JP6431641B1 - Osteotomy instrument - Google Patents

Abstract

An osteotomy device capable of removing a bone having a desired shape by a single resection is provided.
An osteotomy device (1) is a wedge-shaped blade body (10) having an upper surface plate (12) and a lower surface plate (13) intersecting at a predetermined acute angle in the osteotomy device (1) for excising a part of bone. A tip saw blade 11 formed at the tip edge where the face plate 12 and the lower surface plate 13 intersect, and a file 15 formed on at least one surface of the upper surface plate 12 and the lower surface plate 13 are brought into contact with the bone. By oscillating the blade body 10 in the width direction, the blade body 10 is provided with a blade body for cutting the bone contacting the tip saw blade 11 and surface grinding the bone contacting the file 15 and cutting the bone into a wedge shape.
[Selection] Figure 1

Description

  The present invention relates to an osteotomy device for cutting bone.

  Artificial joint replacement and high tibial osteotomy have been performed as treatments for knee osteoarthritis. As surgical instruments used for such treatment, cutting instruments, guide guides, fixing jigs and the like disclosed in Patent Documents 1 to 4 below are provided.

JP2015-16095A JP 2012-55597 A JP 2013-240695 A JP 2017-46783 A

  By the way, in the high-tibial osteotomy, the closed wedge method in which the bone is excised from the outside of the tibia into a wedge shape and the outside of the bone is shortened to correct it, it is necessary to excise the bone into a wedge shape with a predetermined tip angle. . In such a case, conventionally, the bone is cut into a wedge shape by cutting the bone twice at a predetermined angle using a bone cutting blade.

  However, it is very difficult to control the bone cutting blade to an accurate cutting position and cutting angle, and it depends largely on the ability of the doctor. Therefore, conventionally, there is a case where a high-tibial osteotomy cannot be performed even for a patient who desires to perform a high-tibial osteotomy due to a lack of doctor's ability.

  This invention is made | formed in view of such a subject, and it aims at providing the osteotomy instrument which can remove the bone of a desired shape by one excision.

  In order to solve the above-mentioned problems, an osteotomy device according to the present invention is a wedge-shaped blade body having an upper surface plate and a lower surface plate that intersect at a predetermined acute angle in an osteotomy device for excising a part of bone. A tip saw blade formed at a tip edge where the upper surface plate and the lower surface plate intersect with each other, and a file formed on at least one surface of the upper surface plate and the lower surface plate. The blade main body which cuts the bone contacting the tip saw blade and surface-grinds the bone contacting the file and cuts the bone into a wedge shape by vibrating the blade main body in the width direction. Is provided.

  According to the osteotomy instrument according to the present invention, the bone can be excised in a wedge shape by a single cutting by surface grinding with a file while cutting the front bone with a saw blade.

FIG. 1 is a perspective view of an osteotomy device according to an embodiment of the present invention as viewed from above. Drawing 2 is a perspective view seen from the lower part of the osteotomy device concerning the embodiment of the present invention. Drawing 3 is a mimetic diagram showing the use state of the osteotomy device concerning the embodiment of the present invention. FIG. 4 is an upper perspective view of the blade body according to the embodiment of the present invention. FIG. 5 is a lower perspective view of the blade body according to the embodiment of the present invention. FIG. 6 is a plan view of the blade body according to the embodiment of the present invention. FIG. 7 is a side view of the blade body according to the embodiment of the present invention. FIG. 8 is a partially enlarged view of FIG.

  Hereinafter, an osteotomy device according to an embodiment of the present invention will be described with reference to the drawings. FIG. 1 is an upper perspective view of the osteotomy instrument according to the present embodiment. FIG. 2 is a lower perspective view of the osteotomy instrument according to the present embodiment. FIG. 3 is a schematic diagram showing a usage state of the osteotomy instrument according to the present embodiment.

  FIG. 4 is an upper perspective view of the blade body according to the present embodiment. FIG. 5 is a lower perspective view of the blade body according to the present embodiment. FIG. 6 is a plan view of the blade body according to the present embodiment. FIG. 7 is a side view of the blade body according to the present embodiment. FIG. 8 is a partially enlarged view of FIG.

  The osteotomy instrument 1 is an instrument that is used by being set on a bone saw handpiece 6 that is a high-speed electric vibration instrument (10,000 rotations / minute). The osteotomy device 1 includes a blade body 10 and a fixing connection plate 30 that is fixed to the handpiece 6. The blade body 10 and the fixing connection plate 30 are detachably fixed by a fixing screw 35.

  The blade body 10 has a hollow wedge shape (triangular prism shape) in which an upper surface plate 12 and a lower surface plate 13 intersect at a predetermined acute angle at the tip, and a tip saw blade 11 formed at the tip edge and formed on the top surface. And a top saw blade 20 formed at the tip of the top file 15.

  Thus, according to the blade body 10 including the tip saw blade 11 and the upper surface file 15, while the bone located on the distal end side is cut by the tip saw blade 11, the bone located diagonally forward and upward by the upper surface file 15. It can be ground and the wedge-shaped part can be excised from the bone with a single cut.

  The tip edge of the blade body 10 has a circular arc shape that is convex toward the tip side, and the tip saw blade 11 also has an arc shape. When the blade body 10 vibrates at high speed in the width direction, that is, in the extending direction of the tip saw blade 11, the bone at the portion where the tip saw blade 11 contacts is cut.

  The upper surface file 15 is composed of a large number of file blades 16 aligned on the upper surface plate 12, and the upper body that contacts the surface of the upper surface file 15 is faced by the blade body 10 vibrating in the width direction. Grind.

  The top file 15 is divided into two regions in the left-right direction (width direction). The first file portion 17 is located on the right half (upper half in FIG. 6) when viewed from the hand side, and is viewed from the hand side. And a second file portion 18 located in the left half (lower half in FIG. 6).

  In the first file portion 17 and the second file portion 18, the direction of the file blade 16 is reversed except for the boundary portion. The first file portion 17 is formed so that the blade surface 16a of the file blade 16 faces the left side (width direction inner side) and the blade back surface 16b faces the right side (width direction outer side) when viewed from the hand side. The blade surface 16a of the file blade 16 is formed so as to face the right side (width direction inner side) and the blade back surface 16b facing the left side (width direction outer side) when viewed from the hand side. Further, the direction of the file blade 16 is alternately reversed at the boundary portion.

  The file blade 16 cuts the bone mainly when an acute corner where the blade surface 16a and the blade back surface 16b intersect with each other from the blade back surface 16b side. Therefore, when the blade body 10 moves to the right side as viewed from the hand side, the bone is mainly ground by the first file portion 17, and when the blade body 10 moves to the left side, the second file portion mainly. 18 to grind the bone.

  In this way, the upper surface file 15 is composed of the first file portion 17 and the second file portion 18 in which the file blade 16 is installed in the opposite direction, so that the upper file 15 Bone can be reliably ground.

  The first file part 17 and the second file part 18 may be installed and divided so that the direction of the file blade 16 is alternately reversed in the width direction, instead of being divided into two in the vicinity of the middle. Moreover, you may make it install the direction of the file blade 16 at random.

  In the upper surface plate 12, between the tip saw blade 11 and the upper surface file 15, a file blade 16 is not formed, that is, a buffer band 21 having no grinding function is formed. Here, generally, the bone structure has a cortical bone which is a hard bone on the surface side and a cancellous bone which is a soft bone on the inside.

  Further, if the upper surface file 15 also simultaneously contacts the cortical bone while the tip saw blade 11 is cutting the hard cortical bone, it is difficult to surface grind the hard cortical bone. Due to this friction, the blade body 10 cannot vibrate smoothly in the width direction, which hinders cutting with the saw blade 11.

  On the other hand, in the present embodiment, the tip saw blade 11 is provided with a buffer body 21 having a length of 2 mm between the tip saw blade 11 and the upper surface file 15 so as to correspond to the thickness of the cortical bone. While the hard cortical bone is being cut, the upper surface file 15 is configured not to grind the cortical bone, and smooth cutting of the cortical bone with the tip saw blade 11 is realized.

  Although the length of the buffer band 21 can be appropriately changed, in order to cut the cortical bone well with the tip saw blade 11, the thickness of the buffer band 21 should be 1 mm or more in consideration of the thickness of the cortical bone. It is desirable.

  The upper surface plate 12 is inclined at a predetermined tip angle (15 ° in the present embodiment) with respect to the lower surface plate 13. However, in the buffer body 21, the upper surface plate 12 is formed in parallel with the lower surface plate 13. Yes. This is because the function of the upper surface saw blade 20 which will be described later is exhibited well.

  Furthermore, in this embodiment, an upper surface saw blade 20 is formed at the leading edge of the upper surface file 15 that is a boundary portion between the buffer body 21 and the upper surface file 15. The upper surface saw blade 20 is formed substantially parallel to the tip saw blade 11 but is not arcuate but linear.

  The upper surface saw blade 20 is composed of a plurality of file blades 16 positioned at the foremost among the file blades 16 constituting the upper surface file 15, and the blade side surface 16 c on the tip side of the most recent file blade 16 and the blade surface. The sharp corners intersecting with 16a mainly cut bone.

  In this way, by installing the upper surface saw blade 20 at the tip of the upper surface file 15, a portion where the upper surface file 15 contacts is cut by the upper surface saw blade 20 prior to surface grinding by the upper surface file 15. Surface grinding by 15 can be performed more smoothly and quickly.

  A large number of small holes 22 are formed in the upper surface plate 12, the lower surface plate 13, and the left and right side plates 14 of the blade body 10. Since the osteotomy device 1 is vibrated by the hand spinner 6, it is desirable to reduce the weight as much as possible. Therefore, the blade body 10 is lightened by forming a large number of small holes 22 in the blade body 10.

  Further, the chips, which are bone shavings shaved by the tip saw blade 11, the upper surface file 15, and the upper surface saw blade 20, are guided into the hollow blade body 10 through the small holes 22.

  A large opening 24 is formed in the side plate 14 on the rear end side (hand side) of the blade body 10. Further, the lower surface of the blade body 10 is greatly opened, and the fitting insertion portion 32 of the fixing connection plate 30 described later is about half the longitudinal length of the lower surface of the blade body 10. The lower surface has a large opening on the tip side.

  Accordingly, the chips guided into the hollow interior of the blade body 10 are taken out from the opening 24 and the lower surface opening of the rear end side plate 14, so that the removal of the chips by intraoperative cleaning is facilitated.

  The fixing connection plate 30 includes a fitting insertion portion 32 that is fitted and connected to the lower surface plate 13 of the blade body 10, and a joint portion 33 that is fixed to the handpiece 6.

  Although the configuration of the osteotomy device 1 has been described above, the usage mode of the osteotomy device 1 will be described. The osteotomy instrument 1 is used with the joint portion 33 fixed to the connection portion of the handpiece 6, and the blade body 10 vibrates at high speed in the width direction by driving the handpiece 6.

  When the tip of the blade body 10 in a high-speed vibration state is brought into contact with the bone, the bone with which the tip saw blade 11 comes into contact is cut. When the blade body 10 is further pushed into the bone from this state, the tip saw blade 11 advances to the back while cutting the bone, and then the upper surface file 15 together with the upper surface saw blade 20 contacts the bone.

  At this time, the tip saw blade 11 has advanced into the bone by the length of the buffer band 21 and normally passes through the hard cortical bone located on the surface side of the bone and reaches the soft cancellous bone. ing.

  The upper saw blade 20 in contact with the bone advances to the back while cutting the cortical bone as the blade body 10 advances to the back. Subsequently, the upper surface file 15 comes into contact with the bone located obliquely upward in the front, and the contacting bone (cortical bone and cancellous bone) is ground on the surface obliquely upward in the traveling direction as the blade body 10 advances to the back. .

  As described above in detail, in the present embodiment, as the blade body 10 advances to the back, the upper surface file 15 formed on the upper surface plate 12 obliquely upwards while cutting the bone contacting the front of the tip saw blade 11. Since the bone is cut by the surface, the bone can be cut into a wedge shape by one cutting.

  Further, in the blade body 10, the upper surface plate 12 and the lower surface plate 13 intersect at a predetermined tip angle, and the portion of the bone to be excised has a wedge shape that is substantially the same as the wedge shape of the blade body 10. In the high tibial osteotomy by the closed wedge method, it is necessary to remove the bone into a desired wedge shape with high accuracy, and if the tip angle of the excision part is shifted, the treatment is adversely affected. Further, if the distal end of the removed portion is not an acute angle, it is difficult to join the bones themselves.

  On the other hand, in the present embodiment, the bone can be accurately removed with a desired wedge shape with high accuracy by cutting once using the blade body 10, thereby shortening the operation time and reducing the burden on the patient. It can be greatly reduced, and a good operation can be performed even by a doctor who has little experience in high tibial osteotomy without being influenced by the ability of the doctor.

  Here, when providing the osteotomy instrument 1, it is desirable to provide a plurality of sets of blade bodies 10 having different tip angles (intersection angles between the upper surface plate 12 and the lower surface plate 13). In high-tibial osteotomy, the angle at which the bone is tilted varies depending on the patient, and therefore the tip angle of the wedge-shaped portion excised from the bone also varies. Therefore, in order to cut out a desired wedge-shaped portion by a single cut, it is desirable to use the blade body 10 having substantially the same tip angle as the portion to be cut.

  For example, by providing a blade body 10 having a tip angle of 6 °, 10 °, 12 °, and 15 ° and one fixed connection plate 30 as a set, the blade body 10 can be exchanged according to the patient. By fixing and using the fixed connection plate 30, the osteotomy instrument 1 can be used for more patients.

  Although the embodiment according to the present invention has been described above, the present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the gist of the present invention. For example, the shape, size, and material of the members constituting the osteotomy device can be changed as appropriate.

  In this embodiment, the file is installed only on the upper surface of the blade body. However, the file may be installed only on the lower surface, or may be installed on both the upper surface and the lower surface, and either on the upper surface or the lower surface. By installing a wedge shape, it becomes possible to cut out the wedge shape with a single cutting.

  In the above embodiment, the surface grinding member that is installed on the upper surface of the blade body and performs surface grinding employs a file composed of a number of file blades having a blade surface and a blade back surface. It is not limited to such a file, and various surface grinding members can be employed.

  For example, as a file blade of a file, blades of various shapes such as semi-circular, triangular, rhombus, and quadrilateral blades can be used, and as a surface grinding member, a grindstone other than a file, sandpaper Etc. can be used.

  Further, the osteotomy instrument according to the present embodiment can be widely applied not only to the high-order tibial osteotomy but also to a surgical operation or the like for excising a bone into a wedge shape.

DESCRIPTION OF SYMBOLS 1 Osteotomy tool 10 Blade main body 11 Tip saw blade 12 Top plate 13 Bottom plate 14 Side plate 15 Top file 16 File file 16a Blade surface 16b Blade back surface 16c Tip side blade side 17 First file part 18 Second file part 20 Upper surface saw Blade 21 Buffer band 22 Small hole 24 Opening 30 Fixing connection plate 32 Insertion portion 33 Joint portion 35 Fixing screw 6 Handpiece

Claims (3)

In an osteotomy device for excising part of bone,
A wedge-shaped blade body having an upper surface plate and a lower surface plate that intersect at a predetermined acute angle,
A tip saw blade formed at a tip edge where the upper surface plate and the lower surface plate intersect;
A file formed on at least one surface of the upper surface plate and the lower surface plate,
By oscillating the blade body in contact with the bone in the width direction, the bone contacting the tip saw blade is cut, and the bone contacting the file is surface-ground to form a wedge shape. An osteotomy device comprising a blade body for excision.   The osteotomy device according to claim 1, wherein a buffer band having no blade of 1 mm or more is formed between the saw blade and the file on the surface on which the file is formed.   The osteotomy device according to claim 2, wherein the file is an upper surface file formed only on the surface of the upper surface plate.

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