WO2021152845A1 - Instrument d'assistance chirurgicale et procédé de mise en forme de trou osseux - Google Patents

Instrument d'assistance chirurgicale et procédé de mise en forme de trou osseux Download PDF

Info

Publication number
WO2021152845A1
WO2021152845A1 PCT/JP2020/003762 JP2020003762W WO2021152845A1 WO 2021152845 A1 WO2021152845 A1 WO 2021152845A1 JP 2020003762 W JP2020003762 W JP 2020003762W WO 2021152845 A1 WO2021152845 A1 WO 2021152845A1
Authority
WO
WIPO (PCT)
Prior art keywords
bone
bone hole
hole
surface protection
shaping
Prior art date
Application number
PCT/JP2020/003762
Other languages
English (en)
Japanese (ja)
Inventor
藤崎　健
Original Assignee
オリンパス株式会社
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by オリンパス株式会社 filed Critical オリンパス株式会社
Priority to PCT/JP2020/003762 priority Critical patent/WO2021152845A1/fr
Priority to JP2021574419A priority patent/JPWO2021152845A5/ja
Publication of WO2021152845A1 publication Critical patent/WO2021152845A1/fr

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans

Definitions

  • the present invention relates to a surgical aid and a bone hole shaping method.
  • anterior cruciate ligament reconstruction when forming a rectangular bone hole in the lateral condyle of the femur, for example, a plurality of bone holes smaller than the desired rectangular bone hole are formed side by side, and then the small plurality of bone holes are formed. Connect the bone holes of the above to make one bone hole. Then, the bone hole shaping portion of the dilator, which is a surgical aid, is inserted into the bone hole formed in this manner, the base end portion of the dilator is hit with a hammer, and the bone is crushed or cut by the bone hole shaping portion of the dilator. By doing so, the bone hole is dilated.
  • the anterior cruciate ligament attachment part is located on the posterior wall side of the lateral femoral condyle, and the bone intervening between the posterior wall of the lateral femoral condyle and the bone hole is thin. Therefore, when the bone hole formed in the anterior cruciate ligament attachment portion is expanded by the dilator, if too much force is applied to the posterior wall side of the inner wall of the bone hole, the bone may be cracked and the bone hole may be broken.
  • the present invention has been made in view of the above problems, and an object of the present invention is to provide a surgical aid and a bone hole shaping method capable of expanding a bone hole into a shape in which a bone fragment is inserted without breaking the bone hole. It is to be.
  • the surgical aid according to the present invention has a first bone wall surface and a bone hole having a second bone wall surface facing the first bone wall surface.
  • Has a bone hole dilation portion that expands the bone hole by crushing or cutting the bone on the first bone wall surface side when the bone is further inserted into the bone hole.
  • the tip position of the bone hole expansion portion is set from the tip position of the bone surface protection portion. Is also located on the proximal end side in the insertion direction of the bone hole shaping portion into the bone hole.
  • the bone hole shaping portion is configured such that the bone hole expansion portion and the bone surface protection portion are separate bodies, and the rod is at least the said. It is connected to the bone protection part.
  • the bone hole shaping portion is composed of the bone hole expansion portion and the bone surface protection portion as separate bodies, and further, from a striking member.
  • a striking receiving portion that receives a striking portion and a shaft that connects the striking receiving portion and the bone hole dilating portion are provided.
  • the bone hole expansion portion can move with respect to the bone surface protection portion along the insertion direction of the bone hole shaping portion into the bone hole.
  • the bone surface protection portion has a guide portion that guides the movement of the bone hole expansion portion along the insertion direction.
  • the bone hole shaping method according to the present invention is a bone hole shaping method for shaping a bone hole by using a surgical aid having a bone hole shaping part having a bone hole dilation part and a bone surface protection part. Therefore, the bone surface protection portion is inserted into the bone hole, and in a state where the bone surface protection portion is inserted to protect the bone surface, the bone hole expansion portion is inserted into the bone hole to crush the bone. Or cut to dilate and shape the bone hole.
  • the bone surface protection part is used as the posterior wall of the femoral lateral condyle among the bone walls forming the bone hole.
  • the bone can be dilated by contacting the second bone wall surface located on the side and crushing or cutting the bone by the bone hole dilation portion.
  • the force applied to the second bone wall surface forming the bone hole from the bone surface protection portion can be reduced. Therefore, it is possible to prevent excessive force from being applied to the second bone wall surface forming the bone hole. Therefore, the surgical aid and the bone hole shaping method according to the present invention have an effect that the bone hole can be expanded into a shape in which a bone fragment is inserted without breaking the bone hole.
  • FIG. 1 is a diagram showing a surgical assist instrument according to the first embodiment.
  • FIG. 2 is a perspective view of the bone hole shaping portion as viewed from the proximal end side.
  • FIG. 3 is a cross-sectional view in a direction orthogonal to the axial direction of the bone hole shaping portion.
  • FIG. 4 is a cross-sectional view in a direction orthogonal to the axial direction of the rod and the shaft.
  • FIG. 5 is a diagram showing a state in which the bone hole shaping portion is slid toward the tip side from the state of the surgical assist instrument shown in FIG.
  • FIG. 6 is a diagram showing the anterior cruciate ligament attachment portion and the bone hole.
  • FIG. 7 is a diagram showing an example of the shape of the bone hole.
  • FIG. 1 is a diagram showing a surgical assist instrument according to the first embodiment.
  • FIG. 2 is a perspective view of the bone hole shaping portion as viewed from the proximal end side.
  • FIG. 3 is a cross-section
  • FIG. 8A is a diagram showing a bone hole formed in a bone by a cutting tool.
  • FIG. 8B is a cross-sectional view taken along the line A1-A1 of FIG. 8A.
  • FIG. 8C is a cross-sectional view taken along the line B1-B1 of FIG. 8A.
  • FIG. 9A is a diagram showing a state in which the bone surface protection portion is being inserted into the bone hole.
  • 9B is a cross-sectional view taken along the line A2-A2 of FIG. 9A.
  • 9C is a cross-sectional view taken along the line B2-B2 of FIG. 9A.
  • FIG. 10A is a diagram showing a state in which the bone surface protection portion is inserted into the bone hole.
  • FIG. 10A is a diagram showing a state in which the bone surface protection portion is inserted into the bone hole.
  • FIG. 10B is a cross-sectional view taken along the line A3-A3 of FIG. 10A.
  • FIG. 10C is a cross-sectional view taken along the line B3-B3 of FIG. 10A.
  • FIG. 11A is a diagram showing a state in which the bone hole dilation portion is being inserted into the bone hole 120.
  • 11B is a cross-sectional view taken along the line A4-A4 of FIG. 11A.
  • 11C is a cross-sectional view taken along the line B4-B4 of FIG. 11A.
  • FIG. 12A is a diagram showing a state in which the bone hole dilation portion is inserted into the bone hole.
  • FIG. 12B is a cross-sectional view taken along the line A5-A5 of FIG. 12A.
  • FIG. 12C is a cross-sectional view taken along the line B5-B5 of FIG. 12A.
  • FIG. 13A is a diagram showing a bone hole when a surgical aid is removed and showing a bone hole expanded by a bone hole shaping portion.
  • FIG. 13B is a cross-sectional view taken along the line A6-A6 of FIG. 13A.
  • FIG. 13C is a cross-sectional view taken along the line B6-B6 of FIG. 13A.
  • FIG. 14A is a diagram showing a state in which a bone fragment is inserted into the dilated bone hole.
  • 14B is a cross-sectional view taken along the line A7-A7 of FIG. 14A.
  • 14C is a cross-sectional view taken along the line B7-B7 of FIG.
  • FIG. 15 is a perspective view of the surgical assist instrument according to the second embodiment.
  • FIG. 16 is a side view of the bone hole shaping portion.
  • FIG. 17A is a perspective view showing a first other example of the bone hole shaping portion of the surgical assist instrument according to the second embodiment.
  • FIG. 17B is a side view showing a first other example of the bone hole shaping portion of the surgical assist instrument according to the second embodiment.
  • FIG. 18A is a perspective view showing a second other example of the bone hole shaping portion of the surgical assist instrument according to the second embodiment.
  • FIG. 18B is a side view showing a second other example of the bone hole shaping portion of the surgical assist instrument according to the second embodiment.
  • FIG. 1 is a diagram showing a surgical assist instrument 1 according to the first embodiment.
  • FIG. 2 is a perspective view of the bone hole shaping portion 10 as viewed from the proximal end side.
  • FIG. 3 is a cross-sectional view of the bone hole shaping portion 10 in a direction orthogonal to the axial direction.
  • FIG. 4 is a cross-sectional view of the rod 20 and the shaft 40 in a direction orthogonal to the axial direction.
  • FIG. 5 is a diagram showing a state in which the bone hole shaping portion 10 is slid toward the tip side from the state of the surgical assist instrument 1 shown in FIG.
  • the surgical assist instrument 1 is a dilator that expands the bone hole, and has a bone hole shaping portion 10, a rod 20, and a holding portion 30 as shown in FIG.
  • the rod 20 is connected to the proximal end side of the bone surface protection portion 12, and is configured to be slidable by extending along the axial direction from the bone surface protection portion 12.
  • the rod 20 is formed in a prismatic shape.
  • the specific configuration of the bone hole shaping portion 10 will be described later in FIGS. 2 and 3, and the specific configuration of the rod 20 will be described later in FIG.
  • the "axis" is the central axis extending in the longitudinal direction of the rod 20, and the "axis direction" corresponds to the longitudinal direction of the rod 20.
  • the bone hole shaping part 10 includes a bone hole expanding part 11 which is formed separately from each other and which expands the bone hole by crushing or cutting the bone by a force such as striking, and the bone hole dilation. It has a long plate-shaped bone surface protection portion 12 that is longer in the axial direction than the portion 11. In the thickness direction of FIG. 2, the thickness of the bone hole expansion portion 11 is thinner than the thickness of the bone surface protection portion 12. Further, in the width direction of FIG. 2, the size in the width direction orthogonal to the axial direction of the bone hole expansion portion 11 and the size in the width direction orthogonal to the axial direction of the bone surface protection portion 12 are substantially the same. In the present embodiment, the bone hole dilation portion 11 is formed in the shape of a pentagonal plate.
  • the bone hole expansion portion 11 has a first surface 11a and a first surface 11a that come into contact with the bone on the first bone wall surface side of the rectangular bone hole formed in the bone. It has a second surface 11b provided on the opposite side.
  • the bone surface protection portion 12 has a third surface 12a that comes into contact with a second bone wall surface facing the first bone wall surface of the bone hole, and a fourth surface 12a provided on the side opposite to the third surface 12a. It has a surface 12b.
  • the bone hole expansion portion 11 and the bone surface protection portion 12 are arranged so that the second surface 11b and the fourth surface 12b of each other face each other.
  • the bone hole expansion portion 11 can move with respect to the bone surface protection portion 12 along the axial direction (the direction in which the bone hole shaping portion 10 is inserted into the bone hole).
  • the fourth surface 12b of the bone surface protection portion 12 is provided with a guide groove 12c that extends along the axial direction and is a guide portion that guides the movement of the bone hole expansion portion 11 along the insertion direction. There is.
  • the second surface 11b of the bone hole expansion portion 11 is provided with a slide portion 11c that is inserted and arranged in the guide groove 12c of the bone surface protection portion 12.
  • the slide portion 11c of the bone hole expansion portion 11 has substantially the same cross-sectional shape as the guide groove 12c of the bone surface protection portion 12 and a cross section in a direction orthogonal to the axial direction, and extends along the guide groove 12c. It is formed in a prismatic shape.
  • a guide hole 20a having a rectangular cross section is provided inside the rod 20 so as to penetrate along the axial direction. Further, on one side surface of the rod 20, an opening 20b extending along the guide hole 20a is provided so as to communicate the guide hole 20a with the outside. In the direction orthogonal to the axial direction, the width of the opening 20b is smaller than the width of the guide hole 20a.
  • a shaft 40 which is connected to the proximal end side of the bone hole expansion portion 11 and extends along the axial direction from the bone hole expansion portion 11 is arranged.
  • the shaft 40 has substantially the same cross-sectional shape as the guide hole 20a of the rod 20 and a cross section in a direction orthogonal to the axial direction, and is formed in a prismatic shape.
  • the axial length of the shaft 40 is longer than the axial length of the guide hole 20a.
  • a columnar impact receiving portion 50 that is hit by a hammer or the like (not shown), which is a striking member, is coaxially connected to the shaft 40. Then, in the surgical assist instrument 1 according to the first embodiment, by hitting the impact receiving portion 50 with a hammer or the like, the pressing force is transmitted from the impact receiving portion 50 to the bone hole expansion portion 11 through the shaft 40.
  • the holding portion 30 connects a rod-shaped handle portion 31 gripped by the operator, a rod fixing portion 32 to which the base end side of the rod 20 is fixed, and the handle portion 31 and the rod fixing portion 32. It has a connecting portion 33 to be formed.
  • the axis of the handle portion 31 is tilted with respect to the axial direction, and the other end of the handle portion 31 opposite to the connection portion 33 side from one end on the connection portion 33 side is the base end side in the axial direction. It is connected to the rod fixing portion 32 in the posture located at.
  • the rod fixing portion 32 is provided with a through hole having a rectangular cross section in the axial direction, and the rod 20 is fitted into the through hole to fix the rod 20 to the rod fixing portion 32.
  • the rod 20 is fixed by the rod fixing portion 32 at a position slightly separated from the base end of the rod 20 toward the tip end side in the axial direction.
  • the operator moves the impact receiving portion 50 along the axial direction, so that the shaft 40 is guided by the guide hole 20a of the rod 20 and slides. Then, in conjunction with the slide of the shaft 40, the slide portion 11c of the bone hole expansion portion 11 is guided by the guide groove 12c of the bone surface protection portion 12, and the bone hole expansion portion 11 is provided with respect to the bone surface protection portion 12. Can be slid.
  • the tip position of the bone hole expansion portion 11 is the bone surface protection portion 12 as shown in FIG.
  • the bone hole shaping portion 10 is positioned closer to the proximal end side in the insertion direction of the bone hole shaping portion 10 than the tip position of the bone hole.
  • FIG. 6 shows a bone hole having a rectangular opening formed in the femoral lateral condyle 100, which is the treatment target site.
  • cutting of an ultrasonic treatment tool or the like is performed on the anterior cruciate ligament attachment portion 110 to which the anterior cruciate ligament of the femoral lateral condyle 100, which is the treatment target site, is attached, as shown in FIG.
  • the perforation is performed in a plurality of times by an instrument, and the plurality of holes are connected to form a rectangular bone hole 120.
  • FIG. 1 shows a bone hole having a rectangular opening formed in the femoral lateral condyle 100, which is the treatment target site.
  • the bone hole shape may be such that the bone fragment does not fit in the bone hole due to the misalignment of each bone hole.
  • the bone hole 120 formed by the cutting instrument is expanded by the surgical assist instrument 1, and the shape of the bone hole 120 is made into a shape in which the bone fragment fits.
  • FIG. 8A is a diagram showing a bone hole 120 formed in a bone by a cutting tool.
  • FIG. 8B is a cross-sectional view taken along the line A1-A1 of FIG. 8A.
  • FIG. 8C is a cross-sectional view taken along the line B1-B1 of FIG. 8A.
  • the broken lines shown in FIGS. 8A to 8C indicate the shape of the bone fragment 130 to be inserted into the bone hole 120.
  • FIG. 9A is a diagram showing a state in which the bone surface protection portion 12 is being inserted into the bone hole 120.
  • 9B is a cross-sectional view taken along the line A2-A2 of FIG. 9A.
  • 9C is a cross-sectional view taken along the line B2-B2 of FIG. 9A.
  • FIG. 10A is a diagram showing a state in which the bone surface protection portion 12 is inserted into the bone hole 120.
  • FIG. 10B is a cross-sectional view taken along the line A3-A3 of FIG. 10A.
  • FIG. 10C is a cross-sectional view taken along the line B3-B3 of FIG. 10A.
  • the surgeon applies the second bone wall surface 122, which is the bone wall surface on the posterior wall side in the bone hole 120, to the third bone surface protection portion 12 of the surgical assist instrument 1.
  • the bone surface protection portion 12 is inserted into the bone hole 120 by bringing the surfaces 12a into contact with each other.
  • the bone hole expansion portion 11 is located outside the bone hole 120.
  • the operator inserts the bone surface protection portion 12 into the bone surface protection portion 120 until the tip of the bone surface protection portion 12 reaches the bottom surface 123 of the bone hole 120.
  • the position of each configuration of the surgical assist instrument 1 is in the state shown in FIG. 1, and in this state, the bone is not so crushed by the bone hole shaping portion 10.
  • FIG. 11A is a diagram showing a state in which the bone hole dilation portion 11 is being inserted into the bone hole 120.
  • 11B is a cross-sectional view taken along the line A4-A4 of FIG. 11A.
  • 11C is a cross-sectional view taken along the line B4-B4 of FIG. 11A.
  • FIG. 12A is a diagram showing a state in which the bone hole dilation portion 11 is inserted into the bone hole 120.
  • FIG. 12B is a cross-sectional view taken along the line A5-A5 of FIG. 12A.
  • 12C is a cross-sectional view taken along the line B5-B5 of FIG. 12A.
  • the surgeon in the bone hole 120 with the bone surface protection portion 12 inserted in the bone hole 120 as shown in FIGS. 11A to 11C.
  • the first surface 11a of the bone hole expansion portion 11 of the surgical aid 1 is brought into contact with the bone on the first bone wall surface 121 side, which is the bone wall surface on the anterior wall side, and the bone hole expansion portion 11 is formed in the bone hole 120. Will be inserted.
  • the surgeon hits the impact receiving portion 50 of the surgical assist instrument 1 with a hammer or the like, and crushes or cuts the bone on the first bone wall surface 121 side with the tip of the bone hole expansion portion 11 or the like, while crushing or cutting the bone hole.
  • the bone hole dilation portion 11 is driven into the 120. Then, as shown in FIGS. 12A to 12C, the operator inserts the bone hole expansion portion 11 into the bone hole 120 until the tip of the bone hole expansion portion 11 reaches the bottom surface 123 of the bone hole 120. At this time, the position of each configuration of the surgical assist instrument 1 is in the state shown in FIG.
  • FIG. 13A is a diagram showing a bone hole when the surgical aid 1 is pulled out, and a bone hole 120 expanded by the bone hole shaping portion 10.
  • FIG. 13B is a cross-sectional view taken along the line A6-A6 of FIG. 13A.
  • FIG. 13C is a cross-sectional view taken along the line B6-B6 of FIG. 13A.
  • FIG. 14A is a diagram showing a state in which the bone fragment 130 is inserted into the dilated bone hole 120.
  • 14B is a cross-sectional view taken along the line A7-A7 of FIG. 14A.
  • 14C is a cross-sectional view taken along the line B7-B7 of FIG. 14A.
  • the surgeon extracts the bone hole shaping part 10 (bone hole dilation part and bone surface protection part 12) of the surgical assist instrument 1 from the bone hole 120.
  • the lateral femoral condyle 100 is formed with a bone hole 120 in which the bone fragment 130 can be inserted and expanded by the surgical assist instrument 1.
  • the surgeon then inserts the bone fragment 130 into the dilated bone hole 120, as shown in FIGS. 14A-14C.
  • the surgeon uses the surgical assist instrument 1 according to the first embodiment to expand the bone fragment 130 by expanding the first bone wall surface 121 side without expanding the second bone wall surface 122 side.
  • the bone hole 120 can be expanded into a shape that can be inserted.
  • most of the pressing force generated by hitting the impact receiving portion 50 of the surgical aid 1 with a hammer is transmitted to the bone hole expansion portion 11 through the shaft 40, and the bone is crushed by the bone hole expansion portion 11.
  • the bone hole 120 is expanded by cutting. Therefore, the pressing force is hardly transmitted to the bone surface protection portion 12, and it is possible to prevent excessive force from being applied to the second bone wall surface 122, which is the bone wall surface on the posterior wall side of the bone hole 120. Therefore, the surgical assist instrument 1 according to the first embodiment can be expanded into a shape into which a bone fragment is inserted without breaking the bone hole 120.
  • FIG. 15 is a perspective view of the surgical assist instrument 201 according to the second embodiment.
  • FIG. 16 is a side view of the bone hole shaping portion 210.
  • the surgical assist instrument 201 according to the second embodiment has a bone hole shaping portion 210, a rod 220, and a holding portion 230.
  • the rod 220 is connected to the proximal end side of the bone hole shaping portion 210 and has a rod shape extending along the axial direction from the bone hole shaping portion 210.
  • the "axis" is the central axis extending in the longitudinal direction of the rod 220, and the "axis direction” corresponds to the longitudinal direction of the rod 220.
  • the bone hole shaping portion 210 has a bone hole expanding portion 211 for crushing or cutting bone by a force such as striking to expand the bone hole, and a bone surface protecting portion 212. ing.
  • the dotted line X1 shown in FIG. 16 represents the boundary between the bone hole expansion portion 211 and the bone surface protection portion 212.
  • the thickness direction of FIG. 16 the thickness of the bone hole expansion portion 211 is thinner than the thickness of the bone surface protection portion 212.
  • the size in the width direction orthogonal to the axial direction of the bone hole expansion portion 211 and the size in the width direction orthogonal to the axial direction of the bone surface protection portion 212 are substantially the same.
  • the bone hole expansion portion 211 has a first surface 211a and a slope 211b.
  • the first surface 211a extends along the axial direction and is in contact with the bone on the side of the first bone wall surface 121 (see FIG. 8), which is the inner bone wall surface of the bone hole 120 (see FIG. 8).
  • the slope 211b is inclined with respect to the first surface 211a with a downward slope from the base end side in the axial direction toward the tip end side.
  • the base end side of the slope 211b is continuous with the tip end side of the first surface 211a.
  • the tip end side of the slope 211b is continuous with the proximal end side of the fourth surface 212b described later in the bone surface protection portion 212.
  • the bone surface protection portion 212 has a third surface 212a and a fourth surface 212b.
  • the third surface 212a extends along the axial direction and is a surface that comes into contact with the second bone wall surface 122 (see FIG. 8), which is the inner bone wall surface of the bone hole 120.
  • the fourth surface 212b is provided on the side opposite to the third surface 212a and extends along the axial direction.
  • the tip position of the bone hole expansion portion 211 is the proximal end in the insertion direction of the bone hole shaping portion 210 into the bone hole 120 rather than the tip position of the bone surface protection portion 212. Located on the side.
  • the holding portion 230 has a rod-shaped handle portion 231 held by the operator and a striking receiving portion 232 provided at the base end of the handle portion 231 and hit by a hammer or the like (not shown) which is a striking member.
  • the tip of the handle portion 231 is connected to the base end of the rod 220. Then, in the surgical assist instrument 201 according to the second embodiment, by hitting the impact receiving portion 232 with a hammer or the like, the pressing force is transmitted from the impact receiving portion 232 to the bone hole shaping portion 210 through the handle portion 231 and the rod 220. Will be done.
  • the surgeon When the surgeon inserts the bone hole shaping portion 210 of the surgical aid 2 according to the second embodiment into the bone hole 120 as it is formed by the cutting tool, the surgeon first inserts the bone hole shaping portion 210 into the second bone wall surface 122 of the bone hole 120.
  • the third surface 212a of the bone surface protection portion 212 is brought into contact with the bone surface protection portion 212, and the bone surface protection portion 212 is inserted into the bone hole 120.
  • the bone hole expansion portion 211 is located outside the bone hole 120.
  • the operator further inserts the bone surface protection portion 212 into the bone hole 120 and the first of the bone hole 120.
  • the first surface 211a of the bone hole expansion portion 211 is brought into contact with the bone on the bone wall surface 121 side of the bone hole 120, and the bone hole expansion portion 211 is inserted into the bone hole 120.
  • the surgeon hits the impact receiving portion 232 of the surgical assist instrument 201 with a hammer or the like, and crushes or cuts the bone on the first bone wall surface 121 side by the slope 211b of the bone hole expansion portion 211 or the like while crushing or cutting the bone.
  • the bone hole dilation portion 211 is driven into the hole 120.
  • the bone is crushed or cut by the bone hole expanding portion 211 of the bone hole shaping portion 210 without expanding the second bone wall surface 122 side.
  • the bone hole 120 can be expanded into a shape into which the bone fragment 130 (see FIG. 14) can be inserted.
  • the surgical assist instrument 201 according to the second embodiment most of the pressing force generated by hitting the impact receiving portion 232 with a hammer or the like is used for crushing or cutting the bone by the bone hole expanding portion 211. Therefore, the pressing force is hardly transmitted to the bone surface protection portion 212, and it is possible to prevent excessive force from being applied to the second bone wall surface 122, which is the bone wall surface on the posterior wall side of the bone hole 120. Therefore, the surgical assist instrument 201 according to the second embodiment can be expanded into a shape into which a bone fragment is inserted without breaking the bone hole 120.
  • FIG. 17A is a perspective view showing a first other example of the bone hole shaping portion 210 of the surgical assist instrument 201 according to the second embodiment.
  • FIG. 17B is a side view showing a first other example of the bone hole shaping portion 210 of the surgical assist instrument 201 according to the second embodiment.
  • the dotted line X2 shown in FIG. 17B represents the boundary between the bone hole expansion portion 211 and the bone surface protection portion 212.
  • the bone hole expansion portion 211 has a stepped step on the distal end side and the proximal end side in the axial direction, respectively.
  • the first surface 211a of the bone hole expansion portion 211 forms a file-shaped cutting surface.
  • FIG. 18A is a perspective view showing a second other example of the bone hole shaping portion 210 of the surgical assist instrument 201 according to the second embodiment.
  • FIG. 18B is a side view showing a second other example of the bone hole shaping portion 210 of the surgical assist instrument 201 according to the second embodiment.
  • the dotted line X3 shown in FIG. 18B represents the boundary between the bone hole expansion portion 211 and the bone surface protection portion 212.
  • a blade portion 211c is provided at the axial tip of the bone hole expansion portion 211.
  • the blade portion 211c is curved so as to be recessed from the tip end side in the axial direction of the bone hole expansion portion 211 toward the proximal end side.
  • the bone cutting performance by the blade portion 211c can be improved.
  • the present invention can provide a surgical aid and a bone hole shaping method capable of expanding a bone hole into a shape in which a bone fragment is inserted without breaking the bone hole.

Landscapes

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

Abstract

Cet instrument d'assistance chirurgicale est conçu pour élargir un trou osseux ayant une première surface de paroi osseuse et une seconde surface de paroi osseuse faisant face à la première surface de paroi osseuse, et est pourvu d'une tige et d'une unité de mise en forme de trou osseux disposée sur le côté distal de la tige. L'unité de mise en forme de trou osseux comprend : une partie de protection de surface osseuse qui est insérée dans le trou osseux le long de la seconde surface de paroi osseuse et protège la seconde surface de paroi osseuse ; et une partie d'expansion de trou osseux qui est positionnée à l'extérieur du trou osseux lorsque la partie de protection de surface osseuse est au moins partiellement insérée dans le trou osseux, et qui élargit le trou osseux par pulvérisation ou découpe de l'os sur le côté de la première surface de paroi osseuse lorsque la partie de protection de surface osseuse est en outre insérée dans le trou osseux.
PCT/JP2020/003762 2020-01-31 2020-01-31 Instrument d'assistance chirurgicale et procédé de mise en forme de trou osseux WO2021152845A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
PCT/JP2020/003762 WO2021152845A1 (fr) 2020-01-31 2020-01-31 Instrument d'assistance chirurgicale et procédé de mise en forme de trou osseux
JP2021574419A JPWO2021152845A5 (ja) 2020-01-31 手術補助器具

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2020/003762 WO2021152845A1 (fr) 2020-01-31 2020-01-31 Instrument d'assistance chirurgicale et procédé de mise en forme de trou osseux

Publications (1)

Publication Number Publication Date
WO2021152845A1 true WO2021152845A1 (fr) 2021-08-05

Family

ID=77079841

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/JP2020/003762 WO2021152845A1 (fr) 2020-01-31 2020-01-31 Instrument d'assistance chirurgicale et procédé de mise en forme de trou osseux

Country Status (1)

Country Link
WO (1) WO2021152845A1 (fr)

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2013537091A (ja) * 2010-09-14 2013-09-30 アイエムディーエス コーポレイション 往復運動する外科用器具
US8939981B1 (en) * 2009-03-30 2015-01-27 Keith Richard Anderson Surgical saw blade for wedge osteotomies

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8939981B1 (en) * 2009-03-30 2015-01-27 Keith Richard Anderson Surgical saw blade for wedge osteotomies
JP2013537091A (ja) * 2010-09-14 2013-09-30 アイエムディーエス コーポレイション 往復運動する外科用器具

Also Published As

Publication number Publication date
JPWO2021152845A1 (fr) 2021-08-05

Similar Documents

Publication Publication Date Title
CN102481162B (zh) 在外科手术过程中使用的克氏针和方法
AU2002336798C1 (en) Apparatus and methods for bone surgery
US7041107B2 (en) Instrument
US7722614B2 (en) Osteochondral implant fixation method
EP1987784B1 (fr) Dispositif de préparation d'un retrait à rotation non symétrique dans un os
US5931841A (en) Combination broacher-reamer for use in orthopaedic surgery
WO2005004731A1 (fr) Instrument de reconstruction de ligament et procede de reconstruction de ligament
US11234711B2 (en) Polymer 4-in-2 femoral cutting instrument having separable A/P and chamfer cutting blocks
WO2021152845A1 (fr) Instrument d'assistance chirurgicale et procédé de mise en forme de trou osseux
US10660759B2 (en) Set of surgical instruments for an artificial hip joint implant
US20200138470A1 (en) Ultrasonic vibration transmittable probe and ultrasonic treatment assembly
WO2016149635A1 (fr) Instruments stériles pour implants et kits pour implants articulaires flexibles
KR20160119827A (ko) 가요성 뼈 확장기
US20200138471A1 (en) Ultrasonic vibration transmittable probe and ultrasonic treatment assembly
US6524319B1 (en) Surgical instrument for mechanically removing bone cement
US11446051B2 (en) Ultrasonic vibration transmittable probe and ultrasonic treatment assembly
JPWO2021152845A5 (ja) 手術補助器具
JP2022532361A (ja) 骨トンネルを形成するための骨パンチ具および方法
CN109788961B (zh) 包括破碎工具的手术器械
JP2003153915A (ja) 人工膝関節置換術用の大腿骨遠位端処理具
WO2021152854A1 (fr) Dispositif de marquage, procédé de marquage et procédé de formation de trou osseux
JP6987956B2 (ja) 超音波プローブ及び超音波処置アッセンブリ
JP2021175529A (ja) 人工膝関節置換術用手術器具
JP6420787B2 (ja) 骨折部固定具
KR101119626B1 (ko) 가이드핀공을 갖춘 라섭 및 가이드핀을 포함한 라섭 유닛

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 20917175

Country of ref document: EP

Kind code of ref document: A1

ENP Entry into the national phase

Ref document number: 2021574419

Country of ref document: JP

Kind code of ref document: A

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 20917175

Country of ref document: EP

Kind code of ref document: A1