TWI705792B - Orthopedic surgical instruments - Google Patents

Orthopedic surgical instruments Download PDF

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TWI705792B
TWI705792B TW108120245A TW108120245A TWI705792B TW I705792 B TWI705792 B TW I705792B TW 108120245 A TW108120245 A TW 108120245A TW 108120245 A TW108120245 A TW 108120245A TW I705792 B TWI705792 B TW I705792B
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rotating body
bone
component
surgical instrument
orthopedic surgical
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TW108120245A
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TW202000140A (en
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黒田宏一
横山靖治
福原知彦
新真樹
鈴木来
原田実
岩永宗久
浦田光也
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日商奧林巴斯泰爾茂生醫材料股份有限公司
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
    • A61B17/66—Alignment, compression or distraction mechanisms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Medical Informatics (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Neurology (AREA)
  • Surgical Instruments (AREA)

Abstract

一種骨科手術用器具1，其係用於在不降低骨釘嚙合部的固定力、不增加死腔、不擴張骨釘的導孔之情況下，藉由簡便手段施加適度的壓迫力至因截骨術或骨折而打開的骨片間，其具備：固定組件2，其固定於骨B；旋轉體5；旋轉體容置組件4，其係安裝於該固定組件2中不同於固定至該骨B之固定位置的位置，且支撐該旋轉體5使得該旋轉體以與該骨B的表面相交的旋轉軸線為軸而呈可旋轉，且旋轉體5具備可與該骨B卡合，且位於相對於該旋轉軸線偏心的偏心軸線上的錨固部6。 An orthopedic surgical instrument 1 which is used to apply a moderate compression force to the cut-off by a simple method without reducing the fixing force of the bone nail engagement part, without increasing the dead space, and without expanding the guide hole of the bone nail. Between bone fragments opened by osteosurgery or fracture, it is equipped with: a fixing assembly 2 which is fixed to the bone B; a rotating body 5; a rotating body accommodating assembly 4 which is installed in the fixing assembly 2 different from being fixed to the bone The position of the fixed position of B, and supports the rotating body 5 so that the rotating body is rotatable with the axis of rotation intersecting the surface of the bone B as an axis, and the rotating body 5 is capable of engaging with the bone B and is located An anchor 6 on an eccentric axis that is eccentric with respect to the rotation axis.

Description

骨科手術用器具 Orthopedic surgical instruments

本發明係關於骨科手術用器具。 The present invention relates to an appliance for orthopedic surgery.

於變形性膝關節症當中，於例如膝蓋骨與大腿骨的關節軟骨受損的情形係適合截骨術。於此種手術當中，係於骨頭中形成切口(或是使其骨折)來矯正骨頭的彎曲，直到骨頭癒合為止的期間係以骨接合用的骨板來予以固定。當骨板與骨頭之間產生較大空隙時，固定有可能不成功。於此情形中，一般來說會施加像是於骨板中打進於頭部不具螺紋的骨釘，在以骨板壓迫骨頭的同時將分開的截骨面之距離縮短；或是將壓迫力施加於接觸到的截骨面之操作。 In deformable knee joint disease, osteotomy is suitable for cases where articular cartilage of kneecap and femur is damaged. In this type of operation, an incision (or fracture) is formed in the bone to correct the curvature of the bone, and a bone plate for bone joint is used to fix the bone until the bone is healed. When there is a large gap between the bone plate and the bone, the fixation may not succeed. In this case, generally speaking, a bone screw that is not threaded into the head is applied to the bone plate to compress the bone while reducing the distance between the separated osteotomy surfaces; or to reduce the pressure The operation applied to the osteotomy surface that is in contact.

專利文獻1當中記載了一種橢圓形的螺孔，其具有：具凹面部分，該凹面可容置頭部為球狀的骨釘且未形成螺紋；以及頭部為圓錐狀且形成有螺紋可用來固定骨釘之部分。 Patent Document 1 describes an elliptical screw hole, which has: a portion with a concave surface that can accommodate a bone screw with a spherical head without thread formation; and a conical head with a thread formed for use The part that fixes the bone nail.

專利文獻2當中記載了當頭部形成有螺紋的骨釘，以穿過螺孔中靠近未形成螺紋的邊緣位置之方式來插入橢圓形的螺孔時，呈現頭部會動而骨釘鎖固的情形。 Patent Document 2 describes that when a bone screw with a thread formed on the head is inserted into an elliptical screw hole through the threaded hole near the edge of the screw, the head will move and the bone screw will be locked. situation.

專利文獻3當中記載了使骨釘的頭部成為齒輪，並且使跨越骨折部的骨板移動，藉此可使得將分開的截骨面縮短距離並且施加壓迫力之情形。 Patent Document 3 describes that the head of the bone nail becomes a gear, and the bone plate that spans the fracture is moved, thereby shortening the distance of the separated osteotomy surface and applying a compressive force.

[先前技術文獻] [Prior Technical Literature]

[專利文獻] [Patent Literature]

[專利文獻1]日本專利第4162408號公報 [Patent Document 1] Japanese Patent No. 4162408

[專利文獻2]日本專利第4979712號公報 [Patent Document 2] Japanese Patent No. 4979712

[專利文獻3]日本專利第5198623號公報 [Patent Document 3] Japanese Patent No. 5198623

作為先前技術的問題，於專利文獻1及2中，由於螺孔的螺紋形成部係為局部性，導致固定力降低、骨釘插入方向之插入錯誤、或是因死腔增大所致感染風險提升。此外，於必須使用大型壓迫用骨釘來插入骨頭，且於拔出骨釘之後，在使其頭部形成有螺紋的骨釘固定的手術技巧當中，存有因為骨釘的導孔之不必要的擴張而導致骨頭強度降低之風險。 As a problem of the prior art, in Patent Documents 1 and 2, the thread forming part of the screw hole is localized, resulting in a decrease in fixing force, a wrong insertion of the bone nail in the insertion direction, or the risk of infection due to increased dead space Promote. In addition, in the surgical technique of using a large compression bone screw to insert the bone, and after the bone screw is pulled out, there is a need for the guide hole of the bone screw to fix the head with the screw. The expansion of the bones leads to the risk of reduced bone strength.

於專利文獻3當中，頭部為齒輪的骨釘對於骨板與骨頭間的固定力並沒有貢獻，產生整體固定力降低之問題。此外也無法調整移動方向。 In Patent Document 3, the bone nail with the head as a gear does not contribute to the fixing force between the bone plate and the bone, resulting in a problem that the overall fixing force is reduced. In addition, the direction of movement cannot be adjusted.

一種骨科手術用器具，具備：固定組件，其固定於骨；旋轉體，及旋轉體容置組件，其係安裝於該固定組件中不同於固定至該骨之固定位置的位置，且支撐該旋轉體使得該旋轉體以與該骨的表面相交的旋轉軸線為軸而呈可旋轉， 且該旋轉體具備可與該骨卡合，且位於相對於該旋轉軸線偏心的偏心軸線上的錨固部。 An orthopedic surgical instrument, comprising: a fixed component, which is fixed to the bone; a rotating body, and a rotating body accommodating component, which is installed in the fixed component at a position different from the fixed position fixed to the bone and supports the rotation The body makes the rotating body rotatable with the axis of rotation intersecting the surface of the bone as the axis, And the rotating body is provided with an anchoring part which can be engaged with the bone and is located on an eccentric axis that is eccentric with respect to the rotation axis.

根據本發明可達到以下功效：在不降低骨釘嚙合部的固定力、不增加死腔、不擴張骨釘的導孔的情況下，能夠以簡便手段在基於截骨術或骨折方式打開的骨片間施加適度壓迫力。 According to the present invention, the following effects can be achieved: without reducing the fixing force of the bone nail engaging part, without increasing the dead space, and without expanding the guide hole of the bone nail, it is possible to use a simple method to open the bone based on osteotomy or fracture. Appropriate pressure is applied between the films.

1:骨科手術用器具 1: Instruments for orthopedic surgery

2:骨板(固定組件) 2: Bone plate (fixed component)

3:骨釘 3: bone nail

4:旋轉體容置組件 4: Rotating body containing components

5:旋轉體 5: Rotating body

5a:嵌合外表面 5a: Fitting outer surface

6:錨固組件(錨固部) 6: Anchor component (anchor part)

7:螺孔 7: Screw hole

8:外螺紋 8: External thread

9:內孔 9: inner hole

10:抓取部 10: grasping department

11:孔 11: hole

12:凹部 12: recess

15:防轉結構 15: Anti-rotation structure

B:骨 B: bone

C:旋轉軸線 C: axis of rotation

〔圖1〕係為本發明一實施例之骨科手術用器具的斜視立體圖。 [Figure 1] is an oblique perspective view of an orthopedic surgical instrument according to an embodiment of the present invention.

〔圖2〕係為圖1的骨科手術器具的分解縱向剖面圖。 [Fig. 2] is an exploded longitudinal sectional view of the orthopedic surgical instrument in Fig. 1.

〔圖3〕係為顯示將圖2的骨科手術用器具裝載於骨頭之狀態的縱向剖面圖。 [Fig. 3] is a longitudinal sectional view showing a state where the orthopedic surgical instrument of Fig. 2 is mounted on the bone.

〔圖4〕係為顯示開始施加扭力於圖3之骨科手術用器具中旋轉體之狀態的縱向剖面圖。 [Fig. 4] is a longitudinal cross-sectional view showing the state of starting to apply torsion force to the rotating body in the orthopedic surgical instrument of Fig. 3.

〔圖5〕係為顯示180°旋轉圖4中的旋轉體，使截骨面緊貼並施加壓迫力之狀態的縱向剖面圖。 [Fig. 5] is a longitudinal cross-sectional view showing a state where the rotating body in Fig. 4 is rotated by 180° so that the osteotomy surface is in close contact and a compressive force is applied.

〔圖6〕係為顯示於圖5狀態下將骨釘鎖固至其他螺孔之狀態的縱向剖面圖。 [Figure 6] is a longitudinal cross-sectional view showing the state in which the bone nail is locked to other screw holes in the state of Figure 5.

〔圖7〕係顯示於圖6狀態下，從骨板拆卸下旋轉體容置組件、旋轉體及錨固組件之狀態的一縱向剖面圖。 [Fig. 7] is a longitudinal sectional view showing the state in which the rotating body accommodating component, the rotating body and the anchoring component are removed from the bone plate in the state of Fig. 6.

〔圖8〕係為顯示圖1之骨科手術用器具之變形例的縱向剖面圖。 [Fig. 8] is a longitudinal sectional view showing a modification of the orthopedic surgical instrument in Fig. 1.

〔圖9〕係為顯示圖1之骨科手術用器具之旋轉體的變形例的橫向剖面圖。 [Fig. 9] is a transverse cross-sectional view showing a modification of the rotating body of the orthopedic surgical instrument in Fig. 1.

〔圖10〕係為顯示圖1之骨科手術用器具的其他變形例的縱向剖面圖。 [Fig. 10] is a longitudinal sectional view showing another modification of the orthopedic surgical instrument of Fig. 1.

針對本發明一實施型態之骨科手術用器具1，參考圖式進行以下說明。 With regard to the orthopedic surgical instrument 1 of an embodiment of the present invention, the following description will be made with reference to the drawings.

本實施型態之骨科手術用器具1係如圖1所示般，具備：骨板(板組件、固定組件)2；骨釘3，其將該骨板2固定於骨B；旋轉體容置組件4，以可拆裝方式安裝於骨板2；旋轉體5；以及錨固組件(錨固部)6。骨板2配置為跨越於骨B所形成的骨折部或是截骨部，並於骨折部或截骨部的一側上藉由骨釘3來固定至骨B。 The orthopedic surgical instrument 1 of this embodiment is shown in FIG. 1, and includes: a bone plate (plate component, fixing component) 2; a bone nail 3, which fixes the bone plate 2 to the bone B; and a rotating body accommodates The assembly 4 is detachably installed on the bone plate 2; the rotating body 5; and the anchoring assembly (anchoring part) 6. The bone plate 2 is configured to span the fracture or osteotomy formed by the bone B, and is fixed to the bone B by a bone nail 3 on one side of the fracture or osteotomy.

骨板2的材料係以鈦、鈦合金、不鏽鋼、鈷鉻合金、PEEK(聚醚醚酮)材料、聚乳酸等高分子材料，以及不鏽鋼為較佳。骨板2實質上可作為植入物發揮其作用。其標準厚度係以1mm至5mm為較佳；又以2mm至4.5mm為更佳。亦可使用其他的橋接組件來取代骨板2，以作為固定組件。 The material of the bone plate 2 is preferably titanium, titanium alloy, stainless steel, cobalt chromium alloy, PEEK (polyether ether ketone) material, polylactic acid and other polymer materials, as well as stainless steel. The bone plate 2 can essentially serve as an implant. The standard thickness is preferably from 1mm to 5mm; and more preferably from 2mm to 4.5mm. Other bridging components can also be used to replace the bone plate 2 as a fixing component.

旋轉體容置組件4係如圖2所示般，為圓筒狀組件，於長度方向的一端上，具備外螺紋8，該外螺紋8係以可拆裝方式緊固至形成於骨板2的螺孔(貫穿孔)7。旋轉體容置組件4當中，設有沿著其中心軸線而貫穿的-橫向剖面圓形的內孔9。 The rotating body accommodating component 4 is a cylindrical component as shown in FIG. 2 and is provided with an external thread 8 on one end in the length direction. The external thread 8 is detachably fastened to the bone plate 2 The screw holes (through holes)7. The rotating body accommodating assembly 4 is provided with an inner hole 9 with a circular transverse cross section penetrating along its central axis.

旋轉體容置組件4的內孔9的尺寸係以2mm至10mm為較佳，又以3mm至7mm為更佳。 The size of the inner hole 9 of the rotating body accommodating component 4 is preferably 2 mm to 10 mm, and more preferably 3 mm to 7 mm.

旋轉體容置組件4亦可為安裝於骨板2的-骨釘3的導孔穿鑿用鑽機的方向導件。 The rotating body accommodating assembly 4 may also be a direction guide of a drill for the guide hole of the bone nail 3 installed on the bone plate 2.

旋轉體5於長度方向的一側上具有由圓筒表面所構成的嵌合外表面5a，其係以可旋轉方式嵌合於旋轉體容置組件4的內孔9；並於長度方向的另一側上具有用於施加旋轉力的抓取部10。此外，旋轉體5於相對於圓筒表面中心線的旋轉軸線C偏心之位置設置有孔11，該孔11於長度方向貫穿旋轉體5。 The rotating body 5 has a fitting outer surface 5a formed by a cylindrical surface on one side of the length direction, which is rotatably fitted into the inner hole 9 of the rotating body accommodating assembly 4; and another in the length direction On one side, there is a gripper 10 for applying rotational force. In addition, the rotating body 5 is provided with a hole 11 at a position eccentric to the rotation axis C relative to the center line of the cylindrical surface, and the hole 11 penetrates the rotating body 5 in the longitudinal direction.

以旋轉體5的嵌合外表面5a嵌合至旋轉體容置組件4的內孔9之狀態，將例如導銷或細骨釘等的錨固組件6，插入至旋轉體5的孔11中且配置於相對於旋轉軸線C偏心的偏心軸線上，將錨固組件6的前端刺進骨B。藉此使得錨固組件6的前端卡合至骨B。 With the fitting outer surface 5a of the rotating body 5 fitted into the inner hole 9 of the rotating body accommodating assembly 4, an anchoring assembly 6, such as a guide pin or a small bone nail, is inserted into the hole 11 of the rotating body 5 and It is arranged on an eccentric axis that is eccentric with respect to the rotation axis C, and the tip of the anchor assembly 6 is pierced into the bone B. Thereby, the front end of the anchoring assembly 6 is engaged with the bone B.

旋轉體5的抓取部10係以經切痕處理為較佳。據此可輕易地供給扭力至抓取部10。 The grabbing part 10 of the rotating body 5 is preferably processed by cutting. Accordingly, torque can be easily supplied to the gripping portion 10.

此外，旋轉體5的抓取部10當中，設置有沿著長度方向突出的凸部。此外，旋轉體容置組件4的另一端設置有凹部。藉著使旋轉體5插入至旋轉體容置組件4的內孔9，並使抓取部10的凸部嵌合至旋轉體容置組件4的凹部，以構成防轉結構15。防轉結構15在凸部與凹部嵌合的狀態下，係將旋轉體5維持在往垂直於旋轉軸線C的方向壓靠旋轉體容置組件4之狀態，並且限制旋轉體5對旋轉體容置組件4作以旋轉軸線C為軸的相對旋轉。此外，於凸部並未嵌合至凹部的狀態下，旋轉體5可對旋轉容置組件4作以旋轉軸線C為軸的相對旋轉。 In addition, in the gripping portion 10 of the rotating body 5, a convex portion protruding in the longitudinal direction is provided. In addition, the other end of the rotating body accommodating assembly 4 is provided with a recess. The rotating body 5 is inserted into the inner hole 9 of the rotating body accommodating assembly 4 and the convex part of the grasping portion 10 is fitted into the concave part of the rotating body accommodating assembly 4 to form the anti-rotation structure 15. The anti-rotation structure 15 maintains the rotating body 5 in a state in which the rotating body 5 is pressed against the rotating body accommodating assembly 4 in the direction perpendicular to the rotation axis C when the convex portion and the concave portion are fitted, and restricts the rotating body 5 to accommodate the rotating body. The set assembly 4 makes relative rotation around the rotation axis C. In addition, in a state where the convex portion is not fitted into the concave portion, the rotating body 5 can make a relative rotation about the rotation accommodating assembly 4 with the rotation axis C as an axis.

針對操作方法進行說明。 The operation method is explained.

使旋轉體5旋轉之前，必須跨過骨折面於安裝旋轉體容置組件4的螺孔7之對側上，將用於跨越骨折面的骨板2固定至骨B，且必須以其他的骨釘或是導銷等的錨固組件6來予以固定。 Before rotating the rotator 5, it is necessary to cross the fracture surface on the opposite side of the screw hole 7 where the rotator accommodating assembly 4 is installed, and fix the bone plate 2 used to cross the fracture surface to the bone B. Anchor components 6 such as nails or guide pins are used for fixing.

如圖2所示般地將旋轉體容置組件4的外螺紋部8緊固到配置於對側的任一螺孔7中-該對側係指相對於將骨板2固定至骨B的螺孔7而言，跨過骨折面的對側，藉此使得旋轉體容置組件4的中心軸配置於與骨B的表面相交之方向上。此外，以此狀態下，如圖3所示般，使旋轉體5的嵌合外表面5a嵌合至旋轉體容置組件4的內孔9內。 Fasten the external thread 8 of the rotating body accommodating assembly 4 to any screw hole 7 arranged on the opposite side as shown in FIG. 2-the opposite side refers to the fixing of the bone plate 2 to the bone B As far as the screw hole 7 is concerned, it straddles the opposite side of the fracture surface, so that the central axis of the rotating body accommodating assembly 4 is arranged in the direction intersecting the surface of the bone B. In addition, in this state, as shown in FIG. 3, the fitting outer surface 5 a of the rotating body 5 is fitted into the inner hole 9 of the rotating body accommodating assembly 4.

此外，使旋轉體5相對於旋轉體容置組件4以旋轉軸線C為軸旋轉，將偏心的孔11配置於期望的相位位置。以此狀態下，如圖3所示般，將細骨釘或導銷等的錨固組件6插進孔11中，將錨固組件6的前端刺進骨B。 In addition, the rotating body 5 is rotated with respect to the rotating body accommodating assembly 4 about the rotation axis C as an axis, and the eccentric hole 11 is arranged at a desired phase position. In this state, as shown in FIG. 3, an anchor assembly 6 such as a bone nail or a guide pin is inserted into the hole 11, and the tip of the anchor assembly 6 is inserted into the bone B.

此外，於此狀態下，如圖4所示般，施加扭力於旋轉體5的抓取部10，使旋轉體5以旋轉軸線C為軸相對於旋轉體容置組件4而旋轉。由於藉此使得錨固組件6相對於旋轉體容置組件4往垂直於旋轉軸線C的方向移動，因此可縮短骨折面的間隔；或是往擴張方向施加壓迫力於骨B。圖5係表示骨折面的間隔被縮短時的情形。 In addition, in this state, as shown in FIG. 4, a torsion force is applied to the grasping portion 10 of the rotating body 5 so that the rotating body 5 rotates relative to the rotating body accommodating assembly 4 with the rotation axis C as an axis. Because of this, the anchoring component 6 moves in a direction perpendicular to the rotation axis C relative to the rotating body accommodating component 4, so that the interval between the fracture surfaces can be shortened; or a compressive force is applied to the bone B in the expansion direction. Fig. 5 shows the situation when the interval between fracture surfaces is shortened.

旋轉體5的旋轉操作有時需要較大的扭力，可使用能夠施加較大扭力於旋轉體5的螺絲起子或螺蓋、板手。於此情形下，為了調整壓迫力，亦可使用有控管扭力的螺絲起子或是板手。 The rotating operation of the rotating body 5 sometimes requires a large torque, and a screwdriver, screw cap, or wrench that can apply a large torque to the rotating body 5 can be used. In this case, in order to adjust the compression force, a screwdriver or wrench with controlled torque can also be used.

旋轉操作結束後，如圖6所示般，將例如骨釘3等以植入件作為前提的堅固的錨固件固定至骨板2的其他螺孔7。據此使得如圖7所示般，可將旋轉體5、旋轉體容置組件4、以及已安裝的暫時固定用的錨固組件6拔除。由於在固定例如骨釘3等堅固的錨固件之前，存有旋轉體5自主性旋轉而回到原本位置的風險，因此亦可於旋轉方向上加上具限位力的棘爪。 After the rotation operation is completed, as shown in FIG. 6, a strong anchor such as a bone nail 3 based on an implant is fixed to the other screw holes 7 of the bone plate 2. Accordingly, as shown in FIG. 7, the rotating body 5, the rotating body accommodating assembly 4, and the installed anchor assembly 6 for temporary fixation can be removed. Because there is a risk that the rotating body 5 rotates autonomously and returns to its original position before fixing a strong anchor such as the bone nail 3, a pawl with a limit force can also be added to the rotation direction.

此外，當旋轉體容置組件4內的錨固組件6的初始插入位置(旋轉體5的孔11位置)在距離骨折面最遠位置時，若將旋轉體5旋轉180°，則分開的骨折面的縮短量及壓迫力為最大。最大移動量係旋轉體5的孔11的偏心量的2倍。 In addition, when the initial insertion position of the anchoring assembly 6 in the rotating body accommodating assembly 4 (the position of the hole 11 of the rotating body 5) is at the farthest position from the fracture surface, if the rotating body 5 is rotated 180°, the fractured surface will be separated The amount of shortening and compression force is the largest. The maximum amount of movement is twice the amount of eccentricity of the hole 11 of the rotating body 5.

當欲調整骨板2的移動方向時，只要調節錨固組件6的初始相位位置及旋轉後的相位位置即可。 When the moving direction of the bone plate 2 is to be adjusted, it is only necessary to adjust the initial phase position of the anchoring assembly 6 and the phase position after rotation.

此外，如圖8所示般，當設置於旋轉體5的偏心位置的孔11相對於旋轉體5的旋轉軸線C傾斜時，比起平行時，其分開的骨折面之最大移動量係變得比較大。當旋轉體5的孔11相對於旋轉軸線C的傾斜角度過大時，旋轉體5的旋轉扭力變得過大而不會旋轉。此外，施加過度的彎曲力矩至錨固組件6，導致器具破損、無法修復之變形。 In addition, as shown in FIG. 8, when the hole 11 provided at the eccentric position of the rotating body 5 is inclined with respect to the rotation axis C of the rotating body 5, the maximum amount of movement of the fractured fracture surface becomes bigger. When the inclination angle of the hole 11 of the rotating body 5 with respect to the rotation axis C is too large, the rotation torque of the rotating body 5 becomes too large and does not rotate. In addition, an excessive bending moment is applied to the anchoring assembly 6, resulting in damage to the appliance and irreparable deformation.

當使用於膝關節或是踝關節截骨術時，若考慮到所需壓迫力及錨固組件6原料的剛性，旋轉體容置組件4的直徑係以3mm至10mm為較佳，又以4mm至6mm為更佳。錨固組件6的外徑係以1.5mm至5.5mm為較佳，又以2.0mm至3.mm為更佳。於此情況下，較佳地，設置於旋轉體5的偏心位置的孔11之傾斜角度最大為10°。其中又以5°為更佳。 When used for knee or ankle osteotomy, considering the required compression force and the rigidity of the anchoring component 6, the diameter of the rotating body accommodating component 4 is preferably 3mm to 10mm, and 4mm to 4mm to 6mm is better. The outer diameter of the anchoring component 6 is preferably 1.5 mm to 5.5 mm, and more preferably 2.0 mm to 3. mm. In this case, preferably, the inclination angle of the hole 11 provided at the eccentric position of the rotating body 5 is a maximum of 10°. Among them, 5° is more preferable.

也可以安裝2組以上的旋轉體容置組件4、旋轉體5及錨固組件6之組合至同一骨板2。藉著使2組同時作動，可使施加至各旋轉體5的扭力變小。此外，藉著使2組以上的旋轉體容置組件4、旋轉體5及錨固組件6階段式地作動，可使得分開的骨折面縮短量及壓迫量在成為所需狀態之前呈可調整狀態。 It is also possible to install two or more sets of the rotating body accommodating assembly 4, the rotating body 5 and the anchoring assembly 6 to the same bone plate 2. By operating the two groups at the same time, the torque applied to each rotating body 5 can be reduced. In addition, by operating two or more sets of the rotating body accommodating assembly 4, rotating body 5, and anchoring assembly 6 in stages, the amount of shortening and compression of the divided fracture surface can be adjusted before becoming a desired state.

旋轉體5亦可形成為如墊圈般型態。於此情形下，亦可將旋轉體5及骨板2用作植入體內物。錨固組件6亦可為植入體內的骨釘或骨針。亦可將此等組件視為手術用器具。 The rotating body 5 may also be formed in a shape like a washer. In this case, the rotating body 5 and the bone plate 2 can also be used as implants. The anchoring component 6 can also be a bone nail or a bone pin implanted in the body. These components can also be regarded as surgical instruments.

此外，雖然於本實施型態當中，錨固組件6係貫穿孔11，而該孔11係貫穿地形成於旋轉體5，而作為其代替，亦可如圖9所示般貫穿凹部12。此外，使錨固組件6貫穿的孔11亦可構成為往面向骨B表面之端面而逐漸變細。 In addition, although in this embodiment, the anchoring component 6 is a through hole 11, and the hole 11 is formed through the rotating body 5, instead of it, it may penetrate the recess 12 as shown in FIG. 9. In addition, the hole 11 through which the anchoring component 6 penetrates may also be configured to gradually taper toward the end surface facing the surface of the bone B.

此外，雖然設定錨固組件6為貫穿旋轉體5的孔11，但亦可如圖10所示般，使錨固組件6於從旋轉體5之面向骨B表面之端面突出的位置上，形成為與旋轉體5為一體。 In addition, although the anchoring component 6 is set as the hole 11 penetrating the rotating body 5, as shown in FIG. 10, the anchoring component 6 may be formed at a position protruding from the end surface of the rotating body 5 facing the surface of the bone B so as to The rotating body 5 is integrated.

此外，作為防轉結構15，雖已舉例示範了抓取部10設有凸部，而旋轉體容置組件4的另一端設有凹部，但並不設限於此配置。舉例來說，也可以是於抓取部10設有凹部，而旋轉體容置組件4的另一端設有凸部。 In addition, as the anti-rotation structure 15, although it has been exemplified that the grasping portion 10 is provided with a convex portion, and the other end of the rotating body accommodating assembly 4 is provided with a concave portion, it is not limited to this configuration. For example, a concave portion may be provided on the grasping portion 10, and a convex portion may be provided on the other end of the rotating body containing assembly 4.

1:骨科手術用器具 1: Instruments for orthopedic surgery

2:骨板 2: bone plate

3:骨釘 3: bone nail

4:旋轉體容置組件 4: Rotating body containing components

5:旋轉體 5: Rotating body

6:錨固組件 6: Anchor components

7:螺孔 7: Screw hole

15:防轉結構 15: Anti-rotation structure

B:骨 B: bone

Claims (8)

一種骨科手術用器具，具備：固定組件，其固定於骨；旋轉體，及旋轉體容置組件，其係安裝於該固定組件中不同於固定至該骨之固定位置的位置，且支撐該旋轉體使得該旋轉體以與該骨的表面相交的旋轉軸線為軸而呈可旋轉，且該旋轉體具備可與該骨卡合，且位於相對於該旋轉軸線偏心的偏心軸線上的錨固部；其中，該旋轉體藉由旋轉帶動該錨固部相對於該旋轉軸線移動，以緊壓該骨朝一方向密合或擴張。 An orthopedic surgical instrument, comprising: a fixed component, which is fixed to the bone; a rotating body, and a rotating body accommodating component, which is installed in the fixed component at a position different from the fixed position fixed to the bone and supports the rotation A body such that the rotating body is rotatable with a rotation axis intersecting the surface of the bone as an axis, and the rotating body is provided with an anchoring portion that can be engaged with the bone and is located on an eccentric axis that is eccentric relative to the rotation axis; Wherein, the rotating body drives the anchoring portion to move relative to the rotation axis through rotation, so as to compress the bone to close or expand in one direction. 如請求項1所述之骨科手術器具，其中，該固定組件係為板組件，其配置於跨越骨折部之位置。 The orthopedic surgical instrument according to claim 1, wherein the fixing component is a plate component, which is arranged at a position spanning a fracture. 如請求項1所述之骨科手術器具，其中，該旋轉體容置組件、該旋轉體及該錨固部中的其中一者以上為可拆裝式。 The orthopedic surgical instrument according to claim 1, wherein more than one of the rotating body accommodating component, the rotating body and the anchoring part is detachable. 如請求項1所述之骨科手術器具，其中，該錨固部係為圓棒狀，且該旋轉體於該偏心軸線上具有孔或凹部，其使該錨固部以可拆裝方式嵌合。 The orthopedic surgical instrument according to claim 1, wherein the anchoring part is in the shape of a round rod, and the rotating body has a hole or a recess on the eccentric axis, which allows the anchoring part to be fitted in a removable manner. 如請求項4所述之骨科手術器具，其中，該旋轉體容置組件具備內孔，該內孔係將該旋轉體以可旋轉方式容置，且該旋轉體的該旋轉軸線係相對於該旋轉體容置組件的該內孔之中心軸傾斜。 The orthopedic surgical instrument according to claim 4, wherein the rotating body accommodating assembly is provided with an inner hole for rotatably receiving the rotating body, and the rotation axis of the rotating body is relative to the rotating body The central axis of the inner hole of the rotating body accommodating component is inclined. 如請求項1所述之骨科手術器具，其中，該旋轉體容置組件包含2組以上的該旋轉體容置組件、該旋轉體及該錨固部。 The orthopedic surgical instrument according to claim 1, wherein the rotating body accommodating component includes two or more sets of the rotating body accommodating component, the rotating body and the anchoring part. 如請求項3所述之骨科手術器具，其中，該固定組件具備貫穿孔，其使該旋轉體容置組件以可拆裝方式安裝，且於拆卸下該旋轉體容置部之後的該貫穿孔，係可固定直徑比該錨固部還大的骨釘。 The orthopedic surgical instrument according to claim 3, wherein the fixing component is provided with a through hole, which enables the rotating body accommodating component to be detachably installed, and the through hole after the rotating body accommodating portion is removed , It can fix bone nails with a larger diameter than the anchoring part. 如請求項1所述之骨科手術器具，其具有防轉結構，該防轉結構將該旋轉體維持在往垂直於該旋轉軸線之方向壓靠該旋轉體容置組件之狀態。 The orthopedic surgical instrument according to claim 1, which has an anti-rotation structure, and the anti-rotation structure maintains the rotating body in a state where the rotating body is pressed against the rotating body accommodating component in a direction perpendicular to the rotation axis.
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