JP7272701B1 - surgical hammer - Google Patents

Abstract

To provide a hammer that can be used for percutaneous insertion of a screw or the like to fine adjustment with a single hammer. A hammer including a handle, a shaft connected to the handle, and a head attached to the tip of the shaft, wherein: (1) the head has an upper surface, a lower surface and side surfaces; (2) at least a part of the side surface is provided with a metal flat plate so as to be substantially parallel to the longitudinal direction of the shaft portion; (3) one or both of the upper and lower surfaces is partially or entirely composed of at least one material selected from resin and rubber; . [Selection drawing] Fig. 1

Description

The present invention relates to novel surgical hammers.

When treating fractures surgically, it is necessary to immobilize the fracture site. When fixing a fracture site, external fixation for fixation from the outside of the body and internal fixation for fixation inside the body are known. However, internal fixation is performed when sufficient fixation force cannot be obtained by external fixation, such as fractures of the femur or pelvis. Internal fixation is performed by surgically placing a fixing member such as a screw, guide pin, rod, wire, plate, etc. (hereinafter also referred to as "screw etc.") in the body.

Among these internal fixation techniques, percutaneous screw fixation under fluoroscopy, for example, is adopted in many cases because the skin incisions are small and relatively minimally invasive. In such an operation, a screw is inserted into the fracture site, and a hammer is used to drive the screw or the like.

Various hammers have been proposed as hammers used for such treatment (Patent Document 1, Patent Document 2, Patent Document 3). In addition to stainless steel hammers, for example, hammer materials such as nylon hammers and Teflon (registered trademark) hammers that are easy to finely adjust are commercially available (for example, Non-Patent Document 1 and Non-Patent Document 2). .

By the way, when using a hammer to drive a screw, etc., generally, the hammer should be driven with a slightly stronger force at first, and when the tip of the screw, etc. approaches the fracture site, the hammering force should be reduced. The screws are placed in place with fine adjustment. In particular, when fixing pelvic fractures such as acetabular fractures and pelvic ring fractures, nerves and blood vessels are close to the pelvis, and close attention is required when inserting screws, etc. The adjustment of the driving condition of the hammer is extremely important.

Special table 2007-512933 Japanese Patent Laid-Open No. 9-133622 U.S. Pat. No. 6,592,590

Iso Medical Systems Co., Ltd. Website https://isomed.co.jp/products/all-the-products/surgicalinstruments/others/144-002/ Muranaka Medical Equipment Co., Ltd. Website https://www.muranaka.co.jp/online/products/detail.php?product_id=12973

However, with conventional metal hammers, it is not always easy for the operator to control the amount of force with his or her fingers due to the weight of the hammer itself.

For fine adjustment, a method using a nylon hammer or the like as described above may be considered, but a synthetic resin hammer such as a nylon hammer is not suitable for percutaneous penetration of a screw or the like.

In addition, there is a method of using a metal hammer for percutaneous penetration and a synthetic resin hammer for fine adjustment, but it takes time and effort to replace the hammer during the procedure, and gripping different hammers can affect the feel of the fingers of the practitioner. However, there is a possibility that fine adjustments may be hindered.

SUMMARY OF THE INVENTION Accordingly, it is a primary object of the present invention to provide a hammer capable of percutaneous insertion of a screw or the like and fine adjustment thereof with a single hammer.

As a result of earnest research in view of the problems of the prior art, the inventors of the present invention have found that a hammer having a specific structure can achieve the above objects, and have completed the present invention.

That is, the present invention relates to the following surgical hammer.
1. A hammer comprising a handle, a shaft connected to the handle, and a head attached to the tip of the shaft,
(1) the head portion is composed of a substantially plate-like body having an upper surface, a lower surface and side surfaces, and the shaft portion is connected to the side surfaces;
(2) a metal flat surface is formed on at least a part of the side surface so as to be substantially parallel to the longitudinal direction of the shaft portion;
(3) one or both of the upper surface and the lower surface are partially or entirely composed of at least one material selected from resin and rubber;
A surgical hammer characterized by:
2. 2. The surgical hammer according to claim 1, wherein the substantially plate-like body includes a substantially plate-like synthetic resin core and a metal outer frame member surrounding the entire side surface of the core.
3. 3. The surgical hammer according to item 2, wherein a synthetic resin core member constitutes at least part of the upper surface or the lower surface, and the metal outer frame member constitutes the metal flat surface.
4. 4. The surgical hammer according to any one of items 1 to 3, wherein the substantially plate-like body has a thickness of 40 mm or less and an area of the upper surface and the lower surface that are the same or different and equal to or greater than 600 mm ² .
5. 5. The surgical hammer according to any one of items 1 to 4, wherein the material is an X-ray transparent resin.
6. 6. The surgical hammer according to any one of items 1 to 5, wherein one or both of the upper and lower surfaces are anti-slip.
7. 7. The surgical hammer according to any one of items 1 to 6, wherein the metal flat surface is anti-slip.

According to the present invention, it is possible to provide a single hammer that can handle percutaneous insertion of a screw or the like to fine adjustment. In particular, the hammer of the present invention differs from the shape of a normal hammer (hammer) in that the head portion is composed of a substantially plate-like body having an upper surface, a lower surface and side surfaces, and the upper surface/lower surface and the side surfaces are Since they are made of different materials, they can be used properly according to the strength of driving.

For this reason, the operator does not have to switch between different hammers, and the touch and feel (grip feeling, weight feeling, etc.) of the operator's fingers when changing the hammer may affect the treatment. can also be avoided.

Furthermore, when a substantially plate-like X-ray transparent synthetic resin core material is used as the substantially plate-like body of the head portion, for example, the X-ray irradiation source (X-ray) to the head portion (X By photographing (observing) at an angle that is approximately in a straight line in the order of translucent synthetic resin) to the screw, etc., the part where the screw of the hammer is driven is seen through (that is, it does not appear on the X-ray.) . As a result, in fluoroscopy surgery, for example, it is possible to prevent a situation in which part or all of the fracture site is hidden by a hammer, so that the accuracy of the surgery can be ensured, and the physical and mental health of the operator can be improved. It can also reduce the financial burden.

The hammer of the present invention having such characteristics can be used for lower extremity fractures such as femoral shaft fractures, femoral neck fractures, femoral trochanteric/subtrochanteric fractures, calcaneus fractures, pelvic fractures, and tibia fractures. In addition, for inserting screws, etc. used for various fractures such as humeral diaphyseal fractures, proximal humeral fractures, forearm fractures, clavicle fractures, fractures of the upper extremities such as distal radius fractures, etc. It can be suitably used as a hammer.

FIG. 1A is a perspective view showing an example of the surgical hammer of the present invention; FIG. FIG. 1B is a view seen from direction A in FIG. 1A. It is a figure which shows the example of embodiment of the planar shape of a head part. FIG. 3A is a perspective view showing a surgical hammer according to Example 1 of the present invention; FIG. FIG. 3B is a view seen from direction B in FIG. 3A. 4A is a perspective view showing the side of the surgical hammer of Example 1 of the present invention; FIG. FIG. 4B is a diagram viewed from direction C in FIG. 4A.

10, 10' surgical hammer 11 handle 12 shaft 13 head 13a upper surface 13b lower surface 13c side surface F metal flat portion f flange portion x core portion of head portion y outer frame of head portion

A surgical hammer of the present invention is a hammer comprising a handle portion, a shaft portion connected to the handle portion, and a head portion attached to a distal end of the shaft portion,
(1) the head portion is composed of a substantially plate-like body having an upper surface, a lower surface and side surfaces, and the shaft portion is connected to the side surfaces;
(2) a metal flat surface is formed on at least a part of the side surface so as to be substantially parallel to the longitudinal direction of the shaft portion;
(3) one or both of the upper surface and the lower surface are partially or entirely composed of at least one material selected from resin and rubber;
It is characterized by

The present invention will be described with reference to FIG. 1, which shows an example of the configuration of the surgical hammer of the present invention. A hammer 10 shown in FIG. 1 is mainly composed of a handle portion 11, a shaft portion 12 connected to the handle portion, and a head portion 13 attached to the tip of the shaft portion.

The handle portion 11 is a portion that is held by the hands and fingers of the operator. Therefore, its length, cross-sectional diameter, etc. can be set according to the size of the operator's hand so that it can be easily gripped. For example, the length of the handle portion can be set within a range of, for example, about 80 to 150 mm. Also, the cross-sectional diameter can be set, for example, within a range of about 20 to 40 mm. If the cross-sectional shape is not constant, it is preferable that the thinnest part is about 2 to 40 mm.

The shape of the handle portion is not particularly limited as long as it is a shape that can be easily gripped according to the size of the operator's hand, etc., and a shape similar to that of a known or commercially available hammer can be adopted. The cross-sectional shape of the handle portion can also be substantially circular as shown in FIG. 1, but is not limited to this. For example, any shape such as an ellipse or a substantially regular polygon may be used. Further, in order to reduce the weight of the handle portion, a cavity (through hole) may be formed in the handle portion within a range that does not interfere with gripping.

Moreover, the material of the handle portion 11 may be, for example, metal (including alloys; the same shall apply hereinafter), synthetic resin, synthetic rubber (eg, silicon rubber, urethane rubber), or the like. However, it is desirable that the surface be treated to prevent slipping. Anti-slip processing includes, for example, a method of forming grooves in a grid pattern on a part of the surface, a method of roughening the surface, and a method of winding an anti-slip tape.

As another form of non-slip, a flange (not shown) having a larger cross-sectional diameter than the main body of the handle is provided at the distal end of the handle (in the direction of the head) and its tail (in the direction opposite to the head). ) can also be formed. As a result, the anti-slip effect can be obtained more reliably, and the hammer can be prevented from slipping out of the hand.

The shaft portion 12 mainly plays a role of transmitting the force applied to the handle portion 11 to the head portion 13 . Therefore, it is necessary to have suitable strength. Therefore, although it depends on the material of which the shaft is made, the cross-sectional diameter is usually preferably about 8 to 20 mm. When the cross-sectional shape is not substantially circular, it is preferable that the thinnest part is about 8 to 20 mm.

The cross-sectional shape of the shaft portion 12 is generally circular, but is not limited to this. For example, any shape such as an ellipse or a substantially polygonal shape may be used.

The material of the shaft portion 12 is not limited as long as the desired strength can be maintained, but metal is generally preferred. For example, stainless steel, titanium-based alloys, and the like can be suitably used.

The shaft part 12 is connected to the handle part 11, but the connecting means is not limited. For example, in addition to welding, screwing, etc., a method of integrally molding the shaft part and the handle part is also adopted. be able to. In addition, as a locking method using a screw, for example, the end of the handle part on the tip side (in the direction of the head part) of the handle part is made a female screw, and the end of the connecting part of the shaft part with the handle part is made a male screw. A method of connecting by tightening and the like can be mentioned. In addition, a connection method similar to that of a known hammer can be adopted. Moreover, from the point of view of strength, a part of the shaft portion may be connected to the handle portion in a state of being inserted and fitted. In particular, as described above, it is preferable that the shaft portion and the handle portion are integrally molded.

The head portion 13 serves as a portion for driving a screw or the like. The hammer of the present invention is composed of a substantially plate-like body having an upper surface, a lower surface and side surfaces. For example, in the hammer 10 shown in FIG. 1, the head portion 13 has an upper surface 13a, a lower surface 13b and a side surface 13c, and the upper surface and the lower surface have substantially the same shape and area.

In general hammers, the head portion is a cylindrical body that is long in the direction perpendicular to the shaft portion. , has a flattened shape. The shaft 12 is connected to the side portion 13c. As a result, it is possible to secure a relatively large area on the upper surface or the lower surface, thereby facilitating driving a screw or the like on the upper surface or the lower surface. More specifically, the shape of the substantially plate-like body has a thickness (the length in the direction perpendicular to the above) of 40 mm or less (for example, about 10 to 35 mm), and the areas of the upper surface and the lower surface are the same or the same. Differently, it is preferably 600 mm ² or more (eg, 1600 to 3600 mm ² ).

The planar shape of the head portion is not particularly limited as long as it does not hinder the formation of the metal flat portion. For example, as shown in FIG. 1B, a shape in which some chords of a circle are replaced with straight lines can be exemplified. In addition, as shown in FIG. 2, there are substantially regular polygons (FIGS. 2A and 2B), polygons including curved sides (FIG. 2C), and the like. In any of FIGS. 2A to 2C, since there are two surfaces parallel to the longitudinal direction of the shaft portion 12, one surface or both surfaces of the two surfaces can be used as the metal flat portion F.

The connection between the head portion and the shaft portion can be made in the same manner as the connection between the handle portion and the shaft portion described above. However, since the shaft portion is connected to the side surface of the head portion, the cross-sectional diameter R of the shaft portion (the shortest diameter if the cross-sectional shape is not circular) is the length t of the side surface (that is, the thickness of the substantially plate-like body). ) should be smaller than For example, it can be set within a range of about 0.3t≦R≦0.8t, but is not limited to this.

A flat metal portion F is formed on at least a portion of the side surface 13c of the substantially plate-like body that constitutes the head portion 13 . The metal flat portion F is formed so as to be substantially parallel to the longitudinal direction of the shaft portion 12 . As a result, the metal flat portion F can be used particularly when a screw or the like is strongly struck.

The method of forming the metal flat portion F is not limited. For example, the substantially plate-like body is configured with a substantially plate-like synthetic resin core material, and the entire side surface of the core material is surrounded by a metal outer frame member. It can be configured to surround. In particular, it is preferable that a synthetic resin core material constitutes at least part of the upper surface or the lower surface, and that the metal outer frame member constitutes the metal flat surface. The method of joining the substantially plate-shaped synthetic resin core member and the metal outer frame member is not particularly limited, and they can be joined by, for example, an adhesive agent or screws. In addition, a method of attaching a metal plate to the side surface of the head portion with an adhesive, a screw, a screw, or the like can be employed as appropriate.

One or both of the upper surface 13a and the lower surface 13b of the head portion 13 are partially or entirely made of at least one material selected from resin and rubber. This material also includes members made of composite materials in which resin or rubber is reinforced with fibers. With such a configuration, a screw or the like can be struck on the upper surface or the lower surface, but since it is composed of a resin or rubber member, it is possible to perform a milder impact than a metal hammer. Examples of the resin include polyamide resin, fluorine resin, polyetheretherketone resin (PEEK), polyphenylsulfone resin (PPSU), and vinyl chloride resin. As the rubber, for example, urethane rubber, acrylic rubber, silicone rubber, or the like can be used. These may be fiber reinforced composite materials such as carbon fiber reinforced plastics (CFRP). As the CFPR, for example, a carbon fiber reinforced polyetheretherketone resin or the like can be suitably used.

In the present invention, an X-ray transmissive resin can be particularly preferably used as the material. As a result, when inserting a screw or the like under fluoroscopy, it is possible to more reliably avoid a state in which the screw or the like is hidden by the operator's field of view of the hammer. CFPR such as carbon fiber reinforced polyether ether ketone resin can also be preferably used as the X-ray transparent resin.

When the upper surface 13a or the lower surface 13b is made of resin or rubber, a substantially plate-shaped resin molded body or rubber molded body is usually used, and the upper and lower surfaces of the molded body are used as the upper and lower surfaces of the head portion. Good luck. As a result, it is possible to perform a mild hammering peculiar to resin or rubber, so that it can be suitably used for fine adjustment at the final stage of inserting a screw or the like.

In the hammer of the present invention, it is preferable that one or both of the upper surface and the lower surface are anti-slip processed. It is also desirable that the metal flat surface is also anti-slip processed. The method of anti-slip processing can be carried out in the same manner as the method of anti-slip processing of the handle portion.

When the hammer of the present invention is used for surgery, the flat metal surface on the side of the head portion can be used to strongly drive a screw or the like. On the other hand, when finely adjusting the driving force as in the case of final positioning of a screw or the like, the upper surface or the lower surface made of a resin member or rubber member may be used. In this way, one tool can play two roles, so it is possible to eliminate the troublesomeness of switching between two or more hammers, and the problem of differences in feel and discomfort of the practitioner when switching between different hammers. can also be resolved.

EXAMPLES Examples are given below to more specifically describe the features of the present invention. However, the scope of the present invention is not limited to the examples.

[Example 1]
As an example of the embodiment, a hammer 10' as shown in FIG. 3 was produced. FIG. 3A shows a view of the upper surface 13a of the head portion 13 of the hammer 10'. FIG. 3B shows a view from the direction B in FIG. 3A, in which the lower surface 13b of the head portion 13 appears.

As shown in FIG. 4A, the handle portion 11 has a length of 110 mm and a cross-sectional diameter of about 23 mm. Both ends of the handle portion are provided with stoppers processed to have a cross-sectional diameter of 25 mm, which is slightly larger, for anti-slip purposes. The handle is made of stainless steel (SUS630).

As shown in FIG. 4A, the shaft portion 12 is a rod-shaped body with a length of 100 mm and a cross-sectional diameter of 10 mm (the cross-sectional shape is substantially circular). In this hammer 10', since the handle portion and the shaft portion are integrated, the material of the shaft portion is also made of stainless steel (SUS630).

As can be seen from FIG. 3B, the head portion 13 is composed of a synthetic resin (carbon fiber reinforced PEEK) core x and a stainless steel (SUS630) outer frame y. The outer shape of the core part x is a substantially plate-like body, but as shown in FIG. 4A, the upper surface has a flange part f with a thickness of 3 mm, which is arranged so as to cover a part of the end surface of the outer frame y described later. It is By providing the flange portion f, the area of the upper surface (or the lower surface) can be increased, and the head portion can function as a stopper to prevent the head portion from falling off from the outer frame. The upper surface 13a is entirely made of a synthetic resin surface, and grooves are formed in a grid pattern on the surface to provide anti-slip processing. As shown in FIG. 4B, the upper surface is circular with a diameter of 52 mm and its area is 26×26×3.14=approximately 2122 mm ² .

The outer frame y has a regular octagonal outer periphery and a ring-shaped (substantially loop-shaped) inner periphery processed into a circular shape. The height of the outer frame is approximately 25 mm as shown in FIG. 4A. Moreover, as shown in FIG. 4B, the size of the outer periphery is a regular octagon inscribed in a diameter of 52 mm. The head portion 13 is connected to the tip of the shaft portion 12 by welding so that the two sides of the regular octagon are parallel to the longitudinal direction of the shaft portion 12 . The surfaces of the two sides are anti-slip processed by forming grooves in a grid pattern on the surface. The outer frame is made of stainless steel (SUS630).

The outer frame y has a metal flat surface F on two sides parallel to the longitudinal direction of the shaft portion on the regular octagonal outer periphery. That is, a part of the side surface 13c of the head portion 13 (two sides facing each other) can be used as the metal flat surface F. As shown in FIG.

Such a hammer 10' uses the stainless steel surface (metal flat surface F) of the side surface 13c when, for example, strongly driving a screw or the like, while the carbon fiber surface of the top surface 13a is used when, for example, weakly driving a screw or the like. A face made of reinforced PEEK can be used. That is, one hammer can be used for different driving conditions. As a result, it is possible to save the trouble of exchanging two kinds of hammers during the treatment, and to use the same hammer with the same finger feeling. In this case, the lower surface 13b can also be used if desired.

In addition, since the core part x is made of carbon fiber reinforced PEEK (that is, made of X-ray transparent resin), in the case of performing surgery under fluoroscopy, the transmission range shown in FIG. 4A transmits X-rays ( (not displayed on the monitor screen), the operator can see the bone fracture site, the screw, etc. as a whole without obstructing the operator's field of view, so that the screw, etc., can be inserted more accurately at the predetermined position. In addition, since the field of view of the operator is not obstructed, the burden of switching between different hammers is reduced, and the mental stress of the operator can be eliminated.

Claims (7)

A hammer comprising a handle, a shaft connected to the handle, and a head attached to the tip of the shaft,
(1) the head portion is composed of a substantially plate-like body having an upper surface, a lower surface and side surfaces, and the shaft portion is connected to the side surfaces;
(2) a metal flat surface is formed on at least a part of the side surface so as to be substantially parallel to the longitudinal direction of the shaft portion;
(3) one or both of the upper surface and the lower surface are partially or entirely composed of at least one material selected from resin and rubber;
A surgical hammer characterized by: 2. The surgical hammer according to claim 1, wherein the substantially plate-like body includes a substantially plate-like synthetic resin core and a metal outer frame member surrounding the entire side surface of the core. The surgical hammer of claim 2, wherein a synthetic resin core forms at least a portion of the upper or lower surface, and the metallic outer frame member forms the flat metallic surface. The surgical hammer according to any one of claims 1 to 3, wherein the substantially plate-like body has a thickness of 40 mm or less and an area of the upper surface and the lower surface that are the same or different and equal to or greater than 600 mm ² . The surgical hammer of any one of claims 1-4, wherein said material is an X-ray transparent resin. The surgical hammer of any one of claims 1 to 5, wherein one or both of the upper and lower surfaces are non-slip. The surgical hammer of any one of claims 1-6, wherein the flat metal surface is non-slip.

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