JP4477562B2 - Guide device for bone surgery - Google Patents

Description

  The present invention relates to a guide device for bone surgery, and more particularly to a structure of a guide device suitable for use as an aiming device for an intramedullary nail.

  In general, in bone surgery, a guide pin is inserted into the bone, a tool such as a drill or reamer is applied to the bone to perform drilling, or a screw or an intramedullary nail as an implant is introduced into the bone. Is done. Such bone surgical tools such as guide pins, tools, and implants are often applied to bone while being guided by some kind of guide device (guide instrument).

  As an example of the above-mentioned guide device, for example, it has a connecting end connected to the end of an intramedullary nail inserted into the bone marrow, and extends and refracts from this connecting end. An instrument called an index device (target device) having a portion extending substantially parallel to the intramedullary nail is known (see, for example, Patent Document 1 below).

In the above indicator device, an insertion guide structure including a guide hole facing a predetermined direction is provided in a portion extending substantially parallel to the intramedullary nail. In this insertion guide structure, a slit is formed along the guide surface including the predetermined orientation, and the inner diameter of the guide hole can be substantially expanded and contracted by the slit. In addition, a fastening screw for fastening a pair of portions on both sides of the slit is attached to the insertion guide structure so as to cross the slit. When the indicator device is actually used, the guide sleeve is inserted into the guide hole of the insertion guide structure, and the guide sleeve is fixed by tightening with the tightening screw. The bone surgical tool is guided in a predetermined direction by being guided directly or indirectly.
Japanese Patent Laid-Open No. 2001-286480 (refer to reference numerals 22 to 24 in FIG.

  However, in the above-described indicator device, a pair of portions on both sides of the slit in the insertion guide structure is tightened with a tightening screw, and this tightening screw engages with the pair of portions across the slit, Since the tightening screw is configured to perform the tightening operation from one side of the insertion guide structure, the pair of portions on both sides of the slit does not deform evenly. There is a problem that occurs.

  That is, normally, the tightening screw is screwed into one of the pair of parts on both sides of the slit, but the other part is only engaged in the axial direction. It is difficult to configure the stress so as to apply the stress evenly, and the above-described misalignment occurs when one portion has a larger deformation amount than the other. In addition, since an operating force is applied only to one side by operating the tightening screw from one side, there is a possibility that torsional stress is applied from one side to the insertion guide structure, and when this torsional stress is applied, the insertion guide structure is It is also conceivable that the guide direction changes by twisting.

  Therefore, even if the indicator device is configured with high accuracy as a whole, the guide accuracy decreases due to the bias of the insertion guide structure caused by tightening. In addition, since the decrease in guidance accuracy is often different for each guidance device, it cannot be controlled or corrected.

  Therefore, the present invention solves the above-mentioned problems, and the problem is in a bone surgery guide device for determining the guide position and direction of a bone surgery tool by fastening an insertion guide structure having a slit with a fastening means. An object of the present invention is to provide a structure capable of improving the guiding accuracy after tightening by uniformly deforming a pair of portions on both sides of the slit.

In view of such a situation, the guide device for bone surgery of the present invention includes a connection end connected to a patient's bone or an implant embedded in the patient's body, and the connection end and the opposite end. A frame main body having a curved portion therebetween and configured in a U-shape along the guide surface as a whole, and provided on the opposite end of the frame main body, with the guide surface facing the implant And a guide hole penetrating in the penetrating direction of the guide hole, traversing the guide hole, and opened at a free end opposite to the connection end, along the guide surface. comprising an insertion guide structure, and to confirm the guide position and orientation of the bone surgical tools to be inserted into the guide hole by tightening together by clamping means with a pair of portions on both sides of the slit of the insertion guide structure The guide apparatus for bone surgery, said clamping means, said have you on the free end projects in parallel on both sides of each of the slits of a pair of portions on both sides of the slit, on both sides of the slit of the insertion guide structure a pair of protrusions integral male thread Ru is constituted by a screw portion provided respectively, are mounted on the pair of protruding portions, provided with a female screw screwed to the projecting direction with respect to the male screw And at least one of the pair of projecting portions and the drive member is formed with an engagement surface inclined in a conical surface with the screwing shaft of both as an axis, and the engagement surface is on the other side. By contacting the engagement surface provided, the pair of portions are tightened in a direction close to each other according to the screwing depth of the drive member , and the pair of protrusions are adjacent to both sides of the slit. On the edge Has a cut surface part formed by cutting the Kigakarigomen respectively, characterized in that said cutting surface is configured so as not to contact the engagement surface of the drive member.

According to the present invention, the drive member is provided with the pair of projecting portions projecting in parallel from the pair of portions on both sides of the slit, and the driving member screwed in the projecting direction with respect to the pair of projecting portions. Since the pair of protrusions are tightened in the approaching direction according to the screwing depth, it is not necessary to provide a tightening screw that acts on the pair of parts across the slit. Since there is no need to perform the operation from one side, it becomes possible to apply stress to the pair of parts on both sides of the slit more evenly than before when tightening with the drive member. It is possible to reduce the axial deviation and twist of the guide hole due to. Further, in the present invention, it has a frame provided with the insertion guide structure, and the frame includes a connection end connected to a patient's bone or an implant embedded in the patient's body, and the pair of protrusions and the driving member, by a Turkey have from said connection end of said frame is arranged at the free end of the other side can be enhanced operability, disturb the various operations and tasks such as gripping frame Therefore, handling can be performed easily. In particular, at least one of the pair of projecting portions and the driving member is formed with an engagement surface inclined in a conical surface with the screwing shaft as an axis, and the engagement surface is provided on the other side. By contacting the surface, the pair of portions are tightened in a direction approaching each other according to the screwing depth of the drive member, and the pair of protrusions are engaged with the edge portions adjacent to both sides of the slit. Each has a cut surface formed by cutting a part of the mating surface, and the cut surface is configured not to contact the engagement surface of the drive member. It is possible to eliminate the risk of catching the edge portions on both sides and twisting and deforming the protruding portion.

  In the present invention, it is preferable that the pair of protrusions are configured substantially symmetrically on both sides of the slit. According to this, the pair of portions on both sides of the slit can be more uniformly deformed by causing the drive member to act on the pair of protrusions configured substantially symmetrically on both sides of the slit.

  In the present invention, a pair of screw portions formed substantially symmetrically on both sides of the slit is provided on each of the pair of protrusions to form an integral male screw, and the drive member includes the male screw. It is preferable that a female screw that is screwed onto the screw is formed. According to this, since the screwing state of the drive member with respect to the pair of protrusions is substantially symmetric, the tightening stress on the pair of protrusions can be further equalized.

  In the present invention, “substantially symmetrical” means that the actuator is configured to receive uniform deformation when subjected to stress evenly from the drive member, and has a substantial effect on the relationship between stress and deformation. It means not considering differences in details that do not fulfill. In particular, when a pair of symmetrically configured protrusions on both sides of the slit are provided with threaded portions each having an axis in the protruding direction, and these threaded portions constitute an integral male screw, the screw spiral In order to realize the shape, the shape of the pair of screw parts cannot be made completely symmetrical with each other, but it can be regarded as having a substantially symmetrical structure in consideration of the screwed state with respect to the driving member. .

In the present invention, the engagement surface provided on the other side is a conical inclined surface having an inclination angle aligned with an engagement surface formed on at least one of the pair of projecting portions and the drive member. preferable.

  In particular, it is more desirable that the pair of projecting portions and the driving member project in the extending direction of the frame body. According to this, since the pair of projecting portions and the drive member project in the extending direction of the frame at the free end of the frame, structural restrictions on the insertion guide structure can be eliminated, and operability is further improved. In addition, it is possible to further improve the uniformity of the tightening action for the pair of portions of the insertion guide structure.

In the present invention, it is preferable perspective hole penetrating from the outside to the inside of the frame body is found provided in a portion on the side of the end portion of the opposite side of the vertex position of the curved portion in the frame body . According to this, at least a part of the transverse hole of the intramedullary nail can be observed through the fluoroscopic hole on the axial image.

  Hereinafter, embodiments of the present invention will be described together with illustrated examples. FIG. 1 is a partially sectional right side view of a guiding device 100 of the present embodiment, FIG. 2 is a partially sectional rear view of the guiding device 100, and FIG. 3 is a plan view of the guiding device 100. The guide device 100 of this embodiment is connected to an intramedullary nail 10 introduced into the medullary of a tubular bone 1 such as a femur, and guide pins are inserted into transverse holes 12, 13, 14, 15 of the intramedullary nail 10. A device (indicator device) for introducing a tool such as a drill or a reamer or a bone connector 3 or 4 such as a screw.

  The guide device 100 is connected to a frame main body 101 having a connection end 101a connected to the proximal end 10a of the intramedullary nail 10 and an end of the frame main body 101 opposite to the connection end 101a. The insertion guide body 102 is provided. The connection end 101a is provided with a through hole 101b, and the connection bolt 111 is screwed into the shaft hole 11 of the intramedullary nail 10 after the connection bolt 111 indicated by a dotted line is inserted into the through hole 101b. It is comprised so that the part 101a and the proximal end 10a of the intramedullary nail 10 can be connected and fixed.

  The frame main body 101 is formed in a U shape as a whole so as to shift to a posture substantially parallel to the intramedullary nail 10 after being bent from the connection portion 101a. The curved portion of the frame main body 101 extends while curving in an obliquely upward direction (a direction inclined at 25 to 45 degrees, preferably about 30 degrees with respect to the axis of the intramedullary nail) on the connection end 101a side, and reaches a vertex 101x. It has a first bending portion 101A that reaches and a second bending portion 101B that extends while bending downward from the vertex 101x. The second bending portion 101B is bent downward at a gentler inclination angle than the first bending portion, and is connected to an end portion 101C extending substantially parallel to the intramedullary nail 10 at the tip. The vertex 101x is provided at a position that is biased toward the connection end 101a side from the end 101C.

  The frame body 101 is not particularly limited, but is made of a metal material such as stainless steel or aluminum. The frame main body 101 has an opening that opens in a direction perpendicular to a plane along the plane of FIG. 1 (a virtual plane including a plurality of guide directions set in the guide device 100, hereinafter simply referred to as “guide plane”). Holes 101y and 101y are provided. These opening holes 101y are photographed from a direction orthogonal to the guide surface by confirming the hole shape of the opening hole 101y on a fluoroscopic image (front image corresponding to FIG. 1) of an X-ray imaging device or the like. Helps to check whether or not.

  The frame main body 101 is formed with a through hole 101z along the guide surface in the vicinity of the vertex 101x. The through hole 101z extends in a direction Xb obliquely downward from the apex 101x side toward the connection end 101a. In the present embodiment, the direction Xb is set to a direction toward the center of the bone head 1h (a direction in which an extension member such as the guide pin 2 can be inserted into the bone head 1h). An extension member is inserted through the through-hole 101z, and the tip of the extension member shown in the image is connected to the connection end along the guide surface on an image (axial projection image corresponding to FIG. 7) taken from the direction Xa along the guide surface. Since the projection further protrudes from the portion 101a to the opposite side of the guide device 100, the direction along the guide surface depends on the direction in which the extension member shown in the image extends (the bone head portion into which the bone joints 3 and 4 are to be inserted (bone head). It helps to confirm whether or not it is consistent with the direction towards 1h).

  Further, the frame body 101 is formed with a see-through hole 101w formed along the guide surface between the vertex 101x and the end portion 101C, that is, in the second bending portion 101B. That is, the see-through hole 101w penetrates from the outside to the inside of the frame body 101 along the guide surface. Further, the see-through hole 101w has an extended shape extending along the extending direction of the frame body 101. The see-through hole 101w is configured to allow the cross-holes 12 and 13 of the intramedullary nail to be seen through on the axial projection image, whereby the guide pin 2 inserted toward the cross-holes 12 and 13 is bent. It becomes possible to confirm.

  The see-through hole 101w is provided on the guide surface so as to penetrate from the outside of the frame main body 101 toward the intramedullary nail 10 along the direction Xa shown in FIG. Then, as will be described later, when the guide pin 2 is inserted by determining the guide position and direction using the guide device 100, the distal end portion of the guide pin 2 bends in a direction away from the guide surface at the time of insertion. It is provided to confirm the state of insertion in a direction deviated from the direction on the axial projection image and to reinsert the guide pin 2. As shown in FIG. 7, on the axial image, it is configured so that at least a part of all the transverse holes 12 to 15 of the intramedullary nail 10 (all transverse holes in the illustrated example) can be seen through through the see-through hole 101w. ing. Since the position of the transverse hole can be confirmed through the fluoroscopic hole 101w on the axial image, the direction of the guide pin 2 can be observed with the transverse hole as a reference.

  An insertion guide body 102 is connected and fixed to the end 101 </ b> C of the frame main body 101. Although the insertion guide body 102 is not specifically limited, For example, it is comprised with metals, such as aluminum. The insertion guide body 102 is provided so as to extend substantially in parallel with the intramedullary nail 10 from the end portion 101 </ b> C of the frame main body 101. The frame main body 101 and the insertion guide body 102 constitute the frame of the guide device 100. As shown in FIG. 2, the insertion guide body 102 is provided with slits 102s formed along the guide surface G (a surface orthogonal to the paper surface of FIG. 2). The slit 102s is open at the lower end portion (that is, the free end of the frame) of the insertion guide body 102, but inside the upper end portion (the end portion on the side connected to the frame main body 101) of the insertion guide body 102. Has a termination. That is, the slit 102s has a shape cut from the lower end portion of the insertion guide body 102 and stopped inside the upper end portion.

  A pair of portions 102A and 102B are provided on both sides of the slit 102s, and these portions 102A and 102B are configured substantially symmetrically about the guide surface G. Each of the portions 102A and 102B is provided with a plurality of sets of concave grooves on both sides of the slit 102s. Among these concave grooves, the mutually opposite concave grooves symmetrically formed on both sides of the slit 102s constitute a pair of guide holes, whereby a plurality of guide holes 102X are formed in the insertion guide body 102. , 102Y, 102Z, 102V, and 102W. The plurality of guide holes all have axes included in the guide surface G, and have different positions and directions on the guide surface G. These guide holes are configured to define guide positions and directions corresponding to the axes of the transverse holes 12, 13, 14, 15 of the intramedullary nail 10, respectively.

  As shown in FIG. 4, a pair of projecting portions 102 </ b> P and 102 </ b> Q that project in parallel from the portions 102 </ b> A and 102 </ b> B are provided at the lower end portion of the insertion guide body 102. These protrusions 102P and 102Q are parallel to the guide surface G and protrude in the direction along the frame extending direction (downward direction in the figure). The pair of protrusions 102P and 102Q have substantially symmetrical shapes on both sides of the slit 102s (that is, with the guide surface G as a reference). The protruding portions 102P and 102Q are each formed with a screw portion 102t, and the screw portion 102t of the protruding portion 102P and the screw portion 102t of the protruding portion 102Q constitute an integral male screw. That is, the threaded part 102t of the projecting part 102P and the threaded part 102t of the projecting part 102Q are substantially symmetrical (the pair of threaded parts 102t constitutes a helical male screw, but are not completely plane symmetric, A substantially symmetric screw structure having an equivalent thread shape and pitch at a symmetrical position with respect to the guide surface), and a single male screw integrated with the slit 102s. It has become. The male screw is configured around the central portion of the slit 102s, that is, the axis (screw shaft) passing through the guide surface.

  Further, as shown in FIG. 4, the projecting portions 102P and 102Q are respectively provided with conical engaging surfaces 102c. These engaging surfaces 102c are conical surfaces centering on a screwing shaft that is the axis of the male screw, and have a surface shape inclined in the axial direction. The pair of projecting portions 102P and 102Q have cut surfaces 102d formed by cutting a part of the engaging surface 102c on both sides of the slit 102s, and the cut surfaces 102d constitute both sides of the slit 102s. The protrusions 102P and 102Q are configured so that the edge portions of the protrusions 102P and 102Q do not contact an engaging portion of a nut 105 described later. This is to eliminate the possibility that the engaging portion of the nut 105 may be caught by the edge portions on both sides of the slit 102s during the operation, and the protrusions 102P and 102Q may be twisted and deformed.

  A nut 105 as a driving member is screwed into the pair of protrusions 102P and 102Q. As shown in FIG. 5, the nut 105 has a female screw 105b formed on the inner surface of the shaft hole 105a. The female screw 105b is a male screw 102t formed on the pair of protruding portions 102P and 102Q. It is configured to be screwed onto the screw. The retaining pin 106 is a retaining member attached to the nut 105 so that the nut 105 does not fall off the insertion guide body 102. A knurling (knurling) 105 d for facilitating the rotation operation is formed on the outer surface of the nut 105.

  Further, on the inner surface of the shaft hole 105a of the nut 105, an engagement surface 105c that is an engagement portion that engages with the engagement surfaces 102c of the pair of protrusions 102P and 102Q is provided. In the illustrated example, the engagement surface 105c is a conical inclined surface having an inclination angle aligned with the engagement surface 102c. Then, when the engagement surface 102c and the engagement surface 105c are engaged, a deformation amount corresponding to the screwing depth of the nut 105 is generated in the pair of projecting portions 102P and 102Q. That is, in the illustrated example, the nut 105 is screwed into the pair of projecting portions 102P and 102Q, and the engagement surface 105c exerts a tightening force on the engagement surface 102c by increasing the screwing depth. Thus, the pair of protrusions 102P and 102Q are deformed in a direction close to each other by an amount proportional to the increase in the screwing depth. As a result, the portions 102A and 102B are deformed in the approaching direction, the slit 102s is narrowed, and the inner diameters of the guide holes 102X, 102Y, 102Z, 102V, and 102W are substantially reduced.

In this embodiment, it is only necessary that the inner diameter of the guide hole is reduced by changing the screwing depth of the nut 105. Absent. For example, contrary to the above, the insertion guide body 102 may be configured to be tightened by reducing the screwing depth of the nut 105 .

  In the guide device 100 described above, after drilling the proximal end 1a of the bone 1 such as the femur by applying a tool such as a drill or a reamer, as shown in FIGS. The connection end portion 101a is connected and fixed to the proximal end 10a of the nail 10 by a connection bolt 111 or the like to integrate the intramedullary nail 10 and the guide device 100. In this state, the distal end 10b of the intramedullary nail 10 is integrated. Is introduced into the bone 1 from the proximal end 1a. At this time, the posture and depth of the intramedullary nail 10 in the bone 1 are confirmed while viewing a fluoroscopic image such as an X-ray image, and the intramedullary nail 10 is finally disposed at an appropriate position with respect to the bone 1. Set to

  Next, the guide sleeves 107 and 108 shown in FIG. 1 are inserted into the guide holes 102X and 102Y of the insertion guide body 102, and pushed so that the tips of the guide sleeves 107 and 108 are introduced into the body. Then, the tips of the guide sleeves 107 and 108 are brought close to or in contact with the surface of the bone 1, the nut 105 is screwed in, the guide holes 102X and 102Y are tightened, and the guide sleeves 107 and 108 are fixed. At this time, in this embodiment, the nut 105 exerts an equal stress on the pair of projecting portions 102P and 102Q, so that the axis of the guide holes 102X and 102Y does not deviate from the guide surface, and the operating force on the nut 105 is also reduced. Since it acts along the guide surface at the end of the frame, twisting of the shaft hardly occurs. Therefore, the guide positions and directions of the guide sleeves 107 and 108 are set with high accuracy according to the original shape accuracy of the frame of the guide device 100.

  The guide sleeves 107 and 108 are guide members for guiding a guide pin 2 shown in FIG. 1, a tool such as a drill or a reamer (not shown), and a bone surgical instrument such as the screws 3 and 4 shown in FIG. For example, when inserting the guide pin 2, as shown in FIG. 1, an auxiliary sleeve 109 is further inserted into the guide sleeve 107, and the guide pin 2 is inserted through the shaft hole of the auxiliary sleeve 109 and the tip thereof is inserted. Is inserted into the bone 1. At this time, the position and direction of the guide pin 2 are guided by the insertion guide body 102 via the guide sleeve 107 and the auxiliary sleeve 109.

  However, when the guide pin 2 is inserted, the distal end portion of the guide pin 2 bends due to the insertion resistance of the bone 1, and the guide pin 2 is inserted in a position and direction different from the original guide position and direction. May be. When the tip of the guide pin 2 bends in a different direction on the guide surface, it can be confirmed by a perspective image (front image) viewed from a direction orthogonal to the guide surface corresponding to FIG. However, when the tip end portion of the guide pin 2 bends in a direction away from the guide surface, it cannot be confirmed in the perspective image. Therefore, in the present embodiment, a see-through hole 101w along the guide surface is formed in the frame, and the distal end portion of the guide pin 2 is displaced from the axis of the transverse hole 22 of the intramedullary nail 20 through the see-through hole 101w. Can be easily observed on a fluoroscopic image (axial image) taken from the direction Xa along the guide surface. When the bending of the guide pin 2 is found on this image, the guide pin insertion operation is performed again so that the guide pin 2 is inserted correctly in the guide position and direction.

  Further, by inserting another guide pin 2 into the through hole 101z and confirming the extending direction of the guide pin on an axial projection image, the guide surface of the guide device 100 is the bone 1 (particularly in the direction of the head 1h). ) Or whether the guide pin 2 is inserted into a proper position in the bone head 1h of the bone 1 can be easily confirmed. In particular, by inserting the guide pin 2 into the bone head 1h, it is possible to more reliably and easily grasp whether or not the guide surface passes through the center of the bone head 1h on the axial projection image.

  When the insertion of the guide pin 2 is completed, the auxiliary sleeve 109 is removed, and a drilling tool such as a drill or a reamer is introduced in a state of being guided by the guide sleeve 107 and the guide pin 2, and the bone 1 is drilled. . This drilling operation is also performed while viewing the above-described fluoroscopic images (front image and axial image). When the drilling operation is completed, the screws 3 and 4 are screwed into the bone 1 while being guided by the guide sleeves 107 and 108 and the guide pins 2. At this time, the screws 3 and 4 are screwed toward the head 1 h of the bone 1 through the inclined transverse holes 12 and 13 of the intramedullary nail 10.

  In addition to the transverse holes extending in the inclined direction as in the transverse holes 12 and 13, the guide sleeves, guide pins, and tools similar to those described above are applied to the transverse holes 14 and 15 extending in the horizontal direction. Then, a preparatory work is performed, and then a screw (not shown) is inserted to fix the intramedullary nail 10 to the bone 1.

  Thereafter, the guide device 100 is removed from the intramedullary nail 10, and when the screw 4 is not used, a set screw (not shown) is inserted into the shaft hole 11 of the intramedullary nail 10 and the screw 3 is engaged and held. Finally, a cap (not shown) is attached to the shaft hole 11.

  In addition, the guide apparatus of this invention is not limited only to the above-mentioned illustration example, Of course, a various change can be added in the range which does not deviate from the summary of this invention. For example, the guide apparatus 100 described in the above embodiment includes various guides such as guide pins 2 and guide sleeves 107 and 108, tools such as drills and reamers, and bone joint tools such as screws 3 and 4. When an operation is performed using a tool, an example is shown that is configured as an indicator device that performs positioning and orientation so as to align with the positions and directions of the transverse holes 12, 13, 14, and 15 of the intramedullary nail 10. However, the guide device of the present invention is not limited to such a mode, and any device may be used as long as it guides the above-described bone surgical tool applied to the bone in some way.

  Further, in the guide device 100 described in the above embodiment, the pair of projecting portions 102P and 102Q and the nut 105 screwed to the projecting portions 102P and 102Q project from the free ends of the frames 101 and 102 so as to have an axis in the frame extending direction. However, if the pair of projecting portions project in parallel from the portions on both sides of the slit, and the structure is such that the drive member is screwed in the projecting direction, the position and orientation at which they are provided (Projection direction) is arbitrary.

The schematic partial cross section right view which shows a mode (front image) which looked at the guidance apparatus of embodiment from the front. The rear view of the guide device of an embodiment. The top view of the guide device of an embodiment. The enlarged view which shows a pair of protrusion part of the guide apparatus of embodiment. The expanded partial sectional view which shows the nut of the guide apparatus of embodiment. The rear perspective view (a) and front perspective view (b) of a guide device and an intramedullary nail of an embodiment. Explanatory drawing which shows a mode (axial projection image) which looked at the guide apparatus of embodiment from the direction Xa.

DESCRIPTION OF SYMBOLS 100 ... Guide apparatus, 101 ... Frame main body, 101a ... Connection end part, 101A ... 1st bending part, 101B ... 2nd bending part, 101x ... Vertex, 101y ... Opening hole, 101z ... Through-hole, 101w ... Perspective hole, 102 ... insertion guide, 102s ... slit, 102X, 102Y ... guide hole, 102A, 102B ... part, 102P, 102Q ... projecting part, 102t ... screw part, 102c ... engagement surface, 105 ... nut, 105a ... shaft hole, 105b ... Female screw, 105c ... Engagement surface, 111 ... Connection bolt, 1 ... Bone, 1a ... Proximal end, 1h ... Head, 2 ... Guide pin, 3, 4 ... Screw, 10 ... Intramedullary nail, Proximal end ... 10a, 11 ... shaft hole, 12-15 ... transverse hole, distal end ... 10b

Claims (5)

U having a connecting end connected to a patient's bone or an implant embedded in the patient's body and a curved portion between the connecting end and the opposite end, and generally along the guide surface A frame main body configured in a letter shape, a guide hole provided on the opposite end of the frame main body, penetrating on the guide surface toward the implant, and penetrating in the penetrating direction of the guide hole wherein the said connecting end portion with crossing the guide hole is opened at the free end of the opposite side, anda insertion guide structure having a slit along the guide surface, of the slit of the insertion guide structure the guide apparatus for bone surgery to establish the guiding position and orientation of the bone surgical tools to be inserted into the guide hole by tightening together by clamping means with a pair of portions on both sides,
Said clamping means, said protruding in parallel on both sides of each of the slits of a pair of a portion of the insertion guide structure have contact to the free end on both sides of the slit, the threaded portions provided on both sides of the slit has a pair of protrusions integral male thread Ru is configured, is attached to the pair of projecting portions, and a drive member having a female screw screwed to the projecting direction with respect to the male screw,
At least one of the pair of projecting portions and the drive member is formed with an engagement surface inclined in a conical surface with the screwing shaft of both as an axis, and the engagement surface is provided on the engagement surface provided on the other side. By abutting, the pair of portions are tightened in a direction close to each other according to the screwing depth of the driving member ,
Each of the pair of protrusions has a cut surface formed by cutting a part of the engagement surface at an edge portion adjacent to both sides of the slit, and the cut surface contacts the engagement surface of the drive member. A guide device for bone surgery, characterized in that the device is configured not to operate.   The guide device for bone surgery according to claim 1, wherein the pair of protrusions are substantially symmetrical on both sides of the slit. The engagement surface provided on the other side is a conical inclined surface having an inclination angle aligned with an engagement surface formed on at least one of the pair of projecting portions and the drive member. Item 3. A guide device for bone surgery according to item 1 or 2 .   The guide device for bone surgery according to any one of claims 1 to 3, wherein the pair of projecting portions and the driving member project in the extending direction of the frame body. Claims, characterized in that perspective hole penetrating from the outside to the inside of the frame body is found provided in a portion on the side of the end portion of the opposite side of the vertex position of the curved portion in the frame body The guide apparatus for bone surgery as described in any one of 1 thru | or 4.

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