JP2009006066A - Guide instrument for orthopedic surgery on bone part - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a guide instrument for orthopedic surgery on bone part, where an angle is easily changed and a compact angle adjusting part is arranged. <P>SOLUTION: The guide instrument 1 for the orthopedic surgery on bone part includes: a body 10 to be arranged in the reference part 98 of the bone part 90 to be orthopedically operated in the orthopedic surgery on bone part; and an angle regulating part 20 to be extended by prescribed angle with respect to the reference part 98. The angle regulating part 20 is pivotally supported by a support part 40 so as to be shaft-rotatable with respect to the body 10. The opening angle between the body 10 and the angle regulating part 20 with the support part 40 as a center is adjusted by the angle adjusting part 30. The angle adjusting part 30 includes an eccentric cam arranged between the body 10 and the angle regulating part 20, thereby adjusting the opening angle by rotating the eccentric cam and changing an interval between the body 10 and the angle regulating part 20. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to an instrument used to determine an osteotomy surface when shaping a bone, and more particularly to an instrument that defines a defined surface or defined line having a desired angle with respect to a reference site of a body part.

  The knee prosthesis includes a femoral component that is secured to the distal femur and a tibial component that is secured to the proximal tibia. Before installing these components, the distal part of the femur and the proximal part of the tibia are osteotomized and shaped into a predetermined shape. However, in order to install the components in the optimum position, strict osteotomy accuracy is required. .

  In the example of shaping the distal part of the femur shown in FIGS. 8 and 9, the distal part 92 of the femur 90 is cut with five osteotomy surfaces (A to E in the drawings). As the order of osteotomy, a surface A substantially perpendicular to the axis I of the femur 90 and a surface B substantially parallel to the axis I are osteocutted, and then the surfaces C to E are osteocutted. Since the surface A and the surface B serve as a reference for the other surfaces C to E, it is necessary to cut the bone in an accurate direction. Therefore, a bone-shaping guide device that can accurately define the osteotomy surface based on the reference surface or line of the femur 90 is used.

  For cutting the surface B, a bone-shaping guide instrument 1002 as shown in FIG. 10 and a cut guide 2024 as shown in FIG. 11 are used. The cut guide holder 2020 is positioned at a desired angle with respect to the femur 90 by the guide device 1002, and then the cut guide 2024 is attached to the cut guide holder 2020 to perform bone cutting of the surface B.

  A guide instrument 1002 of FIG. 10 is screwed to a guide gauge 2010 and a guide cage 2010 installed on a surface (inner and outer condyle outer surface 98) connecting the posterior surface of the medial condyle 94 and the posterior surface of the lateral condyle 96 of the femur 90. A guide bar 2030 and a cut guide holder 2020 having a groove for slidingly inserting the guide bar 2030 are included. The cut guide holder 2020 positioned at a desired position and angle is fixed to the femur 90 with a pin 1050. Thereafter, the guide gauge 2010 and the guide bar 2030 are removed, and the guide bar 2026 of the cut guide 2024 is slid into the groove of the cut guide holder 2020 into which the guide bar 2030 has been inserted (FIG. 11). The cutting edge is guided by the slit 2028 of the cut guide 2024 to cut the surface B.

  In order to change the angle of the surface B with respect to the external surface 98 of the internal and external condyles, the guide gauge 2010 of the guide device 1002 in FIG. 10 is changed. FIG. 10 shows an example in which a guide gauge 2010 designed so that the outer surface 98 of the inner and outer condyles 98 and the upper surface 2022 of the cut guide holder 2020 rotate 3 ° is used. Since the upper surface 2022 of the cut guide holder 2020 is designed to be parallel to the slit 2028 of the cut guide 2024, as a result, the angle between the outer surface 98 and the slit 2028 of the inner and outer condyles, that is, the outer surface 98 and the surface of the inner and outer condyles. The angle with B turns 3 °.

  For osteotomy of plane A, a bone-shaping guide instrument 1001 as shown in FIG. 12 is used. The guide instrument 1001 includes a rod 1010 inserted along the axis I of the femur 90 from the distal portion 92 of the femur 90, a cylindrical rod guide 1014 that passes through the rod 1010, and a support portion 1040 on the rod guide 1014. And an angle adjusting unit 1030 for adjusting an angle formed by the rod guide 1014 and the angle defining unit 1032 with the support unit 1040 as a center. Further, two connection shafts 1026 are inserted and fixed near the end face of the angle defining portion 1032, the two connection shafts 1026 are connected by an attachment 1028, and one end of the pole 1024 is fixed to the attachment 1028, A cut guide 1020 is fixed to the other end of the pole 1024. The cut guide 1020 is formed with a slit 1022 for guiding the cutting edge, and the surface A is cut along the slit 1022.

The angle adjusting unit 1030 is attached to the rod guide 1014 so as to face the scale 1036 and a scale 1036 attached to the inside of the window part, a substantially pentagonal window part 1034 formed in the angle defining part 1032, and an indicator. 1012 mainly.
In order to adjust the angle between the rod 1010 and the cut guide 1020 using the angle adjuster 1030, the indicator 1012 is set to a desired position of the scale 1036. Depending on the position of the scale 1036 for aligning the indicator 1012, the angle defining portion 1032 rotates around the support portion 1040 in either the direction r ₁ or r ₂ , and accordingly the cut guide 1020 is also set to R ₁ or R ₂ . Rotate in either direction. As a result, the slit 1022 of the cut guide 1020 can be rotated with respect to the axis of the rod 1010 inserted into the rod guide 1014 (that is, the axis I of the femur 90).

  Further, in the bone shaping guide device 1002 as shown in FIG. 10, when changing the angle of the surface B with respect to the outer surface 98 of the inner and outer condyles, it is necessary to replace the guide gauge 2010 with a different setting angle. Was cumbersome.

  In the bone shaping guide device 1001 as shown in FIG. 12, in order to adjust the angle between the rod 1010 and the cut guide 1020 at a small angle pitch, for example, 1 ° pitch, the support portion 1040 and the scale 1036 It is necessary to lengthen the distance. However, in recent minimally invasive surgery (MIS), it is required to reduce the size of an instrument inserted from an incision. Therefore, a smaller angle adjuster than the angle adjuster 1030 as shown in FIG. 12 is required.

  Therefore, an object of the present invention is to provide a bone-shaping guide device that is easy to change the angle and includes a small angle adjustment unit.

  The present invention provides a bone shaping guide comprising a main body arranged at a reference portion of a bone portion to be shaped and an angle defining portion that can extend at a predetermined angle with respect to the reference portion when shaping a bone portion. The angle defining portion is pivotally supported on the main body by a support portion so that the shaft can rotate, and an opening angle between the main body and the angle defining portion around the support portion is adjusted by the angle adjusting portion. The angle adjusting portion has an eccentric cam disposed between the main body and the angle defining portion, and rotating the eccentric cam to change an interval between the main body and the angle defining portion. The opening angle is adjusted.

  Since the angle of the bone-shaping guide device of the present invention can be changed by simply rotating the eccentric cam, it is not necessary to replace the guide gauge 2010 as shown in FIG. 10, and simple angle change is possible. In addition, the bone-shaping guide device of the present invention can be made smaller than that in FIG. 12 by using an eccentric cam in the angle adjusting unit.

Embodiment 1
1 to 4 show the bone-shaping guide device 1 according to the first embodiment, which defines the osteotomy surface of the surface B in FIGS. 8 and 9 with the posterior surface 98 of the medial / lateral condyle as a reference site. . In addition, in FIG. 1, although the example which uses the guide instrument 1 after cutting the bone in the surface A is shown, it can also be used before cutting the surface A.

The guide device 1 includes a main body 10 that is installed in accordance with the posterior surface 98 of the femoral 90, an angle defining portion 20 for defining an angle with respect to the posterior surface 98 of the medial and external condyles, and a main body 10 and an angle defining portion. 20, and a support portion 40 that pivotally supports the shaft 20, and an angle adjustment portion 30 for adjusting an angle between the main body 10 and the angle defining portion 20.
Since the guide device 1 according to the present embodiment includes the angle adjusting unit 30 that did not exist in the conventional bone shaping guide device 1002 (FIG. 10), the medial / lateral condylar posterior surface 98 and the angle defining unit 10 are provided. Is easy to adjust the angle between.

  The main body 10 is a member for positioning the guide device 1 with respect to the posterior surface 98 of the medial / lateral condyle, and in this embodiment, is the plate 12 that contacts the posterior surface 98 of the medial / lateral condyle. The guide device 1 is installed with reference to a surface (referred to as a plate main surface 12c) that contacts the posterior surface 98 of the medial and external condyles of the plate 12.

  The angle defining portion 20 has a defining surface 20c for determining the direction of the surface B to be cut. In the present embodiment, the guide bar 26 is formed in the direction 28 perpendicular to the defining surface 20c. When the pin guide 60 (see FIG. 1) is slid into the guide bar 26 and the pin is driven into the distal portion 92 of the femur 90 along the through-hole 62 of the pin guide 60, the pin is in relation to the defining surface 20c. It is fixed in a predetermined direction. Two pins are driven using the two through holes 62, and a cut guide (not shown) having a cutting edge guide slit is inserted into the two pins, so that the direction of the surface B is finally changed. decide. In this way, the surface B is determined with respect to the defining surface 20c of the angle defining unit 20.

  The support portion 40 is configured by inserting a support shaft 44 into the shaft hole 14 formed in the plate 12 and the shaft hole 24 of the angle defining portion 20. The support shaft 44 pivotally supports the angle defining portion 20 on the plate 12. That is, the angle defining portion 20 can rotate about the support portion 40 with respect to the plate 12. In the present embodiment, the shaft hole 14 of the plate 12 is formed near the end of the plate 12, and the shaft hole 24 of the angle defining unit 20 is also formed near the end of the angle defining unit 20. As described above, when the end of the angle defining portion 20 is pivotally supported on the end of the plate 12 by the support portion 40, the distance between the support portion 40 and the angle conversion portion 30 can be increased. The change interval (pitch) of the angle θ (see FIG. 3) formed by the main surface 12c and the defining surface 20c of the angle defining portion 20 can be reduced. In this specification, the angle θ is referred to as “opening angle θ”.

  The angle adjusting unit 30 includes an eccentric cam 32 having an outer peripheral surface 321 and a cam shaft surface 322, an opening (cam hole 16) formed in the angle defining unit 20 for receiving the outer peripheral surface 321, and a cam shaft surface. It is mainly composed of an opening (cam frame 22) formed in the plate 12 for receiving 322. The eccentric cam 32 used in this specification is a combination of two cylindrical members having different diameters so that the center point of the circle on the bottom surface thereof is shifted (ie, eccentric). The “outer peripheral surface 321” of the eccentric cam 32 refers to the side surface of the large-diameter cylindrical member, and the “cam shaft surface 322” refers to the side surface of the small-diameter cylindrical member. The cam hole 16 of the angle defining portion 20 is formed in a dimensional shape that allows the outer peripheral surface 321 of the eccentric cam 32 to be inserted and that allows the outer peripheral surface 321 to slide. The cam frame 22 is a substantially long rectangular frame-like member having a window portion 22a, and its long side is oriented in a direction parallel to the plate main surface 12c of the main body, and its short side is oriented in a direction perpendicular to the plate main surface 12. ing. The short side direction of the window portion 22a is set to such a dimension that the cam shaft surface 322 of the eccentric cam 32 can be inserted and the cam shaft surface 322 can be rotated.

  In the present embodiment, the angle adjustment unit 30 is disposed between the free end of the plate 12 and the support unit 40. Here, the “free end” refers to an end portion that is not fixed with respect to an end portion (fixed end) fixed by the support portion 40. The angle adjustment unit 30 is disposed between the free end of the plate 12 and the support unit 40 (that is, the angle adjustment unit 30 is disposed between the free end of the angle defining unit 20 and the support unit 40. Therefore, it is not necessary to increase the dimensions of the plate 12 and the angle defining portion 20 in order to install the angle adjusting portion 30 of the plate 12 and the angle defining portion 20, and it is suitable for downsizing the guide device 1. Yes. Furthermore, if the angle adjusting part 30 is formed at a position close to the free ends of the plate 12 and the angle defining part 20, the distance between the support part 40 and the angle adjusting part 30 is increased, and the pitch of the opening angle θ is reduced. It is advantageous.

  With reference to FIGS. 5A to 5D, the operation of the angle adjustment unit 30 using the eccentric cam 32 will be described. In this example, the guide device 1 for cutting the distal portion 92 of the femur 90 of the left leg is illustrated, and it is assumed that an angle is provided in the external rotation direction.

FIG. 5A shows a state where the opening angle θ ₀ is 0 °, that is, a state where the plate main surface 12c of the plate 12 and the defining surface 20c of the angle defining portion 20 are parallel. The center O ₁ of the bottom surface of the cam shaft surface 322 (referred to herein as “axis center O ₁ ”) and the center O ₂ of the bottom surface of the outer peripheral surface 321 (referred to herein as “cam center O ₂ ”). line connecting OL is, to be perpendicular to the plate main surface 12c of the plate 12, and, as the axial center O ₁ is located between the cam center O ₂ and the plate 12, rotation of the eccentric cam 32 The position is adjusted. This state can be expressed using an arrow Y ₀ (referred to herein as “cam direction Y ₀ ”) extending from the cam center O ₂ through the shaft center O ₁ to the cam shaft surface 322 of the eccentric cam 32. , Y ₀ can be described as being perpendicular to the plate main surface 12 c of the plate 12.
5A is a state in which the free end of the angle defining portion 20 is farthest from the plate 12. This is because the point far from the plate 12 among the intersections of the line OL and the outer peripheral surface 321, and the plate 12 This means that the distance d ₀ (referred to as “cam height d ₀ ” in this specification) with the plate main surface 12c is the largest.

5B is a cam direction _{Y 1} of the eccentric cam 32, a state of being rotated by an angle phi ₁ clockwise from _{Y 0} in Figure 5A. By this rotation, the cam height d ₁ becomes smaller than d _{0 and} the free end of the angle defining portion 20 approaches the plate 12. As a result, the opening angle θ ₁ changes from θ ₀ = 0 ° in FIG. 5A. Here, if the rotation of the angle defining portion 20 so that the free end approaches the plate 12 is a “positive direction” rotation, the opening angle θ ₁ is larger than 0 °. This corresponds to rotating the direction of the surface B externally.

Figure 5C, the cam direction _{Y 2} of the eccentric cam 32, a state of being rotated from _{Y 0} in a clockwise angle phi only ₂ (φ ₁ <φ ₂₎ of FIG. 5A, FIG. 5D cam direction Y of the eccentric cam 32 ₃ is a state rotated clockwise by an angle φ ₃ (φ ₂ <φ ₃ ) from Y ₀ in FIG. 5A. By these rotations, the cam heights d ₂ and d ₃ are further reduced in the order of d ₁ > d ₂ > d ₃ , and the free end of the angle defining portion 20 is further brought closer to the plate 12. The opening angles θ ₂ and θ ₃ increase in the order of θ ₁ <θ ₂ <θ ₃ , and accordingly, the external rotation angle of the surface B further increases.

As described above, the angle adjusting unit 30 shown in FIGS. 5A to 5D is suitable for cutting the femur 90 of the left leg. If the angle adjustment unit 30 of the present embodiment is changed for the right leg femur 90, the cam height is opposite to FIG. 5A when the opening angle is θ ₀ = 0 ° as shown in FIG. 5A. may be designed so that d ₀ is minimized is. That is, the opening angle may be designed to be θ ₀ = 0 ° when the cam direction Y ₀ in FIG. 5A is arranged in the reverse direction (a state rotated by 180 °).
As another method for changing to the right leg, the cam direction and the cam height can be changed by changing the formation positions of the end (fixed end) that pivotally supports the plate 12 and the angle defining portion 20 and the free end. Without changing, the angle adjusting unit 30 for the right leg can be obtained.

Further, in order to obtain the angle adjusting unit 30 for both the right leg and the left leg, the cam height d ₀ is an intermediate value between the maximum and the minimum when the opening angle is θ ₀ = 0 ° as shown in FIG. 5A. Should be designed as follows. That is, when placed in a state in which the cam direction Y ₀ is rotated 90 ° in FIG. 5A, it may be designed so that the opening angle is θ _{0 = 0} °. Thus, by changing the rotation direction of the cam from the state where the opening angle θ = 0 °, the free end of the angle defining portion 20 can be moved closer to or away from the plate 12, and angle adjustment for both the left and right legs can be performed. Part 30 is obtained.

  The cam hole 16 of the angle defining portion 20 can include a lock mechanism 50 (see FIG. 3) that can temporarily fix the eccentric cam 32. In the present specification, the “lock mechanism 50” means that when a certain amount of stress is applied in the direction in which the eccentric cam 32 is to be rotated, the lock is released and the eccentric cam 32 is rotated. This is a mechanism for preventing the cam 32 from rotating. The lock mechanism 50 can maintain the state where the eccentric cam 32 is rotated to a predetermined position. For the lock mechanism 50, a known technique such as a ball plunger can be used. In the case where a ball plunger is used for the lock mechanism 50, as shown in FIG. 4, if a dimple (indentation) 34 is provided on the outer periphery of the outer diameter portion 321 of the eccentric cam 32, the ball plunger ball is moved to the dimple. It is preferable that the eccentric cam 32 can be reliably locked by being fitted to 34. The formation position of the dimple 34 is preferably determined so that the eccentric cam 32 is locked at a desired position.

  It is preferable that the angle adjusting unit 30 can adjust the opening angle θ with a 1 ° pitch, and the external rotation angle of the surface B can be adjusted with a 1 ° pitch considered to be necessary in general surgery. . At this time, if the eccentric cam 32 is locked at a pitch of 1 °, it is more preferable because the opening angle θ can be easily adjusted. In order to adjust the lock position, the position of the eccentric cam 32 corresponding to the change of the opening angle θ by 1 ° is calculated, and the lock mechanism 50 (for example, a ball plunger) is fitted to the dimple 34 at the calculated position. The dimple 34 may be formed.

  The plate 12 is preferably separated into two parts: an inner plate 12 a that contacts the medial condyle 94 of the femur 90 and an outer plate 12 b that contacts the lateral condyle 96. During the operation, the ligament attached to the distal portion 92 of the femur 90 is positioned in the recess between the plates 12a and 12b, so that the plate main surface 12c is placed on the medial / lateral condylar posterior surface 98 without damaging the ligament. Can be contacted.

  A dial 36 is fixed to the eccentric cam 32 of FIG. 4 on the outer peripheral surface 321 side. As shown in FIG. 1, the dial 36 can be formed with a scale indicating a change in the opening angle θ when the eccentric cam 32 is rotated and an anti-slip groove when the eccentric cam 32 is rotated.

  The guide device 1 according to the present embodiment can use the cut guide holder 2020 in FIG. 10 instead of the pin guide 60 used in FIG. 1 to fix the cut guide 2024 in FIG. 11 to the cut guide holder 2020. .

  The plate 12, the angle defining portion 20, the support shaft 44, the eccentric cam 32, and the dial 36 can be formed of a material that is safe and sterilizable with respect to a living body, for example, a metal material such as stainless steel or titanium.

Embodiment 2
6 and 7 show the bone shaping guide instrument 101 according to the second embodiment, which defines the osteotomy plane of the plane A in FIGS. 8 and 9 with the axis I of the femur 90 as a reference site. is there.

The guide instrument 101 includes a main body 110 installed in accordance with the axis I of the femur 90, an angle defining unit 120 for defining an angle with respect to the axis I of the femur 90, a main body 110, and an angle defining unit 120. A support portion 140 that pivotally supports the shaft 110 and an angle adjusting portion 130 for adjusting an angle between the main body 110 and the angle defining portion 120.
In the conventional bone shaping guide device 1001 (FIG. 12), the angle is adjusted by the large window portion 1034 of the angle adjustment unit 1030, whereas in the guide device 101 of the present embodiment, the angle is adjusted by the eccentric cam 132. Since the adjustment is performed, the angle adjusting unit 130 can be reduced in size.

  The main body 110 is a member for positioning the guide instrument 101 with respect to the axis I of the femur 90. In the present embodiment, the main body 110 is a cylindrical rod guide 118 capable of inserting and fixing the rod 112 inserted along the axis I from the distal portion 92 of the femur 90. The guide instrument 101 is installed with reference to the axis (rod axis) 112c of the rod 112.

  The angle defining unit 120 has a defining surface 120c for determining the direction of the surface A to be cut. In the present embodiment, two holes 128 are formed in parallel with the defining surface 120c, and two connection shafts 166 are inserted into the holes. The two connection shafts 166 are connected by an attachment 168, and one end of the pole 164 is fixed to the attachment. The direction of the surface B is finally determined by fixing the cut guide 160 having the cutting edge guide slit 162 to the other end of the pole 162. In this way, the surface A is determined with respect to the defining surface 120c of the angle defining unit 120.

  The support portion 140 is configured by inserting a support shaft 144 into the shaft hole 114 formed in the rod guide 118 and the shaft hole 124 of the angle defining portion 120. The support shaft 144 pivotally supports the angle defining portion 120 on the rod guide 118. That is, the angle defining portion 120 can rotate about the support portion 140 with respect to the rod guide 118. In the present embodiment, the shaft hole 114 of the rod guide 118 is formed near the end portion of the rod guide 118, and the shaft hole 124 of the angle defining portion 120 is also formed near the end surface of the angle defining portion 120. As described above, when the vicinity of the end face of the angle defining portion 120 is pivotally supported by the support portion 140 on the end portion of the rod guide 118, the distance between the support portion 140 and the angle conversion portion 130 can be increased. The pitch of the angle (opening angle) formed by the rod shaft 112c of the rod 112 inserted through and the defining surface 120c of the angle defining portion 120 can be reduced.

  The angle adjusting unit 130 includes an eccentric cam 132 having an outer peripheral surface 1321 and a cam shaft surface 1322, an opening (cam hole 122) formed in the cam holder 126 of the angle defining unit 120 to receive the outer peripheral surface 1321. An opening (cam slot 116) formed in the rod guide 118 for receiving the cam shaft surface 1322 is mainly configured. The cam hole 122 of the angle defining portion 120 is formed in a size and shape that allows the outer peripheral surface 1321 of the eccentric cam 132 to be inserted and the outer peripheral surface 1321 to slide. The cam slot 116 of the rod guide 118 is a narrow rectangular opening extending long in one direction, and its longitudinal direction is directed in a direction parallel to the shaft axis 112c. The width of the cam slot 116 is set such that the cam shaft surface 1322 of the eccentric cam 132 can be inserted and the cam shaft surface 1322 can be rotated.

  In the present embodiment, the angle adjustment unit 130 is disposed between the free end of the rod guide 118 and the support unit 140. The angle adjusting unit 130 is disposed between the free end of the rod guide 118 and the support unit 140 (that is, the angle adjusting unit 130 is disposed between the free end of the angle defining unit 120 and the support unit 140. Therefore, it is not necessary to increase the dimensions of the rod guide 118 and the angle defining portion 120 in order to install the angle adjusting unit 130, and it is suitable for downsizing the guide instrument 101. Furthermore, if the angle adjusting part 130 is formed at a position close to the free ends of the rod guide 118 and the angle defining part 120, the distance between the support part 140 and the angle adjusting part 130 is increased, and the pitch of the opening angle is reduced. It is advantageous.

  The present embodiment is different from the first embodiment in that the opening angle between the reference surface 120c of the angle defining portion 120 and the reference line (= rod shaft 112c) of the main body 120 is 90 ° in the initial state. However, the basic operation of changing the angle by the eccentric cam 132 of the angle adjusting unit 130 is the same as that in FIGS. 5A to 5D described in the first embodiment.

  Further, the guide device 101 of the present embodiment can include the lock mechanism 50 as in the first embodiment. In addition, it is preferable that a dimple 134 that fits the lock mechanism 50 is provided on the outer periphery of the outer peripheral surface 1321.

  It is preferable that the angle adjusting unit 130 can adjust the opening angle at a pitch of 1 °, and the external rotation angle of the surface A can be adjusted at a pitch of 1 ° which is considered necessary in general surgery. At this time, if the eccentric cam 132 is locked at a pitch of 1 °, it is more preferable because the opening angle can be easily adjusted. In order to adjust the lock position, the dimple 134 may be formed so as to correspond to the opening angle changing by 1 °.

  A dial 136 is fixed to the eccentric cam 132 of FIG. 7 on the outer peripheral surface 1321 side. The dial 136 can be formed with a scale indicating a change in the opening angle when the eccentric cam 132 is rotated and an anti-slip groove when the eccentric cam 132 is rotated.

  The rod 112, the rod guide 118, the angle defining portion 120 (the cut guide 160, the pole 164, the connection shaft 166, the attachment 168, etc.), the support shaft 144, the eccentric cam 132, and the dial 136 are materials that are safe and sterilizable with respect to the living body. For example, it can be formed from a metal material such as stainless steel or titanium.

  In addition to the bone shaping guide devices 1 and 101 shown in the first and second embodiments, the bone shaping guide device of the present invention includes guide devices that can be used for various types of bone shaping. For example, in the case of a greater trochanteric fracture of the femur, a guide that can be used for surgery to fix the fractured part by inserting a hip screw that passes from the outside of the proximal part of the femur through the greater trochanter neck to the greater trochanter There are parts. In order to accurately define the insertion direction of the hip screw, a guide pin that defines the accurate insertion direction is inserted prior to the insertion of the hip screw. It is suitable as an angle-defining guide device for insertion at a predetermined angle (for example, 125 ° to 145 °) with respect to the bone axis. In another example, the bone shaping guide device of the present invention is suitable for prescribing the holding angle of the reamer with respect to the body axis when the pelvic acetabulum is cut with the reamer.

It is a schematic perspective view of the bone-shaping guide device according to Embodiment 1 fixed to the distal femur. FIG. 3 is a schematic perspective view from the back side of the bone-shaping guide device according to the first embodiment. 2 is a schematic rear view of the bone shaping guide device according to Embodiment 1. FIG. 1 is a schematic exploded perspective view of a bone-shaping guide device according to Embodiment 1. FIG. It is a general | schematic partial rear view for demonstrating operation | movement of the angle adjustment part using an eccentric cam. It is a general | schematic partial rear view for demonstrating operation | movement of the angle adjustment part using an eccentric cam. It is a general | schematic partial rear view for demonstrating operation | movement of the angle adjustment part using an eccentric cam. It is a general | schematic partial rear view for demonstrating operation | movement of the angle adjustment part using an eccentric cam. It is a schematic perspective view of the bone part shaping guide instrument concerning Embodiment 2 fixed to the femur distal part. 6 is a schematic exploded perspective view of a bone-shaping guide instrument according to Embodiment 2. FIG. It is a schematic perspective view which shows the shaping example of the femur distal part before installing an artificial knee joint. It is a schematic side view which shows the shaping example of the femur distal part before installing an artificial knee joint. It is a schematic front view which shows the prior art example of another bone part shaping guide instrument used for osteotomy of the femur distal part. It is a schematic perspective view which shows the state which fixed the cut guide to the another bone part shaping guide instrument of FIG. It is a schematic front view which shows the prior art example of the guide instrument for bone part shaping used for osteotomy of the femur distal part.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1,101 Bone part shaping guide instrument, 10, 110 main body, 12 plate, 20, 120 Angle defining part, 30, 130 Angle adjusting part, 32, 132 Eccentric cam, 40, 140 Support part, 34 Dimple, 50 Lock mechanism , 60 pin guide, 90 femur, 98 posterior surface of internal and external condyles, 112 rod, 160 cut guide, θ opening angle, I axis of femur, O ₁ axis center, O ₂ cam center

Claims (8)

When shaping a bone part, the bone part shaping guide device has a main body arranged at a reference part of a bone part to be shaped, and an angle defining part that can extend at a predetermined angle with respect to the reference part. And
The angle defining portion is pivotally supported by the support portion on the main body so as to be pivotable.
The opening angle between the main body and the angle defining portion around the support portion is adjusted by an angle adjusting portion,
The angle adjusting portion has an eccentric cam disposed between the main body and the angle defining portion;
The bone-shaping guide device according to claim 1, wherein the opening angle is adjusted by rotating the eccentric cam to change a distance between the main body and the angle defining portion.   2. The bone-shaping guide device according to claim 1, wherein an end portion of the angle defining portion is pivotally supported on the main body by the support portion.   The bone angle shaping guide device according to claim 1, wherein the angle adjusting portion is disposed between a free end of the main body and the support portion. The outer peripheral surface of the eccentric cam is slidably inserted into an opening formed in either the angle defining portion or the main body,
The cam shaft surface of the eccentric cam is inserted through the angle defining portion or the opening formed in the other of the main body,
A line connecting the cam center that is the center point of the outer peripheral surface and the shaft center that is the center point of the cam shaft surface is perpendicular to the main body, and the shaft center is located between the cam center and the main body. The bone-shaping guide device according to any one of claims 1 to 3, wherein the opening angle is 0 °.   The bone angle shaping guide device according to any one of claims 1 to 4, wherein the angle adjustment unit includes a lock mechanism that locks the eccentric cam. The bone shaping guide device is used for cutting the distal part of the femur in a direction perpendicular to the axis of the femur;
The reference site is the axis of the femur;
6. The cylindrical rod guide capable of inserting and fixing a rod inserted along the axis of the femur from the end of the distal femur. The bone orthopedic guide device according to claim 1. The bone shaping guide device is used for cutting the front surface of the distal part of the femur in a direction parallel to the axis of the femur,
The reference site is the posterior surface of the inner and outer condyles of the distal femur;
The bone body shaping guide device according to any one of claims 1 to 5, wherein the main body is a plate arranged in accordance with the posterior surface of the inner and outer condyles.   The bone angle reshaping according to claim 6 or 7, wherein the angle defining portion includes a cut guide for defining a bone cutting surface of a distal femur, or a member used for positioning the cut guide. Guide instrument.

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