JP5288926B2 - Bone extender - Google Patents

Description

  The present invention relates to a bone distracter used for osteotomy.

  For example, as a device used for osteogenesis such as fusion of fractured bones or separation and fusion of bones with abnormal morphologies, a bone extender disclosed in JP-A-2001-37767 ( Hereinafter, a conventional example) has been proposed.

  In this conventional example, as shown in FIG. 8, a first lift plate 52 attached to one opposing bone piece 51a via a screw and a second lift plate 52 attached to the other opposite bone piece 51b via a screw. A lift plate 53 and an adjustment shaft 54 that is screwed to the first lift plate 52 and that has a distal end engaged with the second lift plate 53 are provided. Specifically, the first lift plate 52 has one bone A first attachment plate 52a attached to the piece 51a and a screwing portion 52b connected to the first attachment plate 52a and screwed into the adjustment shaft 54 are provided. The second lift plate 53 has the other bone piece 51b. And a locking portion 53b that is connected to the second mounting plate 53a and locks the tip of the adjustment shaft 54 (the adjustment shaft is provided in the hole provided in the locking portion 53b). 54 tips are inserted.)

  Therefore, in the conventional example, the distance between the lift plates 52 and 53 is adjusted by rotating the adjustment shaft 54, and the distance between the opposing bone fragments 51a and 51b can be adjusted. , 53 by appropriately changing the facing distance between them, bone formation can be performed while promoting the fusion of the bone pieces 51a and 51b.

JP 2001-377767 A

  Incidentally, in the conventional example, the screwing portion 52b is connected to the first mounting plate 52a via the hinge portion 52c, and the locking portion 53b is connected to the second mounting plate 53a via the hinge portion 53c.

  This is because when the bone to be subjected to bone extension is a rounded skull, for example, the opposing bone fragments 51a and 51b are not only extended in a linear direction (left and right direction) but also in a radial direction in an attempt to fuse with each other. Although it tries to swell also in the (vertical direction), it is the structure for respond | corresponding to the motion of the bone pieces 51a and 51b which are going to expand | swell in this radial direction by providing the hinge parts 52c and 53c mentioned above. If the hinge portions 52c, 53c are not provided, and the screwed portion 52b (the locking portion 53b on the second mounting plate 53a) does not swing with respect to the first mounting plate 52a, the hinge portions 52c and 53c will swell in this radial direction. It will be in a state that resists the force, and bone formation in a natural state will not be performed.

  However, in the conventional example, it was confirmed that the following problems occur when bone extension is actually performed.

  That is, in the conventional example, when the first lift plate 52 and the second lift plate 53 are attached to the bone pieces 51a and 51b with screws, the first lift plate 52c and 53c are used to hold the parts (for example, with the screwing portion 52b). Since the mounting plate 52a) rotates (finely moves), it cannot be quickly and accurately placed on the bone fragments 51a and 51b, and, for example, in the case of bone extension in the skull, after the skull is cut into small pieces In some cases, the central bone piece 51b is suspended from the left and right bone pieces 51a. In this case, in the conventional example, the hinge portions 52c and 53c are rotated so that the central bone piece 51b is suspended. This causes a problem that the bone piece 51b cannot be placed in an optimal position and supported in a good state. Even if the hinges 52c and 53c are set in advance so as to be difficult to rotate, they gradually loosen and rotate.

  The present invention solves the above-mentioned problems, and provides an epoch-making bone distracter that exhibits an unprecedented effect.

  The gist of the present invention will be described with reference to the accompanying drawings.

Of the opposing bone fragments 1a and 1b, the first arrangement body 2 arranged on one bone piece 1a, the second arrangement body 3 arranged on the other bone piece 1b, and the first arrangement A bone extender comprising an operating body 4 provided between an installation body 2 and the second arrangement body 3 and capable of variably operating an opposing interval between the arrangement bodies 2 and 3, wherein the first arrangement The body 2 and the second disposing body 3 are both the bone piece connecting portions 5 and 15 connected to the bone fragments 1 a and 1 b and the operating body connecting portion 6 connected to the operating body 4. , 16, and at least one of the bone piece connecting portions 5 and 15 and the operating body connecting portions 6 and 16 of the first arrangement body 2 and the second arrangement body 3 are: The operating body connecting portions 6 and 16 are connected to the bone fragment connecting portions 5 and 15 through the thin portions 8 and 18 so as to be finely movable, and the operating body of the first arrangement body 2 is provided. The connecting portion 6 is screwed with a screw rod-like operation body 4. In addition, the operating body connecting portion 16 of the second arrangement body 3 is provided with a recess 16a in which the distal end portion of the operating body 4 is movably held, and the operating body 4 The operation body 4 is pivotably inserted into the recess 16a of the operation body connecting portion 16 of the second arrangement body 3 so as to be tilted and held by being abutted and held. The present invention relates to a bone extender characterized by the following.

  The bone distractor according to claim 1, wherein the bone fragment connecting portions 5, 15 and the operating body connecting portions 6, 16 are integrally formed through the thin portions 8, 18. The present invention relates to a bone extender characterized by the following.

  The bone extender according to any one of claims 1 and 2, wherein the thin portions 8 and 18 are connected to the bone fragment connecting portions 5 and 15 and the operating body connecting portions 6 and 16, respectively. When the slits 7 and 17 are provided in the portion, the present invention relates to a bone distractor characterized in that the slits 7 and 17 are the remaining portions that do not reach.

The bone distractor according to any one of claims 1 to 3, wherein the bone fragment connecting portions 5 and 15 are U-shaped cross-sections that are connected to end edges of the bone fragments 1a and 1b in a fitted state. The present invention relates to a bone distractor characterized by having a shape configuration .

The bone extender according to any one of claims 1 to 4, wherein the proximal end portion 4c of the operation body 4 is formed in a polygonal cross section. .

Moreover, the bone distractor of any one of Claims 1-5 WHEREIN: The proximal end of the said operation body 4 is formed sharply, It concerns on the bone distractor characterized by the above-mentioned.

  Since the present invention is configured as described above, natural and good bone formation is performed in a reliable manner corresponding to the movement of the opposing bone fragments during bone extension, and unlike the above-described conventional example, It will be possible to quickly and accurately place it on the piece, and it will be able to support the bone piece in an optimal position and support it in a good state. Bone extension device.

  Embodiments of the present invention considered to be suitable will be briefly described with reference to the drawings.

  For example, when performing bone extension, the first disposing body 2 is disposed on one bone piece 1a of the opposing bone fragments 1a and 1b, and the second disposing body 3 is disposed on the other bone fragment 1b. In this state, the operation body 4 provided between the first arrangement body 2 and the second arrangement body 3 is operated, and the interval between the arrangement bodies 2 and 3 is appropriately changed to appropriately change the bone. Bone formation is performed while promoting the fusion of the pieces 1a and 1b.

  At this time, the first disposing body 2 and the second disposing body 3 according to the present invention are both connected to the bone piece connecting portions 5 and 15 connected to the bone pieces 1 a and 1 b and the operation body 4. Operating body connecting portions 6, 16, and at least one bone fragment connecting portion 5, 15 and operating body connecting portions 6, 16 of the first disposing body 2 and the second disposing body 3. Means that the operating body connecting portions 6 and 16 are connected to the bone fragment connecting portions 5 and 15 through the thin portions 8 and 18 so as to be finely movable. Is done.

  That is, as described above, when the bone to be subjected to the bone extension is a round skull, for example, the opposing bone fragments 1a and 1b not only extend in a straight direction but also in a radial direction in an attempt to unite. Although it tries to swell, the bone fragment connecting portions 5 and 15 and the operating body connecting portions 6 and 16 according to the present invention are connected to the operating body connecting portions 6 and 16 via the thin portions 8 and 18. It is connected to the connecting portions 5 and 15 so as to be finely movable. Therefore, when a force to expand the bone pieces 1a and 1b in the radial direction acts on the bone pieces 1a and 1b, On the other hand, the operating body connecting portions 6 and 16 are rocked starting from the thin portions 8 and 18, and do not resist the force to expand in the radial direction, but receive this force and deform. By doing so, it will respond reliably.

  Therefore, natural and favorable bone formation is performed in a sure manner corresponding to various movements such as movement in the linear direction and movement in the radial direction of the opposing bone fragments 1a and 1b during bone extension.

  Further, according to the present invention, as a structure in which the operating body connecting portions 6 and 16 swing with respect to the bone piece connecting portions 5 and 15 to correspond to the movement of the bone pieces 1a and 1b, as in the conventional example described above. Because of the structure in which the thin portions 8 and 18 are provided instead of the structure in which the hinge portion is provided, that is, only when a strong force is applied to the bone pieces 1a and 1b in the radial direction, the bone piece continuous portion 5 is provided. 15, the operating body connecting portions 6, 16 are configured to swing. Therefore, for example, when the bone fragment connecting portions 5, 15 are connected to the bone fragments 1 a, 1 b, the bone fragment connecting portions 5, 15 are provided. On the other hand, the operating body connecting portions 6 and 16 do not swing (finely move) and can be quickly and accurately placed on the bone fragments 1a and 1b. After the skull is cut into small pieces, the central bone piece 1b may be suspended from the left and right bone pieces 1a. Unlike the conventional example described above, as shown in FIG. 2, the central bone fragment 1b in the suspended state can be placed at an optimal position and supported in a good state.

  Therefore, unlike the above-described conventional example, the disposition to the bone fragments 1a and 1b can be performed quickly and accurately, and the bone fragments 1a and 1b are surely arranged at optimum positions and supported in a good state. Will be able to.

  A specific embodiment of the present invention will be described with reference to the drawings.

  In the present embodiment, among the opposing bone fragments 1a and 1b, a first arrangement body 2 arranged on one bone piece 1a, and a second arrangement body 3 arranged on the other bone piece 1b, The operating body 4 is provided between the first mounting body 2 and the second mounting body 3 and can variably operate the facing interval between the mounting bodies 2 and 3.

  Hereinafter, each component according to the present embodiment will be described in detail.

  As shown in FIG. 1, the first arrangement body 2 and the second arrangement body 3 are integrally formed of an appropriate metal member, and are connected to the bone fragments 1a and 1b. In this structure, the installation parts 5 and 15 and the operating body connecting parts 6 and 16 connected to the operating body 4 are provided. The first arrangement body 2 and the second arrangement body 3 have the same structure except for the operation body connecting portions 6 and 16 described later.

  As shown in FIGS. 1 to 3, the bone piece continuous portions 5, 15 are formed in concave stripes having a U-shaped cross section, and the groove direction of the bone piece continuous portions 5, 15 is an operating body described later. It is set in a direction intersecting with the cylindrical holes 6a and 16a of the continuous portions 6 and 16, and is configured to be continuously provided in a fitted state at the end edges of the bone fragments 1a and 1b.

  The continuous arrangement of the bone fragments 1a and 1b with respect to the edge portions is a configuration in which the bone fragment continuous portions 5 and 15 having a U-shaped cross section are simply provided in a fitted state. On the other hand, it can be continuously arranged so as to be movable in the left-right direction.

  Further, through holes 5a 'and 15a' are formed in the left and right positions of the upper surface plates 5a and 15a constituting the bone piece continuous portions 5 and 15, and these through holes 5a 'and 15a' are formed in the bone pieces 1a and 1b. On the other hand, it is stop holes 5a ′ and 15a ′ for screwing. In some cases, the screws may be preliminarily screwed through the retaining holes 5a ′ and 15a ′, and when the screws are secured through the two retaining holes 5a ′ and 15a ′, the bone pieces 1a and 1b are moved in the horizontal direction. Movable is impossible.

  The operating body connecting portions 6 and 16 are formed in a cylindrical shape as shown in FIGS. 1 to 3, and a screw groove is formed in the cylindrical hole 6 a of the operating body connecting portion 6 according to the first arrangement body 2. 6a 'is formed, and is configured so that a screw rod-like operation body 4 described later can be screwed. On the other hand, the cylindrical hole 16a of the operating body connecting portion 16 according to the second arrangement body 3 is a concavely curved concave portion 16a that does not penetrate the outer end portion, and is inserted from the inner opening end portion of the cylindrical hole 16a. The distal end portion 4a of the operation body 4 is configured to abut against and hold freely.

  The bone fragment connecting portions 5 and 15 and the operating body connecting portions 6 and 16 configured as described above are slits 7 and 17 at the boundary between the bone fragment connecting portions 5 and 15 and the operating body connecting portions 6 and 16. By providing this, the thin portions 8 and 18 that are thinner than other portions are connected.

  Since this thin part 8 is thinner than other parts, when a force is applied to the bone fragment connecting parts 5 and 15 and the operating body connecting parts 6 and 16, the bone fragment connecting part 5 , 15 is the starting point at which the operating body connecting portions 6 and 16 swing.

  In this embodiment, the thin portions 8 and 18 are formed by providing the slits 7 and 17 when the bone piece continuous portions 5 and 15 and the operating body continuous portions 6 and 16 are integrally formed. However, the thin portions 8 and 18 may be formed by forming the slits 7 and 17 by cutting.

  The operating body 4 is a rod-like body formed of an appropriate metal member as shown in FIGS. 1 to 3, and a screw groove 4b is formed at a predetermined position on the peripheral surface thereof. It is configured to be able to be screwed to the operating body connecting portion 6 related to the body 2.

  Further, the distal end portion 4a of the operation body 4 is formed in a tapered shape, and is held in the free-fit state so as to be freely tiltable and rotatable in the recess 16a of the operation body connecting portion 16 related to the second arrangement body 3. It is configured so that it can be swallowed.

  Further, the base end portion 4c of the operation body 4 is formed in a polygonal cross section (square shape in cross section), and is configured to be attached to a rotating tool for screwing the operation body 4 in a non-rotating state. Yes.

  Note that the base end of the operation body 4 is formed to be sharp and is used when the skin is broken to expose the base end portion 4c of the operation body 4 to the outside of the body.

  A bone extension operation using the bone extender according to the present embodiment configured as described above will be described. Here, a description will be given of a bone extension operation in the skull 1 performed by cutting the skull 1 into small pieces (blocks) as shown in FIGS. Of course, as shown in FIG. 7, a pair of bone extenders may be used.

  First, the bone piece continuous portion 5 of the first arrangement body 2 is continuously provided in the fitted state at the edge portions of the left and right bone pieces 1a obtained by cutting the skull 1 into blocks, and the central bone piece 1b The bone piece connecting portions 15 of the second arrangement body 3 are continuously provided in the fitted state at the left and right end edges, respectively.

  Subsequently, the operating body 4 is screwed to the operating body connecting portion 6 related to the first arrangement body 2 on the left and right, and the operation related to the second arrangement body 3 facing the distal end portion 4a of each of the operating bodies 4 is performed. Insert it into the body connecting part 16 and hold it in the butted state. Note that the operating body 4 may be screwed to the operating body connecting portion 6 related to the first arrangement body 2 in advance.

  In this state, the operation body 4 is screwed to push the operation body connecting portion 16 related to the second arrangement body 3 to widen the facing distance between the first arrangement body 2 and the second arrangement body 3. Thus, bone formation is performed while promoting the fusion of the bone fragments 1a and 1b.

  At this time, the bone fragments 1a and 1b made of the skull 1 not only extend in the linear direction but also swell in the radial direction as the opposing bone fragments 1a and 1b try to coalesce with each other. The bone fragment connecting portions 5 and 15 and the operating body connecting portions 6 and 16 are connected to each other through the thin portions 8 and 18, so that the bone fragments 1a and 1b are swelled in the radial direction. When a force to act is applied, the operating body connecting portions 6 and 16 are swung from the thin portions 8 and 18 with respect to the bone fragment connecting portions 5 and 15 and try to swell in this radial direction. Instead of resisting the force, it can be surely dealt with by receiving this force and deforming (see FIG. 4).

  Further, in this embodiment, the distal end portion 4a of the operation body 4 is formed in a tapered shape, and the operation body 4 is rotatably held by the operation body connecting portion 16 of the second arrangement body 3 so as to be tiltable. The operating body 4 can respond to the radial movement of the bone fragments 1a and 1b by tilting with respect to the operating body connecting portion 16 of the second arrangement body 3, and this configuration is As shown in FIG. 5, the movement of the bone fragments 1a, 1b in the left-right direction can be handled. The movement of the bone fragments 1a, 1b in the left-right direction can be dealt with by the bone fragment continuous portions 5, 15 being continuously provided in the fitted state on the bone fragments 1a, 1b.

  When the first disposition body 2 and the second disposition body 3 are removed after the bone extension, the bone fragments 1a and 1b grow because the bone fragment connecting portions 5 and 15 are in the fitted state. By suppressing this, square holes are formed in the bone fragments 1a and 1b, but the holes formed in the bone fragments 1a and 1b naturally heal after the operation.

  Since the present embodiment is configured as described above, the bone pieces 1a and 1b facing each other during the bone extension operation are surely adapted to various movements such as movement in the linear direction and movement in the radial direction, so that natural and good bones can be obtained. Formation will take place.

  Further, in this embodiment, the operating body connecting portions 6 and 16 are provided to the bone piece connecting portions 5 and 15 only when a strong force is applied to the bone pieces 1a and 1b in the radial direction. For example, when the bone fragment connecting portions 5 and 15 are connected to the bone fragments 1a and 1b, the operating body connecting portions 6 and 16 are rocked with respect to the bone fragment connecting portions 5 and 15 ( In the case of bone extension for the skull 1, for example, after the skull 1 has been cut into blocks, the left and right bones can be placed on the bone fragments 1a and 1b. When the central bone piece 1b is suspended from the piece 1a, unlike the above-described conventional example, the central bone piece 1b in the suspended state is arranged in an optimal position and supported in a good state. Therefore, the disposition to the bone fragments 1a and 1b can be performed quickly and accurately, and the bone fragments 1a and 1b can be securely attached. Therefore, it can be placed in an optimal position and can be supported in a good state.

  Further, in this embodiment, the bone piece connecting portions 5 and 15 and the operating body connecting portions 6 and 16 are integrally formed through the thin portions 8 and 18, so that the number of parts is large and the manufacturing is possible. Compared with the troublesome conventional example, it can be manufactured easily, and it is excellent in mass productivity at low cost.

  Further, in the present embodiment, the bone fragment connecting portions 5 and 15 are formed in a U-shaped cross-section continuously connected to the end edges of the bone fragments 1a and 1b. It is possible to reliably cope with the movement in the left-right direction.

  Further, in this embodiment, the distal end portion of the operation body 4 is formed in a tapered shape, and is configured to be able to rotate and abut against the operation body connecting portion 16 of the second arrangement body 3 so as to be tiltable. Therefore, the movement of the bone fragments 1a and 1b in various directions (three-dimensional directions such as the vertical direction, the horizontal direction, and the diagonal direction) can be reliably handled.

  The present invention is not limited to the present embodiment, and the specific configuration of each component can be designed as appropriate.

It is a disassembled perspective view which shows a present Example. It is use condition explanatory drawing of a present Example. It is explanatory drawing of the principal part which concerns on a present Example. It is operation | movement explanatory drawing of the principal part which concerns on a present Example. It is operation | movement explanatory drawing of the principal part which concerns on a present Example. It is use condition explanatory drawing of a present Example. It is use condition explanatory drawing of a present Example. It is a use condition explanatory drawing of a prior art example.

1a bone fragment 1b bone fragment 2 first arrangement body 3 second arrangement body 4 operation body
4c Base end part 5 Bone fragment continuous part 6 Operation body continuous part 7 Slit 8 Thin part
15 Bone fragment continuous section
16 Control unit connection section
16a recess
17 Slit
18 Thin section

Claims (6)

Of the opposing bone fragments, a first arrangement body arranged on one bone piece, a second arrangement body arranged on the other bone piece, the first arrangement body and the second arrangement body. A bone distractor comprising an operating body provided between the mounting body and capable of variably operating a facing interval between the mounting bodies, wherein the first mounting body and the second mounting body are both It has a configuration having a bone piece continuous portion provided continuously to the bone piece and an operation body continuous portion provided continuously to the operation body, and at least one of the first arrangement body and the second arrangement body The bone piece connecting portion and the operating body connecting portion are connected to the bone piece connecting portion so as to be finely movable with respect to the bone piece connecting portion via a thin portion . The operation body connecting portion of the arrangement body has a structure in which a screw rod-like operation body is screwed, and the distal end portion of the operation body is movable to the operation body connection portion of the second arrangement body. To hold And a distal end portion of the operating body is formed in a tapered shape, and the operating body is rotatably fitted into the recessed portion of the operating body connecting portion of the second arrangement body. A bone distractor characterized by being held at the end .   2. The bone extender according to claim 1, wherein the bone fragment connecting portion and the operating body connecting portion are provided by integral molding through the thin portion.   The bone extender according to any one of claims 1 and 2, wherein the thin portion is formed by providing a slit in a continuous portion between the bone fragment continuous portion and the operating body continuous portion. A bone distractor characterized by a non-reachable remainder. Characterized in that the distraction instrument according to any one of claims 1 to 3, wherein the bone connecting portion is a U-shaped cross section configuration for continuously arranged in the fitted state the edge portion of the bone fragment And bone extender. The bone extender according to any one of claims 1 to 4, wherein a proximal end portion of the operation body is formed in a polygonal cross section. The bone extender according to any one of claims 1 to 5, wherein a proximal end of the operation body is formed to be sharp.

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