JP2561226B2 - Bone tie fittings - Google Patents

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a bone tie mounting device which allows a "bone tie" used for treatment of joint dislocation, bone fracture, bone fracture and the like to be easily and surely mounted on a bone affected part.

[0002]

2. Description of the Related Art The inventor of the present invention is disclosed in JP-A-6-169.
In Japanese Patent Publication No. 942, a novel method for fixing an affected part of a bone with a bone tie made of a fluororesin as shown in FIGS. 3 and 4 is disclosed. Further, in the patent specification filed before the present invention, it was clarified that the use of the dish-shaped receiver not only allows the bone tie to be smoothly inserted into the bone hole but also guides the bone tie in a desired direction. . That is, although a synthetic resin bone tie has a high elasticity, it has a strong waist so that it can be extended with a pin in order to easily insert it into a fine bone hole drilled. Therefore, if there is another bone at the exit of the bone hole, the tip of the bone tie will be stuck there and will not move, and it will be difficult to insert it. Also, if there is soft tissue around the exit of the bone hole, the bone tie protruding straight from the exit will be buried in the surrounding tissue and it will not be known where it went. Finding a missing bone tie during surgery is a hassle,
There was a risk of damaging blood vessels and nerve tissue if I searched in a hurry. Therefore, the bone tie that came out of the bone hole was received by a dish-shaped receiver.

On the other hand, when inserting a bone tie into a bone hole or binding a bone tie that connects bones to each other, the bone ties have conventionally been sandwiched with forceps. When the receiver was undeveloped, to pull out the bone tie stuck in the narrow gap between the bones,
The only option was to pinch it with forceps, but even after it was resolved, the forceps could not be released. This is because, during surgery, the fingertips of the surgical gloved surgeon become bloody and do not slippy and pinch the bone ties. Therefore, in order to tightly bind the bone tie, it is necessary to operate the two forceps with both hands, hold the lock portion of the bone tie with one forceps, and firmly squeeze the bone tie with the other forceps. did not become. I've tried using tweezers instead of forceps, but since I put force on my fingertips, I quickly tired my hand, and it took more than double the time to wear a bone tie.

[0004]

However, the use of forceps has caused some inconveniences. The biggest drawback among them is that the part mechanically pressed by the forceps tends to be weakened. In particular, there was a great deal of anxiety about amputation in places where a great load such as the hip joint was applied. If the tied bone tie is cut off, the surgery will have to be redone. In addition, due to the pressure applied by the forceps, the serrated locking teeth provided on the abdominal surface of the bone tie tend to be crushed by several rows. The crushed locking teeth are not caught by the locking claws protruding into the cavity of the lock portion, so that the locking function of the bone tie is impaired. Therefore, when trying to bind tightly a bone tie that fastens the bones, it is not possible to obtain the desired degree of tightness if the locking teeth that happen to be crushed are in the optimum binding position. Even if there is some slack, it will be fine if it does not hinder, but when it is necessary to securely bind the bone tie such as bone attachment, it was necessary to replace it with a new one and try again, which was very troublesome. Further, since it is impossible to press the lock portion with the fingertips covered in blood, it is necessary to hold the lock portion by sandwiching it with forceps. If the lock was crushed due to a bad grip, I had to replace it with a new one and re-install it. Moreover, it was difficult to keep the forceps holding the lock part still during the binding, and when the forceps moved, the bone tie passed through the lock part could not be pulled straight out. If the bone tie passing through the inside of the lock portion is biased or twisted, the locking claw protruding into the lock portion will be damaged. Therefore, great care must be taken when binding the bone ties. The problem to be solved by the present invention is to avoid the use of forceps as much as possible when attaching a bone tie. In particular, what kind of means should be taken to prevent the lock portion from being pinched by the forceps.

[0005]

A bone tie mounting device according to the present invention solves the above-mentioned problems, and a bone tie is attached to a tip portion of a handle 5 having a shape and size that can be grasped by one hand. Is provided with a tightening portion 1 for binding. The tightening portion 1 is formed by bending the tip end portion of the handle portion 5 at a substantially right angle to integrally form bifurcated legs 2 and 2, and having a width such that a bone tie can be inserted between both legs and smoothly passed. The groove 3 to be held is formed. In addition, the rear end of the handle 5 is provided with a bottom 7 for receiving the tip of the bone tie and advancing it in a desired direction, and an edge 8 for preventing the bone tie from laterally deflecting. It is also possible to provide a dish-shaped guide portion 6.

[0006] The bone tie mounting device comprising the tightening portion 1 and the handle portion 5, or the tightening portion 1, the handle portion 5 and the guide portion 6 is integrally formed of metal such as stainless steel or hard synthetic resin. Is desirable. The shape of the handle portion 5 can be arbitrarily selected such as an elongated flat plate shape, a square bar shape, and a round bar shape. Further, by providing a screwing type or a fitting type engaging portion 9 at an arbitrary position of the handle portion 5, various types of tightening portion 1 and guide portion are provided according to the size of the bone tie or the situation of the surgical field. 6 and 6 can be replaced at will.

The tightening portion 1 provided at the tip of the handle 5 is
It suffices to bend the handle portion 5 substantially at a right angle, and it is not necessary that the handle portion 5 be a right angle. The bending direction may be either above or below the handle 5, and is arbitrary. The pair of legs 2 and 2 may have any shape such as a prismatic shape, a pyramidal shape, a cylindrical shape, and a conical shape. The length of both legs may be the same as or higher than the height of the lock portion of the bone tie. Also, both legs may have equal lengths on the left and right,
Only one leg may be lengthened or thickened. In addition, bend the ends of both legs of equal length at a substantially right angle to
Can also be formed. The width of the groove 3 formed between both legs may be such that a thin plate-shaped bone tie can be inserted and smoothly passed.

The guide portion 6, which is preferably provided at the rear end portion of the handle portion 5, is required to be formed to be significantly longer and narrower and shallower than a spoon of tableware so that it can be easily inserted into a narrow space between bones. is there. As one of the measures to make the bottom shallow, the edge 8 may not be upright from the bottom 7 but may be surrounded by a gently inclined edge around the bottom. Whether the guide portion itself is curved or not and the connecting angle between the guide portion 6 and the handle portion 5 are arbitrary and are not particularly limited.

[0009]

When the bone tie attachment according to the present invention is used, it is convenient to use the bone tie guiding function according to the first aspect. That is, as shown in FIG. 3, the guide portion 6 is applied to the outlet on the other side of the drilled bone hole 10 with one hand, and the forceps held in the other hand is used to secure the bone tie 1 without locking teeth.
Insert the tip 12 of No. 1 into the bone hole 10. After insertion, the forceps are removed from the tip portion 12, and the bone tie 11 is pushed in with the fingertip in the direction of arrow A. Then, the tip portion 12 of the bone tie 11 that has come out from the exit of the hole is received by the bottom 7 of the guide portion 6, so if the bone tie 11 is continuously inserted into the bone hole 10 as it is, the tip portion 12 will have a vertically long bottom surface. It moves forward smoothly. At this time, the edge 8 can prevent lateral deviation. Therefore, even if there is another bone near the exit, it will not get stuck and will not be lost in the surrounding tissue. Further, when the bone tie passed through the first bone hole is to be inserted into the next bone hole, the tip portion 1 of the bone tie is attached to the bottom 7 of the guide portion 6.
It is possible to guide to the entrance of the next bone hole without using the forceps while the 2 is placed.

Next, claim 1 and claim 2 of the present invention
The bone tie bondage function related to is used. That is, when a bone hole of two bones and a bone tie communicating with the bone hole are wound around a bone affected part, the tip of the bone tie is inserted into the lock part and pulled out. After that, as shown in FIG. 4, the bone tie 11 pulled out from the lock portion 13 is inserted into the groove 3 of the tightening portion 1.
Then, hold the handle with your left hand, and lock it with both legs 2 and 2.
While holding, hold the bone tie with the forceps held in the right hand and pull strongly in the direction of arrow B to bind the bone affected area tightly. At this time, since the lock portion 13 is pressed by the legs 2 and 2, the wobbling in the vertical and horizontal directions unlike the case where the lock portion 13 is held by the forceps does not occur. Therefore, since the bone tie can be pulled straight, there is no risk of the locking claws being damaged due to deviation or twisting. Also, since the lock part is not pressed from both sides,
There is no fear of being crushed. Moreover, since the locking teeth 14 that are not passed through the lock portion and are connected to the ventral side of the bone tie are intact, the locking teeth and the locking claws in the lock portion surely mesh with each other, and the lock function is smoothly exhibited. To finish the binding, the tightening portion 1 is strongly pushed in the direction of arrow C while pulling the bone tie sandwiched between the forceps toward you. By this useless pushing, there is no gap between the lock portion and the bone, so that the bone tie can be bound more firmly and securely. Finally, the extra bone tie protruding outside the lock portion is cut off to complete the attachment of the bone tie. Therefore, even if the portion pinched by the forceps is crushed when tightening the bone tie, the bone tie is completely removed and there is no problem. That is, the two legs 2 of the tightening portion 1,
2 is like making the operator's thumb and forefinger smaller, and acts to gently hold the important lock part in place of the slippery fingertips that get wet with blood.

[0011]

Embodiments of the present invention will be described below with reference to FIGS. First Embodiment FIG. 1 is a perspective view showing a first embodiment which is an optimum embodiment of the bone tie attachment according to the present invention. FIG. 2 is a side view thereof. 3 and 4 are plan views showing the usage state. In the first embodiment, the tightening portion 1, the handle portion 5, and the guide portion 6 are integrally formed using a stainless plate having a length and a width that can be gripped with one hand. The tightening portion 1 provided at the tip of the handle portion 5 is bent downward, which is opposite to the guide portion 6. As shown in FIG. 4, the function of the tightening portion 1 is to hold down the lock portion 13 of the bone tie 11 with the pair of legs 2 and 2, so that the connecting angle between the leg and the handle portion is a right angle, or As shown in, it is better to tilt it slightly forward. This makes it easier to push the lock, and prevents the lock from coming off the leg during tightening the bone tie. In terms of manufacturing cost, it is the cheapest to form two legs into a prismatic shape of equal length and size. The groove 3 formed between both legs is for allowing the bone tie pulled out from the lock portion 13 to smoothly pass therethrough. However, if the width is too wide, the bone tie may be biased or twisted. Therefore, the width of the groove 3 is the bone tie 1
It is less than twice the thickness of 1. The guide portion 6 is integrally formed by pressing the rear end portion of the handle portion 5. As shown in the plan view of FIG. 3, it is made to be remarkably long and narrow in width and shallow in bottom as compared to a spoon for dishes. The guide portion 6 having such a shape can be inserted into a narrow gap between bones. Further, even if the bone tie tip is inserted deep into the gap that the operator cannot reach, the tip of the bone tie can be slid over the vertically long bottom surface and guided to the operator's hand.

Second Embodiment A second embodiment of the present invention will be described with reference to the perspective view of FIG. In the second embodiment, the same stainless steel plate as in the previous example is used as the material, and the tightening portion 1 is integrally formed in the upward direction opposite to the previous example. Although not shown, when the connecting portion between the handle portion 5 and the guide portion 6 is curved in an arc shape, it is easier to use the tightening portion 1 facing upward. The tips of the legs 2 and 2 are bent at substantially right angles to form the protrusions 4 and 4. If the protrusions 4 and 4 are pressed against the back of the lock portion, the lock portion can be reliably pressed down while the bone tie is being pulled. However,
It is not indispensable, and even if there is no protrusion, it does not hinder the retention of the lock part by the leg. Unlike the previous example of press working, the guide portion 6 of Example 2 was formed by grinding the rear end of the stainless steel plate into a gentle slope to form a bottom 7 with a grinder, and left both sides to leave an edge 8. It is a thing. Since the material is originally a thin flat plate, the thickness of the guide portion 6 can be finished as thin as a spatula.

Third Embodiment A third embodiment of the present invention will be described with reference to the perspective view of FIG. In the third embodiment, a stainless round bar is used as a material, and a screw-type engaging portion 9 is provided at an intermediate portion of the handle portion 5. If the detachable engagement portion 9 is provided, the tightening portion 1 and the guide portion 6 can be freely replaced with each other according to the size of the bone tie and the size of the surgical field. Further, in the tightening portion 1 of the third embodiment, the legs 2 and 2 are formed in a cylindrical shape, and one leg is long. By inserting this long leg into the bone hole drilled and pulling it, the bone affected part can be moved to a position where the bone tie is easily inserted.

[0014]

When the bone tie attachment according to the present invention is used, the guide portion 6 works to smoothly advance the bone tie inserted through the hole formed in the bone without jamming and guide it in the desired direction. be able to. Therefore, the forceps can be used only when the bone tie is inserted into the bone hole until the bone tie that is inserted through the bone hole is used to fasten the bone affected part. Moreover, since the place to be sandwiched by the forceps is only the tip portion without the locking teeth, the conventional drawbacks such as weakening of the bone ties and damage to the locking teeth are eliminated. Further, when tightly binding the bone tie to which the bone affected part is fastened, the lock portion can be reliably held without using forceps by the action of the tightening portion 1. Therefore, the bone tie is not biased or twisted due to the wobbling of the lock portion during the traction of the bone tie, and the lock portion is not damaged due to the pressure of the forceps. Therefore, the locking claw and the locking tooth can be surely engaged with each other. Further, at the finishing stage, the lock portion can be strongly tightened by the tightening portion 1, so that the affected bone portion can be tightly and securely bound. Therefore, when the bone tie attachment device according to the present invention is used, the attachment of the bone tie can be completed easily, reliably and quickly while the use of forceps is stopped to the minimum necessary.

Moreover, surprisingly, the following unexpected effects were recognized. That is, if one leg 2 of the tightening portion 1 is lengthened and hooked in a bone hole, it can be applied to pulling and lifting bones. Turned out to be much more convenient than. In particular, it exerts tremendous power in the scapula and the pelvic hip, for which the plucky forceps cannot be used. This is because the handle 5 functions as a lever, and if it is used for reducing the fracture, the force can be adjusted to less than half that of the grasping forceps. It is not necessary to open a hole even to the bone that can be grasped by the grasping forceps, but it is certain that the grasping forceps will be unnecessary if the bone has a hole.

[Brief description of drawings]

FIG. 1 is a perspective view showing a first embodiment of the present invention.

FIG. 2 is a side view showing the first embodiment of the present invention.

FIG. 3 is a plan view showing a usage state of the first embodiment of the present invention.

FIG. 4 is a plan view showing a usage state of the first embodiment of the present invention.

FIG. 5 is a perspective view showing a second embodiment of the present invention.

FIG. 6 is a perspective view showing a third embodiment of the present invention.

[Explanation of symbols]

 1 Tightening part 2 Leg 3 Groove 4 Protrusion 5 Handle part 6 Guide part 7 Bottom 8 Edge 9 Engagement part 10 Bone hole 11 Bone tie 12 Tip part 13 Lock part 14 Locking tooth

Claims (2)

(57) [Claims] 1. A tightening portion (1) having a groove (3) having a width such that a bone tie can be inserted between the legs (2) formed in a bifurcated shape, and bent at a substantially right angle to the tightening portion (1). Bone tie attachment, which comprises a handle 5 provided on the bone tie. 2. The bone tie mounting device according to claim 1, comprising the tightening portion 1, the handle portion 5, and a dish-shaped guide portion 6 provided at a rear end portion of the handle portion 5. .