WO2021145336A1 - Outil pour vis de fixation de plaque de fixation de radius - Google Patents

Outil pour vis de fixation de plaque de fixation de radius Download PDF

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Publication number
WO2021145336A1
WO2021145336A1 PCT/JP2021/000830 JP2021000830W WO2021145336A1 WO 2021145336 A1 WO2021145336 A1 WO 2021145336A1 JP 2021000830 W JP2021000830 W JP 2021000830W WO 2021145336 A1 WO2021145336 A1 WO 2021145336A1
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WO
WIPO (PCT)
Prior art keywords
screw
radius
fixing
fixing plate
tool
Prior art date
Application number
PCT/JP2021/000830
Other languages
English (en)
Japanese (ja)
Inventor
平田　仁
秀 栗本
亮介 神村
直朗 安村
将史 横田
優人 大谷
数磨 中村
竣介 大河内
Original Assignee
ニプロ株式会社
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Filing date
Publication date
Application filed by ニプロ株式会社 filed Critical ニプロ株式会社
Priority to JP2021571204A priority Critical patent/JPWO2021145336A1/ja
Publication of WO2021145336A1 publication Critical patent/WO2021145336A1/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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices

Definitions

  • the present invention relates to a tool for fixing a radius fixing plate, which rotates a fixing screw when fixing the radius fixing plate to the radius.
  • a splint ie, splint
  • plaster or FRP cast is known to replace the splint or plaster or FRP cast to secure the radius across the fracture to secure the fractured part of the radius.
  • a metal plate such as titanium or an alloy thereof, which is tough, lightweight, and has high biosafety, has been used as the radius fixing plate.
  • the metal plate does not allow X-rays to pass through, and there is a problem that the state of the fractured part covered with the radius fixing plate cannot be grasped.
  • an object of the present invention is to solve the above-mentioned problems, and to easily and surely regulate the tightening depth and rotation of the fixing screw of the resin-made radius fixing plate, the radius fixing plate fixing. To provide screw tools.
  • the present invention is configured as follows.
  • the present invention is a tool for fixing a radius fixing plate, which rotates a fixing screw for fixing the radius fixing plate to the radius.
  • the screw coupling portion at the tip of the rotating shaft portion protrudes from the tip and is arranged outside the rotating shaft portion so as to be movable in the axial direction between the rotating position and the idling position, and the first engaging protrusion is provided on the outer peripheral surface.
  • the inner cylinder that you have in It is arranged on the outside of the middle cylinder so as to be relatively movable in the axial direction, and when the middle cylinder is located at the rotational position, it engages with the first engaging protrusion around the axis and is integrated with the middle cylinder. On the other hand, when the middle cylinder is located at the idling position, the engagement with the first engaging protrusion around the axis is released and the second is rotatable relative to the middle cylinder.
  • An outer cylinder with an engaging protrusion on the inner peripheral surface Provided is a tool for fixing a radial fixing plate fixing screw.
  • the tool for fixing the radius fixing plate is a tool for rotating the fixing screw for fixing the radius fixing plate to the radius.
  • Shaft and For screw guidance which is relatively rotatable and relatively axially movable by inserting the rotating shaft portion, and whose tip is placed in the screw insertion hole of the radial fixing plate or on the radial fixing plate.
  • a guide cylinder that has a second engaging portion that regulates the movement of the shaft in the screwing direction and is a member separate from the rotating shaft portion.
  • a tool for fixing a radial fixing plate fixing screw is provided.
  • the rotational force when the rotational force input portion is rotated is transmitted through the outer cylinder and the inner cylinder. It is transmitted to the rotating shaft portion, and the fixing screw engaged with the rotating shaft portion is rotated in the tightening direction.
  • the middle cylinder comes into contact with the radius fixing plate or the guide block arranged on the radius fixing plate, and the inside The cylinder is retracted relative to the shaft portion toward the rotational force input portion side, and the axial engagement between the first engaging protrusion and the second engaging protrusion is released.
  • the rotational force input portion is rotated to rotate the rotary shaft portion with respect to the guide cylinder arranged in the screw insertion hole of the rib fixing plate or the guide block, and the first engagement is performed.
  • the rotating shaft portion cannot rotate any more, and the fixing screw cannot be screwed into the rib together with the rotating shaft portion, and the depth (that is, tightening of the screw) cannot be screwed.
  • Depth) regulation and rotation regulation can be performed. Therefore, the tightening depth and rotation of the fixing screw of the resin-made radial fixing plate can be easily and surely regulated.
  • FIG. 1 Perspective perspective view showing a state in which the radius fixing plate is fixed to the radius with a fixing screw using a tool for fixing the radius fixing plate according to the first embodiment of the present invention.
  • Perspective view of the guide block to be placed on the radial fixation plate Side view of the guide block of FIG.
  • Explanatory drawing which partially sees through the state where the fixing screw is penetrated through the guide block and the radius fixing plate by the tool for the radius fixing plate fixing screw which concerns on 1st Embodiment of this invention, and tightening is started.
  • FIG. 16B Longitudinal cross-sectional view near the screw insertion hole in FIG. 16B Perspective view of the main body of the tool for fixing the radius fixing plate according to the second embodiment of the present invention.
  • Longitudinal sectional view of the guide cylinder of FIG. Left side view of the guide cylinder of FIG. A perspective view of the state where tightening is completed when the fixing screw is passed through the guide block and the radius fixing plate and tightened with the radius fixing plate fixing screw tool.
  • a vertical cross-sectional view showing a state in which the fixing screw is passed through the guide block and the radius fixing plate and tightened with the radius fixing plate fixing screw tool.
  • a vertical cross-sectional view showing a state in which the fixing screw is passed through the guide block and the radius fixing plate with a tool for fixing the radius fixing plate and tightening is completed.
  • a vertical cross-sectional view showing a state in which the fixing screw is passed through the radius fixing plate with a tool for fixing the radius fixing plate without a guide block and tightening is completed.
  • the radius fixing plate fixing screw tool 1 is a tool for rotating the fixing screw 4 for fixing the radius fixing plate 2 to the radius 3.
  • the fixing screw 4 is rotated by the radius fixing plate fixing screw tool 1, in order to facilitate the screw tightening work.
  • the guide block 5 as shown in 3 is placed so as to be overlapped on the radius fixing plate 2, the screw tightening work is performed using the screw insertion hole 5d of the guide block 5.
  • the guide block 5 is removed from the radius fixing plate 2.
  • the guide block 5 may not be used.
  • the fractured portion 3a of the radius 3 is divided into a radius main body 3b and a fracture piece 3c with the fractured portion 3a as a boundary.
  • the radius body 3b and the fracture fragment 3c may be completely separated or partially connected.
  • the radius fixing plate 2 is placed on the radius 3 so that the fracture piece 3c is normally connected to the radius body 3b and fixed.
  • the radius fixing plate 2 is made of a thermoplastic resin or a composite material thereof, for example.
  • thermoplastic resins include PEEK (polyetheretherketone) or polyetherimide.
  • the radius fixing plate 2 is composed of a wide distal portion 2a and a proximal portion 2b extending from the distal portion 2a to form a T-shaped plate member.
  • proximal portion means the portion of the radius fixation plate 2 that is closer to the heart
  • distal portion is the radius fixation plate 2.
  • the distal portion 2a is fixed to the fracture piece 3c with a plurality of screws 4, the proximal portion 2b is fixed to the radius body 3b with a plurality of screws 4, and the fracture portion 3a is straddled by the radius fixing plate 2 and the radius body.
  • the fracture piece 3c is fixed to 3b so as to be normally connected.
  • a circular screw is inserted into the distal portion 2a and the proximal portion 2b, respectively, in the axial direction extending in the thickness direction of the radius fixing plate 2 or in the direction in which the tip is inclined outward with respect to the thickness direction.
  • Many holes 2d are formed.
  • a fixing screw 4 is inserted into the screw insertion hole 2d, and the fixing screw 4 is screwed into both a part of the screw insertion hole 2d of the radius fixing plate 2 and the radius 3 so that the radius fixing plate 2 Is fixed to the radius 3.
  • each screw insertion hole 2d is composed of a large-diameter head storage portion 2e and a small-diameter female screw portion 2f smaller than the inner diameter of the head storage portion 2e.
  • the fixing screw 4 to be inserted into the screw insertion hole 2d is made of hard metal and is composed of a head portion 4c and a shaft portion 4a connected to the head portion 4c. There is.
  • the shaft portion 4a has a diameter smaller than the inner diameter of the female screw portion 2f of the screw insertion hole 2d, and can penetrate the female screw portion 2f.
  • the shaft portion 4a is formed with a main screw 4b that self-tappings the radius 3 after penetrating the screw insertion hole 2d.
  • the head 4c has the same outer diameter as the inner diameter of the female screw portion 2f, and is stored in the head storage portion 2e when the screw is tightened.
  • An auxiliary screw 4d screwed into the female screw portion 2f of the screw insertion hole 2d is formed on the outer peripheral surface of the head portion 4c on the shaft portion side.
  • the female screw is not formed in advance in the female screw portion 2f, but is used as a screw forming portion, and the secondary screw 4d is used to self-use the screw forming portion. It may be screwed by performing a tapping action.
  • a hexarobuler hole 4j is formed on the upper surface of the head 4c, and the screw coupling portion 12c of the rotation shaft portion 12 of the tool 1 described later is coupled to allow the fixing screw 4 to rotate in the forward and reverse directions.
  • the hexarobula hole 4j is an example, but the hexarobula hole 4j and the hexarobula wrench-shaped screw joint portion 12c are in contact with each other at the peaks and valleys, and are suitable because they do not slip unless both are licked. Is. That is, by using the hexarobuler hole 4j, the tightening torque is efficiently transmitted, and the risk of damage to the tool or the screw head can be reduced because there is no stress concentration.
  • the guide block 5 is placed on the radius fixing plate 2 so as to facilitate screw tightening work when the fixing screw 4 is rotated by the radius fixing plate fixing screw tool 1. It is a member for doing so.
  • the outer shape of the guide block 5 is the same as the outer shape of the radius fixing plate 2, and covers the entire radius fixing plate 2 and makes it easier to stack.
  • the guide block 5 includes a wide distal portion 5a having the same shape as the wide distal portion 2a of the radius fixing plate 2 and a proximal portion 2b of the radius fixing plate 2 extending from the distal portion 5a.
  • a proximal portion 5b having the same shape is provided to form a T-shaped member.
  • the guide block 5 makes it easier to guide the fixing screw 4 than in the state without the guide block.
  • a holding claw 5c that can be locked and held on the outer peripheral edge of the radius fixing plate 2 is provided on the outer periphery of the back surface of the guide block 5.
  • Holding with the holding claw 5c is an example, and the guide block 5 may be fixed to the radius fixing plate 2 by a fixing method such as a dedicated screw or a combined screw other than the holding claw 5c.
  • the distal portion 5a and the proximal portion 5b are respectively in the thickness direction of the guide block 5 or in the direction in which the tip is inclined outward with respect to the thickness direction, in other words, in the thickness direction of the radius fixing plate 2.
  • a large number of circular screw insertion holes 5d extending in the axial direction are formed in the direction in which the tip is inclined with respect to the thickness direction.
  • Each screw insertion hole 5d is formed and arranged corresponding to each screw insertion hole 2d.
  • each screw insertion hole 5d is composed of a large-diameter middle cylinder guide portion 5e and a small-diameter rotating shaft portion penetrating portion 5f smaller than the inner diameter of the middle cylinder guide portion 5e.
  • a middle cylinder restricting portion 5h composed of an annular edge portion is formed. The tip of the middle cylinder 13 of the tool 1 described later comes into contact with the middle cylinder regulating portion 5h, and the middle cylinder 13 enters the rotating shaft portion penetrating portion 5f in each screw insertion hole 5d rather than the middle cylinder regulating portion 5h. The position is regulated so that there is no such thing.
  • the tool 1 for fixing the radius fixing plate includes at least a rotational force input portion 11, a rotary shaft portion 12, an inner cylinder 13, and an outer cylinder 14, which is an example.
  • the inner cylinder 13 and the outer cylinder 14 can be made of synthetic resin, and the remaining portion can be made of metal.
  • the radius fixing plate fixing screw tool 1 may further include an urging member 15. 4 to 6 are shown as a diagram to show an outline of the tool 1, and FIGS. 7 to 15 are shown as a diagram to show a specific configuration of the tool 1, but the functions of both are almost the same. be.
  • the major difference is that the shapes of the first engaging protrusion 13c and the second engaging protrusion 14c are shown in a simplified gear shape instead of a plate shape having a trapezoidal cross section, which will be described later. , The function is the same.
  • the rotational force input unit (rotational force input member) 11 is a portion that applies a rotational force around the axis to the tool 1, and is composed of a rod-shaped member.
  • the rotational force input unit 11 may connect a surgical tool or the like to input a rotational force from the surgical tool to the rotational force input unit 11 so that the tool 1 can rotate in the forward and reverse directions around the axis.
  • the tool 1 when turning by hand, the tool 1 is held by having a flat surface portion 11a extending in the axial direction and pinching the flat surface portion 11a and the curved back surface portion of the flat surface portion 11a with fingers. It is possible to rotate forward and reverse around the axis.
  • the flat surface portion 11a is not always necessary because the rotational force input unit 11 may be rotated forward and reverse around the axis to tighten and release the fixing screw 4.
  • the tip of the rotational force input unit 11 has a cylindrical fitting recess 11b.
  • the rotating shaft portion (rotating shaft member) 12 is arranged coaxially with the rotational force input portion 11 and is provided at the shaft portion main body 12a having a hexagonal cross section and the tip of the shaft portion main body 12a.
  • a screw joint portion 12c having a tapered tip, a columnar fitting protrusion 12d arranged at the base end of the shaft portion main body 12a, and a diameter closer to the base end of the shaft portion main body 12a than the outer diameter of the shaft portion main body 12a. It is provided with an annular spring locking projection 12e protruding in the direction.
  • the fitting protrusion 12d is fitted and connected to the cylindrical fitting recess 11b at the tip of the rotational force input portion 11 so as to be relatively rotatable around the axis. Therefore, the shaft portion main body 12a extends axially from the tip of the rotational force input portion 11 and is rotatable relative to the rotational force input portion 11 via the fitting projection 12d. As for the method of connecting the rotating shaft portion 12 and the rotational force input portion 11, the relationship between the protrusion and the concave portion may be reversed.
  • the screw coupling portion 12c is a hexalobular screw rotating portion that is arranged at the tip of the shaft portion main body 12a and can be relatively non-rotatably coupled to the hexalobular hole 4j of the head 4c of the fixing screw 4, and is a fixing screw 4
  • the fixing screw 4 can be rotated in the forward and reverse directions in order to tighten or release the tightening.
  • the screw connecting portion 12c is a hexarobula screw rotating portion in the shape of a hexarobula wrench that can engage with the hexarobula hole 4j of the head 4c. It is configured as.
  • the middle cylinder 13 is composed of a cylindrical member as shown in FIGS. 7 to 9 and 11 to 13.
  • the middle cylinder 13 includes a middle cylinder main body 13a and a first engaging protrusion 13c protruding in the radial direction on the outer peripheral surface of the base end of the middle cylinder main body 13a.
  • the middle cylinder body 13a is arranged on the outer outer peripheral surface of the rotating shaft portion 12 on the outer outer peripheral surface of the shaft portion main body 12a having a hexagonal cross section, and is relative to the shaft portion main body 12a having a hexagonal cross section in the axial direction. It has a through hole 13b having a hexagonal cross section as an example of being non-rotatable, in other words, integrally rotatable and movable between the rotating position A and the idling position B in the axial direction.
  • the screw connecting portion 12c at the tip of the rotating shaft portion 12 always protrudes from the tip of the middle cylinder main body 13a.
  • the coil spring 15 as an example of the urging member 15 slightly contracts between the annular base end end surface 13d of the inner cylinder main body 13a and the annular spring locking projection 12e. It is arranged in a state, and the spring force of the coil spring 15 constantly urges the middle cylinder body 13a toward the tip side with respect to the shaft body 12a so that it is always located at the rotation position A instead of the idling position B. ing.
  • the coil spring 15 is not always essential.
  • the coil spring 15 is omitted, and each time the fixing screw 4 is fastened, the middle cylinder 13 is manually returned to the rotation position A, which is the initial position, and the middle cylinder 13 is moved during the fixing screw fastening operation. It can be used with care not to move it. Even in such a case, the above-mentioned idling operation can be performed at the idling position B.
  • the first engaging projection 13c is formed in the shape of a plate having a trapezoidal cross section curved in the radial direction, one or more in the circumferential direction.
  • four first engaging projections 13c are formed at predetermined intervals, for example, at intervals of 90 degrees, and the space on the outer peripheral surface between the adjacent first engaging projections 13c is extracted from the second engaging projections 14c, which will be described later. It functions as a first engaging recess 13e that can enter in the axial direction as much as possible.
  • Each of the first engaging projections 13c has an inclined surface 13g inclined so as to approach the center in the radial direction toward the tip in the axial direction, and engages with the second engaging projection 14c described later. The engagement can be disengaged smoothly.
  • the outer cylinder 14 is composed of a cylindrical member having a tapered shape and a diameter larger than that of the middle cylinder 13.
  • the outer cylinder 14 is arranged outside the inner cylinder 13 so as to be relatively movable in the axial direction, and has a diameter on the inner peripheral surface of the intermediate portion between the outer cylinder main body 14a having a circular through hole 14b and the outer cylinder main body 14a. It includes a first engaging projection 13c that is formed so as to project toward the center of the direction and a second engaging projection 14c that can be engaged.
  • the through hole 14b has a large inner diameter on the base end side, and gradually or gradually decreases in diameter toward the tip end so that the middle cylinder 13 cannot be detached from the outer cylinder 14 toward the tip in the axial direction.
  • the outer cylinder 14 exposes the tip end side portion of the middle cylinder 13 from the tip end of the outer cylinder 14, the base end side portion of the middle cylinder 13, the base end portion of the rotating shaft portion 12, and the tip end of the rotational force input portion 11. It is arranged so as to cover the part. Further, the fixing pin 16 is inserted into the tip end portion of the rotational force input portion 11 and the base end portion of the outer cylinder 14 in the radial direction to fix the tip end portion of the rotational force input portion 11 and the base end portion of the outer cylinder 14. is doing. Therefore, the rotational force input unit 11 and the outer cylinder 14 are integrally rotated in the forward and reverse directions.
  • the second engaging protrusion 14c of the outer cylinder 14 is formed in the shape of a plate having a trapezoidal cross section curved in the radial direction, one or more in the circumferential direction.
  • four second engaging projections 14c are formed at predetermined intervals, for example, at intervals of 90 degrees, and the space on the outer peripheral surface between adjacent second engaging projections 14c can be extracted by the first engaging projections 13c. It functions as a second engaging recess 14e that enters in the axial direction.
  • the first engaging protrusion 13c can advance and retreat in the axial direction between the rotation position A and the idling position B with respect to the second engaging recess 14e.
  • the first engaging protrusion 13c enters the second engaging recess 14e, the first engaging protrusion 13c and the second engaging protrusion 14c are engaged around the axis, and are relative to the axis. It is not possible to rotate.
  • the first engaging protrusion 13c is pulled out from the second engaging recess 14e, the first engaging protrusion 13c and the second engaging protrusion 14c are disengaged around the axis, and the shaft is released. It is relatively rotatable around.
  • the second engaging projection 14c can advance and retreat in the axial direction between the rotation position A and the idling position B.
  • the rotation position A the second engaging protrusion 14c enters the first engaging recess 13e, the first engaging protrusion 13c and the second engaging protrusion 14c are engaged around the axis, and are relative to the axis. It is not possible to rotate.
  • the idling position B the second engaging protrusion 14c is pulled out from the inside of the first engaging recess 13e, and the axial engagement between the first engaging protrusion 13c and the second engaging protrusion 14c is released. It is relatively rotatable around the axis.
  • each of the second engaging protrusions 14c there is an inclined surface 14g inclined so as to approach the center in the radial direction toward the tip in the axial direction, and the inclined surface 14g is the inclination of the first engaging projection 13c. It is slidable with the surface 13g so that it can be smoothly engaged and disengaged with the first engaging projection 13c around the shaft.
  • the coil spring 15 is arranged in the vicinity of the base end portion of the rotating shaft portion 12 so as to have a gap between the coil spring 15 and the rotating shaft portion 12 so as not to hinder the forward and reverse rotation of the rotating shaft portion 12, and the middle cylinder.
  • the middle cylinder 13 is constantly urged toward the tip side along the axial direction so that the 13 is located at the rotation position A.
  • Tool 1 with such a configuration can be used as follows.
  • the guide block 5 is placed on the radius fixing plate 2 in advance and held by a fixing method such as a holding claw 5c or a special screw or a combined screw, and then the guide block 5 and the radius fixing plate 2 are attached as shown in FIG. , Integrally, the radius fixing plate 2 is placed on the radius 3 so as to straddle the fractured portion 3a of the radius 3.
  • a fixing method such as a holding claw 5c or a special screw or a combined screw
  • the fixing screw 4 is inserted into one screw insertion hole 5d of the guide block 5 and the screw insertion hole 2d of the radius fixing plate 2, and the hexalobular hole 4j of the head 4c of the fixing screw 4 is inserted.
  • the screw connecting portion 12c of the rotating shaft portion 12 of the tool 1 is coupled. In this state, the central axes of the screw insertion hole 2d, the screw insertion hole 5d, the fixing screw 4, and the tool 1 are coaxially held.
  • the rotational force input portion 11 of the tool 1 is started to rotate in the tightening direction of the fixing screw 4.
  • the rotational force from the rotational force input unit 11 is transmitted to the outer cylinder 14, the inner cylinder 13 urged to the rotational position A by the coil spring 15, the rotary shaft portion 12, and the fixing screw 4, and the guide block 5 is subjected to.
  • the fixing screw 4 is screwed into the radius 3 while being guided by the screw insertion hole 5d. That is, since the middle cylinder 13 is located at the rotation position A, the rotational force from the outer cylinder 14 is surely applied to the middle cylinder 13 by the axial engagement between the first engaging protrusion 13c and the second engaging protrusion 14c. Be transmitted.
  • the shaft portion 4a of the fixing screw 4 begins to be screwed into the radius 3 while guiding the fixing screw 4 so as to smoothly advance in the axial direction in the screw insertion hole 5d of the guide block 5.
  • the main screw 4b of the shaft portion 4a of the fixing screw 4 performs a self-tapping action on the radius 3 and is screwed.
  • the rotation of the fixing screw 4 in the tightening direction proceeds, and when the fixing screw 4 is screwed into the radius 3, the middle cylinder 13 advances in the middle cylinder guide portion 5e of the screw insertion hole 5d. , The middle cylinder 13 comes into contact with the middle cylinder regulating portion 5h. Even after contact, as the rotation in the tightening direction progresses, when the fixing screw 4 is further screwed into the radius 3 and advances in the axial direction, the middle cylinder 13 begins to retreat relative to the rotating shaft portion 12. .. This means that the middle cylinder 13 has begun to move from the rotation position A to the idling position B.
  • the auxiliary screw 4d of the head 4c of the fixing screw 4 is screwed into the female screw portion 2f of the screw insertion hole 2d of the radius fixing plate 2 or performs a self-tapping action to form the radius fixing plate 2. It is fixed in close contact with the radius 3.
  • the fixing screw 4 is located at a predetermined position (so to speak, the fixing screw tightening position) with respect to the radius fixing plate 2.
  • the predetermined position is, for example, that the head 4c of the fixing screw 4 is placed on the counterbore surface (that is, the boundary between the head accommodating portion 2e and the female screw portion 2f) of the screw insertion hole 2d of the radius fixing plate 2. The position of contact.
  • the lower end of the head portion 4c of the fixing screw 4 is located at a position up to a certain distance (for example, 2 mm) from the counterbore surface of the screw insertion hole 2d.
  • the predetermined position may be a position shifted from the counterbore surface to the opening side of the head storage portion 2e, or conversely, it enters the female screw portion 2f side from the counterbore surface. It may be in the position.
  • the fixing screw 4 When the fixing screw 4 is positioned at such a predetermined position, if the middle cylinder 13 is moved from the rotation position A to the idling position B by the tool 1, the first engagement protrusion 13c and the second engagement protrusion 14c become The engagement around the shaft is released. Then, the outer cylinder 14 idles with respect to the inner cylinder 13, and the rotational force cannot be transmitted from the tool 1 to the fixing screw 4 any more, so that the screw tightening operation cannot be performed.
  • the fixing screw 4 is maintained in a state of being positioned at a predetermined position with respect to the radius fixing plate 2, and the depth regulation and the rotation regulation of the fixing screw 4 are performed.
  • the fixed distance is determined by the thickness of the radius fixing plate 2 or the thickness of the head 4c of the fixing screw 4 and varies. Therefore, it is difficult to uniformly define the fixed distance, as an example. Illustrate.
  • the fixing screw 4 When releasing the tightening, the fixing screw 4 can be loosened and removed by rotating the rotating shaft portion 12 in the reverse direction with the tool 1 or a general screwdriver without the guide block.
  • the first engagement projection 13c and the second engagement projection 14c are engaged with each other, and the rotational force when the rotational force input portion 11 is rotated. Is transmitted to the rotating shaft portion 12 via the outer cylinder 14 and the inner cylinder 13, and the fixing screw 4 connected to the rotating shaft portion 12 is rotated in the tightening direction.
  • the middle cylinder 13 comes into contact with the guide block 5 arranged so as to be overlapped with the radius fixing plate 2, and the middle cylinder 13 refers to the rotating shaft portion 12. It is relatively retracted to the rotational force input unit 11 side.
  • the middle cylinder 13 by moving the middle cylinder 13 from the rotation position A to the idling position B and disengaging it, the depth regulation and the rotation regulation can be enforced, and further, an excessive tightening force is applied to the fixing screw 4 and the radius. It is designed so that it does not cover the fixed plate 2.
  • the present invention is not limited to the first embodiment, and can be implemented in various other embodiments.
  • the center cylinder 13 comes into contact with the center cylinder 13 to move from the rotation position A to the idling position B as a position regulating unit.
  • the radius fixing plate 2 may be provided with a middle cylinder regulating portion 2h as an edge portion. That is, the screw insertion hole 2d of the radius fixing plate 2 is not composed of the head storage portion 2e and the female screw portion 2f, but the head is located on the opening side of the screw insertion hole 2d with respect to the head storage portion 2e.
  • the middle cylinder guide portion 2j corresponding to the middle cylinder guide portion 5e and the rotating shaft portion penetrating portion 2k corresponding to the rotating shaft portion penetrating portion 5f having an inner diameter larger than that of the portion accommodating portion 2e are formed, and the boundary between the two is formed.
  • the middle cylinder regulating portion 2h corresponding to the middle cylinder regulating portion 5h is provided in the portion.
  • the depth position regulation and the rotation regulation by the tool 1 can be enforced without using the guide block 5.
  • the radius fixing plate fixing screw tool 71 according to the second embodiment of the present invention is a tool that can be used in the same manner as the radius fixing plate fixing screw tool 1 shown in FIG.
  • a rotation stop notch 5g cut out in the radial direction at a predetermined position in the circumferential direction, for example, at intervals of 120 degrees around the axis, is arranged as an example of the first rotation stop portion.
  • the rotation stop notch 5g is engaged with the rotation stop protrusion 8g that protrudes in the radial direction on the outer peripheral surface of the guide cylinder 8 of the tool 71, for example, at intervals of 120 degrees. The rotation is stopped by restricting the rotation shaft portion 12 from rotating.
  • the fixing screw 4 inserted into the screw insertion hole 2d is made of hard metal and has a head 4c and a shaft connected to the head 4c, as in the first embodiment. It is composed of a part 4a.
  • each screw insertion hole 5d is composed of a large-diameter guide cylinder guide portion 5e and a small-diameter rotating shaft portion penetrating portion 5f smaller than the inner diameter of the guide cylinder guide portion 5e.
  • a guide cylinder restricting portion 5h formed of an annular edge portion is formed at the boundary between the guide cylinder guide portion 5e and the rotating shaft portion penetrating portion 5f.
  • the tip of the guide cylinder 8 of the tool 71 comes into contact with the guide cylinder restricting portion 5h, and the guide cylinder 8 enters the rotating shaft portion penetrating portion 5f in each screw insertion hole 5d rather than the guide cylinder regulating portion 5h.
  • the position is regulated so that there is no such thing.
  • the radius fixing plate fixing screw tool 71 is composed of a main body 7 and a guide cylinder 8 which is a member different from the main body 7.
  • the main body 7 and the guide cylinder 8 can be made of a metal such as stainless steel.
  • the main body 7 includes a rotational force input unit (rotational force input member) 81 and a rotary shaft portion (rotary shaft member) 82.
  • the rotational force input unit 81 is a portion that applies a rotational force around the axis to the tool 71, and is composed of a rod-shaped member.
  • the rotational force input unit 81 may connect a surgical tool or the like to input a rotational force from the surgical tool to the rotational force input unit 81 so that the tool 71 can rotate forward and reverse around the axis.
  • the tool 71 is held by having a flat surface portion 81a extending in the axial direction and pinching the flat surface portion 81a and the curved back surface portion of the flat surface portion 81a with fingers. It is possible to rotate forward and reverse around the axis.
  • the flat surface portion 81a is not always necessary because the rotational force input portion 81 may be rotated in the forward and reverse directions around the axis to tighten and release the fixing screw 4.
  • the rotating shaft portion 82 is arranged coaxially with the rotational force input portion 81, and has a shaft portion main body 82a having a circular cross section, a screw coupling portion 82c having a tapered tip shape at the tip of the shaft portion main body 82a, and a shaft portion main body 82a. It is provided with a first engaging portion arranged on the proximal end side of the above, that is, the proximal end or the vicinity of the proximal end.
  • the shaft portion main body 82a may be integrally formed of the rotational force input unit 81 and one member, or may be configured and connected to the rotational force input portion 81 by a separate member.
  • the screw coupling portion 82c is a hexalobular screw rotating portion that is arranged at the tip of the shaft portion main body 82a and can be relatively non-rotatably coupled to the hexalobular hole 4j of the head 4c of the fixing screw 4, and is a fixing screw 4
  • the fixing screw 4 can be rotated in the forward and reverse directions in order to tighten or release the tightening.
  • the screw coupling portion 82c serves as a hexarobula screw rotating portion in the shape of a hexarobula wrench that can engage with the hexarobula hole 4j of the head 4c. It is configured.
  • the shaft portion main body 82a At the base end of the shaft portion main body 82a, it is composed of an annular protrusion 82k protruding in the radial direction.
  • the annular protrusion 82k functions as an example of the third engaging portion described later.
  • a first engaging portion 82j is formed adjacent to the annular protrusion 82k on the tip end side of the annular protrusion 82k in the shaft portion main body 82a.
  • the first engaging portion 82j is composed of a male screw as an example.
  • the male screw of the first engaging portion 82j is formed to be smaller in the radial direction than the outer diameter of the annular protrusion of the annular protrusion 82k.
  • the guide cylinder 8 is composed of a cylindrical member into which a rotating shaft portion 82 is inserted and which is relatively movable in the axial direction and relatively rotatable around the axis.
  • the guide cylinder 8 includes a guide cylinder main body 8 m and an annular convex portion 8n that protrudes radially from the outer peripheral surface of the base end of the guide cylinder main body 8 m and has a base end end surface 8k as an example of the fourth engaging portion. ing.
  • the inner diameters of the guide cylinder main body 8m and the annular convex portion 8n are the same, and the rotating shaft portion 82a can be smoothly inserted in the axial direction and can be inserted in the forward and reverse directions around the shaft.
  • the base end end surface 8k comes into contact with the annular protrusion 82k so that the rotation shaft portion 82 can regulate the relative axial movement of the rotation shaft portion 82 toward the tip side with respect to the guide cylinder 8. There is.
  • the length of the guide cylinder 8 is the screwing depth of the fixing screw 4 screwed into the radius 3 when the guide block 5 is placed on the radius fixing plate 2 and the fixing screw 4 is screwed into the radius 3. Determined in consideration of the length of the screw insertion hole 2d of the radius fixing plate 2 and the length of the rotating shaft portion penetrating portion 5f of the screw insertion hole 5d of the guide block 5 so that (that is, the depth) has a predetermined dimension. Can be done.
  • a female screw into which the male screw of the first engaging portion 82j is screwed is formed as an example of the second engaging portion 8j.
  • the pitch of the female screw of the second engaging portion 8j and the male screw of the first engaging portion 82j can be the same as the pitch of the screw of the auxiliary screw 4d of the head 4c of the fixing screw 4. ..
  • the guide cylinder 8 and the guide block 5 Corresponds to the pitch difference between, or between the tip of the screw coupling portion 82c of the rotating shaft portion 82 and the fixing screw 4, or between the fixing screw 4 and the female screw portion 2f of the rib fixing plate 2. There is a possibility that each component is prematurely worn or damaged, or the female screw portion 2f of the rib fixing plate 2 is damaged.
  • the screw coupling of the rotating shaft portion 82 is performed.
  • a gap begins to form between the tip of the portion 82c and the fixing screw 4. That is, it means a state in which the tip of the screw connecting portion 82c of the rotating shaft portion 82 does not properly mesh with the fixing screw 4. This causes "licking" of the tip of the screw coupling portion 82c of the rotating shaft portion 82.
  • the pitch may be the same as described above.
  • a rotation stop protrusion 8 g for radially stopping the rotation is projected at a predetermined position in the circumferential direction, for example, at intervals of 120 degrees around the axis. It is formed so as to extend along the axial direction. Therefore, when a part of the lower side of the guide cylinder 8 is inserted into the guide cylinder guide portion 5e of one screw insertion hole 5d of the guide block 5, the three rotation stop protrusions 8g male screw insertion hole 5d of the guide cylinder 8 are inserted.
  • the guide cylinder 8 can be stopped from rotating with respect to the screw insertion hole 5d by fitting it into the three rotation stop cutouts 5g and locking it around the shaft.
  • the rotation stop portions are arranged unevenly at intervals of 120 degrees, in other words, evenly around the axis by locking the first rotation stop portion and the second rotation stop portion to stop the rotation. It is possible to smoothly and surely regulate the rotation around the axis as compared with the case of doing so.
  • the tool 71 having such a configuration can be used as follows.
  • the guide block 5 is placed on the radius fixing plate 2 in advance and held by a fixing method such as a holding claw 5c or a special screw or a combined screw, and then the guide block 5 and the radius fixing plate 2 are attached as shown in FIG. , Integrally, the radius fixing plate 2 is placed on the radius 3 so as to straddle the fractured portion 3a of the radius 3.
  • a fixing method such as a holding claw 5c or a special screw or a combined screw
  • the rotating shaft portion 82 of the main body portion 7 is inserted into the guide cylinder 8, and the screw connecting portion 82c of the rotating shaft portion 82 of the tool 71 is coupled into the hexalobular hole 4j of the head 4c of the fixing screw 4.
  • the central axes of the screw insertion hole 2d, the screw insertion hole 5d, the fixing screw 4, and the tool 71 are coaxially held.
  • the rotational force input portion 81 of the tool 71 is started to rotate in the tightening direction of the fixing screw 4.
  • the rotational force from the rotational force input portion 81 is transmitted to the rotary shaft portion 82 and the fixing screw 4, and the fixing screw 4 is screwed into the radius 3 while being guided by the screw insertion hole 5d of the guide block 5.
  • the shaft portion 4a of the fixing screw 4 begins to be screwed into the radius 3 while guiding the fixing screw 4 so as to smoothly advance in the axial direction in the screw insertion hole 5d of the guide block 5.
  • the main screw 4b of the shaft portion 4a of the fixing screw 4 performs a self-tapping action on the radius 3 and is screwed.
  • the fixing screw 4 is screwed into the radius 3 to some extent, the male screw of the first engaging portion 82j of the rotating shaft portion 82 starts screwing the second engaging portion 8j into the female screw.
  • the auxiliary screw 4d of the head 4c of the fixing screw 4 is screwed into the female screw portion 2f of the screw insertion hole 2d of the radius fixing plate 2, and the radius fixing plate 2 is fixed in close contact with the radius 3. Will be done.
  • the fixing screw 4 is located at a predetermined position (so to speak, the fixing screw tightening position) with respect to the radius fixing plate 2.
  • the predetermined position is, for example, that the head 4c of the fixing screw 4 is placed on the counterbore surface (that is, the boundary between the head accommodating portion 2e and the female screw portion 2f) of the screw insertion hole 2d of the radius fixing plate 2. The position of contact.
  • the lower end of the head portion 4c of the fixing screw 4 is located at a position up to a certain distance (for example, 2 mm) from the counterbore surface of the screw insertion hole 2d.
  • the predetermined position may be a position shifted from the counterbore surface to the opening side of the head storage portion 2e, or conversely, it enters the female screw portion 2f side from the counterbore surface. It may be in the position.
  • the fixing screw 4 When the fixing screw 4 is positioned at such a predetermined position, the annular protrusion 82k comes into contact with the base end end surface 8k with the tool 71, and the first engaging portion 82j is further screwed to the second engaging portion 8j. I can't put it in.
  • the fixing screw 4 is maintained in a state of being positioned at a predetermined position with respect to the radius fixing plate 2, and the depth regulation and the rotation regulation of the fixing screw 4 are performed.
  • the fixed distance is determined by the thickness of the radius fixing plate 2 or the thickness of the head 4c of the fixing screw 4 and varies. Therefore, it is difficult to uniformly define the fixed distance, as an example. Illustrate.
  • the fixing screw 4 When releasing the tightening, the fixing screw 4 can be loosened and removed by rotating the rotating shaft portion 82 in the reverse direction with a tool 71 or a general screwdriver without a guide block.
  • the rotational force input portion 81 is rotated with respect to the guide cylinder 8 inserted into the screw insertion hole 5d of the radius fixing plate 2 or the guide block 5, and the rotary shaft portion 82 is rotated. And start screwing the fixing screw 4 into the radius 3. After that, when the fixing screw 4 is screwed into the radius 3 and the tightening depth of the fixing screw 4 reaches a predetermined dimension, the annular protrusion 82k and the proximal end surface 8k come into contact with each other and engage with each other. At this time, the rotating shaft portion 82 cannot rotate and proceed any further, and the fixing screw 4 cannot be screwed into the radius 3 together with the rotating shaft portion 82, so that the depth can be regulated.
  • the male screw of the first engaging portion 82j and the female screw of the second engaging portion 8j are screwed in, and the annular protrusion 82k and the proximal end surface 8k come into contact with each other to engage with each other.
  • the rotating shaft portion 82 cannot rotate, over-rotation can be suppressed, and rotation regulation can be performed.
  • the present invention is not limited to the second embodiment, and can be implemented in various other embodiments.
  • the guide block 5 when it is not used, it is formed in the rotation stop notch 2g male screw insertion hole 2d similar to the rotation stop notch 5g as shown in FIG. That is, in each screw insertion hole 2d of the radius fixing plate 2, a rotation stop notch 2g cut out in the radial direction at a predetermined position in the circumferential direction, for example, at intervals of 120 degrees around the axis, is used as an example of the third rotation stop portion. It is arranged.
  • the rotation stop notch 2g has a rotation stop protrusion protruding in the radial direction on the outer peripheral surface of the guide cylinder 8 of the tool 71 as an example of the second rotation stop portion, for example, at intervals of 120 degrees. It is possible to stop the rotation by restricting the rotation shaft portion 82 from rotating by entering and locking 8 g. At this time, the inner diameter of the screw insertion hole 2d is made larger than the outer diameter of the guide cylinder main body 8m so that at least a part of the screw insertion hole 2d enters the guide cylinder main body 8m.
  • the guide cylinder 8 is inserted into the screw insertion hole 2d, and the rotation stop protrusion 8g is inserted into the rotation stop notch 2g. Enters and locks, restricts the rotation shaft portion 82 from rotating, and stops the rotation. Subsequently, with the other hand, the fixing screw 4 is inserted into the guide cylinder 8 and the rotating shaft portion 82 is inserted, and the rotating shaft portion 82 is rotated in the same manner as in the second embodiment to rotate the fixing screw 4 Is screwed in, and the first engaging portion 82j is screwed into the second engaging portion 8j.
  • the first engaging portion 82j cannot be screwed into the second engaging portion 8j, and the annular protrusion 82k and the proximal end surface 8k come into contact with each other.
  • the rotating shaft portion 82 cannot rotate and proceed further, and the fixing screw 4 cannot be screwed into the rib 3 together with the rotating shaft portion 82, so that rotation regulation and depth regulation can be performed. can.
  • the depth position regulation and the rotation regulation by the tool 71 can be enforced without using the guide block 5.
  • the tool for fixing the radius fixing plate according to the above aspect of the present invention can easily and surely regulate the tightening depth and rotation of the fixing screw of the resin fixing plate.

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

Abstract

La présente invention comprend : une unité d'entrée de force de rotation 11 ; un arbre de rotation 12 qui s'étend dans la direction axiale à partir de l'extrémité distale de l'unité d'entrée de force de rotation et qui peut tourner de manière relative ; un cylindre intermédiaire 13 dans lequel une partie raccordement de vis 12c au niveau de l'extrémité distale de l'arbre de rotation fait saillie à partir de l'extrémité distale et qui est disposée à l'extérieur de l'arbre de rotation pour être mobile dans la direction axiale entre une position de rotation A et une position de rotation au ralenti B, et a une première saillie d'ajustement 13c sur la surface circonférentielle externe ; et un cylindre externe 14 disposé à l'extérieur du cylindre intermédiaire pour être relativement mobile dans la direction axiale et ayant, sur la surface circonférentielle interne, une seconde saillie d'ajustement 14c qui, lorsque le cylindre intermédiaire est positionné au niveau de la position de rotation, s'adapte à la première saillie de montage autour de l'axe et peut tourner conjointement avec le cylindre intermédiaire, et lorsque le cylindre intermédiaire est positionné au niveau de la position de rotation au ralenti, est libéré du raccord avec la première saillie de montage autour de l'axe et peut tourner par rapport au cylindre intermédiaire.
PCT/JP2021/000830 2020-01-15 2021-01-13 Outil pour vis de fixation de plaque de fixation de radius WO2021145336A1 (fr)

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090275954A1 (en) * 2008-04-30 2009-11-05 Phan Christopher U Apparatus and methods for inserting facet screws
JP2012519054A (ja) * 2009-04-23 2012-08-23 カーディアック ペースメイカーズ， インコーポレイテッド 埋込式医療デバイスと共に使用する軸方向力制限トルクレンチ
US20130152746A1 (en) * 2011-12-20 2013-06-20 Guillaume Kerboul Torque limiting ratchet device
JP2016005559A (ja) * 2009-09-18 2016-01-14 バイオメット シー ブイＢｉｏｍｅｔ Ｃ．Ｖ． 使い捨て整形外科キット及び構成要素
WO2018106507A2 (fr) * 2016-12-06 2018-06-14 DePuy Synthes Products, Inc. Vis de séparation orthopédiques, outils d'insertion desdites vis ainsi que systèmes et procédés associés
US20180368902A1 (en) * 2017-06-22 2018-12-27 Zimmer Spine S.A.S. Closure top driver depth limiter

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090275954A1 (en) * 2008-04-30 2009-11-05 Phan Christopher U Apparatus and methods for inserting facet screws
JP2012519054A (ja) * 2009-04-23 2012-08-23 カーディアック ペースメイカーズ， インコーポレイテッド 埋込式医療デバイスと共に使用する軸方向力制限トルクレンチ
JP2016005559A (ja) * 2009-09-18 2016-01-14 バイオメット シー ブイＢｉｏｍｅｔ Ｃ．Ｖ． 使い捨て整形外科キット及び構成要素
US20130152746A1 (en) * 2011-12-20 2013-06-20 Guillaume Kerboul Torque limiting ratchet device
WO2018106507A2 (fr) * 2016-12-06 2018-06-14 DePuy Synthes Products, Inc. Vis de séparation orthopédiques, outils d'insertion desdites vis ainsi que systèmes et procédés associés
US20180368902A1 (en) * 2017-06-22 2018-12-27 Zimmer Spine S.A.S. Closure top driver depth limiter

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