JP6803826B2 - Osteojoint parts and osteosynthesis part formation method - Google Patents

Description

The present invention relates to an osteosynthesis component with a positioning function for fracture treatment.

In treating fractures of animals and the like, at present, based on CT scan (computed tomography) data, there are cases where osteosynthesis parts that reflect the surface shape of the fractured bone are manufactured and treated. In addition, since the osteosynthesis component has a shape that follows the shape of the bone, it is considered unlikely that the attachment direction of the osteosynthesis component (direction of the body side and the end side) is mistaken during the operation.

However, with the osteosynthesis component described in Patent Document 1, in the treatment of fractures in a part such as a joint where a specific shape does not exist, it is possible to roughly determine the attachment position, but between bones such as crushed fractures. In the case where there is a gap in the bone joint, there is a high possibility that a mistake will occur in the mounting direction of the osteosynthesis component.

Japanese Patent No. 5221063

When reducing a case where there is a gap between the broken bones such as a crushed fracture, in the conventional treatment, the reduction is often performed based on the knowledge and experience of a doctor, and an osteosynthesis component is attached. Furthermore, there is an ambiguity regarding the arrangement of the osteosynthesis parts for reduction, and it is difficult to reduce the broken bone to the same position as before the fracture and to arrange the osteosynthesis parts. In particular, when there is a gap between bones such as a crushed fracture, there is a high possibility that a mistake in the attachment direction of the osteosynthesis component will occur.

An object of the present invention is to provide an osteosynthesis component having a positioning function capable of reducing a bone to a predicted position that is considered to be a position before the fracture even in the treatment of a crushed fracture or the like.

The osteosynthesis part of the present invention is an osteosynthesis part for fixing a fractured portion of an animal bone, one end of which is in contact with the surface of the broken first bone on the body side of the fractured portion and the other end of the fractured portion. An osteosynthesis component body that contacts the surface of the broken second bone on the terminal side, a first member that is arranged on the osteosynthesis component body and contacts the fracture surface of the first bone, and an osteosynthesis component body that is arranged on the osteosynthesis component body. It is characterized in that a second member that comes into contact with the fracture surface of the second bone is provided.

In the method for forming an osteosynthesis part of the present invention, when creating an osteosynthesis part for fixing a fractured portion in which an intermediate portion of an animal bone is fractured, the first bone broken on the body side of the fractured portion and the end of the fractured portion The shapes of the second bone with a broken side and the normal bone without the fractured part were measured, and the first bone and the second bone were obtained before the fracture based on the shape data of the normal bone obtained by the measurement. The shape data is arranged on the data at the predicted position that seems to be the position, and the osteosynthesis component body is brought into contact between the surface of the first bone and the surface of the second bone placed at the predicted position on the data. Based on this, the first through hole for inserting the first member in the position and direction of penetrating the osteosynthesis component body and contacting the fracture surface of the first bone, and penetrating the osteosynthesis component body, said. A second through hole for inserting the second member is formed at a position and direction in contact with the fracture surface of the second bone, one end protrudes to the back surface side of the osteosynthesis component body, and the other end is the osteosynthesis component body. The first and second members are inserted into the first and second through holes of the osteosynthesis component main body so as to project toward the surface side of the bone joint.

According to this configuration, when attaching the osteosynthesis part, the difference in the reduction state due to individual differences of the veterinarian is eliminated as much as possible, and the treatment very close to the normal state before the fracture becomes possible, and the patient (animal, etc.) after healing becomes possible. Activities in daily life are reproduced. In addition, the positioning function reduces erroneous mounting and leads to suppression of reoperation.

A case where the osteosynthesis component 100 according to the first embodiment of the present invention is used for a crushed fracture case is shown, and (a) a front view of a state in which the osteosynthesis component main body 101 is pressed and fixed to the affected bone, and (b) osteosynthesis. Side view before pulling out the positioning pins 104 and 105 from the component body 101 (A) Normal bone and (b) 3D data conversion and reference point of the fractured part, and (c) Normal bone and the fractured part necessary for manufacturing the osteosynthesis part in the same embodiment so as to fit the fractured part. Explanatory drawing of alignment The positioning pins 104 and 105 are pulled out from the osteosynthesis component main body 101 by attaching (a) a front view of the affected portion and (b) the osteosynthesis component using the osteosynthesis component 100 according to the second embodiment of the present invention in a crushed fracture case. Front side view Flow chart of treatment when using the osteosynthesis component of the present invention Flow chart of treatment when using conventional osteosynthesis parts

Hereinafter, the osteosynthesis component of the present invention will be described based on the embodiment.

(Embodiment 1)
1 (a) and 1 (b) show a fracture treatment site using the osteosynthesis component of the present invention.

The osteosynthesis component 100 includes a plate-shaped osteosynthesis component main body 101, a positioning pin 104 on the body side as a first member arranged in the osteosynthesis component main body 101, and a second osteosynthesis component main body 101. It has a positioning pin 105 on the terminal side as a member.

The structure of the osteosynthesis component 100 will be described by comparing the schematic flowchart of the fracture treatment shown in FIG. 4 with the flow chart of the fracture treatment shown in FIG. 5 using the conventional osteosynthesis component.

First, in the case of conventional fracture treatment, CT scan data of the fractured portion is acquired in step S1 of FIG.

In step S2, the fractured portion is restored on the 3D data based on the CT scan data obtained in step S1.

In step S3, an osteosynthesis part is created according to the bone shape of the fractured portion restored on the 3D data.

In step S4, the affected area is incised and the fractured area is reduced.

In step S5, the osteosynthesis part is fixed to the fractured portion, and finally sutured in step S6 to complete the procedure.

However, in the case of crushed fractures, there is often a gap between the broken bone on the body side and the broken bone on the terminal side. In the case of a fracture with a gap like this, the state of the bone before the fracture cannot be grasped, and even if the conventional osteosynthesis part created in step S3 is used, the broken bone is placed at the position before the fracture and reduced. It is difficult to do.

On the other hand, in the case of the osteosynthesis component 100 of the embodiment, since the broken bone has a positioning function that can reduce the broken bone to the expected position considered to be before the fracture, the broken bone 102 on the body side and the end Even in the case of a fracture in which there is a gap 111 between the broken bones 103 on the side, it can be satisfactorily reduced by using the osteosynthesis component 100.

In the osteosynthesis component 100, the back surface of one end portion of the osteosynthesis component body 101 comes into contact with the surface of the broken bone 102 on the body side as the first bone as shown in FIGS. 1A and 1B, and the bone is formed. The back surface of the other end of the joint component main body 101 is in contact with the surface of the broken bone 103 on the terminal side as the second bone. Note that FIG. 1A does not show the positioning pins 104 and 105 arranged on the osteosynthesis component main body 101.

As shown in FIG. 1B, the positioning pins 104 and 105 are positioned by being inserted through the first and second through holes 106 and 107 formed in the osteosynthesis component main body 101. The fitting of the positioning pin 104 and the first through hole 106 and the fitting of the positioning pin 105 and the second through hole 107 are all intermediate fittings that can be moved manually.

Of the positioning pins 104 and 105 protruding from the back surface of the osteosynthesis component main body 101, the positioning pin 104 contacts the fracture surface 120 of the broken bone 102 on the body side, and the positioning pin 105 is the broken bone 103 on the terminal side. It is in contact with the fracture surface 121 of. The number of positioning pins 104 and 105 is two. The distance L1 between the centers of the positioning pins 104 and 104 is different from the distance L2 between the centers of the positioning pins 105 and 105.

A plurality of screw holes 108a are formed at one end of the osteosynthesis component main body 101 so that the osteosynthesis component main body 101 can be fixed to the bone 102 by a screw (not shown). At the other end of the osteosynthesis component main body 101, a plurality of screw holes 108b are formed so that the osteosynthesis component main body 101 can be fixed to the bone 103 by a screw (not shown).

The osteosynthesis component 100 will be described in more detail with reference to FIGS. 2 and 4.

In the case of a crushed fracture, the position and shape of the bone before the fracture are unknown. Therefore, in step S1 of FIG. 4, the bones 102 and 103 are measured by CT scan (computed tomography), and at the same time, the forefoot, hindfoot, etc. In the case of a bilaterally symmetric bone, a normal bone that is not fractured and is bilaterally symmetric with the affected part is also measured by CT scan. FIG. 2A shows a 3D model (3D model) 201 created from 3D data (3D data) measured by CT scanning normal bone. FIG. 2B shows a 3D model 202 created from 3D data measured by CT scanning the bone 102 and a 3D model 203 created from the 3D data measured by CT scanning the bone 103.

In step S2, the body-side reference point 204b and the terminal-side reference point 205b, which are the reference points for arranging the broken bone at the position of the bone before the fracture, are set for the 3D models 202 and 203. The reference point is a characteristic part such as a joint portion that is similarly present in a broken bone and a normal bone, and the reference point of the 3D model 201 corresponding to the body side reference point 204b of the 3D model 202 is shown in FIG. 2A. It is set to 204a. The reference point of the 3D model 201 corresponding to the terminal reference point 205b of the 3D model 203 is set to 205b in FIG. 2A. Then, the 3D data 202 and 203 are arranged at the expected positions, which are considered to be the positions before the fracture, as follows.

As shown in FIG. 2 (c), the body side was broken at the reference point 204a of the 3D data 206 of the normal bone, which was inverted 180 ° with respect to the longitudinal direction of the bone, with reference to the body side reference point 204b. The 3D data 202 of the bone is superimposed. It is also possible to align in the tilt direction by overlapping. Similarly, by superimposing the 3D data 203 of the broken bone on the terminal side with the reference point 205a of the 3D data 206 with reference to the reference point 205b on the terminal side, the bone is broken so as to be in a state extremely close to the normal state before the fracture. Place the bones on the 3D data.

In step S3, the osteosynthesis component 100 that fits the broken bones 102 and 103 is manufactured based on the 3D data 202, 203, 206 and the like. Here, the shape of the osteosynthesis component main body 101, the lengths of the positioning pins 104 and 105, and the positioning pins 104 and 105 of the osteosynthesis component main body 101 so as to match the surface shape of the fractured portion 111 and the shapes of the fracture surfaces 120 and 121. The osteosynthesis component 100 is manufactured by machining after determining the insertion position and the angle of the bone joint. The positions and angles of the first and second through holes 106 and 107 in the osteosynthesis component main body 101 are determined according to the insertion positions and angles of the positioning pins 104 and 105.

In step S4, the positioning pin 104 comes into contact with the fracture surface 120 of the bone 102 as shown in FIG. 1B, and the positioning pin 105 contacts the fracture surface 121 of the bone 103 with the fractured portion exposed by incising the affected portion. By mounting the osteosynthesis component 100 in this way, even if there is a gap 111 in the affected area, the bones 102 and 103 can be positioned and reduced at the expected position before the fracture.

In step S5, a screw is screwed into the bones 102 and 103 from the screw holes 108a and 108b to connect and fix the osteosynthesis component main body 101 to the bones 102 and 103, and then the positioning pins 104 and 105 are attached as shown in FIG. 1A. Pull out from the osteosynthesis component body 101. Finally, in step S6, the affected area is sutured to complete the procedure.

In this way, by using the osteosynthesis component 100, even in the case of a fracture with a gap 111, the action of the positioning pins 104 and 105 arranged on the osteosynthesis component main body 101 so as to fit the affected part causes The broken bone can be very accurately positioned and reduced to the position before the fracture. Furthermore, since the positioning function of the osteosynthesis component 100 can be arranged three-dimensionally, reduction including tilt and rotation direction is possible, and restoration that is extremely close to the normal state by eliminating the difference in the reduction state due to individual differences of doctors as much as possible. It can be treated and the daily activities of the patient after healing are reproduced.

At least two positioning pins 104 are arranged so as to match the position of the fracture surface 120 of the bone 102 and its inclination. Similarly, at least two positioning pins 105 are arranged so as to match the position of the fracture surface 121 of the bone 103 and its inclination.

(Embodiment 2)
3A and 3B show the second embodiment of the present invention.

It should be noted that those having the same function as that of the first embodiment will be described with the same reference numerals.

In the first embodiment, the amount of protrusion of the positioning pins 104 and 105 from the surface of the osteosynthesis component main body 101 was the same, but in the second embodiment, the amount of protrusion of the positioning pin 104 from the surface of the osteosynthesis component main body 101. L11 and the amount of protrusion L22 of the positioning pin 105 from the surface of the osteosynthesis component main body 101 are different.

A stopper 122 is engaged with at least one of the positioning pins 104 and 105, here each of the positioning pins 104 and 105. The protrusion amounts L11 and L22 are configured to be adjustable depending on the position of the stopper 122 on the positioning pins 104 and 105.

The positioning function of the osteosynthesis component 100 shown in FIG. 3 will be described with reference to FIG.

Steps S1 and S2 of FIG. 4 are executed, and the broken bones 102 and 103 are placed at the predicted positions that are considered to be before the fracture on the 3D data.

In step S3, the shape of the osteosynthesis component main body 101, the lengths of the positioning pins 104 and 105, the insertion positions and angles of the positioning pins 104 and 105 in the osteosynthesis component main body 101, and the like are determined, and the osteosynthesis component main body 101 is machined. The bone joint part 100 is manufactured by processing. At least two positioning pins 104 are arranged so as to match the position of the fracture surface 120 of the bone 102 and its inclination. Similarly, at least two positioning pins 105 are arranged so as to match the position of the fracture surface 121 of the bone 103 and its inclination.

For the arrangement of the positioning pins 104 and 105, a first through hole 106 through which the positioning pin 104 is inserted and a second through hole 107 through which the positioning pin 105 is inserted are formed in the osteosynthesis component main body 101. Specifically, since the shapes of the fractured surfaces 120 and 121 of the broken bones 102 and 103 are also reflected in the 3D data by the data measured by the CT scan, they protrude from the back surface of the osteosynthesis component main body 101 of the positioning pin 104. The first through hole 106 is formed in the osteosynthesis component main body 101 based on the shape of the 3D data so that the portion contacts the fracture surface 120. A second through hole 107 is formed in the osteosynthesis component body 101 based on the shape of the 3D data so that the portion of the positioning pin 105 protruding from the back surface of the osteosynthesis component body 101 comes into contact with the fracture surface 121.

If the positioning pins 104 and 105 are detachably inserted into the first and second through holes 106 and 107 and arranged in the osteosynthesis component main body 101, the positioning function can be arranged three-dimensionally, and the inclination and rotation directions can be arranged. It is possible to reduce the area including the above. This positioning function is the same as in the first embodiment.

More specifically, the diameters of the first and second through holes 106 and 107 are less than 15% of the short length of the osteosynthesis component main body 101, and at least two or more through holes. is there. The diameters of the first and second through holes 106 and 107 are less than 1.5 mm when the distance in the lateral direction of the osteosynthesis component main body 101 is, for example, 10 mm. The fitting of the positioning pin 104 and the first through hole 106 and the fitting of the positioning pin 105 and the second through hole 107 are both so that the positioning pins 104 and 105 can be removed after fixing the osteosynthesis component main body 101 to the bones 102 and 103. Both are fitted in the gap. Further, in order to position the positioning pins 104 and 105 in the osteosynthesis component main body 101, the positioning pins 104 and 105 are provided with stoppers 122 that determine the cross-sectional shape of the bones 102 and 103 and the contact length of the positioning pins 104 and 105. It is attached to the surface side of the osteosynthesis component main body 101.

In step S4, the positioning pin 104 comes into contact with the fracture surface 120 of the bone 102 as shown in FIG. 1B, and the positioning pin 105 contacts the fracture surface 121 of the bone 103 with the fractured portion exposed by incising the affected portion. By mounting the osteosynthesis component 100 in this way, even if there is a gap 111 in the affected area, the bones 102 and 103 can be positioned and reduced at the expected position before the fracture.

In the osteosynthesis component 100, due to the difference in the arrangement of the positioning pins 104 and 105 on the osteosynthesis component main body 101, the body side and the terminal side when the osteosynthesis component main body 101 is attached to the bones 102 and 103 are determined and erroneously attached. Is provided with a function to prevent.

That is, here, the center-to-center distance L1 of the first through hole 106 into which the body-side positioning pin 104 in contact with the bone 102 is inserted is the center-to-center distance of the second through-hole 107 into which the terminal-side positioning pin 105 is inserted. Arrange so that it is wider than L2. As a result, the doctor can easily confirm not only the visual confirmation but also the correct mounting direction of the osteosynthesis component main body 101 by touching the positioning pins 104 and 105, and can prevent the osteosynthesis component 100 from being erroneously mounted.

As shown in FIG. 3B, the protrusion amount L11 of the positioning pin 104 on the body side protruding outward from the surface of the osteosynthesis component main body 101 is made longer than the protrusion amount L22 of the positioning pin 105 on the terminal side. Due to the difference in feel when the doctor touches the positioning pins 104 and 105, it becomes easier to determine the body side and the end side of the osteosynthesis component 100, and the probability of preventing erroneous mounting is further increased.

The distance between the centers of the positioning pins 104 and 105 and the amount of protrusion do not necessarily have to be increased on the body side, and it is sufficient that the body side and the terminal side of the osteosynthesis component 100 can be determined.

In step S5, a screw is screwed into the bones 102 and 103 from the screw holes 108a and 108b to connect and fix the osteosynthesis component main body 101 to the bones 102 and 103, and then the positioning pins 104 and 105 are attached as shown in FIG. 1A. It is pulled out from the osteosynthesis component main body 101 together with the stopper 122. Finally, in step S6, the affected area is sutured to complete the procedure.

In the case of a bilaterally symmetrical bone fracture such as a jaw bone, the state before the fracture is calculated from the data such as past CT scans and the state of the surrounding bone, and crushed with the osteosynthesis part in the same manner as above. It can be used for the treatment of bone fractures and the like.

All of the positioning pins 104 and 105 were gap-fitted into the first and second through holes 106 and 107 and attached to the osteosynthesis component main body 101, but a part of the positioning pins was gap-fitted into the osteosynthesis component body 101. It is also possible to attach the stopper 122 to only a part of the positioning pin which is attached by tightening the rest of the positioning pin to the osteosynthesis component main body 101 and then fitting the positioning pin to the osteosynthesis component main body 101 by gap fitting. ..

Although L1 ≠ L2 and L11 ≠ L22, it is also possible to set L1 = L2 and L11 ≠ L22.

The present invention enables restoration treatment that is extremely close to the normal state by eliminating the difference in the reduction state due to individual differences of doctors as much as possible, reproduces the daily activities of the patient (animal) after healing, and various surgeries for fixing the fractured part. Contribute to improving the quality of the medical industry related to surgery.

100 Bone joint part 101 Bone joint part body 102 Broken bone on the body side (first bone)
103 Broken bone on the terminal side (second bone)
104 Body side positioning pin (first member)
105 Terminal side positioning pin (second member)
106 First through hole on the body side 107 Second through hole on the terminal side 108a, 108b Screw hole 111 Gap caused by crushed fracture 120 Fracture surface on the body side of the broken bone 121 Fracture surface on the terminal side of the broken bone 201 Normal state 3D data 202 3D data of broken bone on the body side 203 3D data of broken bone on the terminal side 204a Body side reference point of normal bone 205a Terminal side reference point of normal bone 204b Body side reference point of bone 102 205b Bone 103 End-side reference point 206 Inverted 3D data of normal bone

Claims (6)

In the osteosynthesis part that fixes the fractured part of the animal bone
An osteosynthesis component body in which one end contacts the surface of the broken first bone on the body side of the fractured portion and the other end contacts the surface of the broken second bone on the terminal side of the fractured portion.
A first member arranged on the osteosynthesis component body and in contact with the fracture surface of the first bone,
A second member arranged on the osteosynthesis component main body and in contact with the fracture surface of the second bone is provided.
Osteosynthesis parts. The first and second members are
Provided by penetrating the main body of the osteosynthesis component
The amount of protrusion of the first member protruding from the osteosynthesis component body to the side opposite to the fracture surface of the first bone protrudes from the osteosynthesis component body to the side opposite to the fracture surface of the second bone. The osteosynthesis component according to claim 1, wherein the amount of protrusion of the second member is different from that of the second member. The number of the first members is two.
The number of the second members is two.
The osteosynthesis component according to claim 1 or 2, wherein the distance between the centers of the two first members in the osteosynthesis component body is different from the distance between the centers of the two second members. At least one member of the first member and the second member is provided with a stopper that comes into contact with the surface of the osteosynthesis component body.
The length of the first member or the second member in contact with the fracture surface of the bone is adjustable by the stopper.
The osteosynthesis component according to any one of claims 1 to 3. In creating an osteosynthesis part that secures a fractured part of an animal's bone
The shapes of the broken first bone on the body side of the fractured portion, the broken second bone on the terminal side of the fractured portion, and the normal bone without the fractured portion were measured.
The first bone and the second bone are arranged on the data at the predicted position before the fracture based on the shape data of the normal bone obtained by the measurement.
Based on the shape data in which the osteosynthesis component main body is brought into contact between the surface of the first bone and the surface of the second bone arranged at the predicted position on the data, the osteosynthesis component main body is penetrated and said. In the position and direction of contacting the fracture surface of the first bone, the first through hole for inserting the first member and the position and direction of penetrating the main body of the osteosynthesis component and contacting the fracture surface of the second bone. A second through hole for inserting the second member is formed,
The first and second members are projected so that one end projects toward the back surface side of the osteosynthesis component body and the other end projects toward the front surface side of the osteosynthesis component body, and the first and second members of the osteosynthesis component body. A method of forming an osteosynthesis part that is inserted through a through hole. A plurality of the first through holes are formed at intervals in the osteosynthesis component main body, and a plurality of the second through holes are formed at intervals in the osteosynthesis component main body.
The method for forming an osteosynthesis component according to claim 5.