JP2007307041A - Device for body fixation - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a device for body fixation, which is excellent in positioning precision, has reproducibility and has adaptability widely adaptable of various individual differences of a living body shape when positioning a living body, especially the membrum. <P>SOLUTION: The leg of a subject is softly and planarly supported on the back side of the knee by a pad 38 for a proximal position and is held by a belt 32. The part of the ankle is held on a heel mounting base 44 fixed with a rotating angle in the direction of opening the toes. The characteristic bone part of the bone (tibia) of a measurement object is horizontally positioned by a reference plane on a caput fibulae abutting base 36 with a height adjusting function and a reference plane on a lateral malleolus abutting base 82. <P>COPYRIGHT: (C)2008,JPO&INPIT

Description

  The present invention relates to a living body fixing device, and more particularly to an apparatus for positioning and fixing living bodies (limbs) such as upper limbs and lower limbs.

  Research has been conducted on measuring or diagnosing mechanical properties such as bone strength, elasticity and viscoelasticity using ultrasonic waves. In this study, the amount of minute bone displacement that occurs when pressure is applied to the bone from outside the body is quantitatively measured by ultrasound. In order to measure bone strength and elasticity, viscoelasticity, plasticity and the like based on the amount of bone displacement, it is important to correctly position the target bone. In particular, when ultrasonically diagnosing bone properties and the degree of fusion at a fracture site under a three-point bending load, it is necessary to correctly position the target tissue including the target bone and securely fix the target tissue. In surgery and other cases, accurate positioning and fixing of the target tissue is required. A technique for ultrasonically diagnosing bone properties and the degree of fusion at a fracture site under a three-point bending load is disclosed in, for example, unpublished Japanese Patent Application No. 2004-362455. For example, Japanese Patent Application No. 2005-379978, Japanese Patent Application No. 2005-37979, and Japanese Patent Application No. 2005-379980 disclose devices for fixing a limb of a living body for diagnosis or treatment. .

  Incidentally, the following Patent Documents 1 and 2 describe a method for diagnosing bone fusion using ultrasonic waves.

JP 2004-298205 A JP 2005-152079 A

  In terms of positioning and fixing a living tissue, when an external force is artificially applied to a bone, a problem is likely to occur in terms of accuracy measurement. That is, since the bones in the body are covered with muscle tissue and skin, it is difficult to accurately position the bones themselves. Therefore, since the reproducibility of positioning can only be performed with low accuracy, when bone diagnosis such as bone strength and elasticity, viscoelasticity, plasticity etc. is continuously performed for several days to several months for a certain bone to be examined However, there is a problem that it is difficult to ensure the reproducibility of measurement without establishing a positioning method.

  It is an object of the present invention to provide a living body fixing device having an adaptability capable of widely adapting to various individual differences in the shape of a living body, in particular when positioning a living body, particularly a limb, having high positioning accuracy and reproducibility. It is to provide.

  The present invention relates to a living body fixing device that fixes a living body with reference to a characteristic bone portion that can be identified from the body surface, and a proximal holding mechanism that holds the proximal portion of the living body, and a distal portion of the living body A proximal abutment portion for mounting at least one proximal feature bone portion present on the proximal portion through the body surface. A proximal support part for generally supporting the proximal part, wherein the distal holding mechanism mounts at least one distal characteristic bone part existing on the distal part via the body surface And a distal support part that supports the distal part as a whole.

  According to the above configuration, the living body is accurately held by a combination of both the proximal holding mechanism and the distal holding mechanism. For example, since the proximal holding mechanism has a proximal abutting portion and a proximal support portion, the proximal abutting portion performs accurate positioning based on the positioning of the proximal characteristic bone portion as a reference for positioning. The weight of the proximal limb can be supported by the position support part. By having the functions of the proximal contact portion for positioning reference and the proximal support portion for supporting the limb, the burden of maintaining the posture of the subject can be reduced. The distal holding mechanism also includes a distal abutment portion and a distal support portion. Like the proximal retention mechanism, the distal abutment portion accurately positions the distal characteristic bone portion as a reference for positioning. It is possible to support the weight of the limb in the distal portion by the distal support portion while performing proper positioning. Here, the terms “proximal” and “distal” indicate a perspective relationship as viewed from the trunk, and a region close to the fingertip or toe is referred to as “distal”, and a region close to the trunk is referred to as “proximal”. The living body to be fixed is preferably a limb such as a foot or an arm. The characteristic bone portion is preferably a local area of the bone that is protruding or raised. For example, it is a protruding or raised bone part that can be recognized by touching or observing the shape of the bone surface existing in the living body from above the skin. In that case, it is desirable that the skin layer of the characteristic bone portion is thinner.

  Preferably, the base member on which the proximal holding mechanism and the distal holding mechanism are installed, at least one of the proximal holding mechanism and the distal holding mechanism, and the relative position of the base member are adjusted. And a position adjusting mechanism.

  According to the above configuration, since the relative positional relationship between the proximal holding mechanism and the distal holding mechanism is defined through the base member, for example, one coordinate system with respect to the base member is defined. Can do. According to this configuration, the position of the distal fixing mechanism may be adjusted after the proximal fixing mechanism is first fixed to the base member, or conversely, the distal fixing mechanism is first fixed to the base member. In addition, the position of the proximal fixing mechanism may be adjusted.

  Preferably, the proximal abutment portion includes a proximal reference surface that contacts a specific proximal feature bone portion existing in the proximal portion via a skin layer, and the proximal reference surface is the proximal support surface. And a horizontal position adjusting mechanism for adjusting a horizontal position relative to the unit.

  According to the above configuration, the proximal portion has a proximal reference surface as a positioning reference and a support base that supports the weight of the proximal portion, and the position of the proximal reference surface can be adjusted in the horizontal direction. It becomes possible. Even when the proximal portion of the living body is positioned by the proximal support base, the proximal reference plane can be horizontally moved independently without being restricted by the installation location of the proximal support base. Therefore, it is most suitable for the proximal positioning of the living body, or it is possible to accurately support the load that presses the bone, or the proximal reference with respect to the less burdened portion of the living body that is pressed against the skin Can touch the surface.

  Preferably, the distal abutment portion includes a distal reference surface that contacts a specific distal feature bone portion existing in the distal portion via a skin layer, and the distal reference surface is the distal support surface. And a horizontal position adjusting mechanism for adjusting a horizontal position relative to the unit.

  According to the above configuration, for example, in the distal portion as well as the proximal portion, it is most suitable for positioning the distal end of the living body, or can accurately support the load that presses against the bone, or the skin. The distal reference plane can be brought into contact with a portion of the living body that is pressed with a small burden.

  Preferably, it includes a mechanism for adjusting the height of each of the proximal reference surface and the distal reference surface. According to the above configuration, the height of the proximal reference plane or the distal reference plane can be optimized together with the horizontal position adjusting mechanism. A height adjustment mechanism can also be used to adjust the bone to be examined horizontally.

  Preferably, the distal support portion includes a heel mount on which the biological heel is placed. When the bone to be examined is a site below the knee, it is desirable to use a strong heel for positioning in the human body.

  Preferably, the heel mount is rotated with the living body's heel mounted thereon, thereby rotating the living body's feet with the extending direction as a rotation axis.

  Preferably, the direction of the flat surface of the tibia in the living body is adjusted by rotating the foot of the living body with the heel mount.

  Preferably, the proximal abutting portion supports the radial head which is the proximal characteristic bone portion, and the distal abutting portion supports the external fruit which is the distal characteristic bone portion. To do. When fixing the legs, especially the lower leg of the ankle from below the knee, either the radial head as the characteristic bone part located proximal to the rib or the external fruit as the characteristic bone part located distal to the rib It is desirable to use as. Alternatively, it is also possible to use the endometrium as a characteristic bone portion located distal to the tibia.

  As described above, according to the living body fixing device of the present invention, when positioning a living body, the positioning accuracy is good and has reproducibility, and has adaptability capable of widely dealing with various individual differences in living body shape. Can do.

  DESCRIPTION OF EXEMPLARY EMBODIMENTS Hereinafter, preferred embodiments of the invention will be described with reference to the drawings.

  FIG. 1 is an overall view schematically showing a state in which the subject's left foot is being examined using the biological fixation device 100 according to the present embodiment. FIG. 1 shows a subject 10, a chair bed 12, a biological fixation device 100, and the like. First, the relationship between the subject 10 and the chair bed 12 will be described.

  The subject 10 is lying on his back on the chair bed 12 for bone diagnosis. The chair bed 12 includes a bed portion and a pedestal portion. The bed portion is composed of a headrest 16, a backrest 14, and the like. The pedestal includes a caster 18, a four-wheel caster lock mechanism (not shown), a chair bed height adjusting mechanism 17, and the like.

  Here, an example of a procedure for using the chair bed 12 when bone diagnosis is performed will be described. First, the subject 10 is seated on the chair bed 12 with the backrest 14 standing. After the examiner who diagnoses the subject brings the chair bed 12 close to the biological fixation device 100, the examiner operates the four-wheel caster lock mechanism to lock all the casters 18 at appropriate positions on the floor surface. After the subject 10 temporarily places the foot to be examined on the living body fixing device 100, the examiner adjusts the angle so that the backrest 14 is slightly inclined using a hydraulic mechanism (not shown). An easy tilt angle for 10 is set. Of course, the examiner can fully support the operation of temporarily placing the feet of the subject. Further, the examiner uses the chair bed height adjusting mechanism 17 to adjust the heights of the subject 10 and the biological fixation device 100. By such a procedure, the left foot 10 </ b> A of the subject 10 is temporarily placed on the biological fixation device 100.

  Next, description of the biological fixation device 100 will be given. The living body fixing device 100 is fixed on a device base 24 that is solidly made by combining metal pillars. Level adjusters 26 are provided at the four corners of the lower part of the device base 24, and are used to install the biological fixation device 100 horizontally. On the upper surface of the device table 24, the biological fixation device 100 and the temporary table 28 are placed. The temporary placing table 28 is a cuboid-shaped lightweight part made of, for example, a foaming member, and is additionally used as a foot placing table that is not an inspection target for the convenience of the subject 10. In FIG. 1, a right foot 10 </ b> B that is not an inspection target is placed.

  FIG. 1 shows a state in which the subject's left foot 10 </ b> A is fixed to the living body fixing device 100. The left knee 10 </ b> C is fixed by the proximal holding part 30, and the left ankle 10 </ b> D is fixed by the distal holding part 40. More specifically, the left knee 10C is placed on the proximal support base 34, and the knee is wound around the belt 32 and fixed. The left ankle 10D is placed on the heel mount 44, and a belt is wound around the ankle. A radial head contact table 36 is disposed near the left knee 10C, and an external fruit contact table 82 is disposed near the left ankle 10D. These components will be described later with reference to FIG. . A bone examination pressure device 200 for bone diagnosis is fixedly mounted on the base 42 at the shin portion of the subject's left foot 10A. The bone inspection pressure device 200 is a device for pressing the bone to be examined. In FIG. 1, the inner portion 10E of the shin of the left leg of the subject is pressed by the bone inspection pressure device 200. The state of being pressed by the mechanism is shown.

  FIG. 2 is a perspective view showing a preferred embodiment of the biological fixation device according to this embodiment. A biological fixation device 100 is provided on the device base 24. As a configuration mechanism of the biological fixation device 100, a proximal holding portion 30 and a distal holding portion 40 are shown. FIG. 2 does not show the bone examination press 200 shown in FIG. A chair bed 12 is arranged on the back side, but the backrest is raised to form a reclining chair.

  FIG. 3 is a perspective view showing the entirety of the biological fixation device 100 according to the embodiment of the present invention. An XYZ coordinate system is defined as the reference coordinate system. The biological fixation device 100 is roughly divided into a base 42, a proximal holding unit 30, and a distal holding unit 40 when functionally divided. Hereinafter, description will be given in the order listed.

  The base 42 is disposed on the bottom surface as a flat pedestal that supports the entire apparatus. The base 42 incorporates a metal frame for ensuring rigidity and is covered with a resin exterior. Since the total weight of the components mounted on the base and the weight of the living body are added to the base 42 and a separate bone examination pressure device 200 (not shown) is also mounted, sufficient rigidity is ensured. ing. Since the bone examination pressure device 200 is placed between the proximal holding portion 30 and the distal holding portion 40, a separate bone examination pressure device 200 is mounted at a substantially central portion of the upper surface of the base 42. In order to do this, an iron substrate 33 is laid. Since the bottom surface portion of the bone examination pressure device 200 has a flat magnet base, the substrate 33 is used to adsorb and fix the bone examination pressure device 200.

  The proximal holding part 30 is located on the back side of the proximal support base 43, the proximal support base 34, the proximal pad 38, the belt 32, and the proximal pad 38 and is not shown in the figure. It consists of a pedestal (see FIG. 1) and the like. The radial head abutment base is disposed on the iron substrate 35. The proximal support base 43 is mounted on the base 42. The proximal support base 43 that functions as a position adjustment mechanism is coupled to the base 42 via a slide adjustment mechanism that allows movement in the X-axis direction. Therefore, the proximal support base 43 can move in the X-axis direction, and the position can be fixed by using a proximal X-axis lock lever (not shown). The bone diagnosis is usually performed with the position adjustment locked. A proximal support base 34 is fixed on the proximal support base 43. The proximal support base 34 is a part having a concave shape as a whole, and the inner surface of the recessed portion at the center is formed in a cylindrical shape. A proximal pad 38 is fitted into the recessed portion of the cylindrical surface. A belt 32 is attached to the concave shoulder portions of the proximal support base 34 that is generally concave. The proximal holding portion 30 is a mechanism for holding the knee portion of the foot, and the back side of the knee or the back side of the thigh is pressed against the proximal pad 38. The proximal pad 38 is made of a low-resilience urethane material. Alternatively, an impact absorbing material other than urethane or a foamable resin such as sponge may be used. The limb is generally softly supported by the proximal pad 38. A hook-and-loop fastener may be used for the belt.

  The radial head abutment base 36 (see FIG. 1) is a cylindrical part and is disposed on the upper surface of the proximal support base 43. The description of the radial head abutment base 36 will be described later with reference to FIG.

  The distal holding portion 40 includes a distal support base 48, a distal support base 45, a heel mount 44, a belt 56, and an outer fruit abutment base 82. The outer fruit abutment table 82 is disposed on the iron substrate 37. The distal support base 48 is mounted on the base 42. Further, a distal support base 45 is mounted on the distal support base 48. The distal support base 48 is coupled to the base 42 via a slide adjustment mechanism that allows movement in the Y-axis direction. Further, the distal support base 45 is coupled to the distal support base 48 via a position adjusting mechanism that enables movement in the X-axis direction. Therefore, the distal support base 45 is movable in the X axis direction and the Y axis direction with respect to the base 42. In particular, the position adjustment mechanism in the Y-axis direction functions effectively when adjusting the position of the distal holding base 45 in response to the fact that the length of the foot below the knee varies depending on the subject.

  On the distal support base 45, a saddle mount base 44 is coupled. Furthermore, the saddle mount 44 is coupled to the distal support 45 via a position adjusting mechanism that enables movement in the Z-axis direction. Therefore, the saddle mount 44 can move in the Z-axis direction with respect to the base 42. Each position adjustment mechanism is provided with a lock lever for each distal direction in the X axis, Y axis, and Z axis (not shown) to lock the position adjustment in each direction. Bone diagnosis is performed in the state.

  A plastic part having a shape surrounding the heel of the foot is used for the heel mount 44, and a belt 56 is wound around the ankle to fix the ankle. The heel mount 44 is provided so that the surface against which the sole of the foot is applied is inclined so as to be inclined approximately 30 degrees from the vertical direction of the Z-axis. This is because the posture in which the ankle is tilted so that the toes are away from the trunk is suitable for holding the foot comfortably and is often an easy posture for the subject. A spacer part may be inserted between the sole of the foot and the heel mount 44 to adjust the angle at which the ankle tilts according to the subject. When a virtual bone axis is defined in the extension direction of the tibia, a rotation mechanism is provided so that the heel mount 44 can freely rotate around the bone axis. In order to press vertically on the medial side of the proximal support base tibia (the almost flat bone surface located inside the shin and just below the skin layer), the entire tibia can be tilted approximately 45 degrees. preferable. The rotation mechanism of the heel mount works effectively even when the inspection foot is switched from one foot to the other foot for inspection. The opening direction of the toes is naturally different between the right foot and the left foot, so the rotation range of the heel mount 44 is assumed when the direction of viewing his / her feet from the eyes of the subject sleeping in a straight posture is assumed. When the left foot is placed, the rotation range is at least about 45 degrees counterclockwise with respect to the bone axis, and when the right foot is placed, the rotation range is at least about 45 degrees clockwise with respect to the bone axis. Note that a rotation locking lever is also provided in the rotation mechanism of the heel mount, and bone diagnosis is usually performed with the rotation locked.

  FIG. 4 is a perspective view showing the radial head abutment base 36. The radial head abutment 36 is a cylindrical part and is placed on the iron substrate 35 on the proximal support base 43 (see FIG. 3). A magnet base 70 is provided on the bottom surface, and the magnetic force can be turned on and off by operating the lever 72. The cylindrical portion 78 subjected to the knurling process has a female screw portion formed on the inner surface, and the female screw portion is screwed to the male screw portion 74.

  By rotating the cylindrical portion 78, the height of the reference surface 76 that is the upper end surface of the cylindrical portion 78 is adjusted. The height of the reference surface 76 against which the characteristic bone portion is abutted through the skin is adjusted up and down by a height adjusting mechanism in which the male screw portion 74 and the female screw portion are screwed together. By using the height adjustment mechanism, the height for supporting the radial head can be adjusted. In order to easily support the weight of the foot, it is preferable that the reference surface 76 is directed upward. The reference surface 76 is not limited to a flat surface, and may have a counterbore or a depression. Alternatively, the reference surface 76 may be covered with soft rubber or the like within a range that does not affect the accuracy and reproducibility of data measurement. In the present embodiment, the outer fruit abutment table 82 (see FIG. 3) has the same structure as the radial head abutment table 36 (see FIG. 4). However, the diameter and height of the cylindrical shape may be changed as appropriate for the outer fruit abutment table 82, or the material of the shape of the reference surface may be changed.

  When a three-point bending load is to be applied to the bone, both ends of the bone need surfaces that serve as positioning references. This is because there are two reference planes that support both ends of the bone, and the amount of flexure of the bone can be measured by pressing the bone near the center under the condition that the reference plane does not move. In the present embodiment, the reference plane indispensable for the three-point bending load is formed by the two reference planes of the radial head contact base 36 and the external fruit contact base 82. The radial head, which is a characteristic bone portion of the radius, is brought into contact with the reference surface on the radius head abutment table 36 through the skin layer. The outer fruit which is the characteristic bone part of the rib is brought into contact with the reference surface on the outer fruit contacting table 82 through the skin layer. Since the height of each of the two reference planes can be adjusted independently, the bone to be examined can be adjusted to be horizontal. The bone positioned horizontally by the two reference planes is pressed against the inner surface of the tibia near the center of the bone by using the bone examination press 200 or the like.

  FIG. 5 shows a biological fixation device 150 according to another embodiment. Constituent parts of the biological fixation device 150 that are functionally the same as those of the biological fixation device 100 described above are denoted by the same reference numerals and description thereof is omitted. One of the features of the biological fixation device 150 is that a pedestal 60 for fixing the pressure device for bone examination is provided at a substantially central portion of the base 42. The pedestal 60 is configured separately from the base 42 and can be removed. Since the pedestal 60 has an arch shape (gate shape) as shown in the drawing, when the pedestal 60 is placed on the base 42, a space is created so as to surround the positioned foot. Therefore, the pedestal 60 can be placed on the base 42 without interfering with the positioned foot.

  The radial head abutment table 36 and the external fruit abutment table 82 are both disposed on a horizontal iron substrate. The position in the horizontal direction can be adjusted on the base 42 or the distal support 45 by attaching and detaching with magnetic force. FIG. 5 shows that the radial head abutment table 36 and the external fruit abutment table 82 can be horizontally moved independently in the X-axis direction or the Y-axis direction, respectively.

  As described above, according to the present embodiment, it is possible to reduce the burden of maintaining the posture of the subject and perform positioning with good reproducibility. By the easy action of placing the foot, the subject can perform positioning and fixing without feeling uncomfortable.

It is a perspective view which shows suitable embodiment of the biofixation apparatus which concerns on this invention. It is a perspective view which shows the state which installed the biological fixing apparatus which concerns on this invention. It is a perspective view which shows the whole external appearance of the biological fixing apparatus concerning embodiment of this invention. It is a perspective view of a radius head contact base. It is a perspective view which shows the whole external appearance of the biological fixing apparatus concerning other embodiment of this invention.

Explanation of symbols

  30 Proximal holder, 32 Belt, 33 Substrate, 35 Substrate, 36 Radial head abutment, 37 Substrate, 38 Proximal pad, 40 Distal retainer, 42 Base, 43 Proximal support base, 44 踵, 45 Distal support base, 48 Distal support base, 56 belt, 82 External fruit abutment base, 100 Biological fixation device.

Claims (9)

A biological fixation device that fixes a living body with reference to a characteristic bone part that can be identified from the body surface,
A proximal holding mechanism for holding the proximal portion of the living body;
A distal holding mechanism for holding the distal portion of the living body;
Have
The proximal retention mechanism comprises:
A proximal abutment for placing at least one proximal feature bone portion present in the proximal portion over the body surface;
A proximal support that generally supports the proximal portion;
Including
The distal retention mechanism is
A distal abutment for mounting at least one distal characteristic bone portion present in the distal portion through a body surface;
A distal support that generally supports the distal portion;
A biofixing device comprising: The biological fixation device according to claim 1,
A base member on which the proximal retention mechanism and the distal retention mechanism are installed;
A position adjusting mechanism for adjusting a relative position between at least one of the proximal holding mechanism and the distal holding mechanism and the base member;
A biological immobilization device comprising: The biological fixation device according to claim 1,
The proximal abutment portion is
A proximal reference plane in contact with a particular proximal feature bone portion present in the proximal portion via a skin layer;
The proximal fixing surface has a horizontal position adjusting mechanism for adjusting a horizontal position relative to the proximal support portion. The biological fixation device according to claim 1,
The distal abutment portion is
A distal reference surface in contact with a particular distal feature bone portion present in the distal portion via a skin layer;
The living body fixing device, wherein the distal reference surface has a horizontal position adjusting mechanism that adjusts a horizontal position relative to the distal support portion. The biological fixation device according to claim 3 or 4,
A living body fixing device comprising a mechanism for adjusting the height of each of the proximal reference surface and the distal reference surface. The biological fixation device according to claim 1,
The said distal support part is equipped with the heel mounting base which mounts the heel of the said biological body, The biological fixing device characterized by the above-mentioned. The biological fixation device according to claim 6, wherein
The living body fixing device, wherein the heel mount is rotated with the living body's heel placed thereon, thereby rotating the living body's legs with the extending direction as a rotation axis. The biological fixation device according to claim 7,
A living body fixing device that adjusts a direction of a flat surface of a tibia in a living body by rotating a foot of the living body by the heel mount. The biological fixation device according to claim 8, wherein
The proximal abutment portion supports the radial head which is the proximal characteristic bone portion;
The distal abutment portion supports an outer fruit which is the distal characteristic bone portion.