WO2020009043A1 - Plaque de fixation osseuse - Google Patents

Plaque de fixation osseuse Download PDF

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Publication number
WO2020009043A1
WO2020009043A1 PCT/JP2019/025967 JP2019025967W WO2020009043A1 WO 2020009043 A1 WO2020009043 A1 WO 2020009043A1 JP 2019025967 W JP2019025967 W JP 2019025967W WO 2020009043 A1 WO2020009043 A1 WO 2020009043A1
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WO
WIPO (PCT)
Prior art keywords
plate
bone
facing
bone fixation
fixing
Prior art date
Application number
PCT/JP2019/025967
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English (en)
Japanese (ja)
Inventor
義弘 岸上
Original Assignee
義弘 岸上
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 義弘 岸上 filed Critical 義弘 岸上
Publication of WO2020009043A1 publication Critical patent/WO2020009043A1/fr

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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
    • 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

Definitions

  • the present invention relates to a bone fixation plate used for fixing a bone during a fracture.
  • a bone fixing plate that fixes the divided bones in a joined state is used. At this time, it is known that healing (union) of the fractured part is delayed when the fractured part is completely fixed by the bone fixing plate. On the other hand, it is known that when a large movement occurs in a fractured part, fine capillaries are torn, thereby inhibiting bone fusion. Therefore, in order to heal the fracture with good quality, a method of fixing the fracture part using “dynamization” that allows a certain degree of fine movement in the fracture part may be used.
  • the living body has a fracture is recognized by repeating the minute movement caused by the intermittent pressure in the axial direction in the fracture part. Then, it grasps the site of the fracture in the living body, and sends cells and cytokines (proteins produced by the cells) for repairing the fracture to the fractured portion to try to heal. Further, there has been proposed a fixing device capable of performing such dynamicization in a fractured portion of a bone (for example, see Patent Document 1).
  • Patent Literature 1 describes a fixing tool in which a main body is fixed to one of the divided bones, a screw-shaped fixing tool is fixed to the other, and the fixing tool is inserted into a groove portion opened in a part of the main body.
  • This allows axial displacement between the main body and the fixture, and regulates other displacements.
  • this configuration allows not only axial displacement around the fixture but also rotation about the fixture. For this reason, when a rotational force other than the axial direction is applied to the fracture, the capillaries may be torn and adversely affect healing.
  • an influence eg, loosening
  • the present invention has been made in view of the above circumstances, and the problem to be solved by the present invention is to promote the fusion of bone by regulating displacement other than axial displacement in a fractured portion, thereby improving the fixation state.
  • the purpose of the present invention is to provide a bone fixation plate which can be maintained well.
  • a bone fixation plate according to the present invention is a bone fixation plate for fixing a first bone and a second bone separated by a fracture in a joined state, and the first plate fixed to the first bone. And, comprising a second plate fixed to the second bone, the first plate and the second plate are configured to be able to approach and separate from each other, relative displacement in the other direction, and, Relative rotation is regulated.
  • the fusion of the bone can be promoted by regulating the displacement other than the axial displacement in the fractured portion, and the fixed state can be maintained well.
  • the first plate and the second plate are fixed to the first bone and the second bone via a fixture penetrating the first plate and the second plate. Is preferred.
  • the bone fixation plate can be firmly attached to the bone.
  • the bone fixation plate further includes a restricting member for restricting a displacement in which the first plate and the second plate approach and separate from each other.
  • the fracture can be firmly fixed at the beginning of the fracture and then axially displaced at the fracture, so that the fusion of the bone can be promoted more reliably.
  • the first plate has a first fixation portion fixed to the first bone, a first facing portion facing the second plate, and the first fixation portion.
  • a first connecting portion for connecting the first opposing portion, the second plate is a second fixing portion fixed to the second bone, the second plate facing the first plate A second facing portion, and a second connecting portion that connects the second fixing portion and the second facing portion, and the first facing portion and the second facing portion, Preferably, it is formed at a position separated from the first bone and the second bone.
  • the periosteum and the muscle can be brought into contact with each other in the outer peripheral portion of the fractured portion, and it becomes easier to feed nutrients to the fractured portion via the capillaries passing through the muscle, so that the fusion of the bone can be further promoted. it can.
  • the circumferential width of the first bone at the first connecting portion and the second connecting portion is the circumferential width at the first fixing portion and the second fixing portion. Is preferably formed to be smaller than the width.
  • each connecting portion can be formed along the muscle direction, invasion to the muscle can be further reduced.
  • the first plate has a projection formed on the side facing the second plate, and the second plate has the projection inserted on the side facing the first plate.
  • a possible concave portion is formed, and the first plate and the second plate are configured to be able to approach and separate from each other by being engaged in a state where the convex portion is inserted into the concave portion. It is preferable that the relative displacement and the relative rotation are regulated.
  • the bone fixation plate, the first plate and the second plate, on the side facing each other are formed with concave and convex shapes that can be engaged with each other, and the concave and convex shapes are engaged with each other, It is preferable that the first plate and the second plate are configured so as to be able to approach and separate from each other, and that relative displacement and relative rotation in other directions are regulated.
  • an amorphous viscoelastic material is interposed at a portion where the first plate and the second plate face each other.
  • the first plate has a first fixing portion fixed to the first bone, and a first facing portion connected to the first fixing portion and facing the second plate.
  • the first opposing portion and the second opposing portion are orthogonal to the surfaces of the first bone and the second bone in a cross-sectional view by a plane orthogonal to the approaching / separating direction. It is preferably formed in a shape having a longitudinal direction in the direction.
  • the first opposing portion and the second opposing portion can be arranged between the muscles in the outer peripheral portion of the fracture portion, so that the bone fixing plate is used regardless of the thickness of the muscle in the fracture portion. It becomes possible.
  • the first opposing portion and the second opposing portion are closer to the first bone and the second bone in a cross-sectional view by a plane orthogonal to the approaching / separating direction.
  • it is formed with a reduced width.
  • the area where the first opposing portion and the second opposing portion are in contact with the first bone and the second bone can be reduced, and the periosteum and the muscle are easily brought into contact with each other at the outer peripheral portion of the fractured portion. Therefore, the fusion of bone can be further promoted.
  • the first opposing portion is connected to the first fixing portion by a first connecting portion
  • the second opposing portion is connected to the second fixing portion by a second connecting portion. It is preferable that the first opposing portion and the second opposing portion are connected to each other and are formed at positions separated from the first bone and the second bone.
  • the periosteum and the muscle can be brought into contact with each other in the outer peripheral portion of the fractured portion, and it becomes easier to feed nutrients to the fractured portion via the capillaries passing through the muscle, so that the fusion of the bone can be further promoted. it can.
  • FIG. 4 is a plan view showing a use state of the bone fixation plate according to the first embodiment.
  • FIG. 3 is a perspective view showing a use state of the bone fixation plate according to the first embodiment.
  • FIG. 14 is a partial cross-sectional view of the bone fixation plate according to the seventh embodiment, which is cut at a central portion in the lateral direction.
  • FIG. 14 is a partial cross-sectional view of the bone fixation plate according to the seventh embodiment, which is cut at a central portion in the lateral direction.
  • FIG. 19 is a partial cross-sectional view of a bone fixation plate according to first and second modifications of the seventh embodiment, which is cut at a central portion in the lateral direction.
  • FIG. 19 is a partial cross-sectional view of a bone fixation plate according to first and second modifications of the seventh embodiment, which is cut at a central portion in the lateral direction.
  • FIG. 29 is a partial cross-sectional view of a bone fixation plate according to a modification of the ninth embodiment, which is cut at a central portion in the lateral direction.
  • FIG. 29 is a partial cross-sectional view of a bone fixation plate according to a modification of the ninth embodiment, which is cut at a central portion in the lateral direction.
  • FIG. 3A is a sectional view taken along line XX in FIG.
  • the bone fixing plate 10 is a plate-shaped member used when a human or an animal fractures the bone B, and is fixed along the longitudinal direction of the bone B. Specifically, as shown in FIG. 1, the bone fixation plate 10 fixes the first bone B1 and the second bone B2, which have been divided at the fracture portion F, in a joined state.
  • tissues other than the bone B such as muscles and blood vessels, are not shown.
  • the bone fixing plate 10 includes a first plate 11 fixed to the first bone B1 and a second plate 12 fixed to the second bone B2. As shown in FIG. 2, the first plate 11 and the second plate 12 are formed in a curved shape in a direction orthogonal to the longitudinal direction of the bone B, thereby fixing the bone fixing plate 10 along the surface of the bone B. can do.
  • the first plate 11 and the second plate 12 have through holes (not shown). Then, a fixing screw S, which is a fixing tool, is inserted into the through hole, and the fixing screw S is screwed into the first bone B1 and the second bone B2, so that the first plate 11 and the second plate 12 are formed. It is fixed to the first bone B1 and the second bone B2.
  • the first plate 11 is formed with a convex portion 11a on the side facing the second plate 12.
  • a concave portion 12a into which the convex portion 11a can be inserted is formed on the side of the second plate 12 facing the first plate 11.
  • the first plate 11 and the second plate 12 are configured to be able to approach and separate from each other along the longitudinal direction of the bone B by inserting the protrusion 11a into the recess 12a.
  • a protruding ridge 11b having a V-shaped cross section is formed at a portion of the outer peripheral surface of the convex portion 11a facing the inner peripheral surface of the concave portion 12a.
  • a groove 12b having the same shape as the protrusion 11b is formed on a portion of the inner surface of the recess 12a facing the outer surface of the protrusion 11a.
  • the first plate 11 and the second plate 12 are configured to be able to approach and separate from each other, and the relative displacement in the other direction and the relative rotation are regulated. You. As described above, by permitting the axial displacement at the fracture portion F, the dynamics can be generated at the fracture portion F. That is, when the living body performs exercise or the like, minute movements due to the intermittent pressure in the axial direction in the fracture portion F are repeated, so that cells and cytokines (proteins produced by the cells) for repairing the fracture can be removed from the fracture portion F. To be healed.
  • the bone fixing plate 10 restricts the displacement other than the axial displacement, thereby preventing a rotational force or the like other than the axial direction from being applied to the fracture portion F, and the capillary can be ruptured to adversely affect healing. Performance can be reduced. That is, the fusion of the bones in the fracture portion F can be promoted, and the fixed state can be favorably maintained.
  • the first plate 11 and the second plate 12 are fixed to the first bone B1 and the second bone B2 via fixing screws S penetrating the first plate 11 and the second plate 12. Have been. Thereby, the bone fixing plate 10 can be firmly attached to the bone B. Specifically, even when the first plate 11 and the second plate 12 are close to and separated from each other, no sliding or the like occurs around the fixing screw S. That is, it is possible to prevent the fixing screw S from affecting the fixed state, such as loosening due to the influence of dynamics.
  • the protrusions 11 b and the grooves 12 b are engaged with the protrusions 11 a of the first plate 11 being inserted into the recesses 12 a of the second plate 12. Accordingly, the first plate 11 and the second plate 12 are configured to be able to approach and separate from each other, and the relative displacement and the relative rotation in the other direction are regulated. With such a configuration, it is possible to easily restrict displacement other than the axial displacement in the fracture portion F.
  • a method of engaging the first plate and the second plate in the fixing plate according to the present invention may be another configuration.
  • the bone fixation plates 110, 210, and 310 according to the second to fourth embodiments will be described with reference to FIGS. 3B to 3D.
  • 3B to 3D are cross-sectional views of central portions of the respective bone fixation plates 110, 210, and 310 in the longitudinal direction.
  • a ridge 111 b having a rectangular cross section is formed on the outer peripheral surface of the projection 111 a formed on the first plate 111.
  • a groove 112b having the same shape as the protrusion 111b is formed on the inner peripheral surface of the recess 112a formed in the second plate 112.
  • the first plate is formed with three columnar projections 211a.
  • the second plate 212 is formed with three cylindrical concave portions 212a. And by inserting each convex part 211a in the concave part 212a, the relative displacement of the direction other than the longitudinal direction of the bone B and the relative rotation between the first plate and the second plate 212 may be restricted. No problem.
  • a projection 311b is formed on the outer peripheral surface of the columnar projection 311a formed on the first plate.
  • a groove 312b having the same shape as the protrusion 311b is formed on the inner peripheral surface of the cylindrical recess 312a formed in the second plate 312.
  • the first plate and the second plate 312 may be configured such that relative displacement and relative rotation of the bone B in directions other than the longitudinal direction are restricted.
  • high rigidity can be exerted between the first plate and the second plate 312 with respect to the rotational force centered on the short direction of the bone fixation plate 310.
  • the first plate 411 and the second plate 412 are formed with concavo-convex shapes that can be engaged with each other on the sides facing each other. Specifically, three protrusions 411a are formed on the first plate 411. Further, two convex portions 412a are formed on the second plate 412. Then, the projections 411a and 412a are engaged with each other in combination.
  • the first plate 411 and the second plate 412 may be configured such that relative displacement and relative rotation of the bone B in directions other than the longitudinal direction are restricted.
  • an amorphous viscoelastic material 13 is interposed in a portion where the first plate 11 and the second plate 12 face each other.
  • a polymer compound such as silicone or synthetic rubber is used. This makes it possible to prevent invasion of living tissue such as collagen and tissue fluid between the first plate 11 and the second plate 12.
  • the bone fixation plate 510 has a fracture in the growth plate G in the bone B, and the first bone B1 and the second bone B separated by the fracture portion F in the growth plate G. Is used to join the bone B2.
  • the bone fixation plate 510 is fixed to the first bone B1 via the fixation screw S, and the second plate B is also fixed to the second bone B2 via the fixation screw S. And two plates 512. That is, the bone fixing plate 510 is fixed across the growth plate G. Then, the convex portion 511a of the first plate 511 is inserted into the concave portion 512a of the second plate 512. Thereby, the first plate 511 and the second plate 512 are configured to be able to approach and separate from each other along the longitudinal direction of the bone B.
  • Bone B can be fixed without the need. That is, even when the bone fixing plate 510 according to the present embodiment is fixed across the growth plate G, it is possible to prevent the growth of the bone B from being adversely affected.
  • the bone fixation plate 610 according to the seventh embodiment shown in FIGS. 7 and 8 includes a first plate 611 and a second plate 612, like the bone fixation plate 10 according to the first embodiment.
  • the first plate 611 has a protrusion 611 a on the side facing the second plate 612. Further, a concave portion 612a into which the convex portion 611a can be inserted is formed on a side of the second plate 612 facing the first plate 611.
  • FIGS. 8A and 8B are diagrams in which the convex portion 611a of the first plate 611 and the concave portion 612a of the second plate 612 are cut at the central portion in the short direction of the first plate 611.
  • the first plate 611 and the second plate 612 are configured to be able to approach and separate from each other along the longitudinal direction of the bone B by inserting the convex portion 611a into the concave portion 612a.
  • the first plate 611 and the second plate 612 are also restricted in relative displacement and relative rotation other than in the axial direction, as in the previous embodiment.
  • a locking recess 611b is formed on the upper surface of the projection 611a of the first plate 611 (the surface opposite to the surface in contact with the bone B, the same applies hereinafter).
  • a support concave portion 612c and an inclined concave portion 612b are formed in order from the concave portion 612a.
  • the bone fixing plate 610 includes a regulating rod 613 as a restricting tool for restricting the displacement of the first plate 611 and the second plate 612 toward and away from each other.
  • the regulating rod 613 has a rotating portion 613a formed on one end and a locking projection 613c formed on the other end. Further, a support protrusion 613b is formed in the middle of the regulating rod 613.
  • the support projection 613b is inserted into the support recess 612c, and the locking projection 613c is inserted into the locking recess 611b.
  • the regulating rod 613 regulates the displacement of the first plate 611 and the second plate 612 approaching and separating from each other.
  • the restricting rod 613 restricts the approach / separation between the first plate 611 and the second plate 612, and thus the fracture The part can be firmly fixed. After that, when the fracture starts to become a callus (approximately three weeks after the operation), the control rod 613 is rotated to allow relative axial displacement between the first plate 611 and the second plate 612. And
  • the structure of the restricting tool is not limited to the restricting rod 613.
  • the first engagement recess 621 b is formed on the upper surface of the projection 621 a of the first plate 621, and the first engagement recess 621 b is formed near the recess 622 a of the second plate 622.
  • Two engagement recesses 622b are formed.
  • FIG. 9A corresponds to FIG. 8A, and is a diagram in which the convex portion 621 a of the first plate 621 and the concave portion 622 a of the second plate 622 are cut at the central portion in the short direction of the first plate 621.
  • the engagement member 623 having the first engagement protrusion 623a and the second engagement protrusion 623b formed at both ends is assembled to the first plate 621 and the second plate 622. Specifically, as shown in FIG. 9A, at the beginning of the fracture, the first engagement protrusion 623a is inserted into the first engagement recess 621b, and the second engagement protrusion 623b is inserted into the second engagement recess 622b.
  • the engagement member 623 regulates the displacement of the first plate 621 and the second plate 622 approaching and separating from each other.
  • the engaging member 623 is separated from the first engaging concave portion 621b and the second engaging concave portion 622b. Therefore, the first plate 621 and the second plate 622 can approach and separate from each other.
  • the other end of the string-shaped member 623c extends from the surgical wound to the outside of the skin.
  • the engaging member 623 may be pulled out of the surgical wound together with the string-shaped member 623c, or may be extracted near the bone fixing plate 620 while being left near the bone fixing plate 620.
  • FIG. 9B corresponds to FIG. 8B, and is a diagram in which the convex portion 631 a of the first plate 631 and the concave portion 632 a of the second plate 632 are cut at the central portion in the short direction of the first plate 631.
  • the string-shaped member 633a whose end is fixed to the regulating block body 633 is pulled as shown by the arrow P, whereby the regulating block body 633 is detached from between the convex portion 631a and the concave portion 632a.
  • the first plate 631 and the second plate 632 can approach and separate from each other.
  • the other end of the string-shaped member 633c extends from the surgical wound to the outside of the skin.
  • the restricting block body 633 may be pulled out of the surgical wound together with the string-shaped member 633c, or may be left near the bone fixing plate 630 and extracted together with the bone fixing plate 630.
  • the bone fixation plate 710 according to the eighth embodiment shown in FIG. 10 includes a first plate 711 and a second plate 712, like the bone fixation plate 10 according to the first embodiment.
  • the first plate 711 includes a curved plate-shaped first fixing portion 713 fixed to one side of the bone B (the first bone B1 in FIG. 1), and a second plate 712.
  • a first connecting portion 717 for connecting the first fixing portion 713 and the first facing portion 715 to each other.
  • the first connecting portion 717 is formed to protrude from the first fixing portion 713 in the thickness direction of the first plate 711. Therefore, the first facing portion 715 is separated from the bone B as shown in FIG.
  • the second plate 712 includes a curved plate-shaped second fixing portion 714 fixed to the other side of the bone B (the second bone B2 in FIG. 1), and a second plate 711 opposed to the first plate 711. And a second connecting portion 718 for connecting the second fixed portion 714 and the second facing portion 716.
  • the second connecting portion 718 is formed to protrude from the second fixing portion 714 in the thickness direction of the second plate 712 with the same length as the first connecting portion 717. Therefore, the second facing portion 716 is separated from the bone B as shown in FIG.
  • a projection 715a is formed on the first facing portion 715 on the side facing the second facing portion 716.
  • a concave portion 716a into which the convex portion 715a can be inserted is formed on a side of the second opposing portion 716 facing the first opposing portion 715.
  • the first plate 711 and the second plate 712 are configured to be able to approach and separate from each other along the longitudinal direction of the bone B by inserting the convex portion 715a into the concave portion 716a.
  • the relative displacement and relative rotation of the first plate 711 and the second plate 712 other than the axial direction are restricted, as in the above-described embodiment.
  • a ridge and a groove that engage with each other are formed on the outer surface of the convex portion 715a and the inner surface of the concave portion 716a. In the state where the portion 715a is inserted into the concave portion 716a, a configuration or the like in which the ridge and the groove are engaged can be adopted.
  • the first facing portion 715 and the second facing portion 716 are formed at positions separated from the bone B. Thereby, the periosteum and the muscle can be kept in contact at the outer peripheral portion of the fractured portion. For this reason, nutrients can be easily delivered to the fractured part via the capillaries passing through the muscles, and the fusion of bones can be further promoted.
  • the circumferential width of the bone B at the first connecting portion 717 and the second connecting portion 718 is equal to the width of the first fixing portion 713 and the second fixing portion 713.
  • the second fixing portion 714 is formed to be smaller than the circumferential width.
  • the bone fixation plate 810 according to the ninth embodiment shown in FIG. 11 includes a first plate 811 and a second plate 812, like the bone fixation plate 710 according to the eighth embodiment. Then, as shown in FIG. 11, the first plate 811 has a curved plate-shaped first fixing portion 813 fixed to one side of the bone B, and a first facing portion 815 facing the second plate 812. , A first connecting portion 817 that connects the first fixing portion 813 and the first facing portion 815. The first connecting portion 817 is formed to protrude from the first fixing portion 813 in the thickness direction of the first plate 811. Therefore, the first facing portion 815 is separated from the bone B as shown in FIG.
  • the second plate 812 includes a curved plate-shaped second fixing portion 814 fixed to the other side of the bone B, a second facing portion 816 facing the first plate 811, and a second fixing portion 816.
  • a second connecting portion 818 that connects the portion 814 and the second facing portion 816.
  • the second connecting portion 818 is formed so as to protrude from the second fixing portion 814 in the thickness direction of the second plate 812 with substantially the same length as the first connecting portion 817. Therefore, the second facing portion 816 is separated from the bone B as shown in FIG.
  • the first facing portion 815 is formed in a columnar shape.
  • the second facing portion 816 is formed in a cylindrical shape into which the first facing portion 815 can be inserted. Then, by inserting the first opposing portion 815 into the second opposing portion 816, the first plate 811 and the second plate 812 are configured to be able to approach and separate from each other along the longitudinal direction of the bone B. .
  • first plate 811 and the second plate 812 other than in the axial direction are restricted as in the above-described embodiment.
  • the outer peripheral surface of the first opposing portion 815 and the inner peripheral surface of the second opposing portion 816 have a ridge portion that engages with each other. It is possible to adopt a configuration in which a groove-like portion is formed, and the projection and the groove engage with each other in a state where the first facing portion 815 is inserted into the second facing portion 816.
  • one of the first facing portion 815 and the second facing portion 816 may have a cylindrical shape, and the other may have a cylindrical shape.
  • the first facing portion 815 and the second facing portion 816 are formed at positions separated from the bone B. Thereby, the periosteum and the muscle can be kept in contact at the outer peripheral portion of the fractured portion. For this reason, nutrients can be easily delivered to the fractured part via the capillaries passing through the muscles, and the fusion of bones can be further promoted.
  • a restricting device for restricting a displacement in which the first plate 811 and the second plate 812 approach and separate from each other.
  • a male screw portion 815a is formed on the outer peripheral surface of the first facing portion 815
  • a male screw portion 816a is formed on the outer peripheral surface of the second facing portion 816. I do.
  • the regulating screw member 819 which is a regulating tool in the present embodiment, has an inner peripheral surface formed in a two-stage shape of a small diameter portion 819a and a large diameter portion 819b. Female screw portions are formed on the small diameter portion 819a and the large diameter portion 819b, respectively.
  • the female screw portion of the small diameter portion 819a is screwed with the male screw portion 815a.
  • the regulating screw member 819 regulates the displacement of the first plate 811 and the second plate 812 approaching and separating from each other.
  • the regulating screw member 819 when the regulating screw member 819 is rotated through the skin to release the engagement between the female screw portion and the male screw portion 816a of the large-diameter portion 819b, the first plate 811
  • the second plate 812 can approach and separate from each other.
  • the restricting screw member 819 restricts the proximity and separation between the first plate 811 and the second plate 812, thereby reducing the fracture portion. Can be fixed firmly.
  • the bone fixation plate 910 according to the tenth embodiment shown in FIG. 13 includes a first plate 911 and a second plate 912, like the bone fixation plate 710 according to the eighth embodiment.
  • the first plate 911 includes a curved plate-shaped first fixing portion 913 fixed to one side of the bone B (the first bone B1 in FIG. 1), and a second plate 912. And a first opposing portion 915 opposing.
  • the second plate 912 has a curved plate-shaped second fixing portion 914 fixed to the other side of the bone B (the second bone B2 in FIG. 1), and a second plate 911 opposed to the first plate 911. And an opposing portion 916 of the above.
  • the first facing portion 915 has a convex portion 915a formed on the side facing the second facing portion 916. Further, a concave portion 916a into which the convex portion 915a can be inserted is formed on a side of the second opposing portion 916 facing the first opposing portion 915.
  • the first plate 911 and the second plate 912 are configured to be able to approach and separate from each other along the longitudinal direction of the bone B by inserting the convex portion 915a into the concave portion 916a.
  • the relative displacement and relative rotation of the first plate 911 and the second plate 912 other than in the axial direction are restricted as in the above-described embodiment.
  • the relative displacement other than the axial direction and the relative rotation are regulated. ing.
  • the first facing portion 915 and the second facing portion 916 are in the direction of approaching and separating the first plate 911 and the second plate 912.
  • a cross-sectional view of a plane orthogonal to the longitudinal direction of the bone B it is formed in a shape having a longitudinal direction in a direction orthogonal to the surface of the bone B (vertical direction in FIG. 13).
  • the first opposing portion 915 and the second opposing portion 916 are formed in a flat plate shape that is parallel to a plane orthogonal to the surface of the bone B.
  • the first opposing portion 915 and the second opposing portion 916 are muscled in the outer peripheral portion of the bone B. (Between muscles or intramuscularly). That is, since the circumferential width of the bone B of the first facing portion 915 and the second facing portion 916 is relatively smaller than that of the other embodiments, the discomfort can be reduced even when the bones B are arranged between the muscles. Can be. Accordingly, even when the muscle around the bone B is thick or thin, the bone fixation plate 910 can be used without any problem. That is, the bone fixing plate 910 can be used regardless of the thickness of the muscle around the bone B.
  • the bone fixation plate 710 when configured as the bone fixation plate 710 according to the eighth embodiment shown in FIG. 10, by keeping the periosteum and muscle in contact, it is possible to further promote the fusion of bone. it can.
  • the heights of the first facing portion 715 and the second facing portion 716 from the first plate 711 and the second plate 712 are adjusted according to the fracture site and the thickness of the muscle of the patient. It must be made to order.
  • the bone fixation plate 910 according to the present embodiment has a cross section of the first opposing portion 915 and the second opposing portion 916 having a vertically long shape, as shown in FIGS.
  • the bone fixation plate 910 although the muscle M is slightly pressed, the cross section of the first opposing portion 915 and the second opposing portion 916 is vertical, so that the periosteum of the bone B is formed. And the muscle M can be kept in contact, and the fusion of the bone B can be promoted.
  • the first opposing portion 915 and the second opposing portion 916 are viewed in a cross-sectional view along a plane orthogonal to the longitudinal direction of the bone B as shown in FIGS. , Are formed with a reduced width (in an inverted triangular shape in a sectional view) as approaching the bone B.
  • the area where the first facing part 915 and the second facing part 916 contact the bone B is increased.
  • the first facing portion 915 is connected to the first fixation portion 913 by the first connection portion 917.
  • the second facing portion 916 is connected to the second fixing portion 914 by the second connecting portion 918.
  • the first opposing portion 915 and the second opposing portion 916 are formed at positions separated from the bone B. Thereby, the periosteum and the muscle can be kept in contact at the outer peripheral portion of the fractured portion. For this reason, nutrients can be easily delivered to the fractured part via the capillaries passing through the muscles, and the fusion of bones can be further promoted.
  • the circumferential width of the bone B at the first connecting portion 917 and the second connecting portion 918 is equal to the width of the first fixing portion 913 and the second fixing portion 918.
  • the second fixing portion 914 is formed to be smaller than the circumferential width.
  • the fusion of the bone can be promoted by restricting the displacement other than the axial displacement in the fracture portion, and the fixation state can be maintained satisfactorily.
  • Bone fixation plate (first embodiment) 11 First plate 11a Convex part 11b ridge 12 second plate 12a recess 12b groove 13 Covering member 110 Bone fixation plate (second embodiment) 111 First plate 111a Convex part 111b Ridge 112 Second plate 112a recess 112b groove 210 Bone fixation plate (third embodiment) 211a convex part 212 second plate 212a recess 310 Bone fixation plate (fourth embodiment) 311a Projection 311b Projection 312 second plate 312a recess 312b Groove 410 Bone fixation plate (fifth embodiment) 411 first plate 411a first engagement projection 412 second plate 412a second engagement projection 510 bone fixation plate (sixth embodiment) 511 First plate 511a Convex part 512 second plate 512a recess 610 Bone fixation plate (seventh embodiment) 611 First plate 611a Convex part 611b Locking recess 612 Second plate 612a recess 612b inclined

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

Abstract

Plaque de fixation osseuse 10 selon un mode de réalisation de la présente invention qui est destinée à fixer un premier os B1 à un second os B2, qui ont été segmentés par une fracture, le premier os B1 étant relié au second os B2, et qui comprend une première plaque 11 qui doit être fixée au premier os B1 et une seconde plaque 12 qui doit être fixée au second os B2, la première plaque 11 et la seconde plaque 12 étant conçues de façon à être mobiles l'une vers l'autre et l'une à distance de l'autre, et le déplacement relatif et la rotation relative de la première plaque 11 et de la seconde plaque 12 dans d'autres directions étant limités.
PCT/JP2019/025967 2018-07-04 2019-06-28 Plaque de fixation osseuse WO2020009043A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
JP2018-127531 2018-07-04
JP2018127531 2018-07-04
JP2018177478 2018-09-21
JP2018-177478 2018-09-21

Publications (1)

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WO2020009043A1 true WO2020009043A1 (fr) 2020-01-09

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Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR1051847A (fr) * 1952-02-28 1954-01-19 Attelle réglable pour ostéosynthèse, permettant l'impaction des fragments
JP2015517349A (ja) * 2012-05-10 2015-06-22 スパイナル シンプリシティ エルエルシーＳｐｉｎａｌ Ｓｉｍｐｌｉｃｉｔｙ ＬＬＣ 動的骨折プレート

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR1051847A (fr) * 1952-02-28 1954-01-19 Attelle réglable pour ostéosynthèse, permettant l'impaction des fragments
JP2015517349A (ja) * 2012-05-10 2015-06-22 スパイナル シンプリシティ エルエルシーＳｐｉｎａｌ Ｓｉｍｐｌｉｃｉｔｙ ＬＬＣ 動的骨折プレート

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