WO2023002817A1

WO2023002817A1 - Bone treatment device and bone treatment/diagnosis device

Info

Publication number: WO2023002817A1
Application number: PCT/JP2022/025907
Authority: WO
Inventors: 伸晃橋元; 潤水野; 康弘関
Original assignee: 公立大学法人公立諏訪東京理科大学
Priority date: 2021-07-21
Filing date: 2022-06-29
Publication date: 2023-01-26
Also published as: JPWO2023002817A1

Abstract

This bone treatment device 100 comprises a vibrator 1 installed at a fracture site 80 so as to not be in direct contact with a fractured bone 8a, and a vibrator drive circuit 2 for driving the vibrator 1 so that the fractured bone 8a is displaced.　With regards to treatment devices for fractured bones, some devices such as those that perform treatment by emitting an ultrasound beam at a fracture position have been put to practical use; however, there is a further need for fast treatment. A bone treatment device 100 according to the present invention makes it possible to provide a bone treatment device with which faster healing is possible.

Description

Bone treatment device and bone treatment/diagnosis device

The present invention relates to a bone treatment device and a bone treatment/diagnosis device.

Various attempts have been made to treat fractured bones. Japanese Patent Application Laid-Open No. 2001-231788 (Patent Document 1) describes various attempts that have been considered so far. For example, there has been an attempt to attach electrodes to a fractured affected area and apply electrical stimulation to the affected area. There has also been an attempt to expose the entire affected area to a magnetic field to generate an induced current in the affected area. Furthermore, there has also been an attempt to irradiate a fractured affected part with an ultrasonic beam, as in the invention of Patent Document 1. In addition, as in Japanese Patent Laying-Open No. 2002-360598 (Patent Document 2), there is also a proposal of a device for inserting a pin into a fractured bone and applying vibration to the bone through the pin.

JP-A-2001-231788 JP-A-2002-360598

However, a device that attaches an electrode to an affected area is invasive, and a device that inserts a pin into a bone is also invasive. In addition, a device that exposes the entire affected area to the magnetic field requires a large-scale device. Devices for irradiating ultrasonic beams are intended to overcome such drawbacks and have been partially put to practical use.
There is also a demand for a bone therapeutic/diagnostic apparatus capable of performing bone therapy and accurate diagnosis.

Therefore, an object of the present invention is to provide a bone treatment device capable of further early healing of fractured bones. Another object of the present invention is to provide a bone treatment/diagnosis apparatus capable of performing bone treatment and accurate diagnosis.

[1] A bone treatment apparatus of the present invention is a treatment apparatus for a fractured bone, comprising: a vibrator installed at a fractured part so as not to be in direct contact with the fractured bone; and a vibrator drive circuit for driving the vibrator.
For example, the displacement may be 0.2 to 1.0 mm and the frequency may be 1 to 100 Hz.

According to the bone treatment apparatus of the present invention, the vibrator installed at the fractured part is driven by the vibrator driving circuit, and the fractured bone is displaced, stimulating the fractured part and promoting the growth of callus and the like. be. Therefore, it is possible to provide a bone treatment device capable of further early healing of fractured bones. In addition, since the vibrator is placed at the fractured part so that it does not come into direct contact with the fractured bone, it enables early healing and non-invasive treatment that places less burden on the treatment target (human or animal). .

[8] A bone therapeutic/diagnostic apparatus of the present invention is a bone therapeutic/diagnostic apparatus for treating and diagnosing a bone, comprising the above-described bone therapeutic apparatus and sound wave irradiation for irradiating a bone fracture site with sound waves. a sound wave emitter drive circuit that drives the sound wave emitter, a sound wave detection circuit that detects reflected sound waves or residual sound waves from the bone fracture site, and a display unit that visualizes the healing state of the bone from the detected sound waves. and a bone diagnosis device.

According to the bone treatment/diagnosis apparatus of the present invention, since both the bone treatment apparatus and the diagnosis apparatus are provided, early healing of the fractured bone by the treatment apparatus and accurate diagnosis of the healing state by the diagnosis apparatus are possible. Become. As described above, the bone treatment apparatus includes a predetermined vibrator and a vibrator drive circuit, and early healing and the like are possible by using these. Moreover, since the diagnostic apparatus has a sound wave emitter, a sound wave emitter drive circuit, a sound wave detector, and a display unit, accurate diagnosis can be made by using these. It is also possible to perform a cycle in which, after treatment with a treatment device, the healing state is diagnosed with a diagnosis device, and the treatment is performed again with the treatment device according to the situation or after feeding back the situation.

1 is a diagram for explaining the treatment apparatus 100 according to Embodiment 1. FIG. FIG. 2 is a view for explaining the rat bone treatment device 100. FIG. The figure shown in order to demonstrate the treatment apparatus 130 which concerns on Embodiment 3. FIG. FIG. 10 is a diagram for explaining the therapeutic device 140 according to the fourth embodiment (explanatory diagram regarding installation locations when a plurality of transducers 1 are used). FIG. 14 is a diagram for explaining the therapeutic device 140 according to the fourth embodiment (explanatory diagram of drive waveforms when a plurality of transducers 1 are used); The figure shown in order to demonstrate the therapeutic apparatus 150 which concerns on Embodiment 5. FIG. FIG. 11 is a diagram (schematic explanatory diagram) shown for explaining a therapeutic/diagnostic apparatus 300 according to a sixth embodiment; FIG. 11 is a diagram (processing flow chart) for explaining the treatment/diagnosis apparatus 300 according to the sixth embodiment; FIG. 11 is a diagram for explaining a therapeutic/diagnostic device 310 according to a seventh embodiment; The figure shown in order to demonstrate the treatment apparatus 180 which concerns on Embodiment 8. FIG.

The bone treatment device and bone treatment/diagnosis device of the present invention will be described below with reference to FIGS. 1 to 9. FIG. Each figure described below is a schematic diagram that simplifies the actual shape, structure, method, and the like. Further, the bone treatment apparatus (100, etc.) and the treatment/diagnosis apparatus (300, etc.) described in the following embodiments may be applied to humans (human bodies) or animals other than humans (for example, dogs and cats. Animals include birds, etc.). , animal bodies).

[Embodiment 1]
FIG. 1 is a diagram for explaining a bone treatment device 100 (bone treatment device) according to Embodiment 1. FIG.
As shown in FIG. 1, the therapeutic device 100 according to the first embodiment is a therapeutic device 100 for a fractured bone, and includes a vibrator 1 installed in a fractured part 80 so as not to be in direct contact with the fractured bone 8a, and a vibrator driving circuit 2 for driving the vibrator 1 so that the fractured bone 8a is displaced.
Here, "fractured bone 8a" refers to any fractured bone to be displaced. A fracture site 81 covered with a living tissue 9 such as muscle and skin includes fractured

bones

8a and 8b. In the first embodiment, the fractured bone 8a is to be displaced.

A fractured part 80 is a region including a fractured part 81, and a cast 91 is formed here to fix and protect the affected part. The vibrator 1 is fixed (non-invasively) to the fractured part 80 using a band 92 so as not to come into direct contact with the fractured bone 8a. “Avoid direct contact” means, for example, to avoid incising the living tissue 9 and mounting the vibrator 1 so as to directly contact the fractured bone 8a. The vibrator 1 is not attached to the pin by inserting the pin into the fractured bone 8a. In Embodiment 1, the fractured bone 8a is covered with the living tissue 9, and the oscillator 1 is placed outside the bone 8a or further outside the cast so that the oscillator 1 does not come into direct contact with the fractured bone 8a. It is placed at the fracture 80 as follows.
In FIG. 1, the vibrator 1 is installed on the side opposite to the side of the cast 91 with the bone (8a) (outside the cast 91). inside the cast 91). Subjects for treatment are humans or rats.

The treatment apparatus 100 according to Embodiment 1 is configured to displace the fractured bone 8a using the transducer 1 and the transducer drive circuit 2 in a direction D1 that intersects the longitudinal direction D5 of the bone 8a.
That is, the vibrator 1 is installed at the fractured part 80 outside the living tissue 9 within the range in which the fractured bone 8a extends in the longitudinal direction D5. Therefore, when the vibrator 1 is driven by the vibrator driving circuit 2, the fractured bone 8a is displaced in the direction D1 crossing the longitudinal direction D5 of the bone 8a. It should be noted that "using . . . " does not mean excluding the use of other items. In addition, the intersecting direction D1 includes not only the direction perpendicular to the longitudinal direction D5 (direction of 90°) but also the direction intersecting with the longitudinal direction D5 at 80°, 60°, 45°, and the like.

The treatment apparatus 100 according to the first embodiment is configured such that the transducer 1 is driven by the transducer driving circuit 2 to generate mechanical displacement, and the mechanical displacement of the transducer 1 displaces the fractured bone 8a. ing. Therefore, as the vibrator 1, instead of vibrating at a high frequency like ultrasonic waves, a vibration motor with a frequency lower than that of ultrasonic waves is used. For example, it is an eccentric rotating mass vibration motor that rotates and vibrates an elliptical weight.

As shown in FIG. 1, the vibrator drive circuit 2 receives a vibrator drive command signal for driving the vibrator 1, and receives a drive signal for driving the vibrator 1 so as to displace the fractured bone 8a. to output When the transducer 1 is driven and mechanically displaced, the fractured bone 8a is thereby displaced. At this time, the vibrator drive circuit 2 controls the amplitude, period, waveform, etc. of the drive signal so that the vibration frequency of the vibrator 1 is 1 to 100 Hz so that the displacement is in the range of 0.2 to 1.0 mm, for example. The vibration of the vibrator 1 may be set so as to fall within the range. When the vibrator drive command signal changes to a drive stop command signal, vibration of the vibrator 1 is stopped, mechanical displacement is eliminated, and the fractured bone 8a is no longer displaced. In FIG. 1, the state before the fractured bone 8a is displaced is indicated by a solid line, and the displaced state is indicated by a dotted line. Although FIG. 1 shows a case in which the fractured bone 8a is displaced upward, it is also displaced downward. Since the drawing is complicated, illustration of the downward displacement is omitted.

The therapeutic device 100 is configured such that the oscillator 1 is driven by the oscillator drive circuit 2 at a predetermined cycle, and the fractured bone 8a is displaced at that cycle. 2 to be driven at the same time every day for the same time (5 to 30 minutes). The fractured bone 8a is displaced during the period when the transducer 1 is driven, and the fractured bone 8a is not displaced during the period when the transducer 1 is not driven.
Also, the vibration of the vibrator 1 is set so that the displacement of the fractured bone 8a is in the range of 0.2 to 1.0 mm, for example. The vibration frequency of the vibrator 1 is set, for example, in the range of 1 to 100 Hz (the fractured bone 8a is also displaced at the same frequency).

[Effect of Embodiment 1]
According to the treatment apparatus 100 according to the first embodiment, the vibrator 1 and the vibrator drive circuit 2 are provided, and the vibrator 1 is driven by the vibrator drive circuit 2 so as to displace the fractured bone 8a. The site 81 is stimulated to promote the growth of callus or the like. Therefore, it is possible to provide the bone treatment device 100 capable of further early healing of the fractured bone 8 . In addition, since the vibrator 1 is installed in the fractured part 80 so as not to be in direct contact with the fractured bone 8a, non-invasive treatment is possible.

According to the treatment apparatus 100 according to the first embodiment, the fractured bone 8a is displaced in the direction D1 intersecting with the longitudinal direction D5 of the bone 8a using the transducer 1 and the transducer driving circuit 2. Therefore, it is easier to displace the fractured bone 8a.
When the displacement of the fractured bone 8a is in the range of 0.2 to 1.0 mm, it is believed that the growth of callus and the like is promoted and damage to the formed callus can be avoided or suppressed. Further, when the vibration frequency of the vibrator 1 is in the range of 1 to 100 Hz, it is believed that the growth of callus and the like is likely to be promoted.
In addition, when the fractured bone 8a is displaced relative to the other bones 8b, a load is applied to the fractured portion 81, and when the displacement is eliminated, the fractured portion 81 is stimulated and the callus or the like is lost. One could speculate that growth would be accelerated.

Also, when a vibration motor is used as the vibrator 1, the vibrator 1 (vibration motor) is driven by the vibrator drive circuit 2 to generate mechanical displacement. Since the fractured bone 8a is displaced by the mechanical displacement of the vibrator 1, the fractured bone 8a can be reliably displaced.

In addition, since the oscillator 1 is driven at a predetermined cycle and the fractured bone 8a is displaced at that cycle, a time period during which the fractured bone 8a is displaced and a time period during which it is not displaced occur. It is presumed that the fracture site 81 is stimulated during the time period when the fractured bone 8a is displaced, and the callus or the like grows due to the stimulation during the time period when the fractured bone 8a is not displaced. Such a cycle of stimulation and callus growth can be expected to further promote healing.

[Experimental therapeutic device 100]
FIG. 2 is a diagram for explaining the rat bone treatment device 100 (experimental treatment device). FIG. 2 shows a bone treatment device 100 in which the fibula has been osteotomized (complete fracture). The fracture site 81 is either incised once and sutured by applying a drug or the like to the fracture site 81, or it is not incised. It is adjusted to the bone position. The fractured part 80 is fixed by, for example, a cast 91, and the vibrator 1 is installed on the opposite side of the cast 91 from the fractured part 81 side (or on the fractured part 81 side, or on the part without the cast 91). There are two fracture locations 81 . The vibrator 1 is installed at the fractured part 80 outside the living tissue 9 within the range in which the (two) fractured bones 8a extend in the longitudinal direction D5. When the vibrator 1 is driven by the vibrator drive circuit 2, the fractured bones 8a (two) are displaced in directions D11 and D12 intersecting with their longitudinal directions D51 and D52.

　An eccentric rotating mass type vibration motor is used as the oscillator 1. The vibrator 1 is fixed with a band 92 . The vibrator 1 is driven by the vibrator driving circuit 2 and vibrates to generate mechanical displacement, which displaces the fractured bone 8a. The vibrator 1 is driven at a fixed time (for example, 9:00 a.m.) for the same time (for example, 10 to 25 minutes) every day, and is vibrated in the range of displacement 0.4 to 0.8 mm and frequency 5 to 80 Hz, resulting in fracture. The bone 8a is displaced in directions D11 and D12 crossing its longitudinal directions D51 and D52. At other times, the vibration of the vibrator 1 stops and the fractured bone 8a is not displaced.

Here, when the period until a fracture is healed is divided into three periods, an inflammation period, a repair period, and a remodeling period, the oscillator 1 is arranged so that the fractured bone 8a is displaced relative to the other bones 8b. is driven primarily by the inflammatory phase, or the inflammatory and repair phase. During the repair period and the remodeling period, the driving of the vibrator 1 is stopped according to the healing state so that the callus is not damaged by the displacement. Alternatively, the amplitude or driving frequency of the vibrator is changed (the displacement of the fractured bone 8a corresponds to the vibration of the vibrator 1).
Note that the inflammatory stage (fracture hematoma stage) is a period in which a large amount of blood collects in the fracture site 81 to cause inflammation and proliferation of osteogenic cells. The repair period (initial callus formation period) is a period in which the bone surrounding the fracture site 81 is gradually replaced with new bone (callus). The remodeling period (remodeling period to sclerosis period) is a period during which the callus is replaced with lamellar bone and the fractured bone is restored to its original normal state.
In FIG. 2, the treatment target of the bone treatment apparatus 100 is a rat, but the treatment target may be a human (human body).

[Embodiment 2]
The therapeutic device (not shown) according to the second embodiment is basically the same as the therapeutic device 100 according to the first embodiment, but uses an ultrasonic transducer such as an ultrasonic phased array as the transducer 1, The difference is that a push pulse is generated by acoustic radiation pressure of ultrasonic waves driven by the vibrator drive circuit 2, and the fractured bone 8a is displaced by the push pulse.
Here, "ultrasonic wave" means a sound with a high frequency that cannot be heard by the human ear. The range of frequencies that humans can hear (audible range) is 20 Hz to 20 kHz, and refers to sounds with frequencies higher than 20 kHz. "Acoustic radiation pressure" refers to the pressure that an object receives when ultrasonic waves are applied to the object. A "push pulse" refers to a single ultrasonic wave. As the transducer 1, for example, an ultrasonic phased array is used.

[Effect of Embodiment 2]
According to the therapeutic apparatus according to the second embodiment, the transducer 1 (ultrasonic transducer, for example, an ultrasonic phased array) is driven by the transducer driving circuit 2 to generate push pulses by ultrasonic acoustic radiation pressure. Using this method, it is possible to transmit push pulses to the position where the fractured bone is likely to move without moving the ultrasonic element by controlling the time of the ultrasonic phased array, thereby fixing the ultrasonic element. This increases the degree of freedom in terms of method, installation location, etc., and makes it easier to displace the fractured bone 8a.

Note that the therapeutic apparatus according to Embodiment 2 is the same as the therapeutic apparatus 100 according to Embodiment 1 except that the bone 8 is displaced by a push pulse due to acoustic radiation pressure of ultrasonic waves. Among the effects of the therapeutic device 100, it has a corresponding effect.

[Embodiment 3]
FIG. 3 is a diagram for explaining the therapeutic device 130 according to the third embodiment.
The treatment apparatus 130 according to Embodiment 3 is basically the same as the treatment apparatus 100 according to Embodiment 1, but as shown in FIG. , the fracture site 81 side, the side opposite to the fracture site 81 side, or the location without the cast 91. These installation locations are outside the living tissue 9 surrounding the fractured bone 8a.

FIG. 3(a) shows a state in which the vibrator 1 (one) is installed at a place (a place between the cast 91 and the living tissue 9) on the fracture site 81 side of the cast 91 for fixing the fractured bone 8a. It is a figure (cross-sectional view) shown. The vibrator 1 is installed at an installation location P1 away from the fracture location 81, an installation location P2 close to the fracture location 81, or an installation location P3 closest to the fracture location 81.
FIG. 3(b) is a view (cross-sectional view) showing how the vibrator 1 (one) is installed on the opposite side of the fracture site 81 of the cast 91 that fixes the fractured bone 8a. Installation locations P1, P2 and P3 are the same as in FIG. The installation location P1 in FIG. 3B is the same as the installation location illustrated in FIG. 1 (Embodiment 1).
FIG. 3(c) is a view (cross-sectional view) showing how the vibrator 1 (one) is installed at a location where the cast 91 is not provided. The vibrator 1 is placed outside the living tissue 9 between the fracture site 81 and the joint 82 .

[Effect of Embodiment 3]
According to the treatment apparatus 130 according to the third embodiment, the vibrator 1 is fixed to the fractured bone 8a in consideration of the condition of the human or rat, the fracture condition, the vibration condition of the fractured bone 8a, the location of the cast 91, and the like. The vibrator 1 can be vibrated more accurately by installing the cast 91 on the fracture site 81 side, on the side opposite to the fracture site 81, or at a location without the cast 91. All of these installation locations are outside the living tissue 9 surrounding the fractured bone 8a, and non-invasive treatment is possible.
It should be noted that placing the vibrator 1 on the fracture site 81 side of the cast 91 or installing it at a place without the cast 91 is better than installing it on the side opposite to the fracture site 81 side of the cast 91 . Easy to displace.

Further, the treatment apparatus 130 according to Embodiment 3 is the same as the treatment apparatus 100 according to Embodiment 1 except for the installation locations (P2, . . . ) of the transducer 1. It has the corresponding effect among the effects of 100.

[Embodiment 4]
FIG. 4 is a diagram (explanatory diagram regarding installation locations when a plurality of transducers 1 are used) for explaining the therapeutic device 140 according to the fourth embodiment.
[Installation of a plurality of vibrators 1]
As shown in FIG. 4, a therapeutic device 140 according to Embodiment 4 is basically the same as the therapeutic device 100 according to Embodiment 1, except that a plurality (two) of transducers 1 are installed. different. These installation locations are outside the living tissue 9 surrounding the fractured bone 8a.

In FIG. 4( a ), two vibrators 1 are placed at different positions in the longitudinal direction (horizontal direction in the drawing) of the fractured bone 8 a sandwiching the fracture site 81 , and separated from the fracture site 81 by the same distance. Three examples of the case of using the location are shown. An installation point P21 indicates an installation point where the two vibrators 1 are equidistant from the fracture site 81 at the location where the cast 91 is present. An installation point P23 indicates an installation point where the two vibrators 1 are equidistant from the fracture site 81 at the location where the cast 91 is present. An installation point P24 indicates an installation point where the two transducers 1 are equidistant from the fracture site 81 without the cast 91 . Note that "equidistant" includes not only strictly equal distances but also approximately equal distances.

As shown in FIG. 4(a), the fractured

bones

8a and 8b are both subject to displacement. The fractured bone 8a is displaced in the direction D1 crossing the longitudinal direction D5 of the bone 8a, and the fractured bone 8b is displaced in the direction D2 crossing the longitudinal direction D6 of the bone 8b. In this figure, two vibrators 1, which are placed on the left and right sides of the fracture site 81 in the figure, are driven with waveforms shifted by 180° in opposite phases to displace the fractured

bones

8a and 8b in opposite phases. 4(b), see FIG. 5(c) which will be described later for drive waveforms).

In FIG. 4(b), two vibrators 1 are placed at different distances from the fracture site 81 in different longitudinal directions (horizontal direction in the drawing) of the fractured bone 8a across the fracture site 81. Two examples of the case of setting the location are shown. At the installation point P31, one of the two transducers 1 installed at the location where the cast 91 is located is installed near the fracture site 81, and the other transducer 1 is installed far from the fracture site 81. indicate the case. At the installation point P32, one of the two transducers 1 is installed at a location with a cast 91 near the fracture site 81, and the other transducer 1 is installed at a location far from the fracture site 81 without a cast 91. It shows the case where it is installed at a location.

FIG. 4(c) shows the case where the two vibrators 1 are installed in the same direction (right side in the drawing) from the fractured bone 81 in the longitudinal direction (horizontal direction in the drawing) of the fractured bone 8a. are shown as three examples. An installation location P41 shows the case where two transducers 1 installed at a location where the cast 91 is located are installed near the bone fracture location 81 . At the installation point P42, one of the two transducers 1 installed at the place where the cast 91 is located is installed near the fracture site 81, and the other transducer 1 is installed far from the fracture site 81. indicate the case. At the installation point P43, one of the two transducers 1 is installed at a location with a cast 91 near the fracture site 81, and the other transducer 1 is located far from the fracture site 81 without a cast 91. It shows the case where it is installed at a location.

In addition, when the vibrator 1 is installed at a place where the cast 91 exists, FIG. (illustration omitted).

[Driving of a plurality of vibrators 1]
FIG. 5 is a diagram (explanatory diagram of driving waveforms when a plurality of transducers 1 are used) for explaining the therapeutic device 140 according to the fourth embodiment. In order to make the explanation easier to understand, the number of vibrators 1 is set to two, and FIGS. FIG. 10 is a diagram showing waveforms (the displacement of the fractured bone 8a corresponds to the driving waveform of the transducer 1);
In the therapeutic device 140 according to the fourth embodiment, the plurality (two) of transducers 1 are driven by the transducer drive circuit 2 such that the amplitudes or drive timings are the same or different. The fractured bone 8a is displaced with corresponding amplitude or timing.

For ease of explanation, the two vibrators 1 will be referred to as first and second vibrators, and the drive waveforms will be W1 and W2, respectively.
FIG. 5A shows a case where drive waveforms W1 and W2 have the same amplitude and drive timing. Here, "same" includes not only completely the same but also almost the same.

FIGS. 5(b) to 5(d) show the case where at least one of the amplitude and the drive timing is different for two drive waveforms corresponding to two vibrators.

FIG. 5B shows a case where the drive waveforms W1 and W2 have the same drive timing but different amplitudes (the amplitude of W2 is greater than W1).
FIG. 5(c) shows a case where a set of drive waveforms W1 and W2 and a case where a set of drive waveforms W1 and W3 are used as drive waveforms for two vibrators. When using the set of drive waveforms W1 and W2, the amplitudes of W1 and W2 are the same, but the drive timings differ by 180°. When using a set of drive waveforms W1 and W3, W3 has a larger amplitude than W1 and the drive timing is also 180° different.
FIG. 5D shows a case where a set of drive waveforms W1 and W2 and a case where a set of drive waveforms W1 and W3 are used as drive waveforms for two vibrators. When using the set of driving waveforms W1 and W2, W1 and W2 have the same amplitude but the driving timing is different by 90°. When using a set of driving waveforms W1 and W3, W3 has a larger amplitude than W1 and the driving timing is also different by 90°.
Although trapezoidal waveforms are shown as the driving waveforms (W1, W2, W3) in FIG. 5, the driving waveforms may be rectangular waveforms, triangular waveforms, sine waveforms, or the like.

[Combination of Installation Locations of Plurality of Vibrators 1 and Drive Waveforms]
4(a) to (c) and the driving waveforms of the plurality of transducers 1 shown in FIGS. 5(a) to (d) are combined as follows. be.
For example, the combination of the installation positions of the plurality of transducers 1/the drive waveforms of the plurality of transducers 1 is shown in FIGS. a)/FIG. 5(c), FIG. 4(a)/FIG. 5(d), FIG. 4(b)/FIG. 5(a), FIG. 4(b)/FIG. 5(b), FIG. 4(b) / FIG. 5(c), FIG. 4(b) / FIG. 5(d), FIG. 4(c) / FIG. 5(a), FIG. 4(c) / FIG. 5(b), FIG. 4(c) / FIG. 5(c), or a combination of FIG. 4(c)/FIG. 5(d).

[Effect of Embodiment 4]
According to the therapeutic device 140 according to the fourth embodiment, by installing and driving a plurality of vibrators 1 as shown in FIGS. 4 and 5, it is possible to more easily vibrate the fractured bone 8a. . For example, even if one vibrator 1 is insufficient in power, using a plurality of vibrators 1 can provide sufficient power, disperse the load to suppress excessive load on the fractured bone 8a, and multiple vibrations. By placing the transducers apart, the power (load) on the bone 8a can be distributed. However, if two vibrators with half the power are placed apart, it is possible to avoid concentration of power in one place while displacing the same size), depending on the size of the bone to be vibrated, etc. One of the effects can be expected.

Note that the treatment apparatus 140 according to Embodiment 4 is the same as the treatment apparatus 100 according to Embodiment 1 except that a plurality of transducers 1 is used, and the effects of the treatment apparatus 100 according to Embodiment 1 are obtained. It has the corresponding effect.

[Embodiment 5]
The therapeutic device 150 according to Embodiment 5 is basically the same as the therapeutic device 100 according to Embodiment 1, but includes structure 7 (structure 7) impregnated with platelet-rich plasma (PRP). 7 is wrapped around the fracture site 81).

FIG. 6 is a diagram for explaining the therapeutic device 150 according to the fifth embodiment. As shown in FIG. 6, a therapeutic device 150 according to Embodiment 5 includes a structure 7 impregnated with platelet-rich plasma. This structure 7 is placed near the fracture site 81 .
A case where the therapeutic device 150 is used as a human or rat bone therapeutic device will be described. First, the body tissue (skin or muscle) at the fractured site is incised, and the structure 7 impregnated with platelet-rich plasma is placed in the vicinity of the fractured site 81 . As a mode of installing the structure 7 in the vicinity of the fracture site 81, as shown in FIG. (upper, lower, lateral, etc.), a mode in which it is placed so as to be sandwiched between the fractured

bones

8a and 8b, and a mode in which these are used in combination.

Platelet-rich plasma is a concentrate of platelets from rats to be treated. As the platelet-rich plasma-impregnated structure 7, for example, a thin membrane prepared by collecting human or rat cells and culturing them in a sheet form is impregnated with the human or rat platelet-rich plasma to be treated. Use Then, the incised portion is sutured. A cast 91 is formed thereon to fix the fracture site 81 . A vibrator 1 is placed on (or under) a cast 91 and fixed with a band 92 . Then, the vibrator 1 is driven by the vibrator drive circuit 2 to displace the fractured bone 8a.

[Effect of Embodiment 5]
According to the treatment apparatus 150 according to Embodiment 5, the structure 7 impregnated with platelet-rich plasma is installed near the fracture site 81, so the growth factors contained in the platelet-rich plasma (promoting repair of damaged tissue) substance) is delivered to the fracture site 81 . Therefore, the growth of callus and the like is further promoted, and early healing of the bone becomes possible.

Note that the treatment apparatus 150 according to Embodiment 5 is the same as the treatment apparatus 100 according to Embodiment 1 except that it further includes a structure 7 impregnated with platelet-rich plasma, and the effects of Embodiment 1 are as follows. have the corresponding effect.

[Embodiment 6]
7 and 8 are diagrams for explaining a bone treatment/diagnosis apparatus 300 according to Embodiment 6. FIG. 7 is a schematic explanatory diagram of the treatment/diagnosis apparatus 300, and FIG. 8 is a treatment/diagnosis apparatus. 3 is a flow chart for explaining the processing in 300;
[Configuration of therapeutic/diagnostic device 300]
As shown in FIG. 7, the treatment/diagnosis apparatus 300 according to the sixth embodiment includes a bone treatment apparatus 100 (see Embodiment 1) and a bone diagnosis apparatus 200 (bone diagnosis apparatus). The bone diagnostic apparatus 200 includes a sound wave emitter 3 that irradiates a sound wave to the fracture site 81, a sound wave emitter drive circuit 4 that drives the sound wave emitter 3, and a sound wave that detects reflected sound waves or residual sound waves from the bone fracture site 81. It has a detector 5 and a display unit 6 for visualizing the healing state of the fractured bone 8a from the detected sound waves.

A detailed description will be given below.
Since the bone treatment device 100 has been described in the first embodiment, the description thereof will be omitted.
The bone diagnostic device 200 will be described. When the sound wave irradiation command signal is input to the sound wave irradiation element drive circuit 4, a drive signal is output from the sound wave irradiation element drive circuit 4 to the sound wave irradiation element 3, and the sound wave irradiation element 3 made of a piezoelectric element such as a piezo is applied to the fracture site. 81 is irradiated with sound waves. The sound waves pass through the living tissue 9 . A sound wave detector 5 made of a piezoelectric element such as piezo detects reflected sound waves or residual sound waves from the bone fracture site 81 . A display unit 6 composed of a liquid crystal display device, an EL display device, or the like visualizes and displays the healing state of the fractured bone 8a from the sound waves detected by the sound wave detector 5. FIG. The bone diagnosis device 200 may be a wearable device.
Although the sound wave emitter 3 and the sound wave detector 5 are separate elements in FIG. 7, the sound wave emitter 3 may also serve as the sound wave detector 5 as is usually done. In this case, after irradiating sound waves, the same element detects reflected or residual sound waves in the radiated sound waves.

[Adjustment of Driving Conditions for Vibrator 1]
FIG. 8 is a flow chart for explaining a process (example) when the treatment/diagnosis apparatus 300 displaces the fractured bone 8a.
The bone treatment/diagnosis apparatus 300 according to the sixth embodiment may further include a drive condition adjustment circuit 28 (illustrated by a dotted line in FIG. 7). The drive condition adjustment circuit 28 is a circuit that can adjust the drive condition of the vibrator 1 with respect to the previous drive condition. The drive conditions of the vibrator 1 are, for example, drive parameters for driving the vibrator 1, such as drive frequency, amplitude, and waveform.

Description will be made with reference to FIGS. 7 and 8. FIG.
When the treatment/diagnosis apparatus 300 adjusts the drive conditions of the transducer 1, first, the transducer drive circuit 2 drives the transducer 1 to vibrate the transducer 1, thereby displacing the fractured bone 8a (FIGS. 8 and 8). step S71).
Before step S71, the structure 7 impregnated with platelet-rich plasma may be placed at the fracture site 81 (step S70).
Then, sound waves are emitted from the sound wave emitter 3 to the bone fracture site 81, reflected sound waves or residual sound waves are detected by the sound wave detector 5, and the bone fracture site 81 is displayed and visualized on the display unit 6 (step S73).

Then, it is determined whether or not it is necessary to further apply vibration to the fractured bone 8a to displace it (step S75). This determination is made based on, for example, the state of healing of the fractured bone 8a, the state of displacement of the fractured bone 8a, and the like. The subject of judgment is the treatment/diagnosis apparatus 300 itself, a doctor (veterinarian), a patient (when the treatment target is a person), or the like.
If it is unnecessary to further displace the fractured bone 8a (step S75, "unnecessary"), the process ends.

On the other hand, if it is necessary to further displace the fractured bone 8a (step S75, "required"), it is determined whether or not to change the driving conditions (amplitude or vibration frequency of the vibrator 1) (step S77).
If it is not necessary to change the driving conditions, the process proceeds to step S73, and the vibrator 1 is driven under the same driving conditions as before to displace the fractured bone 8a in the same manner as before.
If the drive condition needs to be changed, the process moves to step S79 and the drive condition is changed. Then, the process proceeds to step S73, and the vibrator 1 is driven under the changed drive conditions to displace the fractured bone 8a differently from before.

The drive conditions are changed (or maintained) by the drive condition adjustment circuit 28 indicated by the dotted line in FIG.
When the adjustment is performed automatically, the output of the display unit 6 (or the sound wave detector 5) is input to the drive condition adjustment circuit 28 as an adjustment instruction signal (automatic). The driving condition adjustment circuit 28 determines whether or not to change the driving condition based on the adjustment instruction signal (automatic). When the drive condition is to be changed, the vibrator drive command signal is adjusted (adjusted) and input to the vibrator drive circuit 2 . If the drive conditions are not changed, do not adjust.
In the case of manual adjustment, a doctor or the like manually inputs an adjustment instruction signal (manual) to the vibrator drive circuit 2 to change the drive conditions.

[Usage example of treatment/diagnosis device 300]
The therapeutic/diagnostic device 300 is used, for example, as follows.
When the fractured bone 8a is continuously displaced according to the healing state of the fractured bone 8a, the fractured bone 8a is displaced by driving the vibrator 1 under certain drive conditions for a certain period of time at a fixed time determined periodically. (Step S71). After a certain period of time, the driving of the vibrator 1 is stopped (the displacement of the fractured bone 8a is also stopped). A predetermined time passes in this state.
Then, before driving the vibrator 1 at a fixed time in the next cycle (for example, the next day), the healing state of the bone fracture site 81 is visualized with sound waves (S73). When it is determined that it is unnecessary to continue displacing the fractured bone 8a because it has healed (S75), the driving of the vibrator 1 is stopped after this cycle. When it is determined that it is necessary to continue displacing the fractured bone 8a (S75), it is further determined whether or not to change the drive conditions (S77), and the vibrator is operated under the drive conditions adjusted by the drive condition adjusting circuit 28. 1 is driven to displace the fractured bone 8a.

In addition, there are cases where it is desired to provide suitable drive conditions for the vibrator 1 for appropriately displacing the fractured bone 8a. This case will be described with reference to FIG. 8. For example, the vibrator 1 is driven under certain driving conditions at an arbitrary time to displace the fractured bone 8a (step S71). While the vibrator 1 is driven to displace the fractured bone 8a, sound waves are applied to the bone fracture site 81 to check the displacement state of the fractured bone 8a on the display unit 6 (S73). If the displacement (amplitude) of the fractured bone 8a is too large, too small, too fast (frequency), too slow, etc., the driving conditions are adjusted by the driving condition adjustment circuit 28 (S75, S77), and the vibrator 1 to displace the fractured bone 8a, check the displacement state, and adjust the driving conditions. In this way, an appropriate drive condition is generated and used (the drive condition is applied to S71 in the treatment processing flow chart of FIG. 8).

[Effect of Embodiment 6]
According to the bone treatment/diagnosis apparatus 300 according to the sixth embodiment, since both the bone treatment apparatus 100 and the diagnosis apparatus 200 are provided, early healing of the fractured bone 8a by the treatment apparatus 100 and healing by the diagnosis apparatus 200 can be achieved. Accurate diagnosis of the situation becomes possible. As described above, the bone treatment apparatus 100 includes the predetermined oscillator 1 and oscillator drive circuit 2, and early healing and the like are possible by using these. Moreover, since the diagnostic apparatus 200 has the sound wave emitter 3, the sound wave emitter driving circuit 4, the sound wave detector 5, and the display unit 6, accurate diagnosis can be performed by using these. It is also possible to repeat a cycle in which, after treatment with the treatment device 100, the healing status is diagnosed with the diagnosis device 200, and treatment is performed again with the treatment device 100 according to the status or based on feedback of the status. .

According to the bone treatment/diagnosis apparatus 300 according to the sixth embodiment, since the drive condition adjustment circuit 28 is further provided, when the displacement of the fractured bone 8a is desired to be changed, the previous drive condition of the vibrator 1 can be used. Since the driving condition can be adjusted (changed) by changing the

[Embodiment 7]
FIG. 9 is a diagram for explaining a therapeutic/diagnostic device 310 according to the seventh embodiment.
The bone therapeutic/diagnostic device 310 according to the seventh embodiment is basically the same as the bone therapeutic/diagnostic device 300 according to the sixth embodiment, except that the transducer drive circuit 2 and the sound wave emitter drive circuit 4 ( 7) is configured by a vibrator/sound wave emitter driving circuit 20 integrating both as shown in FIG.

As shown in FIG. 9 , a bone treatment/diagnosis apparatus 310 according to the seventh embodiment includes a transducer/sound wave emitter drive circuit 20 . The vibrator/sound wave emitter drive circuit 20 includes a command signal determination circuit 21, a drive signal generation circuit 27, and switches 25A and 25B.
A command signal for driving the elements (1, 3) is input to the vibrator/sound wave emitter drive circuit 20 . The command signal discrimination circuit 21 discriminates whether the command signal is a command signal for driving the transducer 1 or the sound wave emitter 3, and outputs it to the drive signal generation circuit 27 (the sound wave detector 5 driven at the same time as child 3 or after a predetermined time).

The drive signal generation circuit 27 has an oscillator 23, a frequency adjustment circuit 22, and D/

A conversion circuits

24A and 24B. The oscillator 23 outputs a reference signal to the frequency adjustment circuit 22 using a crystal oscillator, a ceramic oscillator, or the like. In accordance with the determination signal from the command signal determination circuit 21, the frequency adjustment circuit 22 receives the reference signal from the oscillator 23 at the same frequency, or divides or multiplies the frequency, and outputs it to the transducer 1 or the sound wave detector 5. , and output to the D/

A conversion circuit

24A or 24B.

The D/

A conversion circuit

24A or 24B converts the drive signal (digital signal) from the frequency adjustment circuit 22 into a drive signal (analog signal) for the vibrator 1 or the sound wave detector 5 and outputs it to the

switches

25A and 25B. do.
The

switches

25A and 25B are opened and closed according to the determination output from the command signal determination circuit 21. FIG. In the case of the determination output for driving the vibrator 1, the switch 25B is opened and the vibrator 1 is driven. In the case of the determination output for driving the sound wave emitter 3, the switch 25A is opened and the sound wave emitter 3 is driven.

Note that if the output of the frequency adjustment circuit 22 can directly drive the transducer 1 or the sound wave emitter 3, the D/

A conversion circuits

24A and 24B are unnecessary. A buffer circuit or the like may be provided in front of the vibrator 1 or the sound wave emitter 3 in order to drive the vibrator 1 or the sound wave emitter 3 with sufficient power.

[Effect of Embodiment 7]
According to the bone treatment/diagnosis apparatus 310 according to the seventh embodiment, the transducer driving circuit and the sound wave irradiation element driving circuit are configured by the transducer/sound wave irradiation element driving circuit 20 in which both are integrated. It is possible to downsize the therapeutic/diagnostic device 310 .

In the bone treatment/diagnosis apparatus 310 according to the seventh embodiment, the vibrator drive circuit and the sound wave emitter drive circuit are configured by the vibrator/sound wave emitter drive circuit 20 in which both are integrated. As for the points, it is the same as the bone treatment/diagnosis apparatus 300 according to the sixth embodiment, and has the corresponding effect among the effects of the sixth embodiment.

[Embodiment 8]
FIG. 10 is a diagram for explaining a therapeutic device 180 according to Embodiment 8. FIG. The therapeutic device 180 according to the eighth embodiment is basically the same as the therapeutic device 100 according to the first embodiment. The difference is that a camshaft is used.

As shown in FIG. 10 , in the therapeutic device 180 , the vibrator 1 is a cam shaft composed of a cam plate 11 , grooves 12 , etc. (cam) and a shaft 13 . This camshaft is a so-called front cam. In addition, in FIG. 10, the cam plate 11 and the like are deformed and enlarged to facilitate understanding of the structure.
To explain the outline of the treatment apparatus 180, a motor (not shown), a cam plate 11 and the like are mounted on a frame 16 constituting a pedestal, and a band 92 is placed on the living tissue 9 (muscle etc.) in the vicinity of the fracture site 81. , and is installed so as to be in a predetermined arrangement position with respect to the bone 8a. A circular (or elliptical) groove 12 (formed on the side surface of the cam plate 11) formed eccentrically with respect to the rotary shaft 14 is formed by rotating the cam plate 11 (driving node) about the rotary shaft 14. A shaft 13 (follower) that rotates and is in sliding or rolling contact with the groove 12 moves along the groove and is guided by guides 17 formed in the frame 16 to reciprocate linearly in the direction of the fractured bone 8a. . The pressure of the linear reciprocating motion of the shaft 13 is transmitted to the bone 8a, mechanically displacing the bone 8a up and down.

In addition, as shown by the dotted line in the lower left of FIG. 10, a similar camshaft (composed of cam plate 11, shaft 13, etc.) is also installed on the lower side of the other fractured bone 8b (on the side opposite to the installation side with respect to bone 8a). may be set. In the illustrated example, when the shaft 13 (upper right) on the side of the bone 8a descends and moves to push the bone 8a downward, the shaft 13 (lower left) on the side of the bone 8b rises at the same timing (in the same phase). and pushes the bone 8b upward, making it possible to further increase the difference in displacement between the fractured

bones

8a and 8b as compared to the case where there is only one camshaft.

In addition, when installing the vibrator 1 of the camshaft at a place where the cast 91 (see FIG. 1) exists, for example, the frame 16, the cam plate 11, etc. are installed outside the cast 91, and the band 92 is wound to fix them. Then, the shaft 13 is linearly reciprocated through a through hole formed in the cast 91 (not shown).
Alternatively, the frame 16, the cam plate 11, etc. are installed inside the cast 91 (on the side of the living tissue 9) so that the shaft 13 can reciprocate linearly through a through hole formed in the cast 91 (not shown). In this case, the band 92 may be wrapped around the cast 91 , but the band 92 may be omitted so that the cast 91 also serves as the band 92 .
Also, the cams forming the camshaft are not limited to front cams, and may be spherical cams, cylindrical cams, or the like.

Further, the shaft 13 shown in FIG. 10 has an elongated rod-like shape with a uniform thickness (the major axis is in the linear reciprocating direction), but the tip is elongated in the linear reciprocating direction and thick at a predetermined distance from the tip. It may be shaped (not shown). As a result, when the living tissue 9 is pushed by the shaft 13 and dented to a predetermined depth, the thick portion of the shaft 13 comes into contact with the periphery of the dent, preventing the distal end of the shaft 13 from advancing any further. Further, the bone 8a may be prevented from being displaced more than a predetermined amount, or the distal end of the shaft 13 may be prevented from sticking into the living tissue 9 and damaging it.

[Effect of Embodiment 8]
According to the treatment apparatus 180 according to the eighth embodiment, by using the camshaft as the oscillator 1, the vibration of the oscillator 1 (linear reciprocating motion of the camshaft) is not dispersed, and the fractured bone 8a (8b) is treated. It is possible to more reliably displace (vibrate) the fractured bone 8a (8b).
Note that the treatment apparatus 180 according to Embodiment 8 is the same as the treatment apparatus 100 according to Embodiment 1 except that a camshaft is used as the oscillator 1, and the effects of the treatment apparatus 100 according to Embodiment 1 are as follows. have the corresponding effect.

[Modification]
Although the present invention has been described based on the above embodiments, the present invention is not limited to the above embodiments. Modifications are possible without departing from the gist of the invention. For example, the following modifications are also possible.

(1) In the first embodiment described above, an eccentric rotating mass type vibration motor is used as the transducer 1, but the transducer used in the bone treatment apparatus or the like of the present invention is limited to an eccentric rotating mass type vibration motor. not a thing For example, it is a linear resonance actuator type vibration motor that incorporates a weight connected to a spring, pushes the weight into the spring with the force of electromagnetic induction, and stops the electromagnetic induction to move the weight with the reaction of the spring. good too. A pneumatic pole vibrator, a piezoelectric vibrator, or the like may be used.

(2) In the eighth embodiment, a camshaft is used as the vibrator 1 to perform linear reciprocating motion, but the linear reciprocating motion mechanism is not limited to the camshaft. For example, a linear reciprocating motion mechanism using a linear drive motor or the like may be used. may be a mechanism (oscillator 1) that creates

DESCRIPTION OF SYMBOLS 1... Vibrator 2...

Vibrator drive circuit

2, 20... Vibrator/sound wave emitter drive circuit 21... Command signal discrimination circuit 22... Frequency adjustment circuit 23...

Oscillator

24A, 24B... D/A conversion circuit , 25A, 25B... switch, 27... drive signal generation circuit, 3... sound wave emitter, 4... sound wave emitter drive circuit, 5... sound wave detector, 6... display unit, 7... structure, 8a, 8b... fractured Bone 81 Fracture site 9 Living tissue 91 Cast 92 Band 20 Vibrator/sound wave irradiation element drive circuit 28 Drive

condition adjustment circuit

100, 110, 200, 210

Treatment device

300 , 310... treatment/diagnosis apparatus, P1, P2, P3, P21, P22, P23, P31, P32, P41, P42, P43... installation location, W1, W2, W3... drive waveform

Claims

A fractured bone treatment device comprising:
a vibrator installed at the fractured part so as not to be in direct contact with the fractured bone;
a vibrator drive circuit that drives the vibrator so that the fractured bone is displaced;
A bone treatment device comprising:
A bone treatment device according to claim 1, wherein
A bone treatment apparatus, wherein the fractured bone is displaced in a direction intersecting the longitudinal direction of the bone using the oscillator and the oscillator drive circuit.
The bone treatment device according to claim 1 or 2,
A bone treatment apparatus, wherein a vibration motor, an ultrasonic transducer, or a camshaft is used as the transducer.
The bone treatment device according to any one of claims 1 to 3,
A bone treatment apparatus, wherein the vibrator is driven by the vibrator driving circuit at a predetermined cycle, and the fractured bone is displaced at the cycle.
The bone treatment device according to any one of claims 1 to 4,
The treatment of bone, wherein the vibrator is driven by the vibrator drive circuit to generate mechanical displacement, and the mechanical displacement of the vibrator displaces the fractured bone. Device.
The bone treatment device according to any one of claims 1 to 4,
Bone treatment, wherein the transducer is driven by the transducer driving circuit to generate a push pulse by acoustic radiation pressure of ultrasonic waves, and the push pulse displaces the fractured bone. Device.
The bone treatment device according to any one of claims 1 to 6,
A bone treatment apparatus, wherein the vibrator is installed at a location on the fracture site side of a cast that fixes the fractured bone, at a location on the opposite side, or at a location without the cast.
The bone treatment device according to any one of claims 1 to 7,
A bone treatment device, further comprising a structure impregnated with platelet-rich plasma, wherein the structure is placed near a fracture site.
A bone therapeutic/diagnostic device for treating and diagnosing a bone,
a bone treatment device according to any one of claims 1 to 8;
A sound wave emitter that irradiates a sound wave to a fracture site, a sound wave emitter drive circuit that drives the sound wave emitter, a sound wave detector that detects a reflected sound wave or a residual sound wave from the bone fracture site, and a bone from the detected sound wave. a bone diagnosis device having a display for visualizing the healing state;
A bone treatment/diagnosis device comprising:
In the bone treatment/diagnosis device according to claim 9,
A bone treatment/diagnosis apparatus, wherein the transducer driving circuit and the sound wave irradiation device driving circuit are configured by a transducer/sound wave irradiation device driving circuit in which both are integrated.
In the bone treatment/diagnosis device according to claim 9 or 10,
A bone treatment/diagnosis apparatus, further comprising a driving condition adjusting circuit capable of adjusting the driving condition of the vibrator with respect to the previous driving condition.