JPH06509490A - Osteopathic planting assemblies and fixtures - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

[Detailed description of the invention] The present invention is particularly useful for treating fractures of the upper end of the upper femur without excluding the tips of other bones. Concerning fixing and repair.

Generally, fractures are classified into four typical types.

In other words, a waist fracture between the waist and head of the femur, and a protrusion on the upper part of the femur. Partial fracture between the trochanter and the waist of the femur, and the cephalothoracic bone at the trochanter There are occasional fractures and accessory trochanteric fractures on the lower side of the trochanter.

Depending on the type of fracture, various osteopathic problems are faced. For example, pin Items such as needles and plates are designed to be locked onto screws with RWE. must be The present invention is particularly designed so that a screw with a head is fixed. Regarding scaled support plates.

Generally, the support plate is shaped to match the shaft of the bone. the support part The upper end of the bone is called the interstitial part and is formed to penetrate the bone. It is. Said interspace is angularly placed within the supported part and is Designed to accept screws with IS. Cylinder and support plate consists of one part.

Morphologically, bone fractures are caused by screws of varying lengths, or fractures made of plates or cylinders. set, the latter having a certain length and relative to the support plate. It has a shape with various angles. Therefore, in order to correspond to the angle of the bone marrow, Requires inventory of several sets of plates and tubes. shall be.

The gap may include not one (, two or more) said gap and said support plate. Multiple osteopathic implants designed for the end of the femur, clearly divided into numbers There are things. In the patent application (WO-A-8804161), for example, from the 2nd part A set of ! is described, i.e. 1! Ili part is femur or other bone designed to be supported by the shaft of the It is designed to. This setting x1 is not sufficient. However, the wj part consisting of one This is because there is the same problem as mentioned above, such as connection with the support plate.

Furthermore, the design does not allow changing the angle of the waist axis. US Patent 44 38782 also has a shortcoming defect. Furthermore, in the US patent, two According to the connection between the component parts, the impact is generally applied to the upper end of the bone, and the bone Folds may occur.

Therefore, as many angles as possible are needed, and other designs have no head. It is not possible to place the screws correctly.

An object of the present invention is to solve the above-mentioned drawbacks simply, reliably, and in a rational manner. It lies in erasing.

The present invention necessarily requires an implant specifically designed for femoral osteotomy to be an assembly, small (It is possible to precisely match the angle of the main axis of the fin.) Planting that can be done provides an assembly.

The purpose is to provide a planting assembly with a changeable and replaceable combination of: Achieved by design.

That is, the combination is A series of support plates shaped to fit around the shaft of the femur, with varying lengths. and has an angular portion that can be locked to the upper end of the support plate. a series of coupling sleeves and a coupling sleeve from the upper end of the support plate to the turnip springs. and a series of screws with heads that freely engage within the sleeve.

The problem with attaching wing type sleeves to the support plate is that Locks the pulling sleeve to prevent translational and rotational movements. The front shoulder, such as locating the shoulder in the center at one angle, This problem can be solved by changing the shape of the upper end of the support plate.

The problem of obtaining a constrained arrangement between the plate and the sleeve is that the sleeve is A conical hole in the shoulder located in the center, i.e. a conical hole formed in the sleeve This can be solved by a hole that matches the shape of the part.

(The time that occurs when aiming at a screw that is aligned with the main axis of the fin and has a head) The issue of correcting the differences as much as possible is resolved as follows.

That is, the conical shaped portion is arranged coaxially with the main body portion of the sleeve. or the conical shaped portion is attached to the main body of the sleeve at a certain angle. and has been offset.

formed in the coupling sleeve and the support plate at an angle. The problem of connecting the shoulder portion is to connect the conical shaped portion and the main body portion of the sleeve. The solution is to have keys that overlap at the point where they meet. Said The key is located in a notch machined into the end of the centrally located shoulder.

The plurality of seven petites are arranged to face each other in the diametrical direction.

Insert a screw having a head into the coupling sleeve at an angle to the support plate. Locking problems are less likely to occur under conditions such as when a The stem, which has both sides, is aligned with the through hole of the coupling sleeve. It is solved by

Following the discussion of the technique, other problems arise regarding the attachment of the support plate. do. Indeed, a screw with a head is very close to the center of the constriction along the major axis of the constriction. Must be positioned accurately. Usually has an angle of 130@ with respect to the shaft. ing. Therefore, in order to determine the positional relationship between the support plate and the intermediate part, There is a screw that has a 1i1 part.

The pin is aimed by an aiming component that is often held by hand; It is used as a guide to determine the main axis. Image intensifier (I■ 1ge-intenslfler) tried the axis #! used to make decisions by mistake. used. The aiming component is configured to move the bin to its original position under angular direction. and help.

Using hand-held quasi-components leads to inaccuracies. If handled improperly, That is, the angle indication exactly matches the angle between the intermediate part and the support plate. Otherwise, the support plate cannot be brought into close contact with the shaft of the femur.

Nevertheless, a decision must be made in order to bring the support plate into close contact with the shaft. The reason for this is that if a reaction force acts on the cylinder, it will have an adverse effect on the fracture point. be.

Another problem of the invention is that according to the invention, the main axis of the waist can be precisely determined. installation of a prosthetic unit.

To solve this problem, we designed a tilting block that can be held in place. , a device with an aiming part having a guide bin for determining the axis of the constriction Invented and developed. In addition, the aiming parts of the bone and soft It is held clamped in place with the other parts.

The problem of matching the main axis of the waist is solved in this way, so that the said aiming part , a slidable support member is attached so that it can be locked into place. Equipped with a board. The support member also allows the tilting block to tilt therein. It has two semicircular arms with a sloft shaped like this. The problem discussed by Akira is that the aiming component cannot be held securely while the person is away. This is the way to hold it.

The method includes a lever in which the irradiation article is connected to the side of the bone and the soft part. By forming two handles on the retractor that are integrated by a resolved. The handle is configured such that the handle acts elastically on the lever. The lever and adjustable graduated locking mechanism keep it in place. is locked.

The objects of the invention are described in more detail in the accompanying drawings.

FIG. 1 is a perspective view of a prosthetic unit y) according to the invention.

Figure 2 shows the repair of a fracture of the trochanter (protrusion of the upper part of the femur) using the prosthetic unit. It is a sectional view showing a state.

Figure 3 is a cross section showing the change in angular position of the coupling sleeve relative to the support plate. It is a diagram.

FIG. 4 is a sectional view taken along line 4-4 in FIG.

FIG. 5 is a perspective view showing the main components of the mounting fixture.

rI! J6 shows the use of the fixture for aiming the main axis.

FIG. 7 is a sectional view taken along line 7-7 in FIG.

1! II includes a series of support plates l, a series of coupling sleeves 2 and a head. A prosthetic unit is described which includes a series of screws 3 having a section.

According to the present invention, the support plate 1 has a support plate attached to the shaft of the femur. A series of a plurality of holes 1a are formed to allow the holes to pass through. In the cross section of plate 1 A very thin indentation is formed to match the anatomical contours of the femur. ing.

According to the present invention, the upper end of the support plate 1 has an angle with respect to the support plate. A shoulder portion 1b located at the center is formed. The shoulder portion 1b is When trying to connect the pulling sleeve 2, it can still ride up and cannot be removed. When attached, prevents translational and rotatable movement. This is nki kaap The conical shaped portion 2a at one end of the ring sleeve 2 fits into the shoulder portion 1b. A conical through hole 1b5 is formed, as shown in FIGS. 2, 3 and 4. is achieved as follows. The conical assembly 11) l, 2m is the coupling slit. a rod for preventing the tube 2 from moving in the axial direction with respect to the support plate 1; Achieve your goals.

As shown in FIG. 1, the coupling sleeve 2 is located at the center of the support plate l. so that it is inserted at various angles with respect to the ll11 part lb located at The wing shape is designed and manufactured. In addition, the circle of the coupling sleeve The conical shaped portion 23 is identical to the body portion 2b of the force-bringing sleeve 20. arranged on the shaft or fixed relative to the body part of said coupling sleeve 2; The angle is Fuseb γ1 (see Figures 1 and 3).

The angle between the main body portion 2b and the conical shaped portion is a meaningless limitation. If cited, 36.6'' and 10'' may be mentioned. Shoulder i located in the center Bi! : The angle with the support plate t is 130°, and the angle with the support plate t is 130°, and the Matched to the anatomical angle between the external surface and the major neck axis.

120° (130@-10) to 140' (130" +10) (D range no. cervicodiaphysie angle ) can be adopted (see Figure 3).

From the viewpoint of reducing the stock of parts, the support plate 1, especially the center position If the turn-pull sleeve is rotatably connected to the shoulder 1b, good. Each of said coupling sleeves has said centrally located shoulder lb. is formed with a key 20 designed to fit into a notch machined into the end of the There is. This key 2C has a conical shape portion 2a and the coupling sleeve 2. It is formed to overlap where the main body part meets. The key is Two nodes are arranged diametrically opposite each other at the end of the shoulder 1t+ located at the center. Tutsi 1b2. It is designed to fit both lb3 and lb3.

From now on, the following things will become clear. That is, the turnip pulling sleeve The angle between the conical shaped part and the notch, i.e., is smaller than the main axis or According to the larger angle, the keys 20 engage.

The head 3 is manufactured according to a well-known method and has a screw formed therein. a and a stem 3b, formed on the turnip pulling sleeve 2 and the shoulder portion 1b. It is arranged in a slidable manner in the hole 2d. The latter is a support play) opened over 1m. It will be done. The rotation of the stem 3b is prevented by inserting the stem 3b into the hole 2d of the force-absorbing sleeve 2. This is achieved by the surface 3bl disposed along the surface formed in .

According to another characteristic of the invention, the prosthetic unit consists essentially of an aiming part 4 and a retractable unit. It can be targeted by using a device equipped with a vector 5.

As shown in FIG. It is provided with a board 4a attached so as to be lockable. sliding support The material 4b is attached to the dovetail joint so that it can slide freely relative to the substrate 4a. It is attached. The screw 6 is inserted into a groove cut out in the supporting member that slides. The latter is used to lock the position and prevent it from moving. .

The sliding support member 4b is tilted so that it can be held in various positions. It is equipped with a dynamic pro-ac 4c and a guide bin 7 for determining the axis of the constriction. Ru. The tilting block 4C has a hinge J at the end of the sliding support member 4b. ! It can be moved within the slot of the semi-circular arm 4d, and also has a grip nozzle. Lock by block, 8+ bad. The tilting block 4C has a vertical direction to the main axis of the aiming component. A series of holes 4cl arranged in an array that may be offset at different angles with respect to the plane is formed.

For example, the holes 4C1 are offset by +5 degrees, +1 [1, -5'', and -10 degrees.

The retractor 5 is connected to the aiming component 4, and as shown in FIG. The lever 5C connects the light 111 part 4 to the side surface and soft part of the bone. Two connected handles 5a and 5b are formed. The cross section of lever 5C is , the aiming part 4, in particular the support member 4b, is attached and two clamps 5c are attached. It has an inverted U-shape forming 1 and 5e2. At the top of this clamp, A lock pin 5c3 is formed to protrude and come in contact with each of the nozzles. Handle 5 a and 5b apply elastic force to the lever 5C + especially the clamps 5cl and 5c2. It acts to lift it up.

Therefore, the following becomes clear. i.e. the tractor handle described above. When grasping each so as to push them down, the clamps 5cl and 5c2 are activated automatically. Close and grasp the part and bone together. The handles 53 and 5b are, for example, Expands due to a gradual locking mechanism consisting of leaf springs 8 and 7 petit pars 9 maintained in the direction. The leaf spring 8 is provided on one handle 5b. The notch bar is provided on the other handle 5a.

The operation of the device used to install the prosthetic unit will now be described.

The retractor 5 is located in a released position on the side of the bone, i.e. the bone and the soft part. be slid to a position between. The pressure on the handles 5a and 5b is 5c1, 5e2 are closed by elastic force, and the front ε aiming part 4 is attached to the bone. Lock it. The locking mechanism (8,9) holds the forefinger tractor in place. We guarantee that

According to surgical practice, the aiming part 4 is attached to the bone and the retractor 5 holds it in place. The tilting block 4c is tilted at a desired angle (usually c arvico-dlaphysie angle, i.e. 130”) be done. The guide bin has an image intensifier that prevents intrusion into the bin position. When it turns out to be correct, in the hole 0 formed in the tilting block be positioned. Also, if it is too high, the substrate can be placed on the slideable support. Move toward the rear in relation to the member.

In order to determine the appropriate entry point of the guide bin, the image intensity is Move the bottle towards its original position under fire control. This image The intensifier indicates that the angle is inaccurate and adjusts the block make it possible to To check the proximity angle of the guide bin surface, The angle can be checked from the side using an image intensifier. Ru.

If the bottle is not located exactly on a line along the axis of the fin, Move it again by +5＠ or -5° with the tilting block and insert it further. The side of the bottle If the bottle does not move, +10' to -10 when considering the finish of it (bottle). It is necessary that the aim within the range of 0 is perfect.

While the benefits are clear from the above description, the following points deserve emphasis.

This means that the strain on the parts is particularly reduced and the coupling sleeve is made very precise. Replaceable by providing a screw or spindle arrangement with a good head. The attachment of the planting parts is simple and efficient.

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Claims (1)

[Claims] 1. Modifiable osteopathic implant assembly particularly suitable for the upper end of the femur and an exchangeable combination, said combination comprising: A series of support plates (1) formed to rest on the shaft of the femur; and a squared part that can be latched onto the upper end of the support plate. a series of coupling sleeves (2) and a series of coupling sleeves (2) extending from the upper end of the support plate to the cup. A series of screw heads ( 3) A planting assembly comprising: 2. A planting assembly according to claim 1, in which the upper end of the support plate has a central A shoulder (1b) located at the center is formed, and the shoulder is arranged at a predetermined angle. , and the coupling sleeve (2) is received so that it cannot move or rotate. A planting assembly characterized by: 3. A planting assembly according to claim 2, wherein said centrally located shoulder (1 b) is a conical shaped portion formed at one end of the coupling sleeve (2); A plant characterized by having a conical through hole (1b1) that corresponds to (2a). Mounting assembly. 4. A planting assembly according to claim 3, in which the conically shaped portion (2a ) is arranged coaxially with the main body of the coupling sleeve (2). A planting assembly featuring: 5. A planting assembly according to claim 3, in which the conically shaped portion (2a ) is offset at a predetermined angle with respect to the main body of the coupling sleeve (2). A planting assembly characterized in that: 6. A planting assembly according to claim 3, in which the conically shaped portion (2a ) and the main body of the coupling sleeve (2) overlap at the point where they meet. A key (2c) is formed, said key being located at the end of said centrally located shoulder (1b). characterized in that it is located in a notch (1b2) (1b3) machined into Planting assembly. 7. A planting assembly according to claim 6, in which the notches (1b2) (1b 3) are arranged diametrically opposite each other. 8. In the osteopathic implant assembly according to claim 3, the coupling slit The through hole (2d) of the loop (2) and the main body portion (3b) of the screw 3 are at the screw stage. complement each other to have at least one vertical surface to achieve a mechanical lock A planting assembly characterized by having a cross-sectional shape as shown in FIG. 9. The arrangement used for the planting assembly according to any of claims 1 to 8. For fixtures, a tilting block ( 4c) and a guide pin (7) for determining the waist axis. Moreover, the aiming part (4) is attached to the side and soft part of the bone. characterized in that it is held in a predetermined position by a vector (5). Mounting hardware. 10. In the fixture according to claim 9, the aiming component (4) is a substrate (4a). on this board that slides to lock into place. A holding member (4b) is placed, and the supporting member holds a tilting block (4c). The tilting block is designed such that the tilting block can be tilted within the tilting block. A semicircular arm (4d) with a slot formed to allow the A mounting tool featuring: 1. In the fitting according to claim 9, the retractor (5) has a bone side. a lever (5c) connecting the aiming part (4) between the surface and the soft part; Two integrated handles (5a) (5b) are formed, and the handle ( 5a) (5b) acts elastically on the lever (5c) and (5c) and an adjustable graduated locking mechanism (8) (9) to lock it into place. A fixture characterized in that it is locked.