JP2010284478A

JP2010284478A - Knife set for incising patellar tendon

Info

Publication number: JP2010284478A
Application number: JP2009159282A
Authority: JP
Inventors: 英卓 ▲高▼; Hidetaka Ko
Original assignee: Individual
Current assignee: Individual
Priority date: 2009-06-12
Filing date: 2009-06-12
Publication date: 2010-12-24
Anticipated expiration: 2029-06-12
Also published as: JP5490455B2

Abstract

<P>PROBLEM TO BE SOLVED: To provide a knife set capable of accurately incising the patellar tendon straight and at a fixed width. <P>SOLUTION: A hard steel wire (15) is inserted into the center of the patella (14). A guide plate (16), whose width is that of the patellar tendon and which is longer than the bone-patellar tendon, whose one end is bifurcated and the other end has a plurality of holes, is inserted from a small skin incised part on the tibia side, and the bifurcated part is hooked on the hard steel wire (15). Next, the guide plate (16) is put at the center of the patellar tendon, and the hard steel wire is inserted into a hole in the guide plate to fix the tibia side of the guide plate. A knife blade (19) is inserted from a slit (10) on the first stage of a handle (20), and fixed in a slit (11) on the second stage. Next, the hard steel wire is inserted into a slender window (9) of the handle (20), and the knife blade is pushed forward along the guide plate (16) using the guide plate as a rail. Then, the patellar tendon can be naturally incised straight and at a fixed width. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

本発明は膝蓋腱を一定の幅で確実、かつ安全に切開するメスセットに関するものである。 The present invention relates to a scalpel set for incising a patella tendon with a certain width reliably and safely.

前十字靱帯断裂はスポーツ選手によくある損傷である。この損傷の治療は手術を要する。手術法としては、靭帯の移植術が主である。いろいろな腱を用いるが、そのなかでも骨付き膝蓋腱の移植が広く行われている。骨付き膝蓋腱とは，膝蓋腱の中央三分の一（１）を膝蓋骨の一部（２）と脛骨の一部（３）を付けて同時に採取したものである（図１）。したがって、骨付きの膝蓋腱を採取するためには、まず膝蓋腱を正確に切開する必要がある。従来のメスを用いて、一本ずつ２本の切開を加える方法、両刃のメスを用いて同時に二つの切開を加える、この二つの方法が行われている。 Anterior cruciate ligament rupture is a common injury to athletes. Treatment of this injury requires surgery. The main surgical procedure is ligament transplantation. Various tendons are used. Among them, patella tendons with bones are widely transplanted. A patella tendon with a bone is a patella tendon (1) with a portion (2) of the patella (2) and a portion of the tibia (3) collected simultaneously (FIG. 1). Therefore, in order to collect a patella tendon with a bone, it is first necessary to accurately incise the patella tendon. There are two methods, a conventional method of making two incisions using a scalpel and a method of making two incisions simultaneously using a double-edged scalpel.

前記の方法では以下の欠点があった。
（イ）従来のメスをもちいて、２本の切開を加える方法。この方法では膝蓋骨側と脛骨側の幅が違うことがあった（図２）。
（ロ）コの字型の両刃のメスもあったが、膝蓋骨側と脛骨側の幅の幅は同じであるが、膝蓋腱を斜めに切開することがあった（図３）。
（ハ）どちらも、骨付き膝蓋腱の長さに相当する長さの皮膚を切開したため、美容上問題があるばかりでなく、痛みがよく残った。
本発明は、以上の問題を解決するためものである。The above method has the following drawbacks.
(A) A method of making two incisions using a conventional scalpel. In this method, the width of the patella side and the tibia side might be different (FIG. 2).
(B) Although there was a U-shaped double-edged knife, the patella side and the tibia side had the same width, but the patella tendon was cut obliquely (FIG. 3).
(C) In both cases, the length of skin corresponding to the length of the patella tendon with bone was incised, so there were not only cosmetic problems but also pain remained.
The present invention is to solve the above problems.

幅は切開する予定の膝蓋腱の幅で、長さは骨付き膝蓋腱より長い、一端を二股、他端に複数の穴を空けた膝蓋腱を切開するためのガイド板。 The width is the width of the patella tendon to be incised, and the length is longer than that of the patella tendon with bone.

前記のガイド板の上に乗せて、膝蓋腱を切開することができる交換可能なコの字型のメス刃。 A replaceable U-shaped female blade that can be placed on the guide plate and can incise the patella tendon.

前記のメス刃を装着でき、柄の先端は二股で、柄の体部に硬鋼線を通すことができる長い窓のある柄。 A handle with a long window that can be fitted with the knife blade, has a bifurcated tip, and allows a hard steel wire to pass through the body of the handle.

本発明は、前記に説明したように構成されているので、以下の効果がある。
（イ）両刃であるので、切開した膝蓋腱の幅は、膝蓋骨側と脛骨側の幅が違うことはなく同じ幅である。
（ロ）骨に固定されたガイド板に沿って切開するので、膝蓋腱を斜めに切開することはない。
（ハ）柄の尾部を押すことにより、小さな皮膚切開で皮下から膝蓋腱を切開できるため、本発明による膝蓋腱切開法は美容上優れていて、痛みも少ない。Since the present invention is configured as described above, the following effects can be obtained.
(B) Because of the double-edged blade, the incised patella tendon has the same width without any difference between the patella side and the tibia side.
(B) Since the incision is made along the guide plate fixed to the bone, the patella tendon is not obliquely incised.
(C) Since the patella tendon can be incised subcutaneously with a small skin incision by pressing the tail of the handle, the patella tendon incision method according to the present invention is cosmetically superior and has little pain.

膝の正面図である。 It is a front view of a knee. 膝蓋骨側と脛骨側の幅が違う図である。 It is a figure in which the widths of the patella side and the tibia side are different. 膝蓋腱を斜めに切開した図である。 It is the figure which cut | disconnected the patella tendon diagonally. ガイド板の平面図である。 It is a top view of a guide plate. メス刃の正面図である。 It is a front view of a knife blade. メス刃の側面図である。 It is a side view of a knife blade. メス刃の斜視図である。 It is a perspective view of a knife blade. 柄の斜視図である。 It is a perspective view of a handle. 柄の先端の側面図である。 It is a side view of the tip of a handle. メス刃を柄に装着したときの柄の先端の斜視図である。 It is a perspective view of the tip of a handle when a knife blade is attached to the handle. メス刃を持針機で把持し時の斜視図である。 It is a perspective view at the time of hold | gripping a knife blade with a needle holder. メス刃を持針機で把持し一段目の割に挿入した時の斜視図である。 It is a perspective view when a knife blade is grasped with a needle holder and inserted into the first stage. メス刃を持針機で把持し二段目の割に挿入した時の斜視図である。 It is a perspective view when a knife blade is grasped with a needle holder and inserted into the second stage. 膝蓋腱を，本発明を用いて切開している時の斜視図。 The perspective view when the patella tendon is incised using the present invention.

以下、本発明実施の形態について説明する。
（イ）幅は切開する予定の膝蓋腱（１）と同じ、長さは採取する骨付き膝蓋腱より少し長い。先端から、数センチの間にわたり硬鋼線が通る穴（７）を数個開ける。もう一方の先端は、二股になっており、二股の間は硬鋼線が通る間隔がある。以上の構成からなるガイド板である（図４）。
（ロ）コの字型のメス刃である（図５）。平行な面に刃（８）を持つ、刃は斜めになっており、刃の向きは両方とも前方である（図６）。刃と刃の間の面は凹型である（図７）。刃と刃の距離は切開する予定の膝蓋腱の幅である。この中間部の幅の狭い部分でメス刃が柄で把持される。以上の構成からなるメス刃である（図７）。
（ハ）柄はうすく、細長い、中に硬鋼線が通る幅の窓（９）をつくり、先端は二股である（図８）。側面から見ると嘴状になって体部より厚い。側面から見ると三段の割が入っている（図９）。一段目の割（１０）は前記のメス刃の入り口で滑らかである。二段目の割（１１）はメス刃を固定するための割である。前記のメス刃の中間部の幅の狭い部分の前後の長さは二段目の割の前後の長さと一致し、柄の幅は前記のメス刃の中間部の幅の狭い部分の横の長さに一致している。そのような構造のため二段目で前記のメス刃を把持することが可能である（図１０）。三段目の割（１２）は嘴の上部分にバネのような機能を持たすための割である。それぞれの割は連続しているが段をなしている。二股にしたため、持針器（１３）でメス刃の中間部の幅の狭い部分を把持したままで（図１１）、一段目の割からメス刃を挿入し（図１２）、二段目の割にメス刃を固定することができる（図１３）。Hereinafter, embodiments of the present invention will be described.
(A) The width is the same as that of the patella tendon (1) to be incised, and the length is slightly longer than the patella tendon with bone to be collected. From the tip, several holes (7) through which the hard steel wire passes for several centimeters are made. The other end is bifurcated, and there is an interval through which the hard steel wire passes. It is a guide plate which consists of the above structure (FIG. 4).
(B) A U-shaped knife blade (FIG. 5). The blades (8) have parallel blades, the blades are slanted, and the blades are both forward (FIG. 6). The surface between the blades is concave (FIG. 7). The distance between the blade and the blade is the width of the patella tendon to be incised. The knife blade is gripped by the handle at the narrow portion of the intermediate portion. It is a knife blade which consists of the above structure (FIG. 7).
(C) The handle is light and elongated, and a window (9) is formed with a width through which the hard steel wire passes, and the tip is bifurcated (FIG. 8). Seen from the side, it looks like a bowl and is thicker than the body. When viewed from the side, there are three levels (Fig. 9). The first split (10) is smooth at the entrance of the knife blade. The second split (11) is a split for fixing the knife blade. The front and rear lengths of the narrow part of the middle part of the knife blade coincide with the front and rear lengths of the second stage, and the width of the handle is the side of the narrow part of the middle part of the knife blade. It matches the length. Because of such a structure, it is possible to hold the knife blade in the second stage (FIG. 10). The third split (12) is a split for providing a spring-like function to the upper part of the ridge. Each percent is continuous but stepped. Since it has been bifurcated, the needle blade (13) holds the narrow part of the middle part of the knife blade (FIG. 11), and inserts the knife blade from the first stage (FIG. 12). The knife blade can be fixed relatively (FIG. 13).

本発明は以上のような構成で、これらを使用するのは以下のように行う。
膝蓋骨（１４）の中央に硬鋼線を刺入（１５）し、脛骨側に数センチの皮膚切開を加えて、本発明のガイド板の二股になっている先端から、脛骨側の皮膚切開部より、ガイド板（１６）を皮下より挿入し、前記の硬鋼線（１５）に掛ける。この操作でガイド板（１６）の膝蓋骨側は固定された。ガイド板（１６）を膝蓋腱（１７）の中央におき、そしてガイド板の穴（７）に硬鋼線を刺入（１８）し脛骨側を固定する。このようにして膝蓋腱の切開するところの直上にガイド板（１６）を正確に置き、固定することができる。本発明のメス刃（１９）を本発明の柄（２０）に装着し、柄（２０）の硬鋼線の入る細長い窓（９）に、ガイド板の脛骨側を固定している硬鋼線（１８）を通し、つぎにメス刃（１９）をガイド板（１６）に沿わせ、押し込むようにして皮下で膝蓋腱を切開する（図１４）。メス刃はガイド板（１６）がレールになり、また硬鋼線（１８）が柄（２０）の中に入っているので柄（２０）はぶれずにまっすぐに進む。その結果、膝蓋腱はガイド板（１６）の幅にまっすぐに正確に切開できる。本発明を用いると、このように膝蓋腱を確実に、かつ正確に切開することができる。柄（２０）の尾部を押して、皮下で切開するので、膝蓋腱の直上の皮膚切開は必要としない。The present invention is configured as described above, and these are used as follows.
A hard steel wire is inserted (15) in the center of the patella (14), a skin incision of several centimeters is made on the tibia side, and a skin incision part on the tibia side is formed from the bifurcated tip of the guide plate of the present invention. Then, the guide plate (16) is inserted subcutaneously and hung on the hard steel wire (15). By this operation, the patella side of the guide plate (16) was fixed. The guide plate (16) is placed in the center of the patella tendon (17), and a hard steel wire is inserted (18) into the hole (7) of the guide plate to fix the tibia side. In this way, the guide plate (16) can be accurately placed and fixed immediately above the incision of the patella tendon. A hard steel wire in which the female blade (19) of the present invention is mounted on the handle (20) of the present invention, and the tibia side of the guide plate is fixed to an elongated window (9) into which the hard steel wire of the handle (20) enters. (18) is passed, and then the female blade (19) is placed along the guide plate (16), and the patella tendon is incised subcutaneously as if pushed down (FIG. 14). In the knife blade, the guide plate (16) becomes a rail, and the hard steel wire (18) is contained in the handle (20), so the handle (20) moves straight without shaking. As a result, the patella tendon can be accurately incised straight into the width of the guide plate (16). When the present invention is used, the patella tendon can be incised reliably and accurately in this way. Since the tail of the handle (20) is pushed and incised subcutaneously, a skin incision just above the patella tendon is not required.

１膝蓋腱の中央三分の一
２膝蓋骨の一部
３脛骨の一部
４大腿骨
５下腿骨
６腓骨
７硬鋼線が通る穴
８メス刃の刃の部分
９硬鋼線が通る窓
１０一段目の割
１１二段目の割
１２三段目の割
１３持針器
１４膝蓋骨
１５膝蓋骨に刺入した硬鋼線
１６本発明のガイド板
１７膝蓋腱
１８脛骨に刺入した硬鋼線
１９本発明のメス刃
２０本発明の柄DESCRIPTION OF SYMBOLS 1 Middle third of patella tendon 2 Part of patella 3 Part of tibia 4 Femur 5 Lower leg bone 6 Rib 7 Hole through which hard steel wire passes 8 Female blade edge part 9 Window through which hard steel wire passes 10 Split of eye 11 Split of second stage 12 Split of third stage 13 Needle holder 14 Patella 15 Hard steel wire inserted into patella 16 Guide plate 17 patella tendon 18 19 hard steel wires inserted into tibia Female knife 20 of the invention Handle of the present invention

Claims

The width is the width of the patella tendon to be incised, and the length is longer than that of the patella tendon with bone.

A replaceable U-shaped female blade that can be placed on the guide plate and can incise the patella tendon.

A handle with an elongated window that can be fitted with the knife blade, has a bifurcated tip, and allows a hard steel wire to pass through the body of the handle.