JP5431812B2 - Bone surgery instrument and manufacturing method thereof - Google Patents

Description

  The present invention relates to a bone surgery instrument and a method for manufacturing the same.

  In bone surgery, for example, a bone is drilled with a tool such as a drill, a guide pin is inserted into the bone, and an implant such as an intramedullary nail or screw is introduced into the bone. Surgical tools such as drills, guide pins, intramedullary nails, and screws used during such bone surgery are often guided using a guide device.

  As an example of a guide device for guiding a surgical tool for bone, a fixing portion fixed to one end of an intramedullary nail inserted into the bone marrow, and a surgical tool is guided from the fixing portion to the intramedullary nail. An apparatus called an index apparatus (also called a target device or the like) having a guide unit is known (see, for example, Patent Document 1).

  The guide portion of the apparatus described in Patent Document 1 is provided with a plurality of guide holes for inserting and guiding a surgical tool and slits formed in a direction in which these guide holes are vertically cut. In this apparatus, a threaded fastening shaft is screwed to the lower end portion of the guide portion so as to cross the slit. In this apparatus, by rotating a lever attached to a threaded fastening shaft, the two portions on both sides of the slit are tightened in a direction approaching each other, thereby reducing the inner diameter of the guide hole.

  When the surgical instrument is guided using the apparatus described in Patent Document 1, a guide member called a guide sleeve is inserted into the guide hole of the guide portion, and the guide sleeve is screwed to the fastening shaft. The surgical tool such as a guide pin is directly or indirectly guided in a predetermined direction by the guide sleeve.

JP 2001-286482 A

  The threaded fastening shaft used in the one described in Patent Document 1 is attached to one of the two parts on both sides of the slit and is screwed to the other part. The force on one part is not uniform. If the force applied to the two portions is not uniform, the displacement of one of the portions more than the other causes the guide member to be displaced or twisted.

  Further, in the case of the configuration as described in Patent Document 1, an operating force is applied only to one of the two portions, and thus a guide hole may be twisted. If the guide hole is misaligned or twisted, there is a concern that the guidance accuracy of the surgical instrument guided by the guide member may be reduced.

Further, in this type of surgical instrument, since the surgical tool is guided and introduced from a position relatively away from the site (for example, the femur) where the surgical tool is introduced, if the guide member is displaced, Introduction becomes difficult. Therefore, further improvement of the guidance accuracy of the surgical tool is desired.
The present invention has been completed based on the above-described circumstances, and an object thereof is to provide a bone surgery instrument with improved guidance accuracy of a surgical instrument.

In order to solve the above-mentioned problems, the present invention provides a bone surgical instrument for guiding a surgical instrument for operating a bone, and a guide member for guiding the surgical instrument to the bone, and directly or indirectly with respect to the bone An instrument body that is positioned and fixed and guides the guide member, and the instrument body has a fixing part that is fixed to the bone, and an insertion part that guides the bone through the guide member. And the insertion guide portion is arranged on the bone side by a first slit formed in a direction intersecting the insertion direction of the guide member. The guide member is divided into a guide portion for inserting and guiding the member, and a positioning portion for fixing and positioning the guide member. The positioning portion inserts the insert portion from one end portion in the axial direction of the positioning portion into the guide member insertion direction. I will divide it into The guide member disposed in the insertion portion is tightened by moving the two portions of the positioning portion together in the axial direction of the positioning portion. A clamping member for fixing the positioning portion, the clamping member sandwiching the two portions of the positioning portion from a direction intersecting the axial direction of the positioning portion, and sandwiching the two portions in the axial direction of the positioning portion And a lever for moving the clamping piece between a position where the two parts of the positioning part are clamped and a position where the two parts are released from the clamping state. It is.

  In addition, as a method for solving the above-described problem, the bone surgery instrument manufacturing method of the present invention includes a step of forming the insertion portion so that the insertion guide portion penetrates the insertion guide portion, and the insertion portion is formed. In the inserted guide part, the first slit is formed in a direction intersecting with the insertion direction of the guide member, and the guide part arranged on the bone side and the guide member are fixed and positioned. A second slit is formed in the positioning portion so as to divide the insertion portion from the one end portion in the axial direction of the positioning portion in the insertion direction of the guide member. And a step of attaching the tightening member.

  When a bone surgical instrument is guided using the bone surgical instrument of the present invention (also referred to as “the instrument of the present invention”), a guide member for guiding the bone surgical instrument is inserted into each insertion portion of the positioning portion and the guide portion. After being inserted and arranged in a predetermined direction, the guide member is fixed and positioned by a tightening member that moves the two portions of the positioning portion in a direction approaching the axis of the positioning portion.

  The instrument of the present invention is provided with a tightening member that moves the two portions of the positioning portion in a direction approaching the axis of the positioning portion, so that an equal force is applied to the two portions of the positioning portion. The shaft misalignment and twist of the insertion part and the shaft misalignment and twist of the guide member arranged in the insertion part are less likely to occur.

Moreover, in this invention, it has the insertion guide part by which the insertion part was provided by penetrating, This insertion guide part is formed in the direction which cross | intersects with respect to the insertion direction (length direction of an insertion part) of a guide member. The first slit is divided into a guide portion and a positioning portion.
That is, in the present invention, since the insertion guide portion provided with the insertion portion which is a through hole is divided into the guide portion and the positioning portion by the first slit, a concentric insertion portion is provided in the guide portion and the positioning portion. It has been. As a result, even if the guide member is inserted into the positioning portion and the guide portion and then fixed by the positioning portion, no deviation occurs.

  Furthermore, in the present invention, since the positioning portion and the guide portion are provided separately, the length of the insertion portion of the positioning portion is made longer than that in which these are integrated (for example, the device described in Patent Document 1). Can be shortened. If the length of the insertion portion of the positioning portion is long, there is a concern that the guide member will rattle in the radial direction after the insertion portion is tightened, but after inserting the guide member by shortening the insertion portion, When the two portions separated by the two slits are tightened, the guide member is less likely to rattle in the radial direction.

By the way, simply shortening the length of the insertion portion of the positioning portion is positioned by the short insertion portion, so that it is not guided in an appropriate direction due to bending of the guide member at a portion closer to the bone than the positioning portion. There is concern. However, in the present invention, since the guide member positioned by the positioning portion is also inserted through the insertion portion of the guide portion arranged on the bone side, it is held in a state of being guided in an appropriate direction.
As mentioned above, according to this invention, since it is excellent in the guidance accuracy of the guide member after clamping a guide member, the instrument for bone surgery which improved the guidance accuracy of the surgical instrument can be provided.

In the present invention, the clamping member sandwiches the two portions of the positioning portion from the direction intersecting the axial direction of the positioning portion, and moves the two portions in the axial direction of the positioning portion. And a lever that moves the clamping piece between a position where the two parts of the positioning portion are clamped and a position where the two parts are released from the clamping state .
Therefore, according to the present invention , the guide member can be positioned simply by moving the lever from the position where the two portions of the positioning portion are released from the clamping state to the position where the two portions are clamped. The operation time can be shortened .
The present invention may have the following configurations.

The length of the insertion part may be longer than the positioning part in the guide part.
With such a configuration, since the length of the insertion portion is longer in the positioning portion than in the guide portion, the two portions separated by the second slit are tightened by shortening the insertion portion in the positioning portion. In this case, it is preferable that the guide member does not rattle in the radial direction, and the length of the insertion portion in the guide portion increases the portion of the guide member that is held.

Of the end portions in the axial direction of the positioning portion, the width dimension in the direction crossing the axial direction is smaller than the other portions at the end portion opposite to the portion sandwiched by the sandwiching pieces. It may be set.
Such a configuration is preferable because the two parts can be easily moved in the axial direction of the positioning part even at a position away from the part held by the clamping piece of the positioning part.

An interval between the positioning portion and the guide portion is maintained between the held portion and the guide portion held by the holding piece of the positioning portion, and the positioning portion is held by the holding piece. A holding plate for holding in a state may be arranged.
With such a configuration, since the distance between the positioning portion and the guide portion is maintained, the two portions of the positioning portion smoothly move in the axial direction. In addition, such a configuration is preferable because the positioning member is held in a state of being sandwiched by the sandwiching pieces, so that the guide member is reliably positioned.

The guide part, the positioning part, and the fastening member may be at least partially made of synthetic resin.
Such a configuration is preferable because the bone surgical instrument of the present invention can be reduced in weight and excellent in workability.

The entire instrument body or the part of the instrument body including the fixing part may be made of titanium.
Such a configuration is preferable because the bone surgical instrument of the present invention can be reduced in weight and titanium having high affinity with a living tissue is used for a portion (fixing portion) that comes into contact with the living body (bone).

  At least one of the guide part and the positioning part may be provided with an instruction part for instructing the insertion direction of the guide member. Such a configuration is preferable because it is easy to determine the insertion direction of the guide member, and the operation time can be shortened.

  ADVANTAGE OF THE INVENTION According to this invention, the instrument for bone surgery which improved the guidance precision of the surgical instrument can be provided.

The perspective view of the parameter | index apparatus which concerns on Embodiment 1. FIG. Side view of the indicator device as applied to the bone Side view of indicator device Rear view of the indicator device when the clamping piece is released from the clamping state Front view of indicator device Rear view of the indicator device when the clamping piece is in the clamping state Partially enlarged rear view showing a lever arranged at a position where the clamping piece is released from the clamping state Partially enlarged rear view showing a lever arranged at a position where the clamping piece is clamped

<Embodiment 1>
Embodiment 1 in which the present invention is applied to an index device 10 for introducing a surgical instrument 2 such as a guide pin 2A to an intramedullary nail 30 introduced into the medullary of an annular bone 1 such as a femur is shown in FIGS. This will be described with reference to FIG. In the following description, the left side in FIGS.

As shown in FIG. 2, the index device 10 of the present embodiment includes a device main body 11 (corresponding to the instrument main body 11) having a fixing portion 12 and an insertion guide portion 13 connected to the end portion 30 </ b> A of the intramedullary nail 30. And a guide member 3 for introducing the surgical instrument 2.
Examples of the surgical instrument 2 include a guide pin 2A, a drill and a screw (not shown), and the guide member 3 for introducing the surgical instrument 2 includes a guide sleeve 3A and an auxiliary sleeve inserted into the guide sleeve 3A shown in FIG. 3B etc. are mentioned.

  The apparatus main body 11 is configured in a U shape as a whole so as to shift to a posture substantially parallel to the intramedullary nail 30 after being bent from the fixing portion 12. A curved portion 16 (referred to as a curved portion 16) of the apparatus body 11 is curved downward on the boundary of the first curved portion 16A and the first curved portion 16A that extends while being curved obliquely upward on the fixed portion 12 side and reaches the vertex 16C. However, it has the 2nd curved part 16B extended. The second bending portion 16B is bent downward at an inclination angle that is gentler than that of the first bending portion 16A.

  The first bending portion 16A and the second bending portion 16B of the apparatus main body 11 are formed with a plurality of bending portion through holes 17A penetrating in the vertical direction in FIG. Further, the insertion guide portion 13 described later is also formed with a curved portion through hole 17B penetrating in the front-rear direction. These curved portion through holes 17A and 17B are for reducing the weight of the apparatus 10.

  Note that the angle of the bending portion 16 (from the fixing portion 12 fixed to the intramedullary nail 30 to the point X in FIG. 3) of the device main body 11 takes into account the inclination of the bone 1 to which the device 10 of the present embodiment is applied. Can be set as appropriate. Further, if the height H from the point X in FIG. 3 of the apparatus main body 11 to the apex 16C of the bending portion 16 is reduced, it is necessary to lengthen the incised portion in the human body, and if it is increased, the incised portion of the human body can be reduced. However, by making the incision portion small, it becomes difficult to see the part to be operated on and the operation efficiency is lowered. Therefore, it is appropriately set in consideration of the burden on the human body and the operation efficiency.

  As shown in FIG. 2, the bending portion 16 of the apparatus main body 11 is connected to an insertion guide portion 13 that extends substantially parallel to the intramedullary nail 30. A lever 26 (details will be described later), which is a tightening member 25, is attached to the recessed portion 13 </ b> A immediately below the curved portion through-hole 17 </ b> B of the insertion guide portion 13.

A guide portion 14 disposed on the left side (bone 1 side) in FIG. 2 by a first slit 15 placed in the vertical direction is provided immediately below a portion 13A to which the lever 26 of the insertion guide portion 13 is attached, and a guide It is divided into the positioning part 20 arranged along with the part 14. The guide part 14 has a function of guiding the guide member 3 to the bone 1, and the positioning part 20 has a function of positioning the guide member 3.
As shown in FIG. 2, an instruction groove 18 (corresponding to the instruction portion 18 of the present invention) that instructs the insertion direction of the guide member 3 is provided on the side wall surfaces of the guide portion 14 and the positioning portion 20.

  The guide portion 14 and the positioning portion 20 are provided with an insertion portion 19 for inserting the guide member 3 such as the guide sleeve 3A for guiding the surgical instrument 2 and guiding the bone 1 through the guide portion 14 and the positioning portion 20. (See FIGS. 2 to 6).

  Although details will be described later, in the present embodiment, after the insertion portion 19 is formed so as to penetrate the insertion guide portion 13, the insertion guide portion 13 is moved in the direction intersecting the insertion direction of the guide member 3. In order to form one slit 15 and divide it into the guide part 14 and the positioning part 20, a concentric insertion part 19 is provided in the guide part 14 and the positioning part 20. The insertion part 19 formed in the guide part is a first insertion part 19A having a hole shape (see FIG. 5). As shown in FIG. 2, the length of the insertion part 19 is longer than the positioning part 20 in the guide part 14.

  As shown in FIG. 3, the gap between the positioning portion 20 and the guide portion 14 is maintained between the upper end portion 23 </ b> A of the positioning portion 20 and the guide portion 14, and the positioning portion 20 is held between the holding pieces 27. A thin plate-like holding plate 24 that is held in a state is provided.

  The positioning portion 20 is formed from the upper end portion 23A [corresponding to one end portion in the axis (YY line) direction] to the vicinity of the lower end portion 23B so as to divide the insertion portion 19 in the insertion direction. The slit 21 is divided into two parts 22A and 22B. As shown in FIGS. 4 and 6, the two portions 22 </ b> A and 22 </ b> B of the positioning portion 20 have a symmetrical shape with respect to the central axis Y of the positioning portion 20, and the lower end portion 23 </ b> B is the lower end of the guide portion 14. It is connected to the part 14B. A groove-like second insertion portion 19B formed by dividing the insertion portion 19 is formed on the surface of the two portions 22A and 22B of the positioning portion 20 on the second slit 21 side.

  As shown in FIG. 4, the upper end portion 23A and the lower end portion 23B of the two portions 22A and 22B of the positioning portion 20 are stepped by reducing the width dimension in the direction intersecting the axis (Y-Y line) direction. I am doing. An upper end portion 23A of the two portions 22A and 22B is a portion (a sandwiched portion 23A) that is sandwiched from the outside in the width direction by a sandwiching piece 27 (described later). The width dimension of the lower end portion 23B of the two portions 22A and 22B of the positioning portion 20 is smaller than the other width portion of the positioning portion 20.

  On the back side of the guide portion 14, the two portions 22 </ b> A and 22 </ b> B are sandwiched between the upper end portion 23 </ b> A of the positioning portion 20 from the direction intersecting the axis (Y-Y line) direction (left-right direction in FIG. 4) 20 has a clamping piece 27 to be moved in the axial direction (center axis Y direction) at one end, and the clamping piece 27 is positioned between the two portions 22A and 22B of the positioning portion 20 and the two portions 22A and 22B. A fastening member 25 having a lever 26 at the other end for moving between a position where the pin is released from the clamping state is attached. In the apparatus 10 of the present embodiment, when the lever 26 is moved upward, the clamping piece 27 is released from the state of clamping the two portions 22A and 22B of the positioning unit 20 (see FIGS. 4 and 7). When the lever 26 moved upward is moved downward and the holding piece 27 comes into contact with the outer surfaces of the two portions 22A and 22B of the positioning portion 20, the holding piece 27 becomes the two portions 22A and 22B of the positioning portion 20. (See FIGS. 6 and 8).

Next, the material which comprises the apparatus 10 of this embodiment is demonstrated.
The indicator device 10 of the present embodiment may be entirely made of a metal material such as titanium, stainless steel, or aluminum, and the fixed portion 12 and the curved portions 16A and 16B are made of these metal materials, and the insertion guide portion. Part (all) of 13 (guide part 14, positioning part 20, and lever 26) may be made of synthetic resin.

  Considering that it is lightweight and excellent in strength and has a high affinity with living tissue, a part including the fixing portion 12 or the entire apparatus main body 11 is made of titanium having a high affinity with living tissue. preferable. Further, in terms of reducing the weight of the device 10 and reducing the manufacturing cost of the device 10, it is preferable that the whole or part of the insertion guide portion 13 is made of a synthetic resin.

Next, a method for manufacturing the index device 10 of the present embodiment will be described.
In the manufacturing method of the index device 10 of the present embodiment, the bending portion 16 and the insertion guide portion 13 of the device main body 11 are separately manufactured, and then both are integrated by a method such as welding or adhesion.

In the method for manufacturing the device 10 of the present embodiment, the insertion guide portion 13 is produced by the following method, for example.
First, a process of forming the insertion portion 19 so as to penetrate the insertion guide portion 13 by cutting the insertion guide portion 13 is performed. Next, the insertion guide part 13 having the insertion part 19 is subjected to wire cutting in a direction intersecting the insertion direction of the guide member 3 to form a first slit 15, and the guide part 14, the positioning part 20, The process of dividing into steps is executed. In this embodiment, concentric insertion parts 19A and 19B are formed in the guide part 14 and the positioning part 20 through such a process.

  Next, the positioning portion 20 is cut to form the second slit 21 so as to divide the insertion portion 19 from the upper end portion 23A of the positioning portion 20 in the insertion direction of the guide member 3 to form the positioning portion 20. A step of dividing the two portions 22A and 22B is executed. Next, a process of attaching the fastening member 25 is executed.

Next, the usage method of the apparatus 10 of this embodiment is demonstrated.
First, after drilling the end 1A of the bone 1 such as the femur by applying a tool such as a drill or a reamer, a fixing portion through-hole (not shown) provided at the end of the fixing portion 12 of the apparatus 10 of the present embodiment. The intramedullary nail 30 and the indicator device 10 are integrated by inserting a connection screw (not shown) through the shaft hole and screwing the connection screw into a shaft hole (not shown) of the intramedullary nail 30. . In this state, the distal end 30 </ b> B of the intramedullary nail 30 is introduced into the bone 1 from the end 1 </ b> A of the bone 1. At this time, the posture and depth of the intramedullary nail 30 in the bone 1 are confirmed while viewing a fluoroscopic image such as an X-ray image, and the intramedullary nail 30 is finally disposed at an appropriate position with respect to the bone 1. Set to

  Next, using the apparatus 10 of the present embodiment, the guide sleeve 3A is inserted through the following procedure. The lever 26 is lifted upward so that the holding piece 27 is in a state (the state shown in FIGS. 4 and 7) in which the two portions 22A and 22B of the positioning portion 20 are released from the holding state, as shown in FIG. The tip of the guide sleeve 3A is inserted into the second insertion portion 19B of the positioning portion 20, and the guide sleeve 3A is inserted in the order of the positioning portion 20 and the guide portion 14 so that the tip of the guide sleeve 3A is introduced into the body. Push in. At this time, the insertion direction can be easily determined by inserting the guide sleeve 3A while referring to the guide groove 18 on the side wall surface of the guide portion 14 and the positioning portion 20.

  The guide sleeve 3A is inserted until the tip of the guide sleeve 3A comes close to or comes into contact with the surface of the bone 1, and then the lever 26 is rotated in the direction of the arrow in FIG. 2 (downward direction). When the clamping piece 27 comes into contact with the two portions 22A and 22B of the positioning portion 20 by the rotation of the lever 26, the two portions 22A and 22B start to move in the axial direction of the positioning portion 20 (the central axis Y direction). In the present embodiment, in the lower end 23B of the positioning unit 20, the width dimension in the direction intersecting the axis (Y-Y line) direction is set to be smaller than the other parts. The two portions 22A and 22B can be easily moved in the axial direction (center axis Y direction). In this embodiment, since the distance between the positioning portion 20 and the guide portion 14 is held by the holding plate 24, the two portions 22A and 22B of the positioning portion 20 can be smoothly moved in the central axis Y direction.

  When the lever 26 is further rotated and lowered to a position where the holding piece 27 abuts against the holding plate 24, the holding plate 24 restricts the movement of the holding piece 27 in the forward direction (left direction in FIG. 2). Thereby, the clamping piece 27 is hold | maintained in the state which clamped the two parts 22A and 22B of the positioning part 20. As shown in FIG. At this time, the clamping piece 27 clamps and tightens the two portions 22A and 22B of the positioning portion 20, whereby the diameter of the second insertion portion 19B is reduced and the guide sleeve 3A is positioned and fixed (FIGS. 6 and 8). See).

  Here, in this embodiment, since the guide part 14 and the positioning part 20 are provided with the concentric insertion part 19, the guide sleeve 3A is inserted into the positioning part 20 and the guide part 14, and then the positioning part 20 Even if fixed, there is no deviation. Furthermore, in this embodiment, the positioning part 20 and the guide part 14 are provided separately, and the length of the second insertion part 19B of the positioning part 20 is set shorter than that in which the positioning part 20 and the guide part 14 are provided integrally. Therefore, after the guide portion 14 sleeve is inserted, when the two portions 22A and 22B separated by the second slit 21 are tightened, the guide member 3 is less likely to rattle in the radial direction.

  By the way, simply by shortening the length of the second insertion portion 19B of the positioning portion 20, since the positioning is performed by the short insertion portion 19, the guide sleeve 3A is positioned in front of the positioning portion 20 (on the bone 1 side). There is a concern that it will not be guided in an appropriate direction due to bending or the like. However, in this embodiment, the guide sleeve 3A positioned by the positioning unit 20 is also inserted through the first insertion part 19A of the guide part 14 disposed on the bone 1 side, so that the guide sleeve 3A is guided in an appropriate direction. It is held in the state.

  In particular, in this embodiment, since the length of the insertion portion 19 is longer in the positioning portion 20 than in the guide portion 14, the insertion portion 19 is set shorter in the positioning portion 20, so that the second slit 21 When the two divided portions 22A and 22B are tightened, the guide sleeve 3A is less likely to rattle in the radial direction. On the other hand, in the guide part 14, the insertion part 19 is set to be long, so that the part where the guide sleeve 3 </ b> A is held becomes long, and the guidance accuracy can be further increased.

  Next, as shown in FIG. 2, the auxiliary sleeve 3B is further inserted into the two guide sleeves 3A, the guide pin 2A is inserted into the shaft hole 3C of the auxiliary sleeve 3B, and the tip thereof is inserted into the bone 1. Put in. At this time, the position and direction of the guide pin 2A are guided by the insertion guide portion 13 via the guide sleeve 3A and the auxiliary sleeve 3B.

  When the insertion of the guide pin 2A is completed, the auxiliary sleeve 3B is removed, and a drilling tool (not shown) such as a drill or a reamer is introduced in a state guided by the guide sleeve 3A and the guide pin 2A, and the bone 1 is drilled. Applied. This drilling operation is also performed while confirming the fluoroscopic image. When the drilling operation is completed, the screw is screwed into the bone 1 while being guided by the guide sleeve 3A and the guide pin 2A. At this time, the screw is screwed toward the head 1B of the bone 1 through the transverse hole 31A provided in the intramedullary nail 30 in an inclined manner.

  Further, the preparatory work is also performed on the transverse hole 31B provided in the intramedullary nail 30 in the horizontal direction using the guide sleeve 3A, the guide pin 2A, and a tool in the same manner as described above, and then a screw (not shown) is attached. The intramedullary nail 30 is fixed to the bone 1 by being inserted.

  Thereafter, the index device 10 of the present embodiment is removed from the intramedullary nail 30, and when a screw is not used, a set screw (not shown) is inserted into the shaft hole of the intramedullary nail 30, and the screw is engaged and held. Finally, a cap (not shown) is attached to the shaft hole.

Next, the effect of this embodiment will be described.
According to the present embodiment, the tightening member 25 (the lever 26 and the clamping piece 27) that moves the two portions 22A and 22B of the positioning portion 20 in the axial center direction (the central axis Y direction) of the positioning portion 20 is provided. Therefore, since an equal force is applied to the two portions 22A and 22B of the positioning portion 20, the axial displacement and twist of the second insertion portion 19B, and the guide member 3 disposed in the second insertion portion 19B Axis misalignment and twisting are unlikely to occur.

  Further, according to the present embodiment, since the guide part 14 and the positioning part 20 are provided with the concentric insertion part 19, the guide member 3 is inserted into the positioning part 20 and the guide part 14, and then the positioning part 20 Even if fixed, there is no deviation.

  Furthermore, according to the present embodiment, since the second insertion portion 19B of the positioning portion 20 can be shortened, the guide member 3 is inserted through the guide portion 14 and then divided by the second slit 21. When the two portions 22A and 22B are tightened, the guide member 3 is less likely to rattle in the radial direction.

In addition, according to the present embodiment, the guide member 3 positioned by the positioning unit 20 is also inserted into the first insertion part 19A of the guide part 14 disposed on the bone 1 side, so that an appropriate direction is obtained. It is held in the state guided by.
As described above, according to the present embodiment, since the guide member 3 is excellent in guide accuracy after the guide member 3 is tightened, a bone surgery instrument with improved guide accuracy of the surgical instrument 2 can be provided.

  Moreover, according to this embodiment, since the guide member 3 can be positioned only by rotating the lever 26, the positioning operation of the guide member 3 can be simplified and the operation time can be shortened. Furthermore, according to the present embodiment, since the instruction groove 18 that instructs the insertion direction of the guide member 3 is provided on the side wall surfaces of the guide portion 14 and the positioning portion 20, the insertion direction of the guide member 3 can be easily determined. , Surgery time can be shortened.

<Other embodiments>
The present invention is not limited to the embodiments described with reference to the above description and drawings. For example, the following embodiments are also included in the technical scope of the present invention.
(1) In the above-described embodiment, the lever includes a lever and a clamping piece as the clamping member. However, the clamping member is a clamp or clip that clamps the two portions of the positioning portion from the outside, or a screw is screwed. An example in which the two parts are brought closer to the axial direction by combining them is given as a reference example.

  (2) In the above-described embodiment, the positioning portion has a narrow bottom end, but the bottom end may have the same width as other portions.

  (3) In the above embodiment, the holding plate is provided between the sandwiched portion and the guide portion. However, the holding plate may not be provided, and a tapered surface is formed instead of the holding plate. May be.

  (4) In the above-described embodiment, the instruction groove is provided as the instruction unit indicating the direction in which the guide member is guided. However, a character or the like may be written, or the instruction unit may not be provided.

  (5) In the above embodiment, the present invention is applied to an index device for introducing a surgical instrument such as a guide pin, a drill, or a screw into an intramedullary nail that is introduced into an intramedullary bone of an annular bone such as a femur. Although shown here, the present invention is not limited to such an embodiment. For example, it may be applied to bones other than the femur.

DESCRIPTION OF SYMBOLS 1 ... Bone 2 ... Surgical instrument 3 ... Guide member 10 ... Indicator apparatus (Bone surgery instrument)
11 ... Main unit (instrument main unit)
DESCRIPTION OF SYMBOLS 12 ... Fixed part 13 ... Insertion guide part 14 ... Guide part 15 ... 1st slit 18 ... Instruction groove (instruction part)
DESCRIPTION OF SYMBOLS 19 ... Insertion part 19A ... 1st insertion part 19B ... 2nd insertion part 20 ... Positioning part 21 ... 2nd slit 22A ... Two parts (right side)
22B… Two parts (left side)
23A: Upper end of the positioning part (clamped part)
23B: Lower end of positioning part 24 ... Holding plate 25 ... Tightening member 26 ... Lever 27 ... Nipping piece 30 ... Intramedullary nail

Claims (8)

A bone surgery instrument for guiding a surgical instrument for operating a bone,
A guide member that guides the surgical instrument to the bone, and an instrument body that is positioned and fixed to the bone directly or indirectly and guides the guide member;
The instrument main body has a fixing portion fixed to the bone, and an insertion guide portion provided through the insertion portion that passes through the guide member and guides the bone,
The insertion guide portion is arranged on the bone side by a first slit formed in a direction intersecting with the insertion direction of the guide member, and guides the guide member through the guide member; It is divided into the positioning part that is fixed and positioned,
The positioning part is divided into two parts by a second slit formed to divide the insertion part in the insertion direction of the guide member from one end part in the axial direction of the positioning part,
By providing both of the two portions of the positioning portion in the axial direction of the positioning portion, a tightening member is provided for tightening and fixing the guide member disposed in the insertion portion ,
The clamping member includes a clamping piece that sandwiches the two portions of the positioning portion from a direction intersecting the axial direction of the positioning portion, and moves the two portions in the axial direction of the positioning portion; An osteosurgical instrument comprising: a lever that moves a piece between a position where the two portions of the positioning portion are clamped and a position where the two portions are released from the clamped state . The bone surgical instrument according to claim 1 , wherein a length of the insertion portion is longer in the guide portion than in the positioning portion . Of the end portions in the axial direction of the positioning portion, the width dimension in the direction crossing the axial direction is smaller than the other portions at the end portion opposite to the portion sandwiched by the sandwiching pieces. bone surgical instrument according to claim 1 or claim 2, characterized in that it is set. An interval between the positioning portion and the guide portion is maintained between the held portion and the guide portion held by the holding piece of the positioning portion, and the positioning portion is held by the holding piece. The bone surgery instrument according to any one of claims 1 to 3, wherein a holding plate for holding in a state is arranged . 5. The bone surgical instrument according to claim 1, wherein at least a part of the guide portion, the positioning portion, and the tightening member is made of a synthetic resin . The bone surgical instrument according to any one of claims 1 to 5, wherein the entire instrument body or a part including the fixing part of the instrument body is made of titanium . The indication part which instruct | indicates the insertion direction of the said guide member is provided in at least one among the said guide part and the said positioning part, The Claim 1 thru | or 6 characterized by the above-mentioned. Bone surgery instrument. A method for manufacturing a bone surgery instrument according to any one of claims 1 to 7,
  Forming the insertion portion so as to penetrate the insertion guide portion in the insertion guide portion;
  Forming the first slit in a direction intersecting the insertion direction of the guide member in the insertion guide portion forming the insertion portion, the guide portion disposed on the bone side, and the guide member A process of dividing into a positioning part to be fixed and positioned;
  Forming the second slit in the positioning portion so as to divide the insertion portion in the insertion direction of the guide member from one end portion in the axial direction of the positioning portion, and dividing the positioning portion into two parts;
  And a step of attaching the tightening member.

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