WO2020166529A1

WO2020166529A1 - Bone treatment apparatus

Info

Publication number: WO2020166529A1
Application number: PCT/JP2020/004951
Authority: WO
Inventors: 黒田　隆
Original assignee: 国立大学法人京都大学
Priority date: 2019-02-13
Filing date: 2020-02-07
Publication date: 2020-08-20
Also published as: JP2020130214A

Abstract

Provided is a readily usable bone treatment apparatus of simple structure, allowing a pin-shaped member to be inserted readily with the correct position and orientation relative to the bone of a patient.　A cylindrical guide part 11 having a pin-shaped member 10 that is to be inserted into the bone 100 of the patient passing therethrough, guides the pin-shaped member 10 in an insertion direction into the bone 100. A main body part 12 has a length direction, and the guide part 11 is fixed thereon. An indexing part 13 is coupled to the main body part 12 so as to be freely slidable, extends in a plane defined as a plane containing the direction in which the guide part 11 extends and the length direction of the main body part 12, and indexes the position of the guide part 11.

Description

Bone treatment instrument

The present invention relates to a bone treatment instrument used when performing a treatment of inserting a pin-shaped member into the bone of a patient.

In various operations performed on a patient's bone, such as bone joint surgery such as bone fracture surgery or bone perforation, a pin-shaped member such as a pin, a drill, or a screw should be inserted into the patient's bone. The procedure to insert it is often done. Then, in the procedure of inserting the pin-shaped member into the bone, an instrument having a tubular portion for inserting the pin-shaped member and guiding the insertion direction of the pin-shaped member into the bone is used (for example, See Non-Patent Document 1). The operator performs a procedure of inserting the pin-shaped member into the bone by inserting the pin-shaped member into the bone while checking the insertion position of the pin-shaped member into the bone under fluoroscopy using such an instrument.

In the procedure of inserting a pin-shaped member into a patient's bone, inserting the pin-shaped member in the correct position and in the correct direction with respect to the bone is an important factor related to surgical results, It is one of the most basic surgical procedures needed. On the other hand, it is difficult to insert the pin-shaped member into the bone of the patient at an accurate position and direction, and the surgeon relies on his experience to perform the free-hand insertion of the pin-shaped member into the bone. For this reason, in order to insert the pin-shaped member into the bone at the correct position and direction with respect to the bone even while confirming it under X-ray fluoroscopy, the operator must perform trial and error to insert the pin-shaped member into the bone. On the other hand, he is forced to re-insert it many times.

If a bone treatment instrument capable of easily inserting the pin-shaped member into the patient's bone at a correct position can be realized, the number of times the pin-shaped member is inserted into the bone can be reduced. As a result, the accuracy of surgery can be improved, the operation time can be shortened, and the exposure time of the medical staff due to X-ray fluoroscopy can be shortened, and the profits of both the patient and the medical staff can be improved. In addition, it is possible to reduce the dependence on the experience of the operator and spread a stable surgical procedure, thereby improving the medical standard.

Further, in the realization of a bone treatment instrument in which a pin-shaped member can be easily inserted into a patient's bone in an accurate position and direction, it is possible to realize a medical economy without using a complicated surgical navigation system at high cost. It is desirable to improve patient benefits and medical standards, including all aspects. Therefore, in realizing a bone treatment instrument capable of easily inserting the pin-shaped member into the bone at an accurate position and direction, it is possible to realize a bone treatment instrument having a simple structure and easy to use. desired.

In view of the above situation, the present invention provides a bone treatment instrument that allows a pin-shaped member to be easily inserted into a patient's bone at an accurate position and direction, and has a simple structure and is easy to use. With the goal.

(1) A bone treatment instrument according to the present invention for achieving the above object, wherein a pin-shaped member to be inserted into a patient's bone is inserted, and has a tubular shape for guiding the insertion direction of the pin-shaped member into the bone. A guide portion, a main body portion having a longitudinal direction to which the guide portion is fixed, and a main body portion that is slidably connected and a direction in which the guide portion extends and the longitudinal direction of the main body portion. An index portion that extends along a surface defined as a surface including the index portion and that indicates the position of the guide portion.

With this configuration, the index portion slidably connected to the main body portion to which the guide portion is fixed extends along the plane including the extending direction of the guide portion and the longitudinal direction of the main body portion, and It is configured to index position. Therefore, the indicator portion is also arranged so as to extend along the same surface as the surface on which the guide portion and the main body portion that extend along the same surface are arranged. Then, when the operator who operates the bone treatment instrument having the above configuration looks at the index portion along the surface on which the index portion and the main body portion are arranged, in the operator's viewpoint direction, the index portion and the guide portion are They will be placed in an overlapping state. Therefore, the operator can accurately and easily determine the position and direction of the guide portion indexed by the index portion in the operator's viewpoint direction only by looking at the index portion along the surface on which the index portion and the main body portion are arranged. Can be grasped. Furthermore, the operator can accurately and easily grasp the position and direction of the pin-shaped member inserted into the guide portion indexed by the index portion, only by looking at the index portion. The indicator portion that is slidably connected to the main body portion and extends along the same surface as the surface on which the guide portion and the main body portion are arranged may extend in a direction parallel to the guide portion. , May extend along a direction intersecting with the extending direction of the guide portion.

When a surgeon performs a procedure in which a pin-shaped member is inserted into a bone of a patient's affected area during an operation, first, the tip of the tubular guide portion is inserted into the bone of the affected area. It is placed in the position. At this time, the portion on the distal end side of the guide portion is inserted into the soft tissue of the patient and hidden from the outside, but the operator places the indicator portion along the surface on which the indicator portion and the main body portion are arranged. By looking at it, it is possible to accurately and easily grasp the position and direction of the guide portion indexed by the index portion in the operator's viewpoint direction. Furthermore, the operator looks at the index portion from the same viewpoint, and the position and direction in which the pin-shaped member inserted into the guide portion indexed by the index portion is inserted into the affected area accurately and also. It can be easily grasped.

Further, even under fluoroscopy such as X-rays, the operator can accurately and easily grasp the position and direction of the guide part indexed by the index part with respect to the bone by viewing the fluoroscopic image from the same viewpoint as above. You can Furthermore, the operator can accurately and easily grasp the position and the direction in which the pin-shaped member inserted into the guide portion indexed by the index portion is inserted into the bone. Note that, under fluoroscopy such as X-rays, the bone treatment instrument and the bone to be treated are displayed on the monitor of a transmission device such as an X-ray device. The operator can accurately and easily grasp the position and the direction of the guide part with respect to the bone, which is indexed by the index part, by looking at the patient's bone and the index part displayed on the monitor. The position and direction in which the inserted pin-shaped member is inserted into the bone can be accurately and easily grasped.

When the surgeon accurately grasps the position and direction of the guide portion indexed by the index portion with respect to the bone, and the position and the insertion direction of the pin-shaped member inserted into the guide portion with respect to the bone, The pin-shaped member is then inserted into the bone. At this time, first, the pin-shaped member is inserted into the guide portion. Then, the pin-shaped member is inserted so as to be inserted into the bone while the insertion direction into the bone is guided by the guide portion. At this time, the operator accurately grasps the insertion position and the insertion direction of the pin-shaped member with respect to the bone by the index portion, and then accurately grasps the pin-shaped member with respect to the bone along the grasped insertion position and insertion direction. And can be easily inserted. Therefore, with the bone treatment instrument having the above-described configuration, the operator can easily insert the pin-shaped member into the bone of the patient at an accurate position and direction.

Further, according to the above configuration, the bone treatment instrument capable of easily inserting the pin-shaped member into the patient's bone at the correct position and direction is provided with the tubular guide portion into which the pin-shaped member is inserted. Is fixed to the main body, and the index portion is slidably connected to the main body to have a simple structure. Therefore, the bone treatment instrument capable of easily inserting the pin-shaped member into the bone at the correct position and direction is realized with a simple structure without using a complicated surgical navigation system at high cost. be able to. The index portion is slidably connected to the main body portion to which the guide portion is fixed. Therefore, the position of the index portion with respect to the main body portion and the guide portion can be easily adjusted by sliding the position to a position desired by the operator. Thereby, the surgeon easily adjusts the position of the index portion with respect to the main body portion and the guide portion according to the state of the area where the bone treatment instrument is used in the patient, and in a state where the surgeon himself is easy to use, Bone treatment instruments can be used. Therefore, a bone treatment instrument capable of easily inserting the pin-shaped member into the patient's bone at an accurate position and direction can be realized as a bone treatment instrument that is easy for an operator to use.

Therefore, according to the above configuration, the pin-shaped member can be easily inserted into the patient's bone at an accurate position and direction, and a bone treatment instrument having a simple structure and easy to use can be provided.

(2) The indicator portion may be provided with a long hole into which a shaft-like portion that is a portion of the main body portion extending in the longitudinal direction is inserted.

According to this configuration, the shaft-shaped portion of the main body is inserted into the elongated hole of the indicator, and the indicator is slidably connected to the main body. Therefore, it is possible to realize a structure in which the indicator portion is slidably movable on the main body portion with a simple structure in which the indicator portion is provided with a long hole.

(3) The shaft-shaped portion is provided with a pair of first slide surfaces extending in parallel along the longitudinal direction on a side surface of the shaft-shaped portion, and the slot has an inner peripheral wall of the slot. A pair of second slide surfaces slidably movable with respect to the pair of first slide surfaces may be provided.

According to this configuration, the pair of second slide surfaces of the inner peripheral wall of the elongated hole of the index portion slide with respect to the pair of parallel first slide surfaces of the main body portion, so that the index portion slides relative to the main body portion. Freely configured. Therefore, the index portion can be slid smoothly in a stable state with respect to the main body portion by the sliding operation of the pair of parallel first slide surfaces and the pair of corresponding second slide surfaces. This can further improve the operability when sliding the index portion with respect to the main body portion.

(4) The bone treatment instrument may further include a fixing mechanism capable of fixing the index portion to the main body portion in a state where the shaft-shaped portion is inserted into the elongated hole.

According to this structure, the shaft-shaped portion of the main body is inserted into the elongated hole, and the indexable portion that is slidably moved to the main body is fixed to the main body at the operator's desired position in the sliding movement direction by the fixing mechanism. Can be fixed.

(5) The fixing mechanism is screwed into the screw hole, which is provided in the index portion and extends from the surface of the index portion toward the elongated hole through a part of the index portion. A screw member, the tip of which comes into contact with the shaft-shaped portion inserted into the elongated hole, may be included.

According to this structure, the mechanism for fixing the indicator portion, which is slidably movable to the body portion, to the body portion is provided with the screw hole penetrating the indicator portion toward the elongated hole and the screw abutting on the shaft-like portion by screwing the screw hole into the screw hole It can be realized with a simple structure provided with a member.

(6) The bone treatment instrument further includes a handle portion provided as a portion gripped by an operator who operates the bone treatment instrument, the handle portion being provided integrally with the main body portion, It may be provided so as to extend obliquely from the main body portion with respect to the longitudinal direction, and to extend from the main body portion along a direction that forms an obtuse angle with a direction in which the guide portion extends from the main body portion.

According to this configuration, the handle portion grasped by the operator who operates the bone treatment instrument is integrally provided on the main body portion to which the guide portion is fixed and the indicator portion is connected. Therefore, it is possible to operate the bone treatment instrument with the main body part located closer to the operator's hand holding the handle part and the guide part and the index part located away from the operator's hand. It will be easy. Thereby, it becomes easy to operate the guide portion and the index portion to a desired posture of the operator, and the operability of the bone treatment instrument can be further improved. Further, according to the above configuration, the handle portion extends along the direction that forms an obtuse angle with the direction in which the guide portion extends. Therefore, even when the distal end portion of the guide portion is inserted into the soft tissue of the patient, it becomes easy to position the handle portion so as to avoid contact with the patient. As a result, it becomes easy to operate the guide portion to a desired posture of the operator, and the operability of the bone treatment instrument can be further improved.

(7) The guide portion may be provided with a portion formed so as to be sharpened toward the front end side at the front end portion thereof.

According to this configuration, the tip of the guide portion has a pointed portion on the tip side. Therefore, when the distal end of the guide portion is arranged at the position where the pin-shaped member is inserted into the bone of the patient, the guide portion bites into the surface of the bone at the tip of the pointed portion, and Engage with. As a result, when the pin-shaped member is inserted into the guide portion and inserted into the bone, the operation of inserting the pin-shaped member into the bone is stably supported by the guide portion that engages with the bone at the tip portion. To be done. Therefore, the operator can more easily insert the pin-shaped member into the patient's bone in the correct position and direction.

According to the present invention, a pin-shaped member can be easily inserted into a patient's bone at an accurate position and direction, and a bone treatment instrument having a simple structure and easy to use can be provided.

It is a figure showing the instrument for bone treatment concerning one embodiment of the present invention, Drawing 1 (A) is a top view, Drawing 1 (B) is a left side view, and Drawing 1 (C) is a front view. 1D is a right side view. It is a figure which shows typically the state in which the pin-shaped member is inserted in the bone using the bone treatment instrument. It is a figure which shows typically the state in which the pin-shaped member is inserted in the bone using the bone treatment instrument. It is a rear view of a bone treatment instrument, and is a figure which abbreviate|omits a part of bone treatment instrument. It is a figure which shows the main-body part in the instrument for bone treatment, a guide part, and a handle part, FIG.5(A) is a top view, FIG.5(B) is a front view, FIG.5(C) is a right side. It is a side view. It is a figure which expands and shows a part of guide part. It is a perspective view of the index part in the instrument for bone treatment. It is a figure which shows an index part, FIG.8(A) is a front view, FIG.8(B) is a top view. It is a figure for demonstrating the relative displacement operation|movement of the main-body part and the index part in a bone treatment instrument. It is a figure which shows typically the state where the instrument for bone treatment is used in the treatment which inserts a pin-shaped member into a bone. It is a figure which shows typically the state in which the instrument for bone treatment is used in the treatment which inserts a pin-shaped member into a bone, and is a figure which shows the see-through image seen on the monitor of a transmission apparatus.

Hereinafter, modes for carrying out the present invention will be described with reference to the drawings.

[Outline of bone treatment instrument]
FIG. 1 is a diagram showing a bone treatment instrument 1 according to an embodiment of the present invention, FIG. 1(A) is a plan view, FIG. 1(B) is a left side view, and FIG. C) is a front view, and FIG. 1D is a right side view. The bone treatment instrument 1 shown in FIG. 1 can be widely used in various operations performed on a patient's bone, such as bone joint surgery such as bone fracture surgery or bone perforation surgery. The bone treatment instrument 1 is used when performing a treatment of inserting a pin-shaped member into the bone of a patient in various operations performed on the bone of the patient.

Further, the bone treatment instrument 1 is preferably used, for example, in performing a treatment for inserting a pin-shaped member into the femur of a patient in a femoral proximal fracture operation or a regenerative medical operation for femoral head necrosis. To be FIGS. 2 and 3 show a state in which the bone treatment instrument 1 is used and the pin-shaped member 10 is inserted into a bone 100 configured as a femur (hereinafter, the bone 100 is also referred to as a femur 100). It is a figure which shows typically. 2 and 3, only the proximal portion of the femur 100 and the bone treatment instrument 1 are shown, and the other elements are not shown. That is, in FIGS. 2 and 3, the soft tissue of the patient, a portion of the femur 100 other than the proximal portion, and an operator who operates the bone treatment instrument 1 are not shown. 2 and 3, the bone treatment instrument 1 is arranged in different postures with respect to the femur 100, respectively.

For example, when the bone treatment instrument 1 is used in regenerative medical surgery for femoral head necrosis, the bone treatment instrument 1 is inserted by inserting the pin-shaped member 10 into the femur 100 of the patient. Used to perform treatment. By using the bone treatment instrument 1, the pin-shaped member 10 is inserted into the femur 100 of the patient at an accurate position and direction, as will be described later. In the surgical operation of regenerative medicine for femoral head necrosis, when the pin-shaped member 10 is inserted into the femur 100, then, for example, a part of the femur 100 is collected as an autologous bone, and the autologous bone is further removed. A procedure is performed in which the containing bone composition is applied to the collapsed portion of the femoral head. In regenerative medical surgery for femoral head necrosis, the pin-shaped member 10 inserted into the femur 100 is used to perform autologous bone collection treatment and bone composition donation treatment to the collapsed portion. It is used as a guide pin for guiding the operation of a surgical instrument (not shown) for performing. When the procedure for collecting the autologous bone and the procedure for applying the bone composition to the collapsed portion are completed, the pin-shaped member 10 is removed from the femur 100.

The pin-shaped member 10 to be inserted into the femur 100 by using the bone treatment instrument 1 in the operation of regenerative medicine for femoral head necrosis includes a pin-shaped member 10 from the outer side (gray-belt) to the inner side (navel) of the femur 100. ), is inserted into the femur 100, and is temporarily fixed. The pin-shaped member 10 is made of, for example, a metal material. The pin-shaped member 10 exemplified in the present embodiment is formed as a needle-shaped pin, which is formed in the shape of a round shaft whose tip is conically pointed. In addition, the thickness of the pin-shaped member 10 is set to, for example, 0.5 mm or more in order to prevent the pin-shaped member 10 from being bent and not being pierced into the femur 100 when attempting to pierce the femur 100. It Further, if it is too thick, it takes time to restore the holes formed by the pin-shaped member 10 naturally, so the thickness of the pin-shaped member 10 is set to, for example, 4 mm or less. In addition, in the present embodiment, the pin-shaped member 10 that is inserted into the bone 100 by using the bone treatment instrument 1 is illustrated as a pin-shaped pin, but this need not be the case. The bone treatment instrument 1 may be used for various types of pin-shaped members. For example, the bone treatment instrument 1 may be used when a pin-shaped member such as a drill or a screw is inserted into bone.

[Details of bone treatment instruments]
Hereinafter, the details of the bone treatment instrument 1 will be described in more detail. As shown in FIGS. 1 to 3, the bone treatment instrument 1 is configured to include a guide portion 11, a main body portion 12, an index portion 13, a fixing mechanism 14, and a handle portion 15. 2 and 3, the fixing mechanism 14 is not shown. The guide portion 11, the main body portion 12, the index portion 13, the fixing mechanism 14, and the handle portion 15 are made of, for example, a metal material. The guide portion 11, the main body portion 12, and the handle portion 15 are integrally formed. The index portion 13 is detachably attached to the main body portion 12 and fixed to the main body portion 12 by the fixing mechanism 14.

FIG. 4 is a rear view of the bone treatment instrument 1, in which a part of the bone treatment instrument 1 is omitted. 5: is a figure which shows the main-body part 12, the guide part 11, and the handle part 15 in the bone treatment instrument 1, FIG. 5(A) is a top view, FIG. 5(B) is a front view. 5C is a right side view. FIG. 6 is an enlarged view showing a part of the guide portion 11.

[Guide part]
The guide portion 11 shown in FIGS. 1 to 6 is provided as a cylindrical portion into which the pin-shaped member 10 to be inserted into the bone 100 of the patient is inserted and which guides the insertion direction of the pin-shaped member 10 into the bone 100. There is. Further, the guide portion 11 is provided as a linearly extending cylindrical portion, and in the present embodiment, is formed as an elongated hollow cylindrical portion. The guide portion 11 is integrally joined to the main body portion 12 by welding or the like on one end side in the longitudinal direction, which is the direction in which the guide portion 11 extends linearly, and is provided so as to extend in a cantilever manner from the main body portion 12. ..

The guide part 11 extending linearly with a circular cross section is provided with an insertion hole 21 penetrating in the longitudinal direction thereof. The insertion hole 21 is provided as a hole through which the pin-shaped member 10 is inserted, and is configured to penetrate the guide portion 11 along the longitudinal direction of the guide portion 11 with a circular cross section. For this reason, the insertion hole 21 is open at the base end side which is one end side of the guide portion 11 integrally connected to the main body portion 12. The insertion hole 21 is also open at the tip end side of the guide portion 11 opposite to the base end side.

The cross-sectional shape of the insertion hole 21 corresponds to the cross-sectional shape of the pin-shaped member 10. That is, the shape of the inner peripheral surface of the guide portion 11 corresponds to the shape of the outer peripheral surface of the pin-shaped member 10. More specifically, the inner diameter of the inner peripheral surface of the guide portion 11 is provided with play, and is set to be larger than the outer diameter of the pin-shaped member 10 by about 0.1 mm to 0.5 mm. With such a shape, the guide portion 11 is configured such that the pin-shaped member 10 can be smoothly inserted and the rattling with the pin-shaped member 10 can be suppressed.

Incidentally, the insertion hole 21 of the guide portion 11 is configured to communicate with the through hole 22 provided in the main body portion 12. That is, the body portion 12 is provided with a through hole 22 penetrating the body portion 12 at a position corresponding to the opening of the insertion hole 21 on the proximal end side of the guide portion 11. The through hole 22 is formed in the same cross-sectional shape as the insertion hole 21, and is provided so as to penetrate the main body 12 on the same straight line as the direction in which the insertion hole 21 extends. When the pin-shaped member 10 is inserted into the guide portion 11, the pin-shaped member 10 is first inserted into the through hole 22 of the main body portion 12, and further inserted from the proximal end side to the distal end side of the guide portion 11. It is inserted through the hole 21.

Further, the guide portion 11 is provided with a plurality of protrusions 23 as a portion that is formed so as to be pointed toward the distal end side in the distal end portion 11a that is a distal end portion that extends in a cantilever manner from the main body portion 12. ing. The plurality of protrusions 23 are provided side by side along the circumferential direction of the opening of the insertion hole 21 at the tip portion 11 a of the guide portion 11. Each of the protrusions 23 is, for example, formed in a V-shape so as to gradually become thinner toward the tip side, and has a blade tip portion at the tip thereof. When the distal end portion 11a of the guide portion 11 is arranged in contact with the bone 100, the plurality of protruding portions 23 engage with the bone 100 at the cutting edge portion of the distal end thereof so as to bite into the bone 100.

[Main body]
The main body portion 12 shown in FIGS. 1 to 5 has a linearly extending longitudinal direction, the guide portion 11 and the handle portion 15 are integrally fixed, and the indicator portion 13 is a portion that is slidably connected. It is provided. The body portion 12 is provided with a shaft-shaped portion 24 which is a portion extending in the longitudinal direction. The basic shape of the cross section of the shaft-like portion 24 is, for example, a substantially rectangular shape, a shape in which the corners of the substantially rectangular shape are chamfered, or a shape in which the corners of the substantially rectangular shape are processed into a curved shape. It is formed in a shape.

The shaft portion 24 is configured such that the index portion 13 is slidably connected along the longitudinal direction thereof. Further, the shaft-shaped portion 24 is provided with a pair of first slide surfaces (24a, 24a) extending in parallel along the longitudinal direction on the side surface of the shaft-shaped portion 24. Here, the side surface of the shaft-shaped portion 24 is a surface that extends parallel to the longitudinal direction of the shaft-shaped portion 24, and is a side surface when the longitudinal direction of the shaft-shaped portion 24 is the front-back direction. The side surface of the shaft-shaped portion 24 does not correspond to the side surface name in the left side view which is the name of FIG. 1B and the right side view which is the name of FIG. 5C.

One first slide surface 24a of the pair of first slide surfaces (24a, 24a) is provided on one side surface of both parallel side surfaces of the shaft-shaped portion 24, and the pair of first slide surfaces (24a , 24a), the other first slide surface 24a is provided on the other side surface of the two parallel side surfaces of the shaft-shaped portion 24. Further, each of the pair of first slide surfaces (24a, 24a) is provided with a groove 24b linearly extending along the longitudinal direction of the shaft-shaped portion 24.

Further, in the main body portion 12, a fixed end portion 25 is provided at one end portion in the longitudinal direction thereof. The fixed end portion 25 is formed as a short cylindrical portion and is provided integrally with one end portion of the shaft-shaped portion 24. The fixed end portion 25 is provided as a portion to which the handle portion 15 and the guide portion 11 are fixed. The handle portion 15 is fixed to the fixed end portion 25 by welding or the like while extending from the fixed end portion 25 toward the side opposite to the shaft-shaped portion 24. The guide portion 11 is fixed to the fixed end portion 25 by welding or the like at the end portion on the base end side thereof. The guide portion 11 is fixed to the main body portion 12 at the fixed end portion 25 while extending in the direction orthogonal to the longitudinal direction of the shaft-shaped portion 24 (that is, the longitudinal direction of the main body portion 12). The fixed end portion 25 is provided with the above-described through hole 22 that communicates with the insertion hole 21 of the guide portion 11.

[Indicator part]
FIG. 7 is a perspective view of the indicator portion 13. 8A and 8B are diagrams showing the index portion 13, FIG. 8A being a front view and FIG. 8B being a plan view. In FIG. 8B, the fixing mechanism 14 is also shown together with the index portion 13. The index portion 13 shown in FIGS. 1 to 4, 7, and 8 is configured to be slidably coupled to the main body portion 12. Then, the index portion 13 extends in a state of being connected to the main body portion 12 along a surface defined as a surface including a direction in which the guide portion 11 extends and a longitudinal direction of the main body portion 12, and the position of the guide portion 11 is determined. It is configured to index.

The indicator portion 13 is configured to include a connecting portion 26 and an indicator shaft 27 that are integrally provided. The connecting portion 26 is provided as a portion that is slidably connected to the main body portion 12. The connecting portion 26 is formed in a block shape having a basic rectangular parallelepiped outer shape. The substantially rectangular parallelepiped connecting portion 26 has the smallest dimension in the thickness direction X1, the largest dimension in the width direction X2 next to the dimension in the thickness direction X1, and the largest dimension in the length direction X3. The thickness direction X1, the width direction X2, and the length direction X3 of the connecting portion 26 are indicated by double-headed arrows X1, X2, and X3 in FIG. 7, respectively.

The connecting portion 26 is provided with a long hole 28 into which the shaft-shaped portion 24 of the main body 12 is inserted. The long hole 28 is provided as a hole penetrating the connecting portion 26 in the thickness direction X1 and is formed as a hole having a rectangular cross section. The elongated hole 28 has a larger dimension in the length direction X3 than in the width direction X2, and is formed as an elongated hole extending parallel to the length direction X3. Further, in the elongated hole 28, on the inner peripheral wall of the elongated hole 28, a pair of second slide faces (24a, 24a) slidably movable with respect to the pair of first slide faces (24a, 24a) of the shaft-shaped portion 24 of the main body 12. 28a, 28a) are provided.

The pair of second slide surfaces (28a, 28a) are configured as a pair of wall surfaces that extend in parallel along the length direction X3 among the four wall surfaces that form the inner peripheral wall of the elongated hole 28. Then, in a state where the shaft-shaped portion 24 is inserted into the elongated hole 28, a pair of second slide surfaces (28a, 28a) of the elongated hole 28 and a pair of first slide surfaces (24a, 24a) of the shaft-shaped portion 24 are formed. The corresponding surfaces are in sliding contact with each other. That is, one of the pair of second slide surfaces (28a, 28a) and one of the pair of first slide surfaces (24a, 24a) slidably contact each other, and the pair of second slide surfaces (28a, 28a). , 28a) and the other of the pair of first slide surfaces (24a, 24a) slidably contact each other. In this manner, with the shaft-shaped portion 24 inserted in the long hole 28, the pair of second slide surfaces (28a, 28a) of the long hole 28 and the pair of first slide surfaces (24a, 24a) of the shaft-shaped portion 24. ) And slidably contacting each other, the indicator portion 13 is slidably connected to the main body portion 12 along the longitudinal direction of the main body portion 12.

Further, since the pair of second slide surfaces (28a, 28a) of the elongated hole 28 and the pair of first slide surfaces (24a, 24a) of the shaft-shaped portion 24 slidably contact each other, the length of the connecting portion 26 is increased. The direction X3 and the longitudinal direction of the main body 12 (the longitudinal direction of the shaft-shaped portion 24) are set so as to extend in directions intersecting with each other. Then, the connecting portion 26 is configured to slide relative to the shaft-like portion 24 in parallel to a plane defined by the length direction X3 of the connecting portion 26 and the longitudinal direction of the main body portion 12.

The dimension of the long hole 28 in the length direction X3 is set to be larger than the dimension of the cross section of the shaft-shaped portion 24 inserted in the long hole 28 in the length direction X3. Therefore, the shaft-shaped portion 24 is inserted into the elongated hole 28 in a loosely fitted state in the length direction X3 of the connecting portion 26. As a result, when the shaft-shaped portion 24 is inserted into the elongated hole 28 of the connection portion 26, the connection portion 26 is configured to be swingably relatively displaced with respect to the shaft-shaped portion 24 of the main body 12. There is. The connecting portion 26 is configured to be swingably relatively displaced with respect to the main body portion 12 in a plane defined by the length direction X3 of the connecting portion 26 and the longitudinal direction of the main body portion 12.

The index shaft 27 is provided as a part for indexing the position of the guide part 11 in a state where the index part 13 is connected to the main body part 12. Further, the index shaft 27 is provided as a round bar-shaped portion that projects in a cantilever manner from the connecting portion 26 and extends linearly. The index shaft 27 is provided so as to extend in a cantilever manner from the connecting portion 26 from one end of the connecting portion 26 in the length direction X3 along the same direction as the length direction X3. That is, the length direction X3 of the connecting portion 26 and the length direction of the index shaft 27 are set to be the same direction. The index shaft 27 is provided integrally with the connecting portion 26, and is provided with the connecting portion 26 so as to be slidable and swingable with respect to the shaft-shaped portion 24 of the main body 12. Therefore, the index shaft 27 is configured to slide relative to the main body portion 12 in parallel with a surface defined by the longitudinal direction of the index shaft 27 and the longitudinal direction of the main body portion 12. Further, the index shaft 27 is configured to be swingably relatively displaced with respect to the main body 12 in a plane defined by the longitudinal direction of the index shaft 27 and the longitudinal direction of the main body 12.

Further, the guide portion 11 fixed to the main body portion 12 while extending in the direction orthogonal to the longitudinal direction of the main body portion 12 is along the direction orthogonal to the extending direction of the pair of slide surfaces (24a, 24a). It is provided so as to extend. Therefore, the length direction X3 of the connecting portion 26 and the longitudinal direction of the index shaft 27 are along a plane P1 defined as a plane including the direction in which the guide portion 11 extends from the body portion 12 and the longitudinal direction of the body portion 12. Set to extend. Further, the index shaft 27 is provided so as to extend on the surface P1 with respect to the main body portion 12 on the same side as the side on which the guide portion 11 extends from the main body portion 12. The index shaft 27 is configured so as to slide relative to the main body 12 in parallel with the surface P1. Further, the index shaft 27 is configured to be swingably relatively displaced with respect to the main body portion 12 on the surface P1. A plane P1 defined as a plane including the extending direction of the guide portion 11 and the longitudinal direction of the main body portion 12 is schematically shown by a one-dot chain line P1 in FIG. 1D.

FIG. 9 (FIG. 9(A) and FIG. 9(B)) is a diagram for explaining relative displacement operation of the main body 12 and the indicator 13 in the bone treatment instrument 1. Note that FIG. 9 shows a rear view of the bone treatment instrument 1. The index portion 13 is configured to be slidable relative to the body portion 12 in parallel with the surface P1 described above, and is configured to be swingable with respect to the body portion 12 on the surface P1. Therefore, the operator swings the indicator portion 13 with respect to the main body portion 12 from the state shown in FIGS. 1 and 4, for example, so that the length of the indicator portion 13 is increased as shown in FIG. 9(A). The angle formed by the direction and the longitudinal direction of the main body 12 changes. Further, the operator slides the index portion 13 with respect to the main body portion 12 from the state shown in FIGS. 1 and 4, so that the index portion 13 with respect to the main body portion 12 is moved as shown in FIG. 9B. The position will change. The slide movement operation and the swing operation of the index portion 13 with respect to the main body portion 12 may be performed at the same timing.

Further, as described above, the index portion 13 is provided so as to extend along the surface P1 defined as a surface including the extending direction of the guide portion 11 and the longitudinal direction of the main body portion 12. The index portion 13 is provided so as to extend on the surface P1 with respect to the main body portion 12 on the same side as the guide portion 11 extends from the main body portion 12. For this reason, when the operator who operates the bone treatment instrument 1 looks at the index portion 13 along the plane P1 on which the index portion 13 and the main body portion 11 are arranged, when the operator manipulates the index portion 13 in the direction of the operator's viewpoint. The guide portion 11 and the guide portion 11 are arranged in an overlapping state. Thereby, the index part 13 will index the position of the guide part 11 when an operator looks at the index part 13 along the surface P1.

[Fixing mechanism]
The fixing mechanism 14 shown in FIG. 1, FIG. 4 and FIG. 8(B) has the indicator portion 13 with respect to the main body portion 12 with the shaft-shaped portion 24 of the main body portion 12 inserted into the elongated hole 28 of the indicator portion 13. It is provided as a mechanism that can be fixed. The fixing mechanism 14 is configured to include a screw hole 29 provided in the index portion 13 and a screw member 30 screwed into the screw hole 29.

The screw hole 29 is provided in the connecting portion 26 of the index portion 13. The screw hole 29 is provided as a screw hole extending from one surface of the connecting portion 26 in the width direction X2 toward the elongated hole 28 inside the connecting portion 26 and penetrating a part of the connecting portion 26. Further, the screw hole 29 is provided so as to open to the elongated hole 28 on one slide surface 28a of the pair of second slide surfaces (28a, 28a). A female screw portion is formed on the inner circumference of the screw hole 29.

The screw member 30 is provided as a member that is screwed into the screw hole 29 and whose tip abuts on the shaft-shaped portion 24 of the main body portion 12 inserted into the elongated hole 28 of the connecting portion 26. The screw member 30 includes a screw shaft 30a and an operation knob 30b. The screw shaft 30a and the operation knob 30b are integrally provided. The screw shaft 30a is provided as a shaft portion that is screwed into the screw hole 29, and a male screw portion that is screwed into a female screw portion on the inner circumference of the screw hole 29 is provided on the outer circumference.

The tip of the screw shaft 30a, which is the end opposite to the end of the screw shaft 30a that is provided integrally with the operation knob 30b, is attached to the shaft-shaped portion 24 of the main body 12 that is inserted into the elongated hole 28 of the connecting portion 26. It is provided as an abutting portion. The screw shaft 30 a is screwed into the screw hole 29 in a state where the shaft-shaped portion 24 is inserted into the elongated hole 28, advances to the inner side of the screw hole 29, and reaches the inside of the elongated hole 28, thereby forming the axial shape. It abuts against the side surface of the portion 24. More specifically, the tip of the screw shaft 30a which is screwed into the screw hole 29 and reaches the elongated hole 28 is provided on one slide surface 24a of the pair of first slide surfaces (24a, 24a). In the state of being engaged with the groove 24b, it abuts against the shaft-shaped portion 24.

The operation knob 30b is provided as a portion operated by an operator when the screw shaft 30a is rotated to rotate the screw shaft 30a into the screw hole 29. The surgeon rotates the operation knob 30b with the shaft-shaped portion 24 of the main body 12 inserted into the elongated hole 28 of the index portion 13 to move the screw shaft 30a into the screw hole 29. Screw it to the side. When the screw shaft 30a is screwed into the screw hole 29 and the tip of the screw shaft 30a abuts the shaft-shaped portion 24, the index portion 13 and the shaft-shaped portion 24 are fixed so as not to be displaced relative to each other. That is, the indicator portion 13 slidably connected to the body portion 12 is fixed to the body portion 12.

[Handle part]
The handle portion 15 is provided as a portion to be gripped by an operator who is an operator who operates the bone treatment instrument 1. The handle portion 15 is integrally provided with the main body portion 12 at the fixed end portion 25. The handle portion 15 is fixed to the fixed end portion 25 by welding or the like in a state where the handle portion 15 extends in a cantilever manner from the fixed end portion 25 toward the side opposite to the shaft-shaped portion 24 with respect to the main body portion 12. .. Further, in the present embodiment, the handle portion 15 is formed in a slender plate shape, and is formed in a shape having a portion that extends while widening as it extends toward the side opposite to the shaft-shaped portion 24. The tip portion of the handle portion 15 extending from the main body portion 12 is formed in a semicircular shape.

Further, the handle portion 15 extends short in parallel with the longitudinal direction of the body portion 12 at the end portion fixed to the body portion 12, and then extends obliquely from the body portion 12 with respect to the longitudinal direction of the body portion 12. It is provided in. Further, the handle portion 15 is provided so as to extend from the main body portion 12 along a direction forming an obtuse angle with a direction in which the guide portion 11 extends from the main body portion 12.

[Actuation of the bone treatment instrument when the pin-shaped member is inserted into the femur]
Next, the operation of the bone treatment instrument 1 when the treatment for inserting the pin-shaped member 10 into the femur 100 of the patient is performed using the bone treatment instrument 1 will be described. As a preparation for the stage before the bone treatment instrument 1 is used, the bone treatment instrument 1 is attached to the outer side portion 100a of the femur 100 by cutting the soft tissue outside the femur 100 of the patient. 2 and FIG. 3)). Further, description will be made on the premise that a transmission device such as an X-ray device is arranged so as to image the hip joint of the patient placed on the operating table from the front (upper side) of the patient.

When the bone treatment instrument 1 is used, first, the indicator portion 13 is connected to the main body portion 12 in which the guide portion 11 and the handle portion 15 are integrally provided. The index portion 13 is slidably coupled to the body portion 12 by inserting the shaft-shaped portion 24 of the body portion 12 into the elongated hole 28 of the coupling portion 26.

FIG. 10 is a diagram schematically showing a state in which the bone treatment instrument 1 is used in the procedure of inserting the pin-shaped member 10 into the femur 100. Note that FIG. 10 illustrates a state in which the distal end portion 11a of the guide portion 11 is arranged below the greater trochanter 100b in the outer side portion 100a of the femur 100. With reference to FIG. 10, the operator who slidably connects the index portion 13 to the main body portion 12 inserts the tip portion 11 a of the guide portion 11 into the lateral portion 100 a of the femur 100 at which the pin-shaped member 10 is inserted. Abut against. Then, the operator arranges the indicator portion 13 in front of (above) the patient, and from the outside of the soft tissue 101 of the patient, the indicator portion 13 is arranged along the plane P1 on which the indicator portion 13 and the main body portion 12 are arranged. By looking, the position and the direction of the guide part 11 are adjusted, checking the position and the direction of the guide part 11. Thereby, the operator adjusts the position and the direction in which the pin-shaped member 10 is inserted while confirming the position and the direction in which the pin-shaped member 10 inserted into the guide portion 11 is inserted into the femur 100. .. At this time, the operator slides the indicator portion 13 with respect to the main body portion 12 and further swings the indicator portion 13 with respect to the main body portion 12 while the indicator portion 13 moves the pin-shaped member 10 Check the insertion position and insertion direction.

Also, the operator confirms the position and direction of the guide portion 11 indexed by the index portion 13 with respect to the femur 100 by looking at the perspective image similar to the viewpoint shown in FIG. While adjusting the position and direction. FIG. 11 is a view schematically showing a state in which the bone treatment instrument 1 is used in the procedure of inserting the pin-shaped member 10 into the femur 100, and shows a perspective image seen on the monitor 200 of the transmission device. FIG. The result of photographing the state shown in FIG. 10 with the transmission device is displayed as a perspective image shown in FIG. In addition, in FIG. 11 and the following description, regarding the images projected on the monitor 200 as the images of the respective members of the bone treatment instrument 1 and the femur 100, the respective members of the bone treatment instrument 1 and the femur 100 corresponding to each other. The description and the description will be given by notating the reference numeral with “M” before the reference numeral.

When the operator adjusts the position and direction of the guide part 11 indexed by the index part 13 with respect to the femur 100, the operator changes the position and direction of the index part 13 so that of the index part image M13 on the monitor 200. The index axis image M27 of is superimposed on the femur image M100 and the guide portion image M11. Accordingly, the index axis image M27 of the index portion image M13 indicates the position and direction in which the pin-shaped member 10 is inserted into the femur 100 and inserted. In this way, the position and the insertion direction of the pin-shaped member 10 into the femur 100 are confirmed by the index axis image M27 of the index portion image M13. Then, the operator operates the bone treatment instrument 1 so that the index axis image M27 of the index portion image M13 and the guide portion image M11 overlap the target insertion position and insertion direction of the pin-shaped member 10, and guides. The position and direction in which the pin-shaped member 10 inserted into the part 11 is inserted into the femur 100 is adjusted.

When the adjustment of the position and the direction in which the pin-shaped member 10 is inserted into the femur 100 is completed, the operator operates the fixing mechanism 14 to fix the index portion 13 to the main body portion 12. That is, the operation knob 30b of the screw member 30 is rotated to screw the screw shaft 30a into the screw hole 29 to engage the shaft portion 24 of the main body portion 12 with the screw shaft 30a. The indicator portion 13 is fixed to 12.

When the index portion 13 is fixed to the main body portion 12, the operator inserts the pin-shaped member 10 into the guide portion 11 while maintaining the position and posture of the bone treatment instrument 1 with respect to the femur 100, and the pin-shaped member is inserted. Insert 10 while inserting into femur 100. At this time, the operator inserts the pin-shaped member 10 into the femur 100 while confirming that the index axis image M27 of the index portion image M13 on the monitor 200 overlaps with the image of the pin-shaped member 10. While inserting. As a result, the pin-shaped member 10 is inserted into the femur 100 at the insertion position and insertion direction confirmed and adjusted as described above.

When the insertion of the pin-shaped member 10 into the femur 100 is completed, the bone treatment instrument 1 is removed from the pin-shaped member 10 with the pin-shaped member 10 being inserted into the femur 100. That is, the bone treatment instrument 1 is moved away from the patient so that the pin-shaped member 10 is pulled out from the guide portion 11, and the bone treatment instrument 1 is removed from the pin-shaped member 10. This completes the procedure for inserting the pin-shaped member 10 into the femur 100 of the patient. When the procedure for inserting the pin-shaped member 10 into the femur 100 is completed, the patient is subsequently subjected to the next procedure in the surgery.

[Operation and effect of the present embodiment]
As described above, according to the present embodiment, the index portion 13 slidably connected to the body portion 12 to which the guide portion 11 is fixed has the guide portion 11 extending direction and the longitudinal direction of the body portion 12. It is configured to extend along the plane P1 including and to indicate the position of the guide portion 11. Therefore, the index portion 13 is also arranged to extend along the same surface as the surface P1 on which the guide portion 11 and the main body portion 12 extending along the same surface are arranged. When the operator who operates the bone treatment instrument 1 looks at the index portion 13 along the plane P1 on which the index portion 13 and the main body portion 12 are arranged, the index portion 13 and the guide are guided in the operator's viewpoint direction. It will be arranged in a state of overlapping with the portion 11. Therefore, the operator only needs to look at the index portion 13 along the plane P1 on which the index portion 13 and the body portion 12 are arranged, and the position of the guide portion 11 indexed by the index portion 13 in the operator's viewpoint direction and The direction can be grasped accurately and easily. Furthermore, the operator can accurately and easily grasp the position and direction of the pin-shaped member 10 inserted into the guide portion 11 indexed by the index portion 13 only by looking at the index portion 13.

When the operator inserts the pin-shaped member 10 into the affected bone 100 of the patient during the operation, first, the distal end 11a of the tubular guide portion 11 is pin-shaped in the affected bone 100. The member 10 is arranged at the position to be inserted. At this time, the portion of the guide portion 11 on the distal end side is inserted into the soft tissue 101 of the patient and hidden from the outside, but the operator does not touch the surface P1 on which the index portion 13 and the main body portion 12 are arranged. By looking at the index portion 13 along it, the position and direction of the guide portion 11 indexed by the index portion 13 in the operator's viewpoint direction can be accurately and easily grasped. Furthermore, the operator looks at the index portion 13 from the same viewpoint, and the position and direction in which the pin-shaped member 10 inserted into the guide portion 11 indexed by the index portion 13 is inserted into the affected area. Can be grasped accurately and easily.

Further, even under fluoroscopy such as X-rays, the operator can accurately and easily determine the position and direction of the guide part 11 indexed by the index part 13 with respect to the bone 100 by viewing the fluoroscopic image from the same viewpoint as above. You can figure it out. Further, the operator can accurately and easily grasp the position and the inserting direction of the pin-shaped member 10 inserted into the guide portion 11 indexed by the index portion 13 with respect to the bone 100. .. Note that, under the fluoroscopy of X-rays or the like, the bone treatment instrument 1 and the bone 100 to be treated are displayed on a monitor of a transmission apparatus such as an X-ray apparatus. By viewing the patient's bone 100 and the indicator portion 13 displayed on the monitor, the operator can accurately and easily grasp the position and direction of the guide portion 11 with respect to the bone 100, which is indicated by the indicator portion 13, Further, the position and the inserting direction of the pin-shaped member 10 inserted into the guide portion 11 with respect to the bone 100 can be accurately and easily grasped.

The operator determines the position and direction of the guide portion 11 with respect to the bone 100, which is indexed by the index portion 13, and the position and direction in which the pin-shaped member 10 inserted into the guide portion 11 is inserted into the bone 100. After grasping correctly, the pin-shaped member 10 is inserted into the bone 100. At this time, first, the pin-shaped member 10 is inserted into the guide portion 11. Then, the pin-shaped member 10 is inserted so as to be inserted into the bone 100 while the guide portion 11 guides the insertion direction into the bone 100. At this time, the operator accurately grasps the insertion position and the insertion direction of the pin-shaped member 10 with respect to the bone 100 by the index portion 13, and then accurately grasps the pin-shaped member 10 along the grasped insertion position and the insertion direction. Can be easily inserted into the bone 100. Therefore, the operator can easily insert the pin-shaped member 10 into the bone 100 of the patient at the correct position and direction by using the bone treatment instrument 1 of the present embodiment.

Further, according to the present embodiment, the bone treatment instrument 1 capable of easily inserting the pin-shaped member 10 into the bone 100 of the patient at the correct position and direction is the tube into which the pin-shaped member 10 is inserted. The guide portion 11 is fixed to the main body portion 12, and the index portion 13 is slidably connected to the main body portion 12 so as to have a simple structure. Therefore, the bone treatment instrument 1 capable of easily inserting the pin-shaped member 10 into the bone 100 at an accurate position and direction has a simple structure without using a complicated surgical navigation system at high cost. Can be achieved with. The index portion 13 is slidably connected to the main body portion 12 to which the guide portion 11 is fixed. Therefore, the position of the index portion 13 with respect to the main body portion 12 and the guide portion 11 can be easily adjusted by sliding it to a position desired by the operator. Thereby, the operator can easily adjust the position of the index portion 13 with respect to the main body portion 12 and the guide portion 11 according to the state of the region where the bone treatment instrument 1 is used in the patient, and the operator himself can use the position. The bone treatment instrument 1 can be used in an easy state. Therefore, the bone treatment instrument 1 capable of easily inserting the pin-shaped member 10 into the bone 100 of the patient at the correct position and direction is realized as the bone treatment instrument 1 which is easy for the operator to use. You can

Therefore, according to the present embodiment, it is possible to easily insert the pin-shaped member 10 into the bone 100 of the patient at an accurate position and direction, and to provide the bone treatment instrument 1 which has a simple structure and is easy to use. You can

Further, according to the present embodiment, the shaft-shaped portion 24 of the main body 12 is inserted into the elongated hole 28 of the indicator 13, and the indicator 13 is slidably connected to the main body 12. Therefore, the structure in which the index portion 13 is slidably movable on the main body portion 12 can be realized with a simple structure in which the elongated hole 28 is provided in the index portion 13.

Further, according to the present embodiment, the pair of second slide surfaces (28a, 28a) of the inner peripheral wall of the elongated hole 28 of the index portion 13 are opposed to the pair of parallel first slide surfaces (24a, 24a) of the main body portion 12. By sliding, the index portion 13 is configured to be slidable with respect to the main body portion 12. Therefore, the index portion 13 is stable with respect to the main body portion 12 by the sliding operation of the pair of parallel first slide surfaces (24a, 24a) and the pair of corresponding second slide surfaces (28a, 28a). You can slide it smoothly. This can further improve the operability when the index portion 13 is slid with respect to the main body portion 12.

Further, according to the present embodiment, the shaft-shaped portion 24 of the main body portion 12 is inserted into the elongated hole 28 so that the index portion 13 that is slidably movable to the main body portion 12 is fixed by the fixing mechanism 14 in the sliding movement direction. Can be fixed to the main body 12 at a desired position.

Further, according to the present embodiment, the fixing mechanism 14 for fixing the slidably movable index portion 13 to the main body portion 12 to the main body portion 12, the screw hole 29 and the screw hole 29 penetrating the indicator portion 13 toward the elongated hole 28. It can be realized with a simple structure in which the screw member 30 that is screwed into the shaft portion 24 and abuts the shaft-shaped portion 24 is provided.

Further, according to the present embodiment, the handle portion 15 grasped by the operator who operates the bone treatment instrument 1 has the body portion 12 to which the guide portion 11 is fixed and the indicator portion 13 is connected. It is provided integrally with. For this reason, with the body portion 12 positioned closer to the operator's hand holding the handle portion 15 and the guide portion 11 and the indicator portion 13 positioned away from the operator's hand, the bone treatment instrument 1 It becomes easy to operate. As a result, it becomes easy to operate the guide portion 11 and the index portion 13 to a desired posture of the operator, and the operability of the bone treatment instrument 1 can be further improved. Further, according to the present embodiment, the handle portion 15 extends along the direction that forms an obtuse angle with the direction in which the guide portion 11 extends. Therefore, even when the distal end portion of the guide portion 11 is inserted into the soft tissue of the patient, it becomes easy to position the handle portion 15 so as to avoid contact with the patient. Thereby, it becomes easy to operate the guide portion 11 to a desired posture of the operator, and the operability of the bone treatment instrument 1 can be further improved.

Further, according to the present embodiment, the projection 23 is provided as a portion that is pointed toward the tip side in the tip portion 11a of the guide portion 11. Therefore, when the tip end portion 11a of the guide portion 11 is arranged at the position where the pin-shaped member 10 is inserted into the bone 100 of the patient, the guide portion 11 has a sharp tip portion at the tip end of the projection portion 23. Engage with the bone 100 by biting into the surface of the bone 100. As a result, when the pin-shaped member 10 is inserted into the guide portion 11 and inserted into the bone 100, the operation of inserting the pin-shaped member 10 into the bone 100 is performed by the guide engaged with the bone 100 at the tip portion 11a. It is stably supported by the part 11. Therefore, the operator can more easily insert the pin-shaped member 10 into the bone 100 of the patient in the correct position and direction.

[Modification]
Although the embodiments of the present invention have been described above, the present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the scope of the claims. For example, the following modifications may be performed.

(1) In the above-described embodiment, the femur has been described as an example of the bone into which the pin-shaped member is inserted using the bone treatment instrument, but the bone may not be so. That is, the form of the bone treatment instrument used in the treatment of inserting the pin-shaped member into the bone other than the femur may be implemented.

(2) In the above-described embodiment, a pin-shaped member is used as the pin-shaped member that is inserted into the bone by using the bone treatment instrument, but the pin-shaped member is not limited to this. The pin-shaped member that is inserted into the bone using the bone treatment instrument may be a pin-shaped member in various forms other than the form of a needle pin, such as a drill or a screw. It may be a pin-shaped member.

(3) In the above-described embodiment, the shaft-shaped portion of the main body is inserted into the elongated hole of the indicator, so that the indicator is slidably connected to the main body. , It doesn't have to be this way. That is, a configuration in which the index portion is slidably connected to the body portion may be implemented by a configuration other than the configuration in which the shaft-shaped portion is inserted into the elongated hole. For example, a mode may be implemented in which the slider portion provided in the indicator portion is slidably fitted into the slide rail groove provided in the main body portion.

(4) In the above-described embodiment, the form of the fixing mechanism constituted by the screw hole provided in the index portion and the screw member screwed into the screw hole has been described as an example, but this need not be the case. .. That is, the fixing mechanism may be configured by a form other than the form formed by the screw hole and the screw member. For example, a concave portion provided at a plurality of positions in the main body portion, and a plunger portion provided in the indicator portion and capable of projecting and engaging with the concave portion and withdrawing from the concave portion and disengaging the plunger portion are provided. A fixing mechanism having a form that can fix the indicator portion at a plurality of positions with respect to the main body portion may be implemented.

(5) In the above-described embodiment, the form of the handle portion, which is provided integrally with the main body portion and extends obliquely with respect to the longitudinal direction of the main body portion, has been described as an example, but this need not be the case. For example, a handle portion may be implemented that is provided integrally with the main body portion and extends on the same straight line as the longitudinal direction of the main body portion. In addition, a handle portion may be provided that is integrally provided to the main body portion via a bridge portion and extends parallel to the longitudinal direction of the main body portion.

The present invention can be widely applied as a bone treatment instrument used when performing a treatment of inserting a pin-shaped member into the bone of a patient.

DESCRIPTION OF SYMBOLS 1 Bone treatment instrument 10 Pin-shaped member 11 Guide part 12 Main body part 13 Index part 14 Fixing mechanism 15 Handle part 100 Bone

Claims

A pin-shaped member to be inserted into the bone of the patient is inserted, and a tubular guide portion that guides the insertion direction of the pin-shaped member into the bone,
A main body portion having a longitudinal direction and to which the guide portion is fixed;
An index that is slidably connected to the main body portion and that extends along a surface defined as a surface that includes the extending direction of the guide portion and the longitudinal direction of the main body portion and that indicates the position of the guide portion. Department,
An instrument for bone treatment, comprising:
The bone treatment instrument according to claim 1, wherein
The bone treatment instrument, wherein the index portion is provided with a long hole into which a shaft-shaped portion that is a portion of the main body portion extending in the longitudinal direction is inserted.
The bone treatment instrument according to claim 2, wherein
The shaft-shaped portion is provided with a pair of first slide surfaces extending in parallel along the longitudinal direction on the side surface of the shaft-shaped portion,
The bone treatment instrument, wherein the elongated hole is provided with a pair of second slide surfaces slidably movable with respect to the pair of first slide surfaces on an inner peripheral wall of the elongated hole.
The bone treatment instrument according to claim 2 or 3, wherein
The bone treatment instrument further comprising a fixing mechanism capable of fixing the indicator portion to the main body portion in a state where the shaft-shaped portion is inserted into the elongated hole.
The bone treatment instrument according to claim 4, wherein
The fixing mechanism is provided in the indicator portion, and a screw hole extending from the surface of the indicator portion toward the elongated hole and penetrating a part of the indicator portion, and the elongated hole screwed into the screw hole A bone treatment instrument, comprising: a screw member whose tip abuts on the shaft-shaped portion that is inserted into the bone treatment instrument.
The bone treatment instrument according to any one of claims 1 to 5, wherein
Further comprising a handle portion provided as a portion gripped by an operator who operates the bone treatment instrument,
The handle portion is provided integrally with the body portion, extends obliquely from the body portion with respect to the longitudinal direction, and extends along the direction that forms an obtuse angle with the direction in which the guide portion extends from the body portion. A bone treatment instrument characterized in that it is provided so as to extend therefrom.
The bone treatment instrument according to any one of claims 1 to 6,
The bone treatment instrument characterized in that the guide portion is provided with a portion formed so as to be sharpened toward the tip side at the tip portion thereof.