JPH09220235A - Osteosymphysis device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To make it possible to deal with various kinds of osteosymphysis with a single device by dividing a tube and a plate and making the mounting direction of the tube to the plate adjustable within a prescribed range. SOLUTION: This osteosymphysis device has the slender flat planar plate 1 and is fixed in pressurized contact with the outer side surface of the femur and is formed as to has many kinds of size corresponding to the size of the bemnr. A tube through-hole 3 is formed above the central part thereof to allow the insertion of the tube 5 for housing a screw means. The tube 5 used in combination with the plate 1 is formed to a cylindrical shape having a through-hole 5a and has a collar part 5b formed as a projecting part having a spherical surface at its base end. The tube 5 is adjustable from the position shown by solid lines with respect to as vertical direction to a position shown by alternate long and short dashed lines. The tube is adjustable in the lateral direction as well within the prescribed range. Namely, the tube 5 is so designed as to be properly adjusted in its mounting direction in the entire direction.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a method in which, when a bone constituting a human body is fractured, the bone separated by the fracture is screwed to the bone body to which the separated bone is connected (hereinafter referred to as "main bone"). Bone-joining device for joining via means. The osteosynthesis device of the present invention is composed of a combination of a plate and a screw means accommodating tube, and since the tube attachment position and angle with respect to the plate can be arbitrarily changed, one osteosynthesis device can be used for joining various bones.
And, it can easily cope with the joining of various parts of the bone. The invention also relates to a compression screw, or so-called "compression screw", for joining separated bones.

[0002]

2. Description of the Related Art Conventionally, when a bone fracture occurs due to an accident or sports, a screw means is inserted into the fracture site to penetrate the main bone and the separated bone, and the separated bone is completely fused to the main bone. Then, after it is confirmed that the screws are integrated as before, the screw means that is no longer needed is removed. For the fitting of the screw means, an osteosynthesis device in which a tube and a plate are integrated, which is usually called a "tube plate", is used.

An example of a conventional osteosynthesis using a tube plate will be described step by step using a fracture of the femoral neck as an example, as shown in the sectional views of FIGS. In this example, as shown in FIG. 12, it is assumed that the neck 101a of the femur 101 is fractured at the jagged solid line A. When such a fracture occurs, the neck 101a separated by the fracture is drawn to the fracture site A of the femur 101 to press it, and further joined and fixed. First, as shown in FIG. 12, an angle guide 103 having an appropriate shape is pressed against the lateral surface (side surface facing the fracture site A) of the femur 101, and the guide pin 105 is placed under the image control. Insert up to 107. After inserting the guide pin 105, an image pickup device such as an X-ray device or an image intensifier is used to confirm that the guide pin 105 is arranged at an accurate position.

Then, as shown in FIG. 13, a guide pin gauge 109 is used to measure the length of the guide pin 105 inserted into the neck 101a in the previous step. This is because the total length of the guide pin 105 has already been measured,
By measuring the length of the portion of the femur 101 protruding to the outside, the length of the punctured portion can be measured inevitably.

Subsequently, reaming is performed as shown in FIG. That is, the combination reamer 111 is attached to the place where the guide pin 105 was inserted in the previous step, and the reaming length of the reamer 111 was subtracted by 10 mm from the already measured insertion length of the guide pin 105. Set so that Then, reaming is performed by the set length, and the diameter of the hole formed by the guide pin 105 is enlarged. After reaming, a trial shaft (not shown) is inserted into the hole formed by the reaming, and the femur 101
And the conformity of the angle of the hole formed penetrating the neck 101a is confirmed.

Further, as shown in FIG. 15, a tap 113 with a sleeve is attached, and tapping is performed while inserting the barrel 113a into the hole formed by reaming. Tapping depth is tap with sleeve 1
Confirm by the scale of the handle 113b of No. 13. Separately, components shown in FIG. 16 are combined to complete the lag screw inserter 115. That is, the lag screw attachment 119 is inserted into the guide shaft 117, and the lag screw 121 having the same length as the previous tapping depth is attached to the tip thereof. Then, the lag screw inserter 115 is assembled by inserting the guide shaft 117 into the center sleeve 123 from the front or the rear and setting the wrench 125.

Next, as shown in FIG. 17, the lag screw inserter 115 is attached to a predetermined position of the femur 101 and the wrench 125 is rotated while rotating the wrench 125.
21 is inserted into the tapped hole along the guide pin 117. Then, the tip of the wrench 125 is screwed in until it reaches the scale of the center sleeve 123. As a result, the tip of the lag screw 121 is attached to the head 107
It is screwed up to a position 10 mm before and the proximal end is embedded in the lateral cortex of the femur 101.

Further, as shown in FIG.
5 and the center sleeve 123 are removed, and the tube plate 127 is attached along the guide shaft 117. Then, as shown in FIG. 19, the guide shaft 117 and the lag screw attachment 119 are removed, and the impactor 129 is used to apply pressure to the fracture site A.

Subsequently, the tube plate 127 is fixed to the femur 101. As shown in FIG. 20, the tube plate is fixed by tapping a predetermined portion of the femur 101, which is in pressure contact with the tube plate 127, using a drill device 131, and further, as shown in FIG. This can be done by fixing with 135 and / or by pulling the lag screw 121 by screwing the compression screw 137 into the proximal end of the lag screw 121. By fixing the tube plate in this way,
Pressure can be applied to the fracture site A.

Through the series of steps described above, the operation of joining the separated bones at the fracture site A is completed.
The subsequent work is a work of removing the respective instruments inserted in the femur after the fracture area A is completely joined after a predetermined curing period. However, some problems remain in the conventional osteosynthesis described above.

The first problem is the structure of the tube plate which is pressed against and fixed to the femur. The tube plate 127 is composed of a plate 127a arranged along the outer side of the femur 101 and a tube 127b inserted into the tapping hole, as can be seen from FIG. There is. Plate 127a
A hole 139 into which a screw 135 (see FIG. 21) is inserted.
Are formed. Further, a through hole 141 is formed in the tube 127b, and the base end portion of the lag screw 121 is arranged in the through hole 141.

By the way, in the case of the above-mentioned integral tube plate, the angle formed by the tube and the plate (vertical body angle = vertical direction corresponding to the angle θ in FIG. 11 described below) Anteversion angle = angle α in Fig. 11
That is, the mounting direction of the tube with respect to the plate is determined in advance and cannot be adjusted. However, the shape and size of the neck of the femur, and the angle of attachment of the neck to the femur, varies from person to person in the osteosynthesis, and thus a single tube plate all There is a problem that it is not possible to cope with the osteosynthesis of. Therefore, in the conventional osteosynthesis, a large number of tube plates having tubes attached in various attachment directions must be prepared in advance, and an appropriate one must be selected and used for each operation. There wasn't.

More specifically, the applicant who is a manufacturer of tube plates prepares a total of 5 types of tube plates in 5 ° increments with a neck angle in the range of 130 to 150 ° to meet customer needs. I'm answering. However, this means that the manufacturer has to accept poor manufacturing yield, complicated handling, and large space required for storage, and the customer can handle various operations without delay. Therefore, there is a problem that many tube plates must be stocked as stock.

Even if an appropriate tube plate can be selected, it does not always match the fracture site of the femur exactly, and the neck angle in the vertical direction, There may be a deviation in the anteversion angle in the left-right direction, and in such a case, a gap will occur between the femur and the plate. However, the gap thus generated cannot be adjusted due to the structure of the plate, etc., and consequently the plate has to be forcibly fixed to the femur with the fixing screw. Therefore, an unreasonable load acts on the fixing screw to damage it, or, unintentionally, it may damage the femur itself.

[0015]

DISCLOSURE OF THE INVENTION The present invention solves the above-mentioned problems of the prior art, and allows osteosynthesis of various bone types and various osteosynthesis sites with a single device. It is an object of the present invention to provide an osteosynthesis device that can be used for surgery. The present invention also has a simple structure,
Moreover, it is an object of the present invention to provide an osteosynthesis device that does not require a complicated process as in the past in osteosynthesis.

Other objects of the present invention will be readily understood from the following detailed description.

[0017]

According to the present invention, the above-described object is an osteosynthesis for joining a separated bone that has been separated or is separable by a fracture or the like to its main bone through screw means. A device, which is pressed against one side surface of the main bone and is fixed, a tube through hole formed through the plate at a predetermined position of the plate, and a tube through hole of the plate. In addition, a screw means accommodating tube that can be embedded inside the main bone, and the tube is inserted into the through hole of the plate and fixed at an angle suitable for screwing and fixing the screw means to the separation bone. And a tube fixing means including a part of the plate and a part of the tube. It can be achieved by a device.

According to the invention, there is also provided a plate for joining at least two separating bones together, which plate is to be crimped to one of said separating bones, said plate being crimped from said plate. A compression screw including a lag screw extending in a direction of the separated bone different from the separated bone and a tube provided with a through hole for accommodating the lag screw, the tube being capable of forming a predetermined angle with respect to the plate And a predetermined angle thereof is selectively changeable so as to correspond to and correspond to a predetermined angle of the separating bone before separation.

[0019]

BEST MODE FOR CARRYING OUT THE INVENTION In the bone joining device according to the present invention, a separated bone generated by a fracture or the like is used as a main bone (bone body such as a femur).
A plate to be joined to the outer surface of the main bone by pressing and fixing,
The tube through hole formed at a predetermined position of this plate and the tube through hole are arranged so as to penetrate therethrough, and the tip end is inserted into the hole formed in the skeleton and the mounting direction to the plate is within a predetermined range. And a tube fixing means for fixing the tube.

In the practice of the present invention, the tube fixing means for fitting and fixing the tube in the through hole of the plate at an angle suitable for screwing and fixing the screw means to the separating bone is preferably a ball. It can be a joint structure. That is, when the tube is passed through the tube through hole to be joined to the plate, the joint portion has a ball joint structure, whereby the attachment direction of the tube to the plate can be arbitrarily adjusted.

In a preferred embodiment, the ball joint structure in the tube mounting portion for the plate is formed as a recess having a spherical surface formed by partially hollowing the side of the tube through hole in the plate opposite to the main bone. Further, in the tube, when the tube is fitted into the tube through hole, a flange portion formed as a convex portion having a spherical surface, which can be combined with the spherical concave portion to form a ball joint structure, is provided. Can be configured as described.

In another preferred embodiment of the ball joint structure, the side of the tube through-hole in the plate opposite to the main bone has a concave portion having a spherical surface formed by being partially hollowed, and the spherical surface. And a cylindrical space portion having a cylindrical surface formed subsequent to the concave portion, and when the tube is fitted into the tube through hole, the spherical concave portion and the cylindrical space portion are combined with each other. It is possible to provide a flange portion formed as a convex portion having a spherical surface, which can be combined to form a ball joint structure.

Further, the tube fixing means preferably includes a pulling screw to be screwed into the base end of the screw means via a washer, and is fitted inside the screw means accommodating tube. When the tip of the screw means is screwed into the separated bone and the pulling screw is screwed in, the separated bone can be pulled toward the main bone to compress the fracture site.

The washer used for screwing the tensioning screw into the base end of the screw means may be of a conventional type, but its side surface is preferably tapered. That is, in one preferred embodiment, the surface of the washer which is to be brought into contact with the spherical recess and / or the cylindrical space, if present, has a taper.

Furthermore, in order to prevent a large load from being applied to the washer when the tension screw is screwed in, the washer is engaged at an arbitrary position of the tube through hole when the tension screw is tightened. It is then stopped and fastened and fixed, and at that time, it is preferable that a part of the surface of the plate corresponding to the upper portion of the washer is built up.

By the way, in carrying out the present invention, a lag screw can be advantageously used as the screw means. Further, in order to easily remove the screw means from the main bone after a predetermined curing period, a male screw portion is provided at the tip of the screw means, and a tap is additionally attached to the male screw portion. preferable. In addition,
The screw means may be left in the main bone as it is without being removed depending on the type of osteosynthesis or under other conditions.

According to the practice of the present invention, a member called a tube plate used in the conventional osteosynthesis is
When the tube is divided into a plate and the tube is inserted into the hole of the main bone through the tube through hole of the plate, its mounting direction, that is, the mounting direction of the tube to the plate can be adjusted within a predetermined range. It was done like this. By doing so, it becomes possible to respond by appropriately adjusting the mounting direction of the tube according to the bone condition etc. which has individual differences, and as in the past, many mounting directions of various mounting directions are available. It is possible to eliminate the complexity of having to prepare and select from among them. The extent to which the mounting direction of the tube with respect to the plate can be adjusted may be set arbitrarily.

Further, according to the present invention, as described above,
A compression screw is provided for joining at least two separate bones together. The compression screw of the present invention includes a plate to be crimped to one of the separated bones, a lag screw extending from the plate in a direction of the separated bone different from the separated bone to which the plate is crimped, and the lag screw. A tube equipped with a through hole for connecting the tube, the tube being independent of the plate and fixedly mountable at a predetermined angle with respect to the plate, and the predetermined The angle of the separated bone corresponds to and coincides with the pre-separation pre-separation angle of the separated bone, and thus, upon completion of the joint of the separated bone, the joined bone is in its original form. It can be changed to.

The plate, the lag screw and the tube described above can each be constructed in the same manner as that of the osteosynthesis device described above. Also, the tube is
Preferably, it can be fitted into a tube through hole formed through the plate at a predetermined position of the plate, and particularly by utilizing a ball joint structure,
Can be configured.

The osteosynthesis device and the compression screw for osteosynthesis according to the present invention can be used when various bones constituting the human body are separated due to fracture or other reasons, or are separable, for example, partially fractured or cracked. In the case of the inclusion of bones, it can be advantageously used in osteosynthesis in surgical hospitals and the like. Here, the bone that can be the target of the osteosynthesis of the present invention is
Although not limited to those listed below, in addition to the femurs specifically described throughout the specification, there are humerus, tibia, fibula, etc., and in some cases, bones such as joints and ligaments. A portion similar to is also included.
Further, since the bone joining device of the present invention can be arbitrarily changed in size, from a large fracture site to a small fracture site,
Can be widely used.

[0031]

EXAMPLES Next, an osteosynthesis device and a compression screw according to the present invention will be described with reference to a preferable example thereof. However, it should be understood that the present invention is not limited to the examples shown below, and various modifications and improvements can be made within the scope of the present invention. The following examples are examples in which the osteosynthesis device of the present invention is used for osteosynthesis of a femoral fracture, however, the following description will be given together with the explanation of the compression screw of the present invention. Is intended. In addition, regarding the femur and others, in order to facilitate understanding,
The same reference numerals as in the drawings referred to in the section of the prior art will be used as they are.

The osteosynthesis device according to the present invention has an elongated flat plate 1 as shown in FIG. The plate 1 is pressed against and fixed to the outer surface of the femur (not shown), and can have various sizes depending on the size of the femur (for example, adult and dwarf). . Further, as a modified example, even when it is used for a joint operation for bones other than the femur, various sizes can be used depending on the type of the bone joint operation, the size of the bone, and the like.

A tube through hole 3 is formed above the center of the plate 1. A tube 5 for accommodating screw means is provided in the tube through hole 3.
Can be inserted. Further, the tube 5 can be inserted into the tapping hole 7 formed in the femur as described above with reference to FIGS. 6 and 7. As shown in the figure, a lag screw 7 as a screw means is inserted into the tube 5 having an internal space from the opening on the left side in the figure, and the base end portion of the tube 5 is opened from the opening on the right side of the tube 5. It projects to the outside. A tension screw 13 is screwed onto the protruding base end portion of the lag screw 7 with a washer 11 interposed.

Next, the configuration of each component of the bone joining device of the present invention as described above will be described more specifically. First, regarding the plate 1, the tube through hole 3 is formed in the plate 1 as described above.
1, the spherical concave portion 3a located on the right side in FIG. 1 has a spherically hollowed-out shape as shown in FIG. 1 (and FIGS. 2, 6 and 7). ing. In addition, the reduced diameter portion 3b on the left side in FIG. 1 has a shape that is hollowed out obliquely from above. On the spherical concave portion 3a side, the tube through hole 3 is gradually reduced in diameter from the inlet side (right side in FIG. 1) toward the outlet side (left side in FIG. 1), and on the reduced diameter portion 3b side. The diameter of the tube through hole 3 is gradually reduced from the outlet side (left side in FIG. 1) toward the inlet side (right side in FIG. 1).

Further, in this plate 1, the portion above the tube through hole 3 is padded to form a padded portion 1b as shown in the figure. Further, the back surface side (the left side portion in FIG. 1) of the plate 1 is a sectional view taken along the line segment III-III in FIG. 2 and a sectional view taken along the line segment IV-IV in FIG. 3 and FIG. As can be seen from FIG. 4, it has a concave shape that is curved so as to come into close contact with the outer surface of the femur. Contrary to this shape, the surface side of the plate 1 has a curved convex shape as illustrated. Further, in addition to the tube through hole 3 as described above, the plate 1 is provided with a large number (6 in the figure) of through holes 1c for screwing a fixing screw (cortical screw) (not shown) into the femur 101. There is.

Further, the tube 5 used in combination with the plate 1 in the osteosynthesis device of the present invention has a tubular shape, is provided with a through hole 5a, and has a convex portion having a spherical surface at the base end thereof. It is provided with a collar portion 5b formed as. Then, the tube 5 is penetrated through the tube through hole 3 of the plate 1 described above,
As shown in FIG. 1, the mounting direction can be freely adjusted within a predetermined range in all directions. That is, as shown in FIG. 1, the tube 5 is adjustable in the vertical direction from the position shown by the solid line in FIG. 1 to the position shown by the chain double-dashed line. Moreover, it can be adjusted within a predetermined range. That is, the tube 5 is configured so that its mounting direction can be adjusted appropriately in all directions, and the cervical body angle in the vertical direction and the anteversion angle in the lateral direction can be adjusted. That is,
The flange portion 5b of the tube 5 is formed in a convex spherical shape, and, as already described, the inner surface of the tube through hole 3 is formed as a spherical concave portion 3a. So-called "ball junit structure"
By this, adjustment of the mounting direction of the tube 5 with respect to the plate 1 is possible in all directions. The insertion side of the lag screw 7 of the inner peripheral surface of the tube 5 has a hexagonal shape.

Incidentally, in the conventional osteosynthesis device, as shown in FIG.
As described with reference to No. 0 and others, the plate and the tube are integrated, and it is called a "tube plate".
Is called. In this conventional tube plate, the attachment direction of the tube to the plate is preset and cannot be changed. The lag screw 7 as a screw means has a male screw portion 7 at its tip.
and a female screw portion 7b to which the tension screw 13 is screwed, is formed on the inner peripheral surface of the base end portion located on the side opposite to the front end portion with respect to the plate 1. There is. Further, the tip portion of the lag screw 7 (the male screw portion 7
The outer diameter of the parts other than a) is hexagonal. And
Tube 5 into which this lag screw 7 should be inserted
However, as already explained, a part of the inner peripheral surface is hexagonal. That is, the lag screw 7 is attached to the tube 5
Both are configured so that they do not rotate relative to each other when inserted. In addition to such characteristics, the tip portion of the lag screw 7 is partially lacking the male screw portion 7a,
That part functions as the tap 7c.

The osteosynthesis apparatus of the present invention as described above can be used to perform the osteosynthesis as follows. In the osteosynthesis described here, the neck 101a of the femur 101 is fractured at the fracture site A in the same manner as described with reference to FIGS. (See)) osteosynthesis. Here, of the series of bone joining steps, the step of attaching the lag screw 7, the tube 5, and the plate 1 to a predetermined portion of the femur 101 is the same as in the case of the conventional technique, and therefore, it will be briefly described below. The process will be described.

First, the angle guide is pressed against the lateral surface of the femur, and the guide pin is inserted into the femoral neck under the image control. Then, after confirming that the guide pin is placed in the correct position,
Measure the length of the guide pin inserted into the femoral neck. Then, after pulling out the guide pin, a combination reamer is attached and reaming is performed. After the reaming is completed, it is confirmed that the femur formed by the reaming and the hole penetrating the neck thereof have proper angles. The holes formed by reaming are tapped and the lag screw is inserted using a lag screw inserter. Subsequently, the tube and plate are fixed to the femur 101.

As a result of performing a series of operations as described above, the state shown in FIG. 6 is obtained. That is, the plate 1 is attached to the femur 101, the tube 5 is inserted into the tube through hole 3 of the plate 1, and the main portion of the tube 5 is embedded in the femur 101. Then, the lag screw 7 is fitted into the inside of the through hole penetrating the tube 5 so as to penetrate almost the entire region of the separated neck 101a of the femur 101. At this point, the tension screw 13 is attached to the lag screw 7
Although it is screwed into the female screw portion 7b of the
It has not reached the point where pressure is applied to.

Then, as shown in FIG. 7, the tension screw 1
3 is further screwed into the female screw portion 7b of the lag screw 7 (see FIGS. 1 and 5), whereby the neck portion 1
01a is pulled toward the femur 101 side, whereby the fracture site A is pressed. At this point, the washer 11 is pressed against any position of the tube through hole 3 of the plate 1, and the load is received by the pressed portion. A gap is formed between the washer 11 and the collar portion 5b. At that time, the plate 1 has a built-up portion 1
Since b is provided, it is possible to sufficiently cope with the load concentrated and acting on it.

In this way, a series of osteosynthesis work is completed, and thereafter, like the ordinary osteosynthesis, each instrument is removed after a predetermined curing period. In addition, in the series of bone joining operations as described above, for example, in FIG.
As shown in, when the lag screw 7 is screwed into the neck 101a of the femur 101, the plate 1 may not match the outer surface of the femur 101. In that case, since the plate 1 can be appropriately moved with respect to the tube 5 to adjust the neck angle,
Finally, the plate 1 can be fitted to the lateral surface of the femur 101. After adjusting the neck angle, the plate 1 may be fixed to the femur 101 with a fixing screw (not shown).

Further, as shown in FIG. 9, even when the anteversion angle is poor, it can be dealt with in the same manner as the adjustment of the neck angle. In this case, the plate 1 may be rotated in the left-right direction so as to match the outer surface of the femur 101, and then fixed to the femur 101 with the fixing screw 135. Incidentally, when the conventional tube plate is used, even if an appropriate tube plate is selected from many types, the states shown in FIGS. 8 and 9 may occur. In that case, The tube plate was fixed to the femur with fixing screws ignoring the existence of gaps and the like. Therefore, an unreasonable load acts on the fixing screw and the femur, causing damage to the screw and the femur itself.

Further, in carrying out the present invention, a part of the plate can be constructed as shown in FIG. 10 (corresponding to FIG. 3) and used as shown in FIG. That is, in the mode shown in FIGS. 10 and 11,
The tube through hole 3 of the plate 1 has a spherical concave portion 3a and a reduced diameter portion 3b as in FIG. 3, and further has a cylindrical space portion 3c on the extension of the spherical concave portion 3a. The cylinder-shaped space portion 3c is overlaid to form an overlaid portion 1b as illustrated.

FIG. 11 is a cross-sectional view showing one step of performing an osteosynthesis using the plate 1 having the tube through hole 3 as shown in FIG. At this stage, femur 1
The plate 1 is attached to 01, and the tube 5 is inserted into the tube through hole 3 of the plate 1. The main part of the tube 5 is embedded in the femur 101. A lag screw 7 is fitted inside the through hole penetrating the tube 5 so as to penetrate almost the entire neck (not shown) of the femur 101.
Further, a tension screw 13 is screwed into a female screw portion (not shown) of the lag screw 7 via a washer 11.
The washer 11 has its tapered surface 11a as shown.
have. In the practice of the present invention, the angle of the tapered surface 11a can be variously changed depending on factors such as the shape of the corresponding cylindrical space portion 3c.

As described above, the tube through hole 3 is provided with the cylindrical space 3c and the washer 11 is provided with the tapered surface 11c.
When a is given, the tube 5 for the plate 1
Can be more freely attached and fixed, and can be arbitrarily adjusted in all attachment directions according to a desired result, and the fixing force can be increased. Further, such an aspect can be advantageously applied to the other embodiments of the present invention described above.

In FIG. 11, the tube 5 is attached to the plate 1.
The cervical angle in the vertical direction is θ, and the anteversion angle in the horizontal direction is α when the is attached. Here, if the cervical angle θ is 140 ° and the anteversion angle α in the left-right direction is 0,
When the tension screw 13 is screwed through the washer 11, the taper surface 11a of the washer 11 bites into the cylindrical space 3c of the tube through hole 3 and is locked, so that a stronger force is obtained. Fixation is achieved. If the cervical body angle θ is 140 ° ± 10 ° and the lateral anteversion angle α is ± 10 °, when the tension screw 13 is screwed through the washer 11, The tapered surface 1 of the washer 11 in the cylindrical space 3c of the tube through hole 3
A part of the upper, lower, left and right sides of 1a are pressed into contact with each other to be locked, and a stronger fixing is achieved here as well.

[0048]

As can be understood from the embodiments described above, the following remarkable effects can be obtained by using the osteosynthesis device and the compression screw of the present invention for osteosynthesis. First, since the tube is a separate member with respect to the plate, and the mounting direction of the tube with respect to the plate can be adjusted within the range of the allowance of the tube through hole, it is particularly preferable to adopt a ball joint structure within the predetermined range. Since it can be adjusted over the direction,
A single osteosynthesis device or compression screw makes it possible to accommodate different bone conditions with individual differences. Therefore, it is possible to eliminate the complexity of preparing a large number of tube plates in advance as in the conventional osteosynthesis and selecting and using an appropriate one from each operation. Further, in this connection, both the manufacturer and the customer can always keep a particularly large amount of inventory in order to meet various demands and avoid the management complexity for the storage. .

Further, when the plate and the tube are attached and fixed to the bone, by positioning and adjusting the positions of those parts according to the state of the bone, this can be performed with high accuracy, and As compared with the case where a proper one is selected from a large number and used as described above, it becomes possible to provide a joint structure more suited to a bone condition.
Therefore, it is possible to prevent an unreasonable load from being applied after the bones are joined to cause damage to each component or the femur.

Further, when the plate and the tube are fastened together to be joined and fixed, the load concentrates and acts on the upper portion of the washer used in combination with the tension screw. Since the portion is provided, it is possible to reliably handle the load. In addition,
Attaching the tube to the plate by adding a spherical recess and a cylindrical surface to the tube through hole of the plate, and correspondingly providing a flange on the proximal end of the tube and a tapered surface on the side surface of the washer. Also, the fixing can be made stronger.

Furthermore, since a tap is provided at the proximal end portion of the male screw portion of the lag screw, when the lag screw is pulled out from the femur after the completion of a predetermined curing period, it is possible to pull it out while cutting the screw. It becomes possible, and thereby the removal work can be facilitated.

[Brief description of drawings]

FIG. 1 is a side view showing the configuration of a preferred example of an osteosynthesis device according to the present invention.

FIG. 2 is a front view of a plate used in the osteosynthesis device shown in FIG.

3 is a cross-sectional view of the plate of FIG. 2 along the line segment III-III.

4 is a sectional view of the plate of FIG. 2 taken along the line IV-IV.

5 is a side view showing the relationship between the lag screw, the tube, the washer, and the tension screw used in the bone joining device shown in FIG.

FIG. 6 is a cross-sectional view showing one step of the osteosynthesis using the osteosynthesis device of the present invention.

FIG. 7 is a view of an osteosynthesis using the osteosynthesis device of the present invention.
FIG. 8 is a cross-sectional view showing a step that follows the step of.

FIG. 8 is a cross-sectional view for explaining an angle adjusting action when using the osteosynthesis device of the present invention.

FIG. 9 is a cross-sectional view for explaining an angle adjusting action when using the osteosynthesis device of the present invention.

10 is a sectional view corresponding to FIG. 3, showing a modification of the plate shown in FIG.

11 is a cross-sectional view showing one step of an osteosynthesis using the osteosynthesis device having the plate shown in FIG.

FIG. 12: First of osteosynthesis using a conventional osteosynthesis device
FIG. 6 is a cross-sectional view showing the step of.

FIG. 13: Second osteosynthesis using a conventional osteosynthesis device
FIG. 6 is a cross-sectional view showing the step of.

FIG. 14: Third part of osteosynthesis using a conventional osteosynthesis device
FIG. 6 is a cross-sectional view showing the step of.

FIG. 15: Fourth of osteosynthesis using a conventional osteosynthesis device
FIG. 6 is a cross-sectional view showing the step of.

FIG. 16: Fifth example of osteosynthesis using a conventional osteosynthesis device
FIG. 6 is a cross-sectional view showing the step of.

FIG. 17: Sixth of the osteosynthesis using the conventional osteosynthesis device
FIG. 6 is a cross-sectional view showing the step of.

FIG. 18: Seventh of the osteosynthesis using the conventional osteosynthesis device
FIG. 6 is a cross-sectional view showing the step of.

FIG. 19: No. 8 of osteosynthesis using a conventional osteosynthesis device
FIG. 6 is a cross-sectional view showing the step of.

FIG. 20: No. 9 of osteosynthesis using a conventional osteosynthesis device
FIG. 6 is a cross-sectional view showing the step of.

FIG. 21 is a cross-sectional view showing the final step of the osteosynthesis using the conventional osteosynthesis device.

FIG. 22 is a side view showing the configuration of a conventional bone cementing device.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Plate 1c ... Plate fixing screw through hole 1b ... Plate overlay part 3 ... Tube through hole 3a ... Tube through hole spherical recess 3b ... Tube through hole reduced diameter part 3c ... Tube through hole cylindrical space part 5 ... Tube 5a ... Through-hole in tube 5b ... Tube flange 7 ... Lag screw 7a ... Male screw 7b ... Female screw 7c ... Tap 11 ... Washer 11a ... Tapered surface 13 ... Tension screw

Claims (13)

[Claims] 1. A bone joining device for joining a separated bone, which has been separated or is in a separable state by a fracture or the like, to the main bone through a screw means, wherein the one side of the main bone is pressed. Then, a plate to be fixed, a tube through hole formed by penetrating the plate at a predetermined position of the plate, and fitted into the tube through hole of the plate,
A screw means accommodating tube that can be embedded inside the main bone, and a tube for fitting and fixing the tube into the through hole of the plate at an angle suitable for screwing and fixing the screw means to the separation bone An osteosynthesis device comprising a tube fixing means including a part of the plate and a part of the tube. 2. The osteosynthesis device according to claim 1, wherein the tube fixing means has a ball joint structure. 3. In the plate, a side of the tube through hole opposite to the main bone is formed as a concave portion having a spherical surface formed by being partially hollowed, and in the tube, the tube is The collar portion formed as a convex portion having a spherical surface, which can be combined with the spherical concave portion to form a ball joint structure when fitted into the tube through hole, is provided. The osteosynthesis device described. 4. In the plate, a side of the tube through hole opposite to the main bone has a concave portion having a spherical surface formed by partially hollowing, and a cylindrical surface formed following the spherical concave portion. A cylindrical space portion, and in the tube, when the tube is fitted into the tube through hole, a ball joint structure can be formed by combining with the spherical concave portion and the cylindrical space portion. The osteosynthesis device according to claim 2, further comprising: a collar portion formed as a convex portion having. 5. The tube fixing means includes a tensioning screw to be screwed into a base end portion of the screw means via a washer, and the screw means is inserted inside the screw means accommodating tube. When the tip portion is screwed into the separated bone and the tension screw is screwed in, it is possible to draw the separated bone to the main bone and press the fracture site.
The osteosynthesis device according to any one of 4 above. 6. The surface of the washer, wherein the spherical recess and / or the surface to be abutted against the cylindrical space, if present, is tapered. The osteosynthesis device according to claim 5. 7. When the tension screw is tightened, the washer is locked at an arbitrary position of the tube through hole to be fastened and fixed, and at that time, the washer corresponds to the upper portion of the washer. The osteosynthesis device according to claim 5 or 6, wherein a part of the surface of the plate is padded. 8. The osteosynthesis device according to claim 1, wherein the screw means is a lag screw. 9. The osteosynthesis device according to claim 8, wherein a male screw portion is provided on a tip portion of the lag screw, and a tap is provided on the male screw portion. 10. A plate for joining together at least two separated bones, the plate to be crimped to one of said separated bones, different from the separated bones from which said plate is crimped. A compression screw comprising a lag screw extending in the direction of the separating bone and a tube equipped with a through hole for accommodating the lag screw, the tube being capable of forming a predetermined angle with respect to the plate, and the predetermined The angle of corresponds to and corresponds to the predetermined angle of the separated bone before separation,
A compression screw characterized by being selectively changeable. 11. The compression screw according to claim 10, wherein the tube can be fitted into a tube through hole formed at a predetermined position of the plate by penetrating the plate. 12. The compression screw according to claim 10, wherein a ball joint structure is used to fit and fix the tube into the tube through hole of the plate. 13. The separation bone is a bone fragment formed by fracture of a femur or the like, 10.
13. The compression screw according to any one of 12.