JP2000139940A - Fixture for joining bone - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a fixture for joining bones, wherein the friction force of a nail with the inner surface of a bone marrow is increased to prevent the falling-off of an anchor nail inserted from a bone hole into a bone joining portion in the bone marrow, and the locking and holding of a nail tail end side are facilitated and secured. SOLUTION: This fixture for joining bones fixes a bone joining portion by inserting a nail 10 from a bone hole 12 into a bone marrow. Convex and concave portions 14 for increasing a friction force are uniformly provided over an entire region from a tip side to a tail end side, and locking means 15, 16 and 17 are provided to lock the nail tail end side protruded out from the bone hole 12 in the vicinity to the bone hole 12.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to the field of orthopedic surgery and the like, for performing osteosynthesis surgery for fracture treatment and correction of long bones such as humerus, femur and tibia.
The present invention relates to an osteosynthesis fixing device used to fix a osteosynthesis to promote bone fusion by inserting a nail into bone marrow.

[0002]

2. Description of the Related Art Intramedullary nail fixation is one of the most common fixation methods conventionally applied to osteosynthesis of long bones such as humerus, femur, and tibia. According to the method, the diameter called the ender nail is 4 to 6 m as the osteosynthesis means.
A stainless steel rod having a length of about 20 m and a length of 20 to 50 cm is used.

For example, a method of fixing a long bone fracture using an ender nail will be described with reference to a case of a proximal femoral fracture shown in FIG. 1. As shown in FIG. After drilling a bone hole 4 of about 1 × 4 cm using a drill or the like in a distant site, ie, a bone cortex distal to the femur, an ender nail 1 having a desired length is inserted from the bone hole 4 in FIG.
Insert into bone marrow as in (b).

[0004] In order to facilitate passage through the bone marrow, the ender nail 1 has a distal end that is curved.
When setting the length of the ender nail 1 to be used, the ender nail 1 is placed directly on the skin from above and along the femur, and this is appropriately selected from various lengths prepared in advance by X-ray fluoroscopy. Select and use appropriate ones.

In order to facilitate insertion and removal after bone fusion, the ender nail 1 may be provided with a locking portion 6 on which a driving tool 5 is mounted, at a rear end side. The head 5a of the driving tool 5 holding the locking portion 6 at 5c
Is hit with a hammer 7 and is driven toward the osteosynthesis 3 and the direction is controlled by rotating the handle 5b.

Normally, at least 3 as shown in FIG.
The endering nail 3 is fixed by inserting the ender nail 1, but there are many cases in which the nervous joint 3 comes out after insertion, so that a few more may be inserted to prevent the deviation due to the frictional force between the nails. The series of osteosynthesis treatments described above is the same for other skeletal bones such as the humerus.

[0007]

However, in the case of the fixing method using the above-mentioned nail 1, the nail 1 is deviated after a short period of operation due to lack of locking force, sinking or dynamization. The danger is that many nails 1
There is a problem that needs to be improved, for example, when inserting a long time, it takes a long operation time and is expensive because many expensive nails are used.

When the nail 1 is inserted from the distal end of the osteosynthesis 3 in order to increase the frictional force with the inner surface of the bone marrow in order to prevent the deviation, the nail 1 needs to be longer by that amount. The material cost and the time spent for insertion are expensive and uneconomical, and when the joint function, for example, the osteosynthesis 3 is a humerus, the elbow joint may be impaired.

The present invention solves these problems of the prior art. The main object of the present invention is to prevent an anchor nail inserted into a osteosynthesis in a bone marrow from a bone hole from deviating. An object of the present invention is to provide an osteosynthesis fixing device that enhances the frictional force between the nail and the inner surface of the bone marrow and easily and reliably locks and holds the nail at the distal end.

[0010]

SUMMARY OF THE INVENTION The present invention relates to an anchor nail which is inserted into a bone marrow from a bone hole to fix an osteosynthesis. And a locking means for locking the end of the nail protruding outside from the bone hole to the vicinity of the bone hole.

According to this anchor nail, the unevenness uniformly provided on the outer peripheral surface of the entire nail acts on the inner surface of the bone marrow and the opening edge of the bone hole to enhance the frictional force.
Since the nail distal end is locked in the vicinity of the bone hole by the locking means, the nail can be prevented from deviating from the insertion position, and the osteosynthesis can be securely fixed and supported.

[0012] Also, by enabling reliable fixing support, it is possible to reduce the number of nails without requiring many nails unlike the conventional ender nail, and to use a short nail to be used from the proximal side of the osteosynthesis. It has advantages such as being able to be inserted, thereby providing an economical effect of reducing expensive nails and shortening the operation time, thereby reducing the burden on both the patient and the physician. Positional insertion also eliminates the risk of impairing joint function (eg, elbow joint if the osteosynthesis is a humerus).

Further, the unevenness is provided uniformly from the tip end to the end side of the nail, so that the general length (maximum length)
The standard nail cut in the above can be adjusted to the individual patient, and one end can be cut and finely adjusted to a desired length, so that various nails having different lengths can be prepared for the individual patient. It is economical because there is no need to prepare in advance.

As the unevenness for enhancing the frictional force of the anchor nail, various known shapes for enhancing the frictional force can be employed, but a shape which can be easily inserted and removed and which does not damage the bone is desirable. For example, it is preferable that annular projections having a lead angle are provided at predetermined intervals on the outer periphery of the nail, or threads are formed.

When the protrusions and recesses for enhancing the frictional force are formed by the annular projection or the thread having the lead angle, the nail can be advanced and retracted by rotating the nail, thereby facilitating the insertion and removal of the nail and not damaging the bone. It is also easy to make fine adjustments to the nails that have been made.Especially, when the unevenness is formed by threads, the effect is remarkable, and it is economical because it is easy to manufacture long objects. is there.

Further, as the unevenness for enhancing the frictional force, there is a form in which unevenness is provided on the outer circumference of the nail in a shape other than the above, or the nail itself is bent in a meandering shape.

The anchoring means on the nail end side of the anchor nail includes a mounting plate through which the nail is inserted, a mounting screw for mounting the mounting plate to the bone cortex, and a nail interposed between the mounting plate and the nail. And a connecting member that is locked and held on the mounting plate so as not to move in the direction.

In the locking means using this mounting plate, the locking position of the connecting member with respect to the nail distal end can be changed, so that the nail is locked and held in a state where the nail is inserted into an appropriate position in the bone marrow. It is easy to do when it is necessary to readjust the length of nail insertion due to post-operative sinking or dynamization, and the attachment of the mounting plate reinforces the vicinity of the bone hole in the cortical bone There are benefits too.

In the case of a nail composed of a screw rod, a through hole formed in the mounting plate as a connecting member in the locking means using the mounting plate is a screw hole, and the screw hole is formed of a screw rod. The nail can be screwed in, in which case it is desirable to drill the screw hole obliquely across the mounting plate, adapted to the nail insertion direction.

In the case of the locking structure using the combination of the screw rod and the screw hole, the nail can be easily adjusted to a required length by rotating the mounting plate before fixing the nail to the cortex.
Excess nails protruding from the mounting plate are cut off.

As another locking means for the nail distal end, a hook is formed by bending the nail distal end into a hook shape, and the nail is inserted into the bone marrow in such a manner as to lock the nail near the bone hole. The required length of the nail can be confirmed in advance by X-ray fluoroscopy of a steel wire with a measure, and the surplus portion is cut at the tip end to adjust the length.

In the locking means in which the nail distal end is curved in a hook shape, the nail is inserted obliquely into a bone hole drilled perpendicular to the bone cortex, so that the nail distal end including the thread is provided. The irregularities engraved on the outer peripheral surface of the bone hole are locked to the opening edge of the bone hole, and the hook-shaped locking portion is locked so as to bite into the bone cortex near the bone hole.

In the case where the nail distal end is bent into a hook shape as a locking means, the structure is extremely simple, so that the nail can be provided at a low cost. There are advantages such as little protrusion and little possibility of stimulating muscles and skin.

As still another locking means for the nail end side, the nail end side is made flat and a mounting hole is provided therein, and a mounting screw is screwed to the bone cortex near the bone hole through this mounting hole. When screwing, the nail is bent in advance along the bone cortex near the bone hole.

[0025]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An example of a preferred embodiment of the osteosynthesis fixing device of the present invention will be described below in detail with reference to the accompanying drawings applied to a humerus which is one of the secretary bones. However, FIG. 2 shows a use state diagram of the osteosynthesis fixing device according to the first embodiment in osteosynthesis surgery, FIG. 3 shows an enlarged sectional view of a main part of FIG. 2, and FIG. FIG. 5 shows a use state diagram of the osteosynthesis fastener, and FIG. 5 shows a use state diagram of the osteosynthesis fastener according to the third embodiment.

Each of these osteosynthesis fixing devices is provided with a nail 10 (1) into a bone marrow through a bone hole 12 formed in a bone cortex 11.
0A, 10B, and 10C) to fix the osteosynthesis portion 13. In each nail, unevenness for enhancing frictional force is uniformly provided on the entire outer peripheral surface from the tip side to the end side. In addition, a common configuration is provided with a locking means for locking the nail end protruding outside from the bone hole 11 to the vicinity of the bone hole.

As the nail 10, a straight steel rod having a suitable rigidity and flexibility and having corrosion resistance, for example, made of titanium or stainless steel and having a diameter of about 2.5 mm is used. Is manufactured as a standard nail previously cut to the general length (maximum length) for each osteosynthesis site of the long bones (humerus, femur, tibia, etc.). Cutting into a suitable desired length for use is more economical than preparing a variety of products having different lengths in advance.

The osteosynthesis operation using these nails 10 is performed by inserting a long nail through a bone hole drilled distal to the osteosynthesis, as in the case of using a conventional ender nail. Although it is possible, it is possible to insert it through a bone hole drilled proximal to the osteosynthesis by strengthening the frictional force and the locking and holding force to enable secure fixed support even with a small number of short nails. It is suitable for performing.

The osteosynthesis fixing device according to the first embodiment includes:
The nail 10A is formed by a threaded bar having a series of threads 14 formed on the outer peripheral surface as one form of the unevenness for enhancing the frictional force. The nail 10A is formed by drilling the nail 10A in the proximal bone cortex 11. When inserted in an oblique direction from 12, the distal portion reaches the osteosynthesis portion 13 and is bent so that the threaded portion 14 is attached to the inner surface of the bone marrow so that the thread 14 frictionally engages.

At the distal end of the nail 10A, a mounting plate 15 having a through hole through which the nail is inserted, and mounting screws 16 for mounting the mounting plate 15 to the bone cortex 11 near the bone hole 12 are provided.
And a connecting member interposed between the mounting plate 15 and the nail to lock and hold the nail on the mounting plate 15 so that the nail does not move in the axial direction. The distal end of the nail 10 </ b> A adjusted to a desired length is fixedly held on the bone cortex 11 near the bone hole 12.

The connecting member according to the first embodiment includes:
A through hole formed in the mounting plate 15 is formed by a screw hole 17, and the screw thread 14 of the nail 10 </ b> A formed by a screw rod is screwed into the screw hole 17. The mounting plate 15 is formed so as to obliquely cross the mounting plate 15 in accordance with the nail insertion direction.

The nail 10A is inserted with the distal end side gripping and rotating with a known appropriate tool or a special tool. The mounting plate 15 has a screw hole 17 at a predetermined length position on the nail distal end measured in advance. The nail 10A is screwed together after insertion or after insertion, and after confirming that the nail 10A has been properly inserted by X-rays or the like, the mounting plate 15 is screwed into an appropriate position. It is adjusted and attached to the bone cortex 11 near the bone hole 12 with the attachment screw 16.

The osteosynthesis fixing device according to the second embodiment comprises:
An annular projection 18 (preferably having a triangular cross section) having a lead angle is provided at predetermined intervals in the axial direction as irregularities for enhancing the frictional force on the outer peripheral surface to form the nail 10B. Attachment plate 2 having a hole 19 through which nails are inserted as locking means for the distal end side
0, a mounting screw 21 for mounting the mounting plate 20 to the cortex 11 near the bone hole 12, and a mounting plate 2 interposed between the mounting plate 20 and the nail to prevent the nail from moving in the axial direction.
And a connecting member that is locked and held at zero.

The connecting member according to the second embodiment comprises:
A clamp member 22 is formed by bending a linear material having elasticity into a V-shape, and the clamp member 22 is wound around an outer peripheral surface of the nail 10B in an arc shape, with both ends facing the mounting plate 20. Locking pieces 23, 2 projecting from
3 and the clamp member 22 is adjacent to the adjacent annular projection 1.
The nail 10B can be locked and held by the mounting plate 20 with the gap between the nails 8 supported. The clamp member 22 is removed when adjusting the length of the nail.

The osteosynthesis fixing device according to the third embodiment comprises:
The nail 10C is formed by providing irregularities for enhancing the frictional force on the outer peripheral surface (the thread 24 in FIG. 5), and the nail end is bent into a hook shape as a locking means for the end of the nail 10C. A locking portion 25 is provided, and the nail 10C is inserted obliquely into the bone hole 12 drilled perpendicular to the bone cortex 11, and the locking portion 25 on the nail end side is inserted into the bone cortex 11 near the bone hole 12. It was locked so that it would bite into.

The osteosynthesis fixing device according to the fourth embodiment includes:
As shown in FIG. 6, a meandering bending process is performed to form unevenness for enhancing the frictional force on the outer peripheral surface, and a nail 10D is formed in which a distal end is processed into a flat shape and a mounting hole 26 is formed. 6A or 6B, the nail 10D is bent to the vicinity of the bone hole 12 as shown in FIG.
6 is fixed to the bone cortex 11 in the vicinity of the bone hole 12 and is locked and held by the mounting screw 27 inserted through the hole 6.

The nail 10 according to the various forms described above
The unevenness for enhancing the frictional force and the retaining means on the distal side can be implemented by any combination other than the above-described embodiment within the scope of the gist, and in the embodiment, the osteosynthesis treatment for the humerus is performed. However, the present invention can be similarly applied to other elongate bones such as a femur and a tibia.

[Brief description of the drawings]

FIG. 1 shows a state of use of an ender nail according to the prior art.

FIG. 2 shows a state of use of the osteosynthesis fastener according to the first embodiment of the present invention.

FIG. 3 is an enlarged sectional view of a main part of FIG. 2;

FIG. 4 is a view showing a use state of an osteosynthesis fastener according to a second embodiment of the present invention.

FIG. 5 is a view showing a use state of an osteosynthesis fastener according to a third embodiment of the present invention.

FIG. 6 shows a use state diagram of an osteosynthesis fastener according to a fourth embodiment of the present invention.

[Explanation of symbols]

 Reference Signs List 10 (10A, 10B, 10C, 10D) Nail 11 Bone cortex 12 Bone hole 13 Bone joint part 14, 24 Thread 15,20 Mounting plate 16,21,27 Mounting screw 17 Screw hole 18 Annular projection 19 Through hole 22 Clamp member 23 Locking piece 25 Locking part 26 Mounting hole

Claims (8)

[Claims] 1. An osteosynthesis fastener for fixing a osteosynthesis by inserting a nail into a bone marrow through a bone hole, and enhancing a frictional force on an outer peripheral surface of the nail from the front end to the end. An osteosynthesis fixing device, wherein unevenness is provided uniformly, and locking means is provided for locking a nail end protruding outside from a bone hole near the bone hole. 2. The osteosynthesis fastener according to claim 1, wherein a thread is provided on the outer periphery of the nail as the unevenness for enhancing the frictional force. 3. The osteosynthesis fastener according to claim 1, wherein annular projections having a lead angle are provided at predetermined intervals on the outer periphery of the nail as the unevenness for enhancing the frictional force. 4. The osteosynthesis fastener according to claim 1, wherein the nail is bent in a meandering shape as the unevenness for enhancing the frictional force. 5. A nail locking means at a distal end side of the nail, a mounting plate for inserting the nail, a mounting screw for mounting the mounting plate to a bone cortex, and a nail interposed between the mounting plate and the nail to allow the nail to move in the axial direction. The osteosynthesis fixing device according to any one of claims 1 to 4, comprising a connecting member that is locked and held on the mounting plate so as not to move. 6. A nail locking means having a hook-like bent portion at the distal end side of the nail as a locking means at the distal end side of the nail, and the nail is inserted obliquely into a bone hole drilled perpendicular to the bone cortex. The osteosynthesis fixing device according to any one of claims 1 to 4, wherein the locking portion on the nail end side is locked near the bone hole. 7. A fixing means for locking the nail distal end side, wherein the nail distal end side is flattened to form a mounting hole, and the nail distal end side is bent near the bone hole and inserted into the mounting hole. The screw is screwed to the bone cortex with a screw.
The osteosynthesis fastener according to any one of the above. 8. A mounting plate having a screw hole through which a nail is inserted in a state where the nail is screwed, wherein a locking means on a nail terminal side is provided.
3. The osteosynthesis fastener according to claim 2, wherein the mounting plate is formed with mounting screws for mounting the mounting plate on the bone cortex, and the screw holes are formed so as to be adapted to the insertion direction of the nail so as to obliquely cross the mounting plate. .