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WO2025191780A1 - Dispositif de guidage - Google Patents

Dispositif de guidage

Info

Publication number
WO2025191780A1
WO2025191780A1 PCT/JP2024/009958 JP2024009958W WO2025191780A1 WO 2025191780 A1 WO2025191780 A1 WO 2025191780A1 JP 2024009958 W JP2024009958 W JP 2024009958W WO 2025191780 A1 WO2025191780 A1 WO 2025191780A1
Authority
WO
WIPO (PCT)
Prior art keywords
guide
bone
cutting tool
guide device
tibia
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
PCT/JP2024/009958
Other languages
English (en)
Japanese (ja)
Inventor
保之 松村
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Olympus Terumo Biomaterials Corp
Original Assignee
Olympus Terumo Biomaterials Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Olympus Terumo Biomaterials Corp filed Critical Olympus Terumo Biomaterials Corp
Priority to PCT/JP2024/009958 priority Critical patent/WO2025191780A1/fr
Priority to TW113113098A priority patent/TWI902211B/zh
Publication of WO2025191780A1 publication Critical patent/WO2025191780A1/fr
Pending legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/14—Surgical saws
    • A61B17/15—Guides therefor

Definitions

  • the present invention relates to a guide device.
  • Foot OA Traditional treatments for osteoarthritis of the ankle (foot OA) include ankle arthrodesis, total ankle arthroplasty, and low tibial osteotomy (LTO). As shown in Figure 11, the ankle joint is composed of the tibia A, talus B, and fibula C. Foot OA develops when the cartilage between the tibia A and talus B wears away.
  • LTO low tibial osteotomy
  • Distal tibial oblique osteotomy has been proposed as a new osteotomy for foot OA (see, for example, Non-Patent Documents 1 and 2).
  • Figure 11 explains DTOO.
  • the distal tibia A is osteotomized obliquely toward the distal tibiofibular joint D (S1), and the distal tibial fragment A2 is rotated distally by widening the osteotomy E (S2). This allows the talus B to be sandwiched between the medial and lateral condyles of the tibia A, improving the stability of the ankle joint.
  • the tibia A is fixed with a bone plate 30 (S4).
  • protrusion F that protrudes medially (S2).
  • Protrusion F causes skin tension when the incision is closed. Therefore, protrusion F is resected (S3), and then the bone plate 30 is placed on the medial surface of the tibia A. At this time, protrusion F must be resected so that the shape of the medial surface after resection matches the shape of the bone contact surface 30a of the bone plate 30.
  • the present invention was made in consideration of the above-mentioned circumstances, and aims to provide a guide device that can resect bone to fit the shape of the bone contact surface of a bone plate.
  • One aspect of the present invention is a guide device used to resect bone in a region where a bone plate will be placed, comprising: a fixed portion that is fixed to the bone and has a resection region that is placed at the resection site of the bone; and a guide portion that guides a cutting tool or a guide member that guides the cutting tool in the resection region, wherein the guide portion guides the cutting tool or the guide member along a plate surface that has the same or substantially the same shape as the bone contact surface of the bone plate.
  • the present invention has the advantage of allowing bone to be resected to fit the shape of the bone contact surface of the bone plate.
  • FIG. 2 is a perspective view of the guide device according to the first embodiment.
  • FIG. 1B is a side view of the guide device of FIG. 1A.
  • FIG. 1B is a plan view of the guide device of FIG. 1A.
  • 10A and 10B are diagrams illustrating the positional relationship between an extension line of a guide pin and a plate surface.
  • 1B is a diagram illustrating a method of using the guide device of FIG. 1A.
  • 1B is a diagram illustrating a method of using the guide device of FIG. 1A.
  • 1B is a diagram illustrating a method of using the guide device of FIG. 1A.
  • FIG. 10 is a perspective view of a guide device according to a second embodiment.
  • FIG. 4B is a side view of the guide device of FIG. 4A.
  • FIG. 4B is a plan view of the guide device of FIG. 4A.
  • 10A and 10B are diagrams illustrating the positional relationship between the extension plane of the guide slit and the plate surface.
  • 4B is a diagram illustrating a method of using the guide device of FIG. 4A.
  • 4B is a diagram illustrating a method of using the guide device of FIG. 4A.
  • 1 is a perspective view of a guide device including a confirmation member.
  • FIG. FIG. 10 is a side view of the confirmation member in use.
  • FIG. 10 is a perspective view of a guide device according to a third embodiment.
  • FIG. 8B is a side view of the guide device of FIG. 8A.
  • FIG. 8B is a plan view of the guide device of FIG. 8A.
  • FIGS. 10A and 10B are diagrams illustrating the positional relationship between the extension planes of the first and second guide slits and the plate surface.
  • 8B is a diagram illustrating a method of using the guide device of FIG. 8A.
  • 8B is a diagram illustrating a method of using the guide device of FIG. 8A.
  • 8B shows a cross section of a tibia resected using the guide device of FIG. 8A.
  • FIG. 1 is a diagram illustrating a DTOO procedure.
  • FIG. 11 illustrates a distal tibial oblique osteotomy (DTOO), which is an application example of the guide device 1 according to this embodiment.
  • DTOO distal tibial oblique osteotomy
  • the skin covering the ankle joint is incised
  • the distal tibia A is osteotomized obliquely toward the distal tibiofibular joint D (S1)
  • the distal tibia fragment (epiphyseal) A2 is rotated distally by enlarging the osteotomy E (S2).
  • the bone plate 30 is placed on the medial surface of the tibia A across the enlarged osteotomy E and fixed to the tibia A with screws 40 (S4).
  • the left, right, upper, and lower sides of Figure 11 correspond to the medial, lateral, proximal, and distal sides of the tibia A, respectively.
  • the bone plate 30 is a strip-shaped member having a shaft portion 31 on the proximal end side and a head portion 32 on the distal end side.
  • the shaft portion 31 is disposed in the diaphysis A1 proximal to the osteotomy portion E, and the head portion 32 is disposed in the epiphysis A2 distal to the osteotomy portion E.
  • the bone plate 30 has a bone contact surface 30a on one side in the thickness direction that contacts the surface of the tibia A.
  • the bone contact surface 30a is three-dimensionally curved in the width direction and length direction to fit the shape of the medial surface of the distal tibia A.
  • the bone plate 30 and the bone contact surface 30a may be twisted about the longitudinal axis so that the head portion 32 is positioned anterior or posterior to the tibia A relative to the shaft portion 31 when the shaft portion 31 is positioned on the medial surface.
  • the rotation of the epiphysis A2 creates a protrusion F (S2).
  • the protrusion F is the medial portion of the epiphysis A2 that protrudes medially from the surface of the distal tibia A before rotation.
  • the opening angle of the osteotomy E is larger than in other osteotomies such as LTO (low tibial osteotomy) and HTO (high tibial osteotomy), resulting in a larger protrusion of the protrusion F.
  • the soft tissues covering the ankle joint, such as the skin are very thin. Therefore, particularly in DTOO, the protrusion F is likely to cause problems such as skin tension during incision closure.
  • the guide device 1 has a width direction X, a length direction Y, and a height direction Z that are perpendicular to each other.
  • the width direction X corresponds to the anterior-posterior direction of the tibia A
  • the length direction Y corresponds to the longitudinal direction of the tibia A
  • the height direction Z corresponds to the left-right direction (medial-lateral direction) of the tibia A.
  • One side and the other side in the length direction Y are the tip side and base side, which correspond to the distal side and proximal side of the tibia A, respectively.
  • One side and the other side in the height direction Y are the upper side and lower side, which correspond to the medial side and lateral side of the tibia A, respectively.
  • the guide device 1 includes a fixing portion 2 that has a resection area S that is arranged in a protruding portion (resection site) F and is fixed to the tibia A, and a guide portion 3 that guides a guide member 51 (see FIGS. 3A and 3B ) that guides a cutting tool.
  • Fig. 1B is a side view of the guide device 1 as seen from the guide portion 3 side in the width direction X
  • Fig. 1C is a plan view of the guide device 1 as seen from above in the height direction Z.
  • the entire guide device 1 is made from a material that is highly biocompatible and highly rigid, for example a metal such as stainless steel.
  • the cutout area S is a spatial area that is wider in the width direction X and length direction Y than the protrusion F in a plan view.
  • the fixing part 2 has a body part (first part) 4 and a tip part (second part) 5 arranged on either side of the cutout area S, and an arm part 6 that connects the body part 4 and the tip part 5.
  • the body part 4, tip part 5 and arm part 6 are formed integrally.
  • the body portion 4 is strip-shaped and extends in the longitudinal direction Y, and the tip portion 5 is spaced apart from the tip of the body portion 4 in the longitudinal direction Y.
  • the resection area S is defined between the body portion 4 and the tip portion 5.
  • the body portion 4 is positioned in the diaphysis A1 proximal to the protrusion F along the longitudinal direction of the diaphysis A1, and the tip portion 5 is positioned in the epiphysis A2 distal to the protrusion F.
  • the body portion 4 and the tip portion 5 each have a lower surface (contact surface) 4a, 5a on the underside thereof that is brought into contact with the surface of the tibia A, and the lower surfaces 4a, 5a are positioned on the plate surface P (see FIG. 1A).
  • the plate surface P is an imaginary surface that has the same or substantially the same shape as the bone contact surface 30a of the bone plate 30. Only the central axis of the plate surface P is shown in FIG. 1B.
  • the lower surface 4a has the same or substantially the same shape as the base end portion of the plate surface P corresponding to the shaft portion 31, and the lower surface 5a is located at or near the tip of the plate surface P. Therefore, in a plan view seen from above in the height direction Z, the tip end portion of the plate surface P including the portion corresponding to the head portion 32 is located in the resection area S (see FIG. 1C ).
  • the arm 6 is in the form of a cantilever extending from the tip of the body 4 to the tip 5, with the tip 5 being provided at the tip of the arm 6.
  • the width of the arm 6 is narrower than the width of the body 4.
  • the arm 6 is designed in a shape that does not interfere with the tibia A and surrounding tissues during surgery, and does not interfere with instruments such as guide pins 51 and 52.
  • the arm 6 is substantially C-shaped and curved in a direction that protrudes upward, and the tip 5 is formed by the tip of a cantilever-shaped member that constitutes the arm 6 .
  • the fixing portion 2 has one or more holes 2a that penetrate the fixing portion 2 in the height direction Z as fixing means for fixing the fixing portion 2 to the tibia A.
  • the fixing portion 2 is fixed to the tibia A by inserting a guide pin 52 into the tibia A through the holes 2a (see FIGS. 3A and 3B ).
  • the holes 2a are provided at least in the body portion 4 and the tip portion 5.
  • the body portion 4 has three holes 2a arranged at intervals in the longitudinal direction Y, and the tip portion 5 has one hole 2a.
  • the arm portion 6 may have one or more holes 2a.
  • the guide portion 3 is a strip-like plate extending in the longitudinal direction Y in parallel with the arm portion 6 in a plan view (see Figure 1C), and is positioned in front of or behind the protrusion F.
  • the guide portion 3 is spaced apart from the arm portion 6 in the width direction X, and is located outside the plate surface P in the width direction X.
  • the base end of the guide portion 3 is fixed to the tip end of the body portion 4 by a connection portion 7 extending in the width direction X.
  • the guide section 3 has multiple pin holes 3a arranged in a row at intervals in the longitudinal direction Y, into which the guide members 51 are inserted, as guide holes for guiding the guide members 51.
  • the guide members 51 are long, thin guide pins.
  • Each pin hole 3a has a diameter slightly larger than the diameter of the guide pin 51, and penetrates the guide section 3 substantially in the width direction X.
  • the guide pin 51 passing through each pin hole 3a traverses the resection area S in the width direction X.
  • the extension lines ⁇ of the central axes ⁇ of the multiple pin holes 3a are aligned along the plate surface P.
  • the multiple pin holes 3a align the multiple guide pins 51 in the resection area S to positions along the plate surface P, so that the multiple guide pins 51 are aligned along the plate surface P at intervals in the longitudinal direction Y.
  • the extension line ⁇ of each pin hole 3a passes through both ends of the plate surface P in the width direction or two points Q1 and Q2 in the vicinity thereof. Therefore, when viewed in the width direction X, the extension lines ⁇ of the multiple pin holes 3a are arranged in a line along the curved plate surface P. Furthermore, if the bone contact surface 30a has a shape twisted around the longitudinal axis, the angle of the multiple extension lines ⁇ when viewed in the longitudinal direction Y gradually changes from the base end side toward the tip end side. As described below, when cutting along the upper end of the guide pin 51 that penetrates the tibia A, points Q1 and Q2 may be positioned offset downward from both ends of the plate surface P by a distance equal to the radius of the guide pin 51.
  • the method of use includes a first step of fixing the fixing part 2 to the surface of the bone, a second step of inserting the guide pin 51 into the bone through the pin hole 3a of the guide part 3, and a third step of cutting off the protrusion F along the guide pin 51 with a cutting tool.
  • the body portion 4 and tip portion 5 are placed on the medial surfaces of the diaphysis A1 and epiphysis A2, respectively, and positioned so that the resection area S is located at the protrusion F.
  • guide pins 52 are inserted into the tibia A through the holes 2a in the body portion 4 and tip portion 5, and the body portion 4 and tip portion 5 are fixed to the diaphysis A1 and epiphysis A2, respectively.
  • multiple guide pins 51 are inserted in the anterior-posterior direction through multiple pin holes 3a into the epiphysis A2.
  • five guide pins 51 are inserted into the epiphysis A2 through five selected pin holes 3a.
  • the guide device 1 is removed from the tibia A, leaving the guide pin 51 in the epiphysis A2.
  • the guide pin 51 is positioned inside the epiphysis A2.
  • a bone cutting tool such as a bone saw or a bone chisel is used to cut the epiphysis A2 along the upper ends of the guide pins 51, thereby removing the bone tissue covering the guide pins 51.
  • the protrusions F that protrude beyond the plate surface P defined by the guide pins 51 are removed.
  • the guide pin 51 is removed from the epiphysis A2, and then the bone plate 30 is placed on the medial surface of the tibia A at the same position as the fixing part 2 and fixed to the tibia A with the screws 40.
  • the multiple guide pins 51 inserted into the tibia A using the guide unit 3 are aligned along the plate surface P, which has the same or substantially the same shape as the bone contact surface 30 a. Therefore, by cutting the tibia A along the guide pins 51, it is possible to resect the protruding portion F of the tibia A so that it fits the shape of the bone contact surface 30 a. This also allows the bone contact surface 30a to conform well to the medial surface of the distal tibia A after resection, so that the incision can be closed without tensioning the skin after the bone plate 30 is fixed.
  • the protrusion F has been removed by a doctor using a cutting tool to finely cut the bone while referring to the bone contact surface 30a, so that the shape of the cut surface of the tibia A approximates the bone contact surface 30a.
  • Such precise cutting requires a high level of skill on the part of the doctor.
  • the bone contact surface 30a is a three-dimensionally curved and twisted surface, it is difficult to accurately cut the bone to fit the bone contact surface 30a.
  • the protrusion F can be easily removed to fit the bone contact surface 30a without relying on the advanced skills of a doctor.
  • the fixing part 2 has the body part 4 and the tip part 5, which are disposed on both sides of the resection area S. This allows a user, such as a doctor, to accurately recognize the position of the resection area S and accurately and easily position the fixing part 2 relative to the tibia A so that the resection area S is disposed on the protrusion F. Furthermore, by fixing the body portion 4 and the tip portion 5 to the diaphysis A1 and epiphysis A2, respectively, using the guide pin 52, the diaphysis A1 and epiphysis A2 are fixed after enlarging the osteotomy E. This prevents the epiphysis A2 from moving when the guide pin 51 is inserted, and allows the guide pin 51 to be inserted accurately at the desired position.
  • the lower surfaces 4a, 5a of the fixing portion 2 are positioned on the plate surface P. Therefore, the user can determine the position of the fixing portion 2 where the lower surfaces 4a, 5a fit the shape of the medial surface of the tibia A as the appropriate position for the bone plate 30. Furthermore, by fixing the fixing portion 2 to the tibia A at that position, the plate surface P is also determined to be an appropriate position relative to the tibia A. Therefore, by cutting the tibia A along the plate surface P and then placing the bone plate 30 in the same position as the fixing portion 2, the bone contact surface 30a can be well-fitted to the medial surface of the tibia A.
  • the bone is cut along the upper end of the guide pin 51, but instead, the bone may be cut along the hole left after removing the guide pin 51.
  • the positions and angles of the central axis ⁇ and extension line ⁇ of the pin hole 3a may be designed so that the lower end of the hole is aligned with the plate surface P.
  • the guide device 1 and the guide pin 51 are removed from the tibia A. Thereafter, the tibia A is cut along the hole formed by the guide pin 51, and the protrusion F is removed.
  • the guide device 10 according to this embodiment differs from the first embodiment in that it has a guide slit 13a that serves as a guide hole to guide the cutting tool.
  • the configurations different from those of the first embodiment will be described, and the configurations common to the first embodiment will be assigned the same reference numerals and will not be described again.
  • the guide device 10 includes a fixing portion 12 that is fixed to the tibia A and a guide portion 13 that guides a cutting tool 50 (see FIG. 6B ).
  • Fig. 4B is a side view of the guide device 10 as seen from the guide portion 13 side in the width direction X
  • Fig. 4C is a plan view of the guide device 10 as seen from above in the height direction Z.
  • the fixing part 12 has a body part 4 and a tip part (second part) 15 arranged on both sides of the resection area S, and an arm part 16 connecting the body part 4 and the tip part 15.
  • the body part 4, the tip part 15 and the arm part 16 are integrally formed.
  • the tip portion 15 is disposed at a distance from the tip of the body portion 4 in the longitudinal direction Y, and a resection area S is defined between the body portion 4 and the tip portion 15.
  • the tip portion 15 has a lower surface (contact surface) 15a that is flat or curved, and the lower surface 15a is disposed at or near the tip of the plate surface P.
  • the arm 16 is disposed outside the plate surface P in the width direction X, and the resection area S is disposed between the arm 16 and the guide 13. This allows the user to easily view the entire protrusion F of the resection area S from above in the height direction Z while using the guide device 10.
  • the fixing part 12 has one or more cylindrical sleeves 12a that protrude in the height direction Z from the upper surface of the fixing part 12 as fixing means for fixing the fixing part 12 to the tibia A.
  • the fixing part 12 is fixed to the tibia A by inserting a guide pin 52 into the tibia A through the sleeve 12a (see FIGS. 6A and 6B).
  • the sleeve 12a is provided at least on the body portion 4 and the tip portion 15. In order to more stably fix the fixation portion 12 to the tibia A, two sleeves 12a may be provided on the tip and base ends of the body portion 4.
  • the guide portion 13 has a strip shape extending in the longitudinal direction Y in parallel with the arm portion 16 in a plan view (see FIG. 4C ).
  • the guide portion 13 is disposed at a distance from the arm portion 16 in the width direction X and is located outside the plate surface P in the width direction X.
  • the guide portion 13 has a guide slit 13a that extends in the length direction Y and serves as a guide hole for guiding a cutting tool 50 such as a bone saw or chisel, into which the cutting tool 50 is inserted.
  • the guide slit 13a has a slit width that is slightly larger than the thickness of the cutting tool 50, and penetrates the guide portion 13 substantially in the width direction X.
  • the cutting tool 50 that passes through the guide slit 13a crosses the resection area S in the width direction X.
  • the center plane ⁇ of the guide slit 13a has a shape corresponding to the shape of the plate surface P, and the extension plane ⁇ of the center plane ⁇ is positioned along the plate surface P.
  • the center plane ⁇ is a plane connecting the center points of the guide slit 13a in the height direction Z.
  • the extension plane ⁇ is a plane extending from the center plane ⁇ in the width direction X.
  • the extension plane ⁇ passes through two points Q1 and Q2 at or near both ends of the width direction of the plate surface P.
  • Figure 5 shows the planes ⁇ and ⁇ at a certain position in the longitudinal direction Y.
  • the planes ⁇ and ⁇ are curved surfaces made up of a collection of straight lines extending in the width direction X, and when viewed in the width direction X, the planes ⁇ and ⁇ curve in accordance with the curvature of the plate surface P. If the bone contact surface 30a has a shape twisted around the longitudinal axis, the angle of the straight lines when viewed in the longitudinal direction Y gradually changes from the base end toward the tip end.
  • the points Q1 and Q2 may be located at positions offset downward from both ends of the plate surface P by a distance equal to the radius of the guide pin 51.
  • the base end and tip end of the guide portion 13 are fixed to the body portion 4 and tip end portion 15 by the connecting portion 7, respectively.
  • a cutting tool passing through the guide slit 13a cuts the tibia A.
  • the method of use includes a first step of fixing the fixing portion 12 to the surface of the bone, and a second step of cutting off the protruding portion F along the guide slit 13 a of the guide portion 13 with a cutting tool 50 .
  • the body portion 4 and tip portion 15 are placed on the inner surfaces of the diaphysis A1 and epiphysis A2, respectively, and positioned so that the resection area S is located at the protrusion F.
  • a guide pin 52 is inserted into the tibia A through the sleeves 12a of the body portion 4 and tip portion 15, and the body portion 4 and tip portion 15 are fixed to the diaphysis A1 and epiphysis A2, respectively.
  • the cutting tool 50 is inserted into the epiphysis A2 in the anterior-posterior direction through the guide slit 13a, and the epiphysis A2 is cut by moving the cutting tool 50 along the guide slit 13a. Since the cutting tool 50 moves along the plate surface P, the protruding portion F protruding beyond the plate surface P is resected.
  • the guide device 10 is removed from the tibia, and then the bone plate 30 is placed on the medial surface of the tibia A in the same position as the fixation portion 12 and fixed to the tibia A with the screws 40 .
  • the cutting tool 50 in the guide slit 13a moves along the plate surface P, which has the same or substantially the same shape as the bone contact surface 30a in the resection area S. Therefore, by moving the cutting tool 50 along the guide slit 13a, the protruding portion F of the tibia A can be resected so as to fit the shape of the bone contact surface 30a. This also allows the bone contact surface 30a to conform well to the medial surface of the distal tibia A after resection, so that the incision can be closed without tensioning the skin after the bone plate 30 is fixed.
  • the confirmation member 17 has a confirmation surface 17c that comes into contact with the bone.
  • the confirmation surface 17c has the same shape as the portion of the plate surface P in the resection area S, and when positioned by the positioning portions 17a and 17b, the confirmation surface 17c coincides with the plate surface P.
  • the connecting portion 7 and the guide portion 13 are omitted.
  • the guide portion 23 has a first guide slit 23a and a second guide slit 23b that each extend in the longitudinal direction Y (see FIG. 8B ).
  • the two guide slits 23a, 23b are arranged in the height direction Z that intersects with the plate surface P and are generally parallel to each other.
  • Each guide slit 23a, 23b passes straight through the guide portion 23 in the width direction X, and the cutting tool 50 passing through the guide slits 23a, 23b crosses the resection area S generally in the width direction X.
  • the first central plane ⁇ 1 of the first guide slit 23a is a plane passing through the center point in the height direction Z of the first guide slit 23a at each position in the width direction X and the length direction Y.
  • the second central plane ⁇ 2 of the second guide slit 23b is a plane passing through the center point in the height direction Z of the second guide slit 23b at each position in the width direction X and the length direction Y.
  • the first extended plane ⁇ 1 and the second extended plane ⁇ 2 are planes obtained by extending the central planes ⁇ 1 and ⁇ 2 in the width direction X, respectively.
  • the method of use includes a first step of fixing the fixing portion 12 to the surface of the bone, and a second step of cutting off the protrusion F along the two guide slits 23a, 23b of the guide portion 23 with a cutting tool 50.
  • the body portion 4 and the tip portion 15 are fixed to the diaphysis A1 and epiphysis A2, respectively.
  • the cutting tool 50 in the guide slits 23a, 23b moves along the plate surface P, which has the same or approximately the same shape as the bone contact surface 30a in the resection area S. Therefore, by moving the cutting tool 50 along the guide slits 23a, 23b, it is possible to resect the protruding portion F of the tibia A so that it fits the shape of the bone contact surface 30a. This also allows the skin incision to be closed without tensioning the skin.
  • the epiphysis A2 is cut along the two extension planes ⁇ 1 and ⁇ 2, and the cut surface of the epiphysis A2 after the resection of the protrusion F consists of two planes that form an angle with each other. This allows the resection of the protrusion F to better fit the bone contact surface 30a, which is curved in the width direction.
  • Other effects of this embodiment are the same as those of the second embodiment, and therefore description thereof will be omitted.
  • the guide device 20 of this embodiment may also further include the confirmation member 17 described in the second embodiment.
  • the guide devices 1, 10, and 20 of each embodiment are designed based on the shape of the bone contact surface 30a of the bone plate 30 to be used. Therefore, the guide devices 1, 10, and 20 may be provided as part of a system for osteotomy.
  • the system includes the guide device 1, 10, or 20 and the bone plate 30, and may further include one or more screws 40 for fixing the bone plate 30 to the tibia A.
  • the fixing portion may have only one of the body portion (first portion) and the tip portion (second portion).
  • the fixing portion 2 may not have the tip portion 5.
  • the user may visually position the body portion 4 relative to the tibia A so that the resection area S is positioned at the protrusion F.
  • the diaphysis A1 and the epiphysis A2 may be fixed using any means other than the guide device 1.
  • the guide device 1 of the first embodiment may also be provided with a confirmation member 17.
  • the epiphysis A2 may be cut along the guide pin 51 while the guide device 1 is fixed to the tibia A, and after cutting, the confirmation member 17 may be attached to the guide device 1 to confirm the shape of the cutting surface.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Dentistry (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne un dispositif de guidage (1) qui est utilisé pour la résection d'un os dans une région où se trouve une plaque osseuse. Afin de réséquer l'os pour que l'os épouse la forme d'une surface de contact osseux de la plaque osseuse, le dispositif de guidage comprend : une partie fixe (2) qui est fixée à l'os et qui comporte une région de résection (S) située au niveau d'un site de résection de l'os ; et une partie de guidage (3) qui guide un outil de coupe ou un élément de guidage dans la région de résection (S). La partie de guidage (3) guide l'outil de coupe ou l'élément de guidage le long d'une surface de plaque (P) présentant la même forme ou sensiblement la même forme que celle de la surface de contact avec l'os de la plaque osseuse.
PCT/JP2024/009958 2024-03-14 2024-03-14 Dispositif de guidage Pending WO2025191780A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
PCT/JP2024/009958 WO2025191780A1 (fr) 2024-03-14 2024-03-14 Dispositif de guidage
TW113113098A TWI902211B (zh) 2024-03-14 2024-04-09 導引裝置

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2024/009958 WO2025191780A1 (fr) 2024-03-14 2024-03-14 Dispositif de guidage

Publications (1)

Publication Number Publication Date
WO2025191780A1 true WO2025191780A1 (fr) 2025-09-18

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Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5234433A (en) * 1989-09-26 1993-08-10 Kirschner Medical Corporation Method and instrumentation for unicompartmental total knee arthroplasty
JP2016512728A (ja) * 2013-03-14 2016-05-09 ライト メディカル テクノロジー インコーポレイテッドＷｒｉｇｈｔ Ｍｅｄｉｃａｌ Ｔｅｃｈｎｏｌｏｇｙ， Ｉｎｃ． 足関節置換システムおよび方法

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5234433A (en) * 1989-09-26 1993-08-10 Kirschner Medical Corporation Method and instrumentation for unicompartmental total knee arthroplasty
JP2016512728A (ja) * 2013-03-14 2016-05-09 ライト メディカル テクノロジー インコーポレイテッドＷｒｉｇｈｔ Ｍｅｄｉｃａｌ Ｔｅｃｈｎｏｌｏｇｙ， Ｉｎｃ． 足関節置換システムおよび方法

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