JP3307805B2 - Intramedullary nail - Google Patents

Intramedullary nail

Info

Publication number
JP3307805B2
JP3307805B2 JP22419195A JP22419195A JP3307805B2 JP 3307805 B2 JP3307805 B2 JP 3307805B2 JP 22419195 A JP22419195 A JP 22419195A JP 22419195 A JP22419195 A JP 22419195A JP 3307805 B2 JP3307805 B2 JP 3307805B2
Authority
JP
Japan
Prior art keywords
nail
screw
hole
proximal
plug
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
JP22419195A
Other languages
Japanese (ja)
Other versions
JPH0966060A (en
Inventor
原 紘 郎 藤
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Mizuho Ika Kogyo KK
Original Assignee
Mizuho Ika Kogyo KK
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Mizuho Ika Kogyo KK filed Critical Mizuho Ika Kogyo KK
Priority to JP22419195A priority Critical patent/JP3307805B2/en
Publication of JPH0966060A publication Critical patent/JPH0966060A/en
Application granted granted Critical
Publication of JP3307805B2 publication Critical patent/JP3307805B2/en
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72Intramedullary pins, nails or other devices
    • A61B17/7233Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A61B17/725Intramedullary pins, nails or other devices with special means of locking the nail to the bone with locking pins or screws of special form
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72Intramedullary pins, nails or other devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72Intramedullary pins, nails or other devices
    • A61B17/7233Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74Devices for the head or neck or trochanter of the femur
    • A61B17/742Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • A61B17/744Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to an intramedullary nail

Description

【発明の詳細な説明】DETAILED DESCRIPTION OF THE INVENTION

【0001】[0001]

【発明の属する技術分野】本発明は、人体の大腿骨近位
部骨折時の治療のための髄内固定法に使用する髄内釘に
関する。
BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an intramedullary nail for use in an intramedullary fixation method for treating a fracture of a proximal femur of a human body.

【0002】[0002]

【従来の技術】髄内釘は、途中の屈曲部を境にして近位
部とこの近位部より長い遠位部とを備えたロッド状ネイ
ルと、このネイルの遠位部に設けられる骨部への係合手
段と、ネイルの屈曲部近傍の近位部に斜めに貫設された
貫通孔と、骨頭部にねじ込まれるスクリューが先端に設
けられかつ前記貫通孔に挿入されるラグスクリューとを
有し、髄内固定法に使用されている。大腿骨近位部骨折
時の治療のためには、まず、ネイルが大腿骨の内腔(骨
髄腔)へ近位部側から打ち込まれる。そして、このよう
な髄内釘は従来すべて同じ寸法に作られている。たとえ
ば、大腿骨内腔に打ち込まれるネイルの長さはすべて一
定である。
2. Description of the Related Art An intramedullary nail is composed of a rod-shaped nail having a proximal portion and a distal portion longer than the proximal portion with a middle bent portion, and a bone provided on the distal portion of the nail. Engaging means to the part, a through hole obliquely penetrated in the proximal part near the bent part of the nail, a screw screwed into the bone head is provided at the tip and a lag screw inserted into the through hole And used for intramedullary fixation. For treatment of a proximal femoral fracture, a nail is first driven into the lumen (bone marrow cavity) of the femur from the proximal side. And all such intramedullary nails are conventionally made to the same size. For example, the length of nails driven into the femoral lumen are all constant.

【0003】[0003]

【発明が解決しようとする課題】しかるに、人により骨
の寸法、たとえば大腿骨の長さは異なる。たとえば大腿
骨が標準より長い人について、大腿骨内腔にネイルを打
ち込む場合、ネイルの長さがー定であるためネイル近位
部の頂端が大腿骨の頂部よりも内側に入るように打ち込
まれてしまい、大腿骨頂部とネイル近位部の頂部との間
には段差が生じる。この段差が生じた部分の骨には肉が
密着しにくく、あるいは、段差が生じた部分に仮骨が入
るなどの問題が生じる。
However, the size of the bone, for example, the length of the femur varies from person to person. For example, when nailing into the femoral cavity for a person whose femur is longer than the standard, the nail is driven so that the apical end of the proximal part of the nail is inside the apex of the femur because the nail length is constant. This results in a step between the top of the femur and the top of the proximal nail. There is a problem that the meat hardly adheres to the bone at the portion where the step has occurred, or that the callus enters the portion where the step has occurred.

【0004】本発明はこれに鑑み、人によって異なる骨
の寸法に対して調節可能な近位部を備えたネイルを有す
る髄内釘を提供することを目的としてなされたものであ
る。
[0004] In view of the foregoing, it is an object of the present invention to provide an intramedullary nail having a nail with a proximal portion that can be adjusted for different bone sizes by different persons.

【0005】[0005]

【課題を解決するための手段】上記従来技術の課題を解
決するため本発明は、大腿骨内腔に打ち込まれるロッド
状ネイルと、このネイルの遠位部に設けられる骨への固
定手段と、前記ネイルの途中に斜めに貫設された貫通孔
と、骨頭部にねじ込まれるスクリューを先端に有しかつ
前記貫通孔に挿入されるラグスクリューと、ラグスクリ
ューをネイルに固定する手段とを有する髄内釘におい
て、前記ネイルの近位部の端部に、近位部の長さ調節用
のプラグが着脱可能に嵌め込まれており、ラグスクリュ
ーをネイルに固定する前記手段が、前記貫通孔に臨むよ
うに前記近位部内にねじ込まれたセットスクリュ−であ
り、前記プラグにはセットスクリュ−を出し入れ可能な
孔が形成されており、前記プラグはセットスクリュ−の
頭部を覆うようにネイル近位部の端部にねじ込まれてい
ることを特徴とする。
SUMMARY OF THE INVENTION In order to solve the above-mentioned problems of the prior art, the present invention provides a rod-shaped nail driven into a femoral cavity, a means for fixing the nail to a bone provided at a distal portion of the nail, and A medulla having a through hole obliquely provided in the middle of the nail, a lag screw having a screw screwed into the bone head at the tip and inserted into the through hole, and means for fixing the lag screw to the nail. In the inner nail, a plug for adjusting the length of the proximal portion is detachably fitted to an end of the proximal portion of the nail, and the means for fixing a lag screw to the nail faces the through hole. Screw is screwed into the proximal portion as described above, the plug is formed with a hole through which the set screw can be inserted and removed, and the plug is screwed to cover the head of the set screw. Wherein the LE is screwed to an end portion of the proximal portion.

【0006】[0006]

【発明の実施の形態】以下、本発明の髄内釘の実施形態
を図面を参照して説明する。図1から図6は本発明の第
1の実施の形態を示す。図1おいて、髄内釘1は、公知
のように、ロッド状のネイル2と、骨との係合手段とし
てのロッキングスクリュー3と、ラグスクリュー(la
g screw)4とを有し、図2に示す大腿骨5の近
位部骨折の治療時の髄内固定法に使用される。
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of an intramedullary nail according to the present invention will be described below with reference to the drawings. 1 to 6 show a first embodiment of the present invention. As shown in FIG. 1, an intramedullary nail 1 includes a rod-shaped nail 2, a locking screw 3 as a means for engaging with a bone, and a lag screw (la).
gscrew) 4 and is used for intramedullary fixation during treatment of a proximal fracture of the femur 5 shown in FIG.

【0007】ネイル2は、図1、図3および図5に示す
ように、途中に小さい角度の屈曲部6を有しており、こ
の屈曲部6に続くー方(図における上方)は近位部7と
され、他方(図における下方)は近位部7より長く、か
つ細い寸法の遠位部8とされている。屈曲部6の一側は
当然のことなが凸側6aとなる。図5に最もよく示すよ
うに、ネイル2の近位部7の屈曲部6近傍には、ラグス
クリュー4のための貫通孔12が近位部7の軸線に対し
て斜めに形成されている。貫通孔12の傾斜は凸側6a
で凹側6bより高くなる(図で見て)ようにされてい
る。ネイル2のラグスクリュー4用貫通孔12より遠位
部8側で、かつ、周面の凸側6aには凹入部13が形成
されている。凹入部13は緩やかな曲線で凹入するよう
にえぐれた形状を有している。
As shown in FIGS. 1, 3 and 5, the nail 2 has a bent portion 6 having a small angle in the middle, and the side following the bent portion 6 (upper side in the figure) is proximal. The other part (the lower part in the figure) is a distal part 8 which is longer and narrower than the proximal part 7. One side of the bent portion 6 is, of course, the convex side 6a. As best shown in FIG. 5, near the bent portion 6 of the proximal portion 7 of the nail 2, a through hole 12 for the lag screw 4 is formed obliquely with respect to the axis of the proximal portion 7. The inclination of the through hole 12 is the convex side 6a.
To be higher than the concave side 6b (as viewed in the figure). A recessed portion 13 is formed on the nail 2 on the side closer to the distal portion 8 than the through hole 12 for the lag screw 4 and on the convex side 6a of the peripheral surface. The concave portion 13 has a hollow shape so as to concave with a gentle curve.

【0008】ネイル2の遠位部8の端部近傍には所定の
間隔を形成して2本のロッキングスクリュー3の貫通ね
じ孔14が遠位部8の軸線に直交するように形成されて
おり、図3に示すように、大腿骨5の部分5aをも貫通
してネイル2の遠位部8に貫通させたロッキングスクリ
ュー3によってネイル2が大腿骨5の部分5aに固定さ
れるようになっている。
In the vicinity of the end of the distal portion 8 of the nail 2, a predetermined gap is formed and through screw holes 14 of the two locking screws 3 are formed so as to be orthogonal to the axis of the distal portion 8. As shown in FIG. 3, the nail 2 is fixed to the part 5a of the femur 5 by the locking screw 3 which also penetrates the part 5a of the femur 5 and penetrates the distal part 8 of the nail 2. ing.

【0009】ラグスクリュー4は先端にスクリュー16
が形成されており、スクリュー16がネイル2の近位部
7側となるようにしてネイル2の貫通孔12に挿通され
るようになっている。ラグスクリュー4の貫通孔12へ
の挿通の方向は図5に矢印Aにより示される。
The lag screw 4 has a screw 16 at its tip.
Is formed, and the screw 16 is inserted into the through hole 12 of the nail 2 so that the screw 16 is on the proximal portion 7 side of the nail 2. The direction of insertion of the lag screw 4 into the through hole 12 is indicated by an arrow A in FIG.

【0010】図5に示すように、ネイル2の近位部7の
端部には、貫通孔12へ挿通されたラグスクリュー4を
ネイル2に固定するためのセットスクリュー9が設けら
れ、このセットスクリュー9の頭部側には本発明の特徴
をなすプラグ10が設けられている。これをさらに詳し
く説明すると、ネイル2の近位部7の端部には、図6に
示すように、大きい径のねじ孔11が形成され、それに
続いて小さい径の段孔22、23が順次形成され、孔2
3は前記貫通孔12に通じている。孔22はねじ孔とし
て形成されており、これに、前記セットスクリュー9を
ねじ込めるようになっている。セットスクリュー9の先
端9aはねじ込みによって貫通孔12内部に達し、貫通
孔12内部に挿通したラグスクリュー4の周面の長手方
向に形成した溝4a(図5)に係合して、ラグスクリュ
ー4の回転を阻止しつつそれをネイル2に固定する。か
くして、図3に示すようにラグスクリュー4はネイル2
に固定される。
As shown in FIG. 5, a set screw 9 for fixing the lag screw 4 inserted through the through hole 12 to the nail 2 is provided at an end of the proximal portion 7 of the nail 2. A plug 10 which is a feature of the present invention is provided on the head side of the screw 9. More specifically, as shown in FIG. 6, a screw hole 11 having a large diameter is formed at an end of the proximal portion 7 of the nail 2, and step holes 22 and 23 having small diameters are sequentially formed. Formed, hole 2
Reference numeral 3 communicates with the through hole 12. The hole 22 is formed as a screw hole, into which the set screw 9 can be screwed. The tip 9a of the set screw 9 reaches the inside of the through hole 12 by screwing, engages with a groove 4a (FIG. 5) formed in the longitudinal direction of the peripheral surface of the lag screw 4 inserted into the through hole 12, and Is fixed to the nail 2 while preventing its rotation. Thus, as shown in FIG.
Fixed to

【0011】プラグ10は筒状のおねじ部10aを有し
ており、このおねじ部10aを図5に示すように前記ね
じ孔22に螺入すると、ネイル2の近位部7の端部はプ
ラグ10によって閉じられる。この時、プラグ10の筒
状おねじ部10aはセットスクリュー9の頭部の外周を
囲み、プラグ10によって近位部7の頂部は閉じられる
ことになる。プラグ10は、図7(A)(B)に示すよ
うに種々の高さの頭部10bをもつものを用意してお
く。したがって、プラグ10のみを交換するかまたはプ
ラグ10を外すことによって、ネイル2の近位部7の長
さを任意に変えることができる。
The plug 10 has a cylindrical threaded portion 10a. When the male threaded portion 10a is screwed into the threaded hole 22 as shown in FIG. Is closed by the plug 10. At this time, the cylindrical male screw portion 10a of the plug 10 surrounds the outer periphery of the head of the set screw 9, and the top of the proximal portion 7 is closed by the plug 10. As shown in FIGS. 7A and 7B, plugs 10 having heads 10b of various heights are prepared. Therefore, the length of the proximal portion 7 of the nail 2 can be arbitrarily changed by replacing only the plug 10 or removing the plug 10.

【0012】次に、以上に述べた髄内釘1の使用法につ
いて説明する。図4に示すように、大腿骨5は骨頭19
を有するとともに内腔(骨髄腔)20を有しており、内
腔20の骨頭19寄りの部分に骨頭19に向かって弧状
にのびる内壁部20aを有している。このような大腿骨
5の近位部に起きる骨折は最も典型的には、図4に符号
18で示すようなものである。このような骨折部18を
仮固定するために大腿骨5の内腔20に髄内釘ネイルを
打ち込むのは、前述のように骨盤が邪魔になるので、内
腔に対して近位部側からやや斜めに矢印B方向に行うこ
とになる。ところが、前述のように、ネイル2は屈曲し
ているので、従来の場合は、その屈曲部6の凸側6aが
打ち込み時に前記弧状にのびる内壁部20aと干渉を起
こす。これは次のようにして解決される。
Next, how to use the above-described intramedullary nail 1 will be described. As shown in FIG. 4, the femur 5 is
And has an inner cavity (medullary cavity) 20, and an inner wall portion 20 a extending in an arc toward the head 19 in a portion of the inner cavity 20 near the head 19. Such a fracture occurring in the proximal part of the femur 5 is most typically such as shown at 18 in FIG. Driving an intramedullary nail into the lumen 20 of the femur 5 to temporarily fix such a fractured portion 18 is performed from the proximal side with respect to the lumen because the pelvis becomes an obstacle as described above. This is performed in the direction of arrow B slightly obliquely. However, as described above, since the nail 2 is bent, in the conventional case, the convex side 6a of the bent portion 6 interferes with the inner wall portion 20a extending in the arc shape at the time of driving. This is solved as follows.

【0013】図4の状態にある大腿骨5に対して、まず
矢印Bで示す部分にその矢印方向にドリルにより穿孔を
施した後、その穿孔を通して、ネイル2を、その凸側6
aの凹入部13が骨頭19側に向くようにして大腿骨内
腔20に向かって打ち込み、図3に示す位置まで到達さ
せる。この場合、ネイル2の貫通孔12の凸側6aには
凹入部13が形成されているので、この凹入部13が、
内腔20の骨部20aへのネイル2の屈曲部の凸側6a
の強い干渉を防ぎ、ネイル2はスムースに、かつ、骨部
20aに損傷を生ずることなく内腔20へ打ち込むこと
ができる。このようにネイル2が所定位置に達したとこ
ろで、大腿骨5の部分5aをも貫通してネイル2の遠位
部8にロッキングスクリュー3を通してネイル2を内腔
20に固定する。次いで、大腿骨5の側壁に穿設した孔
を通してラグスクリュー4をネイル2の貫通孔12に挿
入し、ラグスクリュー4を図示しない工具により回転さ
せてスクリュー16を骨頭19に螺入して固定する。そ
の後、ラグスクリュー4の基端部を反スクリュー側へ引
っ張り、骨頭19側を大腿骨5の本体側に引き寄せて骨
折部18において密接させる。ついで、ネイル2の近位
部7の端部にセットスクリュー9を図3に示すように螺
入して締め付け、ラグスクリュー4をネイル2に対して
固定する。次に、図3に示すようにねじ孔11にプラグ
10を螺入する。これによって、図3に示す最終固定状
態が得られる。そして、この状態は骨折部18が接合さ
れるまで維持される。髄内釘1は、骨折部18の完治
後、前述と逆の順序で取り外される。
The femur 5 in the state shown in FIG. 4 is first drilled in the direction shown by the arrow B by a drill in the direction of the arrow, and the nail 2 is passed through the drill to the convex side 6.
It is driven toward the femoral cavity 20 so that the recessed portion 13a faces the head 19 and reaches the position shown in FIG. In this case, since the concave portion 13 is formed on the convex side 6a of the through hole 12 of the nail 2, the concave portion 13
Convex side 6a of bend of nail 2 to bone 20a of lumen 20
The nail 2 can be driven into the lumen 20 smoothly and without damaging the bone portion 20a. When the nail 2 reaches the predetermined position in this manner, the nail 2 is fixed to the lumen 20 through the locking screw 3 to the distal portion 8 of the nail 2 through the portion 5a of the femur 5 as well. Next, the lag screw 4 is inserted into the through hole 12 of the nail 2 through a hole formed in the side wall of the femur 5, and the lag screw 4 is rotated by a tool (not shown) to screw the screw 16 into the head 19 and fix it. . Thereafter, the proximal end of the lag screw 4 is pulled toward the opposite side of the screw, and the head 19 is pulled toward the main body of the femur 5 so that the lag screw 4 is in close contact with the fracture 18. Then, a set screw 9 is screwed into the end of the proximal portion 7 of the nail 2 as shown in FIG. 3 and tightened, and the lag screw 4 is fixed to the nail 2. Next, the plug 10 is screwed into the screw hole 11 as shown in FIG. Thereby, the final fixed state shown in FIG. 3 is obtained. This state is maintained until the fracture 18 is joined. After the fracture 18 is completely cured, the intramedullary nail 1 is removed in the reverse order.

【0014】図8から図10には本発明の髄内釘の他の
実施の形態を示す。この実施形態がさきの実施形態と異
なる点は、骨折部18より近位部にある骨頭をラグスク
リュー4により引き寄せるために、ラグスクリュー4に
直接力を加えなくてもよいようにした点にある。さきの
実施形態と均等な部分については同じ符号を付して説明
を省略し、異なる点のみについて説明する。この実施形
態では図10に最もよく示されるように、ネイル2の貫
通孔12に例えば円筒状のスリーブ25を摺動可能に挿
通し、このスリーブ25の内部にラグスクリュー4を通
している。ラグスクリュー4はその基端部に軸方向のね
じ孔28が形成されており、このねじ孔28にラグスク
リュー引き寄せ用おねじ29の先端部が螺入されてい
る。そして、おねじ29の基端部には拡大した頭部29
aが一体的に形成されている。そして、通常、この拡大
頭部29aはスリーブ25に基端部の内面に形成した環
状の段部25aに接している。図8の状態で拡大頭部2
9aに回転操作を加えて、おねじ29を、ラグスクリュ
ー4を引き寄せる方向に回転させると、ラグスクリュー
4がその方向に移動してくるので骨折部18を密着させ
ることができる。この時の引き寄せ力の反力は拡大頭部
29aがスリーブ25の内面の段部25aに当接するこ
とによって発生する。
8 to 10 show another embodiment of the intramedullary nail of the present invention. This embodiment differs from the previous embodiment in that the lag screw 4 does not need to apply a direct force to the lag screw 4 in order to draw the head closer to the fracture portion 18 by the lag screw 4. . Portions equivalent to those in the previous embodiment are denoted by the same reference numerals, description thereof will be omitted, and only different points will be described. In this embodiment, as best shown in FIG. 10, for example, a cylindrical sleeve 25 is slidably inserted into the through hole 12 of the nail 2, and the lag screw 4 is passed through the inside of the sleeve 25. An axial screw hole 28 is formed at the base end of the lag screw 4, and the distal end of a lag screw pulling male screw 29 is screwed into the screw hole 28. The enlarged head 29 is located at the base end of the male screw 29.
a is formed integrally. Usually, the enlarged head 29a is in contact with an annular step 25a formed on the inner surface of the base end of the sleeve 25. The enlarged head 2 in the state of FIG.
When the male screw 29 is rotated in a direction to draw the lag screw 4 by applying a rotation operation to 9a, the lag screw 4 moves in that direction, so that the fracture portion 18 can be brought into close contact. The reaction force of the pulling force at this time is generated when the enlarged head 29a contacts the step 25a on the inner surface of the sleeve 25.

【0015】なお、図10において、26はスリーブ2
5の一端に外側へ向かって突設した複数のストッパで、
スリーブ25が図9の状態で大腿骨の側壁より内側に入
り込まないようにするためのものである。また、27は
スリーブ25を大腿骨およびネイル2から外すときにフ
ック等を掛ける小孔である。
In FIG. 10, reference numeral 26 denotes a sleeve 2
5 with a plurality of stoppers protruding outward at one end,
This is for preventing the sleeve 25 from entering inside the side wall of the femur in the state of FIG. Numeral 27 is a small hole for hooking when removing the sleeve 25 from the femur and the nail 2.

【0016】図9の状態を得るには、まずネイル2を大
腿骨内腔20の内部に打ち込んで位置固定した後、ラグ
スクリュー4を骨頭19側の骨部分にねじ込み、ついで
スリーブ25をネイル2の貫通孔12に通し、ラグスク
リュー引き寄せ用おねじ29をラグスクリュー4にねじ
込む。スリーブ25の貫通孔12内での位置はセットス
クリュー9をねじ込んでその先端をスリーブ25の周面
に押し付けることによりなされる。
In order to obtain the state shown in FIG. 9, first, the nail 2 is driven into the inside of the femoral cavity 20 to fix the position, and then the lag screw 4 is screwed into the bone portion on the side of the head 19, and then the sleeve 25 is attached to the nail 2 The lag screw pulling male screw 29 is screwed into the lag screw 4. The position of the sleeve 25 in the through hole 12 is determined by screwing the set screw 9 and pressing the tip of the set screw 9 against the peripheral surface of the sleeve 25.

【0017】この実施形態においても、プラグ10は筒
状のおねじ部10aを有しており、このおねじ部10a
を図10に示すように前記ねじ孔22に螺入すると、ネ
イル2の近位部7の端部はプラグ10によって閉じられ
る。この時、プラグ10の筒状おねじ部10aはセット
スクリュー9の頭部の外周を囲み、プラグ10によって
近位部7の頂部は閉じられることになる。プラグ10
は、図7に示したと同様に種々の高さの頭部10bをも
つものを用意しておく。したがって、プラグ10のみを
交換することによって、またはプラグ10を取り外すこ
とによってネイル2の近位部7の長さを任意に変えるこ
とができる。
Also in this embodiment, the plug 10 has a cylindrical external thread 10a.
Is screwed into the screw hole 22 as shown in FIG. 10, the end of the proximal portion 7 of the nail 2 is closed by the plug 10. At this time, the cylindrical male screw portion 10a of the plug 10 surrounds the outer periphery of the head of the set screw 9, and the top of the proximal portion 7 is closed by the plug 10. Plug 10
Are prepared with heads 10b of various heights as shown in FIG. Accordingly, the length of the proximal portion 7 of the nail 2 can be changed arbitrarily by replacing only the plug 10 or by removing the plug 10.

【0018】[0018]

【発明の効果】以上説明したように、本発明による髄内
釘は、ネイルの近位部の端部に近位部の長さ調節用のプ
ラグを嵌め込んだので、人によって長さの異なる大腿骨
内腔に、プラグを変えたり外したりして適当な長さとし
たネイルを打ち込むことができ、大腿骨頂部とネイルの
近位部頂部との間に段差が生じないようにすることがで
き、段差部に仮骨が入ることを防止することができる。
したがって、段差がないので肉が骨に密着し、骨折部の
直りを早くすることができるなどの効果がある。
As described above, in the intramedullary nail according to the present invention, since the plug for adjusting the length of the proximal portion is fitted into the end of the proximal portion of the nail, the length varies depending on the person. By changing or removing the plug, a nail of appropriate length can be driven into the femoral cavity, so that there is no step between the top of the femur and the top of the nail. The callus can be prevented from entering the step.
Therefore, since there is no step, the meat is brought into close contact with the bone, and there is an effect that the healing of the fracture can be accelerated.

【図面の簡単な説明】[Brief description of the drawings]

【図1】髄内釘の一実施形態を示す斜視図。FIG. 1 is a perspective view showing one embodiment of an intramedullary nail.

【図2】人体大腿骨部分の略図。FIG. 2 is a schematic view of a human femur.

【図3】図1の髄内釘を大腿骨の骨折部に施した状態を
示す一部断面全体図。
FIG. 3 is an overall partial cross-sectional view showing a state where the intramedullary nail of FIG. 1 is applied to a fracture part of a femur.

【図4】大腿骨の骨折状態を示す説明図。FIG. 4 is an explanatory view showing a fracture state of a femur.

【図5】髄内釘の分解断面図。FIG. 5 is an exploded sectional view of the intramedullary nail.

【図6】髄内釘のネイルの近位部の拡大分解図。FIG. 6 is an enlarged exploded view of the proximal portion of the nail of the intramedullary nail.

【図7】プラグの例を示す図。FIG. 7 shows an example of a plug.

【図8】髄内釘の他の実施形態を示す斜視図。FIG. 8 is a perspective view showing another embodiment of an intramedullary nail.

【図9】図8の髄内釘を大腿骨の骨折部に施した状態を
示す一部断面全体図。
9 is an overall partial cross-sectional view showing a state in which the intramedullary nail of FIG. 8 is applied to a fracture part of a femur.

【図10】図8の髄内釘の拡大断面部分図。FIG. 10 is an enlarged sectional partial view of the intramedullary nail of FIG. 8;

【符号の説明】[Explanation of symbols]

1 髄内釘 1A 髄内釘 2 ネイル 3 ロッキングスクリュー 4 ラグスクリュー 5 大腿骨 6 屈曲部 6a 凸側 6b 凹側 7 近位部 8 遠位部 9 セットスクリュー 10 プラグ 10 a プラグ筒状おねじ部 10 b プラグ頭部 12 貫通孔 16 スクリュー 18 骨折部 19 骨頭 21 ねじ孔 22 ねじ孔 20 大腿骨の内腔 25 スリーブ Reference Signs List 1 intramedullary nail 1A intramedullary nail 2 nail 3 locking screw 4 lag screw 5 femur 6 bent part 6a convex side 6b concave side 7 proximal part 8 distal part 9 set screw 10 plug 10 a plug cylindrical screw part 10 b Plug head 12 Through hole 16 Screw 18 Fracture part 19 Head 21 Screw hole 22 Screw hole 20 Femoral lumen 25 Sleeve

フロントページの続き (56)参考文献 特開 平5−176942(JP,A) 特開 平4−215751(JP,A) 特開 平6−205791(JP,A) 藤原(外4名),大腿骨近位部骨折に 対する髄内固定法,中部日本整形外科災 害外科学会雑誌,中部日本整形外科災害 外科学会,1995年3月1日,第38巻,第 2号,p.457−458 (58)調査した分野(Int.Cl.7,DB名) A61B 17/58 315 Continuation of the front page (56) References JP-A-5-176942 (JP, A) JP-A-4-215751 (JP, A) JP-A-6-205791 (JP, A) Fujiwara (four outsiders), thigh Intramedullary fixation for fractures of the proximal bone, Journal of the Central Japan Orthopedic Surgery Association, Central Japan Orthopedic Surgery Society, March 1, 1995, Vol. 38, No. 2, p. 457-458 (58) Field surveyed (Int. Cl. 7 , DB name) A61B 17/58 315

Claims (1)

(57)【特許請求の範囲】(57) [Claims] 【請求項1】大腿骨内腔に打ち込まれるロッド状ネイル
と、このネイルの遠位部に設けられる骨への固定手段
と、前記ネイルの途中に斜めに貫設された貫通孔と、骨
頭部にねじ込まれるスクリューを先端に有しかつ前記貫
通孔に挿入されるラグスクリューと、ラグスクリューを
ネイルに固定する手段とを有する髄内釘において、前記ネイルの近位部の端部に、近位部の長さ調節用のプ
ラグが着脱可能に嵌め込まれており、 ラグスクリューをネイルに固定する前記手段が、前記貫
通孔に臨むように前記近位部内にねじ込まれたセットス
クリュ−であり、 前記プラグにはセットスクリュ−を出し入れ可能な孔が
形成されており、 前記プラグはセットスクリュ−の頭部を覆うようにネイ
ル近位部の端部にねじ込まれている ことを特徴とする髄
内釘。
1. A nail in the form of a rod which is driven into the inner cavity of a femur, means for fixing the nail to a bone provided at a distal portion of the nail, a through hole obliquely provided in the middle of the nail, and a head of the bone. a lag screw that is inserted has and into the through-hole on the tip of the screw to be screwed in, in the intramedullary nail and a means for securing the lag screw to the nail, the end portion of the proximal portion of the nail, the proximal For adjusting the length of the
A lug is removably fitted therein and said means for securing a lag screw to the nail is
A set screwed into the proximal portion to face the through hole
The plug has a hole through which the set screw can be inserted and removed.
The plug is formed so as to cover the head of the set screw.
An intramedullary nail characterized in that it is screwed into the proximal end .
JP22419195A 1995-08-31 1995-08-31 Intramedullary nail Expired - Lifetime JP3307805B2 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
JP22419195A JP3307805B2 (en) 1995-08-31 1995-08-31 Intramedullary nail

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
JP22419195A JP3307805B2 (en) 1995-08-31 1995-08-31 Intramedullary nail

Publications (2)

Publication Number Publication Date
JPH0966060A JPH0966060A (en) 1997-03-11
JP3307805B2 true JP3307805B2 (en) 2002-07-24

Family

ID=16809954

Family Applications (1)

Application Number Title Priority Date Filing Date
JP22419195A Expired - Lifetime JP3307805B2 (en) 1995-08-31 1995-08-31 Intramedullary nail

Country Status (1)

Country Link
JP (1) JP3307805B2 (en)

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WO2004110291A1 (en) 2003-06-12 2004-12-23 Synthes Ag Chur Surgical nail
CN100528094C (en) 2003-06-12 2009-08-19 斯恩蒂斯有限公司 Surgical nail
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KR101743051B1 (en) 2009-06-30 2017-06-02 스미스 앤드 네퓨, 인크. Orthopaedic implant and fastener assembly
KR101419609B1 (en) * 2012-12-18 2014-07-15 고려대학교 산학협력단 Splitted proximal femoral nail device
CN107468324A (en) * 2017-09-01 2017-12-15 成都大学附属医院 A kind of near end of thighbone insertion type strengthens Medullary fixation device
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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11857228B2 (en) 2020-03-06 2024-01-02 Stryker European Operations Limited Set screw for femoral nail

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