JP6751687B2 - Drill guide equipment and drill guide system - Google Patents

Description

The present invention relates to a drill guide device for guiding a drill that drills into a bone when an implant member is placed in the body.

Conventionally, an implant member is arranged in the body in order to connect the fractured bones to each other and to correct the posture of the bones. For example, when fixing a fractured part of a long bone such as a femur, a tibia, a humerus, and a radius including a fractured part around a joint, a plate-shaped plate (bone plate) is used as an implant member. This plate includes a main body that is applied to the trunk of the long bone and a head that is applied to the distal end of the long bone, and holes (screw receivers) for receiving screws in each of the main body and the head. Hole) is formed.

When the plate is fixed to the long bone with a screw, it is common that a hole into which the screw is inserted is previously drilled in the bone by a drill (bone drill). The method of perforating the bone is, for example, temporarily fixing the plate at a predetermined position of the bone and fixing the drill guide device (guide block) to the head portion of the plate. The guide block is provided with guide holes at positions corresponding to a plurality of screw receiving holes provided in the head portion of the plate. The guide hole is a hole (guide hole) for guiding a cylindrical drill guide through which the drill is inserted. Then, with the drill guide inserted in the guide hole, the drill is inserted into the drill guide and the bone is pierced through the screw receiving hole of the plate.

Here, it is desirable that the screw for fixing the bone can be fixed to the plate at various angles so that the fractured portion can be appropriately fixed according to the state of the fracture. Therefore, the guide hole of the guide block is configured so that the drill guide can arbitrarily displace the angle with respect to the guide hole over the entire area in the circumferential direction (see, for example, Patent Document 1).

More specifically, the guide hole of the guide block is provided so as to penetrate from the first surface on the side (inner side) that abuts the plate to the second surface on the opposite side (outside), and in the first surface. The hole shape is a circle larger than the diameter of the drill guide, and the hole shape on the second surface is a truncated cone shape having a circle with a diameter larger than the hole shape on the first surface. Then, when the drill guide is inserted at a position that serves as a reference for insertion into the assumed guide hole, that is, when the central axis C0 of the drill guide is inserted so as to coincide with the central axis of the guide hole, the inner circumference of the guide hole is inserted. The central axis of the drill guide is configured to be able to displace the angle with respect to the guide hole in the entire area in the circumferential direction of the surface.

Japanese Patent No. 49886993

However, in the case of the conventional guide block, the allowable amount of displacement of the angle of the central axis of the drill guide with respect to the guide hole becomes too large, and it may be difficult to contribute to the reduction of the work load of the doctor.

That is, from the viewpoint of allowing the screw to be inserted into the plate at various angles, the displacement of the angle of the central axis of the drill guide in the entire area in the circumferential direction of the hole (from the reference position where the insertion of the drill guide is assumed). It is desirable to allow angular displacement), but on the other hand, interference between the inserted screws must be avoided.

In many cases, it is sufficient for the screw insertion angle to allow displacement only within a predetermined range. In such a case, if the allowable amount of angular displacement of the drill guide in the guide hole is too large, the screw is inserted. There is also an increased possibility that the screws will interfere with each other. In other words, it may be necessary to pay more attention to the interference between the screws than necessary, which may not help the doctor to reduce the work load.

In view of such circumstances, the present invention aims to provide a drill guide device capable of avoiding interference between screws and reducing the work load of a doctor while allowing necessary angular displacement of the drill guide.

Through the diligent research of the present inventors, the above object is achieved by the following means.

The present invention that achieves the above object is (1) a drill guide device for guiding a drill to be drilled into a bone when disposing an implant member in a body, and a position corresponding to a hole of the implant member. Has a plurality of guide holes through which the drill guide instrument is inserted from the first surface to the second surface and into which the drill guide through which the drill is inserted can be inserted, and at least one of the plurality of guide holes is deformed. It is a guide hole, and the deformation guide holes have different sizes of a plurality of cross sections perpendicular to the central axis of the holes, and the first of the displacements of the insertion angle in the first direction of the drill guide by the deformation guide holes . The drill guide instrument is characterized in that the permissible amount of is larger than the second permissible amount of displacement of the insertion angle in a second direction different from the first direction .

(2) The present invention is also the drill guide instrument according to (1) above, wherein the second permissible amount is approximately 0 ° .

(3) The present invention is also the drill guide instrument according to the above (1) or (2), wherein the first allowable amount is 10 ° to 20 ° .

(4) The present invention is also the drill guide instrument according to any one of (1) to (3) above, characterized in that a plurality of the deformation guide holes having different hole shapes are provided .

(5) The present invention is also the drill guide instrument according to any one of (1) to (4) above, wherein the deformation guide hole has a truncated cone shape .

(6) The present invention is also a drill guide system including an implant member and the drill guide device according to any one of (1) to (5) above.

According to the hole structure of the present invention, it is possible to provide a drill guide instrument that can avoid interference between screws and reduce the work load of a doctor while allowing the necessary angular displacement of the drill guide.

It is an external view which shows the guide block which concerns on embodiment of this invention, is (A) one side front view, (B) the other side front view, (C) side view, (D) perspective view. (A) Partial front view and (B) to (G) sectional views showing an enlarged drill guide hole. (A) is a front view of a guide block, and (B) to (I) are sectional views showing enlarged drill guide holes. It is a front view which shows the modification of the guide hole. It is a figure explaining the use example of a guide block. It is a figure explaining the use example of a guide block. It is a figure explaining the use example of a guide block. It is a figure explaining the use example of a guide block. It is a perspective view which shows the plate member. It is a perspective view which shows the same hole structure of a plate member enlarged. (A) is a front view of the same hole structure, (B) is a bottom view of the same hole structure, (C) is a sectional view taken along the line CC in (A), and (D) is an arrow DD in (A). FIG. 5 (E) is a sectional view taken along line EE in (A). (A) is an enlarged front view showing a part of the hole structure, and (B) is a cross-sectional view taken along the line BB in (A). It is (A) front view and (B) sectional view which shows the formation process of the same hole structure. It is (A) front view, (B) sectional view, (C) front view which shows the formation process of the same hole structure. Both (A) and (B) are front views showing a process of forming the same hole structure. Both (A) and (B) are front views showing a process of forming the same hole structure. (A) and (B) are both a front view and a side view showing a screw used when fixing the plate member. It is sectional drawing which shows the hole structure of the mutual coaxial state, and the screwed state of a 2nd screw. (A) front view showing the hole structure in a mutually inclined state and the screwed state of the second screw, (B) is a cross-sectional view taken along the line BB in (A), and (C) is an arrow CC in (A). It is a cross-sectional view. (A) is a front view, (B) is a cross-sectional view taken along the line BB in (A), and (C) is a cross-sectional view taken along the line CC in (A), which is another configuration example of the same hole structure. Both (A) and (B) are cross-sectional views showing a screwed state between the hole structure and the second screw, which are other configuration examples.

Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. In this embodiment, as an implant member, a plate (bone plate) used for fixing a fractured portion of a long bone such as a femur, a tibia, a humerus, and a radius is illustrated, and a drill for drilling into the bone is illustrated. A guide block is illustrated as a drill guide device for guiding the bone. Further, a case where a screw is used as the male screw member for fastening the plate will be illustrated.

<Overall explanation>
1A and 1B are views showing the drill guide instrument (guide block) 100 of the present embodiment, FIG. 1A is a front view of one side of the appearance of the guide block 100, and FIG. 1B is an external view. It is a front view of the other side, the figure (C) is a side view, and the figure (D) is an external perspective view.

The drill guide device (guide block) 100 of the present embodiment is attached to the plate 10 when fixing the fractured portion with the plate 10 (see FIG. 5 (B)), and the direction of the drill guide for guiding the drill to be drilled into the bone. It makes it easy to attach.

The details of the plate 10 will be described later, but a plurality of holes (insertion holes) having a surface in contact with the bone and a surface facing away from the bone and receiving the male screw member (screw) are formed between these two surfaces. It is provided.

When a screw is inserted into the insertion hole of the plate to fix it, the long bone is drilled in advance using a drill (bone drill). Then, in order to facilitate the drilling process at the time of this drilling, the guide block 100 is fixed to the plate 10 (head portion 10B) (see FIG. 5C).

FIG. 1A is a front view of the guide block 100 viewed from the outside, FIG. 1B is a front view viewed from the inside, and FIG. 1C is a side surface with the left side as the distal side. FIG. 3D is a perspective view with the upper side on the distal side and the lower side on the proximal side. As used herein, "proximal" means closer to the heart and "distal" means farther from the heart. The "inner side" means the direction toward the center of the body or the center of the bone (the side facing the bone), and the "outer side" means the direction away from the center of the body or the center of the bone (on the bone). The side opposite to the opposite side). In addition, all of the shapes in the following description mean shapes intended in design, and include slight deformation due to processing error.

As shown in FIGS. (A) and (B), the guide block 100 is provided with a plurality of guide holes 103 and 105, and a drill guide for guiding the drill is inserted into the guide holes 103 and 105. This facilitates the orientation of the drill guide (and thus the screw that secures the drill and plate 10).

The guide block 100 has, for example, a substantially trapezoidal shape whose distal side is wider than the proximal side in a plan view, and has a first surface Sf1 facing outward and a second surface Sf2 facing inward. The second surface Sf2 is used so as to face the plate.

As shown in FIG. 3C, in lateral view, the distal end of the guide block 100 faces outward from the proximal end on both the first and second surfaces Sf1 and the second surface Sf2. It is in a high position, and is inclined so that the distal side is high and the proximal side is low as a whole. In this example, both the first surface Sf1 and the second surface Sf2 are not flat surfaces but have a small curvature, and the curvature is also a curved surface that is slightly displaced depending on the portion. Depending on the part of the guide block 100 other than the distal end and the proximal end, the proximal side is outside the first surface Sf1 (the same applies to the second surface Sf2) than the distal side. There may be a part that is inclined so that it is in a high position toward.

A plurality of guide blocks 100 penetrate from the first surface Sf1 to the second surface Sf2 at positions corresponding to the insertion holes 12 (12A to 12H, see FIG. 5B) of the head portion 10B of the plate 10. Guide holes 103 and 105 (for example, eight guide holes 105A to 105F, 103A and 103B) are provided. A drill guide can be inserted into the guide holes 103 and 105, and a drill for drilling into the bone is inserted inside the drill guide in the axial center direction. The distance (that is, the thickness of the guide block 100) DD between the first surface Sf1 and the second surface Sf2 is larger than the thickness of the head portion 10B (for example, 5 mm or more), and the guide holes 103 and 105 depend on the depth and shape thereof. The drill guide can be oriented.

In this example, the guide holes 103 and 105 are provided with four guide holes 103 and 105 on the distal side (guide holes 105A to 105D) and four guide holes 103 and 105 on the proximal side (guide holes 105E, 103A, 103B and 105F). The size of the plate 10) is appropriately selected according to the shape and size of the long bone to be fixed and the state of the fracture. That is, the shape of the guide block 100 is not limited to the illustrated example of this embodiment. Further, the number and arrangement of the guide holes 103 and 105 also differ depending on the shape and size of the guide block 100, and are not limited to the illustrated examples.

A part of the plurality of guide holes 103 and 105 of the present embodiment is the first guide hole 103. The first guide hole 103 is, for example, a normal (conventional) guide hole 103 formed in a truncated cone shape, and the other part is a second guide hole 105 different from the first guide hole 103. Is. More specifically, the first guide hole (ordinary guide hole) 103 in the present embodiment means that when the drill guide is inserted, the drill guide has a reference position for insertion (hereinafter referred to as an insertion reference position). A guide hole that is configured so that the insertion angle cannot be displaced, or a guide hole that is configured so that the insertion angle of the drill guide can be displaced with respect to the insertion reference position over the entire area in the circumferential direction of the hole. is there.

Here, the "insertion reference position" of the drill guide is a position that serves as a reference for inserting the drill guide assumed in the guide holes 103 and 105 into the guide holes 103 and 105. The insertion reference position is, for example, a position corresponding to the insertion hole 12 formed in the plate 10 to which the guide block 100 is attached. More specifically, the central axis of the insertion hole 12 of the plate 10 and the central axis of the drill guide are The position where the drill guide is inserted so that it matches.

In the example of the figure, the two guide holes 103A and 103B from the center of the long bone in the lateral direction (width direction of the guide block 100) on the proximal side are the first guide holes 103. The first guide hole 103 is a guide hole in which the shape of the guide hole is cylindrical in this example (the cross section perpendicular to the central axis of the guide hole is circular), and in the following description, the first guide hole 103 is circular. It will be described as a guide hole 103.

On the other hand, in the second guide hole 105 in the present embodiment, at least one of the cross sections perpendicular to the central axis of the guide hole displaces the insertion angle of the drill guide only in a part of the entire region in the circumferential direction of the hole. It is a guide hole having a cross section having a displacement allowable guide region 102 that allows the displacement. Hereinafter, the cross section having the displacement allowable guide region 102 will be referred to as a guide cross section G.

The displacement allowable guide region 102 is an region that allows displacement of the insertion angle of the drill guide, but allows the allowable displacement amount to be biased (non-uniformly displaced) in the circumferential direction of the guide hole and guides the drill guide.

Alternatively, the displacement allowable guide region 102 is an region that allows displacement of the insertion angle of the drill guide, but limits (regulates) the allowable region to a partial region in the circumferential direction of the hole.

That is, the second guide hole 105 is a drill inserted at the insertion reference position because at least one of the cross sections perpendicular to the central axis of the guide hole is a guide cross section (a cross section having the displacement allowable guide region 102). When the insertion angle of the guide is to be displaced, the allowable amount of displacement (the end of the guide cross section and the distance to contact with the inner wall surface of the hole) is biased in the circumferential direction of the guide hole and becomes non-uniform.

Alternatively, the second guide hole 105 has a guide cross section (a cross section having a displacement allowable guide region 102) at least one of the cross sections perpendicular to the central axis of the guide hole, so that the drill guide is provided at the insertion reference position. When inserted, the insertion angle can be displaced within a predetermined angle only in a part of the peripheral direction of the hole. In the following description, the second guide hole 105 will be referred to as a deformation guide hole 105.

In the example of the figure, the six guide holes excluding the circular guide holes 103A and 103B are the deformation guide holes 105. Specifically, the four guide holes 105A to 105D provided on the distal side and the two guide holes 105E on both ends in the lateral direction (width direction of the guide block 100) of the long bone on the proximal side. 105F is the deformation guide hole 105.

This will be further described with reference to FIG. FIG. 3A is a partial front view of the guide block 100, and FIG. 3B is a cross section of the circular guide hole 103A shown in FIG. AA along the line aa, that is, a hole of the circular guide hole 103A. It is a cross-sectional view in the axial direction including the central axis CC6 of the above, and the figure (C) is a cross-sectional view of the line bb of the figure (B), that is, a cross-sectional view perpendicular to the central axis CC6 of the hole of the circular guide hole 103A. is there. Further, FIG. (D) is a cross-sectional view taken along the line cc of the deformation guide hole 105A shown in the figure (A), that is, a cross-sectional view in the axial direction including the central axis CC1 of the hole of the deformation guide hole 105A. FIGS. (E) to (G) are cross sections of the dd line, the ee line, and the ff line in the figure (D), that is, perpendicular to the central axis CC1 of the hole of the deformation guide hole 105A. It is a sectional view.

As shown in FIGS. (A) to (C), the circular guide hole 103A has a cylindrical shape, and is located on the central axis CC6 of the hole in the immediate vicinity of the first surface Sf1 and in the immediate vicinity of the second surface Sf2. Both the vertical cross-sectional shape and the cross-sectional shape between the first surface Sf1 and the second surface Sf2 in the direction of the central axis CC6 of the hole are circular shapes having the same diameter. The circular guide hole 103A has a diameter slightly larger than that of the drill guide so that the drill guide can be inserted and the displacement of the insertion angle is not allowed. That is, the shape of the circular guide hole 103A is configured to substantially coincide with the insertion reference position BP of the drill guide (shown by a broken line in FIG. 3C). That is, when the drill guide is inserted into the circular guide hole 103A, the central axis CC6 of the hole and the central axis C0 of the drill guide are oriented in one specific direction (insertion angle) that coincides with each other, and the circular guide hole 103A (the circular guide hole 103A) The insertion angle of the drill guide cannot be displaced while it is inserted at the insertion reference position BP).

On the other hand, as shown in FIGS. (D), (E), and (G), the deformation guide hole 105A is formed on the first surface Sf1 of the cross section perpendicular to the central axis CC6 of the hole. The hole shape in the closest cross section (including a part of the first surface Sf1) and the cross section closest to the second surface Sf2 (including a part of the second surface Sf2), that is, perpendicular to the central axis CC1 of the hole. The shape of the cross section is an oval (or elliptical (the same applies hereinafter)) shape. The oval in the cross section closest to the first surface Sf1 (first oval LC1) is larger in size than the oval in the cross section closest to the second surface Sf2 (second oval LC2). Specifically, the length LA1 of the major axis of the first ellipse LC1 is longer than the length LA2 of the major axis of the second ellipse LC2, and the length SA1 of the minor axis of the first ellipse LC1 is It is the same as the length SA2 of the minor axis of the second ellipse LC2.

Further, as shown in FIG. 3F, the deformation guide hole 105A has a cross-sectional shape perpendicular to the central axis CC1 of the guide hole (a cross section between the first surface Sf1 and the second surface Sf2 in the central axis direction of the hole). Shape) is also an oval. The oval (third oval LC3) in the cross section is smaller than the first oval LC1 and larger than the second oval LC2. Specifically, the length LA3 of the major axis of the third ellipse LC3 is longer than the length LA2 of the major axis of the second ellipse LC2, and the length LA1 of the major axis of the first ellipse LC1. short. Further, the length SA3 of the minor axis of the third ellipse LC3, the length SA1 of the minor axis of the first ellipse LC1, and the length SA2 of the minor axis of the second ellipse LC2 are the same. is there. That is, as shown in FIG. 3C, the hole shape of the deformation guide hole 105A is a truncated cone shape (or an elliptical truncated cone (the same applies hereinafter)) having an elliptical upper surface and a lower surface.

Here, the insertion reference position BP of the drill guide in the deformation guide hole 105A is attached to, for example, the second surface Sf2 side of the guide block 100, as shown by the broken lines in FIGS. (E) to (G). It is a position corresponding to the insertion hole 12 of the plate 10, and more specifically, the central axis of the insertion hole 12 (the center of the head of the screw inserted into the insertion hole 12) coincides with the central axis C0 of the drill guide. The position. Further, in this example, the central axis CC1 of the deformation guide hole 105A and the central axis C0 of the drill guide are configured to coincide with each other.

The deformation guide hole 105A is an insertion hole for the plate 10 so as to allow a substantial inclination of the drill guide even if it has the smallest cross section (cross section on the second surface Sf2 side shown in FIG. It has a shape larger than 12.

Specifically, the first ellipse LC1, the second ellipse LC2, and the third ellipse LC3 in a plurality of cross sections perpendicular to the central axis CC1 of the hole of the deformation guide hole 105A will be any of them in the major axis direction. Also has lengths LA1, LA2, LA3 that are sufficiently larger than the diameter of the drill guide.

On the other hand, the lengths SA1 to SA3 of the minor axis of the first ellipse LC1, the second ellipse LC2, and the third ellipse LC3 are all capable of inserting the drill guide and have a diameter larger than the diameter thereof. It has a slightly larger length (the minimum length required to insert a drill guide). More specifically, the lengths SA1 to SA3 of the minor axis do not interfere with the insertion of the drill guide, but when the inserted drill guide is to be moved (tilted) in the minor axis direction, it comes into contact with the guide hole and moves. Is the regulated length.

That is, when the drill guide is inserted into the insertion reference position BP of the drill guide of the deformation guide hole 105A, the insertion angle of the drill guide is displaced with respect to the insertion reference position BP in the minor axis direction (the insertion hole 12 of the plate 10). The central axis C0 of the drill guide cannot be displaced with respect to the central axis). Strictly speaking, due to the nature of the drill guide, the displacement of the insertion angle is not always zero, but from the viewpoint of the degree of freedom of the insertion angle of the drill guide, it can be said that the displacement cannot be substantially made.

On the other hand, the insertion angle of the drill guide can be displaced to a plurality of positions within a predetermined angle (taper angle of the side surface of the truncated cone) in the long axis direction.

In this way, the drill guide (central axis C0) is limited to the cross section including the long axis of the deformation guide hole 105A (inside the trapezoidal plane (fan-shaped plane) of the truncated cone), and the insertion angle is displaced. It is oriented so that it can be done.

Here, as shown in FIGS. (E) to (G), the cross-sectional shape (first elliptical LC1, second elliptical LC2, third elliptical LC3) perpendicular to the central axis CC1 of the hole. ), The hatched regions outside the insertion reference position BP displace the insertion angle of the drill guide with respect to the insertion reference position BP (in this example, on the central axis of the insertion hole 12 of the plate 10). On the other hand, it is a displacement allowable guide region 102 that allows the central axis C0 of the drill guide to be displaced so as to be inclined.

As described above, the deformation guide hole 105A has an elliptical cross-sectional shape perpendicular to the central axis CC1 of the hole (here, the first ellipse LC1, the second ellipse LC2, and the third ellipse LC3). When these cross-sectional shapes are viewed in a plan view from the central axis CC1 direction of the hole, the insertion angle of the drill guide is set only in a part of the entire region in the circumferential direction of the hole (both ends in the long axis direction). A displacement allowable guide area 102 that allows displacement with respect to the insertion reference position BP is provided. On the other hand, in a region other than the displacement allowable guide region 102 (for example, both ends in the minor axis direction), the displacement of the insertion angle of the drill guide is regulated.

The deformation guide hole 105A is a guide cross section G in which all cross sections perpendicular to the central axis CC1 of the hole are oriented so that the drill guide is limited to a predetermined region and the insertion angle can be displaced.

As shown in FIG. 2C, also in the circular guide hole 103 of the present embodiment, the cross section perpendicular to the central axis CC6 of the hole cannot displace the insertion angle of the inserted drill guide with respect to the insertion reference position BP. To regulate. However, it is not included in the guide cross section G of the present embodiment because it only regulates the displacement of the insertion angle and does not have a region that allows the displacement (displacement allowable guide region 102).

In other words, in the guide cross section G, when the insertion angle of the drill guide inserted at the insertion reference position BP is to be displaced, the allowable amount of displacement (until the end of the guide cross section G comes into contact with the inner wall surface of the hole). Distance) is not uniform in the circumferential direction of the hole.

Specifically, when the drill guide is to be moved in one direction in the guide cross section G (the minor axis direction of each ellipse LC1 to LC3), the end portion of the guide cross section G (inner wall surface of the hole) is immediately moved. ), And the allowable amount (first allowable amount) of the displacement of the insertion angle of the drill guide in the one direction (displacement of the insertion angle with respect to the insertion reference position BP) is almost 0 (as the degree of freedom of the insertion angle). The displacement is almost 0) in a substantial range. On the other hand, the allowable amount of displacement of the insertion angle (second allowable amount) in the other directions in the guide cross section G (the major axis direction of each ellipse LC1 to LC3) is the first allowable amount in the minor axis direction. It is set larger.

With such a configuration, the deformation guide hole 105A can displace the insertion angle of the drill guide when the drill guide is inserted into the insertion reference position BP (for example, the insertion hole 12 of the plate 10). The region where displacement is allowed can be restricted to a part of the entire peripheral region of the hole (in this example, the major axis direction of the oval). That is, the deformation guide hole 105A guides the drill guide so that the insertion angle can be displaced with a predetermined directionality. For example, the insertion angle of the drill guide can be displaced only in the fan-shaped plane including the long axis of the deformation guide hole 105A.

As already described, the guide block 100 of the present embodiment is preferably used in combination with the plate 10 described later. Although details will be described later, the insertion hole 12 of the plate 10 has a hole structure 1 capable of inclining a screw (second screw 30) inserted into the hole (hole 50) with respect to the axial direction of the hole 50. See (FIGS. 18 and 19).

Then, when the guide block 100 of the present embodiment is attached to the plate 10 and the drill guide is inserted into the insertion hole 12 of the plate 10 through the second guide hole 105 of the guide block 100, the drill guide is the insertion reference of the guide hole. The insertion angle can be displaced with respect to the position, that is, the insertion hole 12 of the plate 10. Specifically, the insertion angle of the drill guide is set so as to incline the central axis of the drill guide (insertion angle of the drill guide) from the position where the central axis of the insertion hole 12 of the plate 10 and the central axis of the drill guide coincide with each other. It can be displaced. Further, the region where the insertion angle of the drill guide is displaced can be restricted to a part of the region in the circumferential direction of the guide hole.

As described above, the second guide hole 105 is a guide hole configured so that the insertion of the drill guide has a predetermined directionality and the displacement of the insertion angle is allowed in that direction. Even when the screw (second screw 30) inserted into the insertion hole 12 (hole 50) of 10 is tilted with respect to the axial direction of the hole 50, it is erroneously in an unnecessary direction (for example, the screws interfere with each other). It is possible to prevent drilling in such a direction.

In this example, all the cross sections of the deformation guide hole 105A perpendicular to the central axis CC1 direction are ellipses whose size gradually decreases from the first oval LC1 to the second oval LC2. Although the shape is a truncated cone, the displacement allowable guide region 102 of the present embodiment may be provided in at least one cross section of the cross sections perpendicular to the central axis of the deformation guide hole 105. That is, at least one guide cross section G for directing the drill guide may exist in the central axis direction of the deformation guide hole 105 as long as it has a shape smaller than the shape of the other cross sections. If one of the cross sections (minimum cross section) perpendicular to the central axis of the guide hole is the guide cross section G having the displacement allowable guide region 102, the drill guide can be oriented at the portion of the guide cross section G. ..

Further, the length of the guide hole in the central axis direction contributes to the orientation of the drill guide, and the longer the guide hole (deeper the guide hole), the more reliable the orientation is possible. That is, the formation depth (length along the central axis direction) of the deformation guide hole 105 should be long. Therefore, the deformation guide hole 105 is provided with a displacement allowable guide region 102 in each of a plurality of cross sections separated in the central axis direction of the guide hole (has a plurality of guide cross sections G separated in the central axis direction of the hole). Better if configured.

For example, in the deformed guide hole 105A, the cross section closest to the first surface Sf1 and the cross section closest to the second surface Sf2, which are the farthest from the central axis CC1 direction of the guide hole, are, for example, an oval guide cross section G. , The guide cross section G is an ellipse whose opening size gradually decreases (increases) between both sides in the direction of the central axis CC1 and has a shape in which there is no cross section that hinders orientation between both sides. ing.

The deformation guide holes 105B to 105F other than the deformation guide holes 105A are also deformed except that the size and the shape of the ellipse (the length of the major axis and the minor axis, the depth of the hole, and the inclination angle of the central axis of the hole) are different. The configuration is the same as that of the guide hole 105A. That is, each of the deformation guide holes 105B to 105F has a guide cross section G in which at least one of the cross sections perpendicular to the central axis of the hole has a displacement allowable guide region 102 (for example, the same length as the deformation guide hole 105A). The hole shape of the conical base (the shape of the oval is different) is formed so that the insertion angle of the inserted drill guide is inclined with respect to the insertion reference position BP of the guide hole (for example, of the drill guide). While the central axis C0 can be displaced (so that it is tilted with respect to the central axis of the insertion hole 12 of the plate 10), the region that allows the displacement is a part of the entire circumferential region of the guide hole (this). In the example, it is only in the direction of the long axis of the oval), and it can be regulated so that it cannot be displaced in other areas.

<Method of forming deformation guide holes>
The shape of the deformation guide hole and the method of forming the deformation guide hole will be further described with reference to FIG. The numerical values shown below are examples, and do not limit the present embodiment. FIG. 3 (A) is a front view of the guide block 100 on the first surface Sf1 side, and FIGS. (B) to 3 (I) are the gg line and h- of the same figure (A), respectively. It is sectional drawing of h line, ii line, jj line, kk line, ll line, m line, and nn line.

In the present embodiment, one guide block 100 is provided with, for example, six deformation guide holes 105A to 105F and two circular guide holes 103A and 103B. The six deformation guide holes 105A to 105F are formed in different shapes in order to correspond to the variety of insertion positions and insertion directions of the screws for fixing the plate. Further, as already described, the first surface Sf1 and the second surface Sf2 are surfaces in which a plurality of curved surfaces having a large curvature are mixed, and the thickness (first surface Sf1 and the first surface Sf1 and the first surface Sf2) depends on the portion of the guide block 100. The second surface Sf2) is different. Therefore, by making the formation position and the formation direction of each guide hole different, the depth of the guide hole that contributes to the orientation of the drill guide is also formed to be different.

As shown in FIG. 3B, the deformation guide hole 105A is formed in a shape in which a part of two cylinders (indicated by a thin broken line) having a diameter of 3 mm to 4 mm (for example, 3.56 mm) is overlapped, for example. .. The two cylinders are overlapped so that, for example, their central axes intersect at a virtual reference point P1 and a part of their circumferential surfaces touch each other in the hatched region shown in the figure.

The virtual reference point P1 in this case is, for example, the center point of the insertion hole 12 of the plate 10 corresponding to the deformation guide hole 105A, or the center point of the head of the screw inserted into the insertion hole 12 (screw shaft). Is the center point at which the angle is displaced when the angle can be displaced with respect to the central axis of the insertion hole 12 (the same applies to the following virtual reference points P2 to P6).

The angle formed by the central axis CC1 of the deformation guide hole 105A and the design reference plane pl is β1 (for example, 80 ° to 85 ° (preferably 82 °)). Further, the distance from the intersection (hole reference position) of the reference plane pl and the central axis CC1 of the hole to the virtual reference point P1 is D1 (for example, 5 mm to 6 mm (preferably 5.4 mm)).

The deformation guide hole 105A has a first oval LC1 in a cross section perpendicular to the central axis CC1 of the hole closest to the first surface Sf1, and a cross section perpendicular to the central axis CC1 of the hole closest to the second surface Sf2. The second elliptical LC2 is smaller than the first elliptical LC1, and the hole shape of the truncated cone is such that the first elliptical LC1 and the second elliptical LC2 are the upper surface and the lower surface (or vice versa), respectively. See Figure 2). Further, in this example, the insertion reference position BP of the deformation guide hole 105A is a position corresponding to the insertion hole 12 of the plate 10 corresponding to the deformation guide hole 105A (the central axis C0 of the drill guide and the central axis of the insertion hole 12 coincide with each other). The position to be used is the same as in FIG. 3 below), and the central axis C0 of the drill guide and the central axis CC1 of the guide hole are set to coincide with each other.

As a result, when the drill guide is inserted into the insertion reference position BP of the deformation guide hole 105A (the central axis C0 of the drill guide is aligned with the central axis of the deformation guide hole 105A (the central axis passing through the virtual reference point P1) CC1). In the case of), the central axis C0 of the drill guide is set to a predetermined angle α (distal direction from the central axis CC1) only in the major axis direction of the deformation guide hole 105A with respect to the central axis CC1 of the hole (centered on the virtual reference point P1). It can be displaced at an angle of α / 2 and in the proximal direction (at an angle of α / 2). The predetermined angle α is, for example, 10 ° to 20 ° (preferably, for example, 14 °).

As shown in FIG. 3C, the deformation guide hole 105B also has a shape in which a part of two cylinders (not shown) having a diameter of 3 mm to 4 mm (for example, 3.56 mm) is overlapped like the deformation guide hole 105A. It is formed. The two cylinders are overlapped so that, for example, their central axes intersect at a virtual reference point P2 and a part of their circumferential surfaces touch each other. Here, the virtual reference point P2 is the center point of the head of the screw that is inserted into the hole of the plate corresponding to the deformation guide hole 105B and fixes the plate and the bone, and the deformation guide 105A in the deformation guide hole 105B. It is a reference point corresponding to the virtual reference point P1.

The angle formed by the central axis CC2 of the deformation guide hole 105B and the design reference plane pl is β2 (for example, 70 ° to 80 ° (preferably 75 °)). The distance from the intersection (hole reference position) of the reference plane pl and the central axis CC2 of the hole to the virtual reference point P2 is D2 (for example, 4 mm to 5 mm (preferably 4.1 mm)).

The deformation guide hole 105B has an oval shape in both the cross section perpendicular to the central axis of the hole on the first surface Sf1 and the cross section perpendicular to the central axis of the hole on the second surface Sf2. It has a hole shape of a long truncated cone with upper and lower surfaces. Further, although the plan view of the hole is omitted, the insertion reference position BP of the deformation guide hole 105B is a position corresponding to the insertion hole 12 of the plate 10 corresponding to the deformation guide hole 105B, similarly to the deformation guide hole 105A. The central axis C0 of the drill guide and the central axis CC2 of the guide hole are set to coincide with each other.

As a result, when the drill guide is inserted into the insertion reference position BP of the deformation guide hole 105B (the central axis C0 of the drill guide is the central axis of the deformation guide hole 105B (the central axis passing through the virtual reference point P2) CC2. The central axis C0 of the drill guide can be displaced with respect to the central axis CC2 of the hole only in the long axis direction of the deformation guide hole 105B at a predetermined angle α.

As shown in FIG. 3D, the deformation guide hole 105C also has a shape in which a part of two cylinders (not shown) having a diameter of 3 mm to 4 mm (for example, 3.56 mm) is overlapped like the deformation guide hole 105A. It is formed. The two cylinders are overlapped so that, for example, their central axes intersect at a virtual reference point P3 and a part of their circumferential surfaces touch each other. Here, the virtual reference point P3 is a reference point corresponding to the virtual reference point P1 of the deformation guide 105A in the deformation guide hole 105C.

The angle formed by the central axis CC3 of the deformation guide hole 105C and the design reference plane pl is β3 (for example, 70 ° to 75 ° (preferably 73 °)). Further, the distance from the intersection (hole reference position) of the reference plane pl and the central axis CC3 of the hole to the virtual reference point P3 is D3 (for example, 4 mm to 5 mm (preferably, for example, 4.5 mm)).

The deformation guide hole 105C has an oval shape in both the cross section perpendicular to the central axis of the hole on the first surface Sf1 and the cross section perpendicular to the central axis of the hole on the second surface Sf2. It has a hole shape of a long truncated cone with upper and lower surfaces. Further, although the plan view of the hole is omitted, the insertion reference position BP of the deformation guide hole 105C is a position corresponding to the insertion hole 12 of the plate 10 corresponding to the deformation guide hole 105C, similarly to the deformation guide hole 105A. The central axis C0 of the drill guide and the central axis CC3 of the guide hole are set to coincide with each other.

As a result, when the drill guide is inserted into the insertion reference position BP of the deformation guide hole 105C (the central axis C0 of the drill guide is the central axis of the deformation guide hole 105C (the central axis passing through the virtual reference point P3) CC3. The central axis C0 of the drill guide can be displaced with respect to the central axis CC3 of the hole only in the long axis direction of the deformation guide hole 105C at a predetermined angle α.

As shown in FIG. 3E, the deformation guide hole 105D also has a shape in which a part of two cylinders (not shown) having a diameter of 3 mm to 4 mm (for example, 3.56 mm) is overlapped like the deformation guide hole 105A. It is formed. The two cylinders are overlapped so that, for example, their central axes intersect at a virtual reference point P4 and a part of their circumferential surfaces touch each other. Here, the virtual reference point P4 is a reference point corresponding to the virtual reference point P1 of the deformation guide 105A in the deformation guide hole 105D.

The angle formed by the central axis CC4 of the deformation guide hole 105D and the design reference plane pl is β4 (for example, 75 ° to 85 ° (preferably 80 °)). Further, the distance from the intersection (hole reference position) of the reference plane pl and the central axis CC4 of the hole to the virtual reference point P4 is D4 (for example, 5 mm to 6 mm (preferably 5.3 mm)).

The deformation guide hole 105D has an oval shape in both the cross section perpendicular to the central axis of the hole on the first surface Sf1 and the cross section perpendicular to the central axis of the hole on the second surface Sf2. It has a hole shape of a long truncated cone with upper and lower surfaces. Further, although the plan view of the hole is omitted, the insertion reference position BP of the deformation guide hole 105D is a position corresponding to the insertion hole 12 of the plate 10 corresponding to the deformation guide hole 105D, similarly to the deformation guide hole 105A. The central axis C0 of the drill guide and the central axis CC4 of the guide hole are set to coincide with each other.

As a result, when the drill guide is inserted into the insertion reference position BP of the deformation guide hole 105C (the central axis C0 of the drill guide is aligned with the central axis of the deformation guide hole 105D (the central axis passing through the virtual reference point P4) CC4. In this case), the central axis C0 of the drill guide can be displaced with respect to the central axis CC4 of the hole only in the major axis direction of the deformation guide hole 105D at a predetermined angle α.

As shown in FIG. (F), the deformation guide hole 105E also has a shape in which a part of two cylinders (not shown) having a diameter of 3 mm to 4 mm (for example, 3.56 mm) is overlapped like the deformation guide hole 105A. It is formed. The two cylinders are overlapped so that, for example, their central axes intersect at a virtual reference point P5 and a part of their circumferential surfaces touch each other. Here, the virtual reference point P5 is a reference point corresponding to the virtual reference point P1 of the deformation guide 105A in the deformation guide hole 105E.

The angle formed by the central axis CC5 of the deformation guide hole 105E and the design reference plane pl is β5 (for example, 60 ° to 70 ° (preferably 64 °)). The distance from the intersection (hole reference position) of the reference plane pl and the central axis CC5 of the hole to the virtual reference point P5 is D5 (for example, 3 mm to 4 mm (preferably 3.2 mm)).

The deformation guide hole 105E has an oval shape in both the cross section perpendicular to the central axis of the hole on the first surface Sf1 and the cross section perpendicular to the central axis of the hole on the second surface Sf2. It has a hole shape of a long truncated cone with upper and lower surfaces. Further, although the plan view of the hole is omitted, the insertion reference position BP of the deformation guide hole 105E is a position corresponding to the insertion hole 12 of the plate 10 corresponding to the deformation guide hole 105E, similarly to the deformation guide hole 105A. The central axis C0 of the drill guide and the central axis CC5 of the guide hole are set to coincide with each other.

As a result, when the drill guide is inserted into the insertion reference position BP of the deformation guide hole 105C (the central axis C0 of the drill guide is aligned with the central axis of the deformation guide hole 105E (the central axis passing through the virtual reference point P5) CC5. In this case), the central axis C0 of the drill guide can be displaced with respect to the central axis CC5 of the hole only in the major axis direction of the deformation guide hole 105E at a predetermined angle α.

As shown in FIGS. (G) and (H), the circular guide holes 103A and 103B each have a cylindrical hole shape having a diameter of 3 mm to 4 mm (for example, 3.56 mm).

The angles formed by the central axes CC6 and CC7 of the circular guide holes 103A and 103B and the design reference plane pl are β6 and β7 (for example, 60 ° to 70 ° (preferably 64 °)).

The circular guide holes 103A and 103B have circular cross sections perpendicular to the central axes CC6 and CC7 of the holes and do not have a guide cross section G. Therefore, when the drill guide is inserted, the insertion angle is displaced in any direction. I can't let you.

As shown in FIG. 3I, the deformation guide hole 105F has a shape in which a part of two cylinders (not shown) having a diameter of 3 mm to 4 mm (for example, 3.56 mm) is overlapped like the deformation guide hole 105A. It is formed. The two cylinders are overlapped so that, for example, their central axes intersect at a virtual reference point P8 and a part of their circumferential surfaces touch each other. Here, the virtual reference point P8 is a reference point corresponding to the virtual reference point P1 of the deformation guide 105A in the deformation guide hole 105F.

The angle formed by the central axis CC8 of the deformation guide hole 105F and the design reference plane pl is β8 (for example, 35 ° to 45 ° (preferably 39 °)). The distance from the intersection (hole reference position) of the reference plane pl and the central axis CC8 of the hole to the virtual reference point P8 is D8 (for example, 4.5 mm to 5.5 mm (preferably, 5 mm)).

The deformation guide hole 105F has an oval shape in both the cross section perpendicular to the central axis of the hole on the first surface Sf1 and the cross section perpendicular to the central axis of the hole on the second surface Sf2. It has a hole shape of a long truncated cone with upper and lower surfaces. Further, although the plan view of the hole is omitted, the insertion reference position BP of the deformation guide hole 105F is deformed in the same manner as the deformation guide hole 105A and in the same way as the deformation guide hole 105A, although the plan view of the hole is omitted. It is a position corresponding to the insertion hole 12 of the plate 10 corresponding to the guide hole 105F, and is set so that the central axis C0 of the drill guide and the central axis CC8 of the guide hole coincide with each other.

As a result, when the drill guide is inserted into the insertion reference position BP of the deformation guide hole 105E (the central axis C0 of the drill guide is aligned with the central axis of the deformation guide hole 105F (the central axis passing through the virtual reference point P8) CC8). In this case), the central axis C0 of the drill guide can be displaced with respect to the central axis CC8 of the hole only in the major axis direction of the deformation guide hole 105F at a predetermined angle α.

As described above, the deformation guide holes 105A to 105F all have a truncated cone shape, but their respective shapes are different. Not limited to this example, a plurality of deformation guide holes having the same truncated cone shape may be provided.

<Modification example>
FIG. 4 is a view showing a modified example of the second guide hole (deformed guide hole) 105 of the present embodiment, and is a plan view (front view seen from the axial direction of the guide hole) showing an example of the guide cross section G. is there. Further, when a plurality of guide cross sections G are provided in the axial direction of the guide holes, this is an example of the shape of the smallest guide cross section G.

As shown by hatching in FIGS. 2 (E) to 2 (G), the guide cross sections G of the above-mentioned deformation guide holes 105A (the same applies to the deformation guide holes 105B to 105F) are provided on both sides in the major axis direction, that is, in the circumferential direction. The configuration has two displacement allowable guide regions 102 separated in the direction.

The guide cross section G of the deformation guide hole 105 may have a plurality of displacement allowable guide regions 102 in the circumferential direction, or may have a single displacement allowable guide region 102.

FIG. 4A and FIG. 4B are guide cross sections G in which the displacement allowable guide regions 102 are provided in two directions and both are continuous. The displacement allowable guide region 102 is arranged so that the guide cross section G has an L shape as shown in FIG. 6A, or the guide cross section G has a substantially V shape as shown in FIG. It may be arranged as follows.

In these cases, for example, the area indicated by the broken line is the insertion reference position BP of the drill guide (the position corresponding to the insertion hole 12 of the plate 10) (same in FIG. 4). In this way, the insertion reference position BP may deviate from the center position of the deformation guide hole 105.

Further, as shown in FIG. 6C, the displacement allowable guide region 102 may be provided in three directions so that the guide cross section G has a T-shape, or the displacement allowable as shown in FIG. The guide regions 102 may be provided in four directions so that the guide cross section G has a cross shape.

In the case of FIG. 3D, the displacement allowable guide region 102 exists on the entire circumference of the insertion reference position BP, and the displacement of the insertion angle of the drill guide is permitted on the entire circumference of the insertion reference position BP. It is shown. However, the permissible amount of displacement of the insertion angle in the virtual line V1 direction and the permissible amount of displacement of the insertion angle in the virtual line V2 direction are different.

Further, in the virtual line V1 direction, the displacement of the substantial insertion angle is close to 0.

Further, FIG. 3E is an example of a guide cross section having a single displacement allowable guide region 102 in one direction in the circumferential direction. The modified guide hole 105X has an elliptical truncated cone shape with an elliptical upper surface and a lower surface, and an oval shape with a guide cross section G, but an insertion reference position BP is provided at one end in the major axis direction. At the end, the side surface of the truncated cone is formed substantially perpendicular to the reference plane pl. Thereby, the insertion angle of the drill guide can be displaced by a predetermined angle only in the long axis direction of the hole, for example, the distal direction or the proximal direction.

The figure (F) is also another example of the guide cross section G having a single displacement allowable guide region 102 in the circumferential direction. In this case, the guide cross section G is formed so as to have a substantially fan shape. For example, in the above example, the guide cross section G is formed in an ellipse and the displacement of the insertion angle of the drill guide is allowed only in the long axis direction, whereas in this example, the circumferential direction of the guide cross section G of the ellipse is allowed. In a part of the above, the displacement allowable guide region 102 is also expanded in the minor axis direction.

Further, FIG. (G) is a view showing a cross section along the central axis of the deformation guide hole 105, and one cross section perpendicular to the central axis is a guide cross section G (on the central axis of the deformation guide hole 105X). This is an example of the case where the displacement allowable guide region 102 is formed in one vertical cross section).

In this case, the shape of the cross section of the first surface Sf1 and the second surface Sf2 is larger than the outer shape of the guide cross section G, and the shape is arbitrary, for example. In this case, the insertion angle of the drill guide can be displaced by the one guide cross section G shown in the figure.

For example, in the case of the deformation guide hole 105A, one of the cross-sectional shapes in the direction of the central axis CC1 of the hole is an ellipse as shown in FIGS. 2 (E) to 2 (G), and the other cross sections are the corresponding. If the cross section is larger than the ellipse, for example, a circular shape, the portion having the cross-sectional shape of the ellipse (the portion of the guide cross section G) is limited to a predetermined range (for example, the major axis direction of the ellipse). , The insertion angle of the drill guide can be displaced so as to be tilted with respect to the hole insertion reference position BP (for example, so that the central axis C0 of the drill guide is tilted with respect to the central axis CC1 of the hole).

More specifically, in the deformation guide hole 105A, the cross-sectional shape perpendicular to the central axis of the hole closest to the first surface Sf1 and the second surface Sf2 is circular, and the cross-sectional shape is on the central axis of the hole between both surfaces. The cross section at a certain point may be a guide cross section G (the shape is, for example, a third oval LC3). However, in this case, it is assumed that the outer shape of the cross-sectional shape (circular shape) closest to the first surface Sf1 and the second surface Sf2 is larger than the guide cross-sectional G (third oval LC3).

Alternatively, the cross-sectional shape perpendicular to the central axis of the hole closest to the first surface Sf1 and the second surface Sf2 is larger than the third oval LC3 which is the guide cross section G, and is similar to the third oval LC3. There may be.

That is, the deformation guide hole 105 can be oriented as long as the shape of the cross section perpendicular to the central axis of the hole is a cross section having a displacement allowable guide region 102 (guide cross section G). It becomes.

As described above, the displacement allowable guide region 102 of the present embodiment may be configured such that the displacement of the insertion angle of the drill guide is biased in the circumferential direction of the guide hole, and such a displacement allowable guide region In the guide cross section G having 102, when the insertion angle of the drill guide inserted at the insertion reference position BP is to be displaced, the allowable amount of displacement (until the end of the guide cross section G comes into contact with the inner wall surface of the hole). The distance) may not be uniform in the circumferential direction of the guide hole.

For example, the deformation guide hole 105A of the truncated cone shown in FIG. 3 and the deformation guide hole 105X of FIG. 4 may be mixed in one guide block 100.

Further, the number of guide holes (deformed guide hole 105 and circular guide hole 103) can be appropriately selected according to the size of the guide block 100. For example, only one circular guide hole 103 may be provided in one guide block 100, or all the guide holes of the guide block 100 may be used as deformation guide holes 105.

Further, the shape and size of the deformation guide hole 105 are appropriately selected according to the shapes of the hole 50 and the hole structure 1 of the plate 10 used in combination with the guide block 100.

<How to use the guide block>
Next, a method of using the guide block 100 of the present embodiment will be described with reference to FIGS. 5 to 8. The guide block 100 of the present embodiment is used by being fixed to a plate 10 which is an implant member.

The plate 10 has a main body portion 10A arranged on the proximal side of the long bone and a head portion 10B arranged on the distal side. The main body portion 10A is a substantially rectangular portion along the longitudinal direction of the long bone, and a plurality of insertion holes 11 (11A, 11B) are formed along the longitudinal direction. The head portion 10B is expanded in the plane direction as compared with the main body portion 10A, and a plurality of (8 in this example) insertion holes 12 (12A to 12H) are provided.

In order to insert the screw into these insertion holes 11 and 12, the long bone is drilled in advance using a drill (bone drill). Then, in order to facilitate drilling during this drilling (particularly, drilling of the head portion 10A), the guide block 100 of the present embodiment is fixed to the head portion 10B of the plate 10.

Although the details will be described later, the plate 10 has a predetermined hole structure 1 so that a part of the screws for fixing the plate 10 to the bone is provided with a central axis thereof with respect to the central axis of the hole 50 of the plate 10. Even if it is tilted in a predetermined direction (direction of the recess 62 of the hole structure 1), it can be fastened in a state of being freely tilted in that direction (see FIGS. A1 and A11).

On the other hand, in the guide block 100 of the present embodiment, the deformation guide hole 105 regulates the displacement of the drill guide in the insertion direction more than necessary (the drill guide is limited to a part of the circumferential direction of the deformation guide hole 105). (Because the insertion angle can be displaced), it is possible to avoid drilling at a position where the screw interferes, and it is possible to reduce the risk of imposing an excessive burden on the doctor. Further, after the drill guide is oriented and perforated in the bone using the guide block of the present embodiment, the screw is tilted within an appropriate range by the hole structure 1 of the plate 10 described below. It is possible to conclude with.

The guide holes 103 and 105 of the guide block 100 are located at positions corresponding to the respective holes 50 formed in the plate 10 and have a shape corresponding to the respective holes 50 (the tip of the drill guide is appropriately directed to each hole 50). It is formed in a shape that can be attached, a shape that can be drilled into the bone in a desired trajectory so as to match the hole 50 of the plate 10).

As shown in FIGS. (A) to (C), first, the guide block 100 is fixed to the head portion 10B of the plate 10. The guide block 100 has a shape that substantially overlaps with the head portion 10B of the plate 10, and is arranged so that the second surface Sf2 faces the head portion 10B and abuts. The guide block 100 has a non-removable fixing screw 107, and is fixed at a predetermined position on the plate 10 by the fixing screw 107. Further, the plate 10 to which the guide block 100 is fixed is fixed to the long bone by using a K wire (not shown) or the like.

Next, as shown in FIG. 6A, the drill guide 120 is inserted into the guide hole (for example, the deformation guide hole 105A).

At this time, the deformation guide hole 105A causes the displacement of the insertion angle of the drill guide 120 with respect to the insertion reference position BP of the hole (for example, the central axis of the drill guide 120 is inclined with respect to the central axis of the insertion hole 12 of the plate 10). (Displacement of insertion angle) is possible only in a predetermined area. Specifically, the truncated cone-shaped deformed guide hole 105A having an elliptical cross section perpendicular to the central axis of the guide hole limits the displacement range of the insertion angle of the drill guide 120 to only the long axis direction of the long hole. Will be done. On the other hand, the insertion angle of the drill guide 120 can be arbitrarily displaced in the long axis direction of the elongated hole of the deformation guide hole 105A. Therefore, even if the screw can be fastened in a state of being freely inclined in the concave portion 62 direction of the hole structure 1 of the plate 10, the screw is drilled at a position where the screws interfere with each other. Since the drill guide 120 can be arbitrarily oriented in a predetermined direction (long axis direction of the long hole), the burden on the working doctor can be reduced.

On the other hand, the drill guide 120 inserted into the circular guide hole 103A cannot displace its insertion angle.

The drill guide 120 is appropriately oriented by the deformation guide hole 105A, and the drill guide 120 is fixed to the hole 50 of the plate 10. The tip of the drill guide 120 is provided with a spiral thread portion 120A corresponding to the hole structure 1 of the plate 10. The thread portion 120A has, for example, a thread similar to the male thread portion of the head 32 of the second screw 30 described below, and can be screwed into the hole 50 of the plate 1.

Next, as shown in FIG. 3B, a sleeve 122 for the K wire is attached to the rear portion of the drill guide 120. In FIG. 3B, the sleeve 122 is attached to the drill guide 120 of the circular guide hole 103B, but the sleeve 122 is also attached to the drill guide 120 of the deformation guide hole 105A. The central hole of the sleeve 122 is formed so as to coincide with the central axis of the drill guide 120.

Then, as shown in FIG. 7A, the K wire 124 is inserted into the central hole of the sleeve 122, the direction is confirmed, and the tip thereof is driven into the bone. In FIG. 3A, the K wire 124 is inserted through the sleeve 122 of the circular guide hole 103B, but the K wire 124 is also inserted through the sleeve 122 of the drill guide 120 of the deformation guide hole 105A. As a result, the K wire 124 is driven into the bone which is an extension of the central axis of the drill guide 120. Then, the sleeve 122 is removed from the drill guide 120 (FIG. (B)). In the following drawings, the illustration on the circular guide hole 103B side is omitted.

Next, as shown in FIG. 8A, the hollow drill 126 is attached using the K wire 124 as a guide. That is, the hollow drill 126 is attached to the drill guide 120 by inserting it through the shaft hole of the hollow drill 126. The K wire 124 allows the hollow drill 126 to be attached to the drill guide 120 in a state where the central axis of the hollow drill 126 and the central axis of the drill guide 120 are aligned with each other.

Then, the bone is drilled to a predetermined depth by the hollow drill 126. When the drilling is completed, the hollow drill 126 is removed from the drill guide 120, and the drill guide 120 is removed from the guide block.

After that, as shown in FIG. 3B, a screw (for example, a second screw 30 not shown here) is fastened to the hole 50 of the plate 10 via the deformation guide hole 105A.

The guide block 100 is removed from the plate 10 after all the necessary screws are fastened to the other holes 50 of the plate 10 in the same manner as described above (FIG. (C)).

<Plate>
Next, a plate 10 suitable for use with the guide block 100 will be described with reference to FIGS. 9 to 21.

FIG. 9 shows a plate 10 for fixing a fractured long bone (radius in the example below). The plate 10 is attached to the radius by a first screw 20, a second screw 30, and a third screw 15.

The plate 10 has a body portion 10A located on the proximal side of the radius and a head portion 10B located on the distal side. Two insertion holes 11 are formed in the main body 10A along the longitudinal direction, and a third screw 15 having a male screw portion formed at the tip thereof is inserted to fasten the main body 10A and the radius. The head portion 10B is expanded in the plane direction as compared with the main body portion 10A, and three insertion holes 12A are provided along the distal edge of the radius. Further, two insertion holes 12B are provided adjacent to the insertion holes 12A on the proximal side. In the present embodiment, the hole structure 1 of the present embodiment is applied to the two insertion holes 12B on the proximal side.

A K wire hole 19 is formed in the plate 10, and the relative position between the plate 10 and the radius can be determined in advance by using the K wire.

<Explanation of hole structure>
10 and 11 show the hole structure 1 in an enlarged manner. The hole structure 1 is configured to have a hole 50 and a plurality of screwing protrusions 52 formed on the inner peripheral surface of the hole 50. Further, the row-shaped protrusion group 60 is formed by the plurality of screwing protrusions 52. A plurality of the row-shaped projection groups 60 are arranged in the circumferential direction of the hole 50. In addition, in order to increase the fastening force with the second screw 30, the row-shaped protrusion group 60 is preferably composed of at least three or more screwing protrusions 52.

As shown in FIG. 11C, the hole 50 has a tapered shape (or a mortar shape), and has a large diameter on the Ao side in the lateral axis direction and a small diameter on the Ai (bone side) in the medial axis direction.

As shown enlarged in FIG. 12 (A), the inner peripheral edge 52A of the screwing projection 52 located at the outermost position in the axial outer direction Ao of the hole 50 is the distances R1, R2, R3 from the center C of the hole 50. Gradually changes along the circumferential direction. The tip 53 of the screwing protrusion 52 has the closest distance R2 from the center C of the hole 50, and as it moves from the tip 53 to both outer sides in the circumferential direction, the distance from the center C of the inner peripheral edge of the screwing protrusion 52. R1 and R3 become large. As a result, when the hole 50 is axially viewed, the screwing projection 52 projects radially inward with reference to a virtual perfect circle.

The contour shape of the inner peripheral edge 52A of the screwing protrusion 52 is configured to have a concave first partial arc E1 as the center C1 and a second partial arc E2 as the center C2.

The center C1 is arranged at a position that approaches the screwing protrusion 52 in the radial direction at a position having a phase of about 45 ° in the circumferential direction from the radial direction connecting the center C of the hole 50 and the tip 53. The radius of curvature RE1 is set to be equal to or less than the distance R2 between the center C and the tip 53.

The center C2 is a place different from the center C1, and specifically, at a place having a phase of about −45 ° from the radial direction to the circumferential direction connecting the center C of the hole 50 and the tip 53, toward the screwing protrusion 52. It is placed in a position that approaches in the radial direction. The radius of curvature RE2 is set to be equal to or less than the distance R2 between the center C and the tip 53, and coincides with the radius of curvature RE1. As a result, the first partial arc E1 and the second partial arc E2 are continuous (intersect) at the tip 53. Although the case where the first partial arc E1 and the second partial arc E2 are regular arcs is illustrated, it may be formed by a partial arc such as an ellipse, or may have another shape.

Further, when the axial cross section along the radial direction from the center C of the hole 50 toward the tip 53 is defined as the reference axial cross section, the shape of the reference axial cross section of the screwing protrusion 52 is shown in FIG. 12 (B). It has a mountain shape as shown. Therefore, the screwing protrusion 52 constitutes a part of the female thread for screwing with the male screw member (details will be described later) in the screw 30.

Further, the height of the female screw thread of the screwing protrusion 52 becomes lower as the distance from the tip 53 in the circumferential direction is compared with the height of the female thread at the tip 53. Specifically, as can be seen from the comparison of FIGS. 11 (C) to 11 (E), the basal bottom surface KA of the screwing protrusion 52 (expressed as a valley bottom surface when expressed by a female thread) and the inner peripheral surface of the hole 50. The height of the female thread inward in the radial direction with respect to (which can also be defined) is highest at the tip 53 (see FIG. 11C), and is + 45 ° or -45 ° in the circumferential direction from the position of the tip 53. The height of the female thread at the location of the phase is the lowest (see FIGS. 11D and 11E). However, even in the place where the height of the female thread is the minimum, the female thread itself exists, in other words, the thread groove 54 is always spirally formed between the adjacent female threads.

As shown in FIG. 11C, a plurality of screwing protrusions 52 are arranged in parallel from the outer side (Ao) to the inner side (Ai) in the axial direction. The shapes of these parallel screwing protrusions 52 are substantially the same. The holes 50 are tapered. A row of protrusions 60 is formed by a plurality of screwing protrusions 52.

Further, as shown in FIG. 11 (A), a plurality (here, four) of the row-shaped projection groups 60 are arranged in the circumferential direction of the hole 50. More specifically, at least a pair of row projections 60 are radially opposed to the center C of the hole 50. Here, the four row projection groups 60 are arranged at equal intervals (that is, 90 ° intervals) in the circumferential direction, so that a total of two pairs of row projection groups 60 face each other.

Further, as shown in FIGS. 11 (C) to 11 (E) and FIG. 12 (B), each of the screwing protrusions 52 has a predetermined lead angle, and as a result, the plurality of row protrusions 60 have a predetermined lead angle. It forms part of the female thread. That is, a female screw is formed on the inner peripheral surface of the hole 50 by the row-shaped protrusion group 60 and the thread groove 54. Here, two female threads are configured, and if the even-numbered female threads are used in this way, the shapes of the columnar protrusions 60 facing in the radial direction with respect to the center C on the inner peripheral surface of the hole 50 match or approximate. It is possible to reduce the processing error.

A partially cylindrical or partially elliptical cylinder-shaped (and tapered) recess 62 is formed between the row-shaped protrusions 60 arranged adjacent to each other in the circumferential direction. The space of the recess 62 can be used to incline the second screw 30. The number of the row projection group 60 is preferably 2 or more in the circumferential direction, more preferably 3 or more, and further preferably 4 or more of the row projection group 60. Since the number of recesses 62 formed between them increases, the inclination direction can be diversified. On the other hand, in order to incline the second screw 30 into the recess 62, it is necessary to secure a certain degree of circumferential angle range of the recess 62, so that the number of recesses 62 is preferably 5 or less, which is more desirable. Is 4 or less. Further, the row projection groups 60 are preferably arranged at equal intervals in the circumferential direction. For example, in the case of the two row projection groups 60, the phase difference is 180 °, and the three row projection groups 60 In the case of, it is preferable to dispose of them with a phase difference of 120 °.

This hole structure 1 will be described from another viewpoint with reference to FIG.

As shown in FIG. 11C, a spiral female thread 55 is continuously formed on the inner peripheral surface KA of the tapered hole 50 which is a perfect circle. As shown in FIG. 11A, a plurality of high mountain regions 55A and low mountain regions 55B are formed by repeating the increase and decrease of the mountain height along the circumferential direction of the female thread 55. Further, the circumferential phase of the alpine region 55A that is repeated orbiting is matched with each other, and the circumferential phase of the low mountain region 55B that is repeated orbiting is matched with each other. In this way, the row projection group 60 is formed by the plurality of alpine regions 55A arranged in parallel in the axial direction in the same phase. The recess 62 is formed by a plurality of low mountain regions 55B arranged in parallel in the axial direction in the same phase.

Next, an example of the procedure for forming the hole structure 1 will be described with reference to FIGS. 13 and later.

First, as shown in FIG. 13, a general female thread 55 having two threads is spirally formed on the inner peripheral surface of the opening formed in the plate 10 by cutting or rolling. In this step, the tapered hole 50 is also formed at the same time.

Next, as shown in FIGS. 14A and 14B, a cutting locus S1 in a state where a virtual cone S having a similar shape smaller than the hole 50 is offset in the radial direction and interferes with the female thread 55 is obtained. A part of the female thread 55 is removed so as to be. As a result, as shown in FIG. 14C, a part of the female thread 55 is shaved outward in the radial direction to form a recess 62. Similarly, as shown in FIG. 15A, a part of the female thread 55 is deleted so that a cutting locus S2 in which the phase of the virtual cone S in the offset direction is 180 ° opposite to that of FIG. 14 can be obtained. To do. As a result, as shown in FIG. 15B, a part of the female thread 55 is cut outward in the radial direction to form a second recess 62.

By executing the same steps as those in FIGS. 14 and 15 with the offset direction shifted by 90 °, a part of the female thread 55 is obtained so that the cutting trajectories S3 and S4 can be obtained as shown in FIG. 16 (A). To delete. As a result, as shown in FIG. 16 (B), a part of the female thread 55 is shaved outward in the radial direction to newly form two recesses 62. By the above steps, recesses 62 are formed at four locations in the circumferential direction, and as a result, row-shaped protrusions 60 are created between the recesses 62. The cutting order can be changed as appropriate.

The insertion hole 12A on the distal side is smaller in size than the insertion hole 12B on the proximal side, but the hole structure of the insertion hole 12A is a female thread having two threads on the inner peripheral surface of the tapered hole. Is only formed, and detailed illustration and description thereof are omitted here.

<Explanation of screw>
The first screw 20 and the second screw 30 will be described with reference to FIG. Since both screws 20 and 30 have similar figures in which the first screw 20 is smaller than the second screw 30 except for the axial length, the last digits of the symbols of both screws 20 and 30 are matched with each other. Here, the second screw 30 will be described, and the description of the first screw 20 will be omitted.

The second screw 30 has a head portion 32 and a shaft portion 34. The head 32 has a tapered shape with a large diameter on the outer side in the axial direction and a small diameter on the shaft portion 34 side (tip side). On the peripheral surface of the head 32, a male screw portion 36 of two spiral stripes having the same lead angle as the hole structure 1 is formed. Further, a hexagonal or hexagonal hole 32A is formed on the end surface of the head 32, and can be tightened by engaging with a hexagonal bar wrench or the like. In the present embodiment, the case where the threaded portion is not formed on the peripheral surface of the shaft portion 34 is illustrated, but the present invention is not limited to this.

<Action of hole structure>
Next, the screwing mode of the hole structure 1 and the second screw 30 will be described. As shown in FIG. 18, when the central axis J1 of the hole structure 1 and the central axis J2 of the second screw 30 are coaxial, the head 32 of the second screw 30 penetrates deeper into the hole structure 1. All the row-shaped protrusions 60 and the female thread groove 54 are screwed and fastened to the male threaded portion 36.

On the other hand, as shown in FIG. 19, when the central axis J2 of the second screw 30 is inclined with respect to the central axis J1 of the hole structure 1 (inclined in the direction of the recess 62 of the hole structure 1), the head of the second screw 30 As shown in FIG. 19C, the male screw portion 36 and the row-shaped protrusion group 60 are screwed and fastened while the portion 32 remains at the shallow position of the hole structure 1. At this time, as shown in FIG. 19B, the female thread groove 54 formed in the recess 62 in the inclined direction partially contacts the male thread portion 36, but does not screw. Since the contact area is increased by partially abutting (applying) the male thread portion 36 to the female thread groove 54, the fastening of the hole and the screw should be made stronger than in the case where the female thread groove is not formed in the recess 62. Is possible. Further, as described above, the height of the female thread of the screwing protrusion 52 becomes lower as the distance from the tip 53 in the circumferential direction is compared with the height of the female thread at the tip 53. That is, a clearance is generated between the female thread groove 54 and the male thread portion 36, and this clearance allows the second screw 30 to be inclined with respect to the hole. Therefore, according to the hole structure 1 of the present embodiment, it is possible to fasten the second screw 30 in a state of being freely inclined in the direction of the four recesses 62.

According to the hole structure 1 of the present embodiment described above, a plurality of rows are formed by the screwing protrusions 52 that are convex inward in the radial direction so that the distance from the center C of the hole 50 gradually changes along the circumferential direction. Since the protrusion group 60 is formed, even if the second screw 30 is tilted with respect to the axial direction of the hole 50, it can be screwed with the male screw portion 36.

In particular, since the inner contour shape of the screwing protrusion 52 when viewed from the axial direction of the hole 50 has a first partial arc E1 and a second partial arc E2, the first partial arc E1 or the second The recess 62 formed by the partial arc E2 allows the head 32 of the second screw 30 to be smoothly received.

Further, since at least a pair of row-shaped protrusions 60 are arranged so as to face each other in the radial direction of the hole 50, the second screw 30 can be tilted in the radial direction orthogonal to the radial direction. Further, in the row-shaped protrusion group 60, the shape of the axial cross section of the tip 53 is a mountain shape and can function as a part of the female thread, so that the fastening force with the second screw 30 can be increased. It becomes.

Further, in the screwing protrusion 52 of the present embodiment, the height of the female thread of the tip 53 is the highest, and the height of the female thread gradually decreases as the distance from the tip 53 increases in the circumferential direction, so that the recess 62 can be formed. ing. As a result, the hole structure 1 can exhibit the function of the female screw, and the recess 62 can secure a spare space for tilting the second screw 30.

Further, since the hole 50 of the main hole structure 1 has a tapered shape such as a partial cone, when the hole 50 is coaxial with the male threaded portion 36, the hole 50 accepts the male threaded portion 36 to the depth in the axial direction and screwes them together. On the other hand, when the male threaded portion 36 is inclined, the male threaded portion 36 can be screwed at a shallow position with respect to the hole 50.

In the above embodiment, as shown in FIG. 11, the locus of the valley bottom KA of the female thread 55 is a substantially perfect circle, and the thread height of the female thread 55 is changed in the circumferential direction to form the screwing protrusion 52. However, the present invention is not limited to this. For example, as shown in FIG. 20, the distance from the center of the hole 50 to the valley bottom KB of the spiral female thread 55 may be repeatedly increased or decreased along the circumferential direction. In this way, it is possible to form a plurality of protruding regions 56A and retracted regions 56B by displacement on the valley bottom KB side without changing the height of the female screw thread 55. If the circumferential phases of the plurality of protruding regions 56A are matched with each other and the circumferential phases of the plurality of retracted regions 56B are matched with each other, the row-shaped protrusion group 60 and the recess 62 can be formed. As a result, as shown in FIG. 21, it is possible to screw the second screw 30 which is inclined.

Further, the guide block 100 of the present embodiment is suitable for use together with a plate 10 provided with a plurality of holes 50 having the above-mentioned hole structure 1, but has a conventionally known hole structure (a hole other than the above-mentioned hole structure 1). It may be used together with a plate provided with a hole having a structure).

Although the drill guide device of the present invention has been described above, the present invention is not limited to these embodiments, and various modifications can be made without departing from the gist of the present invention.

1 Hole structure 10 Plate 10A Main body 10B Head 12A Insert hole 12B Insert hole 15 Screw 19 Wire hole 20 First screw 30 Second screw 32 Head 32A Hole 34 Shaft 50 Hole 52 Screwing protrusion 52A Inner peripheral edge 53 Protrusion 54 Groove 55 Female thread 55A Alpine area 55B Low mountain area 56A Protruding area 56B Evacuation area 60 Rowed protrusions 62 Recesses 100 Guide block 102 Displacement allowable guide area 103 First guide hole (circular guide hole)
105 Second guide hole (deformation guide hole)
120 Drill Guide 122 Sleeve 124 Wire 126 Hollow Drill BP Insertion Reference Position G Guide Surface C Center E1 First Part Arc E2 Second Part Arc KA Base Bottom S Virtual Cone

Claims (6)

A drill guide device for guiding a drill to be drilled into a bone when an implant member is placed in the body.
It has a plurality of guide holes that penetrate from the first surface to the second surface of the drill guide instrument at a position corresponding to the hole of the implant member and into which a drill guide through which the drill is inserted can be inserted.
At least one of the plurality of guide holes is a deformation guide hole.
The deformation guide holes have different sizes of a plurality of cross sections perpendicular to the central axis of the holes.
The first permissible amount of displacement of the insertion angle in the first direction of the drill guide by the deformation guide hole is larger than the second permissible amount of displacement of the insertion angle in the second direction different from the first direction. large,
A drill guide instrument that features that. The second tolerance is approximately 0 °.
The drill guide device according to claim 1. The first permissible amount is 10 ° to 20 °.
The drill guide device according to claim 1 or 2, wherein the drill guide device is characterized. A plurality of the deformation guide holes having different hole shapes are provided.
The drill guide device according to any one of claims 1 to 3, wherein the drill guide device is characterized. The deformation guide hole is
The hole shape is a truncated cone shape,
The drill guide device according to any one of claims 1 to 4, wherein the drill guide device is characterized. Implant member and
The drill guide device according to any one of claims 1 to 5.
A drill guide system characterized by being equipped with.