JP2010193954A - Broken bone fixture - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a broken bone fixture which fixes all of a plurality of bone pieces, fixes the bone pieces at prescribed positions of the bone body, and is suited to a low invasive surgery. <P>SOLUTION: The broken bone fixture 1 includes: a plate member 20 which is installed inside the body and fixes a plurality of bone pieces 90 to one another; one or more first bone pin 30 including one end 31 provided with a screw portion 36 for fixing the plate member 20 to the bone pieces 90 and the other end 32 extending outside the body; one or more second bone pin 40 including one end 41 fixed to the bone body 91 and the other end 42 extending outside the body; and an external fixing member 50 which is fixed to the first bone pin 30 and the second bone pin 40 outside the body and holds a position of the first bone pin 20 with respect to the second bone pin 40. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to a fracture fixing device used for fixing a fractured bone, and particularly to a fracture fixing device having a strong fixing force.

  As a method of fixing a fractured bone, a fixing method using a bone plate (internal fixation) and a fixing method using an external fixator (external fixation) are known.

  A bone plate for internal fixation is used by fixing a plate arranged so as to cross a fractured part to a bone with a bone screw (for example, Patent Document 1). The bone plate is placed in the body through open surgery.

  An external fixator for external fixation is configured by inserting a plurality of external pins into each of two or more bones separated by fracture, and maintaining the relative position of the external pins protruding outside the wound, An instrument for fixing a separated bone in a fixed position (for example, Patent Document 2). In order to install the external fixator, the skin and body tissue are incised to form an insertion pin for the external pin.

JP 2004-313514 A JP 2002-306502 A

For example, when a bone to which a plurality of muscles extending from the shoulder are attached, such as the proximal portion of the humerus, is fractured from a predetermined position by the muscles.
For example, in the case of a bone fragment located between the bone body (diaphragm) and the scapula, when the muscle attached to the bone body pulls the bone body upward, the bone fragment is sandwiched between the scapula and the bone body. Compressed. The bone fragment that has received the compressive force is displaced laterally from between the bone body and the shoulder, or rotated from its original direction.
When muscle is attached to the bone fragment itself, the bone fragment is pulled by the muscle. Therefore, the bone fragment is shifted upward from the original position.
Therefore, a fracture fixing device that fixes a bone fragment at a predetermined position of the bone body is required to have a strong fixing force that can fix the bone fragment to the bone body against the traction force of the muscle applied to the bone body or bone piece. It is done.
Furthermore, in recent years, it is desirable to start rehabilitation immediately after the reduction operation of the fracture. In order to meet this requirement, a stronger fixing force is required for the fracture fixing device.

  In addition, in the crushed fracture separated into a plurality of bone fragments, a fixing device that can fix all the bone fragments to the bone body after drawing the bone fragments to a predetermined position of the bone body and reducing the fractured portion is desired.

  Furthermore, in recent surgical operations, an operation with a small incision, a so-called minimally invasive operation is desired in order to reduce the physical burden on the patient and shorten the recovery period after the operation.

  The conventional bone plate is suitable for fixing a plurality of bone fragments because the bone fragments are fixed using a plurality of (for example, 5 to 10) screws. However, the bone plate is difficult to obtain a strong fixing force that can fix the bone fragment to the bone body against the traction force of the muscles applied to the bone body or the bone fragment. In order to give a strong fixing force to the bone plate, it is necessary to increase the size of the bone plate. When a large-sized bone plate is used, the incision at the time of surgery becomes large.

  On the other hand, the external fixator has an advantage that the fixing force is strong and an advantage that the external fixator can be installed on the fracture portion with a small incision. However, since the external fixator has several bone pins (for example, 2 to 3) inserted into the bone fragment, it is difficult to reliably fix a plurality of bone fragments.

  Therefore, an object of the present invention is to provide a fracture fixing device that can fix all of a plurality of bone fragments, has a strong fixing force for fixing the bone fragments to the bone body, and is suitable for minimally invasive surgery.

  The fracture fixing device of the present invention includes a plate member that is installed in the body and fixes a plurality of bone fragments to each other, one end provided with a screw portion that fixes the plate member to the bone fragment, and the other end that extends outside the body. Including one or more first bone pins, one or more second bone pins including one end fixed to the bone body and the other end extending outside the body, the first bone pins, and the second bone pins; And an external fixation member that is fixed outside the body and holds the position of the first bone pin with respect to the second bone pin.

  Since the fracture | rupture part fixing device of this invention contains the plate member, it is suitable for fixing a some bone fragment.

In the fracture fixing device of the present invention, the first bone pin is fixed to the bone fragment by the screw portion at one end, and is further fixed to the bone body via the external fixation member and the second bone pin. . All bone fragments are fixed to each other by a plate member. That is, all the bone fragments are fixed to the bone body via the plate member, the first bone pin, the external fixation member, and the second bone pin. The fixation of the bone fragment and the bone body using the external fixation member has a higher fixing force than the fixation of the bone fragment and the bone body by the conventional bone plate. Therefore, the fracture fixing device of the present invention provided with the external fixator can firmly fix all bone fragments to the bone body.

  Since the fracture fixing device of the present invention includes the external fixation member, the plate member may not have a function of fixing the bone fragment to the bone body. Therefore, the size of the plate member can be reduced. In addition, the operation for fixing the first bone pin and the second bone pin to the bone body can be performed with a small incision. Therefore, the fracture fixing device of the present invention is suitable for minimally invasive surgery.

  Thus, the fracture fixing device of the present invention can fix all of a plurality of bone fragments, can retain the bone fragments in a predetermined position of the bone body, and is suitable for minimally invasive surgery.

FIG. 1 is a schematic perspective view showing a use state of the fracture fixing device according to the first embodiment. FIG. 2 is a side view of the fracture fixing device according to the first embodiment. FIG. 3 is a front view of a plate member included in the fracture fixing device according to the first embodiment. FIG. 4 is a partially cutaway front view of a first bone pin included in the fracture fixing device according to the first embodiment. FIG. 5 is a partially cutaway front view of a second bone pin included in the fracture fixing device according to the first embodiment. 6 is a front view of an external fixation member included in the fracture fixing device according to Embodiment 1. FIG. FIG. 7 is a schematic perspective view of a fixture of the first fixing portion included in the external fixation member of FIG. FIG. 8 is a top view of a first fixing portion included in the external fixation member of FIG. FIG. 9 is a schematic perspective view for explaining a defining surface on which the first bone pin is arranged. FIG. 10 is a perspective view showing a state of reduction of the fracture portion at the proximal portion of the humerus. FIG. 11 is a cross-sectional view of a guide device for installing a first bone pin. FIG. 12 is a top view of a guide body included in the guide instrument of FIG. FIG. 13 is a developed view of a side surface of a guide main body included in the guide device of FIG. FIG. 14 is a front view of a frame member included in the guide device of FIG. 15 is a partially cutaway side view of a cylindrical guide used with the guide device of FIG.

  Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings. In the following description, terms indicating specific directions and positions (for example, “up”, “down”, “right”, “left” and other terms including those terms) are used as necessary. . The use of these terms is to facilitate understanding of the invention with reference to the drawings, and the technical scope of the present invention is not limited by the meaning of these terms. Moreover, the part of the same code | symbol which appears in several drawing shows the same part or member.

<Embodiment 1>
In the present embodiment, a fracture fixing device used for fracture of the proximal humerus will be described.
FIG.1 and FIG.2 has illustrated the state which fixed the fracture | rupture part fixing device 1 which concerns on this Embodiment to the humerus proximal part (right shoulder) of the right arm. The fracture portion is separated into a bone body 91 (diaphysis) and two bone fragments 90.
The fracture fixing device 1 includes a plate member 20, one or more (three in the figure) first bone pins 30, one or more (two in the figure) second bone pins 40, and an external wound. The fixing member 50 is included.

The plate member 20 is installed in the body. The head plate portion 201 (see FIG. 3) of the plate member 20 is disposed on the surface of the bone piece 90 and is fixed to the bone piece 90 by a plurality of bone screws 60 inserted through the through holes 22 of the head plate portion 201. At this time, the individual bone fragments 90 are fixed to each other by the bone screws 60. All the bone fragments 90 are integrally held by the plate member 20 and the plurality of bone screws 60.
Further, the stem plate portion 202 (see FIG. 3) of the plate member 20 is disposed on the surface of the bone main body 91 and is fixed to the bone main body 91 by a plurality of bone screws 60 inserted through the through holes 28 of the stem plate portion 202. .

  The first bone pin 30 is disposed through the skin 92. One end 31 of the first bone pin 30 is fixed to the bone fragment 90, and the other end 32 extends outside the body (see FIG. 1). A screw portion 36 is provided at one end 31 and is screwed into the bone piece 90 through a through hole formed in the plate member 20. The plate member 20 is fixed by the first bone pin 30.

  The second bone pin 40 is also disposed through the skin 92. One end 41 of the second bone pin 40 is fixed to the bone body 91, and the other end 42 extends outside the body (see FIG. 1). The one end 41 is provided with a screw portion 46 and is screwed into the bone main body 91.

  The external fixation member 50 fixes the first bone pin 30 and the second bone pin 40 outside the body. Specifically, the external fixation member 50 includes a first fixing portion 51 that fixes the first bone pin 30 and a second fixing portion 52 that fixes the second bone pin 40. The external fixation member 50 can hold the position of the first bone pin 30 with respect to the second bone pin 40.

  By including the plate member 20, the fracture fixing device 1 can fix a plurality of bone fragments 90. Therefore, it is suitable for fixing a fracture in which a plurality of bone fragments 90 are generated.

Moreover, in the fracture fixing device 1 of the present embodiment, the first bone pin 30 is fixed to the bone fragment 90 by the screw portion 36 formed at the one end 31, and further, via the external fixation member 50, It is fixed to the bone body 91 by the second bone pin 40. All the bone fragments 90 are fixed to each other by the plate member 20. That is, all the bone fragments 90 are fixed to the bone main body 91 via the plate member 20, the first bone pin 30, the external fixation member 50, and the second bone pin 40. When the external fixation member 50 is used, the bone piece 90 and the bone main body 91 can be strongly fixed. Therefore, the fracture fixing device 1 of the present invention including the external fixator 50 can strongly fix all the bone fragments 90 to the bone body 91.

  As described above, the fracture fixing device 1 according to the present embodiment includes a plurality of fractures even when a portion to which a strong muscle such as the proximal portion of the humerus is attached is fractured on a plurality of bone fragments 90. All the bone fragments 90 are fixed, and the bone fragments 90 can be held in a desired position until the bone fragments 90 are fused to the bone body 91 in the original position.

  In the fracture fixing device 1 of the present invention, the external fixation member 50 has a function of fixing the bone fragment 90. Therefore, it is sufficient for the plate member 20 used in the present invention to have a function of fixing the plurality of bone fragments 90 to each other. Therefore, it is not necessary to increase the size of the plate member 20 in order to fix the plate member 20 itself to the bone body 91. Therefore, the fracture fixing device 1 of the present embodiment can be applied to minimally invasive surgery by reducing the plate member 20.

  Below, each member which comprises the fracture | rupture part fixing device 1 is explained in full detail.

(Plate member 20)
As shown in FIG. 3, the plate member 20 includes a head plate portion 201 for fixing the plurality of bone fragments 90 to each other. A plurality of through holes 22 for bone screws 60 (6 holes in 2 columns × 3 rows in FIG. 3) are formed in the head plate portion 201. By inserting a bone screw 60 into each of the through holes 22, all of the reduced bone pieces 90 are fixed to each other (see FIGS. 1 and 2). The through hole 22 includes a counterbore for receiving the head 61 of the bone screw 60 on the surface 26 side of the plate member 20.

  The head plate 201 is further formed with a plurality of through holes 21 (three holes in FIG. 3) for the first bone pin 30. As shown in FIG. 1, the through hole 21 is an elliptical hole that is long in the left-right direction so that the insertion angle in the left-right direction of each first bone pin 30 can be changed. Further, as shown in FIG. 2, the through hole 21 is directed from the front surface 26 to the back surface 27 (the surface in contact with the bone fragment 90, see FIG. 1) so that the first bone pin 30 can be inserted obliquely upward. It is formed obliquely upward. The through-hole 21 has a counterbore for receiving the screw head 35 of the first bone pin 30 on the surface 26 side of the plate member 20.

  As shown in FIG. 3, the plate member 20 can include a trunk plate portion 202 extending from the head plate portion 201. The stem plate portion 202 is disposed on the surface of the bone main body 91 and is directly fixed to the bone main body 91 by the bone screw 60 (see FIG. 1). A plurality of through holes 28 (two holes in FIG. 3) for the bone screw 60 are formed in the stem plate portion 202. The plate member 20 is fixed to the bone body 91 by inserting the bone screw 60 into each of the through holes 28 (see FIGS. 1 and 2). The through hole 28 has a counterbore for receiving the head 61 of the bone screw 60 on the surface 26 side of the plate member 20.

  In general, in order to fix the bone fragment 90 to the bone body 91 by the plate member 20, the plate member 20 having the long stem plate portion 202 is essential. However, in the present invention, since the bone fragment 90 is fixed to the bone main body 91 by the external fixator 50, the fracture member fixer 1 of the present invention is not provided with the plate member 20 or the stem provided with the stem plate portion 202. A plate member 20 having a short plate portion 202 can be used. By not providing the stem plate portion 202 or shortening the stem plate portion 202, the plate member 20 can be made smaller than a general bone plate. Such a small plate member 20 is suitable for minimally invasive surgery.

  In particular, it is preferable to provide the plate member 20 with a short stem plate portion 202, and the bone piece 90 is fixed to the bone body 91 until the bone piece 90 and the bone body 91 are fixed by the external fixator 50 (the fixing force is It can be fixed. Further, the short stem plate portion 202 is also effective when confirming the posture of the plate member 20 with respect to the bone main body 91. This is preferable because the posture of the plate member 20 with respect to the bone main body 91 can be confirmed.

  The plate member 20 can lock a plurality of bone screws 60 in the through holes 22 and 28 of the plate member 20 (so-called locking plate). In a typical locking plate, a female screw is formed on the inner walls of the through holes 22 and 28, and a bone in which a male screw is formed on the outer periphery of the head 61 of the bone screw 60 to be engaged with the female screws of the through holes 22 and 28. Used with screw 60. When the bone screw 60 is completely inserted into the bone fragment 90 or the bone body 91, the male screw of the head 61 of the bone screw 60 is screwed into the female screw of the through holes 22 and 28. Thereby, the bone screw 60 is locked to the plate member 20.

  In the lockable bone screw 60, the insertion direction of each bone screw 60 is determined in one direction by an internal thread formed on the inner walls of the through holes 22 and 28 of the plate member 20. When the plate member 20 is manufactured, the insertion direction of the bone screw 60 is considered in advance so as to cope with fractures in various states, and female threads are formed in the through holes 22 and 28 in accordance with the insertion direction. If one type of plate member 20 is assumed to have a fracture mode that cannot be handled, multiple types of plate members 20 are prepared and matched to the mode of fracture (shape of bone fragment, direction of fracture line, etc.) May be selected as appropriate.

  Furthermore, in recent years, a locking plate that can insert the bone screw 60 in any direction and can lock the head 61 of the bone screw 60 in the through holes 22 and 28 of the plate member 20 is also known. The insertion direction of the bone screw 60 can be arbitrarily changed according to the state of the fracture. Such a locking plate can be used as the plate member 20 of the present invention. However, attention should be paid to the insertion direction of the bone screw 60 so that the bone main body 91 does not come into contact with other bone screws 60 or the first bone pin 30.

(First bone pin 30)
As shown in FIG. 4, the first bone pin 30 includes a screw portion 36 at one end 31. The screw part 36 is screwed into the bone main body 91 through the through hole 21 of the plate member 20. At this time, it is necessary to determine the insertion direction of the first bone pin 30 so that the screw portion 36 does not come into contact with the bone screw 60 (particularly, the bone screw 60 inserted through the through hole 22 of the head plate portion 201). is there. The other end 32 of the first bone pin 30 is formed with a hole 321 that can be fitted with a screwdriver, and is used when the first bone pin 30 is screwed into the bone piece 90.

  The first bone pin 30 preferably includes a screw head 35 on the other end side of the screw portion 36. The screw head 35 is formed at a position where it abuts on the plate member 20 when the screw portion 36 is fixed to the bone piece 90 (see FIGS. 1 and 2). The plate member 20 can be pressed against the bone fragment 90 by the screw head 35. That is, when the first bone pin 30 includes the screw head 35, the first bone pin 30 not only prevents the plate member 20 from shifting in the vertical direction, but also separates the plate member 20 from the bone fragment 90. Can also be suppressed.

The first bone pin 30 is separable from the screw portion 36 and the main body (shaft portion 37) of the first bone pin 30 at a position on the other end side of the screw head 35 (XX line in FIG. 4). It is preferable that
For example, when bone fusion proceeds to some extent, the force required to hold the bone fragment 90 at a predetermined position of the bone body 91 becomes small. Then, when bone fusion has progressed to such an extent that the bone fragment 90 can be held at a predetermined position of the bone body 91 with only the plate member 20 and the plurality of bone screws 60, members protruding outside the body (external fixation member 50, first One bone pin 30 and second bone pin 40) may be removed. At this time, if the first bone pin 30 can be separated into the screw portion 36 and the shaft portion 37, only the shaft portion 37 can be removed instead of removing all of the first bone pins 30. The screw portion 36 remaining in the body functions in the same manner as the bone screw 60 and is effective in fixing the plate member 20 to the bone fragment 90.

The separable first bone pin 30 includes a connecting portion 38 between the screw portion 36 and the shaft portion 37. The connecting portion 38 can be configured by processing the other end 32 side of the screw portion 36 and the one end 31 side of the shaft portion 37 so as to be detachably engaged with each other.
Moreover, the connection part 38 may be comprised using a separate component. Specifically, first, the screw part 36 (with the screw head 35) and the shaft part 37 are prepared separately, and holes are formed in the other end side of the screw head 35 and one end side of the shaft part 37, respectively. The connecting part is inserted into these holes to integrate the screw part 36 and the shaft part 37.
Each of the connecting portions 38 is designed so that the shaft 37 and the screw portion 36 are separated by applying an external force in a predetermined direction to the shaft 37. As a result, the screw portion 36 and the shaft portion 37 can be separated by operating the shaft 37 from the other end 32 protruding outside the body.

  The fracture fixing device 1 includes one or more first bone pins 30, more preferably two or more (three in FIG. 1). It is preferable to include two or more first bone pins 30 because the fixing force for fixing the plate member 20 to the bone fragment 90 is increased. In particular, as shown in FIG. 1, when one of the first bone pins 30 is inserted obliquely with respect to the other, the fixing force is further increased.

(Second bone pin 40)
In the present embodiment, the second bone pin 40 is fixed to the diaphysis of the bone main body 91 instead of the fractured part (the end of the humerus) (see FIGS. 1 and 2). As shown in FIG. 5, the second bone pin 40 includes a screw portion 46 at one end 41. The screw part 46 is screwed into the diaphysis of the bone main body 91. The other end 42 of the second bone pin 40 is formed with a hole 321 that can be fitted with a screwdriver, and is used when the second bone pin 40 is screwed into the bone body 91.

  The fracture fixing device 1 includes one or more second bone pins 40, more preferably two or more (two in FIG. 1). It is preferable to include two or more second bone pins 40 because the fixing force for fixing the first bone pin 30 to the bone body 91 via the external fixation member 50 is increased. When securing two or more second bone pins 40 to the bone body 91, the second bone pins 40 may be oriented diagonally to each other, or as in FIG. All second bone pins 40 may be oriented so as to be parallel.

(External fixation member 50)
The external fixation member 50 is a member for maintaining the position of the first bone pin 30 with respect to the second bone pin 40. As shown in FIGS. 1, 2, and 6, the external fixation member 50 includes a first fixing portion 51 fixed to the first bone pin 30 and a second fixing portion fixed to the second bone pin 40. And a fixing portion 52.

(First fixing portion 51)
In the present embodiment, the first fixing portion 51 includes a fixing tool 511, a fixing plate 512, a spacer 513, and a screw 514 (see FIG. 6).
The fixture 511 is formed of a flat rectangular parallelepiped, and has a through hole 511a for inserting the first bone pin 30 (see FIG. 7). The through hole 511a is formed so that the longitudinal axis Y thereof is parallel to the upper surface 511d and the lower surface 511c. Further, the diameter of the through hole 511a is slightly larger than the diameter of the first bone pin 30. The fixture 511 further includes a gap 511b extending from the through hole 511a to the side surface 511e and a hole 511f penetrating from the upper surface 511d through the gap 511b to the lower surface 511c. When the first fixing portion 51 is assembled, the screw 514 is inserted into the hole 511f.

  As shown in FIG. 6, the spacer 513 is disposed between adjacent fixing plates 512 or above or below the fixing plates 512. The spacer 513 is a solid body such as a rectangular parallelepiped or a cylinder, and has a height substantially equal to the height of the fixture 511. The spacer 513 is formed with a hole 513f penetrating in the vertical direction, and the screw 514 is inserted when the first fixing portion 51 is assembled.

As shown in FIGS. 1, 6, and 8, the fixing plate 512 is formed of an arc-shaped plate. Further, a slit 512f for the screw 514 is formed in the fixed plate 512 along the arc direction. When two or more fixing plates 512 are used as shown in FIGS. 1 and 6, the fixing plate 512 is placed at a predetermined interval by sandwiching a fixing tool 511 and a spacer 513 between the fixing plates 512. And it can arrange | position in parallel mutually.
The number of the fixing plates 512 can be appropriately changed depending on the number of the fixing tools 511 used. For example, when three fixing tools 511 are used, two (FIG. 6) or three (FIG. 1) fixing plates 512 are used.

  As shown in FIG. 6, the lower surface 511c or the upper surface 511d of the fixture 511 is in surface contact with the front surface or the back surface of the fixing plate 512. Further, the longitudinal axis Y (see FIG. 7) of the through-hole 511a of the fixture 511 is parallel to the lower surface 511c and the upper surface 511d of the fixture 511. Therefore, the longitudinal axis Y of the through hole 511a is parallel to the front surface and the back surface of the fixed plate 512.

  The screw 514 is used to assemble the fixture 511, the fixing plate 512, and the spacer 513. Specifically, as shown in FIG. 6, the screw 514 is inserted into the hole 511f of the fixing tool 511, the slit 512f of the fixing plate 512, and / or the notch 513f of the spacer 513, and the end of the screw 514 is inserted into the nut 514g or It is screwed into a screw hole 511g (internal wall is formed on the inner wall) of the fixture 511. Before the screw 514 is tightened, the fixture 511 and the spacer 513 can be moved along the slit 512 f of the fixing plate 512. When the screw 514 is tightened, the fixture 511 and the spacer 513 can be fixed to the fixing plate 512.

  In order to fix the first fixing portion 51 to the first bone pin 30, first, the other end 32 of the first bone pin 30 is inserted into the through hole 511 a of the fixing tool 511 with the screw 514 loosened. . Thereafter, when the screw 514 inserted through the hole 511f of the fixture 511 is tightened, the gap 511b of the fixture 511 is narrowed and the diameter of the through hole 511a is also reduced. As a result, the first bone pin 30 is fixed in the through hole 511a.

  When two or more first bone pins 30 are inserted in an arbitrary direction, the screw portions 36 may come into contact with each other in the bone main body 91. However, since the plurality of first bone pins 30 fixed to the first fixing portion 51 of the present embodiment are arranged in a plurality of planes parallel to each other, the insertion direction of the first bone pin 30 Do not cross. Therefore, it can suppress that the screw part 36 contacts. This will be described in detail below.

As shown in FIGS. 1 and 8, the longitudinal axis Y of the through hole 511 a of the fixing tool 511 coincides with the longitudinal direction of the first bone pin 30. Further, as described above, the longitudinal axis Y of the through hole 511 a is parallel to the surface of the fixed plate 512.
The fixing tool 511 can move in the direction of arrow R along the slit 512f while sliding on the surface of the fixing plate 512. Accordingly, the longitudinal axis Y of the through hole 511a also moves with respect to the fixed plate 512. At this time, the parallelism between the longitudinal axis Y of the through hole 511a and the surface of the fixed plate 512 is maintained. That is, the trajectory of the longitudinal axis Y of the through-hole 511 a due to the movement of the fixing tool 511 (referred to as a “prescribed surface”) is parallel to the fixing plate 512.

FIG. 9 shows _three defining surfaces S _{1 to} S ₃ defined by the longitudinal axes Y (Y ₁ to Y ₃ from the top) of the through holes 511a of the three fixing tools 511. The prescribed surfaces S _{1 to} S ₃ are parallel to the front and back surfaces of the adjacent fixing plates 512, and all the fixing plates 512 are parallel to each other. Therefore, it can be said that the defining surfaces S _{1 to} S ₃ are parallel to each other. .

Longitudinal direction of the first bone pin 30, to match the longitudinal axis Y of the through-hole 511a of the fixture 511, the longitudinal direction is always located in the plane of the defining surface S ₁ to S ₃ of the first bone pin 30 To do. Since the defining surfaces S _{1 to} S ₃ do not intersect with each other, the longitudinal direction of the first bone pin 30 also does not intersect with each other.
As described above, the plurality of first bone pins 30 fixed to the first fixing portion 51 of the present embodiment can easily avoid the screw portions 36 from contacting each other in the bone main body 91.

In particular, the surface interval between the adjacent defined surfaces S _{1 to} S ₃ is set to be equal to or larger than the diameter of the screw portion 36 of the first bone pin 30 (301 to 303). Thereby, it can avoid reliably that the screw part 36 penetrated in parallel contacts each other in the bone main body 91. FIG.

In the present embodiment, the through hole 22 for the bone screw 60 and the through hole 21 for the first bone pin 30 are formed adjacent to the head plate portion 201 of the plate member 20. Therefore, the bone screw 60 and the screw portion 36 of the first bone pin 30 are likely to come into contact with each other in the bone fragment 90. Accordingly, a plane parallel to the defining surface _S 1 to S ₃ (e.g., defining surface _{S 1} parallel to plane _{S 12} is between _{S 2,} defining surface _{S 2} and parallel surfaces _{S 23} in between the _{S 3)} It is preferable to arrange the length of the bone screw 60 in the plane. Since the defining surfaces S _{1 to} S ₃ and the parallel surfaces S ₁₂ and S ₂₃ do not intersect, the screw portion 36 of the first bone pin 30 on the defining surfaces S _{1 to} S ₃ and the parallel surface S _12, bone screws 60 in on the _{S 23} does not intersect.
Therefore, it is easy to avoid the screw portion 36 and the bone screw 60 of the first bone pin 30 coming into contact with each other in the bone body 91.
Incidentally, from the viewpoint of avoiding contact between the screw 36 and the bone screws 60, parallel surfaces _{S 12} in the center of defined surface _{S 1} and _{S 2,} also parallel surfaces _{S 23} in the center of defined surface _{S 2} and _{S 3} , Each is preferably set. Thereby, since the bone screw 60 can be located in the center of the screw part 36 located up and down, it becomes difficult to contact any screw part 36. However, the position of the parallel plane is not limited to this. For example, when the interval between the prescribed surfaces S _{1 to} S ₃ is sufficiently wide, contact between the screw portion 36 and the bone screw 60 can be avoided even if the parallel surface is set at a position close to any one of the prescribed surfaces.

The number of bone screws 60 to insertion, above the defined surface S _1, or below the defined surface S _3, can be set further parallel plane. Further, unlike the prescribed surfaces S _{1 to} S ₃ , a plurality of (for example, two) bone screws 60 may be arranged in one parallel surface S ₁₂ , S ₂₃ . However, the insertion direction must be set so that the bone screws 60 arranged in the same plane do not contact each other.
As a specific example, a parallel plane when the plate member 20 of FIG. 3 is used will be described. The parallel plane is set so as to pass through both of the two through holes 22 arranged in the horizontal direction among the through holes 22 formed in the head plate portion 201 of the plate member 20. The bone screw 60 inserted through the through hole 22 is inserted into a plane parallel to the through hole 22. The plate member 20 in FIG. 3 has three sets (three rows) of through-holes 22 arranged in the horizontal direction, so that three parallel surfaces are set. The uppermost parallel surface is set above the defining surface S ₁ (through the uppermost through hole 21 in FIG. 3). The remaining parallel planes are set between the prescribed planes S _{1 to} S ₃ (parallel planes S ₁₂ and S _{23 in} FIG. 9).

In particular, the surface interval between the adjacent defining surfaces S _{1 to} S ₃ is the sum of the diameter D1 of the screw portion 36 of the first bone pin 30 (301 to 303) and the diameter D2 of the bone screw 60 (see FIG. 2). “D1 + D2” or more is desirable. That is, an interval of the bone screw 60 diameter D2 or more can be provided between the adjacent first bone pins 30 (301 to 303). Thereby, it can avoid reliably that the screw part 36 and the bone screw 60 mutually contact in the bone main body 91. FIG. As a specific example, when the diameter D1 of the screw portion 36 of the first bone pin is 4.5 mm and the diameter D2 of the bone screw 60 is 3.5 mm, the spacing between the prescribed surfaces S _{1 to} S ₃ is 8.0 mm or more. It is good to make it.

Further, the longitudinal direction of the first bone pin 301-303 relative to the plate member 20 is preferably a variable in the plane of the defining surface _S 1 to S _3. Specifically, as shown in FIG. 8, it is preferable that the fixture 511 can be moved in the direction of the arrow R along the slit 512 f of the fixing plate 512. As another example, a plurality of holes arranged in an arc shape may be provided in place of the slit 512f, and the fixture 511 may be fixed at an arbitrary hole position. When making the longitudinal direction of the bone pins 301 to 303 variable, it is preferable that the bone pins 301 to 303 be rotatable around the point O in FIG. Note that the point O in FIG. 8 actually overlaps _three points O _{1 to} O ₃ . Point _{O 1} is defined surface _{S 1,} the point _{O 2} is defined surface _{S 2} and the point _{O 3} is present in the plane of the defining surface _{S 3.} Further, the points O _{1 to} O ₃ respectively coincide with the centers of the three through holes 21 (see FIG. 3) for the first bone pin formed in the plate member 20.
When the longitudinal direction of the first bone pins 301 to 303 is variable, the three first bone pins 301 to 303 can be obliquely inserted into each other as shown in FIG. The fixing force of the plate member 20 by 301-303 can be raised.

(Second fixing portion 52)
In the present embodiment, the second fixing portion 52 includes a main body 521, a holding tool 522, and a screw 523 (see FIG. 6). The main body 521 has two semicircular grooves formed on the surface facing the holding tool 522. The sandwiching tool 522 has two semicircular grooves formed on the surface facing the main body 521 at positions corresponding to the main body 521 and the grooves. When the holding tool 522 is fixed to the main body 521 by the screw 532, a hole 524 is formed by the groove of the main body 521 and the groove of the holding tool 522. The second bone pin 40 is fixed to the second fixing portion 52 by inserting the second bone pin 40 into the hole 524 and tightening the screw 532.

(Movable part 53)
The external fixation member 50 preferably includes a movable portion 53 that can be fixed between the first bone pin 30 and the second bone pin 40. By providing the movable portion 53, the relative position of the first fixed portion 51 with respect to the second fixed portion 52 can be adjusted. For example, when the external fixation member 50 is fixed to the first bone pin 30 and the second bone pin 40, the first fixing portion 51 and the second fixing portion 52 are moved to be in a movable state. Are fixed to the first bone pin 30 and the second fixing portion 52 is fixed to the second bone pin 40, respectively. When the fixing of each fixing portion is completed, the movable portion 53 is fixed, and the relative position of the first fixing portion 51 with respect to the second fixing portion 52 is fixed. Thereby, the relative position of the first bone pin 30 with respect to the second bone pin 40 can be maintained.

  In the present embodiment, the movable portion 53 includes a slide portion 531 and a universal joint 532.

(Slide part 531)
The slide portion 531 includes a belt-like member 531a, a slide shaft 531b, and a screw 531c (see FIGS. 2 and 6). One end of the belt-like member 531a is fixed to the first fixing portion 51, and an elliptical through-hole 531d is formed in the vicinity of the other end. The slide shaft 531b has a screw hole at one end. The screw 531c passes through the through hole 531d of the belt-like member 531a and is screwed into the screw hole of the slide shaft 531b.

  When the screw 531c of the slide portion 531 is loosened, the axis of the screw 531c slides up and down the elliptical through hole 531d. At this time, the first fixing portion 51 can move relative to the second fixing portion 52 in the vertical direction. Further, when the screw 531c is tightened, the screw 531c can be fixed at an arbitrary position of the through hole 531d. As a result, the first fixing portion 51 is fixed relatively to the second fixing portion 52.

(Universal joint 532)
The universal joint 532 includes a case 532a, a ball 532b, a ball support 532c, and a screw 532d (see FIGS. 2 and 6).
The case 532a includes a columnar through hole 532e penetrating in the vertical direction. The diameter of the through hole 532e is slightly larger than the diameter of the ball 532b, but is reduced in diameter near the upper surface of the case 532a so as to be smaller than the diameter of the ball 532b.

  The slide shaft 531b of the slide portion 531 is fixed to the ball 532b. The ball 532b is inserted into the through hole 532e of the case 532a from below, and at this time, the ball 532b is inserted so that the slide shaft 531b faces upward. When the ball 532b is locked to the reduced diameter portion of the through hole 532e, the slide shaft 531b is projected from the upper surface of the case 532a. By rotating the ball 532b in the through hole 532e, the direction of the slide shaft 531b can be arbitrarily changed.

  The ball support portion 532c is disposed below the through hole 532e and supports the ball 532b from below. A conical recess is formed on the upper surface of the ball support portion 532c so that the ball 532b can be stably supported. Further, the ball support portion 532c can be moved in the vertical direction by a screw 532d. When the screw 532d is tightened, the ball support portion 532c rises and the ball 532b is fixed between the reduced diameter portion of the through hole 532e and the ball support portion 532c. When the screw 532d is loosened, the ball support portion 532c is lowered and the ball 532b can freely rotate.

  As shown in FIG. 6, the universal joint 532 can move the first fixing portion 51 in the left-right direction with respect to the second fixing portion 52. Moreover, the universal joint 532 can incline the 1st fixing | fixed part 51 to the diagonal direction with respect to the 2nd fixing | fixed part 52 like FIG.

  As described above, the movable portion 53 of the present embodiment includes the slide portion 531 and the universal joint 532, so that the first fixed portion 51 is moved in the vertical direction and the horizontal direction with respect to the second fixed portion 52. And can be tilted in an oblique direction.

  Below, the method to fix a fracture part using the fracture fixing device 1 of this invention is demonstrated.

(1. Formation of an incision)
The skin and tissue are incised to expose the fractured part (in this embodiment, the proximal part of the humerus). The size of the incision is set such that a procedure such as reduction and insertion of the plate member 20 are possible.

(2. Reduction of fractures)
The bone fragment 90 is reduced to a predetermined position of the bone main body 91. When muscle is attached to the bone fragment 90, the bone fragment 90 is often displaced in the proximal direction. In that case, it is necessary to reduce the bone piece 90 by pulling it against the traction force of the muscle. For example, as shown in FIG. 10, the suture piece 96 may be applied to the base of the muscle 95, and the suture piece 96 may be pulled to facilitate reduction of the bone fragment 90.

(3. Fixing of plate member 20)
The plate member 20 is placed on the surface of the fractured part that has been reduced. Then, for example, a K-wire is punctured into the dedicated through hole 23 (see FIG. 3), and the plate member 20 is temporarily fixed to the bone piece 90 and the bone main body 91. Thereafter, pilot holes are made in the bone piece 90 and the bone body 91 in accordance with the through holes 22 of the plate member 20. Then, the bone screw 60 is screwed into the prepared hole, and the plate member 20 is permanently fixed to the bone fragment 90 and the bone main body 91.

(4. Fixing of positioning bar)
A positioning bar 81 (see FIG. 11) is fixed to the plate member 20. The positioning bar 81 is used when the position of the plate member 20 is confirmed after the incision is sutured by the following “5. The positioning bar 81 is fixed to the through hole 24 (see FIG. 3) for the positioning bar 81 provided in the plate member 20. The positioning bar 81 is formed of a band-like member, and is bent in a “shape” as shown in FIG. One end 811 is provided with a pin 813 that can be inserted and fixed in the through hole 24 of the plate member 20, and the other end 813 extends outside the body through the incision.

(5. Suture of the incision)
With the end 813 of the positioning bar 81 protruding from the incision to the outside of the body, the incision is sutured.

(6. Fixing of guide device 70)
A guide device 70 for guiding the first bone pin 30 and the second bone pin 40 is fixed to the positioning bar 81 (see FIG. 11). The guide device 70 includes a guide main body 71 for accurately guiding the first bone pin 30 and a frame member 72 for roughly guiding the second bone pin 40.
11 shows a cross section along the cutting plane α-α in FIG. 13, and the frame member 72 shows a cross section along the cutting plane β-β in FIG. .

As shown in FIG. 12, the guide main body 71 is curved in an arc shape with the point O as the center. As shown in FIG. 13, the curved outer surface 714 has a plurality of guide holes along three parallel lines (a first line 711x, a second line 712x, and a third line 713x). Are formed at equal intervals. For example, 11 guide holes 711a to 711k are formed along the first line 711x. The guide holes 711a to 711k partially overlap the laterally adjacent guide holes 711a to 711k to form a first elongated hole 711 extending in the lateral direction. The guide hole formed along the second line 712x forms a second slot 712, and the guide hole formed along the third line 713x forms a third slot 713. Yes.
The guide holes 711a to 711k may be formed so as not to overlap with the adjacent guide holes 711a to 711k (that is, the guide holes 711a to 711k are individually independent).

As shown in FIG. 12, the guide hole is formed in a direction perpendicular to the outer surface 714. For example, the guide holes 711a to 711k included in the first long hole 711 are exemplified by the center axis Z of the guide hole (in the drawing, the center axis Z _a of the guide hole 711a and the center axis Z _k of the guide hole 711k). Are aligned in the radial direction centered on the point O (point O ₁ ). The guide hole included in the second elongated hole 712 is formed so that its central axis coincides with the radial direction centered on the point O (point O ₂ ). The guide holes included in the third long hole 712, the central axis is formed so as to coincide with the radial direction around the point O (the point O _3).
In FIG. 12, the positions of the points O _{1 to} O ₃ are the same, but actually the positions in the direction perpendicular to the paper surface are different.

  As shown in FIGS. 11, 12, and 13, a recess (bar receiving portion 74) for receiving the other end 812 (see FIG. 11) of the positioning bar 81 is provided on the inner surface 715 side of the upper surface of the guide body 71. Is formed. Further, a notch 76 for receiving the head of a screw 77 (see FIG. 11) is formed on the outer surface 714 side of the upper surface of the guide body 71. A hole 75 for inserting the screw 77 is formed between the bar receiving portion 74 and the notch 76.

As shown in FIG. 11, when the guide main body 71 is fixed to the positioning bar 81, the central axis Z of the guide hole of the guide main body 71 is located in the plane of the prescribed surfaces S _{1 to} S ₃ in FIG. Specifically, all of the central axes Z _{a to} Z _k of the guide holes 711 a to 711 _k included in the first elongated hole 711 of the guide main body 71 are located in the plane of the defined plane S ₁ . The central axis of the guide hole in the second elongate hole 722 are all located in the plane of the defining surface S _2. Then, the central axis of the guide hole included in the third long hole 723 are all located in the plane of the defining surface S _3.
Further, the intersections O _{1 to} O ₃ of the central axis are the same as the points O _{1 to} O _{3 in} FIG. 8, and the three through holes 21 for the first bone pins formed in the plate member 20 (see FIG. 3) and the center of each.

  As shown in FIGS. 11 and 14, the frame member 72 is formed of a plate-like member, and includes a frame 721 formed of a rectangular frame and a frame holding portion 722 for fixing the frame 721 to the guide body 71. Yes. The upper end of the frame holding part 722 is bent (bent part 722a), and a hole for a screw 79 is formed in the bent part 722a. The bent portion 722a is opposed to the lower surface of the guide body 71, and the screw 79 is screwed through the hole of the bent portion 722a into the screw hole 716 of the guide body 71 (internal thread is formed on the inner surface). 72 is fixed to the guide body 71.

(7. Inserting the first bone pin 30)
The first bone pin 30 is inserted into the bone fragment 90 and the bone main body 91 in a state where the plate member 20 is not visible. The first bone pin 30 passes through the through hole 21 of the plate member 20 and must be inserted into the bone fragment 90 and the bone body 91 while avoiding the bone screw 60 fixing the plate member 20. . Therefore, when the first bone pin 30 is inserted, it is necessary to strictly control the insertion direction. In the present embodiment, the insertion direction of the first bone pin 30 can be strictly controlled by the guide instrument 70 (particularly, the guide main body 71).

In order to insert the first bone pin 30, first, a pilot hole is made in the bone fragment 90 and the bone main body 91 with a drill, and the screw portion 36 of the first bone pin 30 is screwed into the pilot hole.
Specifically, first, the state of the bone piece 90 and the bone main body 91 reduced by the plate member 20 is confirmed by X-rays, and the optimum direction for inserting the three first bone pins 30 is determined. At this time, the first bone pin 30 is positioned in the plane of the defined planes S _{1 to} S _{3 in} FIG. 9 and one first bone pin 30 is positioned on one defined plane. Next, the insertion direction of each of the three first bone pins 30 is determined.

Next, three holes corresponding to the insertion direction of the first bone pin 30 are selected from the guide holes formed in the guide main body 71. At this time, one of the first long hole 711 (corresponding to the first defining surface _{S 1),} one of the second elongate hole 712 (second corresponding to the defining surface _{S 2),} and third long one guide holes from the hole 713 (corresponding to the third defining surface S ₃₎ is to be selected.

  The drill 82 is inserted into the body along the selected guide hole (for example, the guide hole 711 a of the first long hole 711), and pilot holes are made in the bone fragment 90 and the bone body 91. At this time, the guide cylinder 78 is used to guide the drill 82 in the correct direction and to prevent the muscle tissue from being damaged by the cutting edge of the drill 82 (see FIG. 15).

In the example of FIG. 15, the guide cylinder 78 includes an outer cylinder 781 and an inner cylinder 782. When inserting the drill 82, the outer cylinder 781 and the inner cylinder 782 are used in combination. The outer diameter of the outer cylinder 781 is set so that the outer cylinder 78 can be inserted into the guide hole of the guide main body 71 and there is no slack. Therefore, when the guide cylinder 78 is inserted into the guide hole, the guide cylinder 78 is correctly oriented in a predetermined direction. Further, the inner cylinder 782 has an inner diameter set so that the drill 82 can be inserted, the drill 82 can rotate when a pilot hole is drilled, and the drill 82 does not rattle when the drill 82 rotates. Therefore, when the drill 82 is inserted into the guide cylinder 78 and the prepared holes are made in the bone piece 90 and the bone body 91, the prepared holes can be correctly drilled in a predetermined direction.
As shown in FIG. 15, it is preferable to provide handles 781 a and 782 a at the proximal end of the outer cylinder 781 and the proximal end of the inner cylinder 782 because the guide cylinder 78 is easily held while the drill 82 is drilled. .
Note that the guide tube 78 may be formed of one cylindrical member instead of the two members of the outer tube 781 and the inner tube 782.

Hereinafter, a procedure for forming a pilot hole in the bone piece 90 and inserting the first bone pin 30 will be described in detail.
A small incision for passing the guide tube 78 is formed in the skin in accordance with the position of the selected guide hole. Then, the distal end 78a of the guide tube 78 is inserted into a guide hole selected from the outer surface 714 side of the guide body 71, and further, the distal end 78a of the guide tube 78 is inserted into the body through the incision portion. It reaches the through hole 21 (for the first bone pin 30) of the member 20 (see FIGS. 11 and 12). When the guide instrument 70 is used, the guide cylinder 78 can be oriented toward the through hole 21 of the plate member 20 in the plane of the prescribed planes S _{1 to} S ₃ . Then, a drill 82 is inserted from the proximal end 78 b of the guide tube 78, and pilot holes are made in the bone piece 90 and the bone body 91 in accordance with the through holes 21 of the plate member 20.
This operation is repeated three times using the three selected guide holes, and three pilot holes are formed in accordance with the three through holes 21 of the plate member 20.

Next, the first bone pin 30 is inserted into the prepared hole. Also at this time, the guide tube 78 is used to guide the first bone pin 30 in the correct direction and to prevent the muscle tissue from being damaged by the screw portion 36 of the first bone pin 3. Since the outer diameter of the first bone pin 30 is larger than the outer diameter of the drill 82, the inner cylinder 782 of the guide cylinder 78 is removed and only the outer cylinder 781 is used.
When the guide cylinder 78 for the drill 82 is integrally formed, a guide cylinder for the first bone pin 30 is separately prepared.

One end 31 of the first bone pin 30 is inserted from the proximal end of the outer cylinder 781 to enter the through hole 21 of the plate member 20. Then, the screw portion 36 of the first bone pin 30 is screwed into the prepared hole until the screw head 35 of the first bone pin 30 contacts the plate member 20. Thus, the first bone pin 30 is fixed to the bone fragment 90 and the bone body 91, and at the same time, the first bone pin 30 fixes the plate member 20 to the bone fragment 90 and the bone body 91.
This operation is repeated three times using the three selected guide holes, and the three first bone pins 30 are inserted into the three through holes 21 of the plate member 20.

(8. Inserting the second bone pin 40)
The insertion direction of the second bone pin 40 may not be controlled as strictly as the first bone pin 30. In the present embodiment, the insertion direction of the second bone pin 40 is roughly controlled using the frame member 72 of the guide instrument 70.

First, the bone body 91 (diaphysis in FIG. 1) is confirmed by X-ray. Then, the insertion direction of the second bone pin 40 is determined so as to pass through the opening of the frame 721 of the frame member 72 and through substantially the center of the bone main body 91.
When inserting a plurality of (for example, two) second bone pins 40, as shown in FIG. 11, the two second bone pins 40 are inserted into the respective openings so as to pass through the opening of the frame 721. Determine the direction of entry. In the present embodiment, since the two second bone pins 40 are held in the two holes 524 (see FIG. 6) of the second fixing portion 532, the two second bone pins 40 are mutually connected. The insertion direction of the second bone pin 40 is determined so as to be parallel and separated by the same interval as the interval of the holes 524.

  A small incision for passing the guide tube 78 (see FIG. 15) is formed in the skin in accordance with the determined insertion direction. Then, the distal end 78a of the guide cylinder 78 is inserted into the opening from the distal side of the frame 721, penetrates into the body through the incision, and is advanced along the determined insertion direction. The distal end 78a is made to reach the surface of the bone body 91. Then, a drill 82 is inserted from the proximal end 78 b of the guide cylinder 78 to make a pilot hole in the bone body 91.

Next, the second bone pin 40 is inserted into the prepared hole. First, the inner cylinder 782 of the guide cylinder 78 that has entered from the incision portion is removed, and only the outer cylinder 781 is placed. Then, one end 41 of the second bone pin 40 is inserted from the proximal end of the outer cylinder 781, and the screw portion 46 of the second bone pin 40 is screwed into the prepared hole. In this way, the second bone pin 40 is fixed to the bone body 91.
This operation is repeated twice, and the two second bone pins 40 are inserted into the bone body 91 (see FIG. 11).

(9. Installation of external fixator 50)
The external fixator 50 is fixed to the first bone pin 30 and the second bone pin 40.
First, the first fixing part 51 of the external fixator 50 is fixed to the first bone pin 30. The four screws 514 (see FIG. 6) of the first fixing portion 51 are removed, and the first fixing portion 51 is disassembled. And the other end 32 of the 1st bone pin 30 is penetrated to the through-hole 511a of the fixing tool 511 (refer FIG. 1). Then, as shown in FIG. 6, the fixing plate 512 is disposed on the upper surface 511 d and / or the lower surface 511 c of the fixing tool 511. The holes 511f (see FIG. 7) of the fixing tool 511 and the slits 512f of the fixing plate 512 are aligned, and the screw 514 is inserted from the upper side or the lower side. In order to maintain the parallelism of the fixing plates 512, one or more spacers 513 are disposed between the adjacent fixing plates 512 (see FIG. 6). Further, a spacer 513 may be used as appropriate according to the length of the screw 514. Finally, the screw 514 is tightened to firmly fix the first fixing portion 51 to the first bone pin 30.

  Next, the second fixing portion 52 of the external fixator 50 is fixed to the second bone pin 40. The screw 523 of the second fixing portion 52 is removed, and the holding tool 522 is removed from the main body 521. In addition, the movable portion 53 of the external fixator 50 is moved to a movable state (that is, the screw 531c of the slide portion 531 and the screw 532d of the universal joint 532 are loosened), and the second fixed relative to the first fixed portion 51 is made. The position of the fixing part 52 can be adjusted. Then, a semicircular groove formed in the main body 521 of the second fixing portion 52 is assigned to the second bone pin 40. The clamping tool 522 is fixed to the main body 521 with a screw 523 while positioning so that the semicircular groove formed in the clamping tool 522 fits into the second bone pin 40. By tightening the screw 523, the second bone pin 40 is fixed between the groove of the main body 521 and the groove of the holding tool 522 (that is, the hole 524).

  Finally, the movable portion 53 is fixed by tightening the screw 531c of the slide portion 531 and the screw 532d of the universal joint 532.

  By the steps 1 to 9, the fracture fixing device 1 of the present embodiment can be fixed to the fracture.

  In the present embodiment, the fracture fixing device 1 is an example in which the stem plate portion 202 of the plate member 20 can be fixed to the bone main body 91 (that is, an example in which the fracture line is closer to the bone end than the stem plate portion 202). explained. However, even when the stem plate portion 202 cannot be fixed to the bone body 91 (that is, when the fracture line is on the diaphysis side of the stem plate portion 202), the external fixation member 50 included in the fracture fixing device 1 of the present invention. Since the bone fragment 90 and the bone main body 91 can be fixed by the above, the fracture fixing device 1 of the present invention is applicable.

    The fracture fixing device 1 of the present invention can be applied to fractures at similar sites in addition to the proximal portion of the humerus.

DESCRIPTION OF SYMBOLS 1 Fracture part fixing device 20 Plate member 201 Head plate part 202 Stem board part 21 1st bone pin through-hole 22 Bone screw through-hole 30 1st bone pin 31 One end 32 Other end 35 Screw head 36 Screw part 37 Shaft Part 40 second bone pin 41 one end 42 other end 46 screw part 50 external fixation member 51 first fixing part 511 fixing tool 512 fixing plate 52 second fixing part 53 movable part 531 slide part 532 universal joint 60 bone screw 70 Guide device 81 Positioning bar 82 Drill 90 Bone fragment 91 Bone body 92 Skin 95 Muscle 96 Suture

Claims (8)

A plate member installed in the body and fixing a plurality of bone fragments to each other;
One or more first bone pins including one end having a screw portion for fixing the plate member to the bone fragment, and the other end extending outside the body;
One or more second bone pins including one end fixed to the bone body and the other end extending outside the body;
An external fixation member that is fixed to the first bone pin and the second bone pin outside the body and maintains a position of the first bone pin with respect to the second bone pin;
A fracture fixing device.   The external fixation member has a movable part that can be fixed between a first fixing part fixed to the first bone pin and a second fixing part fixed to the second bone pin. The fracture fixing device according to claim 1, comprising: The fracture fixation device includes two or more of the first bone pins;
The external fixation member includes two or more fixtures in a first fixing portion fixed to the first bone pin,
Each of the first bone pins is disposed in a plane of a defined surface defined by each of the fixtures;
The fracture fixing device according to claim 1 or 2, wherein the defining surfaces are parallel to each other.   The fracture portion fixing device according to claim 3, wherein a longitudinal direction of the first bone pin with respect to the plate member is variable in a plane of the defining surface. The plate member is fixed to the bone fragment by a bone screw,
The bone screw is disposed in a plane parallel to the prescribed plane;
5. The fracture fixing device according to claim 3, wherein an interval between the prescribed surfaces is equal to or greater than a sum of a diameter of the screw portion of the first bone pin and a diameter of the bone screw.   The said 1st bone pin has the screw head which contact | abuts to the said plate member when the said screw part is fixed to the said bone main body in the distal side of the said screw part. The fracture fixing device of any one of Claims 1.   The fracture portion fixing according to claim 6, wherein the screw portion of the first bone pin is separable from the main body of the first bone pin at a position on the other end side of the screw head. Instruments.   The fracture bone fixing device according to any one of claims 1 to 7, wherein the bone plate includes a stem plate portion fixed to the bone body.

Images