JPWO2009145116A1 - Nerve extension device - Google Patents

Abstract

The subject of this invention is providing the nerve extending | stretching instrument (1) for extending | stretching slowly to the length which can sew each of the both ends of the cut | disconnected nerve. The nerve extension device (1) of the present invention as a solution to the problem is a device for pulling and extending both ends of the cut nerve and is inserted into the bone with respect to the rod-like member (2). A holding member (4) holding at least two pins (3) is provided in the vicinity of the central portion, and a movable member (5) movable in the direction of the end of the rod-like member (2) is provided on both sides of the holding member (4). And a guide member (8) for guiding a thread-like member (7) whose one end is fixed to the moving member (5) and whose other end is fixed to a gripping member (6) that holds the end of the nerve. Between the holding member (4) and the moving member (5), and moving the moving member (5) in the direction of the end of the rod-shaped member (2), the end of the cut nerve is threaded (7 ) And can be extended by being pulled.

Description

  The present invention provides a length capable of suturing both ends of a cut nerve when a nerve defect gap that cannot be directly sutured due to trauma or the like occurs, or when a nerve is also removed when excising a tumor or the like. The present invention relates to a nerve stretching instrument that is used for performing an operation for suturing both stumps after slowly stretching to a certain extent.

At present, for the treatment of defect gaps such as peripheral nerves, free nerve transplantation is mainly employed in which donor nerves are arranged in the defect part and both cut ends of the cut nerves are sutured to the donor nerves. However, this method may cause a nerve deficiency symptom at the site where the donor nerve is removed, and two suture parts are required. Therefore, when the regeneration axon crosses the suture part, a nerve regeneration error (misdirection) ) And the length of the defect is long, it is difficult to perform good reproduction. Therefore, development of a new treatment method for avoiding such a problem has been promoted, and as one of them, each of both ends of the cut nerve is slowly extended to a suturable length. Thereafter, a method of performing an operation for suturing both stumps has been proposed (Non-Patent Document 1).
Saijilafu et al .: Repair of peripheral nerve defect with direct gradual lengthening of the proximal nerve stump in rats .: Journal of Orthopedic Research, Volume 24, Issue 12, December 2006, 2246-2253.

  An object of the present invention is to provide a nerve stretching instrument for slowly stretching each of both ends of a cut nerve to a length capable of suturing.

  The nerve extending instrument of the present invention made in view of the above points is an instrument for pulling and extending each end of a cut nerve. In this instrument, the rod-shaped member includes a holding member that holds at least two pins to be inserted into the bone in the vicinity of the central portion, and includes movable members that can move in the direction of the end of the rod-shaped member on both sides of the holding member. . Further, the bar-like member includes a guide member that guides the thread-like member between the holding member and the moving member. The filamentary member fixed at one end to the gripping member that holds the end of the nerve passes through the guide member, and the other end is fixed to the moving member. With this configuration, by moving the moving member in the direction of the end of the rod-shaped member, the end of the cut nerve can be pulled and extended by the thread-like member.

  According to the nerve stretching instrument of the present invention, the degree of movement of the moving member in the direction of the end of the rod-shaped member can be freely adjusted. For example, by moving 1 mm per day, the end of the cut nerve Can be slowly extended by 1 mm per day by pulling with a thread-like member. Therefore, it is possible to appropriately extend the cut nerve according to the age of the patient, the state of the affected part, and the like. Further, if the degree of movement of the left and right moving members is made different, the degree of extension of each end portion of the cut nerve can be made different.

(A) is a front view (partially perspective view) showing a schematic configuration of an embodiment of the nerve extending instrument of the present invention, and (b) is a plan view (partially perspective view). It is a figure which shows the use condition of one Embodiment of the nerve extending | stretching instrument of this invention. It is an example of the sewing form of the edge part of the cut | disconnected nerve and the nerve grasping ring 6. FIG.

DESCRIPTION OF SYMBOLS 1 Nerve extension instrument 2 Rod-shaped member 2a Shaft screw 2b Inner cylinder 2c Outer cylinder 3 Pin 4 Holding member 5 Moving member 6 Nerve grasping ring (gripping member)
7 Threaded member 8 Guide member 9 Hexagonal hole 10 Clamping screw 11 Clamping screw 12 Clamping screw 13 Cylinder member 14 Clamping screw 15 Clamping screw

  The nerve extending instrument of the present invention is an instrument for pulling and extending each of both ends of a cut nerve, and a holding member that holds at least two pins to be inserted into a bone with respect to a rod-shaped member A gripping member is provided near the center, and has a movable member that can move in the direction of the end of the rod-shaped member on both sides of the holding member. Further, one end is fixed to the moving member and the other end grips the end of the nerve. A guide member that guides the thread-like member fixed to the member is provided between the holding member and the moving member, and the end of the cut nerve is pulled by the thread-like member by moving the moving member toward the end of the rod-like member. Thus, it can be extended. Hereinafter, although the nerve extending | stretching instrument of this invention is demonstrated based on drawing, the nerve extending | stretching instrument of this invention is limited to the following description, and is not interpreted.

  Fig.1 (a) is a front view (partially see-through | perspective view) which shows schematic structure of one Embodiment of the nerve extending | stretching instrument of this invention, The same (b) is a top view (partially see-through view). In this nerve extending instrument 1, a central rod-shaped member 2 includes a central holding member 4 that holds two pins 3 to be inserted into a bone, and both ends of the holding member 4 in the direction of the end of the rod-shaped member 2. A movable moving member 5 is provided. The rod-shaped member 2 includes guide members 8 that guide the thread-shaped member 7 on both sides of the holding member 4. The thread-like member 7 fixed to the nerve gripping ring 6 as a gripping member whose one end grips the end of the nerve passes through the guide member 8, and the other end is fixed to the moving member 5. The rod-shaped member 2, the pin 3, the holding member 4, the moving member 5, and the guide member 8 are made of, for example, stainless steel, the nerve gripping ring 6 is made of, for example, polyethylene, and the thread-like member 7 is made of, for example, Made of nylon.

  The portion of the rod-like member 2 on the end side from the guide member 8 includes a shaft screw 2a having a hexagonal hole 9 provided on the end surface, an inner cylinder 2b in which a thread groove that engages with the shaft screw 2a is carved on the inner diameter surface, The outer cylinder 2c is fitted with the inner cylinder 2b. A wrench is inserted into the hexagonal hole 9 provided on the end face of the shaft screw 2a, and the shaft screw 2a is rotated about its axis, whereby the outer cylinder 2c is The moving member 5 fixed to the outer cylinder 2c with the clamping screw 10 is also moved in the end direction by sliding with respect to the inner cylinder 2b and moving in the end direction.

  The pin 3 is movable up and down, and is fixed to the holding member 4 at a height that can be easily inserted into the bone by a clamping screw 11.

  The holding member 4 is rotatable about the axis of the rod-shaped member 2 and is fixed to the rod-shaped member 2 at a rotation angle at which the pin 3 can be easily inserted into the bone by the clamping screw 12.

  A cylindrical member 13 for facilitating the pulling of the end of the cut nerve by the thread-like member 7 is fixed to the guide member 8 by a clamping screw 14. The thread-like member 7 is fixed to the guide member 8. One end is fixed to the moving member 5 through the cylindrical member 13, and the other end is fixed to the nerve grasping ring 6. In order to maximize the function of the cylindrical member 13, the end portion on the side inserted into the body is curved, and is fixed to the guide member 8 at a predetermined height. The guide member 8 is rotatable about the axis of the rod-shaped member 2, and is fixed to the rod-shaped member 2 at a rotation angle at which the end of the nerve cut by the clamping screw 15 is easily pulled by the thread-shaped member 7.

  As shown in FIG. 2, after inserting the two pins 3 into the bone to fix the nerve extension device 1, the end of the cut nerve and the nerve grasping ring 6 are sewn, and the surgical site is sutured (this The part embedded in the body by the treatment is a part of the two pins 3, a part of the cylindrical member 13, a part of the nerve grasping ring 6 and the thread-like member 7), and provided on the end face of the shaft screw 2 a. When a wrench is inserted into the hexagonal hole 9 and the shaft screw 2a is rotated about its axis, the outer cylinder 2c moves in the direction of the end of the rod-shaped member 2, so that the moving member 5 fixed to the outer cylinder 2c is also It moves in the direction of the end of the rod-like member 2, whereby the end of the cut nerve can be pulled and extended by the thread-like member 7. For example, every time the shaft screw 2a is rotated about its axis, the shaft screw 2a is threaded so that the outer cylinder 2c moves 0.5 mm. For example, the shaft screw 2 turns once a day in the morning and evening. By rotating 2a and moving the moving member 5 in the direction of the end of the rod-shaped member 2 by 1 mm for one day, the end of the cut nerve is pulled by the thread-like member 7 and slowly extended by 1 mm per day. be able to. Further, if the left and right shaft screws 2a are rotated at different rotational speeds, the degree of extension of the cut nerve ends can be varied.

  By providing a plurality of holes on the side of the nerve grasping ring 6 for passing the end of the cut nerve and the suture thread for sewing the nerve grasping ring 6 (one hole is a straight suture needle). For example, as shown in FIG. 3, it is possible to sew both together, and the end of the cut nerve is a thread-like member. 7 can be reliably pulled and extended.

  INDUSTRIAL APPLICABILITY The present invention has industrial applicability in that it can provide a nerve extension device for slowly extending each of both ends of a cut nerve to a suturable length.

Claims (1)

  An instrument for pulling and extending each of both ends of a cut nerve, comprising a holding member for holding at least two pins to be inserted into a bone in the vicinity of the central portion of the rod-like member, the holding member A thread-like member fixed to a gripping member that has one end fixed to the moving member and the other end gripping the end of the nerve. A guide member for guiding is provided between the holding member and the moving member, and by moving the moving member in the direction of the end of the rod-like member, the end of the cut nerve can be pulled and extended by the thread-like member. A nerve extension device characterized by being made.

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