JP2002165802A - Perforated pin for joining bone as medical transplant body and perforated pin cap for fixing and immobilizing pin which is medical transplant body - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical fracture inner fixing material capable of solving various problems caused by looseness easily generated between a bone joining pin and the bone after an operation in a bone joining operation using the conven tionally used bone joining pin. SOLUTION: (1) This 'perforated pin for joining bone' in which a hole part is formed at the end part of the pin, strongly secures the pin to the bone with a soft steel wire (or a soft thin wire) inserted to the hole part and the looseness of the pin after the operation is completely prevented. (2) In the case of the operation using a non-perforated pin for joining bone, by preparing and using this 'perforated pin cap 36' at the end part of the pin, engaging and fixing both, then inserting the soft steel wire (or the soft thin wire) 33 into the hole part 10 and strongly securing the 'perforated pin cap 36', the generation of the looseness of the pin 31 after the operation is completely prevented.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical implant, and more particularly, to "a perforated bone joining pin as a medical implant" used for fracture surgery and "fixing and immobilizing a pin as a medical implant". Perforated pin cap for making into a hole. "

[0002]

2. Description of the Related Art In the case of a type of fracture in which a conventional bone screw (screw) made of metal or the like cannot be used to properly fix a fractured portion, a metal such as a Kirshner wire (Kurschner steel wire) having a sharply pointed tip is conventionally used. 2. Description of the Related Art A method of performing osteosynthesis by inserting a columnar osteosynthesis pin into a fractured part and penetrating the same is widely and generally performed. Furthermore, after inserting these osteosynthesis pins into the fracture part for the purpose of fixing the fracture part more firmly, the osteosynthesis pin having a soft wire made of a metal mild steel wire or other material outside the bone is left. Then, as viewed from the osteotomy of the osteosynthesis pin, one end of the mild steel wire (or soft wire) is inserted through a tunnel formed in a part of the bone beyond the fracture, and then the mild steel wire (or Soft wire)
The two ends are crossed, twisted, and tightened to apply a compressive force to the fracture to compressively join the bones, so-called t
The extension band wiring method (a compression fastening method using a soft wire) (described later) is also widely applied worldwide.

[0003]

SUMMARY OF THE INVENTION A conventional osteosynthesis operation method using only a non-perforated osteosynthesis pin and a tensio using a conventional non-perforated osteosynthesis pin and a mild steel wire (or a thin wire).
In any of the n band wiring methods, loosening between the osteosynthesis pin and the bone occurs after surgery, the osteosynthesis pin moves, and the Danish orthopedic surgeon Martinez-Romero et al. Jp
n. 0rthop. Assoc. , 74 (9), p40
As reported in 7,2000, many of the following complications arise. The problems are listed below: 1) decrease in fixation strength of osteosynthesis, re-disaggregation of fractures, poor bone fusion, 2) osteosynthesis pin entering into bone, burial, 3)
Visceral damage, muscle damage, vascular damage, nerve damage, skin damage due to the osteosynthesis pin coming out of the bone, pain and wound infection based on these injuries, 4) Avoiding loosening of the osteosynthesis pin Disability, disability, muscular atrophy, bone atrophy, range of motion limitation (joint contracture) due to long-term cast fixation of the fractured part and its adjacent joints, which are inevitable The need for long-term rehabilitation as a treatment for the various disorders described in 4), and the need for reoperation to remove loose osteosynthesis pins, etc. are mentioned. The problem to be solved by the present invention is to prevent the occurrence of loosening of the osteosynthesis pin after the osteosynthesis operation which causes these problems.

[Object of the Invention] The present invention relates to both the "perforated osteosynthesis pin as a medical implant" and the "perforated pin cap for fixing and immobilizing a pin as a medical implant". The object of the present invention is to prevent the occurrence of post-operative loosening of the osteosynthesis pin, and to prevent the occurrence of various problems described in [0003] caused by the loosening of the osteosynthesis pin after surgery. It is intended to improve the treatment results of fractures and to contribute to the improvement of daily activities and quality of life of fracture patients.

[0005]

SUMMARY OF THE INVENTION The problem can be solved by firmly fixing the osteosynthesis pin to the bone. There are two methods for this, which will be described below. As a first means, as described in [Claim 1] of the present invention, a hole is formed in the outer end of the osteosynthesis pin, and after fixing the fractured portion with the pin, the osteosynthesis pin is fixed. A mild steel wire (or soft wire) is inserted through the hole of (1), and the osteosynthesis pin is firmly fixed to the bone with the mild steel wire (or soft wire). As a result, the occurrence of loosening of the osteosynthesis pin after the operation can be completely prevented (details are described in section [0008]). As a second means, the problem can be solved by using the “perforated pin cap” according to the second aspect of the present invention. That is, a normal holeless osteosynthesis pin (Kirschner wire or the like) widely used at present is inserted into a fractured portion and fixed, and then the osteosynthesis is performed. Put the cap part of the `` perforated pin cap '' over the outer end and push it in, and then press the cap part strongly with pliers, etc., so that the `` perforated pin cap '' is hard to pin the boneless osteosynthesis pin,
Both are fixed and integrated. Then, a mild steel wire (or soft wire) is inserted into the hole formed in the head of the “perforated pin cap”, and the “perforated pin cap” is firmly attached to the bone with the mild steel wire (or soft wire). By fixing, the boneless osteosynthesis pin integrated with the “perforated pin cap” can be firmly fixed to the bone. As a result, the post-operative loosening of the conventionally used holeless osteosynthesis pin can be completely prevented. (Detail is

(Described in column [0009])

[0006]

BEST MODE FOR CARRYING OUT THE INVENTION [Form of Perforated Bone Joint Pin as Medical Implant] [Claim 1] "Apertured bone joint pin (perforated bone joint pin as medical implant) 15""
Has a columnar shape, a tapered tip 2 which is one side end thereof has a pointed shape so as to be able to penetrate a bone with a drill, and an end 3 opposite to the opposite end is cylindrical and has a corner. Polished and slightly rounded. These shapes are more commonly used for osteosynthesis pins (Kirschner w.
ire). The feature of the present invention is that a hole 4 through which a mild steel wire (or a soft wire) can be inserted is formed in a tunnel shape at right angles to the long axis of the perforated bone connecting pin 15 at a portion adjacent to the corner of the cylindrical end. (Figure 1).

[The form of a perforated pin cap for fixing and immobilizing a pin which is a medical implant] [A perforated pin cap (for fixing a pin which is a medical implant, Pin cap with holes for immobilization) 36 "
The main part 5 has a cylindrical shape having a tunnel-shaped lumen part 9 which can be inserted into a normal holeless osteosynthesis pin in a cap shape from the cylindrical end of the pin and covered (covered). The tapered tip 6, which is the outer shell of the entrance 8 to the osteosynthesis pin of the "perforated pin cap 36", is tapered so that the pin cap 36 can be easily inserted into the bone (FIG. 2). The opposite end 7 opposite to the tapered tip 6 has a columnar shape, and its corner is hemispherical and rounded (FIG. 2). A hole 10 through which a mild steel wire (or a soft wire) can be inserted is formed in a tunnel shape orthogonal to the long axis of the pin cap 36 at a portion adjacent to the corner of the main portion 5 which is a columnar portion. (Fig. 2). Furthermore, in preparation for using a holeless osteosynthesis pin having a helical external thread structure, the lumen wall of the cylindrical portion of the “perforated pin cap”
A helical internal screw corresponding to the external screw of the osteosynthesis pin can be formed. In this case, an interface for cooperating with a driving tool such as a wrench or a screwdriver is formed on the head of the side end of the cylindrical portion of the “perforated pin cap”.

[Schematic of osteosynthesis operation method using "perforated bone connecting pin" of claim 1] "Perforated bone connecting pin" of the present invention
Useful fracture sites are the mandible, clavicle, scapula, humerus, ulna, radius, carpal, metacarpal, phalange, iliac, pubic, ischial, femur, patella, tibia, fibula , The tarsal bone, the metatarsal bone, the phalange, and the like. Here, the fracture of the ulna of the ulna will be described as an example with reference to FIG. After the skin is incised and the fracture 11 is deployed, the fracture 11 is manually reduced. From the central osteosynthesis pin piercing portion 14 of the elbow head 12, X
Under a fluoroscope, a normal holeless osteosynthesis pin is inserted into the ulnar shaft 13 beyond the fracture 11 using a drill to an appropriate portion, and the fracture 11 is temporarily fixed. The length of the osteosynthesis pin inserted from the puncture opening portion 14 to the ulnar shaft portion 13 is measured and measured using a gauge (tentatively, the length is Acm). After removing the holeless osteosynthesis pin with a length of about Acm + 2.0 mm from the osteosynthesis pin inserted into the bone, the ulna is similarly passed through the fracture part 11 from the puncture part 14. Insert into the diaphyseal part 13 and insert
The insertion is temporarily stopped until the outer end of 5 "remains about 4 cm outside the bone. A tunnel 16 is formed in the bone by drilling the elbow head near the piercing portion 14 with a drill, and a mild steel wire (or soft wire) 17 is inserted into the tunnel 16. Next, the mild steel wire (or soft wire) 17 is inserted into the hole 4 of the “perforated bone joining pin 15”. The "perforated bone connecting pin 15" is driven into the hole portion 4 of the "perforated bone connecting pin 15" by using a driving tool until the hole 4 is located on the bone surface of the elbow head 12. After the both ends of the mild steel wire (or soft wire) 17 are crossed, they are twisted, tightened, and fastened, and the fastening portion 19 is formed in this manner, whereby the “hole-drilling bone joining pin 15” is connected to the elbow head. It is fixed and immobilized on 12 bones (FIG. 3). By the above operation, the fracture portion 11 is fixed, and the "perforated bone connecting pin 15" can be prevented from loosening or deviating after the operation. Thereafter, the wound is washed, the drain is inserted, and then the wound is sutured to complete the operation. Tension band wiring
When the combination is used, the fractured part 20 is more firmly fixed and a compressive force is applied to the fractured part.
The procedure from to is exactly the same as the above-mentioned surgical method. As viewed from the elbow head 21, a tunnel 24 is formed by drilling the ulnar shaft 22 located beyond the fracture line,
Two mild steel wires (or soft wires) 25 are inserted therethrough. Next, first, one mild steel wire (or soft wire) 25 is crossed once, and one of the wires is referred to as “a perforated bone joining pin 1”.
After winding around the part left outside the bone of 5 ", the ends of the mild steel wire (or soft wire) 25 are joined, twisted, tightened, and fastened. By this operation, mild steel wire (or soft wire)
The elbow head 21 is drawn toward the ulnar shaft 22 by the pulling force of 25, and as a result, the fractured part 20 is firmly fixed by compression osteosynthesis (FIG. 4). Next, after another soft steel wire (or soft wire) 25 is once crossed, one of the wires is referred to as a “bone-bonding pin 1 having a hole.
After passing through the hole 4 of "5", the "perforated bone joining pin 15" is driven by a driving tool until the hole 4 reaches the bone surface. Thereafter, the ends of the mild steel wire (or soft wire) 25 are aligned, twisted, tightened, and fastened to form a fastening portion 27 in this way, and the “perforated bone joining pin 15” is fixed to the ulna and immovable. (FIG. 4). By the above operation, the fracture portion 20 is firmly pressed and fixed, and the osteosynthesis pin 15 can be completely prevented from loosening or deviating after the operation.

[Pin cap with hole according to claim 2]
Outline of osteosynthesis operation method using osteosynthesis] The "perforated pin cap 36" of the present invention is for the purpose of preventing deviation of the osteosynthesis pin 31 after the osteosynthesis operation using a normal osteosynthesis pin 31 without a hole. The fracture site to be used is the same as the site described in the column [0008]. Here, taking the ulnar fracture of the ulna as an example, the tension band
FIG. 5 shows the osteosynthesis surgery method combined with the wirring method.
It is described below together with. The skin of the fracture is incised, the fracture is deployed, and the fracture is manually reduced. A normal holeless osteosynthesis pin 31 is drilled from the osteosynthesis pin piercing portion of the elbow head 29 under a fluoroscopic apparatus using a drill.
Inserting into the appropriate part of ulnar shaft 30 beyond 8
The fracture 28 is temporarily fixed. The osteosynthesis pin 31 without a hole is cut while leaving about 2 mm from the bone surface at the piercing portion of the elbow head 29. Cut end of boneless osteosynthesis pin 31 is 4 cm from bone surface
The boneless osteosynthesis pin 31 is pulled out of the bone until it is in the middle. At the end of the osteosynthesis pin 31 "Pinned cap 36"
Cover and press it in sufficiently, and press the outer shell part of the main part 5 which is the cylindrical part of the "perforated pin cap 36" strongly with pliers at several places. Part of the part 5 is inserted into the osteosynthesis pin 31
The "perforated pin cap 36" and the osteosynthesis pin 31 are engaged, fixed, immobilized, and integrated. Then, the “perforated pin cap 36” is driven into the ulna by a driving device for about 2 cm, and the end of the “perforated pin cap 36” is 1-2 cm.
To the extent, leave outside the bone. The ulnar shaft 30 is drilled, and the intraosseous tunnel 3
Form 2 Two soft steel wires (or soft wires) 33 are passed through the intraosseous tunnel 3
After passing through 2 and crossing one of them first,
After winding one side thereof around a "perforated pin cap 36" over the osteosynthesis pin 31, the ends thereof are aligned, twisted and tightened, and the fracture 28 is firmly pressed, fixed, and bone-bonded ( (Fig. 5). Then, both ends of the remaining one mild steel wire (or soft wire) 33 are once crossed, and one end thereof is inserted into the hole 10 of the "perforated pin cap 36". 36 "and the osteosynthesis pin 31 integrated therewith is driven into the hole 10 of the" perforated pin cap 36 "until it reaches the bone surface. After that, the both ends of the mild steel wire (or soft wire) 33 are aligned, twisted, tightened, and fastened to form a fastening portion 35, and the “perforated pin cap 36” integrated with the osteosynthesis pin 31 without a hole is formed. Fixed to the ulna,
Immobilize (FIG. 5). By the above operation, the fracture portion 28 is firmly pressed and fixed, and the bone is connected, and the osteosynthesis pin 31 can be completely prevented from loosening or deviating after the operation. Thereafter, the wound is washed, the drain is inserted, and then the wound is sutured to complete the operation.

[Size of perforated bone joint pin] The size varies depending on the fracture site used, but is approximately as follows.
The total length of the perforated bone connecting pin 15 is at least about 50 mm, and a plurality of kinds are prepared so as to increase by about 50 mm. However, the maximum is about 400 mm. The outer diameter of the main part (columnar part) 1 is at least about 0.5 mm, and a plurality of kinds are prepared so as to increase by about 0.2 mm each. However, the maximum is about 4.0 mm. The diameter of the hole 4 is at least about 0.2 mm, and a plurality of kinds are prepared so as to increase by about 0.2 mm each. However, the maximum is about 3.0 mm.

[Size of Perforated Pin Cap] The size varies depending on the outer diameter of the main portion (columnar portion) of the corresponding boneless osteosynthesis pin 31 and is approximately as follows. The total length of the perforated pin cap 36 is at least about 10 mm, and a plurality of types are prepared so as to increase by about 5 mm. However,
The maximum is about 60 mm. The outer diameter of the main part (cylindrical part) 5 is about 0.7 mm at the minimum, and a plurality of kinds are prepared so as to increase by about 0.2 mm each. However, at most 4.3
mm. The inner diameter of the main part (cylindrical part) 5 is at least about 0.55 mm, and a plurality of kinds are prepared so as to increase by about 0.2 mm each. However, the maximum is about 4.1 mm. Main part (cylindrical part) 5 in which hole 10 is formed
The length in the major axis direction is about 2.0 mm at a minimum, and a plurality of types are prepared so as to increase by about 1.0 mm. However, the maximum is about 8.0 mm. The minimum diameter of the hole 10 is about 0.3 mm, and a plurality of kinds are prepared so as to increase by about 0.2 mm. However, the maximum is about 3.2 mm.

[Material of Invention] "Pin 1 with perforated bone"
5 "and" perforated pin cap 36 "are generally made of cobalt chrome, titanium, stainless steel,
Ceramic materials, bone resorbable materials, and other biocompatible composite materials.

[0013]

EFFECTS OF THE INVENTION In both the "perforated bone connecting pin" and the "perforated pin cap" of the present invention, they occur after the osteosynthesis operation using the osteosynthesis pin which is frequently used in the operation of bone fractures of almost whole body. This has the effect of completely preventing loosening of the osteosynthesis pin, which is easy to do. As described in the section [0003], various problems based on the loosening between the osteosynthesis pin and the bone after the osteosynthesis operation using the conventional osteosynthesis pin, namely, 1) a decrease in the fixing force of the osteosynthesis. Re-disintegration of fractures, incomplete fusion of bones, 2) osteosynthesis pin entering into bone, burial, 3) visceral damage, muscular damage, vascular damage, nerve damage, skin damage due to escape of osteosynthesis pin out of bone And pain due to these injuries, infection of the wound, and 4) inconvenience in daily life based on long-term cast fixation of the fracture site, which is required to avoid the occurrence of loosening of the osteosynthesis pin after surgery. Occurrence of muscle atrophy, bone atrophy, and joint contracture 5)
4) Long-term rehabilitation treatment after long-term fracture healing necessary for various osteoarticular dysfunctions occurring after the operation described in the section, 6) To remove loose osteosynthesis pins Many troublesome problems such as necessary re-operation can be completely prevented beforehand by using any one of the "perforated bone joint pin" or "perforated pin cap" of the present invention. As a result, it is possible to greatly contribute to the improvement of fracture treatment results, and to provide a great benefit to fracture patients.

[Brief description of the drawings]

FIG. 1 shows a “perforated bone joining pin” according to a first embodiment of the present invention, wherein (a) is a side view and (b) is (a).
Is a side view when viewed from below, (c) is a front view when (a) is viewed from the left, and (d) is a rear view when (a) is viewed from the right.

FIG. 2 shows a “perforated pin cap” according to a second embodiment of the present invention, wherein (a) is a side view, (b) is a side sectional view, and (c) is a view of (a) from below. (D) is a longitudinal sectional view, and (e) is a rear view of (a) viewed from the right.

FIG. 3 is a side view showing a state after a simple operation of the osteosynthesis operation method using the “perforated osteosynthesis pin” according to the first embodiment of the present invention.

FIG. 4 is a tension ban of an osteosynthesis operation using a “perforated osteosynthesis pin” according to the first embodiment of the present invention.
It is a side view which shows the state after the operation | movement which combined the technique of dwiring (tightening compression method).

FIG. 5 shows a second embodiment of the present invention using a “perforated pin cap” and a normal non-perforated osteosynthesis pin;
It is a side view which shows the state after the osteosynthesis operation which combined the technique of on band wiring (tightening compression method).

[Description of Signs] 1 Main part (columnar portion) of perforated bone connecting pin 2 Tapered tip of perforated bone connecting pin 3 End opposite to tapered front end of perforated bone connecting pin 4 Hole 5 Perforated Main part (cylindrical part) of pin cap 6 Tapered tip of perforated pin cap 7 End opposite to the tip of perforated pin cap 8 Entrance pin entrance of perforated pin cap 9 Inside of perforated pin cap Cavity part 10 Hole part of perforated pin cap 11 Fracture part 12 Elbow head 13 Ulna shaft 14 Penetration part of osteosynthesis pin 15 Perforated osteosynthesis pin 16 Tunnel formed in elbow head 17 Mild steel wire (or 19 Soft part 20 Fracture part 21 Elbow head 22 Ulna shaft 24 Tunnel formed in the ulna distal to the fracture part 25 Mild steel wire (or soft line) 27 Fastening part 28 Fracture part 29 Elbow head 30 ulnar bone Part 31 normal hole boneless joint pin 32 fractures than drilled formed ulnar distal portion tunnel 33 mild steel wire (or 軟細 line) 35 fastening part 36 perforated pin cap

Claims (2)

[Claims] 1. A pin having a tapered point on one side and a main part having a columnar shape, and a hole for inserting a mild steel wire or a soft wire into a cylindrical end of the main part is perpendicular to a long axis. "Bone joint pins with holes as medical implants" characterized by being formed in a tunnel shape. 2. A cylindrical cap structure capable of biting and fixing after being covered with a holeless osteosynthesis pin, the outer end of which is tapered on one side and the opposite end is cylindrical and is made of mild steel wire or soft steel. A "perforated pin cap for fixing and immobilizing a pin which is a medical implant" is characterized in that a hole for inserting a fine wire is formed in a tunnel shape perpendicular to the long axis.