JP2005270133A - Osteotomy implement - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To prevent complication or others reducing the load acting to a cranial base by facilitating the transection of a bone in transection operation or others of a pterygomaxillary joint and to make a callus quickly grow at cut section of the bone by cutting the bone without giving an adverse influence to the bone in callus extending operation. <P>SOLUTION: An osteotomy implement has at least two cylindrical drill guides 1 connected in a lateral row, and a flexible shaft 2 passing through an inside of the drill guides 1 and having a drill-shape edge 3 at the distal end of the same. The osteotomy implement cuts the bone 4 using the drill-shape edge 3 by rotating the flexible shaft 2, by positioning the drill guide 1 at a predetermined position and guiding the the drill-shape edge 3 at the distal end of the flexible shaft 2 passed through the guide toward a precise position where the bone 4 is cut by the drill guide 1. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to an osteotomy device, and more particularly, to an osteotomy device that is suitable for performing a bone dissection operation in intraoral surgery and craniofacial facial deformation, or for callus extension.

  Conventionally, as a method of intraoral surgery, surgery for craniomaxillofacial deformation treatment, for example, detachment of the wing protrusion maxillary joint, a detachment operation in which the bone is cut using a bone chisel is generally used. there were. However, this method has a problem that an excessive load is applied to the skull base when the bone is cut off, and if it is remarkable, a complication such as a skull base fracture or blindness may be caused.

As an osteotomy device that replaces the bone chisel, an osteotomy device in which a saw is fixed at the tip has been developed (see Patent Document 1).
JP 2002-306514 A

  As shown in FIGS. 1 and 2, the osteotomy instrument described in this publication is composed of an osteotomy body 10 and a saw blade body 11 having a saw blade 12 at its tip. This osteotomy device rotates the rear end and cuts the bone with the saw blade 12 at the front end. The osteotomy tool used in this method is difficult to quickly cut bone at the correct location. This is because it is difficult for the elongated rod-shaped main body to firmly press the saw blade 12 at the distal end firmly to a fixed position of the bone. In this osteotomy device, the direction of cutting the bone is specified as a direction orthogonal to the rod-shaped body. This is because the trajectory along which the saw blade moves when the rod-shaped body is rotated is specified in this direction.

  Furthermore, osteotomy instruments are also used for callus distraction. Callus distraction is when bones are born and the growth of the foot or hand is insufficient, the bone is cut, and the cut bone is stretched at a rate of, for example, 1 mm / day using an instrument to grow the callus at the cut portion. This is a method of extending the entire bone. In this callus extension, the bone is cut with a saw. However, when the bone is cut with a saw, there is a detrimental effect that heat adversely affects the cells on the cut surface and inhibits growth. Callus distraction is a method in which a callus grows at the cut part to extend the bone for a long time, so it is particularly important not to adversely affect the cells on the cut surface.

The inventor of the present invention has arrived at the present invention as a result of intensive studies to solve the above-mentioned problems. That is, the object of the present invention is to facilitate the separation of the bone and perform the load applied to the skull base when performing an intraoral operation, a surgical operation of the wing-projection maxillary joint in the treatment of craniofacial deformation. An object of the present invention is to provide an osteotomy device that can reduce and prevent complications.
In addition, another important object of the present invention is to provide an osteotomy device that can cut bones without adversely affecting bones in bone distraction and can quickly grow the bones at the cut portions of the bones. It is in.

  The osteotomy instrument according to claim 1 of the present invention is provided with at least two cylindrical drill guides 1 connected in a horizontal row, and a drill-like blade 3 provided at the tip of the drill guide 1. The flexible shaft 2 is provided. In this osteotomy instrument, the drill guide 1 is arranged at a fixed position, and the drill-like blade 3 at the tip of the flexible shaft 2 inserted through the drill guide 1 is placed at an accurate position for cutting the bone 4. invite. When the flexible shaft 2 is rotated in this state, the drill-like blade 3 at the tip cuts the bone 4. One after another, the flexible shaft 2 is inserted into another drill guide 1 to cut the bone 4 at an accurate position.

  The osteotomy instrument according to claim 2 of the present invention is shaped to bend the drill guide 1. This osteotomy device cuts the bone 4 by adjusting the curvature radius and position of the bending, and disposing the tip of the drill guide 1 at an accurate position.

  The osteotomy instrument according to claim 3 of the present invention includes one or more flexible shafts 2. An osteotomy instrument having a single flexible shaft 2 is cut through the bone 4 by inserting the flexible shaft 2 through a specific drill guide 1, and then pulled out from the drill guide 1 and placed in another drill guide 1. Disconnect. That is, one flexible shaft 2 is put in another drill guide 1 one after another and the bone 4 is cut. The osteotomy instrument having a plurality of flexible shafts 2 is not pulled out from the bone 4 after cutting the bone 4 by inserting the flexible shaft 2 in one drill guide 1. With the drill-like blade 3 of the flexible shaft 2 cut from the bone 4 being put in the bone 4, the drill guide 1 is temporarily fixed at a fixed position. In this state, the bone 4 is cut by the flexible shaft 2 inserted through another drill guide 1.

  The osteotomy instrument according to claim 4 of the present invention is inserted through the drill guide 1 so that the drill-like blade 3 can be taken in and out. This osteotomy tool is used to fix the drill guide 1 in a state where the flexible shaft 2 is not inserted into the drill guide 1 or a state where the drill-shaped blade 3 of the flexible shaft 2 inserted into the drill guide 1 is accommodated in the drill guide 1. Place in position. Thereafter, the drill-shaped blade 3 of the flexible shaft 2 is projected from the drill guide 1 to cut the bone 4.

  The osteotomy device according to claims 5 and 6 of the present invention is used for intraoral surgery such as surgery in the treatment of craniofacial deformation. The osteotomy device according to claim 7 of the present invention is used for callus extension.

  The osteotomy instrument according to claim 8 of the present invention connects a plurality of drill guides 1 in a planar shape. The osteotomy device having this structure is suitable for cutting the bone 4 in a straight line. Furthermore, the osteotomy instrument according to claim 9 of the present invention is a self-tapping drill-like blade 3. When the self-tapping drill-like blade 3 is rotated, it can be drilled at an accurate position without being displaced from the surface of the bone 4. Furthermore, the osteotomy instrument according to claim 10 of the present invention connects 3 to 15 drill guides 1 in a horizontal row. The osteotomy device for connecting a large number of drill guides 1 in a horizontal row can cut the bone 4 with a long width by reducing the diameter of one drill-like blade 3 to be drilled.

  The osteotomy instrument of the present invention comprises at least a cylindrical drill guide connected in two horizontal rows, and a flexible shaft that has a drill-like blade provided at the tip through the inside of the drill guide, and rotates the flexible shaft. Since the bone is cut, it is easy to detach the bone and reduce the load on the skull base when performing detachment of the wing-projection maxilla joint in intraoral surgery and craniofacial deformity treatment. And it has the feature that complications can be prevented. In particular, the osteotomy instrument of the present invention can cut the exact position of the bone with a plurality of drill guides by guiding a drill-like blade at the distal end of the flexible shaft inserted therethrough to a specific position. Furthermore, with each flexible shaft inserted through multiple drill guides, it is possible to cut bone with multiple holes at multiple accurate positions, so that the bone can be cut at specific accurate positions and other There is a very good feature that does not adversely affect the part. This is because it is possible to effectively prevent the adverse effects of skull base damage to the patient or the eyes due to damage of other parts in the treatment of extremely difficult bone cutting, such as craniofacial deformation. is there.

  Furthermore, the osteotomy device of the present invention uses a drill guide to cut the drill-like blade at the tip of the flexible shaft inserted through the guide while guiding the specific position of the bone, so that the cutting position is restricted with respect to the insertion direction. For example, there is also a feature that bone can be cut quickly in a direction intersecting the insertion direction.

  Further, the osteotomy instrument of the present invention can improve the positioning accuracy for performing osteotomy because it can cut the bone by drilling holes aligned on a straight line by connecting the drill guides in a horizontal row. is there. Thereby, even in a narrow surgical field such as in the oral cavity, osteotomy can be accurately performed at an arbitrary position.

  Furthermore, the osteotomy device of the present invention does not cause heat damage to the bone like a conventional saw in distraction osteogenesis, while cutting the bone in an ideal position at an ideal position. The adverse effect of the cut part on the cells can be reduced. For this reason, the growth of the callus in the cut part of the bone is good, and the bone can be cut in an ideal state as a callus extension.

  Embodiments of the present invention will be described below with reference to the drawings. However, the example shown below illustrates the osteotomy device for embodying the technical idea of the present invention, and the present invention does not specify the osteotomy device as follows.

  Further, in this specification, in order to facilitate understanding of the scope of claims, numbers corresponding to the members shown in the examples are indicated in the “claims” and “means for solving problems” sections. It is added to the members. However, the members shown in the claims are not limited to the members in the embodiments.

  The osteotomy instrument shown in FIGS. 3 to 6 includes a plurality of drill guides 1 and a flexible shaft 2 inserted through the drill guide 1 so as to be rotatable.

  The drill guide 1 is a cylindrical pipe so that the flexible shaft 2 can be inserted and rotated inside. The plurality of drill guides 1 are connected in a horizontal row. The osteotomy instrument preferably has 3 to 15 drill guides 1 arranged in a horizontal row and connected to each other. In the illustrated osteotomy tool, a plurality of drill guides 1 are connected so that the opening at the tip is arranged in a straight line. This osteotomy tool is suitable for cutting the bone 4 in a straight line. However, the osteotomy instrument of the present invention can also connect a plurality of drill guides so that the tip opening is arranged in a curved shape.

  The plurality of drill guides 1 are in contact with the adjacent drill guides 1 and connected by a method such as welding or adhesion. Further, the plurality of drill guides can be connected in a horizontal row by being sandwiched by a connector such as a metal plate.

  The inner diameter of the drill guide 1 is set to an optimum size depending on the application to be used. However, for example, in an osteotomy device used for maxillary osteotomy, the inner diameter of the drill guide 1 is appropriately selected depending on the size of the bone to be cut off. Although it is not, it is usually 1.5 mm or less. Also, the osteotomy instrument used for callus extension is not particularly limited because it is appropriately tipped depending on the size of the bone to be cut, but it is usually 1.5 mm or less.

  The material of the drill guide 1 is not particularly limited as long as it is a material that can support the stress applied to the flexible shaft 2 at the time of bone separation, that is, a material that is not deformed by the rotating flexible shaft 2. Examples of such materials include reinforced resins reinforced with metals such as stainless steel, glass fibers, carbon fibers, and the like.

  The osteotomy instrument shown in FIG. 3 has the drill guide 1 as a straight line, and the osteotomy instruments of FIGS. 4 to 6 curve the drill guide 1. The degree of curvature of the drill guide 1 is appropriately selected depending on the position of the bone 4 to be disconnected in oral surgery, surgery for treatment of craniofacial deformation, etc., but is usually in the range of 0 to 110 degrees. Preferably, it exists in the range of 30 degree | times-100 degree | times. The osteotomy instrument of the curved drill guide 1 is suitable for maxillary osteotomy. This is because the tip of the drill guide 1 can be arranged at the part to be cut as shown in FIG. The drill guide 1 has a strength that is not deformed by the rotating flexible shaft 2. For example, if the drill guide 1 is flexible enough to be deformed by hand and has a shape-retaining property held in a deformed shape, the drill guide 1 It can be conveniently used after being transformed into the most suitable shape.

  The flexible shaft 2 includes a drill-like blade 3 at the tip. The drill-like blade 3 of the flexible shaft 2 is accommodated in the drill guide 1 before use. And it protrudes from the drill guide 1 in use. Since the flexible shaft 2 is inserted into the drill guide 1 and rotated, the flexible shaft 2 is inserted through the drill guide 1 so as to be rotatable, and is usually less than 1.5 mm.

  The flexible shaft 2 rotates the rear end protruding from the drill guide 1 and rotates the drill-like blade 3 at the tip. Further, as shown in FIGS. 4 to 6, in the state of being inserted into the bending drill guide 1, the rear end is rotationally driven to rotate the drill-like blade 3 at the tip while bending inside the drill guide 1. Let That is, the flexible shaft 2 can be deformed into the shape of the drill guide 1 but can transmit the rotational force at the rear end to the drill-like blade 3 at the front end. As the flexible shaft 2 having physical properties, a braided string knitted with a filament such as iron or stainless steel is used.

  The drill-like blade 3 is not particularly limited as long as it has a material and a structure having sufficient strength and hardness to pierce the bone 4. Examples of the material include steel and iron whose surface is diamond processed. The drill blade 3 is preferably a self-tapping tool. The self-tapping drill-like blade 3 has a sharp tip, and can be accurately drilled at a specific position of the bone 4 without side skidding when rotated.

  The osteotomy instrument of the present invention can be provided with a single flexible shaft 2 as shown in FIGS. 3 to 5 or with a plurality of flexible shafts 2 as shown in FIG.

  The osteotomy instrument having one flexible shaft 2 inserts one flexible shaft 2 into another drill guide 1 one after another, cuts the bone 4 by drilling a plurality of holes 6 on the planned cutting position 5. To do. In this osteotomy instrument, the flexible shaft 2 is inserted into the specific drill guide 1 in a state where the tips of the plurality of drill guides 1 are fixed so as to be directed to the planned cutting position 5 on the bone 4. The inserted flexible shaft 2 is rotated and a hole 6 is drilled on the planned cutting position 5 of the bone 4. The flexible shaft 2 is pulled out from the drill guide 1 and inserted into another drill guide 1. The flexible shaft 2 is rotated and a hole 6 is drilled at another position on the planned cutting position 5 of the bone 4. Thereafter, similarly, a plurality of holes 6 are drilled side by side on the planned cutting position 5, and the bone 4 is cut at a predetermined position. In this osteotomy device, one flexible shaft 2 is inserted into a plurality of drill guides 1 in order from the end, for example, aligned in order on the planned cutting position 5, and a plurality of holes 6 are perforated. 4 is cut off. However, the flexible shaft 2 can be inserted into an arbitrary drill guide 1 at random, and a plurality of holes 6 can be formed on the planned cutting position 5 and cut.

  The osteotomy instrument having a plurality of flexible shafts 2 detaches the bone 4 by drilling a plurality of holes 6 on the planned cutting position 5 of the bone 4 without pulling the flexible shaft 2 from the drill guide 1. In the osteotomy instrument, the plurality of drill guides 1 are fixed so that the distal ends of the drill guides 1 are directed to the planned cutting positions 5 on the bone 4, and the flexible shaft 2 is rotated to drill a plurality of holes 6. However, this osteotomy device rotates one flexible shaft 2 and drills a bone 4 with a drill-like blade 3, and then does not pull out the drill-like blade 3 from the drilled hole 6, that is, a drill-like shape. With the blade 3 inserted in the hole 6, the remaining flexible shaft 2 can be rotated while the drill guide 1 is positioned with the drill-shaped blade 3 to drill a plurality of holes 6.

  For example, the plurality of flexible shafts 2 are rotated in order from the end, and the holes 6 are bored side by side on the planned cutting position 5. However, the plurality of flexible shafts 2 can also sequentially drill the plurality of holes 6 by rotating the arbitrary flexible shaft 2 at random. Further, the plurality of flexible shafts 2 can be simultaneously rotated in conjunction with each other. This osteotomy instrument has the feature that it can drill a plurality of holes 6 in a short time.

  As described above, the osteotomy instrument of the present invention drills the plurality of holes 6 on the planned cutting position 5 of the bone 4 and cuts the bone 4 at a predetermined position. However, at this time, it is also possible to use the osteotomy device of the present invention and the bone chisel together if necessary. The bone 4 having a plurality of holes 6 drilled at the planned cutting position 5 using the osteotomy device of the present invention can be cut off very easily even by using a bone chisel or the like. This is because the burden on the skull base can be reduced and complications can be effectively prevented as compared to disconnection.

It is a perspective view which shows the conventional osteotomy instrument. It is a top view which shows the use condition of the osteotomy instrument shown in FIG. It is the schematic of the osteotomy device concerning one Example of this invention. It is the schematic of the osteotomy instrument concerning the other Example of this invention. It is a schematic perspective view which shows the use condition of the osteotomy instrument shown in FIG. It is a schematic perspective view which shows the use condition of the osteotomy instrument concerning the other Example of this invention. It is a figure which shows the usage example of the osteotomy instrument which has the curved drill guide, Comprising: It is the figure which looked at the maxillary bone right front part from the downward direction.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Drill guide 2 ... Flexible shaft 3 ... Drill-shaped blade 4 ... Bone 5 ... Scheduled cutting position 6 ... Hole 10 ... Osteotomy machine body 11 ... Saw blade body 12 ... Saw blade

Claims (10)

  A cylindrical drill guide (1) connected in at least two horizontal rows, and a flexible shaft (2) passing through the inside of the drill guide (1) and provided with a drill-like blade (3) at the tip. An osteotomy device comprising a flexible shaft (2) and cutting the bone (4).   The osteotomy instrument according to claim 1, characterized in that the drill guide (1) is curved.   The osteotomy instrument according to claim 1 or 2, characterized by comprising the drill guide (1) and one or more flexible shafts (2).   The bone according to claim 1 or 2, comprising the drill guide (1) and a flexible shaft (2) inserted through the drill guide (1) so that a drill-like blade (3) can be inserted and removed. Cutting tool.   The osteotomy device according to any one of claims 1 to 4, wherein the osteotomy device is used for intraoral surgery.   The osteotomy device according to any one of claims 1 to 5, which is an osteotomy device used for surgery in the treatment of craniofacial deformation.   The osteotomy device according to any one of claims 1 to 4, wherein the osteotomy device is used for callus extension.   The osteotomy instrument according to any one of claims 1 to 7, wherein the plurality of drill guides (1) are connected so that the opening at the tip is arranged linearly or arranged in a curved shape. .   The osteotomy device according to any one of claims 1 to 7, wherein the drill-like blade (3) is self-tapping. The osteotomy instrument according to any one of claims 1 to 7, wherein 3 to 15 drill guides (1) are connected in a horizontal row.

Images