JP2002345837A - Fixation device outside wound - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a fixation device outside wound capable of fixing a joint and an osteotomy section at the same time. SOLUTION: This fixation device 1 is provided with a fixation pin holding member 21 for holding a fixation pin 17 to be attached on the center side 41 of a cut through tibia 4 performed with osteotomy, a fixation pin holding member 31 for holding fixation pins 18, 19 to be attached to peripheral parts 42 of the tibia 4, a fixation pin holding member 22 for holding a fixation pin 15 attached to a thigh bone 5 rotatably around an axis of the fixation pin 15, a first connecting member 32 for connecting the fixation pin holding member 21 and the fixation pin holding member 31 in manner that the connection distance and the angle between them can be adjusted, and a second connecting member 24 for connecting the fixation pin holding member 21 and the fixation pin holding member 22 in a manner that the connection distance and the angle between them can be adjusted.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an external fixator capable of simultaneously treating knee arthrosis and cartilage damage in knee arthritis accompanied by cartilage damage.

[0002]

2. Description of the Related Art Conventionally, in the treatment of knee osteoarthritis accompanied by cartilage damage, cartilage damage is performed by autologous transplantation or partial excision. It was done by fixing with.

[0003]

However, if the cartilage injury is not fixed with the knee joints separated, the cartilage portions of the femur and the tibia interfere with each other, causing damage again. Therefore, Japanese Patent Application Laid-Open No. 2000-5206 proposes an external fixator that fixes the knee joint in a state where the knee joint is separated.
However, this external fixator is intended only for treating cartilage damage, and in the case of knee arthritis accompanied by cartilage damage, the knee joint disease and cartilage damage must be treated separately, which makes the operation complicated. In addition, since the device is large, there is a risk that the life after external fixation will be affected. Therefore, an object of the present invention is to solve the above problems, to be able to treat joints and osteotomy simultaneously,
Another object of the present invention is to provide an external fixator that can be reduced in size.

[0004]

The above object can be achieved by (1) an external fixator for osteotomy of a joint formed by a first bone to be cut and a second bone not to be cut. Wherein the external fixator comprises a first bone central fixation pin holding member for retaining a first bone central fixation pin attached to the central side of the osteotomized first bone; and an osteotomy. The first
A first bone distal fixation pin holding member for holding a first bone distal fixation pin attached to the distal side of the bone,
A second bone fixation pin holding member for holding a second bone fixation pin attached to the bone so as to be rotatable about an axis of the fixation pin, the first bone center side fixation pin holding member, A first connecting member for connecting the first bone distal-side fixed pin holding member so that a connecting distance and a connecting angle can be adjusted;
An external fixator comprising: a bone center side fixing pin holding member; and a second connecting member that connects the second bone fixing pin holding member so that a connecting distance and a connecting angle can be adjusted.

[0005] The above-mentioned object is achieved by (2)
An external fixator for osteotomy of a joint formed by a first bone to be osteotomized and a second bone not to be osteotomized, the external fixator comprising: A first bone central fixation pin attached to the central side, a first bone distal fixation pin attached to the distal side of the osteotomized first bone, a second bone fixation pin attached to the second bone, First
A first bone center-side fixing pin holding member for detachably holding the bone center-side fixing pin; a first bone distal side fixing pin holding member for holding the first bone center-side fixing pin detachably;
A second bone fixation pin holding member for holding the second bone fixation pin rotatably and detachably about the axis of the fixation pin, the first bone center side fixation pin holding member, 1
A first connecting member that connects the distal bone-side fixed pin holding member so that the connecting distance and the connecting angle can be adjusted; and a first bone center-side fixed pin holding member and the second bone fixed pin holding member that are connected. Second connecting distance and connection angle adjustable
And an external fixing device.

(3) In the above (1) or (2), it is preferable that the second connecting member is separable from the first bone center side fixing pin holding member.

[0007] The above object is achieved by (4)
An external fixator for high tibial osteotomy, the external fixator comprising: a tibial central fixation pin holding member for retaining a tibial central fixation pin attached to a central side of an osteotomized tibia; A tibia distal-side fixing pin holding member for holding a tibia distal-side fixing pin attached to the distal side of the osteotomized tibia, and a femoral fixing pin attached to the femur, with the axis of the fixing pin as the center. A first fixing pin holding member for rotatably holding the femoral bone, and a connection distance and a connection angle between the tibial center side fixing pin holding member and the tibia distal side fixing pin holding member which are adjustable. An external fixator comprising: a connecting member; and a second connecting member that connects the tibial center-side fixing pin holding member and the femur fixing pin holding member so that a connection distance and a connection angle can be adjusted.

[0008] The above object is achieved by (5)
An external fixator for high tibial osteotomy, wherein the external fixator includes a tibial central fixation pin attached to a central side of an osteotomized tibia, and a tibia attached to a distal side of the osteotomized tibia. A distal fixation pin, a femoral fixation pin attached to the femur, a tibial fixation pin holding member for detachably holding the tibial fixation pin, and a tibia for detachably holding the tibial fixation pin A distal-side fixing pin holding member, a femoral fixing pin holding member that rotatably and detachably holds the femoral fixing pin around the axis of the fixing pin, and the tibia central-side fixing pin holding member. A first connecting member for connecting the tibia distal side fixing pin holding member to the connecting distance and the connecting angle so as to be adjustable, and a connecting distance and a connecting distance between the tibia central side fixing pin holding member and the femur fixing pin holding member; Yo A external fixator and a second connecting member for adjustably coupling the connecting angle.

(6) In the above (4) or (5), it is preferable that the second connecting member is separable from the tibia central side fixing pin holding member.

[0010]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, an external fixator according to the present invention will be described in detail with reference to the accompanying drawings. FIG. 1 is a front view of an external fixator according to an embodiment of the present invention, FIG. 2 is an enlarged perspective view of an upper portion of the external fixator shown in FIG. 1, and FIG.
FIG. 4 is a plan view of a femoral fixing pin holding member used in the external fixator shown in FIG. 1, FIG. 4 is a plan view of a clamp member used in the external fixator shown in FIG. 1, and FIG. 6 is a front view of a shaft portion used in the external fixator shown in FIG. 1. FIG.

The external fixator 1 of the present invention is an external fixator 1 for a joint formed by a first bone 4 to be cut and a second bone 5 not to be cut. First bone 4
1st bone central side fixing pin 1 attached to the central side 41
A first bone central-side fixing pin holding member 21 for holding the first and second bones 6 and 17 and a first bone distal-side fixing pin 18 and 19 attached to the distal side 42 of the osteotomized first bone 4. The first bone distal-side fixing pin holding member 31 and the second bone fixing pin 15 attached to the second bone 5 are fixed to the fixing pin 1.
And a second bone fixing pin holding member 22 for rotatably holding the shaft 5 around the first shaft.
1st connection member 32 which connects 1 and 1st bone peripheral side fixed pin holding member 31 so that connection distance and connection angle can be adjusted.
And a second connecting member 24 for connecting the first bone center side fixing pin holding member 21 and the second bone fixing pin holding member 22 so that the connection distance and the connection angle can be adjusted.

The external fixator 1 according to the present invention is an external fixator for osteotomy of a joint formed by a first bone 4 to be cut and a second bone 5 not to be cut. First bone central fixing pins 16 and 17 attached to the central side 41 of the osteotomized first bone 4, and a first bone distal side attached to the distal side 42 of the osteotomized first bone 4. Fixing pin 18,
19, a second bone fixing pin 15 attached to the second bone 5, and a first bone center fixing pin holding member 2 for detachably and non-rotatably holding the first bone center fixing pins 16, 17
1, a first bone fixation pin holding member 31 for detachably and non-rotatably holding the first bone fixation pins 18 and 19, and a second bone fixation pin 15 which is an axis of the fixation pin 15. Bone fixing pin holding member 22 that is rotatably and detachably held about the center, and a first bone center side fixing pin holding member 21
Connecting member 32 for connecting the first bone distal-side fixed pin holding member 31 and the first bone distally fixed pin holding member 31 so that the connecting distance and the connecting angle can be adjusted.
And a second connecting member 24 for connecting the first bone center side fixing pin holding member 21 and the second bone fixing pin holding member 22 so that the connection distance and the connection angle can be adjusted.

Therefore, an external fixator according to the present invention will be described with reference to an embodiment in which the external fixator is applied to a high tibial osteotomy. The external fixator 1 for high tibial osteotomy of this embodiment includes a tibial central fixation pin 16, which is attached to the tibial central side 41 where the bone is cut.
Tibia center side fixing pin holding member 21 for holding
And a tibial distal fixation pin holding member 31 for holding the tibial distal fixation pins 18 and 19 attached to the cut tibia distal side 42, and a femoral fixation pin 15 attached to the femur 5 A femur fixing pin holding member 22 for holding the pin 15 so as to be rotatable about the axis thereof,
A first connecting member 32 for connecting the tibial center-side fixed pin holding member 21 and the tibial distal-side fixed pin holding member 31 so that the connecting distance and the connecting angle can be adjusted; a tibial center-side fixed pin holding member 21 and a thigh bone; A second connecting member 24 for connecting the fixed pin holding member 22 with the connecting distance and the connecting angle so as to be adjustable.

The external fixator 1 for high tibial osteotomy according to the present embodiment includes tibial central fixation pins 16 and 17 which are attached to the tibial central side 41 where the bone has been cut, and the tibial peripheral side where the bone has been cut. Tibial distal fixation pin 1 attached to 42
8, 19, a tibial fixation pin 15 attached to the femur 5, and a tibial fixation pin holding member 21 for detachably and non-rotatably holding the tibial fixation pins 16, 17
A tibial distal fixation pin holding member 31 for detachably and non-rotatably holding the tibial distal fixation pins 18 and 19; and a femoral fixation pin 15 rotatable and detachable about the axis of the fixation pin 15. Femoral fixation pin holding member 2 to be held as possible
2, a first connecting member 32 for connecting the tibial center side fixing pin holding member 21 and the tibial distal side fixing pin holding member 31 so that the connecting distance and the connecting angle can be adjusted, and a tibial center side fixing pin holding member 21 A second connecting member 24 for connecting the femoral fixing pin holding member 22 with the connecting distance and the connecting angle in an adjustable manner.

The external fixator 1 for high tibial osteotomy of this embodiment comprises an external fixator main body and several fixing pins. Tibial central fixation pins 16, 17 attached to the osteotomized tibia central side 41, tibial distal fixation pins 18, 19 attached to the osteotomized tibia distal side, femoral fixation pin 15 attached to the femur For each, a so-called external fixation screw having a screw at the tip is used. Each fixing pin is formed of a biocompatible metal, a hard resin, an inorganic material, or the like. As the metal, titanium or a titanium alloy is preferable. As the inorganic substance, ceramics is preferable.

The external fixator 1 comprises a tibial central fixation pin retaining member 21, a tibial peripheral fixation pin retaining member 31, a femur fixation pin retaining member 22, a tibial central fixation pin retaining member 21, and a tibia. A first connecting member 32 for connecting the distal-side fixed pin holding member 31 and a second connecting member for connecting the tibial center-side fixed pin holding member 21 and the femur fixed pin holding member 22.
And the connecting member 24.

As shown in FIG. 1 and FIG. 2, the tibial center side fixing pin holding member 21 includes a fixing pin holding portion 210 for holding the tibial center side fixing pin non-rotatably and detachably. The fixing pin holding section 210 includes fixing pin fixing holes 211 and 212 for fixing the fixing pins 16 and 17 inserted into the central side 41 of the tibia 4. The fixing pin fixing holes 211 and 212 are arranged in parallel with the fixing pin holding part 210 at a constant interval. In addition, the fixed pin holding part 210 includes the divided upper part 210a and lower part 2.
10b, and these are combined to form fixing pin fixing holes 211 and 212 therein. Also, the upper part 210a and the lower part 210b are
After the combination, it is fixed from above by a fixing bolt 213. In the embodiment, two fixing pin fixing holes are arranged in parallel, but the present invention is not limited to this.
Only one may be used.

The tibia distal side fixing pin holding member 31 is shown in FIG.
As shown in FIG. 7, a fixing pin holding section 310 for holding the tibial distal side fixing pins 18 and 19 non-rotatably and detachably.
And The fixing pin holding portion 310 is a column extending in the axial direction, and includes fixing pin fixing holes 311 and 312 for fixing the fixing pins 18 and 19 inserted and fixed to the distal side 42 of the tibia 4 which has been cut. I have. Fixing pin fixing hole 3
The reference numerals 11 and 312 are arranged at a fixed distance from each other in the axial direction of the fixed pin holding section 310. Further, the fixing pin holding portion 310 includes a divided front part 310a and a rear part 310b, and these are combined to form fixing pin fixing holes 311 and 312 therein. The front part 310a and the rear part 310b are
After assembling, it is fixed with fixing bolts 313 from the front. In the embodiment, the fixing pin fixing holes 311,
Although two 312s are arranged in the axial direction, the present invention is not limited to this, and only one 312 may be provided.

The femur fixing pin holding member 22 holds the femoral fixing pin in a rotatable and detachable manner. As shown in FIGS. 1 and 3, the fixing pin is fixedly inserted into the femur 5. Fixed pin fixing hole 22 through which one end of pin 15 penetrates
1 is provided. Rotating mechanism 2
Reference numeral 22 denotes an accommodation hole 229 that extends from the front to the rear in FIG. 2 (from the lower side to the upper side in FIG. 4) in the enlarged diameter portion 220 of the holding member 22, and is rotatably accommodated in the accommodation hole 229 and is fixed to a fixing pin therein Cylindrical rotating member 23 having hole 221
5 and a fixing bolt 236 that penetrates into the rotating member from the side of the rotating member 235 and fixes the fixing pin 15 in the rotating member.

With such a configuration, the fixing pin 15
One end of the fixing pin 15 is a fixing pin fixing hole 22 of the rotating member.
1 and fixed to the femoral bone fixing pin holding member 22 while being fixed by the fixing bolt 236. For this reason,
Even if the knee joints are separated and fixed for cartilage damage treatment, the knee joints can be extended and flexed. The rotating mechanism may be of any type as long as the femoral fixing pin easily rotates with respect to the femoral fixing pin holding member. The rotation mechanism may have, for example, a bearing mechanism (not shown). It is preferable that a polygonal shape or a thread groove corresponding to a polygonal shape or a thread on one end side of the fixing pin 15 is formed on the inner surface of the bearing mechanism. With such a configuration, one end side of the fixing pin 15 inserted and fixed to the femur 5 is engaged or screwed with the inner surface of the bearing, and rotates at the bearing portion.

A strut penetrating hole 223 is formed in the vicinity of the center of the femur fixing pin holding member 22 so as to extend substantially vertically from the upper end surface to the lower end surface. The strut penetrating hole 223 penetrates the strut 23 described later. By doing so, the femur fixing pin holding member 22 slides up and down around the support 23. Further, a fixing pin holding member 2 for a femur
2 is a positioning fixing bolt 225 attached to the side.
Thus, it is fixed to the column 23.

Specifically, the fixing pin holding member 2 for the femur
When the positioning bolt 225 penetrating from the side surface of the support 2 toward the central axis of the column 23 is tightened, the positioning bolt 22
5 is pressed against the inner surface of the groove 232 of the column 23, whereby the femur fixing pin holding member 22 is fixed to the column 23. Thereby, the vertical and horizontal movement of the femur fixing pin holding member 22 is suppressed. Further, if the fixing bolt 225 is loosened so that the tip of the fixing bolt 225 is in the groove 232, the femur fixing pin holding member 22 can be slid up and down along the groove 232.

The left portion of the femur fixing pin holding member 22 has a thin plate portion 228 which is thinner than other portions of the femur fixing pin holding member 22.
Is provided with a bolt penetration hole 224 through which a bolt 226 for connecting the femur fixing pin holding member 22 to a clamp member 243 described later is penetrated. Bolt penetration hole 22
4 has a thread 226 provided on the bolt 226.
A screw groove 224a is provided for screwing with a.
The bolt penetration hole 224 is formed substantially coaxially with the same diameter as the bolt penetration hole 246 of the second connecting member 24, and the bolt 226 screwed into the bolt penetration hole 224 has a bolt penetration hole 246 (penetration) near the lower portion. Screw groove 24 of hole 246
6a).

With such a configuration, the femur fixing pin holding member 22 is connected to the clamp member 24 via the bolt 226.
3 securely fixes the support 23. Further, when the femoral fixing pin holding member 22 is slid downward with respect to the support 23, the bolt 2
Numeral 26 is fixed from the lower surface of the thin plate portion 228 with a nut 227.

The first connecting member 32 connects the tibial central fixing pin holding member 21 and the tibial distal fixing pin holding member 31 so that the connecting distance and the connecting angle can be adjusted. The first connecting member 32 is a first connecting member having a length adjusting function.
Joint member 217 attached to connecting member main body and tibial center side fixing pin holding member 21 so as to be adjustable in angle.
And a joint member 314 attached to the tibia distal side fixing pin holding member 31 so as to adjust the angle.

The joint member 217 is an annular outer joint forming member for accommodating an inner joint forming portion integrally formed below the lower portion 210b of the fixed pin holding portion 21. The substantially hemispherical inner surface of the inner joint forming portion and the substantially hemispherical inner surface of the outer joint forming portion (joint member 217) face each other, so that a substantially spherical concave portion is formed therebetween. In addition, a ball joint 321 provided at the tip of a shaft portion of the first connecting member main body described later is inserted and fixed in the above-described substantially spherical concave portion between the inner joint forming portion and the outer joint forming portion.

Specifically, a ball joint 321 is provided between the inner surfaces of the inner joint forming portion and the outer joint forming portion.
Then, when the joint fixing bolt 218 attached to the side surface of the outer joint member is tightened, the ball joint 321 is fixed, and the joint fixing bolt 2
By loosening 18, the ball joint 321 can be moved, and the angle and the direction can be changed.

The joint member 314 has the same configuration as the joint member 217, and is an annular outer joint forming member for accommodating the inner joint forming portion integrally formed on the upper portion of the tibia distal side fixing pin holding member 310b. is there. The substantially hemispherical inner surface inside the inner joint forming portion and the outer join forming portion (joint member 314)
When the substantially hemispherical inner surfaces face each other, a substantially spherical concave portion is formed between them. In addition, a ball joint 323 provided at the tip of a shaft portion of the first connecting member main body, which will be described later, is inserted and fixed in the above-described substantially spherical concave portion between the inner joint forming portion and the outer joint forming portion.

Specifically, a ball joint 323 is provided between the inner surfaces of the inner joint forming portion and the outer joint forming portion.
The ball joint 323 is fixed when the joint fixing bolt 315 attached to the side surface of the outer joint forming portion is tightened, and the ball joint 323 is movable when the joint fixing bolt 315 is loosened, and the angle and direction are changed. can do.

As shown in FIGS. 1 and 6, the first connecting member main body has a ball joint 32 projecting upward from the upper end thereof.
1, a gearbox 320 having a ball joint 323 at a lower end thereof, a slide shaft 322 having a rack 322a formed on an outer surface, a gear portion provided with a gear housed in the gearbox and meshing with the rack of the slide shaft 322, A first side closing member for closing one side of the opening of the gear box and a second side closing member for closing the side of the other opening of the gear box are provided.

The ball joint 321 formed integrally with the gear box 320 is connected to the joint member 21 described above.
7, the ball joint 323 integrally formed on the slide shaft 322 is connected to the joint member 314 described above.
The fixed angle can be changed (adjusted).

The first connecting member has a distance adjusting function, and therefore has a gear box 320, a slide shaft 322, a gear portion, a first side closing member, and a second side closing member. A rail portion that allows the slide shaft to slide in the axial direction is provided on the inner surface of the gear box of the first side surface closing member. The gear unit includes a gear arranged to mesh with the rack of the slide shaft, a gear shaft penetrating through the gear, and a gear fixing nut for adjusting rotation of the gear. In the state where the gear fixing nut 325 is tightened, the rack that meshes with the gear cannot be slid because the gear does not rotate, and if the gear fixing nut 325 is loosened,
Since the gears are rotatable, the rack can slide. The length of the shaft portion can be changed by loosening the gear fixing nut and sliding the rack.

Since the first connecting member 32 has the above-described structure, the first connecting member 32 connects the tibial center-side fixing pin holding member 21 and the tibia distal-side fixing pin holding member 31 so that the connecting distance and the connecting angle can be adjusted. ing. The slide shaft has a ball joint 323 at the lower end, but preferably has a stopper at the upper end.

According to such an external fixator 1, since the distance and the angle can be adjusted, the central side 41 of the tibia 4 where the osteotomy is cut and the peripheral side where the osteotomy is cut (non-articular side).
The contact with the bone 42 can be ensured, and a certain amount of contact stress can be applied to the contact surface (bone cut surface) satisfactorily, and that state can be maintained.

The first connecting member of the external fixator for high tibial osteotomy 1 of this embodiment has two angle adjusting mechanisms of a joint member 217 and a joint member 314. The present invention is not limited to this embodiment, and only one of them may be used. Further, the distance adjusting mechanism of the first connecting member is not limited to the above-described mechanism, and may be any mechanism that can adjust and maintain the distance.

The second connecting member 24 connects the tibial center fixing pin holding member 21 and the femur fixing pin holding member 22 so that the connection distance and the connection angle can be adjusted.
The second connecting member 24 includes a support 23 and a clamp member 24.
3 and a joint member 214 attached to the tibial center side fixing pin holding member 21 so as to be adjustable in angle.

As shown in FIGS. 1 and 2, the joint member 214 is an annular outer joint forming member for accommodating an inner joint forming portion 214a integrally formed above the lower portion 210b of the fixed pin holding portion 21. It is. The substantially semi-spherical inner surface inside the inner joint forming portion 214a and the substantially semi-spherical inner surface of the outer joint forming portion (joint member 214) face each other, so that a substantially spherical concave portion is formed therebetween. And the inner joint forming part 2
A ball joint 231 provided at a lower end of a support column 23 of a second connecting member, which will be described later, is inserted and fixed in the above-described substantially spherical recess between the outer joint forming member 214 and the outer joint forming member 214.

Specifically, the inner joint forming portion 214
The ball joint 231 is housed between the inner joint surface a of the outer joint forming member 214 and the joint fixing bolt 215 attached to the side surface of the outer joint forming member 214, whereby the ball joint 231 is fixed. Is loosened, the ball joint 231 can be moved, and the angle and direction can be changed.

The support 23 is formed in a rod shape as shown in FIGS. 1, 2 and 5, and has a ball joint 231 at the base end. A groove 232 is formed in the rod portion of the column 23 so as to be substantially vertical from the tip to the ball joint 231. And ball joint 2
31 is connected to the joint member 214 described above as described above. Further, a femur fixing pin holding member 22 and a second connecting member 24, which will be described later, are fixed to the rod-shaped portion.

As shown in FIG. 4, a notch 241 is formed in the clamp member 243 from the center to the right. The notch 241 is a clamp member 243
And a cut-out portion 241b extending from the right end of the clamp member 243 to the right end of the circular portion 241a. In addition, the clamp member 243 includes a clamp member 2
A clamp fixing bolt 244 is screwed in from the side of 43, and when the clamp fixing bolt 244 is tightened, the circular cutout portion 241 a and the cutout portion 241 b are narrowed, and the clamp member 243 is fastened to the column 23.

A positioning fixing bolt 245 that penetrates toward the center axis of the circular cutout portion 241a is attached to a side surface near the center of the clamp member 243. By screwing the fixing bolt 245,
The tip of the fixing bolt 245 is pressed against the inner surface of the groove 232 of the column 23, and the clamp member 243 is fixed to the column 23. Thereby, the vertical and horizontal movement of the clamp member 243 is suppressed. Also, the fixing bolt 2 is positioned so that the tip of the positioning fixing bolt 245 is located inside the groove 232.
45, the clamp member 243 is
2 can be slid up and down. With the above configuration, the clamp member 243 is firmly fixed to the column 23 by both the clamp fixing bolt 244 and the positioning fixing bolt 245.

The clamp member 243 and the femur fixing pin holding member 2 are provided on the left side of the clamp member 243.
2 is provided with a bolt penetration hole 246 for penetrating a bolt 226 for connecting the bolt 2. A screw thread 226a provided on the outer surface of the bolt 226 is provided on the inner surface of the penetration hole 246.
And a screw groove 246a for screwing into the screw hole. Further, the penetration hole 246 is formed coaxially with the same diameter as the penetration hole 224. With such a configuration, the bolt 226 that has penetrated the penetration hole 224 as described above is screwed with the penetration hole 246 near the lower end, and the femoral pin holding member 22
Is securely fixed to the column 23 by the clamp member 243.

For this reason, the fixing pin holding member 22 for the femur
And the clamp member 243 are fixed to the column 23, and with the joint fixing bolt of the joint member 214 loosened, the femur fixing pin holding member 22 or the clamp member 243 or the femur fixing pin holding member 22 and the clamp Even if the member 243 is gripped and rotated left and right, the femur fixing pin holding member 22 does not move with respect to the column 23.

In the external fixator 1 for high tibial osteotomy of this embodiment, the second connecting member 24 is a tibial center fixing pin holding member 2 which is a first bone center fixing pin holding member.
It is separable from 1. Therefore, it is possible to separate only the portion of the knee joint and the osteotomy where treatment has been completed, and to continue the treatment of the other portions. Specifically, in the embodiment, when only the treatment of the knee joint portion is completed, when the joint fixing bolt 215 is largely loosened, the ball joint 231 of the column 23 and the outer joint forming member 214 are fixed to the tibial center side fixing pin holding member 21. More precisely, it comes off from the inner joint forming portion 214a integrally formed on the upper surface of the holding member 21. Thereby, the fixing pin holding member 22 for the femur is connected to the second connecting member 2.
4 together with the external fixator 1 for high tibial osteotomy.

Further, in the external fixator 1 for high tibial osteotomy of this embodiment, the first connecting member 32 is a tibial center fixing pin holding member 21 which is a first bone center fixing pin holding member.
More separable. When the treatment on the tibia side is completed first, when the joint fixing bolt 218 is largely loosened, the ball joint 321 and the outer joint forming member 217 of the first connecting member 32 are moved from the tibia central side fixing pin holding member 21 by To be more precise, it comes off from the inner joint forming part 217a integrally formed on the lower surface of the holding member 21. Thereby, the tibia distal side fixing pin holding member 31
Together with the first connecting member 32 can be separated from the external fixator 1. This state is the state shown in FIG. The device shown in FIG. 2 is used as an external fixator for joint treatment. Also, it is preferable that each part of the external fixator be chamfered so as not to hurt the body.

Next, a method of using the external fixator 1 will be described. FIG. 7 is an explanatory diagram for explaining a method of using the external fixator. FIG. 7 is a view as seen from the front of the left leg. A skin incision of about 1 cm is made in the central front side of the tibia (central side 41), and a guide pin is inserted into the central front side of the tibia using a percutaneous pin guide. At this time, it is confirmed under X-ray fluoroscopy whether the guide pin is inserted at an appropriate depth and whether it is inserted at an appropriate location, by comparing it with the shading of the fixing pin 16 for insertion.

Next, a pilot hole for a fixing pin is formed by using a cannulated drill along the inserted guide pin. At this time, since the scale is marked on the cannulated drill, the pilot hole can be formed at an appropriate depth. The fixing pin 16 is inserted into the prepared hole for the fixing pin manufactured by the above method using a fixing pin inserter, and penetrated.

Next, a pilot hole for a fixing pin is formed in the same manner as described above on the central rear side of the tibia (central side 41). In addition,
This pilot hole is formed at a position parallel to the fixed pin axis on the center side of the tibia and at a predetermined interval using a parallel guide. Then, a fixing pin 17 having the same size as the above-mentioned fixing pin is inserted into the prepared fixing pin pilot hole by the same method as described above and penetrated.

Next, the percutaneous pin guide is passed through a drill guide with a goniometer adjusted to a predetermined length and a predetermined osteotomy angle with reference to the fixing pin inserted in the front side of the tibia at the central side of the tibia. An incision of about 1 cm is made at a predetermined position (distal side 42), and a guide pin is inserted. Then, a pilot hole for a fixing pin is made along the guide pin with a cannulated drill. When inserting the pin guide, it is preferable to lightly tap the proximal end of the pin guide to fix the distal end of the pin guide to the bone, and then insert the guide pin. Then, the fixing pin guide is set on the drill guide with a goniometer, and the fixing pin 18 is inserted using the fixing pin inserter. A fixing pin having the same length as the fixing pin is used.

Next, a skin incision of about 1 cm was made on the distal side of the tibia from the inserted fixing pin, and the inserted fixing pin 18 was cut.
Insert the guide pin through the percutaneous pin guide through the parallel guide based on. Then, after pulling out the percutaneous pin guide, use the cannulated drill to make another pilot hole for the fixing pin. The fixing pin guide is passed through the parallel guide, and the fixing pin 19 having the same length as the inserted fixing pin 18 is inserted by using the fixing pin inserter as described above.

Next, a femoral condylar rotation center indexing device (not shown) is applied to the inside of the center of the femur 5 near the center of the above-mentioned two fixing pins 16 and 17, and an X-ray is applied. After confirming the optimal direction and position under fluoroscopy, guide pins are inserted into three holes formed so as to surround a through hole provided at the center of the device, and the device is temporarily fixed. Then, the fixation pins 16 and 17 inserted on the central side of the tibia are connected to the femoral condyle rotation center determining device using a rotation center confirmation device (not shown), and the extension and bending of the joint are repeated. Adjust the position of the femoral condylar rotation center indexing device.

After the adjustment, a guide pin sleeve is attached to the through-hole of the femoral condyle rotation center indexing device, and the guide pin is inserted. Then, the guide pin sleeve is pulled out, and a prepared hole for the screw pin is formed with a cannulated drill. Subsequently, the screw pin sleeve is attached to the femoral condyle rotation center indexing device, and the screw pin (fixation pin 15) is inserted by an inserter and penetrated.

As described above, the fixing pins 15, 16, 17,
After inserting the fixing pins 18 and 19, the tibia 4 is cut at a predetermined position. And positioning fixing bolt 2
25, positioning fixing bolt 245, fixing bolt 213,
With the fixing bolt 313, the gear fixing nut 325, the joint fixing bolt 215, the joint fixing bolt 218, and the joint fixing bolt 315 loosened, the external fixator 1 is disposed on the fixing pins 15, 16, 17, and the fixing pins 18, 19. I do.

Specifically, the fixing pin 15 inserted and fixed to the femur 5 is inserted into the fixing pin fixing hole 221 of the fixing pin holding member 22 for the femur, and the fixing pin 15 is inserted and fixed to the knee center side 41 of the tibia 4. Pins 16 and 17 are fixed to fixing pin fixing holes 211 and
12 and the fixing pins 18 and 19 inserted and fixed to the distal side 42 of the tibia 4 are inserted into the fixing pin fixing holes 311 and 312. The insertion of the external fixator 1 into the fixing pin fixing hole is performed from a fixing pin having a long portion protruding from the skin. In this state, the femoral fixing pin holding member 22 of the external fixator 1 is slidable up and down with respect to the support column 23, and the shaft portion 32 is extendable and contractible.

Next, the fixing bolt 213 of the fixing pin holding part 210 and the fixing bolt 313 of the fixing pin holding part 310 are tightened, and the fixing pins 16 and 17 and the fixing pin are fixed to the fixing pin holding part 210 and the fixing pin holding part 310, respectively. 18 and 19 are fixed. Further, the fixing pin 15 is fixed to the fixing pin holding member 22. Then, the length of the shaft portion 32 is adjusted so that an appropriate contact stress is applied between the osteotomy surface on the central side 41 of the tibia 4 and the osteotomy surface on the distal side 42 of the tibia 4, and the gear fixing nut 325 is used. Fix it. At this time, the shaft portion 32 is connected to the joint member 217 and the joint member 3.
The angle is adjusted to an appropriate angle with respect to 14, and fixed with the joint fixing bolts 218 and 315.

Next, as shown in FIG. 7, the strut 2 is positioned so that the femoral side knee joint and the tibia side knee joint are separated by a predetermined distance.
3 along the groove 232
Then, the second connecting member 24 is slid, and the femoral fixing pin holding member 22 is fixed to the column 23 with the positioning bolt 225. Then, after fixing the second connecting member 24 with the positioning bolt 245, the second connecting member 24 is firmly fixed to the column with the clamp fixing bolt 244. In addition,
At the time of the above operation, the support column 23 is adjusted to an appropriate angle with respect to the joint member 214, and is fixed by the joint fixing bolt 218.

If necessary, another external fixation device is mounted on the opposite side of the joint to which the external fixation device 1 is mounted, as shown in FIG. As the external fixator mounted here, an external fixator for joint treatment as shown in FIGS. 2 and 7 is used. The external fixator 100 first connects the tibial distal-side fixing pin holding member 31 and the tibial central-side fixing pin holding member 21 to the tibial distal-side fixing pin holding member 31 so that the connecting distance and the connecting angle can be adjusted. Connecting member 3
It is the same as the external fixator 1 described above except that the external fixator 2 is not provided. In other words, the external fixator 100 includes a tibial center fixing pin holding member 21 that detachably and non-rotatably holds the tibial center fixing pins 16 and 17, and a femoral fixing pin 15.
And the tibial center-side fixing pin holding member 21 and the thigh bone fixing pin holding member 22 that are rotatably and detachably held about the axis of the fixing pin 15. A connection member 24 is provided for connecting the connection angle in an adjustable manner. By the operation as described above, it is possible to simultaneously treat the cartilage damage of the knee joint and the knee joint disease.

[0058]

The external fixator according to the present invention is an external fixator for osteotomy of a joint formed by a first bone to be cut and a second bone not to be cut. The external fixator includes a first bone central fixation pin holding member for retaining a first bone central fixation pin attached to the central side of the osteotomized first bone, and a bone cut first bone. A first bone distal-side fixing pin holding member for holding a first bone distal-side fixing pin attached to the distal side of the bone, and a second bone fixing pin attached to the second bone centered on the axis of the fixing pin. A connection distance and a connection angle between the second bone fixing pin holding member for rotatably holding the first bone central side fixing pin holding member and the first bone distal side fixing pin holding member can be adjusted. Connecting member, the first bone center side fixing pin holding member, and the second bone fixation And a second connecting member for adjustably coupling the coupling distance and connecting angle and down holding member. Therefore, the joint and the osteotomy near the joint can be treated simultaneously, and the size can be reduced.

The external fixation device of the present invention is an external fixation device for high tibial osteotomy, wherein the external fixation device has a tibial center side fixing pin attached to the osteotomized center of the tibia. A tibial central fixation pin holding member for holding the tibia, a tibia distal fixation pin holding member for holding a tibia distal fixation pin attached to the osteotomized tibia distal side, and a femur attached to the femur A connecting distance between the femoral fixing pin holding member for holding the fixing pin for rotation about the axis of the fixing pin, the tibial central fixing pin holding member, and the tibia distal fixing pin holding member. A first connecting member that adjustably connects the connecting angle, and a second connecting that adjusts the connecting distance and the connecting angle between the tibial center-side fixing pin holding member and the femur fixing pin holding member. With members That. Therefore, the knee joint and the osteotomy near the joint can be treated simultaneously, and the size can be reduced.

[Brief description of the drawings]

FIG. 1 is a front view of an external fixator according to an embodiment of the present invention.

FIG. 2 is an enlarged perspective view of an upper part of the external fixator shown in FIG. 1;

FIG. 3 is a plan view of a femur fixing pin holding member used in the external fixator shown in FIG. 1;

FIG. 4 is a plan view of a clamp member used in the external fixator shown in FIG. 1;

FIG. 5 is a front view of a column used in the external fixator shown in FIG. 1;

FIG. 6 is a front view of a shaft portion used in the external fixator shown in FIG. 1;

FIG. 7 is an explanatory diagram for explaining a method of using the external fixator.

[Explanation of symbols]

 Reference Signs List 1 external fixator 4 tibia 5 femur 15, 16, 17 fixing pin 18, 19 fixing pin 21 tibia central side fixing pin holding member 22 femoral fixing pin holding member 24 second connecting member 31 tibia distal side fixing pin Holding member 32 First connection member

Claims (6)

[Claims] An external fixator for an osteotomy of a joint formed by a first bone to be osteotomized and a second bone not to be osteotomized, wherein the external fixator is osteotomized. A first bone center-side fixing pin holding member for holding a first bone center-side fixing pin attached to the center side of the first bone; and a first bone attached to a distal side of the cut bone. A first bone distal fixation pin holding member for retaining the distal fixation pin, and a second bone fixation pin attached to the second bone for holding the second bone fixation pin rotatably about the axis of the fixation pin. A second bone fixing pin holding member, a first connecting member for connecting the first bone central side fixing pin holding member and the first bone distal side fixing pin holding member such that a connecting distance and a connecting angle are adjustable. Connecting distance between the first bone center side fixing pin holding member and the second bone fixing pin holding member. And a second connection member for connecting the connection angle in an adjustable manner. 2. An external fixator for osteotomy of a joint formed by a first bone to be osteotomized and a second bone not to be osteotomized, wherein the external fixator is osteotomized. A first bone central fixation pin attached to the central side of the first bone, a first bone distal fixation pin attached to the distal side of the osteotomized first bone, and a second bone attached to the second bone Fixing pin, a first bone center side fixing pin holding member for detachably holding the first bone center side fixing pin, and a first bone distal side for detachably holding the first bone center side fixing pin. A fixing pin holding member, a second bone fixing pin holding member for rotatably and detachably holding the second bone fixing pin about an axis of the fixing pin, and the first bone center side fixing Adjusting the connection distance and connection angle between the pin holding member and the first bone distal side fixed pin holding member A first connecting member that connects as possible,
An external fixator comprising: a second connecting member that connects the first bone center-side fixing pin holding member and the second bone fixing pin holding member so that a connection distance and a connection angle can be adjusted. . 3. The external fixator according to claim 1, wherein the second connecting member is separable from the first bone center-side fixing pin holding member. 4. An external fixator for high tibial osteotomy, comprising:
The external fixator includes a tibial central fixation pin holding member for retaining a tibial central fixation pin attached to a central side of the osteotomized tibia, and a tibial peripheral attached to a distal side of the osteotomized tibia. A tibial distal fixation pin retaining member for retaining the lateral fixation pin, and a femoral fixation pin retainer for retaining the femoral fixation pin attached to the femur rotatably about the axis of the fixation pin A first member for connecting the member, the tibial center-side fixing pin holding member, and the tibial distal-side fixing pin holding member to adjust a connection distance and a connection angle;
And a second connecting member for connecting the tibial center-side fixing pin holding member and the femur fixing pin holding member so that the connection distance and the connection angle can be adjusted. Fixator. 5. An external fixator for high tibial osteotomy, comprising:
The external fixator includes a tibial central fixation pin attached to the central side of the osteotomized tibia, a tibia distal fixation pin attached to the distal side of the osteotomized tibia, and a femoral fixation attached to the femur. A pin, a tibial central fixation pin holding member that detachably holds the tibial central fixation pin, a tibial distal fixation pin holding member that detachably holds the tibial peripheral fixation pin, and the femoral fixation pin. And a connection distance and a connection between the tibial center-side fixed pin holding member and the tibia distal-side fixed pin holding member, which rotatably and detachably hold the fixed pin around the axis of the fixed pin. A first connecting member for connecting the angle so as to be adjustable, and a second connecting member for connecting the connecting distance and the connecting angle between the tibial center side fixing pin holding member and the femur fixing pin holding member. External fixator, characterized in that it comprises a binding member. 6. The tibial central side fixing pin holding member is separable from the second connecting member.
An external fixation device according to item 1.