JP2001286480A - Positioning device for bone nails - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a positioning device for bone nails that can precisely tell the direction of insertion and induction of lag screws, guide pins, and other materials in positioning to introduce implants such as lag screws, and that can predict beforehand the direction of insertion and induction before inserting guide pins, lag screws and the like. SOLUTION: On the upper side of the end of a connecting part 21a in a connecting arm material 21, a glyph 21d is formed extending in the prolonged direction of the connecting arm material 21. In the glyph 21d, a guiding structure 21h is prepared with a guiding hole 21g. The guiding hole 21 penetrates the inside of the guiding structure 21h in the prolonged direction of the connecting arm material 21.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a device for positioning an intramedullary nail, and more particularly to guiding or assisting the insertion of an implant that is to be installed in the intramedullary nail in a position crossing the intramedullary nail. The present invention relates to a device for positioning an intramedullary nail.

[0002]

2. Description of the Related Art Generally, an intramedullary nail has been used as a device for treating a fracture of a femur. The intramedullary nail is introduced into the intramedullary nail of the femur, and a lateral hole formed in the intramedullary nail is inserted through the bone screw from the outside of the femur to cross the bone part on both sides of the fracture. Are fixed in the rotation direction and the axial direction.

On the other hand, in recent years, an intramedullary nail which is considerably shorter than the entire length of the femur has been used to treat a fracture on the proximal end side of the femur, particularly a fracture near the head of the femur (for example, the neck). ing. This kind of intramedullary nail, like a normal intramedullary nail,
A lateral hole through which the bone screw is inserted is provided near a distal end (an end disposed on the distal end side of the femur), and a proximal end (an end disposed on the proximal end side of the femur). ) It has an inclined hole which is formed so as to be positioned closer and is formed obliquely toward the head of the femur. A bone screw called a lag screw is introduced into the inclined hole from outside the femur, and the tip of the lag screw is screwed into the femoral head through the inclined hole.

[0004] When attaching the above-described intramedullary nail to the femur, a positioning device (also referred to as a target device, an index device, an attachment device, or the like) configured to be connected to the proximal end of the intramedullary nail is used. used. This positioning device generally has a substantially L-shaped shape, and includes a connecting arm portion connected to the proximal end of the intramedullary nail and a positioning portion connected to the connecting arm portion in a bent shape. Have.
The positioning portion is formed so as to extend downward substantially in parallel with the axis of the intramedullary nail in a state where the coupling end formed at the distal end of the coupling arm is connected to the proximal end of the intramedullary nail. The positioning portion is provided with guide means having a guide hole having an axis extending accurately toward an inclined hole or a lateral hole formed in the intramedullary nail.

[0005] In the case of using the above positioning device, a drill, a reamer, or the like is used to drill a hole from the proximal end of the femur into the medulla in advance. And the intramedullary nail is introduced from the proximal end of the femur.
When the intramedullary nail is completely introduced into the medullary bone of the femur, a guide pin (guide wire) is introduced into the femur from the outside of the femur using the guide means of the positioning device, and the femur is passed through the inclined hole. To the inside of the head. Thereafter, the position of the guide pin in the head of the head is confirmed by radiography or the like, and if there is no problem, a hole matching the inclined hole is formed in the femur using a drill or a reamer having an axial hole for receiving the guide pin. . Then, the lag screw having the shaft hole for receiving the guide pin is introduced into the femur along the guide pin, and screwed so that the lag screw passes through the inclined hole and enters the inside of the head. Precisely setting the position of the lag screw in the bone is very important in order to secure the intramedullary nail and prevent its rotation, and to place the fractured head in the correct anatomical position. is important.

[0006]

By the way, in the structure of the conventional positioning device, it is necessary to screw the lag screw into the head through the inclined hole of the intramedullary nail. Usually, the lag screw is screwed in the normal direction. Therefore, it is necessary to accurately set the insertion direction of the guide pin in advance.
The insertion direction of the guide pin is a direct photograph image obtained by irradiating X-rays from the front side of the patient and a diagonally upper side of the patient, that is, in a direction substantially orthogonal to the insertion direction of the guide pin, X
It is confirmed by looking at the axis shot image obtained by irradiating the line.

[0007] In the above directly photographed image, it is possible to check whether the guide pin is displaced vertically (in the direction toward the patient's head or foot) in the head of the femur. (In the direction toward the front or back of the patient) cannot be confirmed. On the other hand, in the axial photographed image, it is possible to confirm whether the guide pin is displaced in the front-back direction in the head of the femur, but it is not possible to confirm whether the guide pin is displaced in the up-down direction. Therefore, the operating doctor assumes the three-dimensional position of the guide pin based on the long-term experience from the direct photograph image and the axial photograph image, and if necessary, corrects the guide pin insertion direction to correct the guide pin insertion direction. The pin is removed, the insertion direction is corrected, and the guide pin is inserted again.

As described above, the conventional surgical method using the positioning device has a problem in that it is very much dependent on the experience and feeling of the surgeon performing the operation, and it is difficult to obtain a reliable and stable surgical result. In particular, the position of the inserted guide pin in the head of the head can be known only from the direct image and the axis image, but the guide pin insertion direction itself cannot be known. There is a problem that even if you do, you have to rely on experience and feeling.

Further, it is not possible to predict the insertion position of the guide pin with respect to the femur in advance before inserting the guide pin. Since it is not possible to know whether or not the guide pin is inserted at the optimum position until the user confirms the position, there is a problem that if the guide pin cannot be inserted at the optimum position at one time, the guide pin must be inserted again.

SUMMARY OF THE INVENTION The present invention has been made to solve the above problems, and has as its object the problem of positioning a guide pin, a lag screw and other members (ie, implant or implant) at the time of positioning operation for introducing an implant such as a lag screw. It is an object of the present invention to provide an intramedullary nail positioning device capable of accurately knowing the insertion direction and the introduction direction of a guide member for introduction). Another object of the present invention is to provide an intramedullary nail positioning device capable of predicting an insertion direction and an introduction direction in advance before inserting or introducing a guide pin, a lag screw or other members.

[0011]

According to the present invention, there is provided an intramedullary nail positioning apparatus according to the present invention, which is mounted on an intramedullary nail introduced into a long bone from an end of a bone, and is attached to the intramedullary nail. A positioning device for an intramedullary nail used for guiding or assisting insertion of an implant assembled in a crossed posture, comprising: a connecting arm portion having a connecting end connected to a proximal end of the intramedullary nail; A positioning portion connected to the connecting arm portion, extending substantially parallel to the intramedullary nail, and provided with guide means for guiding or positioning the implant or a guide device for guiding the implant,
On the outer surface of the connection arm, an extension member having an extension shape is inserted in the extension direction of the connection arm member, and is guided so that it can be inserted beyond the connection end. A structure is provided.

According to the present invention, the extension member guided by the guide structure is inserted in the extending direction of the connecting arm portion, and can be inserted so as to extend beyond the connecting end portion. With the intramedullary nail introduced into the long bone, the guide member for guiding the implant or the implant guided by the positioning device by observing the portion of the extension member extending beyond the connection end Since the insertion position and the insertion direction of the (guide pin) and the like can be predicted, the implant and the guide member can be introduced into the long bone at the accurate insertion position and the insertion direction, and the implant and the guide member can be predicted. It is not necessary to correct the introduction position of the blood vessel, and the operation can be performed without relying on the experience and feeling of the operator.

In the present invention, it is preferable that the guide structure is a through hole penetrating in the guide direction. According to this means, by inserting the extension member into the through-hole and inserting the distal end portion of the extension member into the body beyond the connection end, the extension member can be reliably disposed by a simple operation. Become.

In the present invention, the guide structure may be a guide groove extending in the guide direction. The extension member is inserted into the guide groove, and the distal end of the extension member can be inserted into the body so as to exceed the connection end.

In the present invention, it is preferable that a concave groove extending in the guide direction is formed on an outer surface of the connecting arm, and the guide structure is provided in the concave groove. According to this means, since the guide structure is provided in the concave groove formed on the outer surface of the connection arm portion, the amount of the connection arm portion protruding from the outer shape of the guide structure can be eliminated or reduced. In addition, it is possible to minimize the hindrance of the operation of introducing the intramedullary nail, and to prevent the extension member inserted through the guide structure from protruding from the outer shape of the connection arm portion, or the connection arm in the extension member. Since the amount of protrusion from the outer shape of the portion can be reduced, the insertion operation of the extension member can be easily performed.

In the present invention, the extension member is preferably a guide wire. According to the present invention, by using a guide wire (guide pin) as the extension member, it is possible to reduce the number of instruments used for surgery and to easily insert the instrument into the body.

[0017]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Next, an embodiment of an intramedullary nail positioning apparatus according to the present invention will be described in detail with reference to the accompanying drawings. FIG. 1 is an exploded perspective view showing the entire configuration of the positioning device of the present embodiment and the intramedullary nail introduced into the femur by the positioning device. The positioning device 20 of the present embodiment introduces the intramedullary nail 10 from the proximal end of the femur into the intramedullary,
This is for positioning an introduction direction of a bone screw or the like crossing the intramedullary nail 10.

An intramedullary nail 10 attached using the positioning device of the present embodiment has a relatively thick base 11 as shown in the drawing, and is relatively thin, and its axis is slightly inclined with respect to the base 11. The base portion 11 is formed with two oblique holes 11a and 11b penetrating obliquely through which a lag screw described later is inserted, and has a female screw (not shown) inside. A base end 11c is provided. On the other hand, the insertion portion 12 has a lateral hole 12a for inserting a bone screw to be described later, and a slit 12b extending in the axial direction of the intramedullary nail 10 so that the distal end side of the lateral hole 12a is further branched into two. Are formed.

The positioning device 20 of the present embodiment includes a connecting arm member 21 having a connecting end 21a connected to the base end 11c of the intramedullary nail 10;
And a positioning member 22 connected to the other end 21b. When the connecting arm member 21 is connected to the intramedullary nail 10, at least a portion on the connecting end 21a side is formed so as to extend obliquely in a direction in which the axis of the intramedullary nail 10 extends upward.

A stepped insertion hole 21c for inserting a bolt 23 for connecting the connecting arm member 21 and the intramedullary nail 10 to the engaging end 21a of the connecting arm member 21 so as to be engaged in the axial direction. Are formed. The other end 2
1b is formed with a stepped insertion hole 21f for inserting a bolt 24 for connecting the connecting arm member 21 and the positioning member 22 to engage in the axial direction.

At the end of the connecting end 21a, an engaging projection (not shown) formed so as to fit into a notch-shaped engaging recess (not shown) formed at the proximal end 11c of the intramedullary nail 10. The bolt 23 is inserted into the insertion hole 21c in a state where the engagement convex portion is fitted in the engagement concave portion of the base end portion 11c, and screwed into a female screw (not shown) formed in the base end portion 11c. By doing so, the intramedullary nail 10 can be firmly connected to the connecting arm member 21 so as not to rotate around its axis. At this time, the axis of the connecting arm member 21, the axis of the intramedullary nail 10, and the axis of the inclined hole 11a are configured to be included in a common virtual plane.

Connection end 21 of connection arm member 21
On the upper surface of the portion on the side a, a vertical groove 21 d extending in the extension direction of the connecting arm member 21 is formed. This vertical groove 21d
The end on the side of the connection end 21a is connected to the insertion hole 21c.
Of the vertical groove 21d.
Of the connecting arm member 21
Is open in the direction in which it extends. That is, both ends of the vertical groove 21d are shaped to be open in the extending direction.

A guide structure 21h having a guide hole 21g is provided inside the vertical groove 21d. This guide hole 2
1g penetrates the inside of the guide structure 21h in the extension direction of the connecting arm 21.

The connecting arm member 21 has a plurality of through holes 21e penetrating vertically (in a direction toward the patient's head or feet). Since these through holes 21e are intended to reduce the weight, they may not be through holes but may be holes or recesses formed to a predetermined depth position.

The connecting arm member 21 has a plurality of through holes 21i penetrating in the front-rear direction. These through-holes 21i are intended to reduce the weight, and the X-ray image taken by irradiating the patient with X-rays from the front side or the back side, that is, the shooting direction of the direct shot image is in the normal direction (ie, This is for confirming whether or not the direction is perpendicular to the extension direction of the femur or the direction perpendicular to the intramedullary nail or the positioning device. If the shooting direction of the direct shot image coincides with the normal direction, these through holes 21i have their cross-sectional shapes as they are (for example, a round shape in the case of a round cross section, and a square shape in the case of a square cross section). On the other hand, if the photographing direction is oblique by a predetermined angle with respect to the normal direction, the cross-sectional shape is crushed (for example, a circular cross-section if it is a round cross-section, and a square if it is a square cross-section). (A shape in which a cross-sectional square shape such as a rhombus shape or a rectangular shape is crushed), or if the above-mentioned predetermined angle is large, the cross-sectional shape is not captured in the image at all. Therefore, by checking the cross-sectional shape of the through-hole 21i in the direct-shot image and the presence or absence thereof, it is determined whether or not the shooting direction of the direct-shot image matches the normal direction, and to what extent the shooting direction of the direct-shot image does not match. Can be easily known.

The positioning member 22 is connected to the connecting arm member 21.
From the connection end 22a to the lower guide support 22b.
, So as to extend in parallel with the intramedullary nail 10. At the connection end 22a, the bolt 24
, And an engagement protrusion that fits into an engagement recess formed in the other end 21 b of the connection arm member 21. Therefore, the connecting arm member 21 and the positioning member 22 are abutted with each other such that the engaging convex portion is fitted into the engaging concave portion of the connecting arm member 21, and in this state, the bolt 24 is inserted through the insertion hole 21f. The positioning member 2 is screwed into the female screw portion 22c.
2 can be firmly connected to the connecting arm member 21 so that it cannot be rotated about its extension axis. At this time, the axis of the connecting arm member 21 and the axis of the positioning member 22 are both included on the virtual plane.

The guide support portion 22b is divided into two by a slit 22s formed in the lower half of the positioning member 22 so as to extend vertically. Concave grooves having a semi-cylindrical surface are formed on the mutually facing inner surfaces of the slit 22s at positions corresponding to each other on both sides of the slit 22s, and as a result, various inner and outer diameters and various penetration directions are formed. Five guide holes 22d, 22e, 22f, 22g, and 22h are formed.

A screw hole provided with a female screw is formed at one end of the lower end of the guide support portion 22b across the slit 22s, and a stepped portion (not shown) is provided at a position corresponding to the screw hole at the other portion. An insertion hole is formed. A fastening shaft 23 with a male screw is inserted into the screw hole and the insertion hole from the side where the insertion hole is formed, and a distal end of the fastening shaft 23 is screwed into the screw hole and an intermediate portion of the fastening shaft 23. Are engaged with the stepped portion of the insertion hole, so that the fastening shaft 23 cannot be inserted beyond a predetermined depth. Therefore, depending on the degree of screwing of the fastening shaft 23, the slit 22
The gap amount of the guide support portion 22b formed by s can be adjusted. An operation lever 24 is rotatably connected to the outer end of the fastening shaft 23.
By turning the operation lever 24 in the illustrated state where the position 4 intersects the axis of the fastening shaft 23, the fastening shaft 23 can be easily rotated.

The positioning member 22 has a through hole 21i.
And a through hole 22i penetrating in the same direction as
These through holes 22i are also similar to the through holes 21i.
It is provided to reduce the weight of the positioning device and to confirm the shooting direction of the directly shot image.

In the above embodiment, the connecting arm member 21 and the positioning member 22 are used in a state where they are connected by bolts 24. Then, with the intramedullary nail 10 connected to the connection end 21a of the connection arm member 21, the intramedullary nail 10 is introduced into the marrow from the proximal end of the femur drilled with a reamer or the like. That is, the distal end of the intramedullary nail 10 is inserted from the incision on the side of the pelvis, and is introduced into the medullary through an opening formed above the greater trochanter B of the femur A. In this way,
As shown in FIG. 1, an intramedullary nail 10 is placed in the marrow of the femur A.

When the intramedullary nail 10 is introduced into the medulla of the femur A, as shown in FIG. 2, a guide wire 32 is inserted into a guide hole 21g of the guide structure 21h, and the guide wire 3 is inserted.
The second tip 32a is introduced into the body. FIG. 2 corresponds to a direct photographed image taken by X-ray. In the direct photographed image, the guide wire 32 extends from the outer surface of the connecting arm member 21 to the head C over the connecting end 21a. Stretch towards. At this time, in the direct photograph image, a portion of the guide wire 32 beyond the connection end 21a is clearly shown.

Guide wire 32 inserted through guide hole 21g
Are the intramedullary nail 10, the connecting arm member 21, the positioning member 2
2 and the guide pin which is to be introduced through the inclined hole 11a depending on the direction and position indicated by the tip 32a of the guide pin, because the guide pin extends through the body along the virtual plane including the axes of the inclined hole 11a and the inclined hole 11a. The position of 31 in the head C can be predicted. That is, in a state where the nail depth of the intramedullary nail 10 is too deep, the guide pin 31 introduced through the inclined hole 11a in a later step is introduced into the lower part of the head C, In this state, the guide wire 32 guided by the guide structure 21h
Will point to the lower neck of the head C. Conversely, when the nail 10 is driven into the intramedullary nail at a depth that is too shallow, the guide pin 31 inserted through the inclined hole 11a is introduced into the upper part of the head C. In this state, the guide wire 32 Indicates the upper end of the head C.

Therefore, as shown in FIG. 2, if the distal end portion 32a of the guide wire 32 points to the center position of the head C, the guide pin 31 can be inserted into an appropriate position through the inclined hole 11a. If the distal end portion 32a of 32 points above or below the center of the head C, the driving depth of the intramedullary nail 10 is not appropriate. In the present embodiment, the guide wire 3
The case where the direction indicated by 2 is toward the center of the head C is considered as a normal state. However, the positional relationship between the driving depth of the intramedullary nail 10 and the guide wire 32 also depends on the guide position of the guide structure of the guide structure 21h. Since the relationship is slightly different, the relationship between the two may be appropriately set in advance, and the insertion position of the guide pin 31 may be appropriately predicted according to the setting.

FIG. 3 is an explanatory diagram showing a state viewed from the direction of the arrow F shown in FIG. 2 (obliquely outside the patient's side), that is, a state corresponding to the above-mentioned axially mapped image. In this axial image, the guide wire 32 extends along the axis of the connecting arm member 21 and further extends beyond the connecting end 21a.
The tip 32a points to the head C of the femur. At this time, in the axially-mapped image, a portion of the guide wire 32 extending from the portion beyond the connection end 21a is clearly shown.

In this state, the extension direction of the guide wire 32 substantially matches the extension direction of the guide pin 31 inserted through the inclined hole 11a in a later step. Therefore, if the extension direction of the guide wire 32 in the axial photograph image extends straight toward the center of the head C, the guide pin 31 can be inserted straight, but the direction indicated by the distal end portion 32a of the guide wire 32 Is shifted from the center of the head C, the guide pin 31 is also inserted in the direction (front-back direction) shifted from the center of the head C. Therefore, the front and rear insertion directions of the guide pin 31 can be predicted based on the direction indicated by the guide wire 32 in the axially-mapped image.

In particular, the intramedullary nail 10 introduced into the intramedullary can rotate about the axis of the intramedullary nail 10 relative to the femur A. Is determined. This direction is
Usually, it is not clear unless the guide pins 31 are inserted by the guide structure of the positioning member 22. However, in the present embodiment, the guide wire 32 inserted into the guide structure 21h is included on the same virtual plane as the guide pin 31, and indicates the same rotation direction as the guide pin 31. Therefore, before inserting the guide pin 31 into the bone, the insertion direction can be confirmed.

As described above, after confirming the insertion direction of the guide pin 31 to be introduced in a later step by the guide wire 32 inserted through the guide structure portion 21h, the driving depth of the intramedullary nail 10 and the rotation around the axis are determined. Correct posture and intramedullary nail 1
0 is set to the normal depth and the normal rotation posture of the femur A.

Next, a sleeve-shaped guide device is inserted into the guide hole 22f shown in FIG. 1, the operation lever 24 is rotated, and the guide device is clamped and fixed by the guide support portion 22b. Then, the guide pin 31 is inserted into the femur A while guiding the guide pin 31 by the guide instrument, and the inclined hole 11 a of the intramedullary nail 10 is formed.
And the tip of the guide pin 31 reaches the inside of the head C. Then, a hole is formed along the guide pin 31 using a drilling tool such as a drill or a reamer, and a lag screw (not shown) is inserted along the guide pin 31 into the guide pin 3.
1 and introduced into the bone.

The guide hole 22d of the guide support 22b
Is for guiding a guide pin, a rag screw and the like passing through the inclined hole 11b of the intramedullary nail 10 in the same manner as described above. In addition, the guide holes 22g and 22h are provided for the bone screws 3 passing in the slit 12b of the intramedullary nail 10 in the horizontal direction.
The guide hole 22e is for attaching a guide device (not shown) for guiding the bone screw 33 passing through the lateral hole 12a of the intramedullary nail 10. is there.

In this embodiment, the guide structure 21h
Guide wire 32 guided by the connecting arm member 21 in the extension direction of the connecting arm member 21, and
a that extends beyond the connection end 21a of the guide wire 32 when the intramedullary nail 10 is introduced into the femur A by being configured so as to be inserted into a state extending beyond the connection end 21a. By doing so, the positioning device 20
It is possible to predict an insertion position and an insertion direction of an implant or a guide member (guide pin) for guiding the implant, which is guided by the femur. This makes it unnecessary to correct the introduction position of the implant or the guide member, and allows surgery to be performed without relying on the experience and feeling of the operator.

Further, since the guide structure 21a has the through hole 21g penetrating in the guide direction, the guide wire 32 is inserted through the through hole 21g, and the leading end of the guide wire 32 is moved beyond the connecting end 21a. By inserting the portion 32a into the body, the extension member can be reliably arranged with a simple operation.

In the present invention, the guide structure 21
h is not limited to the through-hole 21g, but may be any one that can guide an extension member such as a guide wire 32 so that the extension member can be inserted beyond the connection end. You may.

Further, in this embodiment, a concave groove 21d extending in the guide direction is formed on the outer surface of the connecting arm member 21, and the guide structure 21h is provided in the concave groove 21d. Since the amount of the connecting arm portion protruding from the outer shape of the portion 21h can be eliminated or reduced, the degree to which the introduction of the intramedullary nail 10 is hindered by the protrusion of the guide structure portion 21h can be reduced as much as possible. Further, the guide wire 32 inserted into the guide structure portion 21h can be prevented from protruding from the outer shape of the connecting arm member 21, or the amount of the guide wire 32 protruding from the outer shape of the connecting arm member 21 can be reduced. Therefore, the insertion operation of the guide wire 32 (the insertion operation into the body) can be easily performed.

In this embodiment, a guide wire (guide pin) 32 is used as an extension member to be inserted into the guide structure 21h.
The use of allows easy insertion into the body. Further, since the same one as the guide pin 31 can be used, the number of instruments used for the operation can be reduced.

It should be noted that the positioning device of the present invention is not limited to the illustrated example described above, and it goes without saying that various changes can be made without departing from the spirit of the present invention.

For example, in the above-described embodiment, an intramedullary nail having a lag screw which is obliquely introduced toward the head of the femur for treating a fracture occurring in the upper part of the femur such as the head or neck of the femur is attached. However, the present invention is not limited to such an intramedullary nail, but may be applied to various intramedullary nail bodies that have been used so far and are configured to be introduced into various long bones. On the other hand, it is also possible to configure as a positioning device for attaching various implants such as the above-mentioned bone screws to the long bone in a predetermined positional relationship.

[0047]

As described above, according to the present invention,
The extension member guided by the guide structure is inserted in the extension direction of the connecting arm portion so as to be inserted in a state of extending beyond the connection end portion, so that the intramedullary nail can be inserted into the long bone. By observing the portion of the extension member extending beyond the connection end in the state where the guide member (guide pin) for guiding the implant or the guide member for guiding the implant (guide pin) is observed, Since the insertion direction can be predicted, it is possible to introduce the implant or the guide member into the long bone at the correct insertion position and the insertion direction, and it is not necessary to correct the introduction position of the implant or the guide member. It is possible to perform the surgery without relying on the experience and feeling of the operator.

[Brief description of the drawings]

FIG. 1 is a schematic perspective view showing an embodiment of an intramedullary nail positioning device according to the present invention.

FIG. 2 is a side view corresponding to a directly shot image for explaining a use state of the embodiment.

FIG. 3 is an explanatory diagram corresponding to an axis shot image for explaining a use state of the embodiment.

[Explanation of symbols]

 Reference Signs List 10 intramedullary nail 11c proximal end 20 positioning device 21 connecting arm member 21a connecting end 21d vertical groove 21g guide hole 21h guide structure 22 positioning member 31 guide pin 32 guide wire

Claims (5)

[Claims] 1. An intramedullary nail which is attached to an intramedullary nail introduced into the long bone from the epiphysis and is used for guiding or assisting insertion of an implant assembled in a posture crossing the intramedullary nail. A positioning device, comprising: a connecting arm having a connecting end connected to a base end of the intramedullary nail; and a connecting arm connected to the connecting arm and extending substantially parallel to the intramedullary nail, wherein the implant is provided. Or a positioning portion having a guide means for guiding or positioning a guide device for guiding the implant, and an extension member having an extension shape is provided on an outer surface of the connection arm portion by extending the connection arm member. A positioning device for an intramedullary nail, characterized in that a guide structure is provided so as to be able to be guided in such a manner that it can be inserted in a direction and inserted beyond the connecting end. 2. The intramedullary nail positioning device according to claim 1, wherein the guide structure is a through hole penetrating in the guide direction. 3. The intramedullary nail positioning device according to claim 1, wherein the guide structure is a guide groove extending in the guide direction. 4. The connecting arm according to claim 1, wherein a concave groove extending in the guide direction is formed on an outer surface of the connecting arm portion, and the guide structure is provided in the concave groove. A device for positioning an intramedullary nail. 5. The intramedullary nail positioning device according to claim 1, wherein the extension member is a guide wire.