JP2005304607A - Fixation device for fracture treatment - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To make a plate for fracture treatments thin to solve the problem that soft tissues at a site where the plate is embedded swell. <P>SOLUTION: A fixation device for fracture treatments is equipped with a plate 7 with a plurality of screw inserting holes, a plurality of screws 10 which penetrate through each screw inserting hole to a bone to fix the plate on the bone and include at least one screw with a head portion 10a formed into a spherical form, and a embedded nut 17 screwed on the entrance of the inserting hole 13 for the screw with the spherical head portion, and has spherical surface seats 18, 21 which hold the spherical head portion of the screw between them and are respectively formed on the exit side of the inserting hole and the end surface of the nut. A male thread 20 of the embedded nut and a female thread 19 of the inserting hole are formed to enclose the maximum diameter part of the spherical head portion of the screw, and a locking hole 22 for a tool for rotating the embedded nut is formed at a boundary part between the male thread and the spherical surface seat of the embedded nut. Consequently, a thickness of the plate is reduced, and the swelling of the soft tissues 24 is prevented. <P>COPYRIGHT: (C)2006,JPO&NCIPI

Description

  The present invention relates to a fixing device for treating a fracture such as a proximal portion of a humerus.

  Conventionally, a fixture composed of a plate and various screws is used to treat a fracture of the distal portion of the humerus. In the treatment, the plate is applied to the fractured humerus, and a plurality of screws are passed through the bone from the outside of the plate. A spherical surface is formed on the head of some screws, and a spherical seat that supports the head of the screw is formed on the plate. A female screw is formed on the upper surface of the spherical seat of the plate, and the male screw of the embedded nut is screwed into the female screw. A spherical seat is formed on the embedded nut, and this spherical seat contacts the spherical surface of the screw head. Thereby, even if the direction of the screw is not constant, the screw can be fixed by the fixing screw, and therefore, the sitting of the plate with respect to the bone can be improved and an appropriate fixing force can be obtained (see, for example, Patent Document 1). ).

JP 2002-153478 A

  However, the embedded nut in the conventional fixing tool is formed to have a diameter substantially the same as the diameter of the spherical head of the screw, and a hexagonal hole for inserting a wrench is formed at the center of the top surface. For this reason, the embedded nut becomes thick with the plate. As a result, there is a problem that the soft tissue of the place where the plate is embedded rises. The conventional fixing device is for treating a fracture of the distal portion of the humerus and is difficult to use as it is for a fracture of the proximal portion.

  Therefore, an object of the present invention is to provide a fracture treatment fixture that can eliminate the above-mentioned problems.

  In order to solve the above-mentioned problems, the invention according to claim 1 includes a plate (7) in which a plurality of screw insertion holes (11, 12, 13) are formed and each screw insertion hole (11, 12, 13). A plurality of screws (8, 9, 10) having a spherical shape with at least one head (10a) penetrating into the bone (4, 5) and fixing the plate (7) to the bone (4, 5). ) And an embedded nut (17) screwed into the inlet of the insertion hole (13) of the screw (10) having a spherical head (10a). The outlet side of the insertion hole (13) and the nut (17) In the fracture treatment fixture in which the spherical seats (18, 21) sandwiching the spherical head (10a) of the screw (10) are formed on the end face of each, the male screw (20) of the embedded nut (17) is inserted. The female screw (19) in the hole (13) -It is formed so as to surround the maximum diameter part of the spherical head (10a) of (10), and the locking hole (22) of the embedded nut rotating tool is provided with the male screw (20) and the spherical seat ( 21) A fracture treatment fixture formed at the boundary with 21) is employed.

  According to a second aspect of the present invention, in the fracture treatment fixture according to the first aspect, the insertion hole (13) of the screw (10) having the spherical head (10a) is a surgical cervical fracture line of the humerus. A fracture treatment fixture formed in a direction extending across (3) from the diaphysis (5) to the head (4) is employed.

  The invention according to claim 3 is the fracture treatment fixture according to claim 1 or 2, wherein the hook (23) inserted into the large humerus (2) of the humerus is attached to the plate (7). The provided fracture treatment fixture is adopted.

  According to the first aspect of the present invention, the plate (7) in which a plurality of screw insertion holes (11, 12, 13) are formed, and each screw insertion hole (11, 12, 13) is made of bone (4, 5). ) And a plurality of screws (8, 9, 10) having a spherical shape with at least one head (10a) for fixing the plate (7) to the bone (4, 5). A screw (10) having a buried nut (17) screwed into the inlet of the insertion hole (13) of the screw (10), and a screw (on the outlet side of the insertion hole (13) and the end face of the nut (17). 10) In the fracture treatment fixture in which spherical seats (18, 21) sandwiching the spherical head (10a) of 10) are formed, the male screw (20) of the embedded nut (17) and the female of the insertion hole (13) Screw (19) is the spherical head of the screw (10) The locking hole (22) of the embedded nut rotating tool is formed at the boundary between the male screw (20) and the spherical seat (21) in the embedded nut (17). Therefore, the thickness of the embedding nut (17) and the plate (7) can be reduced, and therefore the soft tissue (24) is raised at the place where the plate (7) is embedded. Can be prevented.

  According to the second aspect of the present invention, in the fracture treatment fixture according to the first aspect, the insertion hole (13) of the screw (10) having the spherical head (10a) is a surgical cervical fracture line of the humerus. Since (3) was formed in a direction extending across the diaphysis (5) from the diaphysis (4), the screw (10) was connected to the surgical cervical fracture line (3) of the humerus from the diaphysis (5) to the diaphysis (4 ), And can be appropriately treated for fractures occurring in the proximal portion of the humerus.

  According to the invention according to claim 3, in the fracture treatment fixture according to claim 1 or 2, the hook (23) inserted into the large humerus (2) of the humerus is attached to the plate (7). Since it is provided, the bone piece of the large nodule (2) can be fixed to the plate (7) by hooking it with the hook (23).

  The best mode for carrying out the invention will be described below with reference to the drawings.

  The bone shown in FIG. 1 is the proximal portion of the humerus. In the proximal part of the humerus, fractures are particularly likely to occur in the surgical neck 1 and the large nodule 2. Reference numeral 3 indicates a fracture line generated in the surgical neck 1 between the head 4 and the diaphysis 5, and reference numeral 6 indicates a fracture line generated in the major nodule 2.

  The fracture treatment fixture shown in FIGS. 1 (A), 1 (B) and 2 is configured to be suitable for the treatment of a fracture at the proximal portion of the humerus, and is attached to the proximal portion of the humerus. And a plurality of screws 8, 9, 10 for fixing the plate 7 to the bone.

  The plate 7 is formed in such a shape that it hits from the large nodule 2 side to a portion extending from the upper part of the diaphysis 5 to the head 4 at the proximal part of the humerus. The plate 7 is made of, for example, a titanium alloy, stainless steel, or the like.

  A plurality of screw insertion holes 11 that open toward the inside of the bone head 4 are formed in a dispersed manner at locations corresponding to the large nodules 2 in the plate 7. In addition, a plurality of screw insertion holes 12 that open in a direction crossing the diaphysis 5 are formed along the bone axis at locations corresponding to the diaphysis 5 in the plate 7. Further, a screw insertion hole 13 is formed at a position corresponding to the surgical neck portion of the diaphysis 5 on the plate 7 so as to open the surgical cervical fracture line 3 in a direction extending from the diaphysis 5 to the head 4.

  As shown in FIG. 1, the screws are a first screw 8 passed through the head 4, a second screw 9 passed through the diaphysis 5, and a third screw passed from the diaphysis 5 to the head 4. Three types are prepared. Of course, more types or a greater number of screws can be prepared depending on the shape of the fracture, the size of the bone and the like.

  The heads 8a and 9a of the first and second screws 8 and 9 that are passed through the bone head 4 and the diaphysis 5, respectively, have a flat top surface, and a portion adjacent to the screw shaft is formed as a hemispherical surface 14. A locking hole 15 for locking a screw rotating tool such as a hexagon wrench (not shown) is formed on the top surface of the heads 8a and 9a. As shown in FIG. 2, a hemispherical spherical seat 16 is formed on the inlet side of the screw insertion holes 11 and 12 through which the first and second screws 8 and 9 pass in the plate 7. When the first and second screws 8 and 9 pass through the screw insertion holes 11 and 12 into the bones, and the heads 8a and 9a of the screws 8 and 9 are buried in the screw insertion holes 11 and 12, the screws The screwing between the 8 and 9 spirals and the bone ends. Further, since the hemispherical surfaces 14 of the heads 8a and 9a of the screws 8 and 9 abut against the spherical seat 16 of the plate 7 at the time of screwing, even if the axis of each screw 8 and 9 is inclined with respect to the plate 7, the plate 7 Sits on the surface of the bone and makes good contact.

  The third screw 10 passed from the diaphysis 5 to the bone head 4 is called a lag screw, and is used to draw the bone head 4 toward the diaphysis 5. The head 10a of the third screw 10 is formed in a substantially spherical shape. Similar to the first and second screws 8 and 9, a locking hole (not shown) for locking the screw rotating tool is formed on the top surface of the head 10a. As shown in FIG. 2, a substantially hemispherical spherical seat 18 is formed on the outlet side of the screw insertion hole 13 through which the third screw 10 passes in the plate 7. When the third screw 10 penetrates the screw insertion hole 13 from the diaphysis 5 to the skull 4 across the fracture line 3, and the head 10a of the third screw 10 enters the screw insertion hole 13, the third screw 10 The screwing of the ten spirals and the bone is completed. When the screwing is completed, the lower hemispherical surface of the head 10a of the third screw 10 hits the spherical seat 18 of the plate 7, and the third screw 10 is satisfactorily connected to the plate 7.

  A substantially disc-shaped embedded nut 17 is screwed into the inlet of the screw insertion hole 13 into which the third screw 10 is inserted in the plate 7. A female screw 19 is formed at the entrance of the screw insertion hole 13 so as to surround the maximum diameter portion of the spherical head 10 a of the screw 10 seated on the spherical seat 18. A mating male screw 20 is formed. A spherical seat 21 that sandwiches the spherical head 10 a of the third screw 10 together with the spherical seat 18 on the outlet side of the screw insertion hole 13 is formed on the end face of the embedded nut 17. When the embedded nut 17 is screwed toward the head 10a side of the third screw 10, the head 10a of the third screw 10 is moved to the spherical seat 18 on the insertion hole 13 side and the spherical seat 21 on the embedded nut 17 side. As a result, the third screw 10 is fixed to the plate 7 so as not to move. Further, the third nut 10 is prevented from dropping from the insertion hole 13 by the embedded nut 17.

  As shown in FIG. 2, a locking hole 22 for the embedded nut rotating tool is formed at the boundary between the male screw 20 and the spherical seat 21 on the top surface of the embedded nut 17. A plurality of locking holes 22 are formed along the male screw 20 at certain angles. The embedded nut rotating tool is a wrench having a pin that enters all the locking holes 22 (not shown), and the embedded nut 17 can be rotated and retracted by this wrench. Thus, the locking hole 22 is formed at the boundary between the male screw 20 and the spherical seat 21 on the top surface of the embedded nut 17, so that the female male screw 19, 20 is the largest diameter portion of the spherical head 10 a of the screw 10. And the embedded nut 17 can be made thinner.

  As shown in FIGS. 1A and 1B and FIG. 2, a hook 23 inserted into the large nodule 2 is provided as necessary at a location corresponding to the large nodule 2 of the humerus in the plate 7. Although the fracture of the proximal portion of the humerus is likely to involve the fracture of the large nodule 2, the bone piece of the large nodule 2 can be fixed to the plate 7 by inserting the hook 23 into the bone piece of the large nodule 2.

  Next, the operation of the fracture treatment fixture having the above-described configuration will be described.

  As shown in FIGS. 1A and 1B, it is assumed that a fracture occurs in the surgical neck 1 and the large nodule 2 in the proximal portion of the humerus.

  The surgeon incises the soft tissue 24 and applies the plate 7 from the large nodule 2 side to the location from the diaphysis 5 to the head 4 at the proximal portion of the humerus.

  A drill blade (not shown) is inserted into the insertion holes 11 and 12 of the plate 7 to make pilot holes in the diaphysis 5 and the head 4, and then the first and second screws 8 and 9 are rotated with a screw rotating tool such as a wrench. While screwing into the bone. When the heads 8a and 9a of the screws 8 and 9 are buried in the screw insertion holes 11 and 12, the screwing of the screws 8 and 9 with the bone is finished.

  When the mounting of the screws 8 and 9 is completed, the hemispherical surface 14 of the heads 8 a and 9 a hits the spherical seat 16 of the plate 7, and the plate 7 even if the axis of the screws 8 and 9 is inclined with respect to the plate 7. Sits against the bone and makes good contact.

  Further, a drill blade (not shown) is inserted into the other insertion hole 13 of the plate 7 to open a pilot hole from the diaphysis 5 to the head 4 so as to cross the fracture line 3 of the surgical neck 1, and a steel wire (not shown) is provided in the pilot hole. insert. While rotating the third screw 10 with a screw rotating tool such as a wrench, the steel wire is used as a guide and screwed into the bone. Although not shown, the third screw 10 is previously formed with a hole through which a steel wire passes on its axis.

  When the head 10a of the third screw 10 enters the screw insertion hole 13, the screwing of the third screw 10 and the bone ends. The lower hemispherical surface of the head 10 a of the third screw 10 hits the spherical seat 18 of the plate 7, and the third screw 10 is satisfactorily connected to the plate 7.

  The embedded nut 17 is applied to the inlet of the screw insertion hole 13, the pin of the embedded nut rotating tool is inserted into the locking hole 22 on the top surface of the embedded nut 17, and the screw is inserted into the screw insertion hole 13 while turning the embedded nut 17. Enter.

  Thus, the head 10 a of the third screw 10 is sandwiched from above and below by the spherical seat 18 on the insertion hole 13 side and the spherical seat 21 on the embedded nut 17 side, and the third screw 10 is fixed to the plate 7. Further, when the space between the third screw 10 and the head 4 is loosened after the operation, the third nut 10 is prevented from falling out of the insertion hole 13 by the action of the embedded nut 17 as a cap.

  After the plate 7 is mounted with various screws 8, 9, and 10, the incision is sutured.

  As shown in FIG. 2, the locking hole 22 of the embedded nut rotating tool is formed at the boundary between the male screw 20 and the spherical seat 21 in the embedded nut 17, and the female and male screws 19, 20 for fixing the embedded nut 17. Is formed so as to surround the maximum diameter portion of the spherical head portion 10a of the screw 10, the embedded nut 17 and the plate 7 are thinned. As a result, the soft tissue 24 of the portion where the plate 7 is embedded is reduced. The climax is reduced.

  The present invention is not limited to the above-described embodiment. For example, in the above-described embodiment, the fracture treatment of the proximal portion of the humerus has been described, but the present invention can also be applied to the treatment of fractures at other sites.

(A) is a front view which shows the fixing tool for fracture treatment which concerns on this invention with the proximal part of a humerus, (B) is BB arrow sectional drawing in A figure. It is a perspective view of the MRI apparatus provided with the table apparatus. It is an enlarged view of a plate and a 3rd screw shown in Drawing 1 (B).

Explanation of symbols

2 ... Large nodule 3 ... Surgical cervical fracture line 4 ... Bone head 5 ... Stem 7 ... Plate 8, 9, 10 ... Screw 10a ... Spherical head 11, 12, 13 ... Screw insertion hole 17 ... Embedded nut 18, 21 ... Spherical seat DESCRIPTION OF SYMBOLS 19 ... Female screw 20 ... Male screw 22 ... Locking hole of embedded nut rotation tool 23 ... Hook

Claims (3)

  A plate having a plurality of screw insertion holes, a plurality of screws having a spherical shape with at least one head penetrating each screw insertion hole into the bone and fixing the plate to the bone, and a spherical head And an embedded nut that is screwed into an inlet of an insertion hole of the screw having a portion, and a spherical seat for sandwiching the spherical head of the screw between the outlet side of the insertion hole and the end surface of the nut, respectively, In the above, the male screw of the embedded nut and the female screw of the insertion hole are formed so as to surround the maximum diameter portion of the spherical head of the screw, and the locking hole of the tool for rotating the embedded nut is formed between the male screw and the spherical surface of the embedded nut. A fracture treatment fixture characterized by being formed at a boundary with a seat.   2. The fracture treatment fixture according to claim 1, wherein the insertion hole of the screw having a spherical head is formed in a direction extending across the surgical neck fracture line of the humerus from the diaphysis to the bone head. Fracture fixator.   The fracture treatment fixture according to claim 1 or 2, wherein the plate is provided with a hook that is inserted into a large nodule of the humerus.

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