JPH06114076A - Tension meter for orthopaedic surgery - Google Patents

Abstract

PURPOSE:To enable accurate selection of an artificial joint or the like used by burying between bones and the like without depending on intuition of an operator by setting the degree of tension of a ligament based on data or the like in the past with a torque limiter mechanism while a space between the bones is expanded numerically with both fixed and mobile arms. CONSTITUTION:This tension meter 10 measures the degree of tension by causing a tensioning between a plurality of bones before an artificial joint or the like is buried or the like between the bones. In operation, firstly an adjusting part 34 is operated by being turned to set a torque value based on the previous data or the like while a link shaft 32 is fitted into a torque shaft 13. Then, the torque shaft 13 is turned to lift a mobile arm 26 of a meter body 12 from a block part 18 so that the bones are caused to separate therebetween expanding the interval from a fixed arm 19 to stretch a ligament. Subsequently, with the stretching of the ligament, a contracting force working between both the arms 19 and 26 is transmitted to a torque limiter mechanism of a torque setting section 14 and when the force transmitted reaches a set value, the adjusting section 34 is made to idle.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention is intended to expand the space between bones and measure the degree of tension thereof before implanting or implanting artificial joints or artificial bones between the bones. The present invention relates to a tension meter for orthopedic surgery used.

[0002]

2. Description of the Related Art In recent years, various new materials such as ceramics have been developed, and skeleton-based substitute materials having excellent functions are successively provided. The artificial joints and artificial bones produced by such skeletal substitute materials are now widely used in the field of orthopedics, and have a great therapeutic effect. By the way, in order to implant or implant such an artificial joint or artificial bone in a human body by surgery, for example, when replacing a knee joint with an artificial joint, first, as shown in FIG. 6, before actually implanting the artificial joint. The distal part of the femur 1 and the proximal part of the tibia 2 are excised in the space between the bones, and a spacer 3 having an appropriate thickness is inserted between the bones. ) Is touched to check the degree of tension with a fingertip, and further, the portion below the tibia 2 is rocked back and forth, and the degree of tension between the femur 1 and the tibia 2 connected by the ligament is sensed. Here, the strength of the ligament is different for each individual, and the space between the femur 1 and the tibia 2 is expanded at an appropriate interval according to the strength of the ligament of the subject himself, and the ligament is appropriately tensioned. Otherwise, the artificial joint will not function properly. Therefore, the spacers 3 having different thicknesses are exchanged variously to set the distance between the femur 1 and the tibia 2 according to the strength of the ligament of the subject, and then the spacer 3
Remove and embed an artificial joint of the size corresponding to the set interval.

Further, in place of the spacer 3 shown in FIG. 6, an extension tool 4 as shown in FIG. 7 is also known. In the extension tool 4, the upper arm 5 and the lower arm 6 are connected by screws 7, 7, and the distance between the upper arm 5 and the lower arm 6 is adjusted by adjusting the tightening degree of the screws 7, 7. Is. Using this expansion tool 4, the femur 1 and the tibia 2
In order to check the tension between the bones, first insert the upper arm 5 and the lower arm 6 between these bones in a closed state,
Turn 7 to extend between the arms. Then, the surgeon finds an appropriate degree of tension of the ligament by an experience-based intuition by the stress applied to the fingertips when turning the screws 7 and 7, and expands the space between the bones to an appropriate interval. After that, the extension tool 4 is removed from the space between the bones, the space between the upper arm 5 and the lower arm 6 is measured, and an artificial joint having a size corresponding to the distance is selected and embedded between the bones.

In the case of implanting artificial bones for, for example, vertebral body fixation, prior to implanting artificial bones, first, the intervertebral disc at the implantation site is excised, and then the tip of the spreader 8 as shown in FIG. Is inserted to open the space between the vertebral bodies 9 and 9, and then artificial bone is transplanted. In this case, the extent to which the vertebral bodies 9 and 9 are dilated depends on X-ray measurement before surgery and visual measurement of the distance between the upper and lower vertebral bodies 9 and 9 during surgery. It is the actual situation.

[0005]

When replacing the knee joint, the example shown in FIG. 6 is also used.
Even in the example shown in, the tension between the bones is finally measured by the feel of the operator's fingertips, so the part that relies on the intuition of the surgeon becomes large and an artificial joint of the optimum size is not always required. It was hard to say that they were selected, and there were complaints about the reproducibility of the surgery because the accumulation of surgical data made it difficult to select the optimal size more quickly.

Similarly, when implanting artificial bone between the vertebral bodies of the spine as in the example shown in FIG. 8, the extent to which the vertebral bodies are opened is determined by X-ray measurement before surgery, Since it relies on visual measurement of the distance between the upper and lower vertebral bodies during surgery, it is not possible to obtain sufficient accuracy regarding the degree of dilatation. Therefore, whether artificial bone of the optimum size was selected and transplanted or not. As for, there is a complaint that there is no choice but to make a judgment based on the progress after surgery.

The present invention has been made in view of the above circumstances, and an object thereof is to measure an interosseous tension based on quantitative data without depending on the intuition of an operator. Moreover, it is to provide a tension meter capable of performing highly reproducible surgery based on this data.

[0008]

In the tension meter for orthopedic surgery according to the present invention, a grip portion, a tension meter body attached to the grip portion, and a tension meter rotatably connected to the tension meter via a torque shaft. And a fixed arm extending from the tension meter body on the side opposite to the grip portion of the tension meter, and a movable arm that is separable from the tension meter body on the upper side of the tension meter body. And the movable arm is arranged immediately above the fixed arm so as to correspond to the position of the fixed arm, the movable arm is provided with a gear portion meshing with the torque shaft, and the torque setting portion is fixed to the fixed portion. A torque limiter is provided to regulate the relative displacement of the movable arm with respect to the fixed arm based on the force applied between the arm and the movable arm. It was solutions of the problem to be solved.

[0009]

According to the tension meter for orthopedic surgery of the present invention, the degree of tension of the ligament is set in advance by the torque limiter mechanism based on the past data, etc. Without relying on the intuition of
The fixed arm and the movable arm allow appropriate and quantitative expansion.

[0010]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT An embodiment of the tension meter for orthopedic surgery according to the present invention will be described below with reference to FIGS. In these drawings, reference numeral 10 is a tension meter for orthopedic surgery (hereinafter abbreviated as a tension meter).
The tension meter 10 is mainly for measuring the degree of tension between the femur 1 and the tibia 2 prior to replacing the knee joint with an artificial joint, and the grip portion 11 and the grip portion 11 are used. And a torque setting unit 14 rotatably connected to the tension meter 12 via a torque shaft 13.

The gripping portion 11 has a gun-like shape and has the gripping portion 11 to support the tension meter 10 as a whole, and a positioning rod 15 is inserted in the vertical direction of the gripping portion 10 to penetrate the grip portion 11. The holes 16 are formed. The rod 15 is erected vertically on the grip portion 11 and is made parallel to the tibia 2 so that the movable arm and the fixed arm, which will be described later, are used for positioning so that the longitudinal directions thereof are perpendicular to the tibia 2. It is a thing. Further, the tension meter main body 12 is integrally arranged on the upper end side of the grip portion 11 via a connecting rod 17.

The tension meter main body 12 has a rectangular parallelepiped block portion 18, a pair of fixed arms 19 and 19 extending forward of the block portion 18, and an alignment portion 20 formed at the center of the upper surface of the block portion 18. It consists of and. Here, the fixed arms 19 and 19 extend to the side opposite to the grip portion 11, and the tips thereof are formed in an arc shape, and are located on the side of the tibia 2 between the femur 1 and the tibia 2. It can be inserted. Also, these fixed arms 1
9 and 19 are arranged at appropriate intervals and correspond to the ligaments connecting both sides between the femur 1 and the tibia 2,
It is formed so as not to be biased when inserted between the bones.

The alignment portion 20 is formed so as to project in the center of the upper surface of the block portion 18 and extends from the grip portion 11 side to the fixed arms 19 and 19 side.
A semi-cylindrical attachment member 21 is detachably attached to the rear end portion. A through hole 22 penetrating in the front-rear direction is formed in the center of the mounting member 21, and a positioning rod 23 is inserted into the through hole 22. The rod 23 has a function similar to that of the rod 15, is inserted into the attachment member 21 so as to be parallel to the alignment portion 20, and is further parallel to the femur 1 when the knee is bent at a right angle. Tension meter 10
It is used to position the fixing rods 19 and 19 so that the longitudinal direction of the fixing rods 19 and 19 is parallel to the femur 1 by adjusting the position of.

In the block portion 18, as shown in FIG. 2, on the grip portion 11 side of the fixed arms 19, 19, a pair of rack gear holes 23, 23 penetrating from the upper surface to the lower surface and a pair of support rod holes are formed. 24, 24 are formed in parallel. One of these holes 23, 24 is formed on each side of the alignment portion 20. Further, the block portion 18 is formed with a hole 25 on one side surface thereof for inserting the torque shaft 13. This hole 25 is
The block gear 18 communicates with the rack gear holes 23, 23 in the block gear 18, so that the torque shaft 13 and the rack gear of the movable arm, which will be described later, can mesh with each other in the block gear 18.

A pair of movable arms 26, 26 are arranged on the upper surface of the block portion 18 so as to be separated from the block portion 18. These movable arms 26, 26
Is a slender rectangular plate-like member disposed immediately above the fixed arms 19 and 19 corresponding to the positions of the fixed arms 19 and, like the fixed arm 19, has an arc-shaped tip. A rack gear 27 and a support rod 28 are provided on the lower surface so as to hang down. The rack gear 27 is disposed with its gear side facing the grip portion 11 side, and is movably inserted into the rack gear hole 23. The support rod 28 is a round rod-shaped member disposed on the rear end side of the rack gear 27, and is movably inserted into the support rod hole 24. With this structure, the movable arm 26 is detachably attached to the block portion 18 by inserting the rack gear 27 into the rack gear hole 23 and the support rod 28 into the support rod hole 24, respectively. Will be things. The support rod 28 is formed to have a slightly smaller diameter than the support rod hole 24, so that when the tip of the movable arm 26 is loaded and the movable arm 26 tilts, the movable arm 26 cannot move up and down. It has become.

The torque shaft 13 is rotatably inserted into the hole 25 of the block portion 18. This torque shaft 13
Is a round bar, and gear-like pinion parts 29, 29 are formed on the front end side and the rear end side, respectively, and the hole 2 is formed on the rear end.
The large-diameter portion 30 having a diameter larger than 5 is formed. As described above, the pinion portions 29, 29 are positioned so as to mesh with the rack gears 27, 27 of the movable arms 26, 26 in the hole 25, respectively. As the shaft 13 rotates, the rack pinion mechanism including the pinion portions 29, 29 and the rack gears 27, 27 moves up and down on the block portion 18.

Further, the torque shaft 13 has a large diameter portion 30.
Connection hole 31 for connecting the torque setting portion 14 to the end face of the
Are formed. The connecting hole 31 has a square opening and is used for fitting a shaft having a square cross section. The torque setting portion 14 is detachably attached to the connecting hole 31 as shown in FIG. The torque setting unit 14 includes a square columnar connecting shaft 32 that fits into the connecting hole 31.
And a columnar set load scale portion 33 having one end side of the connecting shaft 32 built-in, and a columnar adjustment portion 34 rotatably connected to the set load scale portion 33. With. The torque limiter mechanism is based on a well-known technique, and adjusts the biasing force of a built-in spring so that a force exceeding the adjusted biasing force is not applied. That is, in the torque setting portion 14, the adjusting portion 34 is rotated with respect to the set load scale portion 33 in a state where the connecting shaft 32 is not fitted in the connecting hole 31, and the position of the tip surface of the adjusting portion 34 is set to the set load scale portion 33.
Set the load according to the scale of. Then, in this state, the connecting shaft 32 is fitted into the connecting hole 31, and the adjusting portion 34 is further rotated. Then, since the built-in spring has an urging force corresponding to the set load by turning the adjusting unit 34 with respect to the set load graduation unit 33, the load applied to the connecting shaft 32 matches the set load. Then, the rotation of the connecting shaft 32 due to the rotation of the adjusting portion 34 in the direction in which the load is further applied is stopped, and the adjusting portion 34 becomes idle.

In order to replace the knee joint with the artificial joint by using the tension meter 10 having the above-mentioned structure, the adjusting portion is adjusted so that the degree of tension corresponds to the strength of the ligament of the subject based on the past data and the like. 34 is rotated with respect to the set load scale portion 33 to set a torque value, and in that state, the connecting shaft 32 is fitted into the connecting hole 31 of the torque shaft 13. In this case, the movable arm 2
Needless to say, the reference numerals 6 and 26 are preliminarily attached to the block portion 18 so as not to be spaced apart from the fixed arms 19 and 19, and the respective rack gear portions 27 are meshed with the pinion portions 29 of the torque shaft 13.

Next, the tip ends of the fixed arms 19 and 19 and the movable arms 26 and 26 of the tension meter 10 are inserted between the femur 1 and the tibia 2 of the subject as shown in FIG. Then, the adjusting portion 34 is rotated to rotate the torque shaft 13 via the connecting shaft 32. Then, the torque shaft 13
The rotation of the pinions 29, 29 and the rack gear 2
Movable arm 2 by rack and pinion mechanism with 7,27
6, 26 move up from the block portion 14, and the movable arm 26,
26 and the fixed arms 19 and 19 are widened to separate the femur 1 from the tibia 2, and the ligament is extended. On the other hand, when the ligament is stretched in this manner, a force in the contracting direction is applied between the fixed arms 19 and 19 and the movable arms 26 and 26, and this force is applied to the rack gears 27 and 27 of the movable arms 26 and 26. It is transmitted to the torque limiter mechanism of the torque setting unit 14 via the torque shaft 13 and further the connecting shaft 32. Then, when the transmitted force matches the preset value of the torque limiter mechanism, the movable arms 26, 26 do not rise any more, and the adjusting portion 34 idles. That is, the relative displacement between the movable arms 26, 26 and the fixed arms 19, 19 is restricted by the torque limiter mechanism.

The load value preset in this way (that is, a value converted from the degree of tension of the ligament or the distance between the femur 1 and the tibia 2 and a value corresponding to these degrees of tension or distance) After expanding the space between the femur 1 and the tibia 2 so that the length of the ligament is increased, the operator touches the tension of the ligament with his fingertips or shakes the joints below and to the left and right and back and forth to extend the ligament to the optimum state. Check if there is. And
Such an operation of raising the movable arms 26, 26 to widen the space between the femur 1 and the tibia 2 by an amount corresponding to a preset load value is repeated, and when the optimum state is confirmed, the movable arms 26 at that time are checked. , 26 and the fixed arms 19, 19 are measured, and the artificial joint corresponding to the distance is selected,
This artificial joint is buried.

In such a tension meter 10, the tension of the ligament can be adjusted to a value set by the torque limiter mechanism on the basis of past data or the like, which allows the operator to simply feel the tension. Unlike selecting artificial joints by, it is possible to perform quantitative or more accurate selection of artificial joints, and because quantitative data remains, it is possible to perform reproducible surgery by accumulating data. Like

FIG. 4 shows an example in which the tension meter for orthopedic surgery according to the present invention is used when implanting artificial bone for fixing a vertebral body. Instead of the conventional spreader 8 shown in FIG. By using the tension meter 35, as in the case of the tension meter 10 shown in FIGS. 1 to 3, it is possible to quantitatively or accurately implant an artificial bone without reliance on the operator's intuition, and the reproducibility is improved. It becomes possible to perform expensive surgery. The tension meter 35 used for fixing the vertebral body is different from the tension meter 10 used for knee joint replacement.
It suffices to provide one fixed arm and one movable arm, not one pair, and one arm. Because in the case of the knee joint, since there are ligaments on both sides of each bone, it is difficult for each arm to extend both ligaments evenly when inserting them between the bones and expanding the space between them. It is preferable that there be one pair, but in the case of the spine, there are many ligaments between the vertebral bodies 9, and each arm can be well balanced and there is no problem.

The tension meter for orthopedic surgery of the present invention is not only applied to the replacement of the knee joint with the artificial joint or the transplantation of artificial bone for fixing the vertebral body.
Besides, for example, as shown in FIG. 5, it can be applied to replacement of a hip joint with an artificial joint.

[0024]

As described above, the tension meter for orthopedic surgery according to the present invention is such that the degree of tension of the ligament can be set in advance based on the past data etc. by the torque limiter mechanism. Therefore, fixed and movable arms can be expanded appropriately and quantitatively between the bones without relying on the conventional operator's intuition, and thus the selection of artificial joints and bones can be performed accurately. It is possible to perform the operation, and moreover, the quantitative data remains, so that the operation can be performed with high reproducibility by accumulating the data, thereby speeding up the operation and increasing its certainty.

[Brief description of drawings]

FIG. 1 is a schematic configuration diagram showing an embodiment of a tension meter for orthopedic surgery according to the present invention.

FIG. 2 is an exploded perspective view of the tension meter shown in FIG.

FIG. 3 is a diagram illustrating a method of using the tension meter shown in FIG.

FIG. 4 is a view showing a use of the tension meter for orthopedic surgery of the present invention when used for artificial bone graft for vertebral body fixation.

FIG. 5 is a diagram showing the use of the tension meter for orthopedic surgery according to the present invention when the hip joint is replaced with an artificial joint.

FIG. 6 shows a conventional case of replacing a knee joint with an artificial joint,
It is a figure for explaining an example of a surgical method.

FIG. 7 shows a conventional case of replacing a knee joint with an artificial joint,
It is a figure for explaining other examples of a surgical method.

FIG. 8 is a view for explaining an example of a conventional surgical method when implanting artificial bone between vertebral bodies.

[Explanation of symbols]

 10 Orthopedic Tension Meter 11 Gripping Part 12 Tension Meter Main Body 13 Torque Shaft 14 Torque Setting Section 19 Fixed Arm 26 Movable Arm 27 Rack Gear 32 Connection Shaft 33 Set Load Scale Section 34 Adjusting Section

[Procedure amendment]

[Submission date] November 27, 1991

[Procedure Amendment 1]

[Document name to be amended] Statement

[Correction target item name] Full text

[Correction method] Change

[Correction content]

[Document name] Statement

[Title of the Invention] orthopedic surgical tension meter over

[Claims]

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION This invention, artificial joint or human
Prior to engineering bone embedded to or implanted between the bone and the bone, about the orthopedic surgical tension Gauge used to measure the degree of tension extends between the bone and the bone <br / > Ru.

[0002]

2. Description of the Related Art In recent years, various new materials such as ceramics have been developed, and skeleton-based substitute materials having excellent functions are successively provided. Then, artificial joints and human engineering bone produced by such skeletal system alternative materials are now widely used in the field of orthopedics, it achieved significant therapeutic effect. By the way, in such a case artificial in the joint and human engineering bone embedded in the human body by surgery or transplantation, to replace, for example, the knee joint to artificial joint, actually people
Prior to burying the artificial joint, first, as shown in FIG. 6, the distal part of the femur 1 and the proximal part of the tibia 2 are excised, and a spacer 3 having an appropriate thickness is inserted between these bones. In this state, the surgeon touches the ligaments (not shown) on both sides of the knee joint to check the degree of tension with his fingertips, and further rocks the tibia 2 and lower parts to the left, right, front, and rear, so that the femur 1 and the tibia 2 connected by the ligaments 2 To measure the degree of tension with. Here, the strength of the ligament is different for each individual, and the space between the femur 1 and the tibia 2 is expanded at an appropriate interval according to the strength of the ligament of the subject himself, and the ligament is appropriately tensioned. if not allowed, artificial joint is not to function in aptitude. Therefore, the spacers 3 having different thicknesses are exchanged variously to set the distance between the femur 1 and the tibia 2 according to the strength of the ligament of the subject, and then the spacer 3
To bury the artificial joint of the corresponding dimension to the interval set by removing the.

Further, in place of the spacer 3 shown in FIG. 6, an extension tool 4 as shown in FIG. 7 is also known. In the extension tool 4, the upper arm 5 and the lower arm 6 are connected by screws 7, 7, and the distance between the upper arm 5 and the lower arm 6 is adjusted by adjusting the tightening degree of the screws 7, 7. Is. Using this expansion tool 4, the femur 1 and the tibia 2
In order to check the tension between the bones, first insert the upper arm 5 and the lower arm 6 between these bones in a closed state,
Turn 7 to extend between the arms. Then, the surgeon finds an appropriate degree of tension of the ligament by an experience-based intuition by the stress applied to the fingertips when turning the screws 7 and 7, and expands the space between the bones to an appropriate interval. Then, measure between the upper arm 5 and the lower arm 6 dilator 4 removed from between the bone, this by selecting the artificial joint dimensions corresponding to the distance to bury between the bones.

Further, for example when porting human engineering bone for vertebral fusion, prior to implanting the human engineering bone, after first excised intervertebral disc implantation site, spreader 8 as shown in FIG. 8 pledged the previous and dilatation between vertebral bodies 9, 9, to port then human engineering bone. In this case, the extent to which the vertebral bodies 9 and 9 are dilated depends on X-ray measurement before surgery and visual measurement of the distance between the upper and lower vertebral bodies 9 and 9 during surgery. It is the actual situation.

[0005]

When replacing the knee joint, the example shown in FIG. 6 is also used.
Artificial joints of the degree of tension from that measure, part to rely on intuition of the operator is not necessarily the optimal dimensions become large between the bone and the bone by the feel of the fingertips of the operator is also ultimately in the example shown in It was difficult to say that the selection of the above was not done, and there was a dissatisfaction about the reproducibility of the operation that it was not possible to sufficiently select the optimal size more quickly due to the accumulation of the operation data.

[0006] Similarly, even in the case of transplanted with human engineering bone as in the example shown in FIG. 8 between the vertebral bodies of the spine, Ya X-ray measurement of preoperative about how much to dilatation between vertebral bodies , since it is relying on the distance measurement between the gross superior and inferior vertebral bodies during surgery, or sufficient accuracy can not be obtained, thus transplanted selected human engineering bone optimal dimensions for the degree of dilatation There is a complaint that it can only be judged based on the progress after surgery.

The present invention has been made in view of the above circumstances, and an object thereof is to measure an interosseous tension based on quantitative data without depending on the intuition of an operator. , yet to provide a tension meter over you so allows highly reproducible operation on the basis of this data.

[0008]

Means for Solving the Problems] In orthopedic surgical tension Gauge of the present invention, a grip portion, and a tension Gauge body attached to the grip portion, a torque to the tension main <br/> COMPUTER consists of a pivotally connected torque setting unit via the shaft, a fixed arm extending from said tension meter over the body on the side opposite the gripping portion of the tension Gauge provided, the upper part of the tension Gauge body engaged to the tension Gauge body spaced a movable arm provided for, and the movable arm is arranged directly above the said fixed arm so as to correspond to the position of the fixed arm, the torque shaft to the movable arm And a torque control section for restricting relative displacement of the movable arm with respect to the fixed arm based on a force applied between the fixed arm and the movable arm in the torque setting section. In that a limiter and a solution of the above problems.

[0009]

SUMMARY OF According to orthopedic surgical Tension Gauge <br/> of the present invention, by setting the tension of the ligaments based on the pre-historical data such as a torque limiter mechanism,
The space between the bones can be expanded appropriately and quantitatively by the fixed arm and the movable arm without relying on the intuition of the operator as is conventionally done.

[0010]

EXAMPLES Hereinafter, an embodiment of an orthopedic surgical tension main <br/> COMPUTER the present invention will be described with reference to Figure 1 to Figure 3. These reference numeral 10 is an orthopedic surgical Tension Gauge (hereinafter, tension Gauge and abbreviated), and femur 1 prior to the tension meter over 10 mainly substituted knee in artificial joints For measuring the degree of tension between the tibia 2 and the tibia 2,
This grip portion 11 the tension Gauge body 12 attached to, but which is schematically composed pivotally connected torque setting unit 14. via a torque shaft 13 to the tension meter over 12.

[0011] The present gripper 11 of the gun bunch shape, which supports the entire tension Gauge 10 by having this, for supporting this by allowed through the rod 15 for positioning the vertically The through hole 16 is formed. The rod 15 is erected vertically on the grip portion 11 and is made parallel to the tibia 2 so that the movable arm and the fixed arm, which will be described later, are used for positioning so that the longitudinal directions thereof are perpendicular to the tibia 2. It is a thing. Further, this grip portion 11, the tension Gauge body 12 via a connecting rod 17 at its upper tip end is disposed integrally.

[0012] Tension Gauge body 12 includes a rectangular parallelepiped block portion 18, a pair of fixed arms 19, 19 extending in front of the block portion 18, the positioning portion formed on the center of the upper surface of the block portion 18 And 20. Here, the fixed arms 19 and 19 are the gripping parts 11
It extends to the opposite side, and its tip is formed in an arc shape, and is inserted into the tibia 2 side between the femur 1 and the tibia 2. Also, these fixed arms 1
9 and 19 are arranged at appropriate intervals and correspond to the ligaments connecting both sides between the femur 1 and the tibia 2,
It is formed so as not to be biased when inserted between the bones.

The alignment portion 20 is formed so as to project in the center of the upper surface of the block portion 18 and extends from the grip portion 11 side to the fixed arms 19 and 19 side.
A semi-cylindrical attachment member 21 is detachably attached to the rear end portion. A through hole 22 penetrating in the front-rear direction is formed in the center of the mounting member 21, and a positioning rod 23 is inserted into the through hole 22. The rod 23 has a function similar to that of the rod 15, is inserted into the attachment member 21 so as to be parallel to the alignment portion 20, and is further parallel to the femur 1 when the knee is bent at a right angle. tension meter - 1
By adjusting the position of 0, the fixed rods 19, 19
It is used for positioning so that the length direction of is parallel to the femur 1.

In the block portion 18, as shown in FIG. 2, on the grip portion 11 side of the fixed arms 19, 19, a pair of rack gear holes 23, 23 penetrating from the upper surface to the lower surface and a pair of support rod holes are formed. 24, 24 are formed in parallel. One of these holes 23, 24 is formed on each side of the alignment portion 20. Further, the block portion 18 is formed with a hole 25 on one side surface thereof for inserting the torque shaft 13. This hole 25 is
The block gear 18 communicates with the rack gear holes 23, 23 in the block gear 18, so that the torque shaft 13 and the rack gear of the movable arm, which will be described later, can mesh with each other in the block gear 18.

A pair of movable arms 26, 26 are arranged on the upper surface of the block portion 18 so as to be separated from the block portion 18. These movable arms 26, 26
Is a slender rectangular plate-like member disposed immediately above the fixed arms 19 and 19 corresponding to the positions of the fixed arms 19 and, like the fixed arm 19, has an arc-shaped tip. A rack gear 27 and a support rod 28 are provided on the lower surface so as to hang down. The rack gear 27 is disposed with its gear side facing the grip portion 11 side, and is movably inserted into the rack gear hole 23. The support rod 28 is a round rod-shaped member disposed on the rear end side of the rack gear 27, and is movably inserted into the support rod hole 24. With this structure, the movable arm 26 is detachably attached to the block portion 18 by inserting the rack gear 27 into the rack gear hole 23 and the support rod 28 into the support rod hole 24, respectively. Will be things. The support rod 28 is formed to have a slightly smaller diameter than the support rod hole 24, so that when the tip of the movable arm 26 is loaded and the movable arm 26 tilts, the movable arm 26 cannot move up and down. It has become.

The torque shaft 13 is rotatably inserted into the hole 25 of the block portion 18. This torque shaft 13
Is a round bar, and gear-like pinion parts 29, 29 are formed on the front end side and the rear end side, respectively, and the hole 2 is formed on the rear end.
The large-diameter portion 30 having a diameter larger than 5 is formed. As described above, the pinion portions 29, 29 are positioned so as to mesh with the rack gears 27, 27 of the movable arms 26, 26 in the hole 25, respectively. As the shaft 13 rotates, the rack pinion mechanism including the pinion portions 29, 29 and the rack gears 27, 27 moves up and down on the block portion 18.

Further, the torque shaft 13 has a large diameter portion 30.
Connection hole 31 for connecting the torque setting portion 14 to the end face of the
Are formed. The connecting hole 31 has a square opening and is used for fitting a shaft having a square cross section. The torque setting portion 14 is detachably attached to the connecting hole 31 as shown in FIG. The torque setting unit 14 includes a square columnar connecting shaft 32 that fits into the connecting hole 31.
And a columnar set load scale portion 33 having one end side of the connecting shaft 32 built-in, and a columnar adjustment portion 34 rotatably connected to the set load scale portion 33. With. Torukurimi Tsu coater mechanism is due to the known art, to adjust the internal urging force of the springs, in which a force exceeding the biasing force adjusted by this was not applied. That is, in the torque setting portion 14, the adjusting portion 34 is rotated with respect to the set load scale portion 33 in a state where the connecting shaft 32 is not fitted in the connecting hole 31, and the position of the tip surface of the adjusting portion 34 is set to the set load scale portion 33.
Set the load according to the scale of. Then, in this state, the connecting shaft 32 is fitted into the connecting hole 31, and the adjusting portion 34 is further rotated. Then, since the built-in spring has an urging force corresponding to the set load by turning the adjusting portion 34 with respect to the set load graduation portion 33, the load applied to the connecting shaft 32 matches the set load. Then, the rotation of the connecting shaft 32 due to the rotation of the adjusting portion 34 in the direction in which the load is further applied is stopped, and the adjusting portion 34 becomes idle.

[0018] The tension meter over 10 of such a configuration
To replace the artificial joint to the knee joint by using the Rotate to set load scale 33 the adjusting unit 34 so as to be tone corresponding to the intensity of the ligaments of the surgeon based on historical data, etc. To set the torque value, and in that state, set the connecting shaft 32 to the torque shaft 13
It fits into the connection hole 31 of the. In this case, the movable arm 2
Needless to say, the reference numerals 6 and 26 are preliminarily attached to the block portion 18 so as not to be spaced apart from the fixed arms 19 and 19, and the respective rack gear portions 27 are meshed with the pinion portions 29 of the torque shaft 13.

Next, pledged between the femur 1 and the tibia 2 of the surgeon to indicate the distal end of the fixed arm 19, 19 and movable arms 26, 26 of the tension meter over 10 in FIG. 3, the In this state, the adjusting portion 34 is rotated to rotate the torque shaft 13 via the connecting shaft 32. Then, torque shaft 1
By the rotation of 3, the movable arms 26, 26 rise from the block portion 14 by the rack and pinion mechanism of the pinion portions 29, 29 and the rack gears 27, 27, and the movable arm 2
6 and 26 and the fixed arms 19 and 19 are widened to separate the femur 1 from the tibia 2 and stretch the ligament.
On the other hand, when the ligament is stretched in this way, the force in the contracting direction causes the fixed arms 19 and 19 and the movable arms 26 and 26 to contract.
Between the rack gears 27, 27 of the movable arms 26, 26, the torque shaft 13, and the connecting shaft 32.
Is transmitted to the torque limiter mechanism of the torque setting unit 14 via. Then, when the transmitted force matches the preset value of the torque limiter mechanism, the movable arms 26, 26 do not rise any more, and the adjusting portion 34 idles. That is, the relative displacement between the movable arms 26, 26 and the fixed arms 19, 19 is restricted by the torque limiter mechanism.

The load value preset in this way (that is, a value converted from the degree of tension of the ligament or the distance between the femur 1 and the tibia 2 and a value corresponding to these degrees of tension or distance) After expanding the space between the femur 1 and the tibia 2 so that the length of the ligament is increased, the operator touches the tension of the ligament with his fingertips or shakes the joints below and to the left and right and back and forth to extend the ligament to the optimum state. Check if there is. And
Such an operation of raising the movable arms 26, 26 to widen the space between the femur 1 and the tibia 2 by an amount corresponding to a preset load value is repeated, and when the optimum state is confirmed, the movable arms 26 at that time are checked. , measure the distance between the 26 and the fixed arm 19, to select the artificial joint corresponding to the distance,
Burying the artificial joint.

[0021] In such a tension meter over 10, can be adjusted to a value where the tension of the ligaments and set by the torque limiter mechanism based on historical data and the like, thereby the conventional as simply the operator Person by intuition
Unlike selects Engineering joint, quantitative, i.e. more selective accurate artificial joint can be performed, yet can be performed with high reproducibility operation by the accumulation of data by leaving a quantitative data Like

[0022] Figure 4 shows an example of using when the orthopedic surgical tension <br/> Gauge of the present invention is transplanted human engineering bone for vertebral fusion, prior art shown in FIG. 8 by using the tension Gauge 35 on behalf of the spreader 8, the tension Gauge 1 shown in FIGS. 1 to 3
As in the case of 0, without relying on intuition of the operator, quantitative That can transplant the exact person engineering bone, yet highly reproducible surgery is so performed. Incidentally, in the tension Gauge 35 used for this vertebral fusion,
Unlike tension meter over 10 used in the case of a knee joint replacement, the fixed arm and the movable arm without the provision in pairs respectively, it is only provided one by one, respectively. Because in the case of the knee joint, since there are ligaments on both sides of each bone, it is difficult for each arm to extend both ligaments evenly when inserting them between the bones and expanding the space between them. It is preferable that there is a pair of
This is because, in the case of the spine, there are many ligaments between the vertebral bodies 9 and each arm can be well balanced and there is no problem.

[0023] Incidentally, only the orthopedic surgical tension <br/> Gauge of the present invention is a substituted or to artificial joints of the knee joint, is applied only to transplantation of human engineering bone for vertebral fusion not, can be applied to the replacement of the hip, as in the other, for example, in FIG artificial joints.

[0024]

As described above, according to the present invention, the orthopedic surgical tension Gauge of the present invention has to be able to set the tension of the ligaments based on the pre-historical data such as by the torque limiter mechanism some because, without relying on intuition of the conventional as operator between the bone and the bone, suitably moreover can be expanded numerically by fixed arm and the movable arm, thus selection of artificial joints and human engineering bone The operation can be performed accurately, and since the quantitative data remains, the operation can be performed with high reproducibility by accumulating the data, thereby speeding up the operation and increasing its certainty.

[Brief description of drawings]

1 is a schematic block diagram showing one embodiment of an orthopedic surgical Tension Gauge <br/> of the present invention.

It is an exploded perspective view of the tension Gauge shown in FIG. 1. FIG.

3 is a usage illustration of the tension Gauge shown in FIG.

[4] The orthopedic surgical Tension Gauge <br/> of the present invention is the use view when used for human engineering bone graft for vertebral fusion.

[5] The orthopedic surgical Tension Gauge <br/> of the present invention is the use diagram when used in substitution of the hip joint of the artificial joint.

[6] of the past, of if you want to replace the artificial joint of the knee joint,
It is a figure for explaining an example of a surgical method.

[7] of the past, of if you want to replace the artificial joint of the knee joint,
It is a figure for explaining other examples of a surgical method.

FIG. 8 is a diagram for explaining an example of a conventional surgical method when implanting an artificial bone between vertebral bodies.

[Description of reference numerals] 10 orthopedic surgical Tension Gauge 11 grip portion 12 the tension Gauge body 13 torque shaft 14 torque setting unit 19 fixed arm 26 movable arm 27 rack gear 32 coupling shaft 33 set load scale part 34 adjusting unit

Claims (1)

[Claims] 1. A tension for orthopedic surgery for expanding the space between the bones and measuring the degree of tension thereof before embedding or implanting the artificial joint or the artificial bone between the bones. A grip part of the tension meter, which comprises a grip part, a tension meter main body attached to the grip part, and a torque setting part rotatably connected to the tension meter via a torque shaft. A fixed arm extending from the tension meter main body is provided on the side opposite to the tension meter main body, a movable arm that can be separated from the tension meter main body is provided above the tension meter main body, and the movable arm corresponds to the position of the fixed arm. Is arranged directly above the fixed arm, the movable arm is provided with a gear portion that meshes with the torque shaft, and the torque setting portion includes the fixed arm and the movable arm. A tension meter for orthopedic surgery, comprising a torque limiter for restricting relative displacement of a movable arm with respect to a fixed arm based on a force applied therebetween.