JP2002017740A - Bone repair and treatment device - Google Patents

Abstract

(57) [Problem] To provide a bone repairing / treating device capable of performing a treatment with a minimum incision when a fractured and cut bone is moved to its original position and restored. A robot arm for relatively moving a support device such as a pin inserted into each of two or more divided bone parts is provided.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a device for moving and / or turning a bone in a divided body without exposing the bone to the outside, and for repairing / treating the bone in a normal position. The present invention relates to a treatment device capable of moving a damaged bone to its original position, and more particularly to a treatment device suitably used for a femur and a tibia among limbs.

[0002]

2. Description of the Related Art Conventionally, in the treatment of a fracture or the like, it has been general to repair the diseased part in a state where the affected part is incised widely to expose the fractured bone. Therefore, it takes time to heal the incision and a large scar remains, so that the patient suffers great pain.

[0003] It has been considered that the original restoration is performed while confirming with an X-ray image without making an incision. However, in the case of a leg bone, the entire leg must be pulled or turned, and the confirmation of forced operation is required. Therefore, it is necessary to perform frequent X-ray fluoroscopy, and it is difficult to make fine adjustments, and it is difficult for even a skilled person to perform the operation. In addition, radiation exposure of operators and employees is also a major problem.

[0004]

SUMMARY OF THE INVENTION The present invention provides a device which can be repaired with a minimum incision without making a large incision as in the prior art.

[0005]

According to the first aspect of the present invention, there is provided a robot for relatively moving a support member such as a pin fixed to each of two or more bone parts divided by a fracture or other causes. It is a bone repair / treatment device provided with an arm.

The support member preferably takes the form of a pin, but is not limited to this, and the distal end of the robot arm itself may constitute a support member such as a pin.

To fix a support member such as a pin to a bone,
It is preferable that this is inserted into the bone, but the present invention is not limited to this. For example, it can be adhered to the surface of the bone or other fixing means can be appropriately used.

[0008] A support member such as a pin is fixed to an undamaged portion of each bone, that is, a portion to which a load can be applied. At least a part of the fixed pin is exposed outside the body, and the exposed pin is operated by a robot arm to perform a repair operation.

Since the robot arm only needs to be able to move relatively, for example, in the case of a device having two robot arms, if one of the robot arms can move and turn, the other robot arm does not move. It may have a function of simply fixing the bone part supported by the bone part.

According to the first aspect of the present invention, since the bone is moved by the machine, it is possible to move a very small amount of the bone while applying a large force to the bone. And the repair work will be easier.

[0011] In order to smoothly perform the above operation, it is preferable that at least one of the robot arms can move and turn in three axial directions.

Further, in the present invention, by using an image processing system (a so-called bone navigation system), the positional relationship of the bone can be observed on the monitor based on the data once stored. If necessary, the movement itself can be automatically performed by the machine by a program.

[0013] That is, in general, the total length of a femur or the like shrinks when a fracture occurs.
It is preferable to program the movement for aligning the axis of the bone after relatively separating the divided bone part using a support member such as a pin and turning the bone if necessary. The program is not limited to this, and it is preferable that an optimal program can be selected according to various symptoms.

According to a fourth aspect of the present invention, it is preferable to provide a robot arm for inserting a rod through two or more bone portions when the bone reaches the repaired position. This robot arm may also be used as one of the robot arms that move relatively.

According to a fifth aspect of the present invention, the rod to be inserted when the repair by the robot arm is completed as described above may be flexible. In other words, an object such as an endoscope or a catheter that can freely determine the direction of travel is used as a rod, inserted into two bones, and when a certain degree of alignment is achieved, the rod is made rigid (that is, the rod becomes rigid). ), And positioning may be performed. Alternatively, the rod may be inserted into the two bones and rigidified once the alignment is achieved to some extent.

Further, the rod may be a rigid rod instead of being flexible, and may be inserted into two bones when the positioning is completed.

According to a sixth aspect of the present invention, there is provided an apparatus for recognizing a positional relationship of a fractured bone by an image, an arithmetic unit for determining a bone movement path for repairing the bone from the image data, and Alternatively, there is provided a fracture treatment apparatus having a robot arm that supports and moves via a support member, and moves, turns, and repairs the robot arm so that the bone moves along the path.

In this case, it is preferable that a monitor for constantly displaying an image of the movement of the bone be provided.

[0019]

DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, the present invention will be described specifically with reference to examples. Note that the examples do not limit the scope of the present invention.

As shown in FIG. 1, the bone repairing and treating apparatus of the present invention comprises an X-ray imaging apparatus and an optical infrared camera 10, a display 12, a computer 14, a control unit 16, and a robot 18. It is configured. The robot 18 includes at least two robot arms, not shown, and a plurality of drive motors for moving at least one of the robot arms in three axial directions and rotating around each of the three axes. .

The X-ray imaging apparatus and the optical infrared camera are combined to provide two directions (one direction such as front and side, and a direction orthogonal thereto).
Surgical navigation can be performed by using the X-ray image of Fluoro-Navi (trademark).

First, the embodiment shown in FIG. 2 will be described.

Reference numerals 26 and 28 denote two robot arms provided in the bone repair / repair device (not shown) of the present invention.
Each robot arm 26, 28 has a pin 30, 32, respectively.
Holding. (Note that FIG. 2 shows a state in which the pin 30 is driven into a bone. Before the driving, the pin 30 is also held by an arm (not shown) similar to the arm 28,
It is driven into the bone by this arm. For example, suppose that the femur A is broken into two at the site excluding the epiphysis. The thigh, where the bone is no longer supported, contracts by the force of the muscles and becomes shorter as shown in FIG. For now, in this state, radiographs are taken from two or more directions to grasp the positional relationship between the bones. By applying this data to the X-ray imaging apparatus and the optical infrared camera, it is possible to always track the positional relationship of the bone even when the affected part is moved. Judging where the bone is easily operated by the robot arm by hitting a pin on the bone, the two bone parts a1 and a2 from outside the body
Hit pins 30 and 32 on At this time, for example, a diameter of 5 mm
A slight incision is made to pass through the metal pins 30, 32 of a certain degree. The optimum position for hitting the pin may be calculated by a computer based on the image data. For example, 30, 32 in FIG.
Hit perpendicular to the axis of the bone. The pins may be threaded on the outer surface to prevent skidding. When it penetrates, both ends may be fixed with a horseshoe-shaped member 34.

The pins 30, 32 are connected to the robot arms 26, 2
8 move in the direction away from each other. Thereafter, if the bone parts a1 and a2 are twisted, the robot arm 3
Is turned to bring the bone parts a1 and a2 into a correct positional relationship. Thereafter, as shown in FIG.
The bone A is fixed by inserting the rod 36 penetrating a2 into the bone A from near the epiphysis 38. At this time, the repair work is completed only by making a few small holes in the patient's leg.

The operation of the robot arm is performed automatically as follows. The positional relationship between the fractured bones ascertained by the X-ray imaging apparatus and the optical infrared camera is displayed on the display 12, and information on the positional relationship is stored by the computer 14. The computer 14 determines the amount of movement and the amount of rotation of the pin in the three axial directions, and controls the robot 1 via the control device 16.
A control signal is sent to the drive motors No. 8 to drive each motor. When it is detected that the encoder attached to each motor has driven the motor to the value specified by the computer 14, the driving of each motor is stopped.

In the embodiment shown in FIG. 3, the pin and the robot arm holding it are the same as those in FIG.

It is assumed that a fracture has occurred as in the case of FIG. At this time, the pins 130 and 132 are hit from outside the body. At this time,
The pin 130 is driven in the same manner as the pin 30 in FIG. 2, but the pin 132 is driven to a certain length from an angle close to the axial direction of the bone A. The pin 132 is fixed by a robot arm 128, and the pin 130 is moved by another robot arm (not shown) to align the axes of the bones. After the bone has been properly moved, the pin 132 is pushed in place of the rod 36 in FIG. 2 to fix the bone.

The apparatus of the embodiment shown in FIG. 4 has a robot arm (not shown) for holding the pins 230 and 232 similar to the apparatus of the embodiment shown in FIGS. 2 and 3, but is flexible and hollow. It differs from the embodiment of FIGS. 2 and 3 in having another robot arm 242 for supplying the rod 240.

In this case, it is assumed that a fracture has occurred as in the embodiment of FIG. At this time, the pin 23
0, 232 are driven in the same way as the pins 30, 32 in the embodiment of FIG. Next, the flexible rod 240 is inserted from the robot arm 242, and the tip is fixed to the pin 230. When tension is applied between the rod 240 and the pin 230 after the pins 230 and 232 move away from each other, the rod 240 is straightened, and the axes of the fractured bone parts a1 and a2 are aligned. In this state, a small-diameter rod (not shown) can be inserted into the hollow interior of the rod 240 and placed in the bone A in the same manner as shown in FIG.

The apparatus of the embodiment of FIG. 5 differs from the embodiment of FIG. 4 in that the rod 340 supplied from the rod arm 342 is a flexible rod, and the other points are the same as those of the embodiment of FIG. Is the same.

In this embodiment, it is assumed that a fracture has occurred in the same manner as in the embodiment of FIG. At this time, the pins 330 and 332 are driven in from outside the body in the same manner as the pins 30 and 32 in the embodiment of FIG. A flexible rod 340 is inserted from the robot arm 342, and the two fractured bone parts a1,
Enter while capturing the center of a2. Pin 330, 332
Are moved away from each other,
0 is stiffened and straightened, thereby aligning the axis of the bone A with a straight line. In this state, a rigid small-diameter rod 344 may be inserted into the hollow interior of the rod 340, and may be left in the bone. The flexible rod 340 is withdrawn after the bone fusion is completed.

The pin to be inserted may be a jig other than the pin as long as it can fix and move the bone. The number, angle, shape, material, and the like of the pins or jigs other than the pins may be appropriately selected as necessary.

Although not shown, the robot arm may be moved by remote control while monitoring a monitor without executing a program.

[0034]

According to the present invention, fracture treatment of a femur or the like can be performed by making only a few small incisions. Also,
Since it is controlled by a robot, a large force can be output and a minute movement can be performed, so that positioning can be easily performed.

Further, if the navigation system is used, the positional relationship between the bones can always be confirmed, and it can be confirmed that the actual treatment is properly performed.

[Brief description of the drawings]

FIG. 1 is a block diagram showing the overall configuration of an embodiment of the apparatus of the present invention.

FIG. 2 is a schematic view of a main part showing an embodiment of the apparatus of the present invention.

FIG. 3 is a diagram similar to the previous diagram showing another embodiment.

FIG. 4 is a similar view showing still another embodiment.

FIG. 5 is a similar view showing another embodiment.

[Explanation of symbols]

A bone a1 bone part a2 bone part 26, 28, 128, 242, 342 Robot arm 30, 32, 130, 132, 230, 232, 33
0,332 Pin 240,340 Rod

Claims (7)

[Claims] An apparatus for repairing and treating a bone provided with a robot arm for relatively moving a supporting member such as a pin fixed to each of two or more bone parts divided by a fracture or the like. 2. The repair / treatment device according to claim 1, wherein at least one of the robot arms is capable of moving and turning in three axial directions. 3. The movement according to claim 1, wherein the divided bone parts are relatively separated via a supporting member, and if necessary, pivoted through the supporting member, and then the movement for aligning the axis of the bone is programmed. Repair and treatment equipment. 4. The repair according to claim 1, further comprising a robot arm for inserting a rod through at least two bone portions when the bone reaches a repaired position.・ Treatment device. 5. The repair device according to claim 4, wherein the rod is flexible. 6. An apparatus for recognizing a positional relationship of a fractured bone by an image, an arithmetic unit for determining a bone movement path for repairing the bone from the image data, and a robot arm for supporting and moving the bone. A fracture treatment apparatus, comprising: moving and rotating a robot arm so that bone moves along the path to repair and treat the bone. 7. The fracture treatment apparatus according to claim 5, further comprising a monitor for constantly displaying an image of the movement of the bone.