JP2942539B1 - Osteosynthesis device - Google Patents

Abstract

To provide a plate set of a novel osteosynthesis device which is easy to operate during an operation, and which can be appropriately adapted according to a bone shape and a fracture state of a patient. A protruding engagement portion (14) is provided at an upper end of a bone plate (10), and a long protruding engagement hole (14) is provided at the center thereof.
a is formed. The protruding engagement portion 14 is configured so that a socket-like base engagement portion 41 of the extension plate 40 is fitted. The base engaging portion 41 is formed in a frame shape, and has a fitting accommodation groove 14b for fitting the projecting engaging portion 14 therein.
Is configured. A circular base engaging hole 41a is formed in a plate surface on the front side of the fitting accommodation groove 14b. The extension plate 40 has a tongue 4 extending from the base engagement portion 41.
2, 43 and 44 are provided, and an extension engagement hole 42 is provided at the tip.
a, 43a and 44a are formed.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an osteosynthesis device, and more particularly, to a plate set suitable for fixing and treating the vicinity of a femoral head.

[0002]

2. Description of the Related Art Conventionally, fractures and necrosis of the femoral head often occur near the femoral head where a large load is applied. Therefore, the fracture near the femoral head is fixed or an artificial bone or artificial joint is attached. Various bone plates have been developed and used for treatment. To fix a bone or an artificial object, a bone plate having a screw engagement hole for receiving and engaging a fixation screw is arranged on the outer surface of the bone, and the fixation screw is inserted through the screw engagement hole. The most common method is to screw the screw into the inside and to engage the head of the fixing screw with the screw engagement hole. Such a normal set of bone plates and bone screws may also be used near the femoral head,
A dedicated plate set according to the bone shape of the femoral head is often used.

The plate set dedicated to the head of the femur is mainly used for fixing and treating a fracture between the head of the femur and the diaphyseal, along the outer surface of the shaft of the femur. A bone plate which is arranged so as to extend vertically and has a plurality of screw engagement holes formed in the extension direction, and a cylindrical sleeve extending obliquely upward from the vicinity of the upper end is integrally formed or attached separately. There is. A bone screw called a lag screw is inserted into the sleeve and screwed down to the inside of the femoral head to hold the head and diaphysis in a compressed state. A plate set of this type is disclosed in Japanese Patent Application No. 1-26611.
No. 6 and the like.

On the other hand, there are large trochanters, small trochanters and the like connected to the tendons connected to the muscle near the femoral head, and these may be broken because they may receive a large load from the tendons. There are many. In addition, the vicinity of the head of the bone receives a large load from the joint, so that a complicated fracture is relatively likely to occur. When treating such an unstable fracture near the femoral head,
In many cases, the above-described plate set that simply fixes between the head of the femur and the diaphysis is insufficient. For this reason, a relatively thick collar-shaped extension is integrally provided at the upper end of the bone plate above the base of the sleeve, and a plurality of screw engagement holes are formed in the extension. A plate set has been sold in which a fixing screw is engaged with the screw engaging hole and screwed into a bone to fix a fractured portion near the greater trochanter.

Also, registered utility model publication No. 3021149
In the issue, a thick extension plate that is detachably configured with respect to the shoulder at the upper end of the conventional bone plate is detachably configured,
There is disclosed an extension plate in which a screw engagement hole is formed to insert and engage a fixing screw for fixing an unstable fracture near the greater trochanter.

[0006]

However, since the actual bone shape and fracture state near the femoral head differs greatly from patient to patient, even if a bone plate integrally provided with the above-mentioned extended portion is used, the femoral head may be used. In many cases, it is not possible to properly fix a bone depending on the situation in the vicinity. For example, since the shape near the femoral head differs from patient to patient, the bone plate as a whole floats up from the diaphyseal part, or conversely, the extension part moves away from the upper part of the femur, depending on the shape of the extension part. In addition, since the fracture state varies greatly from patient to patient,
The screwing position of the fixing screw also needs to be set variously in accordance with the fracture state, but in the extension formed integrally with the bone plate, the position of the screw engagement hole for inserting and engaging the fixing screw is Since it is fixed, it is necessary to provide a large number of screw engagement holes in the extension portion, or to prepare various types of bone plates having extension portions having screw engagement holes in different shapes and different positions. There is.

On the other hand, in the case of the bone plate described in the above-mentioned registered utility model publication, since the extension plate is configured to be detachable from the bone plate, it is possible to attach or detach the extension plate as necessary. If various types of extension plates are prepared, various situations can be dealt with. However, since this extension plate has a thick shape that fits over the shoulder at the upper end of the bone plate and is integrated with the bone plate, the engagement between the bone plate and the extension plate is not always good, Moreover, there is a problem that it is difficult to attach and detach the extension plate while the bone plate is fixed on the bone surface. In addition, the compatibility with the bone shape of the patient is not always sufficient, and the extension angle of the extension plate with respect to the bone plate is also fixed rigidly. There is a problem that must be.

Accordingly, the present invention is to solve the above-mentioned problems of the conventional bone plate, and the problem thereof is that the operation during the operation is easy, and that the operation is appropriately performed according to the bone shape and the fracture state of the patient. It is an object of the present invention to provide a plate set of a new osteosynthesis device which can be used with high responsiveness.

[0009]

In order to solve the above-mentioned problems, a means (claim 1) taken by the present invention is an osteosynthesis device for holding and fixing a bone or an equivalent thereof, wherein the bone is an outer surface of the bone. A bone plate fixed thereon, and an extended engagement for engaging a fixing member inserted into the bone to engage the bone plate and further fix a position away from the bone plate; An extension plate provided with a hole, a protruding engagement portion protruding from an end of the bone plate is formed, and a base portion configured to be insertable into and removable from the projection engagement portion at a base portion of the extension plate. An engaging portion is provided. Here, the equivalent of bone refers to bone substitutes such as artificial bones and artificial joints, and muscles, tendons, and their substitutes.

According to this means, a protruding engagement portion is formed so as to protrude from the end of the bone plate, and the base engagement portion which removably engages with the protruding engagement portion is formed. Since the extension plate provided is provided, the extension plate can be reliably engaged and held regardless of the shape of the bone plate, and the extension plate can be easily inserted and removed during surgery. .

In the first aspect of the present invention, it is preferable that the projecting engaging portion is formed with a projecting engagement hole for inserting and engaging a fixing member introduced into the bone. According to this means, by providing the protruding engaging hole in the protruding engaging portion, the fixing member can be engaged with the portion protruding from the end of the bone plate and introduced into the bone without mounting the extension plate. , Fractures and the like can be fixed.

In the first or second aspect, the base engaging portion is formed with a base engaging hole for inserting and engaging a fixing member, and the extension plate is engaged with the projecting engaging portion. It is desirable that the protruding engagement hole and the base engagement hole be configured to overlap in a planar manner in a state where the protruding engagement hole is made to overlap. According to this means, since the base engagement hole formed in the base engagement portion is configured to overlap the projecting engagement hole in a plane, when the extension plate is mounted on the bone plate, The bone plate and the extension plate can be firmly connected to each other by inserting the fixing member through the overlapping base engaging hole and the protruding engaging hole and introducing the fixing member into the bone. It is also possible to fix a fractured part or the like by a fixing member inserted through the base engaging hole and the protruding engaging hole.

[0013] In any one of the first to third aspects, it is preferable that the projecting engagement portion projects in a direction along a shape of a bone surface with which the bone plate contacts. According to this means, the protruding engagement portion protrudes in a direction along the shape of the bone surface, so that the bone plate can be stably placed on the bone surface, and can be stably mounted even when the extension plate is attached. The property is not impaired.
In this case, particularly when the bone plate is fixed on the outer surface of the diaphysis near the head of the femur, and the projecting engagement portion is formed at the upper end thereof, the projecting engagement portion is moved away from the bone surface. By projecting obliquely, the upper end of the bone plate can be shaped to match the surface of the bone above the femur, and the bone plate can be stably fixed.

[0014] In any one of the first to fourth aspects, it is preferable that the base engaging portion is configured to be fitted so as to surround the projecting engaging portion.
According to this means, since the base engaging portion is fitted so as to wrap the projecting engaging portion, the shape of the projecting engaging portion formed at the end of the bone plate can be simplified, and the shape of the projecting engaging portion can be reduced without fail. The manufacturing cost of the bone plate can be reduced, and the plate surface can be configured to have a simple and smooth shape suitable for implantation in the body even when the bone plate is used without connecting the extension plate.

[0015] In any one of the first to fifth aspects, it is desirable that the extension engagement hole is formed in a portion that can be deformed by a finger extending from the base engagement portion. According to this means, since the extension engagement hole is formed in a portion that extends from the base engagement portion and can be deformed by a finger, the formation portion of the extension engagement hole is formed on a bone surface or a portion to be fixed during surgery. Since the fixing member can be inserted and engaged and fixed in a deformed state so as to be adapted, it is possible to exhibit high responsiveness according to the bone shape and the state of the bone of the patient.

6. The distal end of a tongue-shaped portion thinner than the bone plate, wherein the extension engagement hole extends from the base engagement portion of the extension plate. Preferably, it is formed in the vicinity. According to this means, by forming the extension engagement hole near the distal end of the thin tongue, the thin tongue can be bent in conformity with the bone surface. It is possible to reliably introduce the fixing member into the bone.

According to a seventh aspect of the present invention, it is preferable that a root portion of the tongue portion closer to the base engagement portion than a position where the extension engagement hole is formed has a narrow width. According to this means, since the base portion of the tongue portion is formed in a narrow width, it is possible to deform the tongue portion at the base portion and change the direction in which the tongue portion extends, and the shape of the bone surface can be changed. Depending on the material, it is also possible to cut and remove the base of the tongue in order to remove the tongue having an unnecessary extension engagement hole, in addition to being able to respond more flexibly.

Each of the above means is particularly effective when a protruding engagement portion is provided at the upper end of a bone plate fixed on the outer surface of the femoral shaft to hold and fix the vicinity of the femoral head. It is. In this case, the unstable fracture of the upper part of the femur can be easily fixed and held. The bone plate for holding and fixing the vicinity of the head of the femur directly engages a lag screw that is introduced to extend obliquely upward toward the inside of the bone head, or indirectly engages via a sleeve. Or the like. Also,
In each of the above means, the projecting engagement portion is formed in a plate shape thinner than the main body of the bone plate, and the portion other than the base engagement portion of the extension plate is formed in a thin plate shape, so that the bone plate is placed on the bone surface. In this state, the extension plate can be easily attached and detached, and the protruding engagement portion and the extension plate can be deformed to improve the responsiveness to the shape of the bone surface and the situation such as a fracture.

[0019]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Next, an embodiment of an osteosynthesis device according to the present invention will be described with reference to the accompanying drawings. FIG. 1 shows a plan view (a) of a bone plate with an extension plate attached thereto in the osteosynthesis device of the present embodiment, and a partial plan view (b) showing the vicinity of the upper end of the bone plate with the extension plate removed. FIG. 2 is an assembled partial cross-sectional view showing a set state of a bone plate, a sleeve body and a lag screw with an extension plate removed, and FIG. 3 is an assembly of the extension plate, a bone plate, a sleeve body and a lag screw. It is an assembly side view showing the set state. 2 and 3, the outline shape of the upper part of the femur to which the present embodiment is attached is indicated by a chain line.

The plate set of the osteosynthesis device of the present embodiment should be entirely made of a biocompatible material because it is buried in a living body, and formed of stainless steel, titanium or a titanium alloy, a biocompatible resin, or the like. can do. Specifically, pure titanium (CP class 1, class 2, etc.)
And alloys such as Ti-6Al-4V and SUS316. The present embodiment includes a bone plate 10 to be disposed on the outer surface of the diaphyseal portion of the upper part of the femur, a sleeve body 20 configured to be inserted into and engaged with the bone plate 10,
A lag screw 30 inserted into the sleeve body 20 and an extension plate 40 detachably attached to the bone plate 10
It is composed of In the present embodiment, the bone plate 10,
The sleeve body 20, the lag screw 30, and the fixing screw (not shown) are all made of the above-mentioned material.

The bone plate 10 comprises an upper engaging portion 11 formed to be slightly thicker and a lower fixing portion 12 formed to be slightly thinner than the upper engaging portion 11. The upper engaging portion 11 is provided with a main engaging hole 11a formed obliquely to the plate surface. Upper engaging portion 1 adjacent to main engaging hole 11a
A bayonet rotator 13 is rotatably accommodated in 1, and the engagement ridge 13 a of the bayonet rotator 13 is configured to protrude into the adjacent main engagement hole 11 a. The engagement ridge 13a of the bayonet rotator 13 is formed by a ridge line of a stepped cylindrical step portion, and a part of the ridge line of the step portion in the circumferential direction is deleted by a tapered surface 13b shown in FIG. Further, the bayonet rotating body 13 is provided with a cutout portion 13 c in an operation portion exposed on the surface of the upper engagement portion 11. When the bayonet rotator 13 is rotated so that the notch 13c is disposed on the side (upper side) of the main engagement hole 11a, the engagement ridge 13a protrudes into the main engagement hole 11a, and the notch 13c is engaged with the main engagement hole 11a. When the bayonet rotator 13 is rotated so as to be disposed on the opposite side (lower side) from the hole 11a, the tapered surface 1
3b faces the main engagement hole 11a, so that the engagement ridge 13a does not protrude into the main engagement hole 11a.

A rib 11 is formed on the inner surface of the main engagement hole 11a so as to extend in the penetrating direction (axial direction).
b is formed, and the rib 11b is
Is fitted into a not-shown concave groove formed on the outer peripheral surface of the sleeve member 20 to restrict the rotation of the sleeve body 20 inserted into the main engagement hole 11a around the axis. The sleeve body 20 is formed with an engagement groove that engages with the engagement ridge 13a of the bayonet rotator 13, and the sleeve body 20 is inserted into the main engagement hole 11a.
And the engagement ridge 13a and the engagement groove are fitted by rotating the bayonet rotor 13 so that the sleeve 2
0 is fixed in the axial direction.

On the other hand, the lower fixing portion 12 is provided with one screw engaging hole 12a and a plurality of screw engaging holes 12b arranged in tandem in the extension direction. These screw engagement holes 1
2a and 12b are configured to engage with the heads of the fixing screws when the fixing screws (not shown) are inserted and screwed into the bone, whereby the bone plate 10 is placed on the outer surface of the diaphyseal portion of the femur. It is configured so that it can be fixed. The screw engagement hole 12a is formed at the uppermost part of the lower fixing portion 12, and not only receives the fixing screw perpendicularly to the plate surface and engages with the fixing screw, but also tilts the fixing screw obliquely upward similarly to the lag screw 30. The inner surface of the hole is formed so that the shaft portion of the fixing screw can be inserted diagonally upward so that it can be engaged in a screwed posture (for example, it can be screwed toward the smaller trochanter).

The sleeve body 20 is formed in a cylindrical shape, and is inserted into the main engagement hole 11a and is axially regulated by the engagement ridge 13a as shown in FIG.
Are regulated in the rotation direction by the rib 11b shown in FIG. A lag screw 30 is inserted into the sleeve body 20 in advance, and the head 31 of the lag screw 30 shown in FIG.
The lag screw 30 comes into contact with a frame-shaped portion formed inside the tip of the sleeve body 2 in the state shown in FIGS.
0 can be pulled into the inside of the sleeve body 20 from the state shown in the figure.
Cannot be further extracted to the distal end side.

As shown in FIG. 2, the lag screw 30 has a head 31 having an engaging structure (cross groove, minus groove, hexagonal hole, etc.) on its end face for engaging a tool for rotating such as a driver. It is formed and held in the sleeve body 20. The head 31 is connected to the shaft 32, and a spiral engagement screw 33 is formed at the tip of the shaft 32. The lag screw 30 has a not-shown shaft hole through which a guide pin can be inserted along the axis thereof.

At the upper end of the bone plate 10, a plate-shaped projecting engagement portion 14 is integrally formed. This projecting engagement portion 14
In the center of the plate, a long hole-shaped projecting engagement hole 14a slightly extended in the longitudinal direction of the plate is formed. Projection engaging part 1
4 is configured so that a base engaging portion 41 formed in a socket shape of the extension plate 40 is fitted. FIG. 6 shows a plan view (a), a side view (b) and a front view (c) of the extension plate 40. Here, the front of the figure is represented as an end face on the bone plate 10 side. Base engaging part 4
Reference numeral 1 is formed in a frame shape with an open back surface side, and has a fitting accommodation groove 41b for fitting the projecting engagement portion 14 therein. A circular base engaging hole 41a is formed in the plate surface on the front side of the fitting accommodation groove 41b. The extension plate 40 is provided with three tongues 42, 43, and 44 extending in a tongue shape from the base engagement portion 41 to the distal end side, respectively, and each of the tongues is formed in a substantially constant thin plate shape. At the same time, the base has a planar shape that is slightly narrower at the base side and wider at the distal end side, and extended engagement holes 42a, 43a, 44a are formed at the distal ends of the tongues 42, 43, 44.

As shown in FIG. 3, the bottom surface of the upper end of the bone plate 10 is entirely opposed to the plate surface (an imaginary plane parallel to the lower surface of the upper engaging portion 11 and the lower surface of the lower fixing portion 12). Is formed so as to warp toward the surface side (side away from the bone) by about an angle α = 7 degrees. In practice, this angle α is 5
It is preferable to set the angle within a range of 15 degrees. This angle α is formed according to the shape of the outer surface from the diaphysis of the upper part of the femur to the greater trochanter. This warped bottom part
From the viewpoint of facilitating manufacture, it is preferable that the substrate bend in a plane in the above-mentioned angle range. However, from the viewpoint of bringing the bone plate 10 into close contact with the femur, the overall warped shape falls within the above-mentioned angle range, but is continuously curved in a curved shape from below to above in accordance with the outer surface of the bone. It is desirable that On the other hand, the protruding engagement portion 14 further protruding from the upper end of the main body of the bone plate 10 is formed in a shape warped further to the surface side than the bottom surface of the upper end of the main body of the bone plate 10. As shown in FIG. 2, in the present embodiment, the projecting direction of the projecting engagement portion 14 is inclined by an angle β = 30 degrees with respect to the plate surface. This angle β
Is preferably set within the range of 20 to 45 degrees. The projecting engagement portion 14 is also preferably formed in a flat shape from the viewpoint of manufacturing, but may be curved in a curved shape in accordance with the outer surface of the bone.

According to the embodiment described above, the extension plate 40 is configured to be detachable from the protruding engagement portion 14 of the bone plate 10, so that if there is an unstable fracture near the femoral head, As shown in FIG. 3, with the extension plate 40 attached to the protruding engagement portion 14, the bone plate 10 is fixed on the outer surface of the diaphyseal portion of the femur with a fixing screw or the like. In addition to fixing the broken portion, a fixing screw may be inserted into the extended engagement holes 42a, 43a, 44a of the tongue portions 42, 43, 44 of the extension plate 40 to simultaneously fix the broken portion near the greater trochanter. it can.
In this case, portions other than the base engaging portion 41 of the extension plate 40, particularly the tongue portions 42, 43, and 44, are formed in a relatively thin plate shape, so that they can be easily bent by a finger or the like during the operation. it can. For this reason, as shown in FIG.
Since the tongue of the extension plate 40 can be deformed so as to be attached to the surface of the femur,
After deforming the tongue so that it fits on the surface of the femur, it can be tightened and fixed with a fixing screw inserted through the extension engagement hole, so that the shape of the femur differs for each patient. Appropriate holding and fixing can be performed according to the situation of unstable fracture. At this time, when applied to the upper part of the femur,
The central tongue 43 of the three tongues is deformed so as to adhere along the bone surface near the greater trochanter, and the left and right tongues 4
Since the reference numerals 2 and 44 deviate left and right from the axis of the base engaging portion 41, they are deformed so as to wrap around the front and rear sides of the body with respect to the greater trochanter. In particular, since the tongues 42, 43, and 44 having the extension engagement holes formed at the distal end are formed narrow on the base side and wide on the distal end, deformation of the tongue is extremely easy. The formation portion of the extended engagement hole in the tongue can be reliably brought into contact with the bone surface. In this case, unnecessary tongues 42, 43, and 44 which do not require the fixing screw to be inserted into the extension engagement holes may be kept pressed against the surface of the femur. It can also be removed from the root with a pin cutter or a saw.

In this embodiment, the extension plate 40 is not attached to the protruding engagement portion 14, and as shown in FIG.
Bone plate 10, sleeve body 20, and lag screw 3
It is also possible to fix a fractured part or the like with only a fixing screw 0 and not shown. In this case, it is also possible to insert a fixing screw into the protruding engagement hole 14a formed in the protruding engagement portion 14 and screw the screw into the bone to engage the head of the fixing screw with the protruding engagement hole 14a. On the other hand, when the use of the protruding engagement hole 14a is not sufficient, the extension plate 40 is fitted to the protruding engagement portion 14 as described above, so that the extension engagement hole of the extension plate 40 is also used. Can be fixed. In this case, since the protruding engagement hole 14a and the base engagement hole 41a are configured to overlap each other, the fixation screw is inserted through the overlapping portion of the two holes and screwed, so that the bone plate 10 and the extension plate 40 Can be firmly bonded. Of course, the fixing screw inserted into the overlapping portion may be used not only for connecting the bone plate 10 and the extension plate 40 but also for fixing the fracture.

In the above-described embodiment, a case is described in which a fixing screw is inserted into each of the engagement holes. However, a simple fixing pin having no screw may be inserted so as to protrude from the bone. Further, in the above embodiment, the projecting engagement hole 14 is used.
a is formed in the shape of a long hole, so that the protruding engagement hole 14a and the base engagement hole 41a overlap in a plane even when the base engagement portion is inserted and removed to some extent in the axial direction of the bone plate 10. When a fixing screw or a fixing pin is inserted into both holes, the projecting engagement portion 14 and the base engagement portion 41 can be set.
It is possible to have a certain degree of freedom in fitting depth. Further, in the above embodiment, the bone plate and the extension plate are joined by fitting the projecting engaging portion and the base engaging portion to each other, but the projecting engaging portion and the base engaging portion are each connected to the plate. In a state in which both are simply overlapped, the fixing screw and the like are inserted by aligning the protrusion engaging hole formed in the protrusion engaging portion with the base engaging hole formed in the base engaging portion,
The bone plate and the extension plate may be connected by screwing the fixing screw into the bone.

In the present invention, the bone plate and the extension plate may be made of the same material, or the bone plate and the extension plate may be made of different materials. In the latter case, as an extension plate, it is easy to use by configuring it to be deformable according to the bone surface,
It is preferable to use a material softer than the bone plate. In both the case where the extension plate is made of a material softer than the bone plate and the case where it is made of the same material, it is preferable that at least a portion other than the base engaging portion of the extension plate is configured to be deformable, particularly In addition, it is desirable to be configured so that it can be easily deformed by a finger or the like during the operation, and that the extension portion can be sufficiently fixed to the fractured portion. For example, in the case of a relatively hard Ti alloy, the thickness is preferably about 1.5 to 3 mm, and more preferably, 1.5 to 2 mm. When it is formed of relatively flexible pure Ti or SUS316, the thickness is preferably 2 to 4 mm, particularly 2 to 3 mm.
mm is more desirable. If the thickness of the extension plate exceeds these ranges, it will be difficult to deform during the operation to fit the bone surface, and if the thickness is less than these ranges, it will not be possible to obtain sufficient holding and support of the fractured part.

FIGS. 7 to 9 show examples of the shape of another extension plate which has a different shape from the extension plate 40 but can be attached to the bone plate 10 of the above embodiment. The extension plate 50 shown in FIG. 7A includes a base engaging portion 51 that can be engaged with the projecting engaging portion 14, a base connecting portion 52 extending upward from the base engaging portion 51, and a base connecting portion 52. And a tongue 53 extending to the left from the tip of the tongue. A base engaging hole 51a is formed in the base engaging portion 51, and an extended engaging hole 52a is formed in a distal end portion of the base connecting portion 52.
a is formed, and an extension engagement hole 53 is formed at the tip of the tongue 53.
a is formed. In this example, the extension engagement hole 53a is formed so as to be shifted to the left from the axis of the base engagement portion 51, so that it is particularly suitable for treating the femoral head of the right leg. This is because, for example, there is a anteversion angle in the head of the femur of the right leg (especially in the case of Oriental people), that is, the right angle to the plate surface of the bone plate 10 fixed to the outer surface of the shaft. Since the head of the bone projects obliquely toward the obliquely forward side of the body corresponding to the above, screwing the fixing screw from the left side (rear side of the body) slightly from the axis of the bone plate 10 will cause a fracture near the head of the bone. This is because it can be more easily fixed.
Therefore, the extension plate for the left leg has a tongue extending rightward, contrary to the extension plate shown in FIG.

The extension plate 60 shown in FIG. 7B has a base engaging portion 61, a base connecting portion 62 extending upward from the base engaging portion 61, and extending to the left from the tip of the base connecting portion 62. A tongue 63 and a tongue 64 extending rightward in the figure from the distal end of the base connection 62 are provided. Base engaging part 6
1, a base engaging hole 61a is formed, an extended engaging hole 62a is formed at the tip of the base connecting portion 62, and extended engaging holes 63a, 64 are formed in tongue-shaped portions 63, 64 extending left and right, respectively.
a is formed. In this example, the base engaging portion 6
The extension engagement holes 63a,
Since the 64a is formed, the fixing screw can be screwed into the femur of either of the left and right legs from both the frontward and the rearward, so that even a complicated unstable fracture can be easily fixed, An extension plate that can be used at any location can be configured. In this case, the extension engaging portions 42a and 44a of the extension plate 40 of the above embodiment are used.
The extension engagement holes 63a and 64a are formed at positions substantially equal to those of the extension engagement holes 62a and 63a and 6a.
This is particularly effective when it is desired to increase the mutual fixing strength between the portions 4a.

The extension plate 70 shown in FIG. 8A includes a base engaging portion 71 having a base engaging hole 71a, and two tongue-shaped portions 72 and 73 projecting from the base engaging portion 71, respectively. I have. The tongue 72 extends upward along the axis of the base engaging portion 71, while the tongue 73 extends in a direction deviated to the left from the axis. Extending engagement holes 72a, 73a are formed at the tips of the tongues 72, 73, respectively. This extension plate 70 is particularly suitable for use on the right leg for the same reason as described above. By making the shape symmetrical with respect to the shape shown in this figure with the axis of the base engaging portion 71 interposed therebetween, a shape suitable for the left leg can also be constructed.

The extension plate 80 shown in FIG. 8B includes a base engaging portion 81 having a base engaging hole 81a, and a tongue-shaped portion 82 extending in a direction shifted leftward from the axis of the base engaging portion 81.
And a tongue 83 extending in a direction shifted rightward from the axis.
And The tongue portions 82, 83 are formed with extension engagement holes 82a, 83a, respectively. This extension plate 80 is suitable when a fixing screw is screwed in from a direction shifted left and right from the axis of the base engaging portion 81.

The extension plate 90 shown in FIG. 9A has a tongue 92 extending leftward from the base engagement portion 91 having a base engagement hole 91a. The hole 92a is formed. The extension plate 100 shown in FIG. 9B has a tongue portion 10 extending upward in the axial direction from the base engagement portion 101 having the base engagement hole 101a.
2 and an extended engagement hole 102a is provided at the tip of the tongue 102.
Is formed. These extension plates 90, 1
No. 00 has a single tongue and an extended engagement hole.

FIG. 5 shows a modification in which the osteosynthesis device of the above embodiment is formed particularly for the left leg.
In the figure, (a) is a plan view in which the bone plate 110 and the extension plate 140 are combined, (b) is a side view of the bone plate 110, (c) is a plan view of only the bone plate 110,
FIG. 4D shows a front view of only the bone plate 110. In this modification, the plate surface of the upper engaging portion 111 slightly rotates clockwise in the front view (d) with respect to the plate surface of the lower fixing portion 112 fixed on the outer surface of the diaphyseal portion of the femur. When the lower fixing portion 112 is fixed to the outer surface of the diaphyseal portion, the main engaging hole 111a formed in the upper engaging portion 111 is formed. Projection engagement hole 1 of joint 114
14a and the extension engagement holes 142a of the extension plate 140,
The fixing screws that pass through 143a and 144a are both screwed obliquely leftward. Therefore, considering the anteversion angle of the femoral head, it is more suitable for the left leg. Similarly, a plate set more suitable for the right leg can be formed by making the shape symmetrical with respect to the axis of the bone plate 110. Although not shown in this modification, the same sleeve body and rug screw as those in the above embodiment can be used. In addition, bone plate 1
The torsion between the upper engaging portion 111 and the lower fixing portion 112 is caused by the anteversion angle and other torsion between the femoral shaft and the femoral head when the bone plate 10 is fixed to the upper part of the femur. Preferably, it is configured to match the structure.

In the above embodiment, the bone plate 10
And the sleeve body 20 are configured to be detachable, and the sleeve body 20 and the lag screw 30 are combined to be attached to the bone plate. However, the bone plate 10 and the sleeve body 20 are integrated. Alternatively, the lag screw 30 may be configured to be inserted into the sleeve body 20. Further, in the above embodiment, an example of a plate set for repairing a fracture near the head of the femur is shown. However, any part provided with a bone plate fixed on the bone surface and an extension plate can be used. May be applied.

[0039]

As described above, the protruding engagement portion is formed so as to protrude from the end of the bone plate, and the base engagement is removably engaged with the protruding engagement portion. Since the extension plate with the portion is provided, the extension plate can be securely engaged and held regardless of the shape of the bone plate,
The extension plate can be easily inserted and removed during the operation.

[Brief description of the drawings]

FIG. 1 is a plan view showing a joint structure (a) of a bone plate and an extension plate and a structure (b) near a protruding engagement portion in a bone plate in an embodiment of an osteosynthesis device according to the present invention.

FIG. 2 is an assembly partial cross-sectional view showing an entire configuration of the plate set of the embodiment except for an extension plate and a use state;

FIG. 3 is an assembled side view showing an entire configuration and a used state of the plate set of the embodiment.

FIG. 4 is an assembled side view showing a state in which the extension plate is deformed according to the bone surface when using the plate set of the embodiment.

FIG. 5 is an assembled plan view of a bone plate and an extension plate in a modification of the embodiment (a), a side view of the bone plate (b), a plan view of the bone plate (c), and a front view of the bone plate (d). It is.

FIG. 6 is a plan view (a), a side view (b), and a front view (c) of the extension plate of the embodiment.

FIG. 7 is a plan view showing modified examples (a) and (b) of an extension plate.

FIG. 8 is a plan view showing modified examples (a) and (b) of the extension plate.

FIG. 9 is a plan view showing modified examples (a) and (b) of the extension plate.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 10 Bone plate 11 Upper engaging part 11a Main engaging hole 12 Lower fixing part 12a, 12b Screw engaging hole 13 Bayonet rotating body 14 Projecting engaging part 14a Projecting engaging hole 20 Sleeve body 30 Lug screw 40 Extension plate 41 Base member Joint 41a Base engaging hole 42, 43, 44 Tongue 42a, 43a, 44a Extension engaging hole

Claims (8)

(57) [Claims] 1. An osteosynthesis device for holding and fixing bone or its equivalent, comprising: a bone plate fixed on an outer surface of the bone; a bone plate engaged with the bone plate, and separated from the bone plate. An extension plate provided with an extension engagement hole for inserting and engaging a fixing member inserted into the bone to additionally fix the bone portion, wherein the projection engagement portion projects from an end of the bone plate Wherein the base plate of the extension plate is provided with a base engaging portion configured to be insertable into and removable from the protruding engaging portion. 2. The osteosynthesis device according to claim 1, wherein a protrusion engagement hole is formed in the protrusion engagement portion for inserting and engaging a fixing member introduced into the bone. 3. The base engaging portion according to claim 1, wherein a base engaging hole is formed in the base engaging portion for inserting and engaging a fixing member, and the extension plate is engaged with the projecting engaging portion. The osteosynthesis device, wherein the protruding engagement hole and the base engagement hole are configured to overlap in a planar manner in a combined state. 4. One of claims 1 to 3
2. The osteosynthesis device according to claim 1, wherein the projecting engagement portion projects in a direction along a shape of a bone surface with which the bone plate contacts. 5. The method according to claim 1, wherein:
In the paragraph, the osteosynthesis device is characterized in that the base engaging portion is fitted so as to wrap around the projecting engaging portion. 6. Any one of claims 1 to 5
In the paragraph, the extension engagement hole is formed in a portion that can be deformed by a finger extending from the base engagement portion. 7. Any one of claims 1 to 5
In the paragraph, the extension engagement hole is formed near a tip end of a tongue-shaped portion thinner than the bone plate and extending from the base engagement portion of the extension plate. 8. The osteosynthesis according to claim 7, wherein the tongue-shaped portion is formed such that a root portion closer to the base engagement portion than a position where the extension engagement hole is formed has a narrow width. apparatus.