JP2000051225A - Intramedullary nail and distal side stopping method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To obtain an intramedullary nail capable of facilitating the distal lateral stopping by screws to mounting holes of the intramedullary nail and decreasing the exposure dose of X-rays. SOLUTION: The front end side of the intramedullary nail 10 which is inserted into the pulp cavity of the long tubular bone 17 to fix a fracture part 18 is provided with the one or plural mounting holes 11, 12 for the screws 26, 27 for side stopping for fixing the intramedullary nail 10 to the distal part of the long tubular bone 17 across the intramedullary nail. The front end side adjacent to the mounting hole 12 at the foremost end is provided with a guide hole 13 for positioning having a free fitting insertion part 14 of the diameter sufficiently larger than the diameter of the mounting hole. The intramedullary nail 10 communicating the free fitting insertion part 14 of the guide hole 13 for positioning and the mounting hole 12 at the foremost end and the screw 26 for lateral stopping inserted into the free fitting insertion part 14 of the intramedullary nail 10 are relatively moved and positioned to the mounting hole 11 by the insertion of the intramedullary nail 10.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an intramedullary nail for fixing a fractured part by inserting it into a medullary cavity of a fractured bone when a long bone such as a femur or a tibia is fractured. The present invention relates to a method of stopping a nail from a lateral side with respect to a distal end side of an inner nail, that is, a distal portion opposite to an insertion portion with a screw.

[0002]

2. Description of the Related Art When a long bone is fractured, for example, FIG.
As shown in FIG. 2, the nail 1 is inserted from the proximal side in such a manner that the fracture portion 4 is erected in the long axis cavity of the long bone 3, and the proximal side with respect to the nail 1 Is fixed by another fixing means, and screws 2 and 2 are inserted from one side into one or two or more mounting holes 5 and 5 previously drilled near the tip of the intramedullary nail 1. Fix to the long bone 3
Orthopedic surgery is performed to hold the fractured part 4 so as not to be displaced by rotation or separation.

It is desirable that the mounting holes 5 and 5 formed in the intramedullary nail 1 are tightly fitted to each other with as little play as possible between the mounting holes 5 and the screw 2 which penetrates the long bone 3 almost perpendicularly. Since the outer diameter of the mounting holes 5 and 5 is set to a diameter that allows the screw 2 to pass through, it is extremely difficult to accurately check the positions of the mounting holes 5 and 5 and insert the screw 2. Was.

That is, since the long holes 3 are present outside the intramedullary nail 1, the mounting holes 5, 5 cannot be seen directly. Therefore, the mounting holes 5, 5 are confirmed by irradiating an X-ray. In this method, the axis of the direction in which the X-ray is irradiated coincides with the axis of the direction in which the screw 2 is inserted. In this method, the screw 2 can be inserted while viewing the image taken by the X-ray. It takes a long time to determine the position accurately.

[0005] In addition, in this method, there is a risk that the patient and medical staff may be exposed to the X-ray, and if it is necessary to repeat the position check with the X-ray many times and take a long time,
There is a risk that the amount of exposure to X-rays will increase and cause a problem of biotoxicity to the human body.

[0006]

SUMMARY OF THE INVENTION Accordingly, the present invention provides an intramedullary nail and a method of stopping a distal crossing which can solve the above-mentioned problems of the prior art. It is an object of the present invention to provide an intramedullary nail and a distal lateral stop method capable of facilitating the stopping and reducing the exposure time of the X-ray by shortening the irradiation time of the X-ray.

[0007]

An intramedullary nail according to the present invention comprises:
At the distal end, there is provided a mounting hole for one or more side-stopping screws that is fixed to the distal portion of the long bone across the intramedullary nail. Is provided with a positioning guide hole provided with a loose fitting insertion portion having a diameter sufficiently larger than the mounting hole, and a guide slot hole is provided between the loose fitting insertion portion of the positioning guide hole and the most advanced mounting hole. Communicated. (Claim 1)

[0008] In the intramedullary nail according to the first aspect, when the intramedullary nail is further inserted with the Kirschner wire or the side stop screw inserted through the loose fitting insertion portion having a diameter sufficiently larger than the mounting hole, the guiding slot hole is formed. Then, the position is transferred to the mounting hole at the forefront through the positioning, so that the position confirmation work of the loose fitting insertion portion by the irradiation of the X-ray can be easily performed, and the operation can be completed in a short time.

Accordingly, the risk of exposure of the patient and medical personnel to X-rays is significantly reduced with the shortening of the position confirmation work time, and the entire operation time is also reduced, so that the mental and physical condition of the patient and medical personnel is reduced. Burden is reduced,
In addition, the side stop screw mounted on the basis of accurate positioning has a high fixing strength, and the fracture portion is stably held to promote the recovery. Further, since the structure is simple, it can be provided at a low cost.

[0010] Another intramedullary nail according to the present invention is provided at the distal end thereof with a mounting hole for one or a plurality of side stop screws which are fixed to the distal portion of the long bone across the intramedullary nail. And
A positioning guide hole provided with a loose fitting insertion portion having a diameter sufficiently larger than the mounting hole is provided on the distal end side adjacent to the mounting hole of the most advanced position. A positioning portion smaller in diameter than the mounting hole is provided at a position close to the mounting hole, and the guide groove hole communicates between the loose-fit insertion portion and the positioning portion. The interval was set to a predetermined interval. (Claim 2)

In the intramedullary nail according to the second aspect, the intramedullary nail according to the first aspect has a small-diameter positioning portion separately from the most advanced mounting hole, while the most advanced mounting hole also serves as the positioning portion. The Kirschner wire passed through the loose fitting insertion portion is moved to the positioning portion by the same operation as in the case of the intramedullary nail according to claim 1, and positioning is performed. The operation of confirming the position of a certain state-of-the-art mounting hole can be performed easily and accurately in a short time, and the same effect as that of the intramedullary nail of claim 1 can be obtained.

[0012] Still another intramedullary nail according to the present invention is provided on the distal end side with a plurality of mounting holes for cross stop screws which are fixed to the distal portion of the long bone across the intramedullary nail. A positioning guide hole provided with a loose fitting insertion portion having a diameter sufficiently larger than the mounting hole is provided on the distal end side adjacent to the mounting hole at the forefront, and the loose fitting insertion portion of the positioning guide hole and each mounting hole are provided. The hole was communicated with the hole at the guide slot. (Claim 3)

[0013] In the intramedullary nail according to the third aspect, in the intramedullary nail according to the first aspect, the positioning hole is also used for the rearmost mounting hole, while the mounting hole at the foremost end also functions as the positioning part. The Kirschner wire passed through the loose fitting insertion portion is moved to the positioning portion by the same operation as in the case of the intramedullary nail according to claim 1, and positioning is performed. The operation for confirming the position of the mounting hole can be easily and accurately performed in a short time, and the same effect as that of the intramedullary nail of claim 1 can be obtained.

The positioning guide holes in the intramedullary nail according to claims 1 to 3 can take various shapes.
These shapes have a large-diameter loose-fitting insertion portion through which a Kirschner wire or a side-stopping screw can be easily inserted, and a guide slot hole through which the Kirschner wire or the side-stopping screw can smoothly transition from the loose-fitting insertion portion to the positioning portion. In particular, it is preferable that the guide slot has a tapered guide surface, and the configuration according to claims 1 to 3 is a combination of a positioning guide hole and a mounting hole.
There is also a mode in which a plurality of sets are arranged along the longitudinal direction of the intramedullary nail.

[0015] The method for distally locking an intramedullary nail according to the present invention comprises:
Use an intramedullary nail provided with a positioning guide hole provided with a loose-fit insertion portion having a diameter sufficiently larger than the mounting hole, which is communicated via a guide slot to the distal end side adjacent to the most advanced mounting hole. ,
After the Kirschner wire is inserted through the loose fitting insertion portion, the intramedullary nail is further inserted and positioned in the mounting hole at the foremost end. (Claim 4)

According to a fourth aspect of the present invention, there is provided a method of stopping a distal side of an intramedullary nail.
Since the small-diameter Kirschner wire only needs to be inserted through the large-diameter loose-fitting insertion part, the position check of the loose-fitting insertion part by irradiation of X-rays, etc., does not need to be performed with extremely high accuracy, and is easy and in a short time It can be finished and the transition to the positioning section is easy, and a hollow canned screw can be externally fitted to the Kirschner wire transferred to the positioning section as a lateral retaining screw, and laterally retained.

[0017] Another method of stopping the distal end of an intramedullary nail according to the present invention is to provide a play with a diameter sufficiently larger than the mounting hole that is communicated through a guide slot to the distal end adjacent to the most advanced mounting hole. Using an intramedullary nail with a positioning guide hole with a fitting insertion part, insert the intramedullary nail further with the side stop screw inserted through the loose insertion part, and position it in the most advanced mounting hole Let it. (Claim 5)

According to a fifth aspect of the present invention, there is provided a method for stopping a nail at a distal side of an intramedullary nail.
Since it is possible to shift to the state-of-the-art mounting hole with the side-stopping screw inserted directly into the loose-fitting insertion portion, the work of inserting the side-stopping screw into the mounting hole is simplified.

According to another method of stopping the distal end of an intramedullary nail according to the present invention, a positioning guide hole provided with a loose-fit insertion portion having a diameter sufficiently larger than the mounting hole on the distal end side adjacent to the mounting hole at the most distal end. In addition, the positioning guide hole has a smaller diameter than the mounting hole, and a positioning portion which is communicated with the loose fitting insertion portion via the guide groove hole portion. Using the intramedullary nail provided at the interval position, after further inserting the intramedullary nail with the Kirschner wire inserted through the loose fitting insertion part and positioning it in the positioning part, screw Attach. (Claim 6)

[0020] In the method for stopping a distal end of an intramedullary nail according to claim 6,
In addition to the same effect as in the method of stopping the distal side of the intramedullary nail according to the fourth aspect, the positioning portion for which the positioning confirmation operation has been completed can be used as a mounting hole.

[0021] Still another method of stopping the distal end of an intramedullary nail according to the present invention is that the diameter of the nail is sufficiently larger than that of the mounting hole which is communicated with the distal end side adjacent to the mounting hole through a guide slot. Using an intramedullary nail provided with a positioning guide hole with a loose fitting insertion part, further inserting the intramedullary nail with the Kirschner wire inserted through the loose fitting insertion part and positioning it in the rearmost mounting hole After that, the side stop screw is attached to the mounting hole. (Claim 7)

[0022] In the method for stopping a distal end of an intramedullary nail according to claim 6,
The Kirschner wire relatively moved along the guide slot communicating between the mounting holes regulates the direction of the intramedullary nail inserted into the medullary cavity and also functions as a guide.

[0023]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, the intramedullary nail and the method of stopping the distal side of the present invention will be described in detail with reference to the attached drawings of FIGS. ~
3 shows an intramedullary nail according to the third embodiment, FIG. 4 shows a distal embolization method using these intramedullary nails, FIG. 5 shows a distal embolization method according to another embodiment, and FIG. FIG. 7 shows an intramedullary nail according to a fourth embodiment, and FIG. 7 shows an intramedullary nail according to the fourth embodiment.

This intramedullary nail 10 is a long rod-like body, and preferably has a rounded and tapered tip so that it can be safely and smoothly inserted into the medullary cavity. Two or more mounting holes 11 and 12 are provided at predetermined intervals L, and positioning guide holes 13 are provided in front of the mounting holes 11 and 12.

The positioning guide hole 13 is formed at the distal end thereof with a loose fitting insertion portion 14 having a diameter sufficiently larger than the mounting hole, and at the base end side, a positioning hole having the same diameter as or smaller than the mounting holes 11 and 12. There is also a mode in which the positioning portion 15 is also used by the mounting hole 12 provided at the forefront, and the mounting holes 11 and 12 are provided between the loose fitting insertion portion 14 and the positioning portion 15.
Are communicated with each other by a guide slot 16 having a diameter equal to or smaller than that of the guide groove.

In the intramedullary nail 10 (10A) according to the first embodiment shown in FIG. 3 (a), the positioning guide hole 13A has a configuration in which the loose fitting insertion portion 14 has a diameter sufficiently larger than the mounting holes 11 and 12. Mounting hole 1
2 is also formed of a circular hole 15a having the same diameter as the mounting hole 11 also serving as the positioning portion 15, and a guide slot 16 formed by a parallel thin slot 16a between the circular cavity 14a and the circular hole 15a, that is, the mounting hole 12. It communicates with.

In the intramedullary nail 10 (10B) according to the second embodiment shown in FIG. 3 (b), a large-diameter circular cavity 1 serving as a loose insertion portion 14 is formed as a positioning guide hole 13B.
4b and a circular hole 15b, which is a positioning portion 15 that is also used by the mounting hole 12, is a tapered slot 16 whose diameter is gradually reduced.
b communicates with the guide slot 16.

In the intramedullary nail 10 (10C) according to the third embodiment shown in FIG. 3 (c), the large-diameter circular hollow portion 1 serving as the loose fitting insertion portion 14 is formed as the positioning guide hole 13C.
4b and the circular hole 15b which is the positioning portion 15 which is also used by the mounting hole 12, are communicated with the mounting holes 11 and 12 by the guide slot 16 having the same diameter as the parallel slot 16c.

The intramedullary nail 10 (1) according to the first to third embodiments
0A, 10B, and 10C), a method of performing distal arrest on a fractured long bone using FIGS. 4 and 5,
The method of FIG. 4 uses an intramedullary nail 10 according to the first or second embodiment.
As shown in (10A, 10B), the guide slot 16 is applied when the groove width is smaller than the screw inserted into the mounting holes 11 and 12, and the method of FIG. 5 is applied to the intramedullary nail according to the third embodiment. As shown in FIG. 10 (10C), the present invention is applied to a case where the width of the guide slot 16 is wider than the screws inserted into the mounting holes 11 and 12.

In the method of stopping the distal side shown in FIG.
After inserting the intramedullary nail 10 into the fractured portion 18 in the intramedullary cavity of No. 7 and confirming the position of the loose fitting insertion portion 14 of the positioning guide hole 13 by the image irradiated with the X-ray, the loose fitting insertion is performed. A Kirschner wire 19 whose tip is formed at the point of a cone is inserted through the portion 14 as shown in FIG.

Next, from the proximal side of the long bone 17, the intramedullary nail 10
When the distal end portion is further moved to the distal side by hitting or applying pressure, the Kirschner wire 19 inserted through the loose fitting insertion portion 14 passes through the guide slot 16 as shown in FIG. Since the cantilever 12 is relatively moved to the positioning portion 15 which is also used, a hollow and self-piercing canned screw 20 is fitted onto the Kirschner wire 19, and the canned screw 20 is guided by the Kirschner wire 19 as a guide. It is inserted through the mounting hole 12.

Next, a positioning jig 2 in which through holes 21 and 22 are previously formed at a predetermined distance L between the mounting holes 11 and 12 is provided.
When the Kirschner wire 19 is inserted through the through hole 21 and another Kirschner wire 24 inserted through the through hole 22 is inserted into the long bone 17, the Kirschner wire 19 is inserted through the mounting hole 11. The canned screw 25 can be inserted through the mounting hole 11 by externally fitting the rated screw 25 and using the Kirschner wire 24 as a guide.

Thereafter, Kirschner wires 19, 24
Then, when the positioning jig 23 is removed, as shown in FIG. 4C (in the drawing, the front and rear directions of the screws 20 and 25 are reversed). Intramedullary nail 1 by 20, 25
0 is laterally stopped at the distal end of the long bone 17, and the fractured portion 8 can be held so as not to be displaced by rotation or separation,
The number of mounting holes can be additionally two or more.

In this method, the mounting holes 11,
A thin Kirschner wire 19 inserted through the loose fitting insertion portion 14 having a diameter sufficiently larger than that of the intramedullary nail 12 is transferred to the positioning portion 15 shared by the mounting hole 12 through the guide slot 16 by the relative movement of the intramedullary nail 10. The cantilever screw 2 is moved along the Kirschner wires 19 and 24 serving as guides.
0, 25 through the mounting holes 11, 12, and
The intramedullary nail 10 at the distal end of the nail.

Therefore, when the position of the loose fitting insertion portion 14 is confirmed by irradiation with an X-ray, if the approximate position is known, the Kirschner wire 19 can be easily inserted.
The checking operation is completed in a short time, and the amount of X-rays exposed to the patient and the medical staff can be significantly reduced, and there is no danger of impairing health.

Further, the Kirschner wire 19 is easily and accurately positioned in the positioning portion 15 which is also used by the mounting hole 12, and is easily inserted into the adjacent mounting hole 11 through the Kirschner wire 24 inserted through the positioning jig 23. In addition, since the positioning is performed accurately, the canned screws 20 and 25 can be easily and accurately inserted into the mounting holes 11 and 12 in a short time, thereby reducing the burden on the patient and medical staff.

As a modification of this method, the Kirschner wire 19 is positioned at the positioning portion 15 which is also used by the mounting hole 12, and then pulled out. After passing through the drawn hole, a tapping screw or a drill screw is used. A self-drilling screw is inserted through the mounting hole 12, and a self-drilling screw that is also not a canned screw is inserted into the adjacent mounting hole 11, and the intramedullary nail 10 is inserted into the distal end of the long bone 17. Can be stopped.

Further, the positioning jig 23 may be an independent plate-shaped one.
It is also possible to form an integrated positioning jig by connecting the jig for guiding the insertion of the zero and the jig for stopping the proximal side, and furthermore, the predetermined interval L between the mounting holes 11 and 12 is known in advance. Therefore, the self-drilling screw can be inserted by measuring the position of the mounting hole 11 from the positioning part 15 without using the positioning jig 23.

Next, the method of stopping the distal side shown in FIG. 5 will be described. This side stopping method can be implemented without using a Kirschner wire or a canned screw. After confirming the position of the insertion portion 14, the loose-fit insertion portion 14
As shown in (a), a self-piercing screw 26 which is not a canned screw is directly inserted.

Next, from the proximal side of the long bone 17, the intramedullary nail 10
When the distal end is further moved to the distal side by hitting or applying pressure, the self-piercing screw 26 inserted through the loose fitting insertion portion 14 is guided through the guide slot 16 as shown in FIG. The mounting hole 12 is relatively moved to the positioning part 15 which is also used.

Next, a position separated by a predetermined distance L from the self-drilling screw 26 is positioned by a jig or measurement similar to the positioning jig 23, and when the self-drilling screw 27 is inserted therein, the mounting hole 11 is formed. Penetrated,
As shown in FIG. 5C, the intramedullary nail 10 is laterally stopped at the distal end of the long bone 17 so that the fractured portion 8 can be held so as not to be displaced by rotation or separation.

In this distal side stopping method, in addition to the effect of the above-mentioned distal side stopping method, the operation can be performed without using a Kirschner wire, so that the operation is simple, and a hollow canned screw is used. Since there is no fixing effect, it is possible to expect effects such as enhancement of fixing strength, and inexpensiveness by not using both.

FIG. 6 shows another embodiment of the intramedullary nail 10. In the intramedullary nail 10 (10D), the positioning guide hole 13D has a loose fitting insertion portion 14. A tapered slot 16d that gradually reduces the diameter between the large-diameter circular cavity portion 14d and the circular hole 15d that is the positioning portion 15
3 and the intramedullary nail 10 shown in FIG. 3, the circular hole 15 d serving as the positioning portion 15 is independent without using the mounting hole 12, and the Kirschner wire can be inserted. The difference is that the diameter is small.

Accordingly, in the distal lateral locking method using the intramedullary nail 10 (10D), the Kirschner wire 19 inserted through the large-diameter circular cavity 14d, which is the loosely inserted insertion portion 14, is used.
With the tapered slot 1 by relative movement of the intramedullary nail 10 (10D).
After the positioning portion 15 is positioned in the circular hole 15d as the positioning portion 15 through the guide slot 16 formed by 6d, the positioning portion 1
5, mounting holes 11, which are separated from each other by a predetermined distance L,
12 and set the canned screws 20 and 2
5 or self-piercing screws 26, 27 are inserted.

However, in the method for stopping the distal side using the intramedullary nail 10 (10D), the circular hole 1
Canned screws 20, 25 for 5d
Alternatively, there is also a mode in which the self-drilling screws 26 and 27 are inserted, and it is preferable that the screw is inserted after the screws are inserted into the mounting holes 11 and 12 so as not to cause a positional shift. Functions in the same way as when three positions are fixed.

FIG. 7 shows another embodiment of the intramedullary nail 10. In the intramedullary nail 10 (10E), the positioning guide hole 13E is a loose fitting insertion portion 14. A guide slot 16 formed by a parallel narrow slot 16e is provided between a large-diameter deformed cavity 14e, a circular hole 15e serving as a positioning portion 15 also serving as the attachment slot 11, and an attachment slot 12 located therebetween. They are communicating.

The intramedullary nail 10 (10E) is different from the intramedullary nail 10 shown in FIG. 3 in that the circular hole 15d as the positioning portion 15 also serves as the mounting hole 11 instead of the mounting hole 12, and is loosely fitted. The difference is that the large-diameter deformed cavity portion 14e, which is the insertion portion 14, and the mounting holes 11, 12 are communicated with each other through a small parallel groove 16e having a diameter small enough to allow a Kirschner wire to be inserted.

Therefore, in the distal lateral locking method using the intramedullary nail 10 (10E), the Kirschner wire 19 inserted through the large-diameter deformed hollow portion 14e, which is the loosely inserted insertion portion 14, is provided.
Is moved by the relative movement of the intramedullary nail 10 (10E).
e, the positioning hole 15e, that is, the mounting hole 11, which is the positioning portion 15 via the guide slot 16 is set, and the mounting hole 12 separated from the positioning portion 15 by a predetermined distance L is set. Rated screw 2
0, 25 or self-piercing screws 26, 27 are inserted.

[Brief description of the drawings]

FIG. 1 is an overall explanatory view of a conventional method for fixing an intramedullary nail and a lateral stopper.

FIG. 2 is an explanatory view of a main part of a conventional method for fixing an intramedullary nail and a lateral stopper.

FIG. 3 shows an embodiment of an intramedullary nail according to the invention,
The principal part enlarged plan view of the intramedullary nail by 3rd Embodiment.

FIG. 4 is a perspective view showing an embodiment of a method for laterally stopping an intramedullary nail according to the present invention.

FIG. 5 is an explanatory view showing a perspective view of another embodiment of the distal side stop method of the intramedullary nail according to the present invention.

FIG. 6 is an enlarged plan view of a main part of an intramedullary nail according to a fourth embodiment, showing another embodiment of the intramedullary nail according to the present invention.

FIG. 7 is an enlarged plan view of a main part of an intramedullary nail according to a fifth embodiment, showing still another embodiment of the intramedullary nail according to the present invention.

[Explanation of symbols]

10, 10A, 10B, 10C, 10D, 10E Intramedullary nail 11, 12 Mounting hole 13 Positioning guide hole 14 Free-fitting insertion part 15 Positioning part 16 Guide groove hole part 17 Long bone 18 Fracture part 19, 24 Kirschner wire 20 , 25 Cannulated screw (screw for side stop) 21,22 Through hole 23 Positioning jig 26,27 Self-drilling screw (screw for side stop)

Claims (7)

[Claims] 1. An intramedullary nail which is inserted into the medullary cavity of a long bone to fix a fracture, and the distal end of the intramedullary nail crosses the intramedullary nail to form a long bone. A mounting hole for one or a plurality of side stop screws to be fixed to the distal portion is provided, and a free-fit insertion portion having a diameter sufficiently larger than the mounting hole is provided at the distal end side adjacent to the mounting hole at the foremost end. An intramedullary nail characterized in that a positioning guide hole is provided, and a guide slot connects the loose-fitting insertion portion of the positioning guide hole and the mounting hole at the forefront. 2. An intramedullary nail for fixing a fracture portion by being inserted into a medullary cavity of a long bone, wherein the distal end of the intramedullary nail crosses the intramedullary nail. A mounting hole for one or a plurality of side stop screws to be fixed to the distal portion is provided, and a free-fit insertion portion having a diameter sufficiently larger than the mounting hole is provided at the distal end side adjacent to the mounting hole at the foremost end. A positioning portion having a smaller diameter than the mounting hole is provided at a position closer to the most advanced mounting hole than the loosely inserted portion of the positioning guide hole, and the loosely inserted portion and the positioning portion are provided. And a guide slot, and a predetermined interval is set between the positioning portion and the mounting hole at the forefront. 3. An intramedullary nail which is inserted into a medullary canal of a long bone to fix a fracture, and a distal side of the intramedullary nail extends across the intramedullary nail. A mounting hole for a plurality of side stop screws fixed to the distal portion is provided, and a positioning having a loose-fit insertion portion having a diameter sufficiently larger than the mounting hole is provided on the tip side adjacent to the mounting hole at the foremost end. Guide holes are provided,
An intramedullary nail characterized in that a guide slot communicates between the loosely inserted portion of the positioning guide hole and each mounting hole. 4. A side stop screw for inserting an intramedullary nail for fixing a fractured part into the medullary cavity of a long bone, and crossing the intramedullary nail through one or more mounting holes drilled on the distal end side. This is a method of stopping the intramedullary nail to be fixed to the distal part of the long bone by attaching the diaper to the distal end adjacent to the mounting hole at the foremost end via the guide slot. Using an intramedullary nail provided with a positioning guide hole with a loosely inserted portion that is sufficiently larger than the mounting hole,
The medullary gland characterized by further inserting an intramedullary nail in a state where the Kirschner wire is inserted through the loose-fitting insertion part and positioning the nail in the most advanced mounting hole, and then attaching a side-stopping screw to the mounting hole. How to stop the inner nail distally. 5. A lateral stop screw for inserting an intramedullary nail for fixing a fractured part into the medullary cavity of a long bone, and crossing the intramedullary nail through one or a plurality of mounting holes drilled on the distal end side. This is a method of stopping the intramedullary nail to be fixed to the distal part of the long bone by attaching the diaper to the distal end adjacent to the mounting hole at the foremost end via the guide slot. Using an intramedullary nail provided with a positioning guide hole with a loosely inserted portion that is sufficiently larger than the mounting hole,
A method for distally stopping an intramedullary nail, wherein the intramedullary nail is further inserted and positioned in a mounting hole at the most distal end in a state in which the screw for lateral prevention is inserted through the loosely inserted insertion portion. 6. A locking screw for inserting an intramedullary nail for fixing a fractured portion into the medullary cavity of a long tubular bone and crossing the intramedullary nail through one or a plurality of mounting holes drilled on the distal end side. A method of locking a distal end of an intramedullary nail, which is attached to a distal portion of a long bone by attaching a nail, wherein a play having a diameter sufficiently larger than the mounting hole is provided at a distal end side adjacent to the mounting hole at the most distal end. A positioning guide hole having a fitting insertion portion is provided, and a positioning portion having a diameter smaller than that of the mounting hole and communicating with the loose fitting insertion portion via a guide slot is provided in the positioning guide hole. After using the intramedullary nail provided at a predetermined interval closer to the mounting hole at the forefront than the part, and further inserting the intramedullary nail with the Kirschner wire inserted through the loose fitting insertion part and positioning it in the positioning part Marrow characterized by attaching a side stop screw to the mounting hole The distal transverse locking method of nails. 7. An intramedullary nail for fixing a fractured portion is inserted into a medullary cavity of a long bone, and a plurality of mounting holes formed on a distal end side of the intramedullary nail are provided with a locking screw for crossing the intramedullary nail. A method for distally locking an intramedullary nail to affix to a distal portion of a long bone, wherein the attachment is communicated via a guide slot to a distal end adjacent to a most distal mounting hole. Using an intramedullary nail with a positioning guide hole with a loose-fitting insertion part with a diameter sufficiently larger than the hole,
After inserting the intramedullary nail with the Kirschner wire inserted through the loose fitting insertion portion and positioning the nail in the rearmost mounting hole, a side stop screw is attached to the mounting hole. How to stop the inner nail distally.