JP5107468B1 - Surgical bone drill drill stopper - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a surgical bone drilling drill stopper for a tubular bone that can be used for a general-purpose drill and can prevent over-invasion with high accuracy during drilling.
A drill stopper 1 is provided so as to be fitted on a shaft-shaped drill blade 100, and is used in a procedure for drilling a through hole in a front bone cortex 113 and a contralateral bone cortex 114 of a tubular bone. A distal end side of the inner cylinder portion can be inserted in a telescopic manner in an inner cylinder portion 2 having a drill insertion hole 6 into which a drill blade 100 can be inserted, and an inner cylinder insertion hole 15 in which the inner cylinder portion 2 can be inserted coaxially. An outer cylinder part 3; a fixing mechanism 7a provided at a rear position of the inner cylinder part 2 and fixing the inner cylinder part to a shaft of a drill blade inserted into the drill insertion hole; and an inner side of the contralateral bone cortex In a state where the tip of the drill blade is in contact with the wall surface, the outer tube portion and the outer tube portion 23 are arranged such that the distance L between the tip of the outer tube portion 23 and the near bone cortex 113 becomes the thickness dimension of the contralateral bone cortex 114. And a holding mechanism 11 that holds the inner cylinder portion.
[Selection] Figure 1

Description

  INDUSTRIAL APPLICABILITY The present invention is used by inserting a general-purpose shaft-shaped drill blade for drilling a tubular bone in an orthopedic surgical operation or the like that requires a screw fixation of the tubular bone due to limb fracture or the like. The present invention relates to a surgical bone drilling drill stopper for controlling the drilling depth.

  In general, the tubular bone constitutes the limb skeleton such as the upper arm, forearm, thigh, and lower leg, and is composed of a soft bone marrow cavity in the center of the tube and a hard, tubular cortical bone that surrounds the bone. being called. In the operation of the tubular bone, a surgical technique or a surgical instrument different from the vertebra and the skull is used depending on the bone structure. For example, a tubular bone broken due to a fracture is reduced and fixed with several screws. For this purpose, it is necessary to drill a plurality of tubular bone through holes for screw insertion fixation. In other words, drilling is started from the surgically opened surgical field to the hard proximal bone cortex, which is the directly visible part of the tubular bone, and then drilled through the central soft bone marrow cavity to the hard contralateral bone cortex It is best to screw the two-stage hard cortical bone hole. And the drill drive for drill drilling does not affect only by hand rotation operation, drilling while controlling the direction and depth while holding the airway type or electric drill rotation drive body with the operator's hand Is required.

  When an operator manipulates such a power drill, when the drill penetrates the tubular bone, an important nerve that exists on the back side of the bone due to excessive penetration of the drill with a drill blade that penetrates too deeply into the back side of the bone. There is a risk of damaging blood vessels, muscle tendons.

  In order to avoid this risk, attempts have been made to calculate the diameter of the bone by X-ray photography in advance and to adjust the drilling distance to the calculated value before starting the drill. However, since the screw fixing direction must be changed depending on the direction of the fracture line of the tubular bone and the like, the drilling angle of the drill with respect to the tubular bone axis is often not limited to a right angle but also an oblique direction. For this reason, the perforation penetration distance is not simply a diameter of a tubular bone that can be read in advance from a two-dimensional X-ray photograph or the like, but varies depending on the surgical situation and must correspond to it.

  Also, depending on the condition of the fracture, even for surgery on one patient, multiple types of screws with slightly different diameters may be used, and it is necessary to prepare a safety device with consideration for handling multiple types of drill shafts. is there.

  Furthermore, in the operation on the tubular bone, since the power drill drive main body is used by being grasped and controlled by the operator's hand as described above, the safety device must be considerably strong.

  Conventionally, instruments for measuring and controlling the depth of penetration of a drill in an operation for drilling a bone are disclosed in Patent Documents 1 to 6, Non-Patent Document 1, and the like.

  The orthopedic surgical instrument described in Patent Document 1 includes a shaft body having a perforated blade formed at the tip, a cylinder body slidably fitted to the shaft body, and a cylinder body fixed on the shaft body. And by fixing the drilling blade at the tip of the shaft body from the distal end side of the cylinder, the tip of the cylinder abuts on the bone when drilling with the instrument. It is an instrument that prevents excessive entry of water. However, this drill shaft body is a special prism-shaped one provided with a groove for fixing the cylindrical body on the shaft body. The reference also discloses a double-tube guide attachment for a tap, and the inner cylinder as an adjustment cylinder is fixed to the outer cylinder as a reference cylinder with reference to the scale of the depth measured in advance. It is a system, it is only for hand-tapping taps, mainly for spinal surgery, and not used for power drill operations.

  The drill guide described in Patent Document 2 is used by being fitted on a specially-shaped dedicated drill having a shoulder portion having a large diameter at an intermediate position of a drill shaft. And a slider configured to change a mounting position in the sleeve. According to this drill guide, when drilling progresses to a predetermined depth, the shoulder portion of the drill shaft comes into contact with the slider and the penetration of the drill stops at that position, so that excessive drill penetration can be prevented. On the other hand, since it has a handle, at the time of use, the position of the slider is first determined, and then drilling is started with a drill, and it is structurally difficult to adjust the position of the slider after starting drilling.

  In the drilling guide described in Patent Document 3, two cylindrical adjacent members composed of a plunger and a sleeve are slidably inserted under friction, and the drilling guide has a length approximately equal to that of the drilling tool. Insert a tool and drill. Since the total length of the drilling guide is almost the same as the drilling tool, the tip side is in contact with the bone during drilling, and the drill chuck of the drilling tool pushes the plunger as the drilling proceeds, and the plunger is pushed into the sleeve . The surgeon can know the drilling depth by reading the scale on the plunger. In order to use this as a safety device, it is necessary to calculate the drilling depth in advance and perform treatment based on this depth value.

  The drill guide described in Patent Document 4 includes a stopper cylinder member provided coaxially with the guide cylinder, and is configured to change and fix the positions of the guide cylinder and the stopper cylinder member. . Adjust the length of the drill guide by attaching the drill guide to the shaft of the drill and changing the position of the guide cylinder and stopper cylinder member, and the drill will over-enter beyond the position corresponding to the length To prevent. Although this drill guide has a handle, it has the feature that the length of the drill guide can be adjusted while grasping the handle from the position and shape of the handle, but it requires an operation with both hands from the start of drilling to the end of operation. .

  The devices described in Patent Documents 5 and 6 and Non-Patent Document 1 are all drill stoppers for skull drilling. Among them, the device described in Patent Document 5 has a triple cylinder structure, a drill shaft dedicated to the innermost cylinder is fixed, and a cylinder with a scale for adjusting the drill depth is extrapolated to the innermost cylinder. The depth of the drill is controlled to fix the position of the cylinder with the scale for adjusting the drill depth, and both hands are required by the fastening fitting of the outermost cylinder. It is necessary to adjust the depth before starting drilling.

  The devices described in Patent Document 6 and Non-Patent Document 1 each include an inner drill and an outer drill for drilling the skull, and a drill drive main body connected to the compression drill, and when the drill resistance is reduced, the compression is performed. Although the spring clutch function works to stop the drill drive and prevent the outer drill from excessive entry, it is mainly a stopper mechanism dedicated to the skull, which is a plate-like bone.

JP-A-11-188043 JP 2004-33761 A Japanese translation of PCT publication No. 2002-502282 JP 2011-115515 A Japanese Utility Model Publication No. 51-022891 JP-A-57-99950

Codman Disposable Perforator Instruction Manual http://www.info.pmda.go.jp/downfiles/md/PDF/340216_21900BZX00872000_A_06_01.pdf Johnson & Johnson Co., Ltd.

  However, the above document disclosure examples have the following problems. The instruments shown in Patent Documents 1 and 2 are stoppers that prevent excessive penetration of a drill that drills through holes, but require a dedicated drill shaft configuration with a special structure as a stopper, and are easy to use. Badness was a problem. That is, the diameter of the perforation varies depending on the disease and the condition, and a plurality of types or a plurality of drill shafts may be used flexibly depending on the situation of the operation due to a decrease in sharpness due to wear of the drill blade. However, since the instruments shown in Patent Documents 1 and 2 use a dedicated drill shaft that requires a unique configuration, a general-purpose drill shaft cannot be used. There was a problem that the types and number of dedicated drill shafts increased, and the cost increased accordingly. Patent Document 1 also discloses a guide for a double cylinder for a tap, but the scale is adjusted to a depth calculated in advance, the reference cylinder is an outer cylinder, and the adjustment cylinder is an inner cylinder. Since the outer cylinder is not firmly fixed to the shaft, it is only for hand-tapped taps, mainly for spinal surgery, and cannot withstand power drill operations.

  Further, the drilling depth has a feature that it changes according to the drilling angle and the drilling position. The screw fixing direction must be changed depending on the direction of the fracture line of the tubular bone. For this reason, the drilling angle of the drill with respect to the tubular bone axis is not limited to a right angle but also an oblique direction, and the drilling penetration distance is not a simple outer diameter of the tubular bone that can be read in advance from X-rays, etc. Need to respond to it. In other words, when drilling at an angle, it is necessary to drill the drill to a position longer than the outer diameter of the bone, while penetrating the bone at a distance shorter than the outer diameter of the bone at a position where the drilling position deviates from the center of the bone. There is also. Therefore, based on the X-ray photograph taken before or during the operation, the perforation depth until penetrating the bone was calculated in advance, and the perforation depth of the instrument according to Patent Documents 1 and 2 was set to start perforation. Even so, there has been a problem that the accuracy of the depth of advance of the drill by the stopper is lowered because the drilling position and the drilling angle change according to the situation during the operation.

  Furthermore, as described above, bone perforation is not limited to one place for one operation, and a plurality of perforations may be required at different angles and positions. In this case, as in the instruments according to Patent Documents 1 and 2, the position of the stopper is adjusted each time before the start of drilling according to the depth of drilling that changes variously using a dedicated drill. This causes inconveniences, lengthens the operation time, causes medical errors, and increases the time and effort of use.

  The instrument shown in Patent Document 3 is a device for measuring the drilling depth based on the length of the plunger being pushed. In order to use this as a safety device, the drilling depth is calculated in advance, It is necessary to perform treatment based on the depth value. As described above, it is difficult to use in various operations in which the drill direction and depth vary depending on the operation phase, such as the operation of the tubular bone fracture that is aimed at this time.

  Moreover, since the instrument shown in Patent Document 4 punctures the tubular bone in two steps, the front side and the opposite side, the drilling depth can be controlled with higher accuracy than the instruments of Patent Documents 1 and 2. However, it was necessary to adjust the stopper cylinder after holding the guide cylinder with a handle. Further, the mechanism for fixing the position of the guide cylinder and the stopper cylinder member is composed of small protrusions and slits, and there is a problem that the operability is inferior. That is, in drilling work, it is necessary to operate the drill drive main body with one hand and adjust the stopper with the other hand, but after holding the handle with one hand and twisting and sliding the stopper cylinder member with the same hand It has to be fixed, operability is complicated, and both hands are required throughout the work.

  In addition, the instrument shown in Patent Document 5 is a drill with a safety device for drilling a skull, and the position fixing of a cylinder with a scale for adjusting the drill depth is performed with both hands using a clamp of the outermost cylinder. It is necessary to adjust the depth before starting drilling. Therefore, it is difficult to use in various operations for tubular bone fractures.

  The devices described in Patent Document 6 and Non-Patent Document 1 are mainly used for the skull, which is a plate-like bone, and surrounds the bone marrow cavity at the center like a tubular bone, and is a two-stage hard device. It is difficult to pierce through cortical bone with resistance. In addition, the use is limited in the case of drilling in a direction perpendicular to the bone surface, and it is not assumed that the drilling direction is changed in a flexible manner according to the situation during the operation like a tubular bone. .

  Therefore, the technical problem to be solved by the present invention is to use a general-purpose drill shaft, not limited to a special drill shaft, in a drill drilling operation using a pneumatic or electric drill drive body to a tubular bone. Surgery of the tubular bone that does not require measurement of the outer diameter of the tubular bone in advance, can easily control the drilling distance with the other hand, and avoids the danger of the drill blade surging deeply into the back side of the bone It is to provide a bone drill drill stopper.

  In order to solve the above technical problem, the present invention provides a surgical bone drill drill stopper having the following configuration.

According to the first aspect of the present invention, it is provided to be fitted to a shaft-shaped drill blade and used for a procedure for drilling a through hole in the near-side bone cortex and the contralateral bone cortex of a tubular bone having a bone marrow cavity in the center. A surgical bone drill drill stopper
An inner cylinder portion having a drill insertion hole into which the drill blade can be inserted;
An outer cylinder part capable of telescopically inserting a distal end side of the inner cylinder part into an inner cylinder insertion hole into which the inner cylinder part can be inserted coaxially;
A fixing mechanism which is provided at a rear position of the inner cylinder part and fixes the inner cylinder part to a shaft of a drill blade inserted into the drill insertion hole;
With the tip of a drill blade in contact with the inner wall surface of the contralateral bone cortex, the distance between the distal end of the outer tube portion and the near side bone cortex is the thickness dimension of the contralateral bone cortex, A holding mechanism for holding the connection position of the outer cylinder part and the inner cylinder part;
A surgical bone drill drill stopper is provided.

  According to the second aspect of the present invention, the holding mechanism is composed of a connection groove provided on the outer surface of the inner cylinder part and a connection engagement piece provided in the outer cylinder part and removable from the connection groove. A surgical bone drill drill stopper according to the first aspect is provided.

  According to a third aspect of the present invention, there is provided the surgical bone drilling drill stopper according to the second aspect, wherein a plurality of the connecting grooves are provided at regular intervals.

According to a fourth aspect of the present invention, any one of the first to third aspects is characterized in that the fixing mechanism fixes the inner cylinder portion so as to contact the fixed base end portion of the drill drive main body . One surgical bone drill drill stopper is provided.

  According to the fifth aspect of the present invention, the fixing mechanism is configured by a fixing screw that is connected to the drill insertion hole of the inner cylinder portion and that can contact the shaft of the drill blade inserted into the drill insertion hole. A surgical bone drill drill stopper according to any one of the first to fourth aspects is provided.

  According to the sixth aspect of the present invention, the fixing mechanism is defined by a plurality of notches provided along the longitudinal direction on the rear end side of the inner cylinder portion, and is pressed against the drill blade shaft when the drill blade is fixed. A surgical bone perforation drill stopper according to any one of the first to fourth aspects is provided, characterized in that the surgical bone perforation drill stopper is constituted by a drill pressing piece.

  According to the present invention, the inner cylinder part and the outer cylinder part are coaxially inserted so as to be slidable, and the length dimension thereof is configured to be extendable and retractable, so that the tubular part is inserted with the drill blade exposed. Bone drilling can be performed. At this time, since the drill blade shaft and the inner cylinder portion are fixed by the fixing mechanism, the drill blade shaft does not run idle, and torque loss of the drill can be prevented. In addition, when the drilling progressed and the drill blade reached the inner wall surface of the contralateral bone cortex, the length was adjusted by operating the holding mechanism, and the perforation was advanced in that state to penetrate the contralateral bone cortex. When the tip of the drill blade protrudes slightly, the drill can be stopped. Therefore, the drilling depth can be controlled flexibly according to the situation during the drilling operation, and the drilling depth is higher than that of a device for drilling at a time based on the outer diameter of the tubular bone measured in advance. It can be controlled with accuracy.

  According to the 2nd aspect of this invention, the position of an inner cylinder part and an outer cylinder part can be fixed reliably by a connection groove | channel and a connection engagement piece, and the excessive penetration | invasion of a drill can be prevented more reliably. . Moreover, the holding position of the inner cylinder part and the outer cylinder part can be finely set by providing a plurality of connecting grooves at regular intervals.

  According to the fourth aspect of the present invention, since the inner cylinder portion is fixed at the fixed base end to the drill drive main body, even if a strong force in the axial direction by the power drill is applied, the drill blade shaft and the inner cylinder There is very little possibility that the positional relationship will shift, and the stopper function is reliable. Further, by using a fixing screw provided in the inner cylinder portion, the drill stopper can be easily attached and detached.

  According to the sixth aspect of the present invention, the chuck for attaching the drill blade shaft to the drill drive main body and the inner tube portion are fixed together, thereby strengthening the fixation between the drill blade shaft and the inner tube portion, Desorption can be facilitated.

It is a perspective view which shows the structure of the surgical bone drill drill stopper concerning 1st Embodiment of this invention. It is sectional drawing which shows the structure of the inner cylinder part of the drill stopper of FIG. It is sectional drawing which shows the structure of the outer cylinder part of the drill stopper of FIG. It is sectional drawing in the IV-IV line of FIG. It is a perspective view which shows the state which attached the drill stopper of FIG. 1 to the drill blade axis | shaft. It is a schematic diagram which shows the state which starts drilling the near side bone cortex with the drill blade which attached the drill stopper of FIG. It is a schematic diagram which shows the state which the drill blade which attached the drill stopper of FIG. 1 reached the contralateral bone cortex inner wall surface. It is a schematic diagram which shows position adjustment of the outer cylinder part of the drill stopper of FIG. It is a schematic diagram which shows the state which the drill blade which attached the drill stopper of FIG. 1 penetrated the contralateral bone cortex. It is a figure which shows the difference in the drill drilling | drilling path | route by the difference in a drill direction. It is a perspective view which shows the structure of the surgical bone drill drill stopper concerning 2nd Embodiment of this invention. It is a perspective view which shows the state which attached the drill stopper of FIG. 11 to the drill blade axis | shaft. FIG. 13 is a cross-sectional view schematically showing a state in which the drill pressing piece and the drill blade shaft are integrally fixed by a chuck in the drill stopper of FIG. 12.

  Hereinafter, a surgical bone drill drill stopper according to each embodiment of the present invention will be described with reference to the drawings.

(First embodiment)
FIG. 1 is a perspective view showing a configuration of a surgical bone drilling drill stopper according to a first embodiment of the present invention. As shown in FIG. 1, the surgical bone perforation drill stopper 1 according to the present embodiment includes an inner cylinder portion 2 positioned on the rear end side, and an outer cylinder portion 3 positioned on the distal end side provided with a slightly larger diameter. It is composed of Hereinafter, in the description of the embodiments, the front end side means the pointed end side of the drill blade when the stopper is attached to the drill, and the rear end side means the chuck side of the drill driving body.

  As shown in FIGS. 1 and 2, the inner cylinder portion 2 is a cylindrical body that includes an insertion portion 4 that is inserted into the outer cylinder portion 3 and is configured so that the rear end side has a large diameter. A plurality of connecting grooves 5 are provided on the outer peripheral surface of the insertion portion 4 at regular intervals. The connecting groove 5 is used for fixing to the outer cylinder portion 3 described later, and is provided every 2 mm in the present embodiment.

  As shown in FIG. 2, the inner cylinder portion 2 is provided with a drill insertion hole 6 for inserting a drill blade. The rear fixing portion 7 located on the rear end side of the insertion portion 4 has a fixing screw 7a as an example of a fixing mechanism for fixing the inner cylinder portion 2 to the drill blade shaft in a state where the drill blade is inserted. Is provided. The inner diameter dimension of the drill insertion hole 6 is not necessarily configured to be substantially the same as the outer diameter dimension of the drill shaft, and the drill blade can be fixed with a fixing screw even if it is slightly larger than the drill blade shaft diameter to be inserted. A margin may be provided for the range of possible shaft diameters.

  The length dimension Li of the insertion part 4 of the inner cylinder part 2 is comprised by about 36 mm in this embodiment. However, these length dimensions Li may be appropriately changed according to the size of the drill blade to be used, the depth from the skin incision position to the drilling location, etc., and should be increased when using a large or long drill blade. Can do.

  The fixing screw 7a is provided in the rear fixing portion 7 of the inner cylinder portion 2, and fixes the inner cylinder portion 2 to the drill blade by pressing the drill blade shaft inserted through the drill insertion hole 6. As will be described later, since the inner cylinder portion 2 and the outer cylinder portion 3 are engaged, the entire stopper 1 is fixed to the drill blade by a fixing screw.

  FIG. 3 is a cross-sectional view showing the configuration of the outer cylinder portion of the drill stopper of FIG. 4 is a cross-sectional view taken along line IV-IV in FIG. The outer cylindrical portion 3 includes a cylindrical portion 8 provided on the front end side and a connecting portion 9 provided on the rear end side and storing a holding mechanism for connecting and holding the inner cylindrical portion 2.

  Further, an inner cylinder insertion hole 15 is provided through the cylindrical portion 8 and the connecting portion 9 to both ends, and the insertion portion 4 of the inner cylinder portion 2 is accommodated. The inner cylinder insertion hole 15 is continuous with the drill insertion hole 6 of the inner cylinder part 2 in a state where the inner cylinder part 2 is inserted, and the axis of the drill blade inserted into the drill insertion hole 6 is the tip of the outer cylinder part. Exposed from the side. In addition, in order to facilitate the insertion of the drill into the affected area and to be thin with respect to the inner cylinder insertion hole 15 which is larger than the drill diameter, to reduce the blur of the drill stopper accompanying the rotation of the drill blade, The tip 10 of the portion 8 is configured with a small diameter.

  The connection part 9 is provided with a connection release button 11 as an example of a holding mechanism. When the connection part 9 is pressed, the connection with the inner cylinder part 2 is released, and the outer cylinder part 3 is connected to the inner cylinder part 2. It can be slidable. The connection release button 11 includes an opening 11a provided at the position of the inner cylinder insertion hole 15 embedded in the connection portion 9, and a connection engagement piece 12 provided so as to protrude inward from the opening 11a. Since the coupling engagement piece 12 is urged by the spring 13 provided on the spring substrate 14 so as to contact the inner cylinder portion side, the connection engagement piece 12 is fitted into the coupling groove 5 of the inner cylinder portion 2. The inner cylinder part 2 and the outer cylinder part 3 are fixed together, and the connection release button 11 is pressed to release the engagement between the connection engagement piece 12 and the connection groove 5.

Next, a procedure for using the surgical bone drill drill stopper according to this embodiment will be described. As shown in FIG. 5, the surgical bone perforation drill stopper according to this embodiment is attached by fixing the inner cylinder portion 2 to the shaft of the drill blade 100 inserted into the drill insertion hole 6. The drill blade 100 is fixed to the shaft by the fixing screw 7a as described above. The mounting position is preferably such that the rear end of the rear fixing portion 7 of the inner cylinder portion 2 is close to the chuck 101 side which is the fixed base end of the drill driving main body for fixing the shaft of the drill blade 100. By fixing it in a state where it abuts against 101, even if a general-purpose columnar drill blade shaft is used, the drill stopper reliably stops the drill stopper without causing a displacement when penetrating the tubular bone described later. Can be made. Depending on the type of drill, there is a non-cylindrical cylinder with a constant diameter, such as the cross-sectional shape of the portion held by the chuck 101 is not circular, but in the case of such a drill, Drill by attaching it with a fixing screw 7a so that the rear end of the rear fixing part 7 of the inner cylinder part 2 is in contact with the step or protruding part of the surface shape of the drill shaft such as the boundary with the cylindrical part. The position shift of the stopper can be prevented.

  At the start of drilling, it is preferable to increase the exposed length on the tip side of the drill blade 100 by increasing the insertion width of the inner cylinder portion 2 and the outer cylinder portion 3. However, the insertion area between the inner cylinder part 2 and the outer cylinder part 3 is adjusted so that the surgical field where drilling is performed is prevented and the intermediate part 100b of the drill blade does not involve the tissue located around the drill shaft. You may make it coat | cover the outer surface of the intermediate part 100b of a drill blade.

  Next, as shown in FIG. 6, drilling of the tubular bone 110 to be drilled is started. The tubular bone 110 is composed of a tubular cortical bone 111 and a central bone marrow cavity 112. Among the bone cortex 111, the bone cortex on the side to which the drill is applied from the outside in the surgical field where the skin was incised at the start of drilling is the bone cortex 113 on the near side, the bone marrow cavity 112 penetrating through the bone cortex, and the inside of the lumen For convenience, the bone cortex to which the drill is applied is distinguished from the contralateral bone cortex 114. During drilling, the drill stopper 1 also rotates with the rotation of the drill blade 100. However, the cylindrical portion 8 of the outer cylindrical portion 3 is sufficiently thin and has a smooth surface, and a fixing screw is provided for the inner cylindrical portion 2. Since it is provided at the rear end, there is no particular problem in the drilling operation. In drilling, the distal end of the drill blade 100 is applied to the surface of the front bone cortex 113, and the hard front bone cortex 113 is drilled while operating the drill device to control the direction of drilling. At this point, since it is an invasion of the bone marrow cavity to be passed, it is safe to drill with vigor.

  FIG. 7 shows a state in which the tip 100a of the drill blade 100 is in contact with the inner wall surface of the contralateral bone cortex 114 with a hard resistance after passing through the front bone cortex 113 and further passing through the bone marrow cavity 112. Yes. In drilling with a drill, when the drill blade tip 100a penetrates the near bone cortex 113 with a hard resistance and reaches the bone marrow cavity 112, the drill resistance is weakened, and when reaching the hard contralateral cortical bone 114 again, the drill resistance becomes strong. It is easily sensed by the operator's hand holding the drill drive body. At that time, the rotation of the drill is temporarily stopped. As shown in FIG. 8, with the tip 100 a of the drill blade 100 held in contact with the inner wall surface of the contralateral cortical bone 114, The outer cylinder part 3 is pulled out to the tubular bone side as indicated by an arrow 90 by the operation of the hand, and the distance L between the distal end 10 of the cylindrical part of the outer cylinder part 3 and the surface of the front bone cortex 113 is generally contralateral. The bone cortex 114 is adjusted so as to have a thickness dimension. Since the near-side bone cortex 113 has already been penetrated, the surgeon can easily predict the thickness dimension of the contralateral bone cortex based on the basic anatomical basis to be described later, and the distal end portion 9 of the outer cylinder portion 3 can be easily estimated. This can be used as a guide when setting the distance L between the front surface of the bone cortex 113 and the front bone cortex 113.

  After adjusting the connection position of the outer tube part 3, the contralateral bone cortex 114 is perforated. As shown in FIG. 9, after penetrating the contralateral bone cortex 114, the distal end of the outer tube portion 3 comes into contact with the surface of the near side bone cortex 113, so that the drill does not advance beyond the adjusted gap, and excessive drilling is performed. Is suppressed. Therefore, the progress of the drill tip 100a immediately after penetrating the contralateral bone cortex 114 of the tubular bone can be stopped, and damage to important nerves, blood vessels, muscle tendon tissues and the like located on the back side of the tubular bone can be prevented. can do.

  According to the surgical bone drill drill stopper 1 according to the present embodiment, it is possible to eliminate the need for measuring the outer diameter of the tubular bone in advance based on the basic anatomical basis described below. That is, the outer diameter of a human limb tubular bone varies depending on the physique and may be 30 mm or more, but the thickness of the tubular bone cortex that forms the tubular structure is approximately several mm even in the upper arm, forearm, thigh, and lower leg. In the following, the variation difference in the range is easily estimated by the preoperative physique and limb part of the patient, and even if the drill direction is tilted by about 45 degrees, the error is several mm or less. This variation difference is clearly less than when drilling with the entire outer diameter of the tubular bone as a guide. In other words, in the drilling of a tubular bone drill, it is not necessary to measure the outer diameter of the tubular bone in advance, drilling from the near bone cortex to the central bone marrow cavity, and the tip of the drill blade with a hard resistance to the inner wall of the contralateral bone cortex When the thickness of the remaining tubular bone cortex is predicted based on the above anatomical basis and the drill drilling distance is controlled, the excessive drill penetration can be suppressed with the above error.

  Specifically, as shown in FIG. 10, (1) the drilling path when the drill direction passes through the central axis of the tubular bone and (2) the drilling path when the drill direction deviates from the central axis, and (3) the axial direction of the tubular bone (4) For drill drilling paths when tilted, the error is reduced by using the thickness d of the contralateral bone cortex as a guide rather than using the outer diameter D of the tubular bone as a guide. Obviously it can be.

  Furthermore, according to the surgical bone drilling drill stopper 1 according to the present embodiment, it is attached in a state of being fixed to the drill shaft, and it is not necessary to hold the stopper at the start of drilling, so one hand is free. Therefore, other instruments such as forceps can be operated with a free hand to increase the degree of freedom of the operation. Moreover, the position adjustment of the outer cylinder part 3 is easy because the connection release button 11 is merely operated and slid.

(Second embodiment)
FIG. 11 is a perspective view showing a configuration of a surgical bone drilling drill stopper according to a second embodiment of the present invention. FIG. 11 shows a state where the drill blade 100 is inserted for understanding. As shown in FIG. 11, the surgical bone perforation drill stopper 21 according to the present embodiment includes an inner cylindrical portion 22 positioned on the rear end side and an outer cylindrical portion 23 positioned on the distal end side that is slightly larger in diameter. It is composed of

  As shown in FIG. 11, the inner cylindrical portion 22 is a cylindrical member, and includes an insertion portion 24 that is inserted into the outer cylindrical portion 23, and a plurality of connections provided at regular intervals on the outer peripheral surface of the insertion portion. A groove 25 is provided. The connecting groove 25 is used for fixing to the outer cylinder portion 23 described later, and is provided every 2 mm in the present embodiment.

  As in the first embodiment, the inner cylinder portion 2 is provided with a drill insertion hole for inserting a drill blade. The rear end of the inner cylinder part is provided with a plurality of notches 26 extending along the axial direction, and a drill pressing piece 27 defined by the notch 26 is formed at the rear end of the inner cylinder part. The drill pressing piece 27 is an example of a fixing mechanism, and its length dimension is configured to be approximately 2 to 3 cm.

  In the present embodiment, three drill pressing pieces 27 are provided in accordance with the number of chips of the chuck 101, but the number is not limited, and the drill blade 100 and the inner cylindrical portion 22 can be securely fixed. I just need it. As shown in FIGS. 12 and 13, when the drill pressing piece 27 is held together with the shaft of the drill blade 100 by the chuck of the drill drive main body for rotating the drill blade, the drill pressing piece 27 is pressed against the drill. And the inner cylinder part 22 are fixed.

  The outer cylinder part 23 includes a cylindrical part 28 provided on the front end side and a connecting part 29 provided on the rear end side. Similarly to the first embodiment, an inner cylinder insertion hole is provided through the cylindrical portion 28 and the connecting portion 29 to both ends, and the insertion portion 24 of the inner cylinder portion 22 is accommodated. The inner cylinder insertion hole is continuous with the drill insertion hole of the inner cylinder part 22 in a state in which the inner cylinder part 22 is inserted, and the axis of the drill blade inserted into the drill insertion hole 6 extends from the distal end side of the outer cylinder part. Exposed.

  The connection part 29 is provided with a connection release button 31, which can be released from being fixed to the inner cylinder part 22 to be slidable with respect to the inner cylinder part 22. it can. Similarly to the first embodiment, by operating the connection release button 31, the engagement between the connection engagement piece and the connection groove is released.

  Next, a procedure for using the surgical bone drill drill stopper according to this embodiment will be described. As shown in FIG. 12, the surgical bone drilling drill stopper according to this embodiment is inserted into the inner cylinder portion 22 with the shaft of the drill blade 100 exposed from the rear end side, and is inserted into the chuck 101 of the drill drive main body. It is fixed together with the cylinder part 22. As described above, the drill pressing piece 27 is provided at the rear end of the inner cylinder portion 22, and the drill pressing piece 27 sandwiched between the chucks 101 is pressed by being sandwiched between the chucks 101 as shown in FIG. 13. Thus, the shaft of the drill blade 100 and the inner cylindrical portion 22 are integrally fixed to the chuck 101 so as to be bent toward the axis of the drill blade 100 and sandwich the shaft of the drill blade 100. Further, at the start of drilling, it is preferable to increase the exposed length on the tip side of the drill blade 100 by increasing the insertion width between the inner cylindrical portion 22 and the outer cylindrical portion 23.

  After fixing the shaft of the drill blade 100 and the inner cylinder portion 22, drilling is started in the tubular bone. The drilling procedure is the same as in the first embodiment. That is, the front end of the drill blade 100 is applied to the surface of the front bone cortex 113, and the hard front bone cortex 113 is drilled while operating the drill device to control the direction of drilling. When the tip of the drill blade reaches the hard contralateral cortical bone 114 again, the rotation of the drill is temporarily stopped while grasping the drill driving body with the hand of the operator, and the tip 100a of the drill blade 100 is placed on the contralateral cortex. In a state where it is held in contact with the inner wall surface of the bone 114, the connection release button 31 is operated with the other hand to pull out the outer cylinder part 23 to the distal end side (tubular bone side), and the cylindrical part of the outer cylinder part 23 Adjustment and fixation are performed so that the distance between the distal end 30 and the surface of the front bone cortex 113 is approximately the thickness dimension of the contralateral bone cortex 114. Next, after adjusting the position of the outer tube portion 23, the contralateral bone cortex 114 is perforated.

  According to the surgical bone drilling drill stopper 21 according to the present embodiment, the surgical bone drilling drill stopper 21 is fixedly attached to the drill shaft, and it is not necessary to hold the stopper during drilling except for the operation of the connection release button 31 and the outer cylinder position adjustment. In the meantime, one hand is free. Therefore, other instruments such as forceps can be operated with a free hand to increase the degree of freedom of the operation. Further, the position adjustment of the outer cylinder portion 23 is easy because the connection release button 31 is only operated and slid.

  In addition, this invention is not limited to the said embodiment, It can implement in another various aspect.

1,21 Surgical bone drilling drill stoppers 2,22 Inner cylinder part 3,23 Outer cylinder part 4,24 Insertion part 5,25 Connection groove 6 Drill insertion hole 7 Back fixing part 7a Fixing screw 8,28 Cylindrical part 9, 29 Connecting portion 10, 30 Cylindrical portion distal end 11, 31 Connection release button 11 a Opening 12 Connecting engagement piece 13 Spring 14 Spring substrate 15 Inner tube insertion hole 26 Notch 27 Drill pressing piece 90 Direction for pulling out outer tube portion 3 100 Drill Blade 100a Drill blade tip 100b Drill blade middle portion 101 Chuck 110 Tubular bone 111 Bone cortex 112 Bone marrow cavity 113 Front bone cortex 114 Contralateral bone cortex Li Length dimension L of the insertion portion 4 of the inner tube portion 2 Tube portion tip 10 and the distance to the surface of the front bone cortex 113 D outer diameter of the tubular bone d thickness of the contralateral bone cortex

Claims (6)

A surgical bone perforation drill stopper for use in a procedure for drilling a through hole in the near-side bone cortex and contralateral bone cortex of a tubular bone having a bone marrow cavity in the center, which is provided by being fitted on an axial drill blade. ,
An inner cylinder portion having a drill insertion hole into which the drill blade can be inserted;
An outer cylinder part capable of telescopically inserting a distal end side of the inner cylinder part into an inner cylinder insertion hole into which the inner cylinder part can be inserted coaxially;
A fixing mechanism which is provided at a rear position of the inner cylinder part and fixes the inner cylinder part to a shaft of a drill blade inserted into the drill insertion hole;
With the tip of a drill blade in contact with the inner wall surface of the contralateral bone cortex, the distance between the distal end of the outer tube portion and the near side bone cortex is the thickness dimension of the contralateral bone cortex, A holding mechanism for holding the connection position of the outer cylinder part and the inner cylinder part;
A surgical bone drill drill stopper, comprising:   The said holding | maintenance mechanism is comprised by the connection groove | channel provided in the inner cylinder part outer surface, and the connection engagement piece which is provided in an outer cylinder part and can be attached or detached to the said connection groove | channel. Surgical bone drill drill stopper.   The surgical bone drill drill stopper according to claim 2, wherein a plurality of the connecting grooves are provided at regular intervals.   The surgical bone perforation drill stopper according to any one of claims 1 to 3, wherein the fixing mechanism fixes the inner tube portion so as to abut on a fixed base end portion of a drill driving main body. .   The said fixing mechanism is comprised by the fixing screw connected with the drill penetration hole of the said inner cylinder part, and can contact | abut to the axis | shaft of the drill blade inserted in the said drill penetration hole. 5. The surgical bone drill drill stopper according to any one of 1 to 4. The fixing mechanism is defined by a plurality of notches provided along the longitudinal direction on the rear end side of the inner cylinder portion, and is configured by a drill pressing piece that is pressed against a drill blade shaft when the drill blade is fixed. The surgical bone drill drill stopper according to any one of claims 1 to 4, characterized in that:

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