WO2008018612A1 - Ultrasound bone fracture healing device, receiver for healing bone fracture, and bone fracture position examining device - Google Patents

Abstract

An ultrasound bone fracture healing device, a receiver, and a bone fracture position examining device for confirming that an ultrasound is applied correctly to a fractured bone portion are provided. The ultrasound bone fracture healing device comprises a transmitting transducer (4) placed on the body surface (12) near the fractured bone portion and used to apply an ultrasound to the fractured bone portion (3), and a receiving transducer (5) placed on the body surface near the bone having a fractured portion and used to receive the ultrasound propagated through the bone. The ultrasound bone fracture healing device comprises a judging device(6) for confirming that an ultrasound is applied from the transmitting transducer to a fractured bone portion by means of the reception signal of the receiving transducer.

Description

Ultrasound fracture treatment device, fracture treatment receiver and fracture position inspection device

Technical field

 The present invention relates to an ultrasonic fracture treatment device, and in particular, to have a receiving transducer and adjust a transmitting transducer to an appropriate position.

The present invention relates to an ultrasonic fracture treatment device that can confirm that ultrasonic waves are applied to a fracture site. The present invention also provides an ultrasonic fracture treatment receiver that receives ultrasonic waves applied to a bone from an ultrasonic treatment device, and a transducer suitable for performing ultrasonic fracture treatment using ultrasonic waves. It also relates to an ultrasonic fracture position tester that confirms the position.

Background art

 The ultrasonic fracture treatment device used to promote fracture healing treats the fracture site by irradiating the fracture site with ultrasonic waves. Ultrasound is generally used for diagnosis and treatment as a safe and simple physical therapy.

 In an ultrasonic fracture treatment device, it is necessary to accurately irradiate the fracture position with ultrasonic waves. Conventionally, the fracture position is identified by X-ray imaging, and the ultrasonic irradiation position is determined from the body surface in the vicinity, and treatment is performed. However, X-ray photography has only two-dimensional information and does not have three-dimensional information that reflects the shape of the body surface. When treating thick femur and humerus.

In order to solve the above problems, ultrasonic waves are applied to the bone from the therapeutic ultrasonic transducer and the reflected waves are received by the receiving ultrasonic transducer. A technique for judging whether or not the bone is correctly irradiated by receiving the signal has been disclosed (Japanese Patent Laid-Open No. 2 0 0 1-2 997 7 2). However, with this technology, the direction of the reflected wave is not constant depending on the shape of the bone and the bone part, and it often happens that the reflected wave from the bone cannot be received, and the precise transmission of the intended transmitting transducer There was a problem that the position could not be confirmed. In addition, it may be possible to receive by adjusting the installation position of the receiving transducer, but it is necessary to adjust the position of the transmitting transducer and the position of the receiving transducer at the same time, and determine the irradiation position. However, there was a problem in practical use.

 As another prior art, according to Japanese translation of PCT publication No. 2 0 0 0 — 5 0 4 9 4 6, an ultrasonic device for determining the characteristics of bone is disclosed. According to this, an ultrasonic wave is transmitted along a transmission path such as bone via a medium such as soft tissue interposed from the first position, and again sent to a second position via a medium such as soft tissue and along the transmission path. Measuring the transmission time of the ultrasonic wave, measuring the thickness of the intervening medium, measuring the acoustic velocity of the intervening medium, the distance between the two positions, Calculating the acoustic velocity in the individual based on the thickness and the acoustic velocity in the intervening medium. Although this method can measure the physical properties of bone using ultrasound, it is not intended to use ultrasound to treat fractures. It is not intended to adjust the position.

Further, in Japanese Patent Laid-Open No. 2 0 5-1 0 2 7 1 6, a vibrator placed on the tibial plow portion receives a drive signal from a signal generator to vibrate the tibia, The ultrasonic deep transducer and the transmitter / receiver transmit ultrasonic waves in response to vibrations transmitted through the tibia, and receive the returned ultrasonic waves. The phase comparator compares the phase of the received signal, and the correlation calculator compares the phase. Signal correlation calculation is performed, and the intensity of vibration at each part of the tibia, which is the result of the correlation calculation, is displayed on the display unit. According to this prior art, the bone condition can be diagnosed by measuring the strength of the vibration of the bone, but the fracture treatment is performed by irradiating an appropriate fracture site with ultrasound for fracture treatment. It is not intended to be done.

 Patent Document 1 Japanese Patent Laid-Open No. 2 0 0 1 — 2 9 9 7 7 2

 Patent Document 2 Special Table 2 0 0 0— 5 0 4 9 4 6

 Patent Document 3 Japanese Patent Laid-Open No. 2 0 0 5-1 0 2 7 1 6 Disclosure of Invention

Problems to be solved by the invention

 An object of the present invention is to provide an ultrasonic fracture treatment device that can confirm that a therapeutic ultrasonic wave is accurately irradiated to a fracture site and can be used easily. The present invention also provides an ultrasonic fracture treatment receiver associated with the ultrasonic fracture treatment device and an ultrasonic wave for confirming the position of an appropriate acupuncture lance reducer for performing ultrasonic fracture treatment using ultrasonic waves. It is an object to provide a fracture position inspection device. Means for solving the problem

 As a result of intensive studies on the above problems, the present inventors have installed the transducer on the body surface in the vicinity of the fracture site, radiates ultrasonic waves to the fracture site, and the transducer on the body surface of the bone. It is possible to solve the above-mentioned problems by providing a reception lancet transducer for receiving propagating ultrasonic waves and a judgment device for confirming that ultrasonic waves are irradiated from the transmission lance lance reducer to the fracture site. This is what we found.

That is, the present invention is installed on the body surface near the fracture site, A transmitting transducer that transmits ultrasonic waves for fracture treatment, and a receiving transducer that is installed on the body surface near the bone having the fracture site and receives ultrasonic waves propagating through the bone. An ultrasonic fracture treatment device comprising: a determination device configured to confirm that ultrasonic waves are transmitted from a transducer to a fracture site by comparing a reception signal of a reception transducer with a set determination condition. Is to provide.

 In this specification, “bone” means the bone surface, periosteum, dense (cortical bone) and cancellous bone (cancellous bone), and bone marrow, and “bone fracture” It is meant to include any damage related to these bones.

 Also, the present invention is characterized in that the receiving transducer receives ultrasonic waves at the body surface of the soft tissue near the proximal end and Z or near the distal end of the bone, and in particular, the bone In the case of the femur, receiving the wave propagated through the femur at the body surface near the outer epicondyle of the femur, the inner epicondyle of the femur, or the greater trochanter of the femur, if the bone is the humerus, The present invention provides an ultrasonic fracture treatment device characterized by receiving a wave propagated through the humerus near the outer surface of the humerus or near the inner humerus.

 The discrimination condition is based on a preset threshold value and Z or an ultrasonic wave propagation characteristic value of a bone to be treated. In particular, the ultrasonic propagation characteristic value is a parameter obtained from at least one of the amplitude, frequency, waveform shape, or propagation time from the transmitted ultrasonic wave of the received signal.

The transmission 卜 lance reducer is capable of transmitting both fracture treatment ultrasound to be transmitted to the fracture site and inspection ultrasound to confirm that the fracture is being transmitted to the fracture site, or fracture treatment ultrasound. Features. In addition, the inspection ultrasonic wave has a shorter burst width than a period in which no therapeutic ultrasonic waves are transmitted, and is transmitted while no therapeutic ultrasonic waves are transmitted.

 Further, according to the present invention, the determination device includes a receiving circuit in which the receiving transducer receives an ultrasonic signal, a storage unit that stores a determination condition in advance, and the reception signal and the determination condition. It is characterized by comprising a discriminating means for discriminating that it is transmitting, a display means for displaying at least a discrimination result, and a control means for controlling the receiving circuit and the display means. Alternatively, the determination device includes: a transmission circuit that transmits an electrical signal that drives the transmission transducer; a reception circuit that receives the ultrasonic signal from the reception transducer; a storage unit that stores a determination condition; A discriminating means for comparing the signal with the discriminating condition and discriminating that ultrasonic waves are transmitted to the fracture site; a display means for displaying at least the discrimination result; and the transmitting circuit, the receiving circuit, and the display means. Control means for controlling is provided.

 The receiving lance transducer includes a first receiving transducer and a second receiving transducer, and the first receiving lance transducer is located near the proximal end of the bone, and the second receiving lance transducer. The transducer is characterized in that it receives ultrasound on the body surface of the thin part of soft tissue near the distal end of the bone.

The present invention also includes (1) a step of calculating the ultrasonic feature value from an electrical signal received by the receiving transducer, and the feature value is recorded in advance by the recording means. (2) After the step of (1), ultrasonic waves are irradiated from the transmitting lance transducer, the ultrasonic waves transmitted through the bone are received by the receiving transducer, and the discrimination means performs an electrical signal at that time. Comparing with the characteristic value obtained in (1) and / or the threshold value and determining whether the difference is within a predetermined range An ultrasonic fracture treatment device is provided.

 Further, the present invention provides the ultrasonic fracture treatment characterized in that, in the step (2), the display means changes the display content depending on whether or not the electrical signal of the received ultrasonic wave is within a predetermined range. A container is provided.

 In the present invention, when the control means determines that the ultrasonic wave is applied to the fracture site by the step (2), the transmission transducer controls the ultrasonic wave for treatment. It is an object of the present invention to provide an ultrasonic fracture treatment device.

 Further, the present invention provides the ultrasonic fracture treatment device, wherein the transmission transducer irradiates the inspection ultrasonic wave at a predetermined interval during a period in which the therapeutic ultrasonic wave is not irradiated, and repeats the step (2). Is to provide.

 The present invention further includes a receiving transducer that is installed on the body surface near the bone and receives ultrasonic waves propagating through the bone, and that the ultrasonic wave is irradiated from the ultrasonic therapy device to the bone. There is provided an ultrasonic receiving device comprising a determination device for confirming by comparing a signal with a set determination condition. The receiving acupuncture lance reducer receives ultrasonic waves on the body surface of a thin portion of soft tissue near the proximal end or the distal end of the bone.

Further, according to the present invention, the determination device includes at least a receiving circuit in which a receiving transducer receives an ultrasonic signal, a storage unit that stores a determination condition in advance, and compares the received signal with the determination condition. A discriminating means for discriminating that the bone is irradiated with ultrasonic waves from the vessel, a display means for displaying the discrimination result, and a control means for controlling the receiving circuit and the display means. An ultrasonic therapy receiver is provided. In the present invention, the determination condition is It is characterized by the threshold value of the bone to be treated and z or the ultrasonic propagation characteristic value set in advance, in particular, at least one of the amplitude, frequency, waveform shape, or propagation time from the transmitted ultrasonic wave of the received signal It provides a receiving device for ultrasonic therapy in which the parameter obtained from

 In addition, the present invention includes (A) a step of calculating the ultrasonic feature value from an electrical signal received by the receiving transducer, and the feature value is recorded in advance by the recording means. (B) After the step (A), an ultrasonic wave is irradiated from an ultrasonic therapy device, the ultrasonic wave propagated through the bone is received by the receiving transducer, and the discriminating means receives the electric signal at that time ( A feature of the present invention is to provide an ultrasonic receiving apparatus having a step of comparing the characteristic value obtained in step A) with the threshold value or the threshold value and determining whether the difference is within a predetermined range.

 Further, the present invention is characterized in that, in the step (B), the display means changes display contents depending on whether or not the electrical signal of the received ultrasonic wave is within a predetermined range. When it is determined that the ultrasonic wave is applied to the fracture site by the step (B), the means instructs the ultrasonic therapeutic device to irradiate the therapeutic ultrasonic wave. A device is provided.

 In the present invention, the receiving transducer is composed of a first receiving transducer and a second receiving transducer, and the first receiving heel transducer is near the proximal end of the bone, the second receiving transducer There is provided an ultrasonic fracture receiving device characterized in that the receiving transducer receives ultrasonic waves respectively on the body surface of a thin portion of soft tissue near the distal end of the bone.

Furthermore, the present invention provides a transmitting transducer that is installed on a body surface in the vicinity of a fracture site and that transmits ultrasonic waves for examination to the fracture site, and the fracture It is installed on the body surface in the vicinity of the bone having the part, provided with a receiving transducer for receiving the ultrasonic wave propagating through the bone, and for receiving that the ultrasonic wave is transmitted from the transmitting transducer to the fractured part. There is provided an ultrasonic fracture position inspecting device comprising a determination device for confirming by the received signal.

 Further, the present invention is characterized in that the determination device at least transmits an electrical signal that drives the transmission transducer, a reception circuit that receives the ultrasonic signal from the reception transducer, and stores a determination condition in advance. A storage means, a determination means for comparing the received signal with the determination condition, and determining that the ultrasonic wave is irradiated to the fracture site; a display means for displaying at least the determination result; and the transmitting circuit, the receiving circuit, and An ultrasonic fracture position inspection device is provided, comprising a control means for controlling the display means.

 Further, the present invention is characterized in that the determination condition is based on a preset threshold value and / or an ultrasonic propagation characteristic value of a bone to be treated, and in particular, the ultrasonic wave for examination is an ultrasonic wave for treatment. There is provided an ultrasonic fracture position inspection device characterized by having a burst width shorter than that of a non-irradiation period and being transmitted while not being irradiated with therapeutic ultrasonic waves.

The present invention also provides an ultrasonic fracture position inspection device characterized by performing the steps (1) and (2). (1) A step of calculating the ultrasonic feature value from an electrical signal received by the receiving transducer, and recording the feature value in advance by the recording means. (2) After the step of (1), the transmitting transducer receives the ultrasonic wave from the transmitting transducer, and the receiving transducer receives the ultrasonic wave propagated through the bone. Compare with the feature value obtained in the step 1) and / or the threshold value, and determine whether the ultrasonic wave is irradiated to the fracture site based on whether the difference is within a predetermined range. Process.

 Further, the present invention is characterized in that the control means determines that the ultrasonic wave is irradiated to the fracture site by the step (2).

 In the present invention, the receiving transducer is composed of a first receiving transducer and a second receiving transducer, and the first receiving lance transducer is near the proximal end of the bone, and the second receiving transformer. An ultrasonic fracture position detector is provided in which the Duzer receives ultrasonic waves at the body surface of a thin portion of soft tissue near the distal end of the bone. Brief Description of Drawings

 FIG. 1 is a schematic view of an embodiment using the fracture treatment device of the present invention. Figure 2 is a schematic diagram of the components of the device.

 Figure 3 shows an example of received signal analysis.

 FIG. 4 is a schematic view of another embodiment using the fracture treatment device of the present invention.

 Figure 5 is a schematic diagram of the transmission mechanism.

 FIG. 6 is a schematic diagram of the receiving mechanism.

 FIG. 7 is a diagram of an embodiment of an electric signal for driving the transmitting transducer according to the present invention.

 FIG. 8 is a schematic view of an embodiment using two receiving transducers in the fracture treatment device of the present invention.

 FIG. 9 is a schematic diagram of the components of the apparatus of the embodiment using two receiving transducers.

FIG. 10 is a diagram of an example of received signal analysis in an embodiment using two receiving transducers. Explanation of symbols

 1 Soft tissue

 2 femur

 3 Fracture site

 4 Transmission trans

5 Reception 卜 Lance Du

6 Judgment device

 7 Ultrasonic propagation material

8 Cable

 9 Receiver cable

1 0 Fixing means

 1 1 Fixing means

 1 2 Body

 1 3 Control means

 1 4 Transmitter circuit

 1 5 Receiver circuit

 1 6 Recording means

 1 7 Power supply means

1 8 Display means

 1 9 Received signal amplitude

2 0 Receive signal propagation time

2 1 Receive signal time width

2 2 Discrimination means

 2 3 Receiver

 2 4 Transmitter

 2 5 therapeutic ultrasound signals

2 6 Ultrasonic signal for inspection Transceiver for second reception

 Second receiving cable

 Distal received signal

 Proximal received signal

 Distal received signal amplitude

 Proximal received signal amplitude

 Distal signal propagation time

 Proximal received signal propagation time Best mode for carrying out the invention

 Hereinafter, the present invention will be described based on embodiments shown in the drawings. The present invention is not limited to the illustrated embodiment.

 Figure 1 shows an example of the application of the ultrasonic fracture treatment device of the present invention, with an example of treating a femoral fracture. In the following examples, only the application of the femur is mentioned, but the technique of the present invention can be applied to other limb bones and trunk bones as well.

 When the fracture site 3 is treated, the transmitting transducer 4 is placed at the mounting position determined by the medical institution, and is mounted on the thigh using the fixing means 10. The fixing means 10 may be any means as long as it can fix the transmitting transducer 4 to the body surface 12. For example, a belt or the like is used. At this time, an ultrasonic propagation material 7 is interposed between the transmitting transducer 4 and the body surface 12. The ultrasonic propagation material 7 may be anything that propagates ultrasonic waves. For example, water or ultrasonic gel is suitable.

In addition, the receiving transducer 5 is fixed to a location on the body surface 12 near the femur 2 at a location different from the location where the transmitting transducer 4 is installed. The receiving transducer 5 is fixed using the fixing means 1 1 in the same manner as the transmitting transducer 4. Transceiver for reception An ultrasonic propagating substance 7 is also interposed between the sensor 5 and the body surface 12.

 The receiving lance transducer 5 can be installed anywhere as long as it can receive ultrasonic waves that have propagated through the bone. Specifically, the proximal end and the distal end of the bone to be treated, which are close to the bone to be treated and the soft tissue 1 is thin, are preferable. The place where the soft tissue 1 is thin is preferably a place where the presence of bone can be confirmed when the body is touched through the body surface. In this place, when the distance from the body surface to the bone is very short, and the ultrasonic wave propagated through the bone travels through the soft tissue, the receiving transducer is installed in the range of the body surface where the propagated ultrasonic wave reaches. This is because the attenuation of the propagating ultrasonic wave is small. For example, if the bone to be treated is the femur, there are the vicinity of the outer epicondyle of the femur, the vicinity of the inner epicondyle of the femur, and the greater trochanter of the femur. In Fig. 1, it is placed near the lateral epicondyle of the femur. As another example, when treating the humerus, a receiving transducer may be placed near the outer epicondyle of the humerus or inside the humerus. In this way, by installing the receiving heel transducer 5 at a location where the soft tissue 1 is thin, it is easy to reliably receive the ultrasonic waves propagating in the bone axis direction with the receiving transducer 5. It is possible to solve the problem that conventional technology could not receive ultrasonic waves.

In addition, since the receiving part of the receiving lance transducer is often fixed at the joint part, the fixing means 11 is desired to be easily fixed at the joint part. For example, by using two or more belts, if the femur is wound around the thigh and the lower thigh, it can be fixed without shifting to the femoral medial epicondyle or the femoral lateral epicondyle. In addition, it can be fixed on the body surface at the target position by attaching an adhesive material such as polyurethane gel to the ultrasonic receiving surface and / or the periphery of the receiving transducer. The signal condition of the therapeutic ultrasonic wave transmitted by the transducer 4 for transmission may be an ultrasonic wave suitable for the treatment of a fracture. For example, one of the suitable ultrasonic conditions is a frequency of 1.5 MHz, a burst width of 2 00 ^ s, a repetition frequency of 1 kHz, and a time average and spatial average of ultrasonic power of 30 mW / cm ² ultrasound is preferred. In this example, the above conditions were used.

 Evening to confirm that the position of the receiving transducer 4 is correct is performed at the time of diagnosis by a medical worker at a medical institution or before starting treatment. It can also be done as confirmation after the end of treatment.

When transmitting the transmission signal of the ultrasonic wave for inspection from the transmission circuit 1 4 of the determination device 6 to the transmission transducer 4, the condition of the ultrasonic signal may be any condition as long as it propagates through the soft tissue 1 and the bone 2. Conditions different from therapeutic ultrasound may be used. The ultrasonic wave for inspection is a continuous wave with a frequency of 50 kHz—3 MHz or a fundamental frequency of 50 kHz, 3 MHz, a burst width of 5—200 MS, a repetition frequency of 10 Hz—1 The time average and the spatial average of the intermittent wave and ultrasonic output of 0 kHz (period 10 00 ms— 0. lms) are preferably 0.5 — 100 mWZ cm ² . Considering the straightness of the ultrasonic wave, the frequency is preferably 50 kHz to 1 MHz, and the shorter the burst width is 5 to 50 seconds, the easier the signal analysis is. During the treatment, if it is confirmed that the position of the transmitting lance transducer 4 is correct, the therapeutic ultrasound signal can also be used as the examination ultrasound. In addition, when using ultrasound for testing under conditions different from those for therapeutic ultrasound, it is necessary to use ultrasound with a parsing width shorter than the time when irradiation with therapeutic ultrasound is not performed (8 0 0 ^ s in this example). There is. The ultrasonic conditions other than the width of the berth are preferably used within the range of the ultrasonic conditions for inspection. In this embodiment, the fundamental frequency is 1.5 MHz as the ultrasonic conditions for inspection. , Burst width 1 0 ^ s, a repetition frequency 1 k H z, the average and spatial average during the time the ultrasonic output with ^{1. 5 m W / cm 2} .

 Next, an example of confirming the position of the transmitting transducer 4 will be described. If the transmission lance transducer 4 is correctly installed at the irradiation position, the ultrasonic wave is irradiated to the fracture site 3. The ultrasonic wave irradiated to the fracture site 3 is transmitted in the long axis direction of the femur 2, and the ultrasonic wave propagated through the bone is received using the receiving transducer 5. When a signal cannot be received by the receiving transducer, the status is shown in the display means 18 described later. From the information shown, it can be seen that ultrasonic waves are not applied to the fracture site 3. In this case, change the installation position and orientation of the transmitting transducer 4 and repeat the operation until the receiving transducer 5 can receive the signal. If the signal can be received and it satisfies the discrimination conditions such as the signal amplitude frequency set in advance in the recording means 16 described below, the discrimination means described below indicates that the fracture site 3 can be irradiated with ultrasonic waves. Since 2 is judged and the result is displayed on the display means 18 as information, it can be judged that the fracture site 3 is correctly irradiated.

 Before treatment, if it is determined that the correct irradiation position is based on the discrimination conditions of the recording means 1 6, the ultrasonic wave irradiated from the transmitting transducer 4 is changed from the ultrasonic wave for examination to the ultrasonic wave for treatment. To start. Thus, the transmission transducer 4 can also have a function as a therapeutic transducer by using a transducer that can transmit not only the ultrasonic wave for examination but also the ultrasonic wave for treatment.

If the transmitter 卜 Reducer 4 also has a function as a treatment transducer, the position can be confirmed during treatment. In this example, while irradiating therapeutic ultrasonic waves, a repetition frequency of 1 kHz, that is, a repetition period lms, of a period of 8 000 s at which no therapeutic ultrasonic waves are irradiated at predetermined intervals. Irradiate ultrasound for inspection It is determined by When performing during treatment, if the position of the transmitting transducer 4 is not correct, the display means 1 8 can always inform the patient that the transmitting transducer is not installed correctly, each time the transmitting transducer. Correcting position 4 can be expected to improve the therapeutic effect.

 An example using this embodiment will be specifically described in the case of confirming the position during treatment. The electrical signals that drive the transmitting transducer 4 at this time are shown in FIG. First, an ultrasonic signal 2 5 0 S for treatment with a width of 2 0 0 S is sent, and an ultrasonic signal 2 6 for inspection with a width of 1 0 β s is sent once every 4 0 0 L s after the irradiation. Ultrasonic wave for examination which propagated bone with transducer 5 for reception by setting discriminating section considering delay of ultrasonic wave propagation time through bone between remaining 3 90 as before sending ultrasonic wave 2 5 for treatment Is detected, and the appropriateness of the position of the transmitting transducer 4 is determined from the signal detected in the determination section. For example, a method of sending the test ultrasonic signal 26 once every time the therapeutic ultrasonic signal 25 is sent 10 times is also possible.

 As another method, ultrasonic waves for examination can be irradiated only three times at an interval of, for example, 200 ns during the 80 S when the ultrasonic waves for treatment are not irradiated. However, in this case, the burst width of the ultrasonic wave for inspection needs to be within 200 ns.

 As a determination condition for confirming the position of the transmitting transducer 4, an ultrasonic propagation feature value corresponding to each patient can be used.

When the correct irradiation position is first determined in the medical institution, as shown in Fig. 3, based on the signal detected by the receiving transducer 5, the received signal amplitude is 19, received signal propagation time 2 0, received signal time width 2 1 and the frequency of the received signal can be measured as signal characteristic values. Time t when the vertical and horizontal axes in Fig. 3 intersect. Is the time to complete the ultrasound irradiation for inspection. In this example, 10 seconds after the test ultrasonic irradiation, that is, when the test ultrasonic irradiation ends! : It is said. The period between the time t before the start of the inspection ultrasonic wave reception and the time t ₂ after the end of the reception of the ultrasonic inspection wave is the discrimination interval. Time! ; And t ₂ can be set to a wider time width than the received signal time width 2 1 in consideration of errors from the received signal propagation time 2 0 and the received signal time width 2 1; When the femur is treated, the received signal propagation time 2 0 is the propagation of ultrasonic waves from the transmitting transducer 4 to the receiving transducer 5 via the soft tissue, the fracture site, the femur, and the outer epicondyle of the femur. It is almost determined by the length of the route. Therefore, the closer the fracture site is to the receiving cage transducer 5, the shorter the received signal propagation time 20 and the smaller the attenuation of the ultrasonic wave, the larger the received signal amplitude 19 tends to be. At least one of the signal feature values is recorded in the recording means 16 of the judgment device 6 and treated as a judgment condition. The patient is treated using the judgment device 6 that records the discrimination conditions.

 In this embodiment, the reception signal amplitude 19 and the reception signal propagation time 20 can be used for easy discrimination. The waveform of the received signal amplitude 19 is usually a sine wave or a similar waveform, and its frequency is the resonance frequency unique to the receiving transducer. Therefore, it is more convenient to use the receiving transducer 5 having the same frequency characteristics as the transmitting transducer 4 in order to efficiently convert the mechanical energy of the ultrasonic wave propagating to the transducer into an electric signal. is there.

It is preferable to provide an appropriate amplifier and a narrow band-pass filter (in this example, the center frequency is 1.5 MHz) in the receiving circuit 15 to improve the S / N of the received signal. In the case of the ultrasonic wave for inspection having the fundamental frequency of 1.5 MHz and the burst width of 10 X s, the transmitting transducer is driven by exactly 15 pulse waves by an electronic circuit. Even if the drive signal is lost, Since the receiving transducer has a transmission characteristic that lasts for a long time and converts ultrasonic mechanical energy into an electrical signal, it also has a reception characteristic.

The received signal time width 21 is not the same as the burst width, but it is reproducible if both transducers are mounted accurately at the same position. Received signal propagation time 20 has a factor that slightly changes due to changes in the thickness of soft tissue during the healing process of fractures, changes in the propagation path length of ultrasound due to bone formation at the fracture site, changes in the density of the propagation material, etc. However, it has the same measurement reproducibility as the received signal propagation time 20. On the other hand, the reproducibility of the received signal amplitude 19 is particularly significant because a slight difference in the irradiation axis of the transmitting transducer 4 changes the ultrasonic energy (intensity) that propagates through the femur. It is often inferior to that of signal propagation time 20. Therefore, it is necessary to provide a wide error range for the received signal amplitude 19 as a characteristic value for discrimination. Therefore, in order to improve measurement accuracy, it is preferable to use either or both of the received signal propagation time 20 and the received signal time width 21 as feature values.

 The received signal amplitude 19 can be measured in real time using the peak hold circuit that follows the maximum and minimum values of the approximate sine wave and the AZ D conversion function built into the microcomputer. Further, the reception signal time width 21 can be easily measured by time-converting the section in which the AD conversion value is larger than a preset threshold value in the microcomputer. The received signal propagation time 2 0 can also be easily measured.

As another method of confirming the position during treatment, therapeutic ultrasonic waves can also be used as inspection ultrasonic waves. In this case, as shown in FIG. 7, first, a therapeutic ultrasonic wave 25 having a width of 20 s is irradiated, and after that irradiation, during the 80 ns period between the irradiation and the next therapeutic ultrasonic wave. Appropriate discriminant interval t ₃ — t ₄ is provided, and ultrasonic waves for examination 2 6 that have been propagated through the bone are detected by the receiving lance transducer 5, and the signal detected in the discriminant interval is detected. , For transmission 卜 Determine whether the position of lance reducer 4 is appropriate. When the discrimination section is provided, it does not include the period of 20 s when the ultrasonic wave is applied. The noise generated by transmitting the ultrasonic wave in the same device appears in the signal of the receiving circuit. This is to make S-N worse. Start timing between discrimination District not when the driving pulse transmitting transducer 4 has stopped, the fully expected they time the time until there is no ultrasound emitted from that point to the t _3, S / N As best. Also, t ₄ can be set in consideration of an error after completion of the ultrasonic receiving. In this way, it is possible to provide an appropriate discrimination section, detect the ultrasonic wave transmitted through the bone by the receiving transducer 5, perform the treatment, and confirm the position of the transmitting transducer 4 at the same time.

 When treating the fracture site 3, attach the transmitting transducer 4 and the receiving transducer 5 to the position determined by the medical institution using the fixing means 1 0 and 1 1, irradiate the ultrasound for inspection, and receive A comparison is made between the characteristic value of the received signal detected by converting it to a voltage signal in the receiving circuit 15 to which the transducer 5 is connected and the discrimination condition recorded in the recording means 16 of the judgment device 6 in advance. Do.

As a judgment condition, the characteristic value at the time of position determination in a medical institution is used as a reference value, and this is compared with the characteristic value at the time of treatment. The received signal amplitude 19 is within the reference value ± 50%. In this embodiment, the propagation time 20 is determined to be a correct irradiation position if the difference is within 20% of the reference value soil. When the feature value deviates from the setting range, the display means 18 displays that the treatment position is not correct. On the other hand, when the feature value is within the set range, the display means 18 indicates that the irradiation position is correct. In this case, change the ultrasound condition irradiated from the transmitting lance transducer 4 from the testing ultrasound to the treatment ultrasound and start treatment. Or, remove the transducer 4 for transmission, and use the treatment transformer for ultrasonic fracture treatment. Sending the Deusa 卜 Lance Dusa 4 is placed in the same position as the wearing position and treatment starts.

 Figure 2 shows an example of equipment components.

 The determination device 6 is a determination unit, and includes a control unit 13, a transmission circuit 14, a reception circuit 15, a recording unit 16, a power supply unit 17, a display unit 18, and a determination unit 22. . The ultrasonic drive signal emitted from the transducer 4 is transmitted from the transmission circuit 14 through the cable 8. The electric signal generated when the ultrasonic wave propagating through the bone is detected by the receiving transducer 5 is detected as a voltage signal by the receiving circuit 15 through the cable 9, calculated by the control means 13, and recorded by the recording means 16. Saved as a feature value. The power supply means 17 is a means for supplying power to other means and circuits from the built-in power supply or an external power supply, and serves as a drive source for the ultrasonic fracture treatment device. For example, the control means 13 can be easily composed of a microcomputer and peripheral circuits, and the storage means (memory) 16 is composed of a semiconductor memory. The display unit 18 is a display unit that displays information such as the state of the determination device 6 and the determination result of ultrasonic irradiation. As the display unit, for example, it can be easily configured by LCD or the like, and can be easily configured by using LED, and the function can be realized. In this embodiment, L CD is used. The discriminating means 22 is a means for discriminating that the ultrasonic wave irradiated by the transmitting transducer 4 is applied to the fracture site 3. For example, the discriminating operation circuit, the recorded feature value and the feature value of the received signal The comparison is performed by the microcomputer.

As another characteristic value, the received signal is obtained by comparing the received signal with a predetermined threshold value (signal derived from the memory means 16 by the DZA conversion function of the microcomputer) by the comparator circuit provided in the discriminating means 2 2. It is also possible to use the number of sine waves whose signal amplitude exceeds the threshold (in other words, frequency). In this case, it is used at the time of positioning Set the appropriate threshold, and use 50% as the threshold during treatment.

 Fig. 4 shows an example in which the ultrasonic transmission and reception mechanisms of the present invention are implemented by two devices. The transmitting transducer 4 is a device that emits ultrasonic waves for examination and treatment from the transmitting device 24. The transmitter 2 4 may be an ultrasonic fracture treatment device itself. The receiving transducer 5 is connected to the receiving device 23, receives ultrasonic waves propagated through the bone as an electrical signal, and whether the receiving device 23 is irradiated with ultrasonic waves at an appropriate position. Judging.

 In this aspect, there is an advantage that each device can be downsized and easy to use. Further, by integrating the receiving transducer 5 and the receiving device 2 3, the receiving cable 9 is eliminated, and the size can be further reduced. In addition, since the receiving device 23 is independent from the mechanism for transmitting ultrasonic waves, there is an advantage that the receiving device can have the same frequency characteristic component and is difficult to receive external noise emitted by the transmitting device.

Figure 5 shows an example of the transmission mechanism and Figure 6 shows an example of the reception mechanism when the transmission mechanism and the reception mechanism are implemented separately. The transmission mechanism of FIG. 5 includes a control device 1 3, a transmission circuit 1 4, and a transmission device 2 4 including a display unit 1 8, a power supply unit 1 7, a cable 8, and a transmission transducer 4. The receiving mechanism shown in FIG. 6 includes a control unit 13, a receiving circuit 15, a recording unit 16, a display unit 18, and a discriminating unit 2 2, a receiving device 2 3, a power supply unit 17, a cable 9 and a receiving unit. For use with transducer 5. The operation of each component may be configured in the same manner as in the above-described embodiment. In this case, it is easier for the device to use the feature value such as the received signal amplitude from the received signal propagation time 20 as the feature value, but the therapeutic ultrasonic wave is transmitted from the transmitting device 24 to the receiving device 23. Send a timing signal to send and / or stop with a cable (not shown) or By sending it by radio (not shown) etc., the reception signal propagation time 20 can be easily used as a feature value. By using the received signal propagation time 20 as a characteristic value, the detection accuracy becomes higher than when not using it. Further, when it is determined by the cable or wireless that ultrasonic waves are radiated on the bone to be treated, an instruction can be sent to the transmitting device 24 to irradiate therapeutic ultrasonic waves.

 Fig. 8 shows an example of using the device of the present invention for a femoral fracture using two receiving transducers. The receiving transducer 5 was attached to the outer upper thighbone, and the second receiving transducer 2 7 was attached to the greater trochanter of the femur. By attaching receiving transducers to both the distal and proximal ends of the fractured bone, the device of the present invention can accurately recognize not only the bone position but also the fracture position. The distal shown here indicates a position far from the trunk of the target bone, and the proximal indicates a position close to the trunk of the target bone.

Fig. 10 shows an example of the received signal when the fracture position is irradiated. The distal portion received signal 29 is received by the receiving transducer 5, and the proximal portion received signal 30 is a signal received by the second receiving transducer 27. Received signals corresponding to the distance between the lateral epicondyle of the femur and the greater trochanter of the femur are obtained from the irradiation position. At the medical institution, this received signal is recorded in the recording means 16 as a reference value of the characteristic value. When ultrasonic waves are applied to the bone but different from the fracture position, the receiving transducer whose distance from the transmitting transducer 4 is closer to the condition for recording the reference value in the distal and proximal signals. The signal propagation time is shortened, the amplitude is increased, and the distance from the transmitting transducer 4 is farther than the condition for recording the reference value. Tend to be. The feature value at the time of position determination at a medical institution is used as a reference value, and this is compared with the feature value at the time of treatment. The distal reception signal amplitude 3 1 and the proximal reception signal amplitude 3 2 are within ± 50% of the reference value, and the distal reception signal propagation time 3 3 and the proximal reception signal propagation time 3 4 If the difference is within 20% of the reference value soil, the correct irradiation position is determined in this embodiment.

 Figure 9 shows an example of a device component that uses two receiving transducers.

 The determination device 6 includes a control means 13, a transmission circuit 14, a reception circuit 15, a recording means 16, a power supply means 17, a display means 18, and a determination means 2 2. The ultrasonic drive signal emitted from the transmitting transducer 4 is transmitted from the transmitting circuit 14 through the cable 8. Electricity generated when the ultrasonic wave propagated through the bone is detected by the receiving transducer 5 and the second receiving transducer 27. The signals are detected as voltage signals by the receiving circuit 15 through the cables 9 and 28, respectively. Then, it is calculated by the control means 13 and stored as a feature value by the recording means 16. The power supply means 17 is a means for supplying power to other means and circuits from the built-in power supply or an external power supply, and serves as a drive source for the ultrasonic fracture treatment device. For example, the control means 13 can be easily configured from a microcomputer and peripheral circuits, and the storage means 16 is configured from a semiconductor memory. The display means 18 is means for displaying information such as the state of the judgment device 6 and the judgment result of ultrasonic irradiation. As a display means, it can be easily configured, for example, by L CD or the like, and can be easily configured by using L E D, and the function can be realized. In this embodiment, L CD is used. The discriminating means 2 2 is a means for discriminating that the ultrasonic wave irradiated by the transmitting transducer 4 is irradiated on the fracture site 3 and, for example, comparing the recorded feature value with the feature value of the received signal. Performed by the microcomputer.

Next, as an example of application of the ultrasonic fracture position inspection device of the present invention, as in the case of an ultrasonic fracture treatment device, the case of determining the fracture position of the femur as an example is shown in FIG. Shown with reference to.

 Use the fixing means 10 to send the inspection ultrasonic wave lance de user 4 to the thigh. Transmitting 卜 Ultrasonic propagating substance 7 is interposed between lance reducer 4 and body surface 12. In addition, the receiving transducer 5 is fixed at a location different from the location where the transmitting transducer 4 is installed on the body surface 12 near the femur 2. The receiving transformer 5 is fixed using the fixing means 1 1 in the same manner as the transmitting transducer 4. An ultrasonic propagation material 7 is also interposed between the receiving transducer 5 and the body surface 12.

The receiving transducer 5 may be installed anywhere as long as it can receive the ultrasonic wave propagated through the bone. Specifically, the proximal end and the distal end of the bone to be inspected, which are close to the bone to be inspected and the soft tissue 1 is thin, are preferable. The place where the soft tissue 1 is thin is preferably a place where the presence of bone can be confirmed when the body is touched through the body surface. In this place, when the distance from the body surface to the bone is very short, and the ultrasonic wave propagated through the bone travels through the soft tissue, the receiving transducer is installed in the range of the body surface where the propagated ultrasonic wave reaches. This is because the attenuation of the propagating ultrasonic wave is small. For example, if the bone to be examined is the femur, there are the vicinity of the outer epicondyle of the femur, the vicinity of the inner epicondyle of the femur, and the greater trochanter of the femur. In Fig. 1, it is placed near the lateral epicondyle of the femur. As another example, when the humerus is to be examined, a receiving transducer may be placed near the outer humerus condyle or the inner humeral condyle. In this way, by installing the receiving transducer 5 in a place where the soft tissue 1 is thin, it is possible to reliably receive the ultrasonic wave propagating in the bone direction in the bone by the receiving transducer 5. Yes, it can solve the problem that conventional technology could not receive ultrasonic waves. In addition, since the receiving transducer is often fixed at the joint site, the fixing means 11 is desired to be easily fixed at the joint site. For example, by using two or more bell heels and wrapping a belt around the thigh and lower thigh, the femur can be fixed without shifting to the femoral medial epicondyle or the femoral lateral epicondyle. In addition, it can be fixed to the body surface at the target position by attaching an adhesive material such as polyurethane gel to the ultrasonic receiving surface and Z or the periphery of the receiving lance transducer.

 The timing to confirm that the position of the transmitting transducer 4 is correct is performed at the time of diagnosis by a medical worker at a medical institution or before the start of treatment. It can also be confirmed after treatment.

When transmitting the transmission signal of the ultrasonic wave for inspection from the transmission circuit 14 of the judgment device 6 to the transducer 4 for transmission, the condition of the ultrasonic signal may be any condition as long as it propagates through the soft tissue 1 or bone 2. The ultrasonic wave is a continuous wave with a frequency of 50 kH z—3 MHz or a fundamental frequency of 50 k H z-3 MHz, a nose width of 5—2 0 0 0 S, a repetition frequency of 1 0 H z— 1 0 The time average and the spatial average of the intermittent wave and ultrasonic output of k Hz (period 100 m s— 0. lms) are preferably 0.5 — 100 mW / cm ² . Considering the straightness of the ultrasonic wave, the frequency is preferably 50 kHz to 3 MHz, and the shorter the burst width is 5 to 50 S, the easier the signal analysis is.

In this example, the fundamental frequency of 1.5 MHz, the verse width 10 0 s, the repetition frequency lk Hz, and the time average and spatial average of the ultrasonic output are 1. SmWZcm ² as the ultrasonic conditions for inspection. ing.

 Next, an example of how to confirm that the transmission 卜 lance transducer 4 is installed in the correct position is described.

When the transmitting transducer 4 is installed at the correct irradiation position In this case, ultrasonic waves are applied to the fracture site 3. The ultrasonic wave irradiated to the fracture site 3 is transmitted in the long axis direction of the femur 2, and the ultrasonic wave propagated through the bone is received using the receiving transducer 5 installed near the outer epicondyle of the femur. When signals cannot be received by the receiving transducer, the status is shown in the following display means (display section) 18. From this displayed information, it can be seen that ultrasonic waves are not applied to the fracture site 3. In this case, the installation position and orientation of the transmission transducer 4 are changed, and the operation is repeated until the signal can be received by the reception transducer 5. If the signal can be received and it satisfies the discriminating conditions such as the signal amplitude frequency preset in the recording means (memory) '1 6 described below, the fracture site 3 can be irradiated with ultrasound and the following The discriminating means (discriminating operation circuit) 2 2 makes the determination, and the result is displayed as information on the display means (display unit) 18, so that it is possible to determine that the fracture site 3 is correctly irradiated.

 As a determination condition for confirming the position of the transmitting transducer 4, an ultrasonic propagation feature value corresponding to each patient can be used.

When the correct irradiation position is first determined in the medical institution, as shown in Fig. 3, based on the signal detected by the receiving transducer 5, the received signal amplitude is 19, received signal propagation time 2 0, received signal time width 2 1 and the frequency of the received signal can be measured as signal characteristic values. The time t _{Q at} which the vertical and horizontal axes in FIG. 3 intersect indicates the end time of the inspection ultrasonic irradiation. In this example, 10 seconds after the inspection ultrasonic irradiation, that is, the inspection ultrasonic wave The time at the end of irradiation is t. It is said. During the ultrasonic reception before the start time for the test t _x and the ultrasonic receiver after the end of the time for inspection t ₂ is the the discrimination periods. In addition, time! : Discrimination periods of E and t ₂ is in consideration of an error from the received signal propagation time 2 0, and the received signal time width 2 1, can be set wider time width from the received signal the time width 2 1. Receive signal propagation Time 20 is the length of the ultrasonic propagation path from the transmitting transducer 4 to the receiving transducer 5 via the soft tissue, the fracture site, the femur, and the outer epicondyle of the femur, when treating the femur. Now it is almost decided. Therefore, the closer the fracture site is to the receiving transducer 5, the shorter the received signal propagation time 20 and the smaller the attenuation of the ultrasonic wave, the larger the received signal amplitude 19 tends to be. Record at least one of the feature values of the signal in the recording means (memory) 16 of the judging means 6 and treat it as a judgment condition. The patient prepares for the start of treatment using the judgment device 6 that records the judgment conditions.

 In this embodiment, the reception signal amplitude 19 and the reception signal propagation time 2 0 are used, so that it can be easily discriminated. The waveform of the received signal amplitude 19 is usually a sine wave or a similar waveform, and its frequency is the resonance frequency unique to the receiving transducer. Therefore, it is more convenient to use the transducer 5 for receiving that has the same frequency characteristics as the transducer 4 for transmitting in order to efficiently convert the mechanical energy of the ultrasonic wave propagating to the transducer into an electrical signal. It is.

It is preferable to provide an appropriate amplifier and a narrow band-pass filter (in this example, the center frequency is 1.5 MHz) in the receiving circuit 15 to improve the S / N of the received signal. In the case of the inspection ultrasonic wave having a fundamental frequency of 1.5 MHz and a burst width of 10 s, the transmitting transducer is driven with exactly 15 pulse waves by an electronic circuit, but a transmitting lance transducer is generated. Ultrasound has a transmission characteristic that lasts for a short time even when there is no drive signal, and a receiving transducer that converts the mechanical energy of ultrasonic waves into an electrical signal also has a reception characteristic. 1 is not the same as the burst width, but it is reproducible if both transducers are mounted exactly at the same position. Changes in thickness of soft tissue during healing of fractures, and supersonic sound due to bone formation at fracture sites Although the reception signal propagation time 20 has a slight change factor due to changes in the propagation path length of the wave and changes in the density of the propagation material, the measurement reproducibility is comparable to the reception signal time width 2 1. . On the other hand, the reproducibility of the received signal amplitude 1 9 is that the slight difference in the irradiation axis of the transmitting transducer 4 changes the ultrasonic energy (intensity) that propagates through the femur. Reproducibility is often inferior to that of 0. Therefore, as a characteristic value for discrimination, the received signal amplitude 19 needs to have a wide error range. Therefore, in order to improve the measurement accuracy, it is preferable to use either the received signal propagation time 20 or the received signal time width 21 or both as feature values.

 The received signal amplitude 19 can be measured in real time using a peak hold circuit that follows the maximum and minimum values of the approximate sine wave and the microcomputer's built-in A / D conversion function. Further, the reception signal time width 21 can be easily measured by time-converting a section in which the A / D conversion value is larger than a preset threshold value in the microcomputer. The received signal propagation time 2 0 can also be easily measured.

 When inspecting the fracture site 3, the transmitting transducer 4 and the receiving transducer 5 are attached to the position determined by the medical institution using the fixing means 1 0 and 1 1, and the inspection ultrasonic wave is irradiated and received.特 徴 Compares the characteristic value of the received signal detected by converting it to a voltage signal with the receiving circuit 15 to which the transducer 5 is connected and the discrimination condition recorded in the recording unit 16 of the judging unit 6 in advance. .

As a judgment condition, the characteristic value at the time of position determination in a medical institution is used as a reference value, and this is compared with the characteristic value at the time of treatment. The received signal amplitude 19 is within the reference value ± 50%. In this embodiment, the propagation time 20 is determined to be the correct irradiation position if the difference is within 20% of the reference value soil. If the feature value deviates from the setting range, display means (display section) ) 1 8 indicates that the treatment position is not correct. On the other hand, if the feature value is within the set range, the display means (display unit) 18 indicates that the irradiation position is correct. As described above, when the correct position can be confirmed by the ultrasonic fracture position inspecting device of the present invention, the transmitting transducer 4 is removed, and the ultrasonic fracture treatment device is placed at the same location as the transmitting transducer 4 is mounted. Fracture treatment is started by wearing it accurately.

 An example of the components of an ultrasonic fracture location tester is shown with reference to Fig. 2 as in the case of an ultrasonic fracture treatment instrument.

The determination device 6 includes control means 1 3, transmission circuit 1 4, reception circuit 1 5, recording means (memory) 1 6, power supply means 1 7, display means (display unit) 1 8, and discrimination means (discrimination calculation) Circuit) 2 2 equipped.卜 The drive signal of the ultrasonic wave irradiated from the user 4 is transmitted from the transmission circuit 14 through the cable 8. The electrical signal generated when the ultrasonic wave propagating through the bone is detected by the receiving transducer 5 is detected as a voltage signal by the receiving circuit 15 through the cable 9 and is calculated by the control means 13. The recording means (memory) is stored as a feature value in 16. The power supply means 17 is a means for supplying power to the other means and circuit from the built-in power supply or an external power supply, and serves as a drive source for the ultrasonic fracture position tester. For example, the control means 13 can be easily configured from a microcomputer and peripheral circuits, and the storage means 16 is configured from a semiconductor memory. Display means (display unit) 18 is means for displaying information such as the state of the judgment means 6 and the judgment result of the ultrasonic irradiation. The display means (display unit) can be easily configured, for example, with an LCD or the like, and can also be easily configured by using an LED to realize the function. In this embodiment, an LCD is used. The discriminating means (discriminant calculation circuit) 2 2 is a means for judging that the ultrasonic wave irradiated by the transmitting lance transducer 4 is irradiated to the fracture site 3. For example, the recorded feature value and the received signal feature Comparison with values Performed by the microcomputer.

 As another characteristic value, the received signal is compared with a predetermined threshold value (a signal derived from the memory means 16 by the DZA conversion function of the microcomputer) by the comparator circuit provided in the discriminating means (discriminant calculation circuit) 2 2 The number of sine waves (in other words, the frequency) in which the amplitude of the received signal exceeds the threshold can also be used. In this case, the threshold used at the time of position determination in a medical institution is set appropriately, and 50% is used as the threshold during treatment.

 Next, an example in which the transmission and reception mechanisms of the ultrasonic fracture position inspection device of the present invention are realized by two devices will be described with reference to FIG. The transmission lance transducer 4 is a device that emits ultrasonic waves for inspection from the transmitter 24. The transmitter 2 4 may be an ultrasonic fracture treatment device itself. The receiving transducer 5 is connected to the receiving device 23, receives the ultrasonic wave propagated through the bone as an electrical signal, and the receiving device 23 determines whether the ultrasonic wave is irradiated to an appropriate position on the bone. To do. This mode has the advantage that each device can be downsized and easy to use. Further, by integrating the receiving transducer 5 and the receiving device 23, the receiving cable 9 is eliminated, and the size can be further reduced. In addition, since the receiving device 23 is independent of the mechanism for transmitting ultrasonic waves, there is an advantage that the receiving device can have a same frequency characteristic component and is less susceptible to external noise emitted by the transmitting device.

In the ultrasonic fracture position inspection device of the present invention, when the transmission mechanism and the reception mechanism are separately realized, an example of the transmission mechanism can be configured in the same manner as in FIG. 5, and an example of the reception mechanism can be configured in the same manner as in FIG. The transmission mechanism shown in FIG. 5 includes a control device 1 3, a transmission circuit 1 4, and a display device (display unit) 1 8, a transmission device 2 4, a power supply unit 1 7, a cable 8, and a transmission 卜 reducer 4. Prepare. The receiving mechanism in Fig. 6 consists of control means 1 3, receiving circuit 1 5, Recording means (memory) 1 6, display means (display section) 1 8, and discrimination means (discriminant calculation circuit) 2 2, receiving device 2 3, power supply means 1 7, cable 9 and receiving transducer 5 Prepare. The operation of each component may be configured in the same manner as in the above-described embodiment. In this case, it is easier for the device to use the feature value such as the received signal amplitude than the received signal propagation time 20 as the feature value, but the ultrasonic wave for inspection is transmitted from the transmitting device 24 to the receiving device 23. By transmitting a timing signal for transmitting and / or stopping the signal via a cable (not shown) or wireless (not shown), the reception signal propagation time 20 can be easily used as a feature value. By using the reception signal propagation time 2 0 as a characteristic value, the detection accuracy is improved as compared with the case where it is not used.

 The ultrasonic fracture inspecting device of the present embodiment can also be used for femoral fracture inspection using two receiving transducers, as described in FIG. The receiving transducer 5 is attached to the lateral epicondyle of the femur, and the second receiving transducer 2 7 is attached to the greater trochanter of the femur. In this case as well, the fracture position can be more accurately recognized by attaching receiving transducers to the distal and proximal ends of the fractured bone. The distal shown here indicates a position far from the trunk of the target bone, and the proximal indicates a position close to the trunk of the target bone.

 Regarding the received signal examples and device components, the ultrasonic fracture treatment device similar to that shown in FIGS. 9 and 10 can also be applied to the ultrasonic fracture position inspection device.

The ultrasonic fracture treatment device, the fracture treatment receiving device, and the ultrasonic fracture position inspection device of the present invention can also be used when irradiating a bone other than the fracture site with ultrasonic waves. When irradiating bones other than the fracture site with ultrasound, determination of bone density measurement location and ultrasonic hyperthermia for bone tumors, etc. The position determination in the case of using is mentioned.

 In the ultrasonic fracture treatment device, the fracture treatment receiving device, and the ultrasonic fracture position inspection device of the present invention, the same configuration can be applied to elements having common actions. Industrial applicability

 As described above, according to the present invention, it is possible to confirm that therapeutic ultrasonic waves are accurately applied to the fracture site. In addition, since the present invention uses the ultrasonic wave transmitted through the bone instead of the reflected wave of the bone when the bone is irradiated with the ultrasonic wave, the influence of the bone shape, the bone site, or the thickness of the soft tissue is affected. Smaller than conventional methods. Therefore, it is possible to provide an ultrasonic fracture treatment device and an ultrasonic receiving device that can be used easily. Further, an ultrasonic fracture position inspecting device for discriminating a fracture position only needs to be able to transmit ultrasonic waves for inspection, and thus can be a simpler device than an ultrasonic fracture treatment device. This enables low-cost production and facilitates the configuration of the transmitter circuit.

Claims

1. A transmitter transducer that is installed on the body surface near the fracture site and transmits ultrasonic waves for fracture treatment to the fracture site, and an ultrasound that is installed on the body surface near the bone having the fracture site and propagates through the bone. A receiving transducer for receiving sound waves, and a bone from the transmitting transducer. An ultrasonic fracture treatment device comprising: a determination device that confirms that a therapeutic ultrasonic wave is transmitted to a folding site based on a reception signal of a reception transdeuser and a set determination condition.  2. The receiving transducer according to claim 1, wherein the receiving transducer receives super-enclosed sound waves at a body surface of a thin portion of a soft tissue near a proximal end of a bone and a heel or a distal end. Ultrasound fracture treatment device.  3. The bone is the femur, and the receiving lance transducer receives the waves propagated through the femur near the outer epicondyle of the femur, the inner condyle of the femur, or the greater trochanter of the femur. The ultrasonic fracture treatment device according to claim 1, wherein:  4. The bone is a humerus, and the reception 卜 lancer receives a wave propagated through the humerus near the outer epicondyle near the outer humerus or the inner humerus near the upper condyle. The ultrasonic fracture treatment device according to claim 1.  5. The ultrasonic fracture treatment device according to any one of claims 1 to 4, wherein the discrimination condition is based on a set threshold value and an ultrasonic propagation characteristic value of a heel or a bone to be treated. . 6. The ultrasonic wave propagation characteristic value is a parameter obtained from at least one of the amplitude, frequency, waveform shape, or propagation time from the transmitted ultrasonic wave of the received signal. Sonic fracture treatment 7. The transmission 卜 Lance reducer can transmit both the fracture treatment ultrasound to be transmitted to the fracture site and the test ultrasound to confirm transmission to the fracture site, or the fracture treatment ultrasound. The ultrasonic fracture treatment device according to any one of claims 1 to 6, wherein  8. The examination ultrasonic wave has a short burst width compared to a period in which no therapeutic ultrasonic wave is transmitted, and is transmitted while no therapeutic ultrasonic wave is transmitted. Ultrasound fracture treatment device.  9. The determination device includes: a receiving circuit for receiving the ultrasonic signal by the receiving transducer; a storage unit for storing a determination condition in advance; and comparing the received signal with the determination condition; The discriminating means for discriminating that it is transmitting, the display means for displaying at least the discrimination result, and the control means for controlling the receiving circuit and the display means are provided. Ultrasound fracture treatment according to item 1 1 0. The determination device includes: a transmission circuit that transmits an electrical signal that drives the transmission 卜 transducer; a reception circuit that receives the ultrasonic signal from the reception 卜 transducer; a storage unit that stores a determination condition; A discriminating means for discriminating that the ultrasonic wave is transmitted to the fracture site by comparing the received signal with the discriminating condition, a display means for displaying at least the discrimination result, and the transmitting circuit, the receiving circuit, and the display means The ultrasonic fracture treatment device according to any one of claims 1 to 8, further comprising a control means for controlling the movement. 1 1. The receiving transducer includes a first receiving transducer and a second receiving transducer, and the first receiving transducer is located near the proximal end of the bone, the second receiving transducer. 1. Any one of claims 1 to 10, characterized in that the lance de user receives ultrasound at the body surface of a thin part of soft tissue near the distal end of the bone, respectively. The ultrasonic fracture treatment device according to Item.  1 2. The ultrasonic fracture treatment device according to any one of claims 5 to 11, wherein the steps (1) and (2) are performed.  (1) A step of calculating the ultrasonic feature value from an electrical signal received by the receiving transducer, and recording the feature value in advance by the recording means.  (2) After the step (1), an ultrasonic wave is transmitted from the transmitting transducer, the ultrasonic wave propagated through the bone is received by the receiving transducer, and the discrimination means A step of comparing the signal with the feature value obtained in the step (1) and Z or the threshold value, and determining whether the difference is within a predetermined range.  1 3. In the step (2), the display means changes display contents depending on whether or not the electric signal of the received ultrasonic wave is within a predetermined range. The ultrasonic fracture treatment device described.  1 4. According to the step (2), the control means determines that an ultrasonic wave is transmitted to the fracture site when the difference is within a predetermined range, and then transmits the transmitting transducer. The ultrasonic fracture treatment device according to claim 12, wherein the ultrasonic fracture treatment device is controlled to transmit therapeutic ultrasonic waves.  1 5. The transmitting transducer transmits inspection ultrasonic waves at a predetermined interval during a period in which therapeutic ultrasonic waves are not transmitted, and repeats the step (2). The ultrasonic fracture treatment device according to any one of 1 to 1 to 4. 1 6. It is installed on the surface of the body near the bone with the fracture site, is equipped with a receiving transducer that receives the ultrasound that propagates through the bone, and that the ultrasound is transmitted from the ultrasound transmitter to the fracture location. Confirmation is made by comparing the received signal of the receiving transducer with the set judgment condition. An ultrasonic receiving device comprising: a determination device for recognizing.  17. The ultrasonic transducer according to claim 16, wherein the receiving transducer receives an ultrasonic wave on a body surface of a thin portion of a soft tissue near a proximal end and / or a distal end of a bone. Receiver device.  18. The ultrasonic receiving apparatus according to claim 16, wherein the discrimination condition is based on a preset threshold and Z or an ultrasonic propagation characteristic value of a bone to be treated.  1 9. The ultrasonic propagation characteristic value is an amplitude, frequency, waveform shape, or parameter obtained from at least one of propagation times from a transmitted ultrasonic wave. 18. The ultrasonic receiver according to 8.  2 0. The determination device includes: a receiving circuit in which a receiving transducer receives an ultrasonic signal; a storage unit that stores a determination condition in advance; a reception signal and a determination condition; 2. A discriminating unit that discriminates that a sound wave is transmitted to a fracture site, a display unit that displays at least a discrimination result, and a control unit that controls the receiving circuit and the display unit. The ultrasonic receiver according to any one of 6 to 19.  2 1. The receiving transducer is composed of a first receiving terminal and a second receiving transducer, and the first receiving transducer is located near the proximal end of the bone, and the second receiving transducer. The ultrasonic wave according to any one of claims 16 to 20, wherein the trans-user receives ultrasonic waves at a thin body surface of soft tissue near the distal end of the bone, respectively. Fracture receiving device.  2. The ultrasonic receiver according to claim 18, wherein steps (A) and (B) are performed. (A) The receiving transducer receives the ultrasonic wave propagated through the bone. A step of calculating the ultrasonic feature value from the electrical signal, and recording the feature value in advance by the recording means.  (B) After the process of (A), the receiving transducer newly receives the ultrasonic wave propagated through the bone, and the discriminating means obtained the electrical signal at that time in the process of (A). Comparing the characteristic value and / or the threshold value to determine whether the difference is within a predetermined range.  23. In the step (B), the display means changes display contents depending on whether or not the electrical signal of the received ultrasonic wave is within a predetermined range. The ultrasonic receiving device described.  2 4. If the control means determines in step (B) that the ultrasonic wave is transmitted to the treatment target bone, the ultrasonic wave is transmitted to the ultrasonic transmitter that transmits the therapeutic ultrasonic wave. The ultrasonic receiver according to claim 22, wherein the transmitter is instructed to transmit.  2 5. Installed on the body surface near the fracture site, installed on the body surface near the bone having the fracture site, and a transmitter transducer for transmitting ultrasonic waves for fracture inspection to the fracture site. A receiving device for receiving ultrasonic waves, and a determination device for confirming that ultrasonic waves are transmitted from the transmitting transducer to the fracture site based on the received signal of the receiving lance transducer and the set determination condition An ultrasonic fracture position inspection device comprising:  26. The ultrasonic transducer according to claim 25, wherein the receiving transducer receives ultrasonic waves on a body surface of a thin portion of soft tissue near a proximal end and / or a distal end of a bone. Sonic fracture position tester. 27. The bone is a femur, and the wave transmitted through the femur on the body surface near the outer epicondyle of the femur, near the epicondyle of the femur, or near the greater trochanter of the femur The ultrasonic fracture position inspection device according to claim 25, wherein the ultrasonic fracture position inspection device is received. 28. The bone is a humerus, and the receiving transdeuser receives a wave propagated through the humerus near the outer epicondyle of the humerus or near the inner condyle of the humerus. The ultrasonic fracture position tester according to claim 25.  29. The ultrasonic fracture position according to any one of claims 25 to 28, wherein the determination condition is based on a preset threshold value and / or an ultrasonic propagation characteristic value of a bone to be treated. tester. 30. The ultrasonic wave propagation characteristic value is a parameter obtained from at least one of the amplitude, frequency, waveform shape, or propagation time from the transmitted ultrasonic wave of the received signal. ₂ Ultrasonic fracture position tester according to 9.  3 1. The determination device includes: a receiving circuit in which the receiving transducer receives an ultrasonic signal; storage means for storing a determination condition in advance; and a comparison between the received signal and the determination condition; The discriminating means for discriminating whether there is at least one display means for displaying the discrimination result, and the control means for controlling the receiving circuit and the display means. The ultrasonic fracture position tester according to the item.  3 2. The determination device includes: a transmission circuit that transmits an electrical signal that drives the transmission transducer; a reception circuit that receives the ultrasonic signal from the reception transducer; a storage unit that stores a determination condition; and a reception signal; Control means for determining that ultrasonic waves are transmitted to the fracture site, display means for displaying at least the determination result, and the transmitter circuit, the receiver circuit, and the display means, as compared with the determination conditions The ultrasonic fracture position inspector according to any one of claims 25 to 30, further comprising a control unit. 3 3. The receiving transducer is a first receiving transducer. Consists of a user and a second receiving transducer, the first receiving 卜 lancer is near the proximal end of the bone, the second receiving 卜 lancer is the thin soft tissue near the distal end of the bone The ultrasonic fracture position inspection device according to any one of claims 25 to 32, wherein an ultrasonic wave is received on each body surface of the part.  3 4. The ultrasonic fracture position inspection device according to any one of claims 29 to 33, wherein the steps (1) and (2) are performed.  (1) A step of calculating the ultrasonic feature value from an electrical signal received by the receiving cage reducer, and recording the feature value in advance by the recording means.  (2) After the step of (1), an ultrasonic wave is transmitted from the transmitting transducer, the ultrasonic wave propagating through the bone is received by the receiving lance transducer, and the discriminating means performs an electrical signal at that time. Is compared with the characteristic value obtained in the step (1) and / or the threshold value, and it is determined that the ultrasonic wave is transmitted to the fracture site depending on whether the difference is within a predetermined range. About.  35. In the step (2), the display means changes display contents depending on whether or not the electrical signal of the received ultrasonic wave is within a predetermined range. Described ultrasonic fracture position tester