JP6235331B2 - Hip surgery instrument - Google Patents

Description

  The present invention relates to a surgical instrument for an artificial hip joint for fixing an artificial hip joint to a femur.

  2. Description of the Related Art Conventionally, a broach system (artificial hip joint surgery instrument) that is used in hip joint surgery and includes a broach for making a hole in the medullary cavity of a femur and a broach handle for gripping the broach in a desired state. Are known. As such a surgical instrument for an artificial hip joint, for example, Patent Document 1 discloses a broach handle that can hold a broach by opening a protrusion at the tip up and down and pressing the protrusion into the broach from the inside by the force of a leaf spring. It is disclosed.

JP 2002-191610 A

  By the way, in the broach handle disclosed in the above-mentioned patent document 1, there is a possibility that the broach may rattle due to dimensional tolerance or the like in the left-right direction (the direction perpendicular to the direction in which the leaf spring biases the protrusion). Further, when the elastic force of the leaf spring is reduced, the gripping force of the broach is reduced.

  The present invention is to solve the above-mentioned problems, and an object of the present invention is to provide a surgical instrument for an artificial hip joint including a broach handle that can grip the broach with a high gripping force.

  (1) A surgical instrument for an artificial hip joint according to an aspect of the present invention for achieving the above object is provided with a hole for a stem into which a stem of an artificial hip joint fixed to a proximal end of the femur is inserted. An artificial hip joint comprising: a broach that is driven into the femur to form a broach handle, and a broach handle having a handle main body portion formed with an engagement convex portion that engages with an engagement hole formed in the broach. A surgical instrument for use, wherein a pair of convex side taper surfaces approaching each other from one side to the other side in a direction intersecting with a direction in which the convex part protrudes are formed on the outer wall of the engaging convex part And a pair of hole side taper surfaces corresponding to the pair of convex side taper surfaces are formed on the inner wall of the engagement hole, and the broach handle has the engagement convex part formed by the engagement hole part. In the state of being inserted into the engagement convex portion, By pressing the rectangular side to the pressing direction is a direction toward the other side, pressing mechanism for pressing the pair of convex portions side tapered surface in the pair of holes side tapered surface, and further comprising a.

  In this configuration, the broach is fixed to the broach handle by engaging the engagement convex portion of the broach handle with the engagement hole of the broach. Then, when the surgeon strikes the broach handle with a hammer or the like with the tip of the broach applied to the proximal end of the femur, the broach is driven into the femur. Thereby, the hole for stems in which the stem of an artificial hip joint is inserted can be formed in a femur.

  In this configuration, the pressing mechanism presses the engaging convex portion while the engaging convex portion is inserted into the engaging hole portion, so that each of the pair of convex side tapered surfaces formed on the engaging convex portion is provided. Presses each of the pair of hole side taper surfaces formed in the engagement hole. At this time, the engaging convex portion is inserted in a wedge shape with respect to the engaging hole portion. Thereby, since an engagement convex part and an engagement hole part are fixed firmly, a broach is hold | gripped with a high grip force with a broach handle.

  Therefore, according to the above-described configuration, it is possible to provide a surgical instrument for an artificial hip joint including a broach handle that can grip the broach with a high gripping force.

  (2) Preferably, the pressing mechanism includes an operating portion that is displaced with respect to the handle main body portion, and the engagement in a state in which the pressing portion is inserted into the engaging hole portion when the operating portion is displaced by being operated. A pressing portion that presses the convex portion toward the pressing direction with respect to the engagement hole portion.

  In this configuration, by operating the operating portion, the engaging convex portion inserted in the engaging hole portion can be pressed against the engaging hole portion by the pressing portion. Thereby, the broach can be firmly fixed to the broach handle.

  (3) Preferably, the broach can rotate a flattening device that rotates or polishes the opening peripheral portion of the stem hole portion by rotating about the rotation shaft portion so as to be rotatable. A rotation shaft hole into which the rotation shaft portion is inserted is formed.

  In this configuration, after the broach is driven into the femur and the hole for the stem is formed, the rotation shaft is inserted into the rotation shaft hole of the broach in that state, and the flattening device is centered on the rotation shaft By rotating, the opening peripheral edge of the stem hole can be flattened. That is, according to this configuration, when using the flattening device, other members (for example, an adapter attached to the broach) that rotatably supports the rotating shaft portion of the flattening device are not necessary. Therefore, the number of parts constituting the broach system can be reduced. Further, according to this configuration, it is possible to easily form a flat surface having a desired inclination angle at the opening peripheral edge portion of the stem hole portion.

  (4) More preferably, the rotation shaft hole portion and the engagement hole portion are formed so that internal spaces of the hole portions communicate with each other when viewed from the opening direction of the hole portions, and the engagement The convex part is formed by integrating a first convex part inserted into the engaging hole part and a second convex part inserted into the rotary shaft hole part.

  In this configuration, since the engaging convex portion can be formed by integrating the two convex portions (the first convex portion and the second convex portion), the engaging convex portion can be efficiently formed within a limited space. Can be bigger. Thereby, it can be made the shape which an engagement convex part cannot damage easily.

  (5) More preferably, the rotation shaft hole is formed on the inner side of the human body than the engagement hole in the broach in a state of being driven into the proximal end of the femur.

  In this configuration, the flattening instrument can be rotated on the medial side of the human body at the proximal end of the femur. Accordingly, the inner side portion of the proximal end of the femur can be flattened without removing the flattening device from the broach and avoiding interference between the flattening device and the greater trochanter. Therefore, no uncut residue is generated on the inner side of the proximal end of the femur, and the proximal end of the femur can be easily flattened as a whole.

  (6) More preferably, the rotation shaft hole portion is a circle having an arc of the inner wall of the rotation shaft hole portion as a part of the circumference when viewed from the opening direction of the rotation shaft hole portion. The diameter is formed so as to be larger than the distance between the pair of hole side tapered surfaces in the engagement hole.

  In this configuration, since the outer diameter of the rotating shaft portion of the flattening device can be efficiently increased within a limited space, the rotating shaft portion of the flattening device can be shaped so as not to be damaged.

  (7) Preferably, the bottom portion of the rotation shaft hole portion is formed at a position lower than the bottom portion of the engagement hole portion.

  According to this configuration, a circumferential wall having a circular cross section perpendicular to the axis is formed in a portion of the circumferential wall of the rotation shaft hole portion on the bottom side of the rotation shaft hole portion. Thereby, since the flattening instrument can be rotated with the circumferential wall surrounding the outer periphery of the rotation shaft portion, the flattening device can be smoothly rotated without rattling of the rotation shaft portion of the flattening device.

  (8) Preferably, the surgical instrument for a hip prosthesis further includes the flattening instrument having the rotation shaft portion inserted into the rotation shaft hole portion.

  With this configuration, it is possible to provide a surgical instrument for a hip prosthesis including a flattening instrument that flattens an opening peripheral edge of a stem hole.

  ADVANTAGE OF THE INVENTION According to this invention, the surgical instrument for artificial hip joints provided with the broach handle which can hold | grip a broach with high holding force can be provided.

It is a figure which shows the usage condition of a broach and a broach handle among the broach systems which concern on embodiment of this invention. It is a figure which shows the usage condition of a calcare reamer among the broach systems which concern on embodiment of this invention. FIG. 3A is a perspective view of the broach, and FIG. 3B shows the shape of the broach hole from the direction of arrow IIIB in FIG. 3A. FIG. 3 and FIG. 3C are cross-sectional views taken along the line IIIC-IIIC in FIG. 3B, showing the cross-sectional shape of the broach hole. FIG. 4A is a perspective view of the broach handle, and FIG. 4B is an engagement convex portion when viewed from the direction of arrow IVB in FIG. 4A. FIG. FIG. 5A is a partial cross-sectional view of the broach handle, and FIG. 5A is a view showing a state where the lever is pulled up, and FIG. 5B is a view showing a state where the lever is pushed. It is a perspective view of Calcarreamer. It is a perspective view which shows the state of a broach handle and a broach at the time of fixing a broach with respect to a broach handle. It is a figure for demonstrating the engagement state of an engagement convex part and a broach hole. It is a figure which shows the usage aspect of a calcare reamer, Comprising: It is the figure which looked at the calcare reamer in the state by which the rotating shaft part was inserted in the hole for rotating shafts of the broach driven into the femur from the side. (A)-(C) is a figure which shows the shape of the broach hole which concerns on a modification, respectively, Comprising: It is the figure which looked at the broach hole from the opening direction.

  Hereinafter, embodiments for carrying out the present invention will be described with reference to the drawings. The present invention is widely applicable to broach systems (surgical instruments for artificial hip joints) for fixing an artificial hip joint to a femur.

  FIG.1 and FIG.2 is a figure for demonstrating the usage aspect of the broach system 1 (surgical instrument for artificial hip joints) which concerns on this embodiment. As shown in FIGS. 1 and 2, the broach system 1 according to the present embodiment includes a broach 2, a broach handle 10, and a calcare reamer 30 (a flattening device). In FIG. 1, a usage mode of the broach 2 and the broach handle 10 is illustrated in the broach system 1, and a usage mode of the calcare reamer 30 in the broach system 1 is illustrated in FIG. 2.

  With reference to FIG.1 and FIG.2, the outline of the usage method of the broach system 1 is demonstrated first. The broach system 1 is used to form a stem hole for attaching a stem (not shown) of an artificial hip joint at the proximal end 101 of the femur 100. At this time, the broach 2 is driven into the femur 100 and a hole formed by extracting the broach 2 from the femur 100 is used as a stem hole. The broach system 1 is used for the femur 100 in a state where a temporary hole for inserting the broach 2 is formed in the osteotomy section 102 from which the greater trochanter has been excised.

  First, the operator engages the broach 2 with the broach handle 10, and in this state, brings the tip of the broach 2 into contact with the opening of the temporary hole of the osteotomy section 102. Next, in this state, the surgeon strikes the rear end portion of the broach handle 10 (the portion of the broach handle 10 opposite to the side where the broach 2 is engaged) with a hammer or the like. Accordingly, the broach 2 is inserted into the medullary cavity while cutting the temporary hole (see FIG. 1), and a stem hole is formed in the medullary cavity.

  Next, the surgeon cuts the opening peripheral edge of the hole for stem with the calcare reamer 30 (see FIG. 2). Thereby, the said opening peripheral part can be planarized. Then, the operator removes the broach 2 from the medullary cavity and inserts and fixes the stem into the hole for the stem. Thereby, the stem of the artificial hip joint can be attached to the femur 100.

[Broach system configuration]
Next, the configuration of the broach system 1 will be described. As described above, the broach system 1 includes the broach 2, the broach handle 10, and the calcare reamer 30.

[Broach configuration]
FIG. 3 is a view for explaining the shape of the broach. 3A is a perspective view of the broach 2, and FIG. 3B shows the shape of the broach hole 5 when the broach 2 is viewed from the direction of arrow IIIB in FIG. FIG. 3C is a cross-sectional view taken along the line IIIC-IIIC in FIG. 3B, and shows a cross-sectional shape of the broach hole 5.

  The broach 2 is made of, for example, a metal material that has been approved as a medical device for living body implantation. The broach 2 has a broach body 3 and a plurality of blade portions 4 formed on the outer peripheral surface of the broach body 3. The broach 2 is formed so as to taper from the base end portion 2a toward the tip end portion 2b and to have a substantially arc shape when viewed from the side (in the direction of arrow A in FIG. 3A). Has been. In the following, the left part when viewed from the direction of arrow A in FIG. 3A is referred to as the inside of the broach, and the right part is referred to as the outside of the broach (see FIG. 3A).

  As shown in FIGS. 3A to 3C, a broach hole 5 is formed in the broach 2. The broach hole 5 is a bottomed hole formed in the end surface 2 c on the base end portion 2 a side of the broach 2. The broach hole 5 has a substantially keyhole shape as shown in FIG. Specifically, the broach hole 5 has a shape as viewed from the opening side of the broach hole 5 such that the internal spaces of the substantially rectangular portion 5a and the substantially circular portion 5b communicate with each other. It has become. In the broach hole 5, a substantially circular portion 5b is formed inside the broach 2, and a substantially rectangular portion 5a is formed outside the broach.

  The substantially rectangular portion 5 a formed in the broach hole 5 is provided as an engagement hole 6. The engaging projections 14 of the broach handle 10, which will be described in detail later, are engaged with the engaging holes 6.

  A first inner wall surface 6 a and a pair of hole side taper surfaces 6 b and 6 b are formed on the inner wall of the engagement hole portion 6. As shown in FIG. 3B, the first inner wall surface 6a is provided as a surface facing the substantially circular portion 5b in the broach hole 5.

  The pair of hole side taper surfaces 6b, 6b is formed of a pair of flat surfaces extending so as to gradually approach each other from the first inner wall surface 6a toward the substantially circular portion 5b. Each hole side taper surface 6b corresponds to each of the pair of convex side taper surfaces 15b, 15b formed on the engaging convex portion 14 of the broach handle 10 as will be described in detail later.

Further, the circular portion 5 b formed in the broach hole 5 is provided as a rotation shaft hole 7. An inner peripheral wall 7 a formed in an arc shape when viewed from the opening direction of the rotation shaft hole 7 (the direction of arrow IIIB in FIG. 3A) is formed on the inner wall of the rotation shaft hole 7. The inner peripheral wall 7a, the diameter D ₁ of the circle arcs of the circumference of a portion of the inner peripheral wall 7a when viewed from an arrow IIIB direction shown in FIG. 3 (A) is a pair of hole-side tapered surface 6b, It is formed to be larger than the distance D ₂ between 6b. Further, the diameter D ₁ is in detail is slightly larger than the outer diameter of the rotating shaft portion 33 of Karukarima 30 to be described later. That is, the rotation shaft hole 7 is formed to be rotatable in a state where the rotation shaft 33 of the calcare reamer 30 is inserted into the rotation shaft hole 7.

In the broach hole 5, the bottom 7 b of the rotation shaft hole 7 is formed at a position deeper than the bottom 6 c of the engagement hole 6. That is, in the peripheral wall of the rotation shaft hole 7, a peripheral wall 7c having a circular cross section perpendicular to the axis is formed on the bottom 7b side of the rotation shaft hole 7. The outer diameter of the circumferential wall 7c is the same as the diameter D ₁ as described above. A chamfered portion 5 c is formed on the opening peripheral edge of the broach hole 5.

  As shown in FIG. 1, the broach 2 is driven into the femur 100 so that the inner part of the broach 2 is on the inner side of the human body. That is, in the broach 2 in a state of being driven into the femur 100, the engagement hole 6 is positioned on the outer side, and the rotary shaft hole 7 is positioned on the inner side.

  A step 8 is formed at the base end 2 a of the broach 2. The step portion 8 is engaged with a convex portion of a neck trial (not shown). Accordingly, when the neck trial is fixed to the broach 2 in the state of being driven into the femur 100, the neck trial can be easily positioned with respect to the broach 2, and the neck trial can be prevented from rotating with respect to the broach 2. it can.

[Composition of broach handle]
4 and 5 are diagrams for explaining the shape of the broach handle 10. Specifically, FIG. 4 (A) is a perspective view of the broach handle 10 and FIG. 4 (B) shows the engagement convex portion 14 when the broach handle 10 is viewed from the direction of arrow IVB in FIG. 4 (A). It is a figure which shows a shape. 5 is a partial cross-sectional view of the broach handle 10. FIG. 5A shows a state in which the lever 20 is pulled up from the main body 11, and FIG. 5B shows the lever 20 in the main body. It is a figure which shows the state pushed in to the part 11 side. 5A and 5B, only the general shape of the broach handle 10 is shown for portions other than the portion whose cross-sectional shape is shown.

  As shown in FIGS. 4 and 5, the broach handle 10 has a main body portion 11 (handle main body portion), a lever 20 (operation portion), and a link mechanism 22, which are formed by combining them. Yes.

  The main body part 11 includes a straight part 12, an impact plate 13, and an engaging convex part 14.

  The straight line portion 12 is a member formed in a straight line shape. The straight portion 12 is formed with a first slit portion 12a (see FIGS. 5A and 5B) that extends in the same direction as the direction in which the straight portion 12 extends. The link mechanism 22 is accommodated in the first slit portion 12a.

  The impact plate 13 is a member formed in a slightly thick plate shape, and is attached to one end side (rear end side) portion of the linear portion 12. The impact plate 13 is a portion hit by a hammer or the like in order to drive the broach 2 engaged with the broach handle 10 into the femur 100.

  The engaging convex portion 14 is formed integrally with the linear portion 12 on the distal end side of the linear portion 12 (on the opposite side of the linear portion 12 to the portion where the impact plate 13 is attached). The engaging convex portion 14 is formed so as to protrude from the tip side of the linear portion 12.

  The engaging convex portion 14 is formed in a size that can be inserted into the broach hole 5 of the broach 2. Specifically, as shown in FIG. 4B and the like, the engaging convex portion 14 includes a first convex portion 15 that is a portion inserted into the engaging hole portion 6 of the broach hole 5 and the broach hole 5. And a second convex portion 16 which is a portion to be inserted into the rotation shaft hole portion 7, and these are integrally formed.

  A first outer wall surface 15 a and a pair of convex portion side tapered surfaces 15 b and 15 b are formed on the outer wall of the first convex portion 15. The first outer wall surface 15 a is provided as a surface facing the first inner wall surface 6 a of the broach hole 5 in a state where the engaging convex portion 14 is inserted into the broach hole 5.

  The first outer wall surface 15 a is formed with a second slit portion 17 that extends between the first outer wall surface 15 a and the straight portion 12. The second slit portion 17 accommodates a protruding portion 24c of the second link member 24 described later in detail.

  A pair of convex part side taper surface 15b, 15b is comprised by a pair of flat surface extended so that it may mutually approach gradually toward the 2nd convex part 16 side from the 1st outer wall surface 15a. Each convex side taper surface 15 b corresponds to each of a pair of hole side tapered surfaces 6 b and 6 b formed in the broach hole 5.

  The second convex portion 16 is a portion formed in a substantially columnar shape, and is formed in a size that can be inserted into the rotation shaft hole portion 7 of the broach hole 5.

  The lever 20 is rotatably connected to the main body 11 via the first connecting pin 21. The lever 20 has a force point portion 20a, a fulcrum portion 20b, and an action point portion (not shown), which are integrally formed.

  The force point portion 20a is formed in an elongated and substantially plate shape, and is provided as a portion operated by an operator. The force point portion 20a is disposed outside the first slit portion 12a. The force point portion 20a is grasped by the operator and functions as a grasping portion 20a for pushing and pulling up the lever 20.

  Both the fulcrum portion 20b and the action point portion are accommodated in the first slit portion 12a. The fulcrum portion 20 b is provided as a portion that is rotatably connected to a portion on the impact plate 13 side in the linear portion 12 by the first connecting pin 21. The action point portion is provided as a portion to which one end side of the first link member 23 of the link mechanism 22 is connected.

  The link mechanism 22 is accommodated in the first slit portion 12a. The link mechanism 22 has a first link member 23 and a second link member 24. The link mechanism 22 is configured such that a protrusion 24 c formed on the second link member 24 advances and retreats from the main body 11 when the lever 20 is operated.

  Although only a part of the first link member 23 is shown in FIG. 5, the first link member 23 is formed in a substantially straight shape and is accommodated in the first slit portion 12 a so as to extend along the straight portion 12. One end portion (end portion on the impact plate 13 side) of the first link member 23 is rotatably connected to the operating point portion of the lever 20 by a second connecting pin (not shown). On the other hand, the other end portion (the end portion on the engagement convex portion 14 side) of the first link member 23 is rotatably connected to the second link member 24 by a third connection pin (not shown).

  Although only a part of the second link member 24 is shown in FIG. 5, the second link member 24 is formed in a slightly long piece shape in one direction, and is accommodated in a portion of the first slit portion 12 a on the engaging convex portion 14 side. ing.

  One end of the second link member 24 is provided as a force point portion (not shown), and is rotatably connected to the other end of the first link member 23 by the third connecting pin as described above.

  A midway portion in the longitudinal direction of the second link member 24 is provided as a fulcrum portion 24 b and is rotatably connected to a portion on the engagement convex portion 14 side of the linear portion 12 by a fourth connecting pin 27.

  The other end of the second link member 24 is provided as an action point portion 24c. The action point portion 24c is constituted by the protruding portion 24c protruding from the fulcrum portion 24b. Further, the action point portion 24 c is a pressing portion 28 for pressing the engaging convex portion 14 inserted in the broach hole 5 toward the rotation shaft hole 7 side (pressing direction side) in the broach hole 5. It is provided as.

[Configuration and operation of pressing mechanism]
The broach system 1 includes a pressing mechanism 9. The pressing mechanism 9 includes the lever 20, the link mechanism 22, and the pressing portion 28 described above.

  The pressing mechanism 9 operates when the operator operates the grip 20a of the lever 20. Specifically, in the pressing mechanism 9, when the grip 20a of the lever 20 is pulled up, the rear end of the first link member 23 is also lifted. Then, since the second link member 24 rotates in the clockwise direction in FIG. 5 around the fulcrum portion 24b, the pressing portion 28 (the action point portion 24c and the protruding portion 24c) is accommodated in the first slit portion 12a. And retreats (see FIG. 5A).

  On the other hand, in the pressing mechanism 9, when the grip portion 20a of the lever 20 is pushed, the rear end portion of the first link member 23 is also pushed into the first slit portion 12a. Then, since the second link member 24 rotates in the counterclockwise direction in FIG. 5 around the fulcrum portion 24b, the second link member 24 advances so that the pressing portion 28 is exposed to the outside from the inside of the first slit portion 12a (FIG. 5 (B)). Accordingly, when the lever 20 is pushed in as described above in a state where the engaging convex portion 14 is inserted into the broach hole 5, the engaging convex portion 14 is pressed toward the pressing direction in the broach hole 5, and the engaging convex portion 14 is firmly fixed to the broach hole 5.

[Composition of Calcarreamer]
FIG. 6 is a perspective view of the calcare reamer 30. The calcare reamer 30 includes a shaft portion 31, a reamer main body portion 32, and a rotating shaft portion 33.

  The shaft portion 31 and the reamer main body portion 32 are integrally formed of, for example, a metal material. The shaft portion 31 is a portion formed in a round bar shape. The reamer main body 32 is a portion formed in a substantially disc shape that is concentrically arranged with the shaft portion 31, and is provided at a portion on one end side of the shaft portion 31. The reamer main body 32 is formed with a plurality of blade portions 32 a protruding to the opposite side of the shaft portion 31 in the axial direction of the shaft portion 31.

The rotating shaft portion 33 is a member formed in a round bar shape. The rotary shaft portion 33 is fixed to the shaft portion 31 and the reamer main body portion 32 by being press-fitted into a fitting hole that extends through the central axis of the reamer main body portion 32 and extends to a midway portion in the axial direction of the shaft portion 31. Is done. The outer diameter of the rotating shaft 33 is slightly smaller than the diameter D _{1 of} the rotating shaft hole 7 formed in the broach 2. Accordingly, the calcare reamer 30 can rotate with respect to the broach 2 in a state where the rotary shaft portion 33 is inserted into the rotary shaft hole portion 7.

[How to use the broach system]
7 to 9 are diagrams for explaining a method of using the broach system 1. Specifically, FIG. 7 is a perspective view illustrating a state of the broach handle 10 and the broach 2 when the broach 2 is fixed to the broach handle 10, and FIG. 8 is a diagram illustrating the engagement convex portion 14 and the broach hole. FIG. 9 is a view illustrating a usage state of the calcare reamer 30, in which the rotation shaft is inserted into the rotation shaft hole 7 of the broach 2 driven into the femur 100. It is the figure which looked at the calcare reamer 30 of the state in which the part 33 was inserted from the side. A method of using the broach system 1 will be described in detail with reference to FIGS. In FIG. 8, the chamfered portion 5c illustrated in FIG. 3B is not illustrated.

  First, the surgeon engages the broach 2 with the broach handle 10. Specifically, the operator inserts the engaging convex portion 14 of the broach handle 10 into the broach hole 5 with the lever 20 of the broach handle 10 pulled up (see FIG. 7). In the state where the lever 20 is pulled up, the pressing portion 28 of the second link member 24 is retracted to the second slit portion 17 side and is accommodated in the second slit portion 17 (FIG. 5A). )reference).

  Next, the surgeon pushes the lever 20 toward the main body 11 of the broach handle 10. Then, since the pressing portion 28 presses the first inner wall surface 6a of the broach hole 5, the engagement convex portion 14 is pressed against the broach hole 5 in the pressing direction (the direction of the white arrow in FIG. 8). Thereby, each of a pair of convex part side taper surface 15b, 15b in the engagement convex part 14 presses each of a pair of hole side taper surface 6b, 6b in the broach hole 5 (refer FIG. 8). That is, the engaging convex part 14 and the broach hole 5 are fixed to each other by pressing each other with the pair of tapered surfaces 6b, 15b in surface contact with each other. Thereby, since the engagement convex part 14 and the broach hole 5 can be pressed with respect to each other in a state of contact over a wide range, the broach 2 can be firmly fixed to the broach handle 10.

  Next, the operator causes the distal end portion 2b of the broach 2 fixed to the broach handle 10 to abut against the opening of the temporary hole in the osteotomy portion 102 of the femur 100, and in this state, the broach handle 10 Hitting the impact plate 13 with a hammer or the like. Accordingly, the broach 2 is inserted into the medullary cavity while cutting the temporary hole (see FIG. 1), and a stem hole is formed in the medullary cavity.

  Next, the operator pulls up the lever 20 of the broach handle 10 to release the engagement between the broach handle 10 and the broach 2, and then pulls out the broach handle 10 from the broach 2 in a state of being inserted into the medullary cavity.

  Next, the operator sets the reamer main body portion 32 of the calcare reamer 30 with respect to the osteotomy portion 102 by inserting the rotation shaft portion 33 of the calcare reamer 30 into the hole 7 for the rotation shaft of the broach 2 (FIG. 9). reference). In this state, the surgeon rotates the calcare reamer 30 with a reamer driver (not shown) or the like. At this time, the calcare reamer 30 rotates with respect to the osteotomy portion 102 by rotating while rotating the outer peripheral surface of the rotation shaft portion 33 with respect to the inner peripheral wall 7a and the circumferential wall 7c of the rotation shaft hole portion 7. . Thereby, the surface of the osteotomy part 102 can be cut and made flat.

  Then, the operator removes the broach 2 from the medullary cavity and inserts and fixes the stem into the hole for the stem. Thereby, the stem of the artificial hip joint can be attached to the femur 100.

[effect]
As described above, in the broach system 1 according to the present embodiment, the broach 2 is fixed to the broach handle 10 by engaging the engagement convex portion 14 of the broach handle 10 with the broach hole 5. Then, the surgeon strikes the impact plate 13 with a hammer or the like while the tip of the broach 2 is in contact with the proximal end 101 of the femur 100, whereby the broach 2 is driven into the femur 100. Thereby, the stem hole into which the stem of the artificial hip joint is inserted can be formed in the femur 100.

  In the broach system 1, the pressing mechanism 9 presses the engaging convex portion 14 in a state where the engaging convex portion 14 is inserted into the broach hole 5, whereby a pair of convex portions formed on the engaging convex portion 14 side. Each of the taper surfaces 15b and 15b presses each of the pair of hole side taper surfaces 6b and 6b formed in the engagement hole 6. At this time, the engaging convex portion 14 is inserted in a wedge shape with respect to the engaging hole portion 6. Thereby, since the engaging convex part 14 and the engaging hole part 6 are firmly fixed, the broach 2 is gripped by the broach handle 10 with a high gripping force.

  Therefore, the broach system 1 can provide a broach system including the broach handle 10 that can grip the broach 2 with a high gripping force.

  Further, in the broach system 1, by operating the lever 20, the engagement convex portion 14 inserted into the engagement hole 6 can be pressed against the engagement hole 6 by the pressing portion 28. . Thereby, the broach 2 can be firmly fixed to the broach handle 10.

  Further, in the broach system 1, after the broach 2 is driven into the femur 100 to form a hole for the stem, the rotation shaft portion 33 is inserted into the rotation shaft hole 7 of the broach 2 in that state, and the rotation is performed. By rotating the calcare reamer 30 around the shaft portion 33, the opening peripheral edge portion of the stem hole portion can be flattened. That is, according to the broach system 1, when the calcare reamer 30 is used, another member (for example, an adapter attached to the broach) that rotatably supports the rotating shaft portion 33 of the calcare reamer 30 is not necessary. Therefore, the number of parts constituting the broach system can be reduced. Moreover, in the broach system 1, it becomes possible to easily form a flat surface having a desired inclination angle at the peripheral edge of the opening of the stem hole.

  Moreover, in the broach system 1, since the engagement convex part 14 can be formed by integrating two convex parts (the 1st convex part 15 and the 2nd convex part 16), it is efficient in the limited space. The engagement convex part 14 can be enlarged well. Thereby, the engagement convex part 14 can be made into the shape which is hard to damage.

  Further, in the broach system 1, the rotation shaft hole 7 is formed on the inner side of the human body than the engagement hole 6 in the broach 2 in a state of being driven into the proximal end 101 of the femur 100. In this way, the calcare reamer 30 can be rotated on the inner side of the human body at the proximal end 101 of the femur 100. Thereby, the part inside the proximal end 101 of the femur 100 can be flattened without removing the calcare reamer 30 from the broach 2 and avoiding interference between the calcare reamer 30 and the greater trochanter. Accordingly, no uncut residue is generated on the inner side of the proximal end 101 of the femur 100, and the proximal end of the femur can be easily flattened as a whole.

Further, in the broach system 1, the rotation shaft hole portion 7 is a part of the circumference of the circular arc of the inner peripheral wall 7 a of the rotation shaft hole portion 7 when viewed from the opening direction of the rotation shaft hole portion 7. the diameter D ₁ of the circle is, the pair of holes side tapered surface 6b of the engagement holes 6, is formed to be larger than the distance D ₂ between 6b. If it carries out like this, since the outer diameter of the rotating shaft part 33 of the calcare reamer 30 can be enlarged efficiently in the limited space, the rotating shaft part 33 of the calcare reamer 30 can be made into a shape which is hard to be damaged.

  In the broach system 1, the bottom 7 b of the rotation shaft hole 7 is formed at a position deeper than the bottom 6 c of the engagement hole 6. That is, a circumferential wall 7 c having a circular cross section perpendicular to the axis is formed on the bottom wall 7 b side of the circumferential wall of the rotation shaft hole 7. Thereby, since the calcare reamer 30 can be rotated with the circumferential wall 7c surrounding the outer periphery of the rotary shaft portion 33, the calcare reamer 30 can be smoothly rotated without rattling of the rotary shaft portion 33 of the calcare reamer 30.

  Moreover, in the broach system 1, the surgical instrument for artificial hip joints provided with the calcare reamer 30 which flattens the opening peripheral part of the hole part for stems can be provided.

  Although the embodiments of the present invention have been described above, the present invention is not limited to the above-described embodiments, and various modifications are possible as long as they are described in the claims. For example, the following modifications may be made.

[Modification]
(1) FIG. 10 (A) is a view showing the shape of the broach hole 40 of the broach according to the modification, and is a view corresponding to FIG. 3 (B). In the said embodiment, although the broach system 1 provided with the calcare reamer 30 was illustrated, it is not restricted to this, You may comprise the broach system by which the calcare reamer was abbreviate | omitted. In this case, as shown in FIG. 10 (A), the shape of the broach hole 40 may be a shape in which the rotation shaft hole 7 in FIG. 3 (B) is omitted. In this case, the shape of the engagement convex portion of the broach handle may be a shape corresponding to the shape of the broach hole 40 shown in FIG.

(2) FIG. 10 (B) is a diagram showing the shape of the broach hole 41 of the broach according to the modification, and is a diagram corresponding to FIG. 3 (B). In the above embodiment, the diameter D ₁ in the rotation shaft hole portion 7, a pair of holes side tapered surface 6b, but is larger than the distance D ₂ of 6b, not limited thereto, shown in FIG. 10 (B) as such, the diameter D ₃ of the rotary shaft hole portion 42, a pair of holes side tapered surface 6b, may be smaller than 6b distance D ₄ of.

  (3) FIG. 10 (C) is a diagram showing the shape of the broach hole 43 of the broach according to the modification, and is a diagram corresponding to FIG. 3 (B). In the above embodiment, the broach hole 5 is formed so that each of the internal spaces of the engagement hole 6 and the rotary shaft hole 7 communicate with each other. However, the present invention is not limited to this, as shown in FIG. In addition, the engagement hole 44 and the rotary shaft hole 45 may be formed separately.

  The present invention can be widely applied as a surgical instrument for an artificial hip joint for fixing an artificial hip joint to a femur.

1 Brooch system (surgical instrument for artificial hip joints)
2 Broach 6 Engagement hole 6b Hole side taper surface 9 Pressing mechanism 10 Broach handle 11 Body (handle body)
14 Engaging convex part 15b Convex part side taper surface 20 Calcare reamer (flattening device)
100 femur 101 proximal end of femur

Claims (6)

A broach that is driven into the femur to form a hole for a stem into which the stem of an artificial hip joint fixed to the proximal end of the femur is inserted, and an engagement hole formed in the broach A broach handle having a handle main body portion formed with an engaging convex portion to be engaged with the surgical instrument for a hip prosthesis,
A pair of convex side taper surfaces approaching each other from one side to the other side in the direction intersecting the protruding direction of the engaging convex part is formed on the outer wall of the engaging convex part,
A pair of hole side taper surfaces corresponding to the pair of convex part side taper surfaces are formed on the inner wall of the engagement hole part,
The broach handle is configured to press the engaging convex portion toward the pressing direction which is a direction from the one side to the other side in a state where the engaging convex portion is inserted into the engaging hole portion. A pressing mechanism that presses the pair of convex side taper surfaces against the pair of hole side tapered surfaces ,
The rotary shaft portion is inserted into the broach so that a flattening tool that rotates or flattenes the peripheral edge of the opening of the stem hole by rotating about the rotational shaft portion can rotate. A rotating shaft hole is formed,
The rotation shaft hole and the engagement hole are formed so that the internal spaces of the holes communicate with each other when viewed from the opening direction of the holes,
The engaging convex part is formed by integrating a first convex part inserted into the engaging hole part and a second convex part inserted into the rotary shaft hole part. Surgical instrument for artificial hip joints. The surgical instrument for an artificial hip joint according to claim 1,
The pressing mechanism is
An operating portion that is displaced with respect to the handle body portion;
A pressing part that presses the engaging convex part inserted into the engaging hole part toward the pressing direction side with respect to the engaging hole part by operating and displacing the operating part,
A surgical instrument for an artificial hip joint, characterized by comprising: The surgical instrument for a hip prosthesis according to claim 1 or 2 ,
The rotation shaft hole portion is formed on the inner side of the human body with respect to the engagement hole portion in the broach in a state of being driven into the proximal end of the femur. Surgical instruments. The surgical instrument for an artificial hip joint according to claim 3 ,
The rotation shaft hole portion has a diameter of a circle having an arc of an inner wall of the rotation shaft hole portion as a part of a circumference when viewed from the opening direction of the rotation shaft hole portion. A surgical instrument for a hip prosthesis, wherein the surgical instrument is formed so as to be larger than a distance between the pair of hole side taper surfaces in the portion. The surgical instrument for an artificial hip joint according to any one of claims 1 to 4 ,
The surgical instrument for an artificial hip joint, wherein a bottom portion of the rotation shaft hole portion is formed at a position lower than a bottom portion of the engagement hole portion. The surgical instrument for an artificial hip joint according to any one of claims 1 to 5 ,
The surgical instrument for a hip prosthesis, further comprising the flattening device having the rotating shaft portion inserted into the rotating shaft hole portion.

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