JP2020058501A - Artificial hip joint surgical instrument - Google Patents

Abstract

To reduce a labor and a time when selecting a suitable neck in artificial hip joint replacement and artificial femoral head replacement.SOLUTION: An artificial hip joint surgical instrument (3) is detachably attached to a stem trial (2) installed on a femur of a patient, and comprises: a tip end part (300) which contacts a head trial (4) which is detachably attached to the artificial hip joint surgical instrument (3); bottoms (331b, 332b) contacting the stem trial (2); and a movable part (310) which is integrated with the tip end part (300) or bottoms (331b, 332b) and moves according to an operation performed by an operator for varying a length of the artificial hip joint surgical instrument (3).SELECTED DRAWING: Figure 2

Description

  TECHNICAL FIELD The present invention relates to an artificial hip joint surgical instrument used in artificial hip joint replacement and artificial head replacement.

  BACKGROUND ART Conventionally, surgical support instruments used in artificial hip joint replacement and artificial head replacement have been known. The total hip arthroplasty is performed mainly for diseases such as osteoarthritis and is a surgery for rebuilding the hip joint by replacing the deformed hip joint with an artificial object. The artificial head replacement technique is mainly performed on hip fractures (femoral neck fractures), and is an operation of replacing a fractured hip joint with an artificial one instead of fixing the bone with metal.

  In Patent Document 1, a stem trial (stem broach) imitating a shape of a stem is provided on a proximal portion of a femur of a patient, a neck trial detachable with respect to the stem trial, and detachable with respect to the neck trial. A surgical assistance instrument for hip arthroplasty having a head trial is described. In the technique of Patent Document 1, for example, in the artificial hip joint replacement, after the head of the patient's femur in the proximal part (part on the pelvis side) is excised, the bone tissue inside the femur is utilized by using the stem trial. A hole for inserting the stem is formed by scraping. Then, with the stem trial still inserted, the neck trial is fixed to the proximal portion of the stem trial, and the head trial is fitted to the tip of the neck trial. In this state, the operator confirms how the patient's leg moves and determines the shape of the stem and the shape of the head to be attached to the patient. Then, these trials are taken out from the patient's body and the stem or the like is attached to the patient.

JP, 2013-094331, A

  In the surgery as described above, it is necessary to properly adjust the tension of the hip joint. The tension of the hip joint is mainly determined by the installation position of the cup, which is the implant of the pelvic acetabulum, the installation position of the stem, which is the implant of the femur, and the length of the neck between the cup and the stem. In surgery, first, the cup and stem are placed, so the postoperative results depend on the choice of neck. In this respect, since there are necks of various lengths, the operator has to change the neck trial many times in order to select the optimum neck, which is troublesome.

  An object of the present invention is to provide an artificial hip joint surgical instrument capable of reducing the trouble when selecting an appropriate neck in the artificial hip joint replacement or artificial femoral head replacement.

  In order to solve the above problems, an artificial hip joint surgery instrument according to the present invention is an artificial hip joint surgery instrument that is detachable from a stem trial installed in a femur of a patient, and The tip part that contacts the detachable head trial, the bottom part that contacts the stem trial, and the tip part or the bottom part are integrated, and the length of the artificial hip joint surgical instrument is changed by moving according to the operation of the operator. And a movable part that is variable.

  Further, in one aspect of the present invention, the movable part has a tooth profile on a side surface, the artificial hip joint surgery instrument further includes a gear meshing with the tooth profile, and the gear has a rotation operation for rotating the gear. It is characterized by including a reception part which receives, and the movable part receives force from the gear wheel rotated by the rotation operation of the operator, and moves.

  Further, in one aspect of the present invention, the reception unit is disposed on a front side of the artificial hip joint surgical instrument, and a first reception unit that receives the rotation operation from the front side and a rear side of the artificial hip joint surgical instrument. And a second reception unit that receives the rotation operation from the back side, and the movable unit moves according to the rotation operation received by the first reception unit or the second reception unit. It is characterized by:

  Further, in one aspect of the present invention, the artificial hip joint surgery instrument further includes a housing portion that stores the gear, and the housing portion of the housing portion in which the gear is stored is formed in a convex shape. The corners of the storage portion of the casing are rounded.

  Further, in one aspect of the present invention, the movable part has the tooth profile on a first side surface and a plurality of grooves on a second side surface, and the artificial hip joint surgical instrument is any one of the plurality of grooves. Further includes a claw portion that restrains the movable portion from moving in a direction opposite to the traveling direction, and each of the plurality of grooves has an inclination on the traveling direction side more than an inclination on the reverse direction side. It is characterized in that it is steep and the inclination on the traveling direction side is smaller than 90 °.

  Further, in one aspect of the present invention, the movable portion has a mark on a front surface, and the artificial hip joint surgery instrument further includes a housing portion that stores the movable portion, and the housing portion has a position of the landmark. According to the present invention, a hole for guiding the current length of the artificial hip joint surgical instrument is formed in the front surface.

It is a figure which shows an example of the surgery assistance instrument which concerns on embodiment. It is a figure which shows the detail of a neck trial. It is sectional drawing of a movable part. It is a side view of a neck trial. It is a figure which shows a mode that a gear rotates and the length of a neck trial changes. It is a figure which shows a mode that a neck trial extends.

  Hereinafter, an example of an embodiment according to the present invention will be described in detail with reference to the drawings. FIG. 1 is a diagram showing an example of a surgery support instrument according to an embodiment. The surgical operation support instrument 1 is an instrument that supports artificial hip joint replacement and artificial head replacement, and includes, for example, a stem trial 2, a neck trial 3, a head trial 4, and a driver 5.

  The stem trial 2 is a member corresponding to the stem of the artificial hip joint, and is used to form a hole for installing the stem inside the femur. The stem trial 2 has an external shape substantially similar to that of the stem, and is made of metal such as stainless steel. Although not shown in FIG. 1, the stem trial 2 has a large number of blades on the outside, and the operator inserts the stem trial 2 into the proximal portion of the femur of the patient and attaches the blades. The hole is formed by utilizing and scraping the bone tissue in the femur. A hole portion into which the neck trial 3 can be inserted is provided in the proximal portion 2a of the stem trial 2.

  The neck trial 3 is an example of the artificial hip joint surgical instrument according to the present invention, and may be called a trial neck or a karker trial (a karker is below the neck of the femur). The neck trial 3 is a member corresponding to the neck of the artificial hip joint. In the present embodiment, the stem trial 2 and the neck trial 3 that are experimentally installed in the patient's body are separate members from each other, but the artificial hip joint finally implanted in the patient's body is The neck may be integrated, or the stem and the neck may be separate as in the trial.

  The neck trial 3 is attachable to and detachable from the stem trial 2 installed on the femur of the patient, and serves as a neck portion extending from the proximal portion 2 a of the stem trial 2. The neck trial 3 may be made of any material, for example, metal such as stainless steel, carbon, or resin. In the present embodiment, the case where the neck trial 3 is male and the stem trial 2 is female is described, but the male / female relationship may be reversed. However, the male / female relationship as in the present embodiment makes it easier to secure a space for storing a structure for changing the length of the neck trial 3 inside the neck trial 3.

  The head trial 4 is a member corresponding to the head (bone head ball) of the artificial hip joint. The head trial 4 is attachable to and detachable from the neck trial 3 and is slidable in a cup installed in the pelvis of a patient. The head trial 4 has a shape in which a part of a spherical member is cut off, and has a hole for inserting a tip portion of a neck trial 3 described later. The diameter of the hole of the head trial 4 is substantially the same as the diameter of the tip of the neck trial 3. For example, a rubber ring for slip prevention is arranged in the hole. The head trial 4 may be made of any material, and may be made of metal such as stainless steel, carbon, or resin, for example.

  The driver 5 is inserted into a later-described reception unit 321 of the neck trial 3 and is used to change the length of the neck trial 3. The length of the neck trial 3 is the length in the longitudinal direction of the neck trial 3, and is the distance between the top surface and the bottom surface of the neck trial 3 (the distance from the top surface to the bottom surface). The tip portion 5a of the driver 5 may have any shape, and is a quadrangle in this embodiment, but may be another polygon such as a triangle, a pentagon, or a hexagon, or a cross. Other shapes such as

  FIG. 2 is a diagram showing details of the neck trial 3. FIG. 2A is a perspective view of the neck trial 3, and FIG. 2B is an exploded view of the neck trial 3. As shown in FIGS. 2A and 2B, the neck trial 3 is composed of a plurality of members, for example, the tip portion 300, the movable portion 310, the gear 320, the housing portion 330, the claw portion 340, The holding part 350 and the stop parts 360 and 370 are included.

  The tip portion 300 is a member that is in contact with the head trial 4 that is detachable from the neck trial 3. The tip portion 300 is provided as a receiving portion for receiving the head trial 4. The tip portion 300 is a portion that protrudes from the hole portion of the stem trial 2 when the bottom portion of the housing portion 330 is inserted into the hole portion. The shape of the tip portion 300 is substantially the same as the hole portion provided inside the head trial 4, and the head trial 4 is attached to the neck trial 3 by inserting the tip portion 300 into the hole portion of the head trial 4. It

  In the present embodiment, the tip portion 300 has a hollow cylindrical shape and is tapered toward the upper surface. The tip portion 300 may have any shape as long as it can be inserted into the hole portion of the head trial 4, and any shape can be applied. The tip portion 300 may be of any shape as long as it matches the shape of the hole portion of the head trial 4, and may have, for example, a cylindrical shape, an elliptic cylindrical shape, or a prismatic shape.

  The movable portion 310 is a member that is integrated with the distal end portion 300 and moves according to the operation of the operator to change the length of the neck trial 3. In the present embodiment, a case will be described in which the tip portion 300 is fitted into the movable portion 310 and is in close contact with each other. However, the tip portion 300 and the movable portion 310 are not separate members but integrated as a member. May be. The movable portion 310 corresponds to the neck portion of the neck trial 3 and is movable in the longitudinal direction of the neck trial 3.

  3 is a sectional view of the movable portion 310, and FIG. 3A is a sectional view of the movable portion 310 taken along the line AA. As shown in FIG. 3A, the cross section of the movable portion 310 is a semi-cylindrical type, which ensures higher strength than a simple columnar type or the like. In other words, the cross section of the movable portion 310 has a shape in which a rectangle is sandwiched between two semicircles, and the strength of the rectangle is stronger because the side of the rectangle in the longitudinal direction is longer than the diameter of the semicircle. Has become. The movable portion 310 may have any shape, and may be, for example, a prism, a cylinder, or an elliptic cylinder.

  FIG. 3B is a cross-sectional view of the movable portion 310 taken along the line BB. Note that FIG. 3B also shows a cross section of the tip portion 300. As shown in FIG. 3B, the movable portion 310 is inserted inside the tip portion 300 and is integrated with the tip portion 300. The movable part 310 is provided with a tooth mold 311 on its side surface. The tooth mold 311 is provided on the surface of the movable portion 310 on the longitudinal direction side, for example, on the right side surface when viewed from the front of the neck trial 3. The tooth profile 311 has a straight tooth line, and a plurality of teeth are arranged on the straight line. The tooth profile 311 is a straight tooth profile that meshes with the gear 320.

  The movable part 310 is a bar-shaped gear that moves linearly by having the tooth profile 311. In other words, the movable part 310 is a rack in a so-called rack and pinion. The rack is a linear gear that has an infinite pitch cylinder radius. The tooth mold 311 may have any shape as long as it meshes with the gear 320, and a tooth trace of any shape can be applied. In the present embodiment, it is assumed that the gear 320 is a spur gear (a gear whose teeth are parallel to the axis) and the tooth profile 311 has the same shape, but the gear 320 is a helical rack (spur gear). The tooth mold 311 may also have an oblique shape as long as it is a helical gear in which the teeth of (4) are cut obliquely with respect to the axis.

  In the present embodiment, the movable part 310 is provided with the tooth mold 311 on the first side surface and is provided with the plurality of grooves 312 on the second side surface. In the present embodiment, the first side surface and the second side surface are surfaces opposite to each other. In the example of FIGS. 2 and 3B, the first side surface is the right side surface when viewed from the front, and the second side surface is the left side surface when viewed from the front. The second side surface does not have to be the opposite side of the first side surface, and the second side surface may be a surface next to the first side surface. Further, in the present embodiment, the case where the interval (pitch width) of the tooth mold 311 and the interval of the groove 312 are different, but they may be the same.

  FIG. 3C is an enlarged view of the groove 312. As shown in FIG. 3C, each of the plurality of grooves 312 is V-shaped and has a predetermined inclination. In the present embodiment, in the groove 312, the inclination 312a on the advancing direction side is steeper than the inclination 312b on the reverse direction side, and the inclination 312a on the advancing direction side is smaller than 90 °.

  The traveling direction is a direction in which the movable portion 310 moves, and in the present embodiment, a direction from the bottom surface to the upper surface of the movable portion 310. In other words, the traveling direction is the direction in which the neck trial 3 extends. The opposite direction is a direction having an intersection angle of 180 ° with the traveling direction, and in the present embodiment, a direction from the upper surface to the bottom surface of the movable portion 310. In other words, the opposite direction is the direction in which the neck trial 3 contracts.

  In the present embodiment, the movable portion 310 moves upward when viewed from the front, so that of the two inclinations of the groove 312, the upper inclination 312a is steeper than the lower inclination 312b and the upper inclination is higher. The inclination 312a is smaller than 90 °. If the inclination 312a is too loose, even if the claw portion 340 is in contact with the groove 312, the movement of the movable portion 310 in the opposite direction cannot be suppressed, so that it has a certain angle. For example, the angle of the inclination 312a is 70 ° or more and less than 90 °. On the other hand, if the inclination 312b is too steep, the movable portion 310 does not move in the traveling direction, so the angle is set to an extent that does not suppress the movement of the movable portion 310. For example, the angle of the inclination 312a is 10 ° or more and less than 45 °.

  The groove 312 may have any shape as long as it can prevent the movable portion 310 from moving in the opposite direction by engaging with the tip of the claw 340, and the shape of the groove 312 is not limited to the above example. The groove 312 may have another shape, the inclination 312a on the traveling direction side may be 90 ° or more, and the groove 312 may have another shape such as a U shape instead of the V shape. It may be.

  Returning to FIG. 2, the movable portion 310 is provided with marks 313 and 314 on its surface. In this embodiment, each of the marks 313 and 314 is a groove provided on the front surface of the movable portion 310. The marks 313 and 314 are visible through holes in the first housing 331, which will be described later, and the current length of the neck trial 3 is guided by the positions of the marks 313 and 314. It is assumed that the similar mark is also provided on the back surface of the movable section 310 and can be seen from the hole of the second housing section 332 described later. It should be noted that the marks 313 and 314 may be any marks that can guide the current length of the neck trial 3, and may be markers printed on the movable portion 310 or the movable portion 310 in addition to the groove. It may be an attached seal or the like.

  The gear 320 is a gear that meshes with the tooth mold 311. In the present embodiment, since the rack and pinion is used to linearly move the movable portion 310, the gear 320 is a pinion (cylindrical gear). The gear 320 may have any shape as long as it meshes with the tooth mold 311 and a tooth trace of any shape can be applied. As shown in FIG. 2, in the present embodiment, the tooth mold 311 is a spur gear, and therefore the gear 320 is also a spur gear. However, if the tooth mold 311 is a helical rack, the gear 320 is provided with slanted teeth. It will be the helical pinion.

  The pitch width (distance from one tooth to the next tooth) of the tooth mold 311 and the gear 320 may be any length, for example, a pitch according to the length of the neck to be actually implanted in the patient's body. You can For example, if a plurality of necks having different lengths are prepared and the difference in the length of each neck is X (X is an arbitrary positive number) mm, the pitch of each of the tooth mold 311 and the gear 320 is X. A value obtained by dividing millimeters by Y (Y is a natural number) may be used. With such a pitch, the movable portion 310 can be moved according to the length of the neck to be actually embedded. Further, the interval between the grooves 312 may be arbitrary, but when X millimeter is divided by Z (Z is a natural number and may be the same as or different from Y), the rotation of the gear 320 is reduced. The claw portion 340 can be engaged with the groove 312 so that

  For example, the gear 320 includes a reception unit 321 that receives a rotation operation. The reception unit 321 is provided on the rotation shaft of the gear 320. The rotating operation is an operation of rotating the gear 320, and in the present embodiment, is an operation of rotating the gear 5 in a predetermined direction with the tip portion 5a of the driver 5 inserted in the hole of the receiving portion 321. The surgeon inserts the tip portion 5a of the driver 5 into the receiving portion 321 of the neck trial 3 and rotates the gear 320 to rotate the gear 320 to change the length of the neck trial 3. The surgeon may rotate the neck trial 3 with the stem trial 2 attached to the stem trial 2, or may rotate the neck trial 3 before attaching the neck trial 3 to the stem trial 2. You may change it.

  Note that the rotating operation can be applied to any operation and is not limited to the operation using the driver 5. For example, a knob may be provided on the rotating shaft of the gear 320, and the operator may turn the knob, which corresponds to the rotating operation. In this case, the knob corresponds to the reception unit 321.

  In the present embodiment, the reception unit 321 is arranged on the front side of the neck trial 3, the first reception unit 322 that receives a rotation operation from the front side, and the rear side of the neck trial 3 are arranged from the rear side. And a second accepting unit 323 that accepts the rotation operation of. It should be noted that the accepting unit 321 may not have either the first accepting unit 322 or the second accepting unit 323, and may accept only the rotating operation from one side.

  The first receiving portion 322 has a hole having the same shape as the tip portion 5a of the driver 5, and the tip portion 5a of the driver 5 can be inserted therein. In the present embodiment, the tip portion 5a of the driver 5 has a square shape, and therefore the hole of the first receiving portion 322 also has a square shape. However, if the tip portion 5a of the driver 5 has another shape, the first The hole of the reception unit 322 also has the other shape. The first receiving unit 322 is integrated with the gear 320 and serves as a rotation shaft of the gear 320.

  In addition, in the example of FIG. 2, the case where the first receiving portion 322 has a hollow cylindrical shape and a square hole is formed inside the first receiving portion 322 will be described, but the first receiving portion 322 has an arbitrary shape. It may be, for example, a hollow prism or an elliptic cylinder. The second receiving unit 323 has the same structure and role as the first receiving unit 322, and thus the description thereof will be omitted. The first receiving unit 322 and the second receiving unit 323 are arranged so as to sandwich the main body portion of the gear 320.

  The housing portion 330 is a member that stores the movable portion 310, the gear 320, and the like. The housing portion 330 has a shape that can be inserted into the stem trial 2 and has a size that allows each member of the neck trial 3 to be stored therein. It is not limited to the example of the embodiment.

  As shown in FIG. 2, in the present embodiment, the housing section 330 includes a first housing section 331 arranged on the front side and a second housing section 332 arranged on the back side. Each member such as the movable portion 310 and the gear 320 is housed in the housing portion 330 so as to be sandwiched between the first housing portion 331 and the second housing portion 332.

  The first housing 331 is a housing on the front side of the neck trial 3. As shown in FIG. 2, the storage portion 331a of the first housing 331, in which the gear 320 is stored, is formed in a convex shape. The convex shape means that the storage portion 331a is protruded from the surroundings, and the storage portion 331a is protruded from other portions of the first housing portion 331 (for example, the storage portion of the movable portion 310 or the claw portion 340). The storage portion 331a only needs to have a size capable of storing the gear 320, and the height (convexity) of the storage portion 331a is designed according to the length of the gear 320 in the rotation axis direction. The width of 331a may be designed according to the diameter of the gear 320.

  FIG. 4 is a side view of the neck trial 3. The side view of FIG. 4 shows how the neck trial 3 is seen from the arrow indicated by the symbol I in FIG. As shown in FIG. 4, in the present embodiment, the corners of the storage portion 331a of the first housing 331 are rounded so that gauze or the like is less likely to get caught during surgery. That is, the end of the surface of the protruding portion of the storage portion 331a (around the upper surface of the storage portion 331a) is not angular but curved and rounded. The angle of the storage portion 331a may not be 90 °, and the bending degree may be arbitrary.

  Further, the storage portion 331a has a hole for inserting the first receiving portion 322 of the gear 320. This hole is provided to match the diameter of the first receiving portion 322, and the first receiving portion 322 is inserted and fixed in the storage portion 331a. A similar hole is also provided in the storage portion 332a of the second housing portion 332 so that the second receiving portion 323 can be inserted. When the neck trial 3 is assembled, the first receiving portion 322 and the second receiving portion 322 of the gear 320 are supported by the storage portions 331a and 332a, and when the operator inserts the driver 5 and performs a rotation operation. The gear 320 rotates.

  Returning to FIG. 2B, the first housing portion 331 includes a bottom portion 331b that is in contact with the stem trial 2. The bottom portion 331b has a shape that can be inserted into a hole provided in the proximal portion 2a of the stem trial 2. A hole is provided on the surface of the bottom portion 331b of the first housing portion 331, and the protrusion provided on the bottom portion 332b of the second housing portion 332 is inserted into the first housing portion 331 and the second housing portion 331. The body portions 332 are adapted to be in close contact with each other.

  In the present embodiment, a hole 331c for guiding the current length of the neck trial 3 is formed on the front surface of the first housing portion 331 depending on the positions of the marks 313 and 314. For example, the hole 331c is elongated in the moving direction of the movable portion 310, and is formed at a position where the marks 313 and 312 of the movable portion 310 can be seen when the neck trial 3 is assembled.

  In the present embodiment, the length of the neck trial 3 changes in four steps. As shown in FIG. 2B, letters “A” to “D” indicating the respective stages are shown near the hole 331c. These characters may be engraved on the surface of the first housing portion 331 or may be printed on the surface.

  For example, “A” indicates the length of the first step, and indicates that the neck trial 3 is the shortest. “A” is provided at the position of the mark 313 when the neck trial 3 has the length of the first step (when the claw portion 340 is fitted in the uppermost groove 312).

  Further, for example, “B” indicates the length of the second stage, and indicates that the neck trial 3 is in the second shortest state (third longest state). “B” is arranged at the midpoint of “A” and “C”, and when the neck trial 3 has the length of the second stage (when the claw portion 340 is fitted in the second groove 312 from the top). It is provided at the position of the mark 313.

  Further, for example, “C” indicates the length of the third stage, and indicates that the neck trial 3 is in the third shortest state (second longest state). “C” is provided at the position of the mark 313 when the neck trial 3 has the length of the third stage (when the claw portion 340 is fitted in the second groove 312 from the bottom). The spacing between the letters “A” to “C” is the same as the spacing between the grooves 312.

  Further, for example, “D” indicates the length of the fourth stage, and the neck trial 3 indicates the longest state. In the present embodiment, when the neck trial 3 is in the longest state, the mark 313 protrudes outside the first housing portion 331, so the length is guided by the mark 314 on the lower side. Therefore, “D” is shown below “A” in the first stage, and when the neck trial 3 has the length of the fourth stage (the claw portion 340 is fitted in the lowermost groove 312). It is provided at the position of the mark 314 (at time). FIG. 2A shows the case where the neck trial 3 has the length of the fourth step, and as shown in FIG. 2A, the mark 314 is at the position of “D”.

  The mark 314 is hidden in the first housing 331 until the neck trial 3 is in the longest state, and cannot be seen from the hole 331c. When the neck trial 3 is in the longest state, the mark 314 emerges from the hole 331c and moves to the position indicated by the letter "D", as shown in FIG. 2 (a). In this case, the mark 313 protrudes outside the housing section 330.

  The second housing portion 332 has a structure similar to that of the first housing portion 331, but is different from the first housing portion 331 in that the bottom portion 332b has a protrusion instead of a hole as described above. The other structure of the second casing 332 is similar to that of the first casing 331.

  The claw portion 340 is a member that engages with any of the plurality of grooves 312 and prevents the movable portion 310 from moving in the direction opposite to the traveling direction. The claw portion 340 may have any shape as long as it engages with the groove 312. In the present embodiment, since the groove 312 has a V shape, the tip of the claw portion 340 also has a V shape.

  As shown in FIG. 2B, the claw portion 340 has a convex portion 341 arranged on the front side and a convex portion 342 arranged on the rear side. The convex portion 341 is inserted into the hole 331d of the first housing portion 331, and the convex portion 342 is inserted into the hole 332d of the second housing portion 332. Therefore, when the neck trial 3 is assembled, as shown in FIG. 2A, the claw portion 340 is fixed by being sandwiched between the first housing portion 331 and the second housing portion 332.

  For example, the claw portion 340 includes a knob 343 for releasing the engagement state with the groove 312. As shown in FIG. 2, since the protrusions 341 and 342 and the holes 331d and 332d are circular with respect to each other, when the operator pushes down the knob 343 after assembling the neck trial 3, the claw 340 is removed. , And rotates about the center line of the convex portions 341 and 342. As a result, the tip of the claw portion 340 moves in a direction away from the groove 312, and the engagement state between the claw portion 340 and the groove 312 is released. When the engaged state is released, the movable part 310 can be moved in the direction opposite to the traveling direction.

  The pressing portion 350 is a member for returning the pawl portion 340 to the original posture by the repulsive force when the operator releases the hand after pushing down the knob 343 of the pawl portion 340. The pressing portion 350 is arranged closer to the movable portion 310 side than the claw portion 340. When the operator pushes down the knob 343 of the claw portion 340, the rotating claw portion 340 receives pressure toward the movable portion 310 side. After that, when the operator releases the finger from the knob 343 of the claw 340, a repulsive force that causes the pressing portion 350 to return to the original position acts, and the claw 340 rotates in the opposite direction and returns to the original posture.

  The stoppers 360 and 370 are members for connecting the first housing portion 331 and the second housing portion 332. The shapes of the stoppers 360 and 370 are such that they fit into the recesses of the first housing portion 331 and the second housing portion 332.

  FIG. 5 is a diagram showing how the gear 320 rotates to change the length of the neck trial 3. Note that, in FIG. 5, only the tip portion 300, the movable portion 310, the gear 320, the claw portion 340, and the holding portion 350 are shown for simplification of description. As shown in FIG. 5, when the gear 320 rotates with the claw 340 fitted in the groove 312, the gear 320 meshes with the tooth mold 311 of the movable portion 310, so that the movable portion 310 contacts the gear 320. An external force due to the rotation of the gear 320 is received from the part that is moving, and moves in the traveling direction.

  When the movable portion 310 moves in the traveling direction, the claw portion 340 moves up the slope 312b on the lower side of the groove 312, and then comes out of the groove 312. When the claw portion 340 is disengaged from the groove 312, the side surface of the movable portion 310 is touched. After that, when the gear 320 continues to rotate and the claw portion 340 moves to the next groove 312, the claw portion 340 slides down the slope 312a on the upper side of the groove 312 and fits in the groove 312. When the claw 340 fits in the groove 312, vibration is generated, and the operator can feel that the claw 340 fits in the groove 312 from the sound or the sense of the hand.

  FIG. 6 is a diagram showing how the neck trial 3 extends. In addition, in FIG. 6, reference numerals not specifically referred to are omitted. In the present embodiment, the neck trial 3 is variable in length in four stages, so in FIGS. 6A to 6D, the neck trial 3 extends from the first stage to the fourth stage. Shows. As described above, since the movable part 310 moves by receiving the force from the gear 320 that rotates by the rotation operation of the operator, for example, the operator inserts the tip 5a of the driver 5 into the first receiving part 322. When the gear is rotated in a predetermined direction by, the gear 320 integrated with the first receiving portion 322 rotates in the predetermined direction.

  For example, when the operator inserts the driver 5 into the first receiving unit 322 and rotates it clockwise (clockwise) when viewed from the front, the gear rotates clockwise and the movable unit 310 is pushed upward. Receives the force of direction. As a result, the movable portion 310 moves in the upward direction, which is the traveling direction, by the pitch width of the teeth. When the operator inserts the driver 5 into the first receiving portion 322 and rotates it counterclockwise when viewed from the front, when the claw portion 340 is engaged with the groove 312, , The movable portion 310 is restrained from moving downward.

  However, since the second receiving unit 323 is provided on the back side, the rotation direction of the driver 5 for moving the movable unit 310 is different from that of the first receiving unit 322. For example, when the operator inserts the driver 5 into the second receiving unit 323 and rotates it counterclockwise (clockwise) when viewed from the back, the gear rotates counterclockwise and the movable unit 310 is pushed upward. Receives the force of direction. As a result, the movable portion 310 moves in the upward direction, which is the traveling direction, by the pitch width of the teeth. When the operator rotates the driver 5 in the opposite direction, the movable portion 310 is restrained from moving downward, which is similar to the first receiving portion 322.

  The operator may use either the first reception unit 322 or the second reception unit 323. For example, if the front of the neck trial 3 faces the surgeon when operating the patient's left leg hip joint, the surgeon inserts the driver 5 into the first reception unit 322 to move the movable unit 310. Further, for example, if the back surface of the neck trial 3 faces the operator when operating the hip joint of the patient's right leg, the operator inserts the driver 5 into the second reception unit 323 to move the movable unit 310. The movable unit 310 may be moved according to the rotation operation received by the first reception unit 322 or the second reception unit 323.

  Even if the neck trial 3 described above is attached to the stem trial 2, the operator can move the movable portion 310 to change the length, so that the neck trial 3 having a different length can be selected. It is possible to eliminate the trouble of changing the neck trial many times and to reduce the trouble of selecting an appropriate neck in the artificial hip joint replacement and the artificial head replacement. Therefore, the operator can easily select a neck suitable for the patient. Further, the operation time can be shortened, and the burden on the operator and the patient can be reduced.

  Further, since the toothed part 311 is provided on the side surface of the movable part 310 and the movable part 310 is moved by rotating the gear 320 that meshes with the toothed part 311, the operator changes the length of the neck trial 3 by a simple operation. be able to. For this reason, it is possible to effectively reduce the trouble in selecting the neck. Further, when the receiving portion 321 is provided on the front side or the back side of the neck trial 3 as in the present embodiment, when the neck trial 3 is attached to the stem trial 2 installed in the femur of the patient, the receiving portion 321 is Since it faces the operator, it becomes easy to perform a rotating operation using the driver 5.

  Moreover, the neck trial 3 has the 1st reception part 322 and the 2nd reception part 323, and can receive a rotation operation from both the front side and the back side. Therefore, for example, when operating on the left side of the hip joint, the first reception unit 322 on the front side can be used, and when operating on the right side of the hip joint, the second reception unit 323 on the back side can be used. No matter which side of the surgery is performed, one neck trial 3 can be used. Therefore, the trouble of preparing a right neck trial and a left neck trial can be saved.

  Further, since the storage portion 331a of the housing portion 330 in which the gear 320 is stored is formed in a convex shape and the driver 5 can be inserted easily, the rotating operation becomes easy. Further, by rounding the corners of the storage portion 331a, it becomes difficult for gauze or the like used during surgery to be caught.

  Further, by making the inclination 312a on the advancing direction side of the groove 312 that meshes with the claw portion 340 steeper than the inclination 312b on the opposite side, the claw portion 340 can be engaged more reliably. Further, when the inclination 312a of the groove 312 on the traveling direction side is 90 °, it may be difficult to feel the sound or the texture when the claw portion 340 is fitted in the groove 312, but the inclination is made smaller than 90 °. As a result, the tip of the claw portion 340 fits into the groove 312 while sliding down the surface of the slant 312a, so that it is easy to feel the sound and the texture when the claw portion 340 fits into the groove 312. Further, by making the inclination 312a smaller than 90 °, when the knob 343 of the claw 340 is pushed down, the tip of the claw 340 easily comes off the groove 312, and the operation of contracting the neck trial 3 becomes easy.

  Further, by making the marks 313 and 314 of the movable portion 310 visible through the hole 331c of the housing portion 330, it becomes easy to confirm the current length of the neck trial 3. Further, when the neck trial 3 is attached to the stem trial 2 installed in the femur of the patient by providing the holes 331c and the marks 313 and 314 on the front side, the marks 313 and 314 face the operator. It will be easier to check the current length of Trial 3.

  The present invention is not limited to the embodiment described above. Modifications can be made as appropriate without departing from the spirit of the present invention.

  For example, in the embodiment, the current length of the neck trial 3 is guided by the marks 313 and 314 of the movable portion 310, the letters “A” to “D” and the holes 331c and 332c of the housing portion 330. Although the case has been described, other methods may be used to guide the current length of the neck trial 3. For example, while marking the first receiving portion 322 and writing the letters “A” to “D” around the storage portion 331a, the current rotational position of the gear 320 is used to determine the current state of the neck trial 3. May be guided. In this case, it is assumed that the letter "A" is written at the position where the mark of the first receiving portion 322 faces when the neck trial 3 has the length of the first stage. Similarly, for the other characters, the letters "B" to "D" are written at the positions where the marks of the first reception portion 322 face when the neck trial 3 has the lengths of the second stage to the fourth stage, respectively. It has been done. Since the mark of the first receiving portion 322 faces the direction corresponding to the current rotational position of the gear 320, the surgeon can grasp the current length of the neck trial 3 by the character in the direction indicated by the mark. You can Similarly, on the back side, in addition to marking the second receiving portion 323, the letters "A" to "D" are written around the storage portion 332a, and using the current rotational position of the gear 320, The current length of the neck trial 3 may be guided. Alternatively, for example, a similar mark may be provided on the driver 5, and the current length of the neck trial 3 may be guided by guiding how much the driver 5 has been turned.

  Further, for example, in the embodiment, the traveling direction of the movable portion 310 is the upward direction, but the traveling direction of the movable portion 310 may be the downward direction. In this case, the neck trial 3 is gradually shortened from the longest state. When the traveling direction is opposite to that of the embodiment, the direction of the rotation operation for moving the movable portion 310 (the rotation direction of the gear 320) is also the opposite direction. Further, the shape of the groove 312 is also upside down, and the inclination of the lower side becomes steep and the inclination of the upper side becomes gentle.

  Further, for example, in the embodiment, the case where the distal end portion 300 and the movable portion 310 are integrated has been described. However, the movable portion 310 is integrated with the bottom portion 331b and moves according to the operation of the operator, so that the neck The length of the trial 3 may be variable. In this case, the movable portion 310 is extended by the rotating gear 320 toward the stem trial 2 side. When the movable part 310 and the bottom part 331b are integrated, it is assumed that the main part of the housing part 330 is a separate member.

  Further, for example, the method of moving the movable portion 310 is not limited to the method using the gear 320. For example, the housing portion 330 may be provided with a screw hole, and the movable portion 310 may be a screw. In this case, by rotating the movable portion 310, which is a screw, the length of the neck trial 3 is reduced. It may be variable. Alternatively, for example, the movable portion 310 may be moved using a spring, a slide rail, or the like.

  Further, for example, in the embodiment, the case where the traveling direction of the movable portion 310 is the vertical direction when viewed from the front and the movable portion 310 extends straight has been described. However, in addition to the linear neck, a neck that bends at a certain angle in the middle Also exists. In order to deal with such a neck, the tip portion 300 may be movable in the horizontal direction (the left-right direction or the front direction when viewed from the front of FIG. 2). For example, a mechanism capable of sliding the tip portion 300 in the horizontal direction (for example, a slide rail) is attached in advance, and the tip portion 300 may be slid in the horizontal direction to deal with a curved neck. In addition, for example, as described in the embodiment, when the tip portion 300 and the movable portion 310 are integrated, a mechanism capable of bending the movable portion 310 in the middle (for example, a ratchet including gears and pawls) is provided. The movable part 310 may be provided and bent in the middle to deal with a curved neck.

  DESCRIPTION OF SYMBOLS 1 Surgery support device, 2 stem trial, 2a proximal part, 3 neck trial, 4 head trial, 5 driver, 5a tip part, 300 tip part, 310 movable part, 311 tooth model, 312 groove, 312a, 312b inclination, 313 , 314 mark, 320 gear, 321 reception part, 322 first reception part, 323 second reception part, 330 housing part, 331 first housing part, 331a storage part, 331b bottom part, 331c hole, 331d hole, 332d 2 housing part, 332a storage part, 332b bottom part, 332c hole, 332d hole, 340 claw part, 341, 342 convex part, 343 knob, 350 pressing part, 360, 370 stop part.

Claims (6)

An artificial hip joint surgical instrument detachable from a stem trial installed on a patient's femur,
A tip portion that comes into contact with a removable head trial with respect to the artificial hip joint surgical instrument;
A bottom portion in contact with the stem trial,
A movable part that is integrated with the tip part or the bottom part and moves according to an operation of an operator to change the length of the artificial hip joint surgical instrument,
An artificial hip joint surgical instrument comprising: The movable part has a tooth profile on a side surface,
The artificial hip joint surgery instrument further includes a gear that meshes with the tooth pattern,
The gear includes a reception unit that receives a rotation operation for rotating the gear,
The movable part receives a force from the gear that rotates by the rotation operation of the operator and moves,
The artificial hip joint surgical instrument according to claim 1, wherein: The reception unit is
A first reception unit that is disposed on the front side of the artificial hip joint surgery instrument and that receives the rotation operation from the front side;
A second receiving portion that is disposed on the back side of the artificial hip joint surgical instrument and that receives the rotation operation from the back side;
Including,
The movable unit moves according to the rotation operation received by the first reception unit or the second reception unit;
The artificial hip joint surgical instrument according to claim 2, wherein The artificial hip joint surgical instrument further includes a housing portion that stores the gear.
In the housing portion, the storage portion in which the gear is stored is formed in a convex shape,
The corners of the storage portion of the housing are rounded,
The artificial hip joint surgical instrument according to claim 2 or 3, wherein The movable part has the tooth pattern on a first side surface and a plurality of grooves on a second side surface,
The artificial hip joint surgery instrument further includes a claw portion that engages with any of the plurality of grooves and that suppresses movement of the movable portion in a direction opposite to the traveling direction,
In each of the plurality of grooves, the inclination on the traveling direction side is steeper than the inclination on the opposite direction side, and the inclination on the traveling direction side is smaller than 90 °.
The artificial hip joint surgical instrument according to any one of claims 2 to 4, wherein The movable part has a mark on the front,
The artificial hip joint surgical instrument further includes a housing portion that houses the movable portion,
The housing portion has a hole formed in the front surface for guiding the current length of the artificial hip joint surgery instrument according to the position of the mark,
The artificial hip joint surgery instrument according to any one of claims 1 to 5, wherein

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