JP2010115242A - Olecranon fracture therapeutic tool and collimator attached to olecranon fracture therapeutic tool - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To surely and stably implant a pin for medically treating a broken bone, generated at the olecranon after an artificial elbow joint replacement operation, by utilizing an artificial elbow joint. <P>SOLUTION: This olecranon fracture therapeutic tool consists of: a core block which is fitted in the joint surface of a joint surface body constituting an ulna component; an arm which is extended from the core block to a proximal side; a housing block which is installed on the rear end of the arm; and a guide sleeve which is inserted in the housing block to keep a hole bored for making the pin passed. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  INDUSTRIAL APPLICABILITY The present invention can preliminarily confirm the direction of a pin that is attached to the fracture treatment tool and inserted into the fracture treatment tool for treating a fracture that has occurred in the ulna of the ulna after artificial elbow joint replacement. It relates to the sight.

  There are various elbow diseases, but in either case, the artificial elbow joint may be replaced depending on the medical condition. Artificial elbow joints are loaded at the joints of the humerus and ulna, but fractures may occur after or during the treatment because of the need for osteotomy. In particular, since many elderly patients replace the artificial elbow joint, fractures often occur due to bone weakness. Fractures that occur at the elbow joint are often proximal to the large volume ulna, that is, the elbow head.

The basis of fracture treatment is to fix the fracture surface. Recently, many internal fixation methods have been introduced in which a pin, nail or the like (hereinafter referred to as a pin) is inserted into the bone and pierced through the fracture surface. An olecranon fracture is no exception, and an internal fixture as shown in Patent Document 1 below is used. In this case, since the location and method of piercing the pin are left to the doctor's freehand, skill and skill are required and stability is also lacking. In addition, when the artificial elbow joint was replaced, the pin could interfere with the ulnar component and fail to penetrate the target site successfully.
JP 2001-245894 A

  According to the present invention, a pin can be inserted stably and accurately by mounting a fracture treatment jig for pin insertion using an articular surface of an ulna component. In addition, the elbow joint function can be maintained during treatment. In addition, when inserting a pin from this jig, the direction can be confirmed in advance.

  Under the above-mentioned problems, the present invention provides a core block that is fitted to the joint surface of the joint face body constituting the ulna component, an arm that extends proximally from the core block, and an arm according to claim 1 The present invention provides an olecranon fracture treatment device comprising a housing block provided at the rear end of the housing block and a guide sleeve formed in the housing block and formed with a hole through which a pin can be inserted.

  According to the present invention, in the above fracture treatment device, the housing block according to claim 2 can be removed from the arm, and the guide sleeve according to claim 3 can slide back and forth within the housing block. A means capable of forming a plurality of holes in the guide sleeve according to claim 4 is provided.

  Furthermore, the present invention is an sighting device for measuring a pin insertion direction by the above-described fracture treatment device according to claim 5, wherein the sighting device includes a base attached to the housing block, a hole from the base to the guide sleeve, 7. A sighting device attached to an olecranon fracture treatment device characterized by comprising a rod extending parallel to the outside of the skin, wherein the base and the housing block have a dovetail relationship according to claim 6 Provides means for slidably fitting back and forth.

  According to the means of claim 1, since the core block constituting the fracture treatment tool is fitted to the joint surface of the joint face body of the ulna component, the holding is ensured and the posture is stabilized. Therefore, the pin can be inserted accurately and reliably at the target location.

  According to the second aspect of the present invention, the fracture treatment tool can be removed from the joint face body after inserting the pin, and the joint function can be maintained even during the fracture treatment by loading the humerus component on the joint face. . According to the third aspect of the present invention, even if there are individual differences in the size and shape of the elbow head, the guide sleeve can be brought into close contact with the elbow head of the ulna, and accurate and reliable insertion can be ensured. According to the means of claim 4, the selection of the insertion location of the pin is widened, and the insertion can be performed at the optimum position.

  According to the means of claim 5, since the direction in which the pin is inserted from the fracture treatment tool can be confirmed in advance, it is possible to avoid the situation where the pin is inserted into an inappropriate place, to ensure safety, and to reduce the burden on the patient. Reduce. And since this sight is a simple structure consisting of a base and a rod, it is easy to handle and operate.

  Hereinafter, embodiments of the present invention will be described with reference to the drawings. FIG. 9 is a plan view of a state in which an artificial elbow joint called a snap-in type is replaced with a living elbow joint and the left arm is straightened (with the palm up), and FIG. 10 is a side view of the left arm viewed from the inside. Although it is a figure, the artificial elbow joint of this invention consists of the humerus component 2 with which the humerus 1 side is loaded, and the ulna component 4 with which the ulna 3 side is loaded (5 is a radius).

  The humeral component 2 comprises a pulley 6 followed by a stem 7. The pulley 6 has a cylindrical body and exhibits a joint function with an articular surface body, which will be described later, of the ulna component 4, and is a biocompatible metal made of titanium alloy, cobalt chrome molybdenum alloy, stainless steel alloy, or the like, or medical ceramics, etc. Consists of. The stem 7 is an anchor that is inserted into the medullary cavity of the humerus 1 to fix the pulley 6. In this description, the position and direction are designated, but this is based on FIG. 2 and FIG.

  The ulna component 4 is composed of an articular face body 8 and a stem 9 following the joint face body 8. The joint surface body 8 is a substantially semi-cylindrical concave surface body, and the inner periphery thereof is used as a joint surface 8a, and the pulley 6 is rotatably held here. In the snap-in type artificial elbow joint, a space between both end portions (notch portions) of the concave body extends beyond the diameter, and an opening 10 having a width A is formed at a position around 45 ° rearward. The joint surface body 8 is made of metal and medical resin such as ultra-high molecular weight polyethylene having good sliding characteristics. Therefore, when the pulley 6 having a diameter larger than the width A of the opening 10 is inserted from the opposite side of the opening 10, the joint face body 8 is elastically deformed to accept the pulley 6, and in this respect, It is called a snap-in type.

  As described above, the pulley 6 and the joint surface 8a are movable on their contact surfaces to allow the elbow to rotate (bend and stretch) and allow a slight rotational motion. Will be played. The stem 9 is also inserted into the medullary cavity of the ulna 3 to fix the joint face body 8, and is made of the same material as the joint face body 8.

  When the above-mentioned artificial elbow joint is replaced with a living elbow joint, or during the replacement operation, a fracture may occur in the elbow head of the ulna 3 that has been relatively thinned by osteotomy. In this case as well, a pin is inserted. However, as described above, this operation is performed by a doctor's freehand, and thus certainty and stability may be lacking. In addition, when the artificial elbow joint was replaced, the pin could interfere with the ulnar component and fail to penetrate the target site successfully. In view of this, the present invention uses a joint face body of an ulna component and attaches a pin insertion jig thereto so that the pin can be inserted accurately and stably. In addition, the elbow joint function can be maintained during treatment.

  1 is a side view of a fracture treatment device according to the present invention, FIG. 2 is a partially sectional bottom view, and FIG. 3 is a rear view. This fracture treatment device is composed of a strong metal or resin or the like. Thus, the core block 11 fitted to the joint surface 8a of the joint face body 8, the arm 12 extending rearward from the core block 11, the housing block 13 provided at the rear end of the arm 12, and the housing block 13 are inserted. And a guide sleeve 14.

  The core block 11 is fitted and held without any play on the joint surface 8a. For this reason, the outer peripheral surface of the core block 11 has a circular shape corresponding to the shape of the joint surface 8a. However, in this example, the upper and lower thicknesses W of the arm 12 are partially cut out. It is formed in a parallel plane and the remainder is circular. This reason will be described later.

  The arm 12 extends rearward from one side of the core block 11 in a substantially 90-degree curve after extending backward substantially parallel to the parallel plane described above. Note that a stopper portion 11 a is formed at the rear end of the core block 11, and this is applied to the lower end of the opening 10 to secure the posture with the ulna component 4. The housing block 13 is attached to the rear end of the arm 12 substantially horizontally toward the joint face body 8 side. In this example, a fitting groove 15 is formed at the front end of the housing block 13, and the arm 12 is attached to the fitting groove 15. I accept it.

  Then, a screw hole is formed in the portion of the arm 12 to be inserted into the insertion groove 15 in the front-rear direction (a hole concentric with the screw hole is formed in the housing block 13). 16 is screwed into the screw hole of the arm 12 and fixed. Therefore, when the knob bolt 16 is loosened, the housing block 13 can be removed from the arm 12.

  Further, a guide sleeve 14 is inserted into the housing block 13. The guide sleeve 14 is configured to be slidable back and forth within the housing block 13 and is formed with a plurality of holes 18 into which pins 17 that pierce the fracture surface inward and outward can be inserted.

  The fracture treatment method using the above fracture treatment tool will be described. First, the affected part is incised to remove the pulley 6 from the joint face body 8. Next, the core block 11 is fitted to the joint surface 8a, and FIG. 4 is an explanatory view showing the state. When the core block 11 is fitted to the joint surface 8a, the thickness W of the core block 11 is Since it is set to be smaller than the width A of the opening 10, this thickness W portion is inserted into the opening 10 (the insertion has directionality).

  When the core block 11 is fitted to the joint surface 8a, the core block 11 is rotated downward until the stopper portion 11a hits the lower end of the opening 10 so that the guide sleeve 14 is parallel to the stem 9 of the ulna component 4. (This posture of the core block 11 is a normal posture). The reason why the core block 11 is inserted as described above is to prevent the ulna component 4 from being subjected to a load causing loosening during fitting.

  When the above is completed, the insertion direction of the pin 17 is confirmed in advance using the sighting device 19. 6 is a perspective view showing the mounting state of the sight 19 and FIG. 7 is a rear view. The sight 19 includes a base 20 extending in parallel to the housing block 13 and a rod 21 extending forward at right angles to the base 20. The base 20 is fitted and attached to the housing block 13 from the front-rear direction. At this time, the rod 21 is set so as to extend outside the bone (skin), but is set so as to indicate the insertion direction in a parallel relationship with the actual pin 17. Further, in order to adjust the tip position of the rod 21, the base 20 can slide back and forth with respect to the housing block 13.

  FIG. 7 is a rear view showing another example of the sighting device 19. In this example, the ant 13a is provided on one or both surfaces of the housing block 13 in the front-rear direction, and the bifurcated base 20 is provided on the inner surface. Is a dovetail relationship formed by forming dovetail grooves 20a that fit into the dovetails 13a. This is because the base 20 does not cause a positional shift in the inner and outer directions with respect to the housing block 13 and can slide smoothly without back and forth. In this case, the rod 21 is set so as to be located L outward from the center of the guide sleeve 14 and to be located H higher than the ulna component 4 (the upper surface of the stem 7) (H should be zero). The rod 21 and the hole 18 (pin 17) are in a parallel relationship.

  When the sighting device 19 is attached to the fracture treatment device in consideration of the above numerical values, the orientation and position of the rod 21 are visually confirmed, so that the actual pin 17 is directed to the target direction and, of course, the ulna component 4 It will also be possible to confirm whether or not interference occurs. When the rod 21 is in the normal direction, the pin 17 is inserted into the ulna 3 through the hole 18 of the guide sleeve 14 by a power tool (not shown).

  In this case, the positions in the inner and outer directions where the pins 17 are inserted are determined by selecting the holes 18. A plurality of holes 18 may be used, and a plurality of pins 17 may be inserted. Although illustration is omitted, if the hole of the housing block 13 through which the knob bolt 16 passes is made a long hole up and down, the vertical position can also be adjusted. Furthermore, if the knob bolt 16 is provided inward and outward so that the housing block 13 can be tilted up and down with respect to the arm 12, the insertion angle of the pin 17 can be adjusted.

  FIG. 5 is a side view showing a state in which the pin 17 is inserted. However, when the pin 17 is inserted, if the tip of the guide sleeve 14 is brought into contact with the elbow head, stable insertion can be ensured. The insertion depth of the pin 17 is up to the tip of the stem 9 of the ulna component 4, but if this depth is inserted, the fracture surface C passes through the fracture surface C wherever it is. . The pin 17 is made of a biocompatible metal having strength, specifically a titanium alloy or the like.

  When the insertion of the pin 17 is completed, the knob bolt 16 is loosened to remove the housing block 13 from the arm 12 (withdrawal from the pin 17), and then the core block 11 is removed from the joint surface 8a by the reverse operation. This order is taken because the pin 17 is inserted into the guide sleeve 14, and in this state, the core block 11 cannot be removed directly from the joint surface 8a.

  When the removal of the core block 11 is completed, the pin 17 is cut off from the end of the ulna 3 appropriately. Next, the rear end of the pin 17 is bent, and a soft steel wire is stretched between the pin 17 and a hole formed at an appropriate position of the ulna 3 to reduce the fracture (not shown). Thereafter, when the pulley 6 of the humeral component 2 is fitted again to the joint surface 8a and the wound is sutured, the fixing operation is completed. As a result, the elbow joint function can be maintained even during fracture treatment. In principle, when the fracture is healed, the pin 17 is removed.

  The above description is for a snap-in type elbow joint, but the fracture treatment device of the present invention can also be applied to a surface elbow joint. FIG. 8 is a perspective view of a fracture treatment device applied to this surface-mounted artificial elbow joint. In this type of artificial elbow joint, both ends of the opening 10 of the joint surface 8a extend to a portion exceeding the diameter. The separation action of the humerus component 2 and the ulna component 4 cannot be suppressed. The fracture treatment tool in this case is such that the shank 22 is straightly extended from the core block 11 and the arm 12 serving also as the housing block 13 is attached to this with a knob bolt 16, but other structures including the sight 19 are included. Is the same as above.

It is a side view of a fracture treatment tool. It is a partial cross section bottom view of a fracture treatment tool. It is a rear view of a fracture treatment tool. It is explanatory drawing of the state which mounts a fracture treatment tool to an artificial elbow joint. It is a side view of the state which inserts a pin in an elbow head using a fracture treatment tool. It is a perspective view of the state which equipped the sighting device to the fracture treatment tool. It is a perspective view in the state where a sighting device of another example was attached to a fracture treatment tool. It is a perspective view of another type of fracture treatment tool. It is a top view of the left arm which replaced the artificial elbow joint. It is a side view of the left arm which replaced the artificial elbow joint.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 humerus 2 humerus component 3 ulna 4 ulna component 5 flexure 6 pulley 7 stem 8 joint face body 8a joint face of joint face body 9 stem 10 opening part 11 core block 11a core block stopper part 12 arm 13 housing block 13a ant 14 Guide sleeve 15 Insertion groove 16 Knob bolt 17 Pin 18 Hole 19 Sighting device 20 Base 20a Dovetail groove 21 Rod 22 Shank

Claims (6)

  A core block fitted to the joint surface of the joint face body constituting the ulna component, an arm extending proximally from the core block, a housing block provided at the rear end of the arm, and inserted into the housing block An olecranon fracture treatment device comprising a guide sleeve having a hole through which a pin can be inserted.   The olecranon fracture treatment device according to claim 1, wherein the housing block can be detached from the arm.   The elbow head fracture treatment device according to claim 1 or 2, wherein the guide sleeve can slide back and forth within the housing block.   The olecranon fracture treatment device according to any one of claims 1 to 3, wherein a plurality of holes are formed in the guide sleeve.   An sighting device for estimating the insertion direction of a pin by the olecranon fracture treatment device according to any one of claims 1 to 4, wherein the sighting device is disposed outside the skin in parallel with a base attached to the housing block and a hole of the guide sleeve from the base. A sighting device attached to an olecranon fracture treatment device comprising an extending rod.   The sighting device attached to the olecranon fracture treatment device according to claim 5, wherein the base and the housing block are slidably fitted back and forth in a dovetail relationship.