JPH09168548A - Fixing instrument of bone adhering to surrounding structure - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a new fixing instrument capable of fixing a fractured bone part that is adhering to surrounding structures without removing the surrounding structures from the bone, and an example of the bone is the lesser trochanter of an upper part of a thighbone. SOLUTION: A fixing instrument is equipped with a through hole 10a and a fixing hole 10b, and both of these holes have openings of an oval or a rather elongated circular shape in the axial direction of the fixing instrument 10. A first plate part 11 consists of a connection part 11a, a supporting part 11b, and a fixing part 11c. A second plate part 12 consists of a connection part 12a, a supporting part 12b, and a fixing part 12c. The connection part 11b and the fixing part 12a are fit to each other, and they are connected through a single axis hole. A connecting axis 13 is placed in the axis hole. The supporting parts 11b and 12b constitute a peripheral part of the left and right sides of the through hole 10a. The fixing parts 11c and 12c face each other with the fixing part 12c facing upwards and 11c downwards. With rotating the first plate part 11 and the second plate part 12 mutually, the through hole 10a can be opened or closed.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a fixing device for bones attached to other tissues, and more particularly to a fixing device for bones suitable for repairing a fracture of the base of the lesser trochanter on the upper part of the femur.

[0002]

2. Description of the Related Art Conventionally, a plate made of various biocompatible materials for fixing a fractured part in order to repair a fractured bone part, for example, an inert metal such as titanium, ceramics, bioabsorbable resin, etc. , Bone joints such as shafts and nails are used. These bone connectors have different shapes and structures depending on the fractured part. For example, a small plate is used for complicated facial fractures and a relatively large plate is used for femoral fractures.

There are various surgical methods for attaching the above-mentioned bone connector according to the fracture site. For example, when the above-mentioned plate is used, the epidermis and supracone of the fractured part are incised to expose the fractured part, and the fractured part is held and fixed so as to return to its original state. Next, the plate is abutted so as to straddle the fractured part, the surface position of the bone part corresponding to the fixing hole of the plate is confirmed, and a screw hole is drilled in the bone part from that position by a drill or the like. Finally, the plate is again brought into contact so as to straddle the fractured portion, a screw is inserted into the fixing hole of the plate, and the screw is screwed into the screw hole of the bone portion to fix the plate.

By the way, a tendon formed at the base of the thigh muscle is attached to the lesser trochanter existing above the femur. The base of the lesser trochanter often fractures due to some stress. If the lesser trochanter fractures, it is necessary to re-fix the base of the lesser trochanter to the femur.In particular, the lesser trochanter with the tendon attached is stressed by the muscles that are continuous with the tendon, so the trochanter is securely fixed. There is a need to.

[0005]

The tendon and muscle are attached to the base of the lesser trochanter, so in order to repair and fix the fracture of this part, the tendon and muscle are once cut and removed. It is necessary to fix the base of the lesser trochanter to the femur. Therefore, the operation of the fractured part requires the work of cutting and suturing the tendon and the muscle, which complicates the operation, and after the operation, it is necessary to wait for the adhesion of the cut part of the tendon and the muscle. Further, after the fractured part is healed, it is necessary to remove the fixing device as needed, and also in this case, it becomes necessary to cut the tendon. There are many other sites, such as the lesser trochanter, where tendons, cartilage, etc. are attached to the bone, and the same problem as above occurs when a fracture occurs near these sites.

Therefore, the present invention is to solve the above-mentioned problems, and the problem is to attach other tissues such as tendons, cartilage and muscles to the bone, like the fracture of the base of the lesser trochanter. It is an object of the present invention to provide a new bone fixing device capable of fixing a fracture of an existing bone portion without the need to cut these other tissues.

[0007]

[Means for Solving the Problems] Means to be taken by the present invention to solve the above problems is a fixing device for fixing a site where another tissue is attached to a bone, which is for fixing the site. A through hole formed in the portion and a fixing hole for fixing the device to the bone via a fastening member, and the peripheral edge portion of the through hole includes at least a first peripheral edge portion and a second peripheral edge portion. And the insertion hole can be opened and closed by a movable structure in which the first peripheral portion and the second peripheral portion are relatively movable. It is a fixing device.

According to this means, since the insertion hole can be opened and closed by the first peripheral portion and the second peripheral portion which are configured to be movable with respect to each other, the site to which another tissue is attached is fixed. At this time, the first peripheral portion and the second peripheral portion are moved relatively to each other to open the insertion hole so that another tissue is inserted into the insertion hole, and in this state, the site can be fixed. . Therefore, the site can be fixed without cutting other tissues, and the fixing device can be removed without cutting other tissues.

Further, the movable structure is provided with a first peripheral portion which is joined to the movable structure so as to be rotatable relative to each other.
And a second portion having the second peripheral portion, and the insertion hole is opened and closed by relatively rotating the first portion and the second portion. Preferably.

According to this means, the insertion hole can be opened and closed simply by rotating the first portion and the second portion joined by the shaft supporting portion, so that the operation of the device when fixing the above-mentioned portion is performed. It is possible to improve the sex.

In this case, further, the first fixing hole portion formed in the first portion and configured so that the fixing holes can be overlapped with each other, and the second fixing hole portion are formed.
And a second fixing hole portion formed in a portion of the first fixing hole portion and the second fixing hole portion in a state where the insertion hole is closed.
It is desirable that the fixing holes are overlapped with each other concentrically.

According to this means, since the fixing hole is composed of the first fixing hole portion and the second fixing hole portion which are concentrically overlapped with each other with the insertion hole closed, the fixing hole is fixed. By inserting a fastening member such as a fixing screw or a fixing pin into the hole, the device can be fixed to the bone, and at the same time, the closed state of the insertion hole can be held. It is not necessary to provide it, and the operation for maintaining the closed state is also unnecessary.

Further, it is preferable that the insertion hole is provided with an inclined inner surface that widens from the front surface side toward the back surface side facing the bone. According to this means, since the insertion hole is configured to widen toward the back surface side, the insertion hole not only has the function of inserting another tissue, but also protrudes like a protrusion of bone. Since it can be fixed so as to be fitted to the other tissue attachment site in the above-described shape, it is possible to reliably perform the fixation of the site to the bone and the fixation of the device to the bone.

Further, it is preferable that the fixing hole is formed in an elongated hole shape extending in a direction toward the insertion hole. According to this means, since the fixing hole is formed in a shape extending toward the insertion hole formed in the portion for fixing the other tissue attachment site, the insertion hole of the fastening member that is inserted into the fixing hole The distance with respect to can be changed as needed, and the fastening member can be attached at any position within the range where the fixing hole is formed.

[0015]

BEST MODE FOR CARRYING OUT THE INVENTION Next, an embodiment of a fixing device for another tissue-attached bone portion according to the present invention will be described with reference to the accompanying drawings. FIG. 1 shows a perspective view showing the entire fixing device 10 of the present embodiment, and FIG. 2 shows a plan view of the fixing device 10.
4 shows the opened state of the fixing device 10, and FIGS. 4 (a) and 4 (b) show cross sections taken along the lines AA and BB of FIG. 2 of the fixing device 10, respectively.

In this fixing device 10, a first plate member 11 and a second plate member 12 made of a titanium alloy are joined by a joining shaft 13 which inserts joining portions 11a and 12a formed at the ends. . In the state shown in FIGS. 1, 2, and 4 in which the first plate member 11 and the second plate member 12 are fitted together, the plate surface of the fixing device 10 is formed with the insertion hole 10a and the fixing hole 10b. . Both the insertion hole 10a and the fixing hole 10b have an elliptical or oval opening shape extended in the axial direction of the fixing device 10. The edge portion on the front surface side of the fixing device 10 is formed into a curved surface having a large curvature, and the fixing device 10
The edge portion on the back surface side has a curvature smaller than that of the edge portion on the front surface side, but is surely curved.

The first plate member 11 has the joint portion 11a and
The support portion 11b connected to the joint portion 11a and the support portion 1
It is roughly configured with a fixed portion 11c connected to 1b. In addition, the second plate portion agent 12 includes the joint portion 12a, the support portion 12b connected to the joint portion 12a, and the support portion 12.
It is roughly configured with a fixing portion 12c connected to b.
In the joint portions 11a, 12a and the support portions 11b, 12b, the first plate member 11 and the second plate member 12 are in a state of being fitted in the left and right, and the fixing portions 11c and 12c are different from each other in the fixing portion 12c. It is in a state of overlapping with the fixed portion 11c on the upper side. Further, the joint portions 11a, 12a and the support portions 11b, 12b are formed thicker than the overlapping portion of the fixed portion 11c and the fixed portion 12c, and the surfaces of the joint portions 11a, 12a and the support portions 11b, 12b are the same as those of the fixed portion 12c. It is higher than the surface.

The shapes of the first plate member 11 and the second plate member 12 constituting the fixing device 10 are shown in FIGS. 3 and 4, respectively. The upper and lower parts of the joining portion 11a of the first plate member are 2
Two protrusions and recesses formed between these protrusions are provided, and the joint portion 12a of the second plate member 12 has two upper and lower recesses and a protrusion formed between these recesses. And the joint 11a thus formed.
And 12a are fitted together. A shaft hole that penetrates vertically is formed in the fitted joint portions 11a and 12a,
The joining shaft 13 is press-fitted into this shaft hole.

The joint shaft 13 pivotally supports the first plate member 11 and the second plate member 12 so as to be rotatable relative to each other. In FIG. 3, the first plate member 11 and the second plate member 12 are rotated to insert the insertion hole 10a.
It shows a state in which is opened. The insertion hole 10a has a first
Two semi-elliptical inclined curved surfaces 11A formed inside the supporting portion 11b of the plate member 11 and two semi-elliptical inclined curved surfaces 12A formed inside the supporting portion 12 of the second plate member 12 are opposed to each other. It is composed of a semi-elliptical inner surface (peripheral portion). As shown in FIG. 3, the first plate member 11 and the second plate member 12
When the fixing portions 11c and 12c are rotated so as to open, the insertion hole 10a is largely opened by separating the inclined curved surfaces 11A and 12A.

As shown in FIGS. 3 and 4, the first plate member 1
The fixed portion 11c of No. 1 has a surface that recedes largely below the surface of the support portion 11b, and the second plate member 1 is provided on the surface.
It is configured to receive the two fixing portions 12c.
An elongated hole 11B extending in the axial direction of the first plate member 11 is formed in the fixed portion 11c.

On the other hand, the fixed portion 12c of the second plate member 12 is
With a surface slightly recessed from the surface of the support portion 12b,
An elongated hole 12B extending in the axial direction of the second plate member 12 is formed. A tapered surface 12d is formed on the peripheral portion of the oblong hole 12B on the front surface side. Slot 11B and slot 12
As shown in FIG. 1 and FIG. 2, B is arranged so as to be vertically concentric with each other when the insertion hole 10a is closed, and constitutes a continuous fixed hole 10b as one long hole. There is.

FIG. 5 is a plan view showing a fixing device 20 as a second embodiment different from the fixing device 10. The fixing device 20 includes a first plate member 21, a second plate member 22, a joining shaft 23, an insertion hole 20a, a fixing hole 20b, joining portions 21a, 22a, a supporting portion 21b, which have substantially the same structure as the fixing device 10. 22b and fixing parts 21c and 22c are provided,
Two long holes 20b and 20b along the axial direction of the fixing device 20 are formed in the fixing portions 21c and 22c side by side in the axial direction.

The above-mentioned two embodiments are applied to the fracture of the base of the lesser trochanter 51 existing in the portion near the upper head of the femur 50 shown in FIGS. 6 and 7. Little trochanter 5
A tendon 52 is attached to the tendon 1, and a thigh muscle 53 is connected to the tendon 52. In the illustrated example, the fractured part 54 is present at the base of the lesser trochanter 51.

The fractured lesser trochanter 51 is brought into contact with the original position of the femur 50 to hold the state, and as shown in FIG.
The support parts 11b and 12b of the fixing device 10 in the open state are arranged on both sides of the lesser trochanter 51. In this state, the fixing device 1
While gradually closing 0, the fixing portions 11c and 12c are also made to slip under the tendon 52 and the thigh muscle 53 (on the femur side) to obtain the state shown in FIG.

In this state, avoiding the tendon 52 and the thigh muscle 53, a screw hole is bored from the surface of the femur 50, and the fixing screw 60 is inserted into the fixing hole 10b as shown in FIG. The fixation device 10 by screwing it into the femur 50
Fixed on the surface of. At this time, the jaw portion 61 of the head of the fixing screw 60 engages with the tapered surface 12d formed on the peripheral portion on the surface side of the fixing hole 10b to securely press the fixing device 10 to the femur 50. Further, the fixing hole 10b of the fixing device 10
Has a long hole extending in the axial direction, the fixing screw 60 can be attached to an appropriate position in the axial direction of the fixing device 10 within the range where the fixing hole 10b is formed.
At this time, the supporting portions 11b and 12b of the fixing device 10 and the peripheral edge portion of the insertion hole 10a existing in the center thereof come into contact with the surface of the lesser trochanter 51, and the lesser trochanter 51 is pressed and fixed to the femur.

According to this fixing device 10, the lesser trochanter 51 can be easily fixed without cutting the tendon 52 and the thigh muscle 53, and when the fixing device 10 is removed, the fixing screw 60 is used. Simply remove the tendon 52 and thigh muscle 5
It can be easily removed without cutting 3. Further, the insertion hole 10a of the fixing device 10 can be maintained in the closed state only by inserting the fixing screw into the fixing hole 10b in a state where the first plate member 11 and the second plate member 12 are closed. It is extremely easy to handle. Furthermore, since the fixing hole 10b is a long hole as described above, the fixing screw can be inserted at an arbitrary position in the axial direction within a predetermined range.

In order to further improve the handling of the fixing device 10, the first plate member 11 joined by the joining shaft 13 is used.
Also, the rotation characteristic of the second plate member 12 is such that it can be rotated only when a force is applied by gripping both the first plate member 11 and the second plate member 12. Preferably.

Further, the rotation angle between the first plate member 11 and the second plate member 12 (for example, the first plate member 1 in the state shown in FIG. 3)
By setting the maximum value of the angle between the axis of No. 1 and the axis of the second plate member 12) to a predetermined angle in advance, excessive opening can be prevented. For example, it is desirable to set the angle to about 110 degrees at the maximum in order to improve operability during surgery. To set the maximum turning angle in this way, the joint 11
It may be formed in such a shape that the fitting portions of a and 12a are in contact with each other in a state where the fitting portions of a and 12a are open to prevent rotation.

Further, when the fixing device 10 is closed, a snap structure or the like is formed so that a light holding force is exerted, whereby the operability is further improved. Also,
In order to improve the installability of the fixing device 10, the fixing device 1
It is preferable that the back surface shape of 0 (particularly, the back surface shape of the fixing portion 11c of the first plate member 11) is matched with the surface shape of the femur around the lesser trochanter (particularly immediately below the lesser trochanter).

The advantages of the fixing device 10 described above are directly applied to the fixing device 20. However, the fixing device 20
Since the fixing hole is divided into two, the fixing screw 6
The arbitrariness of the insertion position of 0 is somewhat inferior.

In order to match the protruding shape of the lesser trochanter 51, the insertion holes 10a and 20a are preferably formed with a tapered inclined peripheral surface as shown in FIG. 4 (a). In this case, in particular, in order to better adapt to the protruding shape of the lesser trochanter 51, as shown in FIG. 11A, the inclination angle between the two peripheral surface portions facing each other in the longitudinal direction (axial direction) of the insertion hole. It is preferable that φ be about 90 degrees, and on the other hand, as shown in FIG. 4A, the inclination angle θ between two peripheral surface portions facing each other in the direction orthogonal to the longitudinal direction be about 56 degrees. . The inclination angles .theta. And .phi. Should be appropriately set in conformity with the shape of each bone portion attached to a tissue other than the lesser trochanter 51. In any case, since the inner surface of the insertion hole is an inclined taper surface, this insertion hole allows other tissues to be inserted, and at the same time, has a function of fixing the bone part in conformity with the projection shape of the bone part. Will have.

In the above embodiment, the fixing holes 10b and 20b are provided.
Although the taper surfaces 12d and 20d are formed on and are engaged with the fixing screw 60, since the fixing hole is a long hole, the fixing screw 60 may be displaced in the axial direction of the fixing hole. In order to prevent the displacement of the fixing screw, as in the fixing device 30 shown in FIG. 11B, the fixing hole 30b has a long length of the first plate member 31 having an inner peripheral surface both formed of a tapered surface. Hole 3
1B and the elongated hole 32B of the second plate member 32 are preferable. In this case, the taper nut 40 having the screw hole 41 and the two opposed tapered surfaces 42 and 43 formed on the peripheral surface is inserted into the fixing hole 30b, and the fixing screw is inserted into the screw hole 41 of the taper nut 40. While screwing 60, it is further screwed into the screw hole formed in the femur. At this time, the taper surfaces 42 and 43 of the taper nut 40 are
Is pressed by the inner peripheral surface of the fixing hole 30b, which is formed by the tapered surface. Therefore, the friction between the tapered surfaces 42, 43 and the inner peripheral surface of the fixing hole 30b causes the fixing screw 60 to shift in the longitudinal direction of the fixing hole 30b. Is prevented.

In the above embodiment, the first plate member and the second plate member are rotatably joined by the joining shaft at the end portion on the insertion hole side, but within the scope of the present invention, the insertion member is inserted. A part for opening and closing may be provided at the peripheral portion of the hole, and the opening / closing structure of the insertion hole may be a sliding structure instead of a rotating structure. In addition, the joint portion may be provided at another portion, for example, an intermediate portion between the insertion hole and the fixing hole or an end portion on the fixing hole side.

[0034]

As described above, according to the present invention, since the insertion hole can be opened and closed by the first peripheral portion and the second peripheral portion that are movable with respect to each other, other tissues In fixing the part to which the adhered portion is attached, the first peripheral portion and the second peripheral portion are relatively moved to open the insertion hole so that another tissue is inserted into the insertion hole. In this state, The part can be fixed. Therefore, the site can be fixed without cutting other tissues, and the fixing device can be removed without cutting other tissues.

[Brief description of the drawings]

FIG. 1 is a first part of the fixing device for another tissue-attached bone part according to the present invention.
FIG. 3 is a perspective view showing the overall structure of the embodiment of FIG.

FIG. 2 is a plan view of the first embodiment.

FIG. 3 is a plan view showing a state in which the insertion hole of the first embodiment is opened.

4 is a cross-sectional arrow view (a) showing a state cut along the line AA of FIG. 2 and a cross-sectional arrow view (b) showing a state cut along the line BB of FIG. is there.

FIG. 5 is a second part of the fixing device for another tissue-attached bone part according to the present invention.
It is a top view which shows the whole structure of embodiment.

FIG. 6 is a front view showing the upper part of the femur to which the above embodiment is applied.

FIG. 7 is a side view showing an upper portion of a femur to which the above embodiment is applied.

FIG. 8 is a partial side cross-sectional view showing the upper part of the femur to which the first embodiment is attached.

FIG. 9 is a front view showing the upper portion of the femur when the first embodiment is worn.

FIG. 10 is a front view showing the upper part of the femur to which the first embodiment is attached.

FIG. 11 is a vertical cross-sectional view (a) showing an internal structure in the axial direction of the first embodiment, a cross-sectional view (b) showing a structure of a fixing portion of a fixing device 30 having fixing holes 30b having different shapes, and It is a perspective view (c) which shows the taper nut matched with the fixed hole 30b.

[Explanation of symbols]

 10, 20 Fixing device 10a, 20a Insertion hole 10b, 20b Fixing hole 11,21 First plate member 11A, 12A Inclined curved surface 11B, 12B Long hole 12,22 Second plate member 13, 23 Joining shaft 11a, 12a Joining part 11b , 12b Supporting part 11c, 12c Fixed part

Claims (5)

[Claims] 1. A fixing device for fixing a site to which another tissue adheres to bone, the device including an insertion hole formed in a part for fixing the site, and the device fixed to the bone via a fastening member. And a peripheral edge of the insertion hole is composed of at least a first peripheral edge and a second peripheral edge, and the first peripheral edge and the second peripheral edge are relative to each other. The fixing device for another tissue-attached bone part, wherein the insertion hole is configured to be openable and closable by a movable structure configured to be movable. 2. The movable structure according to claim 1, wherein the movable structure includes a first portion having the first peripheral edge portion and a second peripheral edge portion that are rotatably joined to each other by a shaft support portion. Another tissue, characterized in that it is constituted by a second portion provided, and the insertion hole is opened and closed by relatively rotating the first portion and the second portion. Fixing device for attached bone. 3. The first fixing hole portion formed in the first portion, wherein the fixing hole is configured to be superposed on each other, and the second portion. A second fixing hole portion formed in the first fixing hole portion, and the first fixing hole portion and the second fixing hole portion are concentrically overlapped with each other with the insertion hole closed. A device for fixing a bone part attached to another tissue, which is characterized in that: 4. The fixing device for another tissue-attached bone portion according to claim 1, wherein the insertion hole has an inclined inner surface that widens from the front surface side toward the back surface side facing the bone. 5. The fixing device for another tissue-attached bone part according to claim 1, wherein the fixing hole is formed in an elongated hole shape extending in a direction toward the insertion hole.