JP2010284479A - Guide instrument for trephine drill - Google Patents
Guide instrument for trephine drill Download PDFInfo
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- JP2010284479A JP2010284479A JP2009159283A JP2009159283A JP2010284479A JP 2010284479 A JP2010284479 A JP 2010284479A JP 2009159283 A JP2009159283 A JP 2009159283A JP 2009159283 A JP2009159283 A JP 2009159283A JP 2010284479 A JP2010284479 A JP 2010284479A
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- patella
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Abstract
Description
本発明は骨付き膝蓋腱の膝蓋骨側の骨を安全に切るための器械に関するものである。 The present invention relates to an instrument for safely cutting bone on the patella side of a patella tendon with bone.
前十字靱帯断裂はスポーツ選手によくある損傷である、この断裂の治療は手術を要する。手術法としては、靭帯の移植術が主である。いろいろな腱を用いるが、そのなかでも骨付き膝蓋腱の移植が広く行われている。骨付き膝蓋腱とは、膝蓋腱を膝蓋骨の一部と脛骨の一部を付けて同時に採取したものである（図１）。骨付き膝蓋腱を採取するためには、まず膝蓋腱（１）を正確に切開する必要がある。つぎに脛骨側の骨を従来の骨鋸（８）を用いて骨を膝蓋腱の幅、長さは約２ｃｍに切り、脛骨の一部（２）を遊離させる。最後に膝蓋骨側の骨を従来の骨鋸（８）を用いて、幅は膝蓋腱の幅、長さは約２ｃｍに切り膝蓋骨の一部（３）を遊離させる（図２）。このようにして骨付き膝蓋腱を採取する。 Anterior cruciate ligament rupture is a common injury to athletes. Treatment of this rupture requires surgery. The main surgical procedure is ligament transplantation. Various tendons are used. Among them, patella tendons with bones are widely transplanted. The patella tendon with bone is a patella tendon obtained by attaching a part of the patella and a part of the tibia simultaneously (FIG. 1). In order to collect the patella tendon with bone, it is necessary to first accurately incise the patella tendon (1). Next, the bone on the tibia side is cut to about 2 cm in width and length of the patella tendon using a conventional bone saw (8), and a part (2) of the tibia is released. Finally, the bone on the patella side is cut into a width of the patella tendon and a length of about 2 cm using a conventional bone saw (8) to release a part of the patella (3) (FIG. 2). In this way, the patella tendon with bone is collected.
前記の方法では、次のような問題点があった。
（イ）従来の方法では、切る予定の深さ以上に骨切り（９）をするので（図３）、膝蓋骨の強度が低下する。脛骨では問題ないが、膝蓋骨（７）は小さいので、リハビリ中に大きくない外力で、膝蓋骨の縦骨折（１０）を起こすことがよくあった（図４）。
（ロ）膝蓋骨（７）の直上から骨鋸（８）を用いて切るため、大きな皮膚切開を要し、美容上問題があった。The above method has the following problems.
(A) In the conventional method, since the bone is cut (9) beyond the depth to be cut (FIG. 3), the strength of the patella decreases. Although there is no problem with the tibia, the patella (7) is small, so it often caused a vertical fracture (10) of the patella with a small external force during rehabilitation (FIG. 4).
(B) Since a bone saw (8) was used to cut from just above the patella (7), a large skin incision was required, and there was a cosmetic problem.
先端は嘴状で、大きな嘴は二股で膝蓋骨に沿う様な形をしており、小さな嘴は鋭く、膝蓋骨の下極に刺さるような形になっている。体部は円筒状で、尾部に取っ手をつけてある。以上の構成を持つガイド器である。 The tip is hook-shaped, and the large hook is bifurcated to follow the patella. The small hook is sharp and pierces the lower pole of the patella. The body is cylindrical and has a handle on the tail. This is a guide device having the above configuration.
本発明は、前記に説明したように構成されているので、以下の効果がある。
（イ）骨付き膝蓋腱の膝蓋骨側の骨部分の骨切を行う時に、トレフィンドリル（１１）を用いて、単独で骨切りを行うのは技術的に困難であるが（図６）、本発明を用いるとトレフィンドリル（１１）を容易に固定できるので、必要最小限の骨切りができ（図５）、膝蓋骨の縦骨折を従来の方法より起こしにくい。
（ロ）先に遊離した膝蓋腱と脛骨の骨片をトレフィンドリル（１１）に入れ、膝蓋骨の下極（１２）より、骨切りを行う。そのため、膝蓋骨直上の皮膚切開を必要としないので、美容上優れている。Since the present invention is configured as described above, the following effects can be obtained.
(A) When performing osteotomy of the bone part on the patella side of the patella tendon with bone, it is technically difficult to perform osteotomy alone using the trephine drill (11) (FIG. 6). Since the trephine drill (11) can be easily fixed by using the present invention, the minimum necessary osteotomy can be performed (FIG. 5), and the longitudinal fracture of the patella is less likely to occur than in the conventional method.
(B) The previously released patella tendon and tibial bone fragment are put into a trephine drill (11), and osteotomy is performed from the lower pole (12) of the patella. Therefore, it does not require a skin incision just above the patella, which is excellent in cosmetics.
以下、本発明の実施の形態について説明する。
（イ）先端は嘴状である。大きな嘴の部分（１３）は、二股で膝蓋骨に沿う様な形をしている。小さな嘴（１４）は鋭く、膝蓋骨の下極（１２）に刺さるような形になっている（図７）。
（ロ）体部は円筒である。内径はトレフィンドリル（１１）の外径と一致する。つまり適合している。本発明（１６）は、トレフィンドリル（１１）を完全に挿入した際に、トレフィンドリル（１１）の先端は小さな嘴の先端より、骨切り予定の長さだけ長く、二股の底の部分には達さないように設計されている（図８）。
（ハ）尾部にＴ字型の取っ手（１５）をつけてある（図９）。
本発明は以上のような構成である。Embodiments of the present invention will be described below.
(A) The tip is bowl-shaped. The large heel portion (13) has a bifurcated shape along the patella. The small heel (14) is sharp and shaped to pierce the lower pole (12) of the patella (FIG. 7).
(B) The body part is a cylinder. The inner diameter coincides with the outer diameter of the trephine drill (11). In other words, it is compatible. According to the present invention (16), when the trephine drill (11) is completely inserted, the tip of the trephine drill (11) is longer than the tip of the small scissors by the length that is scheduled for osteotomy. It is designed not to reach (Fig. 8).
(C) A T-shaped handle (15) is attached to the tail (FIG. 9).
The present invention is configured as described above.
骨付き膝蓋腱を採取するときに、まず膝蓋腱（１）を切開し、次に脛骨部分（２）を遊離する。遊離した脛骨（２）に紐（１７）をかけ、その紐を本発明のガイド（１６）に通して、遊離した脛骨と膝蓋腱をガイドの中に通す。このガイド（１６）の大きな嘴（１３）を膝蓋骨の表面に合わる（図１０）。小さな嘴（１４）を膝蓋骨の下極にあてる（図１０）。この段階で、前記の紐をトレフィンドリル（１１）に通して引きながら、トレフィンドリル（１１）をガイド（１６）の尾部より挿入する（図１１）。紐（１７）をしっかり引き、Ｔ字型の取っ手（１５）を押し、この段階で大きな嘴（１３）の二股の間（１８）に硬鋼線（１９）を刺入する（図１２）。Ｔ字型の取っ手（１５）をさらに押し、小さな嘴（１４）を膝蓋骨の下極（１２）に刺す。この段階でガイドはしっかり固定されている（図１１）。トレフィンドリル（１１）を回転させ骨切りをおこなう。突き当るところまで骨切りを行うと、予定の骨切りの長さだけ正確に骨切りができる（図１３）。最後に骨付き膝蓋腱の膝蓋骨の近位端を通常の骨鋸を用いて骨切りすると骨付き膝蓋腱は完全に採取される。なお、膝蓋骨の下極から、皮下より骨切りができるので、膝蓋骨の直上の皮膚切開を要しない。 When collecting a patella tendon with a bone, first the patella tendon (1) is incised and then the tibia part (2) is released. A string (17) is put on the released tibia (2), the string is passed through the guide (16) of the present invention, and the released tibia and patella tendon are passed through the guide. The large heel (13) of this guide (16) is aligned with the surface of the patella (FIG. 10). A small heel (14) is applied to the lower pole of the patella (Fig. 10). At this stage, the trephine drill (11) is inserted from the tail of the guide (16) while pulling the string through the trephine drill (11) (FIG. 11). The string (17) is pulled firmly and the T-shaped handle (15) is pushed, and at this stage, the hard steel wire (19) is inserted between the forks (18) of the large ridge (13) (FIG. 12). Push the T-shaped handle (15) further and pierce the small pole (14) into the lower pole (12) of the patella. At this stage, the guide is firmly fixed (FIG. 11). The trephine drill (11) is rotated to cut the bone. When the bone is cut to the end, the bone can be cut accurately for the length of the planned bone cut (FIG. 13). Finally, when the proximal end of the patella of the patella tendon with bone is cut using a normal bone saw, the patella tendon with bone is completely collected. Since the bone can be cut subcutaneously from the lower pole of the patella, skin incision directly above the patella is not required.
１ 膝蓋腱の中央三分の一
２ 脛骨の一部
３ 膝蓋骨の一部
４ 大腿骨
５ 脛骨
６ 腓骨
７ 膝蓋骨
８ 骨鋸
９ 従来の骨鋸を用いて、必要以上に骨切りしたときの骨切り線
１０ 膝蓋骨の縦骨折
１１ トレフィンドリル
１２ 膝蓋骨の下極
１３ 大きな嘴の部分
１４ 小さな嘴の部分
１５ 取っ手
１６ 本発明のガイド器
１７ 脛骨に掛けた紐
１８ 二股の間
１９ 硬鋼線1 Central third of the
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2009159283A JP5436072B2 (en) | 2009-06-12 | 2009-06-12 | Trephine drill guide device |
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|---|---|---|---|
| JP2009159283A JP5436072B2 (en) | 2009-06-12 | 2009-06-12 | Trephine drill guide device |
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| JP2010284479A true JP2010284479A (en) | 2010-12-24 |
| JP5436072B2 JP5436072B2 (en) | 2014-03-05 |
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Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN107184266A (en) * | 2017-05-17 | 2017-09-22 | 陈伟 | A kind of fixing device fixed and healed beneficial to patellar fracture |
| WO2018174169A1 (en) * | 2017-03-23 | 2018-09-27 | 国立大学法人京都大学 | Bone treatment guide, bone treatment guide set, and method for using bone treatment guide |
| CN112888374A (en) * | 2018-10-05 | 2021-06-01 | 史密夫和内修有限公司 | Tendon harvesting system |
Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH08507936A (en) * | 1992-10-27 | 1996-08-27 | ネオリガメンツ・リミテッド | Ligament graft harvesting method and instrument |
-
2009
- 2009-06-12 JP JP2009159283A patent/JP5436072B2/en not_active Expired - Fee Related
Patent Citations (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH08507936A (en) * | 1992-10-27 | 1996-08-27 | ネオリガメンツ・リミテッド | Ligament graft harvesting method and instrument |
Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2018174169A1 (en) * | 2017-03-23 | 2018-09-27 | 国立大学法人京都大学 | Bone treatment guide, bone treatment guide set, and method for using bone treatment guide |
| JPWO2018174169A1 (en) * | 2017-03-23 | 2020-01-30 | 国立大学法人京都大学 | Bone treatment guide, bone treatment guide set, and method of using the bone treatment guide |
| CN107184266A (en) * | 2017-05-17 | 2017-09-22 | 陈伟 | A kind of fixing device fixed and healed beneficial to patellar fracture |
| CN107184266B (en) * | 2017-05-17 | 2023-11-21 | 陈伟 | Fixing device beneficial to patella fracture fixation and healing |
| CN112888374A (en) * | 2018-10-05 | 2021-06-01 | 史密夫和内修有限公司 | Tendon harvesting system |
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| Publication number | Publication date |
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| JP5436072B2 (en) | 2014-03-05 |
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