JP2942489B2 - Fixation device for bone attached to other tissues - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a device for fixing a bone attached to another tissue, and more particularly to a device for fixing a bone suitable for repairing a fracture at the base of a lesser trochanter at the top of a femur.

[0002]

2. Description of the Related Art Conventionally, in order to repair a fractured bone, a plate made of various biocompatible materials for fixing the fracture, for example, an inert metal such as titanium, ceramics, bioabsorbable resin, or the like. Osteosynthesis such as shafts, nails, etc. are used. These osteosynthesis devices have different shapes and structures depending on the fracture parts. For example, a small plate is used for a complicated fracture of the face, and a relatively large plate is used for a femoral fracture.

[0003] There are various surgical methods for attaching the above-mentioned osteosynthesis device according to the fracture site. For example, when the above-described plate is used, the epidermis and the supra-bone tissue of the fractured part are incised to expose the fractured part, and the fractured part is held and fixed so as to return to the original state. Next, the plate is abutted so as to straddle the fractured portion, the surface position of the bone corresponding to the fixing hole of the plate is confirmed, and a screw hole is drilled in the bone from the position. Finally, the plate is abutted again so as to straddle the fractured portion, a screw is inserted into the fixing hole of the plate, and a screw is screwed into the screw hole of the bone portion to fix the plate.

[0004] By the way, tendons formed at the base of the thigh muscle adhere to small trochanters located above the femur. The base of the lesser trochanter often breaks due to some stress. If this trochanter fractures, it is necessary to fix the base of the trochanter to the femur again, especially for the lesser trochanter with attached tendon, because stress is applied from the muscle connected to the tendon, so it is fixed securely There is a need to.

[0005]

Since tendons and muscles are attached to the base of the lesser trochanter, in order to repair and fix a fracture in this portion, the tendons and muscles must be cut and removed once. After that, it is necessary to fix the base of the lesser trochanter to the femur. For this reason, the operation of the fracture requires the operation of cutting and suturing tendons and muscles, which makes the operation complicated, and after the operation, it is necessary to wait for adhesion of the cut parts of tendons and muscles. Further, after the fracture has healed, it is necessary to remove the fixing device as necessary, and in this case, it is necessary to cut the tendon. There are many other sites such as the lesser trochanter where tendons, cartilage, and the like are attached to the bone, and the same problem occurs when a fracture occurs near those sites.

Accordingly, the present invention has been made to solve the above-mentioned problem, and the problem is that the other bones such as tendon, cartilage, muscle and the like adhere to the bone like the fracture of the base of the above-mentioned trochanter. It is an object of the present invention to realize a novel bone fixing device capable of fixing a fracture of a bone part without cutting other tissues.

[0007]

Means for Solving the Problems To solve the above-mentioned problems, a means taken by the present invention is a fixing device for fixing a site where another tissue adheres to a bone, and is used for fixing the site. And a fixing hole for fixing the device to the bone via a fastening member, wherein a peripheral edge of the insertion hole is at least a first peripheral edge and a second peripheral edge. Wherein the insertion hole is configured to be openable and closable by a movable structure configured to relatively move the first peripheral portion and the second peripheral portion. The fixing device.

According to this means, since the insertion hole is configured to be openable and closable by the first peripheral portion and the second peripheral portion which are configured to be movable with respect to each other, a portion to which another tissue adheres is fixed. In this case, the first peripheral portion and the second peripheral portion are relatively moved to open the insertion hole so that another tissue is inserted into the insertion hole, and the above-described portion can be fixed in this state. . Therefore, the above-described portion can be fixed without cutting other tissues, and the fixing device can be removed without cutting other tissues.

[0009] A first structure having the first peripheral portion, wherein the movable structure is rotatably joined to each other at a pivot portion.
And the second portion provided with the second peripheral portion, and the insertion hole is opened and closed by relatively rotating the first portion and the second portion. Is preferred.

According to this means, the insertion hole can be opened and closed only by rotating the first portion and the second portion joined by the pivot, so that the operation of the device when the above-mentioned portion is fixed can be performed. Performance can be improved.

[0011] In this case, the first fixing portion further includes a first fixing hole portion formed in the first portion, the first fixing hole portion being configured to be overlapped with each other, and
And a second fixing hole formed in a part of the first fixing hole and the second fixing hole in a state where the insertion hole is closed.
It is preferable that the fixing holes are concentrically overlapped with each other.

According to this means, the fixing hole is composed of the first fixing hole and the second fixing hole which are concentrically overlapped with each other in a state where the insertion hole is closed. By inserting a fastening member such as a fixing screw or a fixing pin into the hole, the device can be fixed to the bone, and at the same time, the closed state of the insertion hole can be maintained. There is no need to provide it, and the operation of maintaining the closed state is not required.

[0013] It is preferable that the insertion hole is provided with an inclined inner surface extending from the front side to the back side facing the bone. According to this means, since the insertion hole is formed in a shape expanding toward the rear surface side, the insertion hole not only has a function of simply inserting another tissue, but also has a projecting shape of a bone. Since the fixed shape can be fixed so as to be fitted to another tissue attachment site, the fixation of the site to the bone and the fixation of the device to the bone can be reliably performed.

Further, it is preferable that the fixing hole is formed in a long hole shape extending in a direction toward the insertion hole. According to this means, since the fixing hole is formed in a shape extending toward the insertion hole formed in the portion for fixing the other tissue attachment site, the insertion hole of the fastening member inserted into the fixing hole. Can be appropriately changed as necessary, and the fastening member can be attached to an arbitrary position within a range where the fixing hole is formed.

[0015]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Next, an embodiment of a fixing device for a bone attached to another tissue according to the present invention will be described with reference to the accompanying drawings. FIG. 1 is a perspective view showing the entire fixing device 10 of the present embodiment, FIG. 2 is a plan view of the fixing device 10, and FIG.
4 shows an open state of the fixing device 10, and FIGS. 4A and 4B show cross sections of the fixing device 10 taken along lines AA and BB in FIG. 2, respectively.

In this fixing device 10, a first plate member 11 and a second plate member 12 made of a titanium alloy are joined by a joint shaft 13 that passes through joints 11a and 12a formed at the ends. . In the state shown in FIGS. 1, 2, and 4 in which the first plate member 11 and the second plate member 12 are fitted, an insertion hole 10 a and a fixing hole 10 b are formed on the plate surface of the fixing device 10. . Both the insertion hole 10a and the fixing hole 10b have an elliptical or elliptical opening shape extending in the axial direction of the fixing device 10. The edge on the front side of the fixing device 10 is formed into a curved surface having a large curvature.
The edge on the back side has a smaller curvature than the edge on the front side, but is surely curved.

The first plate member 11 is provided with the joint 11a,
A supporting portion 11b connected to the joining portion 11a;
1b. In addition, the second plate member 12 includes the joint 12a, the support 12b connected to the joint 12a, and the support 12
and the fixing portion 12c connected to the contact portion b.
At the joints 11a, 12a and the support parts 11b, 12b, the first plate member 11 and the second plate member 12 are fitted left and right, and the fixed parts 11c and 12c are fixed to the fixed part 12c. It is in a state of being overlapped with the fixing portion 11c facing down. Also, the joints 11a, 12a and the support parts 11b, 12b are formed to be thicker than the overlapping part of the fixed part 11c and the fixed part 12c, and the surfaces of the joints 11a, 12a and the support parts 11b, 12b are formed on the fixed part 12c. Higher than the surface.

The respective shapes of the first plate member 11 and the second plate member 12 constituting the fixing device 10 are shown in FIG. 3 and FIG. The upper and lower 2
Two protrusions and a recess formed between these protrusions are provided, and a joining portion 12a of the second plate member 12 has two upper and lower recesses and a protrusion formed between these recesses. Is provided, and the bonding portion 11a thus formed is provided.
And 12a are mutually fitted. The fitted joints 11a and 12a are provided with shaft holes penetrating vertically.
The joint shaft 13 is press-fitted into the shaft hole.

The joint shaft 13 supports the first plate member 11 and the second plate member 12 so as to be rotatable relative to each other. FIG. 3 shows that the first plate member 11 and the second plate member 12 are rotated so that the insertion holes 10a are formed.
Is open. The insertion hole 10a is
A semi-elliptical inclined curved surface 11A formed inside the support portion 11b of the plate member 11 and a semi-elliptical inclined curved surface 12A formed inside the support portion 12 of the second plate member 12 oppose each other. It is composed of a semi-elliptical inner surface (peripheral edge). As shown in FIG. 3, the first plate member 11 and the second plate member 12
When the fixing portions 11c and 12c are rotated so as to open, the insertion hole 10a is largely opened by separating the inclined curved surfaces 11A and 12A.

As shown in FIGS. 3 and 4, the first plate member 1
1 has a surface that is largely receded below the surface of the support portion 11b, and the second plate member 1
It is configured to receive the second fixing portion 12c.
The fixing portion 11c is formed with an elongated hole 11B extending in the axial direction of the first plate member 11.

On the other hand, the fixing portion 12c of the second plate member 12
With a surface slightly recessed from the surface of the support portion 12b,
An elongated hole 12B extending in the axial direction of the second plate member 12 is formed. A tapered surface 12d is formed at the peripheral edge of the long hole 12B on the surface side. Slot 11B and Slot 12
As shown in FIG. 1 and FIG. 2, when the insertion hole 10a is closed as shown in FIGS. 1 and 2, they are arranged one above the other and are concentric with each other to form a fixed hole 10b as one continuous long hole. I have.

FIG. 5 is a plan view showing a fixing device 20 according to a second embodiment which is different from the fixing device 10 described above. The fixing device 20 includes a first plate member 21, a second plate member 22, a joining shaft 23, an insertion hole 20a, fixing holes 20b, joining portions 21a and 22a, supporting portions 21b, 22b and fixing portions 21c and 22c,
The fixing portions 21c and 22c are formed with two long holes 20b and 20b along the axial direction of the fixing device 20, respectively, arranged in the axial direction.

The above two embodiments are applied to the fracture of the base of the lesser trochanter 51 which is present in the upper part of the femur 50 near the head of the femur shown in FIGS. 6 and 7. Small trochanter 5
1 has a tendon 52 attached thereto, and a thigh muscle 53 is connected to the tendon 52. In the illustrated example, a fracture 54 exists at the base of the lesser trochanter 51.

The broken trochanter 51 is brought into contact with the original position of the femur 50 to maintain the state, and as shown in FIG.
On both sides of the small trochanter 51, the support portions 11b and 12b of the fixing device 10 in an open state are arranged. In this state, the fixing device 1
While gradually closing 0, the fixing portions 11c and 12c are inserted under the tendon 52 and the thigh muscle 53 (the side of the femur) to obtain the state shown in FIG.

In this state, a screw hole is formed from the surface of the femur 50 while avoiding the tendon 52 and the thigh muscle 53, and a fixing screw 60 is inserted into the fixing hole 10b as shown in FIG. Screwing the fixation device 10 into the femur 50
On the surface of. At this time, the jaw 61 of the head of the fixing screw 60 engages with the tapered surface 12d formed on the peripheral edge on the surface side of the fixing hole 10b, thereby securely pressing the fixing device 10 to the femur 50. Also, the fixing hole 10b of the fixing device 10
The fixing screw 60 can be attached to an appropriate position in the axial direction of the fixing device 10 as long as the fixing screw 60 is within the range in which the fixing hole 10b is formed.
At this time, the peripheral portions of the supporting portions 11b and 12b of the fixing device 10 and the insertion hole 10a located at the center thereof come into contact with the surface of the small trochanter 51, and the small trochanter 51 is pressed against the femur and fixed.

According to the fixing device 10, the small trochanter 51 can be easily fixed without cutting the tendon 52 and the thigh muscle 53. Simply by removing, tendon 52 and thigh muscle 5
3 can be easily removed without cutting. In addition, by simply inserting the fixing screw into the fixing hole 10b while the first plate member 11 and the second plate member 12 are closed, the closed state of the insertion hole 10a of the fixing device 10 can be maintained. Handling is extremely easy. Further, since the fixing hole 10b is a long hole as described above, the fixing screw can be inserted into an arbitrary position in the axial direction within a predetermined range.

In order to further improve the handling of the fixing device 10, the first plate member 11 joined by the joint shaft 13 is used.
In addition, the rotation characteristics of the second plate member 12 are such that the rotation resistance is such that the rotation can be performed only when both the first plate member 11 and the second plate member 12 are gripped and a force is applied. Preferably,

The rotation angle between the first plate member 11 and the second plate member 12 (for example, the first plate member 1 in the state shown in FIG. 3)
By setting the maximum value of the angle between the first axis and the axis of the second plate member 12) at a predetermined angle in advance, it is possible to prevent over-opening. For example, it is desirable to set the above angle to about 110 degrees at the maximum in order to improve operability during surgery. In order to set the maximum rotation angle in this manner, the joint 11
What is necessary is just to shape it so that it may contact | abut so that rotation may be prevented in the state where the fitting part of a and 12a was opened.

Further, when the fixing device 10 is in the closed state, the operability is further improved by forming a light holding force by a snap structure or the like. Also,
In order to improve the installation of the fixing device 10, the fixing device 1
It is preferable that the back surface shape of 0 (especially the back surface shape of the fixing portion 11c of the first plate member 11) conforms to the surface shape of the periphery of the lesser trochanter of the femur (particularly, the portion immediately below the lesser trochanter).

The advantages of the fixing device 10 also apply to the fixing device 20 as they are. However, the fixing device 20
Since the fixing hole is divided into two, the fixing screw 6
The arbitrariness of the insertion position of 0 is somewhat inferior.

The insertion holes 10a and 20a are preferably formed with tapered inclined peripheral surfaces as shown in FIG. 4A in order to match the protruding shape of the small trochanter 51. In this case, in particular, in order to better match the protruding shape of the small trochanter 51, as shown in FIG. 11A, the inclination angle between the two peripheral surface portions facing each other in the longitudinal direction (axial direction) of the insertion hole. φ is about 90 degrees, while, as shown in FIG. 4A, it is preferable that the inclination angle θ between the two peripheral surface portions facing each other in the direction orthogonal to the longitudinal direction is about 56 degrees. . The inclination angles θ and φ should be set as appropriate for the bone attached to the tissue other than the lesser trochanter 51 in accordance with the shape of each bone. In any case, since the inner surface of the insertion hole is an inclined tapered surface, this insertion hole enables the insertion of other tissues, and at the same time, has a function of matching and fixing to the projection shape of the bone part. Will have.

In the above embodiment, the fixing holes 10b, 20b
The tapered surfaces 12d and 20d are formed on the fixing screw 60, and the fixing screw 60 is engaged with the fixing screw 60. However, since the fixing hole is a long hole, the fixing screw 60 may be shifted in the axial direction of the fixing hole. In order to prevent the displacement of the fixing screw, as shown in a fixing device 30 shown in FIG. 11 (b), a fixing hole 30b is formed by the length of a first plate member 31 having an inner peripheral surface both formed by tapered surfaces. Hole 3
1B and the long hole 32B of the second plate member 32. In this case, a taper nut 40 having a screw hole 41 and two opposing tapered surfaces 42 and 43 formed on the peripheral surface is inserted into the fixing hole 30b, and a fixing screw is inserted into the screw hole 41 of the taper nut 40. While screwing 60, it is further screwed into the screw hole formed in the femur. At this time, the tapered surfaces 42, 43 of the tapered nut 40
Is pressed against the inner peripheral surface formed by the tapered surface of the fixing hole 30b, so that the friction between the tapered surfaces 42, 43 and the inner peripheral surface of the fixing hole 30b causes a displacement of the fixing screw 60 in the longitudinal direction of the fixing hole 30b. Is prevented.

In the above embodiment, the first plate member and the second plate member are rotatably connected to each other at the end on the side of the insertion hole by the connecting shaft. However, the insertion is within the scope of the present invention. A portion that can be partially opened and closed may be provided on the peripheral edge of the hole, and the opening and closing structure of the insertion hole may be a slide structure instead of a rotating structure. Further, the joining portion may be provided in another portion, for example, an intermediate portion between the insertion hole and the fixing hole, an end portion on the fixing hole side, or the like.

[0034]

As described above, according to the present invention, since the insertion hole can be opened and closed by the first peripheral edge and the second peripheral edge which are movable relative to each other, other tissues can be used. In fixing the portion to which is attached, the first peripheral portion and the second peripheral portion are relatively moved to open a through-hole, so that another tissue is inserted into the through-hole. The site can be fixed. Therefore, the above-described portion can be fixed without cutting other tissues, and the fixing device can be removed without cutting other tissues.

[Brief description of the drawings]

FIG. 1 is a first view of a device for fixing a bone attached to another tissue according to the present invention.
It is a perspective view which shows the whole structure of embodiment.

FIG. 2 is a plan view of the first embodiment.

FIG. 3 is a plan view showing a state in which the insertion hole of the first embodiment is opened.

4A is a sectional view taken along line AA of FIG. 2 and FIG. 4B is a sectional view taken along line BB of FIG. is there.

FIG. 5 is a second view of the device for fixing a bone attached to another tissue according to the present invention.
It is a top view which shows the whole structure of embodiment.

FIG. 6 is a front view showing an upper part of a femur to which the embodiment is applied.

FIG. 7 is a side view showing an upper part of a femur to which the embodiment is applied.

FIG. 8 is a partial side sectional view showing an upper part of a femur to which the first embodiment is mounted.

FIG. 9 is a front view showing the upper part of the femur at the time of mounting the first embodiment.

FIG. 10 is a front view showing an upper part of a femur to which the first embodiment is mounted.

11A is a longitudinal sectional view showing the internal structure in the axial direction of the first embodiment, FIG. 11B is a sectional view showing the structure of a fixing portion of the fixing device 30 having fixing holes 30b having different shapes, and FIG. It is a perspective view (c) showing the taper nut adapted to fixing hole 30b.

[Explanation of symbols]

 10, 20 Fixing device 10a, 20a Insertion hole 10b, 20b Fixing hole 11, 21 First plate member 11A, 12A Inclined curved surface 11B, 12B Long hole 12, 22, Second plate member 13, 23 Joint shaft 11a, 12a Joint portion 11b , 12b Support part 11c, 12c Fixing part

Claims (5)

(57) [Claims] 1. A fixing device for fixing a portion where another tissue has adhered to a bone, wherein an insertion hole formed in a portion for fixing the portion and a device are fixed to the bone via a fastening member. And a peripheral portion of the insertion hole includes at least a first peripheral portion and a second peripheral portion, and the first peripheral portion and the second peripheral portion are relatively positioned. A fixing device for a bone attached to another tissue, characterized in that the insertion hole is configured to be openable and closable by a movable structure configured to be movable to the outside. 2. The movable structure according to claim 1, wherein the movable structure comprises a first portion provided with the first peripheral portion and a second peripheral portion, which are rotatably joined to each other at a pivot portion. Another tissue, comprising a second part provided with the insertion hole, which is opened and closed by relatively rotating the first part and the second part. An attached bone fixing device. 3. The fixing device according to claim 2, wherein the fixing holes are formed so as to be superimposable on each other, a first fixing hole formed in the first portion, and the second portion. The first fixing hole and the second fixing hole are concentrically overlapped with each other in a state where the insertion hole is closed. An apparatus for fixing a bone attached to another tissue, wherein the bone is fixed. 4. The device for fixing a bone attached to another tissue according to claim 1, wherein the insertion hole has an inclined inner surface extending from a front surface side to a back surface side facing the bone. 5. The fixing device according to claim 1, wherein the fixing hole is formed in a long hole shape extending in a direction toward the insertion hole.