During dynamization, if there is a large displacement in which the stretched image area shrinks more than necessary, this will actually hinder bone growth, but this device does not have this risk.

〔Effect of the invention〕

Since the present invention is constructed as described above, the radius of movement of the bone can be reduced, and the bone can be corrected in two directions with each axis being independently free, and the fixation and extension of the bone can be performed accurately and stably. This makes it possible to prevent excessive shortening during tienamization.Furthermore, by providing a detection member, the state of bone growth can be accurately grasped at all times, and the timing of tienamization and the time to remove the fixation device can be accurately determined. play.

[Brief explanation of the drawing]

Fig. 1 is a perspective view of the bone fixation device of the present invention, Fig. 2 is a plan view thereof, Fig. 3 is a side view thereof, Fig. 1 is a front view thereof, and Fig. 5 is an explanatory diagram of the action during tienamization. , FIGS. 6 and 7 are explanatory diagrams of bone correction states, and No. 8I21I is a front view of a conventional bone fixation device. 1...Fixing device, 2...Body frame, 3a, 3b...
Holding frame, 4.12... Kite board, 5, 6... Rocking plate, 7, 8... Pin head, 30... Load cell, 4
0...Position measuring device. Applicant's representative Yasuo Ishikawa Figure 2 Figure 3 Figure 4 Figure W Figure 5 (a) (b)
6 Figures (a) (b) Figure 7 Figure 8 Amendment to Figure Procedures July 6, 1986

Claims (2)

[Claims] 1. A main body frame that has linear rigidity and extends in the X-axis direction, two holding frames that are fixed to this main body frame in a position-adjustable manner and hold insertion pins that are inserted into bones that extend in the Z-axis direction, and this holding frame. a rocking plate that extends in the Y-axis direction from the holding frame and is attached to the rocking plate and is swingable around the Y-axis; A bone fixation device comprising: a pin head for detachably holding a pin; and a position adjustment mechanism for moving at least one of the two holding frames on a main body frame. 2. 2. The bone fixation device according to claim 1, wherein the bone fixation device includes a compressive load detection device for detecting a compressive load applied to the holding frame via the insertion pin.