200924701 九、發明說明： 【發明所屬之技彳标領域】 本發明係一種涉及於骨科醫療適用的器具，尤指穿裝於人體諸 如股骨等長骨骨髓腔内或以微創手術植入的骨髓内釘。 【先前技術】 按由骨骼發生骨折意外時，尤其是下肢長骨之處通常會使 用骨髓内釘來連結斷骨，因而骨髓内釘一般意指是放在骨髓腔 内的長鋼釘。比如下肢的股骨和脛骨，本身有如空心的水管， 在置入骨髓内釘，在骨頭的一端開個傷口放入骨髓内釘後，視 情況在骨髓内釘的近端及遠端加上固定釘，可以防止骨頭的旋 轉及縮短。 一般傳統的骨髓内釘係呈空心圓柱的長桿狀，一般係在二 端部貫穿數螺孔，當骨髓内釘進入骨髓腔後，再由數螺栓穿經 一側的斷骨並穿過骨髓内釘的螺絲孔，最後再鎖固連結於另一 侧的斷骨。但是這種由外側鎖入螺栓〔可說是固定釘作用〕的 骨髓内釘構造，常造成諸如螺栓的固定釘外露，而感到行動有 磨擦干涉導致疼痛；此外，由外側鎖入螺栓，很不容易讓螺栓對 準螺孔，因此操作費時又不易連結準確。 5 200924701 【發明内容】 本發明者㈣前柄㈣，進㈣ 明主要目的係在提供-種分離式㈣^研朗發，因此本發 内釘免除螺栓等固定釘由外側進 要係骨髓 置於骨髓中空處，刹田μ , 的方式，由骨髓内釘容 骨。 了互鎖而使骨髓内釘分別連結兩側斷200924701 IX. Description of the invention: [Technical target field to which the invention belongs] The present invention relates to an appliance suitable for orthopedic medical treatment, in particular, a bone marrow that is worn in a long bone marrow cavity such as a femur or a minimally invasive surgery. Inner nail. [Prior Art] In the case of a fracture from a bone, especially in the case of a long bone of the lower extremity, an intramedullary nail is usually used to connect the broken bone, and thus the intramedullary nail generally means a long steel nail placed in the bone marrow cavity. For example, the femur and tibia of the lower extremities, such as a hollow water tube, are placed in the bone marrow nail, and a wound is placed at one end of the bone into the intramedullary nail, and the nail is fixed at the proximal end and the distal end of the nail in the bone marrow as the case may be. It can prevent the rotation and shortening of the bone. Generally, the traditional intramedullary nailing system has a long rod shape of a hollow cylinder, generally extending through a plurality of screw holes at the two end portions. When the intramedullary nail enters the medullary cavity, a few bolts pass through the broken bone on one side and pass through the bone marrow. The screw hole of the inner nail is finally locked to the broken bone on the other side. However, this type of intramedullary nail, which is locked by a bolt (which can be said to be a fixing nail), often causes a fixing nail such as a bolt to be exposed, and feels frictional interference causing pain; in addition, the bolt is locked from the outside, and is not It is easy to align the bolts with the screw holes, so the operation is time-consuming and difficult to connect accurately. 5 200924701 SUMMARY OF THE INVENTION The present inventors (4) The front handle (four), the entrance (four) The main purpose is to provide a separate type (four) ^ research and development, so the nails of the hair nails are removed from the outer bones of the main body. The hollow part of the bone marrow, the brake field μ, the way to the bone by the bone marrow. Interlocking and interlocking the intramedullary nails
❹ 於提供為了Λ達到前述主要目的，本發料運用的技術手段係在 於k供-種分離式㈣内钉裝置，其係包含： —種分離式骨髓内釘裝置，其係包含： -第-接合元件，其為，空狀，外側為第一接端 一 接端一端是六角沈頭孔，相鄰處為内孔1同於該内孔之另一 Γ側為通孔，用以該第―接合元件於該内孔處形成徑向面積 ㈣擋部’用以—呈中空螺栓狀之連接栓得進入 範圍内，該連接栓所具之頭部係受該擋部之擋止； 一與第一接合元件相接合之第二接合元件，其為長形中空 轴桿狀，—端供裝人該第—接合元件之通孔内之頸部，不同: 該頸部另一端是第二接端，位於該頸部内側係為内螺紋，用以 供該連接栓螺合於該内螺紋而帶動該第一接合元件配合該第二 接元件接合斷骨。 因此依據本發明的技術手段，本發明可以獲得的功效簡要 說明如下所列： 1、本發明之第一接合元件、第二接合元件係為分離式， 200924701 因此在兩者之間，係配合連接栓以及第一接合元件來調整與第 二接合元件的相對距離，因此很方便地根據斷骨長度情形來自 由、精確地調整，以確保斷骨的接觸吻合很可靠，提昇完全的 癒合性。 2、 骨髓内釘隱藏於骨髓腔内’免除於外侧鎖入固定釘作 法’因此骨髓内釘係隱置於骨髓腔内部不會外露因此不會讓骨 頭感到顯著疼痛，大幅降低不適感。 3、 本發明不同於以往需於骨頭外側鎖入固定釘以定位骨 髓内釘的方式’所設置的分離式骨髓内釘裝置，是利用兩相連 結的第一、二接合元件，藉以第一、二接合元件分別形成的第 一接端、第二接端，使骨髓内釘方便快速地進入骨趙腔内，並 順利連結兩側的斷骨。 4、 本創作可以適用於目前的微創手術，以具有傷口小， 並且骨髓内釘可以隱入骨頭中，可視狀況不需要取出來而可免 於二次手術。 ®【實施方式】 本發明係一種分離式骨髓内釘裝置，如第一圖所示，其係 骨趙内釘-端—端透過連接栓⑽將一第一接合元件⑽連結 於第二接合元件⑽，用以可依據各人體骨絡長度不同，調整 斷骨在遠端骨與近端骨的接合性。 月再參看第一、二、四圖來說明各部元件的具體形態以及 相互關係。其中該第一接合元件（1〇)係為中空之螺桿狀，外侧 面形成外螺紋的第一接端⑴）’頂部為六角的沈頭孔’近頂部 200924701 係形成内孔（13)，第一接合元件（10)在内孔（13)之下直通到另 一端係形成一内徑大於内孔（13)的通孔（12)，因此第一接合元 件（10)在形成内孔（13)相對突出於通孔（12)内侧的徑向厚度係 為擋部（14);以及 為對應安裝調整第一接合元件（10)而另設置連接栓 (16)。連接栓（16)係為螺栓狀，中央形成一道貫穿狀之穿孔 (161)，藉以可伸入第一接合元件（1〇)範圍内。 該第二接合元件（20)係為長形中空轴桿狀，一端為供第一 〇 接合元件（10)通孔（12)内側裝入之頸部（21)，相鄰頸部（21)為 軸向長度更長、外徑更大的身部（22)，身部（22)不同於頸部（21) 另一端是呈外螺紋狀之第二接端（25)。其中前述之頸部（21)頂 部形成六角狀之頂槽（211)，第二接合元件（2〇)位於頸部（21) 内側係形成内螺紋（23)，用以供連接栓（16)螺合於内螺紋（23) 中，而第二接合元件（2〇)中央係為貫穿狀之中孔（24)，形成區 域大抵由頸部（21)内螺紋（23)之外直到第二接端（25)内側為止； 〇 另於身部（22)位於頸部（21)與第二接端（25)之間的兩相對側各’ 磨設或銑設為平面（221)。 實施時’如第四、五圖所示，透過手術先行於傷骨外侧處 鑽孔用以導引桿（40)進入，而第二接合元件⑽之中孔（24)順 者導引桿（40)而伸人骨趙腔内，此即訂具卡制頂槽（2⑴以驅 動第二接合元件（20)，使其利用第二接端（25)的外螺紋旋移至 斷骨的遠端骨骨髖腔内[比較遠離外端];其次，如第四、六圖所 示’將第-接合元件（1G)通過導引桿⑽，讓第—接合元件⑽ 的通孔（12)對準並套|於第二接合元件⑽）的頸部⑻外側； 200924701 再其次’如第四、七、八圖所示，將連接栓（16)之穿孔（161) 對準導引桿（40)進入到第二接合元件（20)内，讓連接栓（16)外 螺紋得以螺合於第二接合元件（2〇)的内螺紋（23)，並由連接栓 (16)頭部靠於擋部（14)上，推進第一接合元件（1〇)之第一接端 (11)螺旋移位，使第一接端（11)在螺旋移位到斷骨的近端骨聽 腔内形成接合； 接下來，即視遠、近端骨接觸面要吻合的情形，繼續緊固 或是鬆退第一接合元件（10)，緊固推進第一接合元件（1〇)者， ® 則以轉動連接栓（16)以帶動第一接端（11);反之，如要鬆退第一 接合元件（10)，則以工具驅動第一接合元件（10)位於内孔（13) 外側的六角沈頭孔，直到第一接合元件（10)之第一接端（11)帶 動近端骨的位置，是與第二接端（25)結合的遠端骨彼此接觸面 吻合；最後即可自中孔（24)、穿孔（161)而抽出導引桿（4〇)，完 成接斷骨目的。 此外，如第九圖所示’係骨髓内釘可在第二接端（25)末端 ❹ 由端口開始，等分地沿軸向形成近V形的又槽（27)，叉槽（27) 一内側呈弧形，另一側較為平直；藉以旋入斷骨處時，能更輕易 旋動鑽入，同時該叉槽（27)有能使旋入時產生的細屑方便排 出，而使鑽動過程更順暢。 又，身部（22)上形成的兩對稱的平面（221)，係用以骨髓 内釘如果發生斷裂情形者，可供工具來夾持於平面（221)位置， 以方便將斷裂殘留餘體取出。 如此一來，本發明的分離式骨髓内釘裝置不需額外以固定 釘從外侧鎖入定位，完全隱藏於骨髓腔内而不外露，並且可以 200924701 藉第一接合元件（10)、第二接合元件（20)依據斷骨長度不同而 調整連結位置。 另卜_本發明之第一接合元件（11)亦可形成錐狀体取代該 外螺紋之作用而同樣能抵定定位於斷骨處。 而第一、二接端（11)(25)各自形成外螺紋的螺距、直徑、 長度可以不同，以供使用上具選擇性，擴大適用性。上述實施 例僅為例示性說明本發明之技術及其功效，而非用於限制本發 明。任何熟於此項技術人士均可在不違背本發明之技術原理及 ® 精神的情況下，對上述實施例進行修改及變化，因此本發明之 權利保護範圍應如後所述之申請專利範圍所列。 200924701 【圖式簡單說明】 第一圖係本發明較佳實施例之立體圖。 第二圖係本發明較佳實施例之立體元件分解圖。 第三圖係本發明較佳實施例之組合剖視圖。 第四圖係本發明較佳實施例之部份放大剖視圖，以顯示第 一、二接合元件與連接栓的關係。 第五圖係本發明較佳實施例之實施動作剖視示意圖（一）。 第六圖係本發明較佳實施例之實施動作剖視示意圖（二）。 φ 第七圖係本發明較佳實施例之實施動作剖視示意圖（三）。 第八圖係本發明較佳實施例之實施動作剖視示意圖（四）。 第九圖係本發明另一較佳實施例之立體圖。In order to achieve the above-mentioned main purpose, the technical means for the present invention is to provide a separate (four) internal nail device comprising: a separate intramedullary nail device comprising: - The engaging element is an empty shape, and the outer side is the first connecting end, one end of the connecting end is a hexagonal countersunk hole, and the adjacent end is the inner hole 1 and the other side of the inner hole is a through hole, for the first The engaging element forms a radial area (four) stop portion at the inner hole for the access bolt to be in the range of a hollow bolt-like connecting rod, and the head of the connecting bolt is blocked by the blocking portion; a second engaging element joined by the first engaging element, which is in the shape of an elongated hollow shaft, the end is for the neck of the through hole of the first engaging element, different: the other end of the neck is the second joint The end of the neck is internally threaded for the connecting bolt to be screwed to the internal thread to drive the first engaging element to engage the second connecting element to engage the broken bone. Therefore, according to the technical means of the present invention, the functions obtained by the present invention are briefly described as follows: 1. The first joint element and the second joint element of the present invention are separated, 200924701, therefore, the connection between the two is The bolt and the first engaging element adjust the relative distance from the second engaging element, so it is convenient to adjust and precisely adjust according to the length of the broken bone to ensure that the contact and anastomosis of the broken bone is reliable and improve the complete healing. 2. The intramedullary nail is hidden in the medullary cavity. It is exempted from locking the fixation nail on the outside. Therefore, the intramedullary nail is hidden inside the medullary cavity and will not be exposed, so that the bone will not be significantly painful and the discomfort will be greatly reduced. 3, the present invention is different from the conventional method of requiring the locking nail to lock the nail outside the bone to locate the intramedullary nail. The separate intramedullary nail device is a first and second engaging element connected by two phases, whereby the first The first joint end and the second joint end formed by the two engaging elements respectively enable the intramedullary nail to enter the bone cavity conveniently and quickly, and smoothly connect the broken bones on both sides. 4. This creation can be applied to the current minimally invasive surgery to have a small wound, and the intramedullary nail can be hidden into the bone, and the visual condition does not need to be taken out to be free from secondary surgery. ® [Embodiment] The present invention is a separate intramedullary nail device, as shown in the first figure, the pedicle inner nail end-end-end is connected to the second engaging element through a connecting plug (10). (10), for adjusting the jointability of the broken bone at the distal bone and the proximal bone according to the length of each human bone. See the first, second, and fourth figures again to illustrate the specific shape and relationship of each component. Wherein the first engaging element (1〇) is a hollow screw shape, the first side end (1) of the external thread forming an external thread, and the top end is a hexagonal counterbore hole. The top end 200924701 forms an inner hole (13), the first An engaging element (10) is passed through the inner hole (13) to the other end to form a through hole (12) having an inner diameter larger than the inner hole (13), so that the first engaging element (10) is formed in the inner hole (13). The radial thickness that protrudes relatively from the inside of the through hole (12) is the stopper (14); and the connecting plug (16) is additionally provided for adjusting the first engaging element (10) for the corresponding mounting. The connecting bolt (16) is in the form of a bolt, and a through-hole (161) is formed in the center so as to extend into the first engaging element (1〇). The second engaging element (20) is in the form of an elongated hollow shaft, one end is a neck (21) for inserting the inside of the through hole (12) of the first weir engaging element (10), and the adjacent neck (21) For a body (22) having a longer axial length and a larger outer diameter, the body (22) is different from the neck (21) and the other end is a second end (25) having an external thread shape. The top of the neck (21) has a hexagonal top groove (211), and the second engaging element (2〇) is located inside the neck (21) to form an internal thread (23) for the connecting bolt (16). Screwed into the internal thread (23), and the center of the second engaging element (2〇) is a through-hole (24), and the forming area is larger than the internal thread (23) of the neck (21) until the second The other end of the joint (25) is located on the opposite sides of the body (22) between the neck (21) and the second end (25). In the implementation, as shown in the fourth and fifth figures, the hole is drilled at the outer side of the injured bone through the operation to guide the rod (40), and the hole (24) of the second engaging element (10) is guided by the guide rod ( 40) and extending into the human cavity, this is the custom-made top groove (2 (1) to drive the second engaging element (20), so that it is rotated to the distal end of the broken bone by the external thread of the second end (25) Bone in the hip cavity [relatively far from the outer end]; secondly, as shown in the fourth and sixth figures, the first engaging element (1G) is passed through the guiding rod (10), and the through hole (12) of the first engaging element (10) is paired The quasi-parallel sleeve|on the outside of the neck (8) of the second engaging element (10); 200924701 and then 'as shown in the fourth, seventh and eighth figures, aligning the perforation (161) of the connecting pin (16) with the guiding rod (40) Entering into the second engaging element (20), the external thread of the connecting bolt (16) is screwed to the internal thread (23) of the second engaging element (2〇), and the head of the connecting bolt (16) is placed against a first portion (11) of the first engaging element (1) is helically displaced on the blocking portion (14), so that the first connecting end (11) is helically displaced into the proximal endodontic cavity of the broken bone Form a joint; That is, if the distal and proximal bone contact surfaces are to be matched, continue to tighten or loosen the first engaging element (10), and fasten the first engaging element (1〇), and then rotate the connecting bolt ( 16) to drive the first end (11); conversely, to retract the first engaging element (10), the hexagonal counterbore of the first engaging element (10) located outside the inner hole (13) is driven by the tool, Until the first end (11) of the first engaging element (10) drives the position of the proximal bone, the distal bone combined with the second end (25) is in contact with each other; finally, the central hole (24) ), piercing (161) and pulling out the guide rod (4 〇) to complete the purpose of cutting the bone. In addition, as shown in the ninth figure, the intramedullary nail can be started at the end of the second end (25), and the groove (27) is formed in the near-V shape in the axial direction, and the fork groove (27) One inner side is curved and the other side is relatively straight; when screwed into the broken bone, the drilling can be more easily rotated, and the fork groove (27) has the fine particles which can be generated when screwing in, and is easily discharged. Make the drilling process smoother. Moreover, the two symmetrical planes (221) formed on the body (22) are used for the intramedullary nail to be clamped to the plane (221) if the fracture occurs, so as to facilitate the residual residue. take out. In this way, the split intramedullary nail device of the present invention does not need to be additionally locked by the fixing nail from the outside, is completely hidden in the marrow cavity without being exposed, and can be borrowed from the first engaging element (10) and the second joint in 200924701. The element (20) adjusts the joint position depending on the length of the broken bone. Alternatively, the first engaging element (11) of the present invention may form a tapered body instead of the external thread to be positioned to be positioned at the broken bone. The pitch, diameter and length of the first and second ends (11) and (25) respectively forming external threads may be different for use, and the applicability is expanded. The above embodiments are merely illustrative of the technology of the present invention and its effects, and are not intended to limit the present invention. Any person skilled in the art can modify and change the above embodiments without departing from the technical principles and spirit of the present invention. Therefore, the scope of protection of the present invention should be as follows. Column. BRIEF DESCRIPTION OF THE DRAWINGS The first drawing is a perspective view of a preferred embodiment of the present invention. The second drawing is an exploded view of a three-dimensional element of a preferred embodiment of the present invention. The third drawing is a combined cross-sectional view of a preferred embodiment of the present invention. The fourth drawing is a partially enlarged cross-sectional view of a preferred embodiment of the present invention to show the relationship of the first and second engaging members to the connecting bolt. Figure 5 is a schematic cross-sectional view (I) of the preferred embodiment of the present invention. Figure 6 is a schematic cross-sectional view showing the operation of the preferred embodiment of the present invention (2). φ Fig. 7 is a schematic cross-sectional view showing the operation of the preferred embodiment of the present invention (3). Figure 8 is a schematic cross-sectional view showing the operation of the preferred embodiment of the present invention (4). Figure 9 is a perspective view of another preferred embodiment of the present invention.
【主要元件符號說明】 (10)第一接合元件 (11)第一接端 (12)通孔 (13)内孔 (14)擋部 (16)連接栓 （161)穿孔 (20)第二接合元件 (21)頸部 (211)頂槽 (22)身部 (23)内螺紋 (24)中孔 (25)第二接端 (27)叉槽 (221)平面 (40)導引桿 11[Description of main component symbols] (10) First joint element (11) First joint end (12) Through hole (13) Inner hole (14) Stop portion (16) Connection plug (161) Perforation (20) Second joint Component (21) neck (211) top slot (22) body (23) internal thread (24) middle hole (25) second end (27) fork groove (221) plane (40) guide rod 11